Asian Journal of Oral and Maxillofacial Surgery最新文献

Objective

Posterior repositioning of the maxilla using a novel modification in combined Le Fort I and horseshoe osteotomy in bimaxillary surgeries is described and assessed for accuracy.

Materials and methods

In this prospective study, posterior repositioning of maxilla was performed in a total of 10 patients where the planned posterior setback was at least 3 mm or greater. In all patients, the maxilla was first osteotomized with Le Fort I and horseshoe osteotomy in addition to a new technique to trim maxillary tuberosity and posterior palatal walls, and followed by bilateral sagittal split ramus osteotomy in the mandible with or without additional genioplasty. Lateral cephalograms were obtained preoperatively and 1 week postoperatively. The changes in upper incisor (U1) and upper molar mesial cusp tip (UMT) were examined.

Results

The discrepancy between the planned and actual posterior movement was 0.35 and 0.28 mm at U1 and UMT, respectively. There were no severe complications such as intraoperative haemorrhage, avascular necrosis of the maxilla (partial/total), devitalization of teeth, and oroantral or oronasal fistulas in any of the cases.

Conclusions

These results suggest that when greater posterior repositioning of the maxilla is indicated, this newly introduced novel modification in horseshoe osteotomy combined with Le Fort I osteotomy is an effective technique for safety and accuracy.

Objective

To decrease the incidence of oro-nasal fistula formation following palatoplasty using modified Von Langenbeck technique and Fibrin Glue adhesive between the oral and nasal layer.

Subjects and methods

Prospective study of 20 primary closure of cleft palate using modified Von Langenbeck technique with and without a adhesive medium between the oral and nasal layer to compare the incidence of oro-nasal fistula formation.

Results

The results showed decrease in the incidence of oro-nasal fistula formation. With 0% fistula formation in the cases where Fibrin Glue was used. And 30% fistula formation in patients/controls where Fibrin Glue was not used.

A case of fracture of the genial tubercles in a 68-year-old woman is reported. This is an uncommon diagnosis which is usually associated with a severely atrophied edentulous mandible with hypertrophied genial tubercles. Clinical complaints include swollen floor of mouth and dysphagia. A complete denture is usually worn. The diagnosis will normally be revealed with a true occlusal radiograph. However, a computed tomogram may be necessary in cases which are less typical. This case was managed conservatively with a good outcome.

Objective

The aim of the present study was to analyze the expression of p53 and Ki-67 in proliferative verrucous leukoplakia (PVL) and surrounding epithelium (SE) and to characterize SE that may assist in the diagnosis and treatment.

Patient and methods

A 66-year-old man was referred for evaluation and management of white region on the right margin of the tongue. The intraoral examination showed non-homogeneous white speckled and nodular lesion on the right margin of the tongue, lower surface of the tongue and the floor of the mouth. The lesion was treated by surgical excision with appropriate safe margin. The monoclonal antibodies of anti-p53 and anti-Ki-67 antigen were used for immunohistochemical staining. The percentage of positive cells was calculated [labeling index (LI)].

Results

Histological diagnosis was verrucous hyperkeratosis, acanthosis, and basilar hyperplasia with mild dysplasia consistent with a late stage of PVL. p53 and Ki-67 in PVL and SE were expressed in basal cell layer. There was no significant difference of LI of p53 and Ki-67 in PVL and SE.

Conclusions

These findings suggested that SE has the ability to malignant change and wide safe margin is needed for resection of PVL to increase the chances of a favorable outcome.

This study is addressed to define postoperative pattern of blood flow in free microvascular flaps by using a laser Doppler flowmetry (LDF) and to reveal effects of the prostaglandin E1 (PGE1) administration on the blood flow. Postoperative blood flows in the flaps were monitored with LDF in 14 patients, who were administrated PGE1 twice a day for 7 days after the operation. The average blood flow rates in the flaps gradually increased after the operation, reached peak at 7 days after the operation, and then become stable until 21 days after the operation. After the PGE1 administration, the blood flow rates in all of the patients increased within 15 min and reached the peak between 75 min and 105 min. These results suggest that PGE1 is useful to increase the blood flow in the flap. Furthermore, the present study revealed these postoperative patterns of the changes in the blood flow in the flaps, careful monitoring of the flaps with LDF as performed in the present study will provide significant information to identify a disturbance of circulation in the flaps as soon as possible.

In the present report, we review the clinical features and biophysiological roles, including gene expression, of nevoid basal cell carcinoma syndrome (NBCCS) in Japanese cases. The frequency of clinical findings of Japanese cases (n = 186) was reported in NBCCS including keratocystic odontogenic tumors (KOTs). The syndromes resulted from mutation in the patched (PTCH1) gene in both neoplastic lesion basal cell carcinoma (BCCs) and KOTs. BCCs originate from hair follicles and express Gli gene; KOTs, classically known as odontogenic keratocysts, originate from odontogenic epithelial rest cells and considerable variation in the recurrence rate after surgery. PTCH1 gene alteration may have significant roles in the pathogenesis of NBCCS and sporadic KOTs. However, their histogenetic origin was found to differ: basal cell carcinoma in the skin originated from hair follicle cells and KOTs originated from odontogenic epithelial rest cells in the jaw.

Langerhans’ cell histiocytosis is a collective term used to describe a group of enigmatic, proliferative disorders. The natural history of the disease varies from a slow, benign, localized, symptomatic bony or soft-tissue lesion, to a rapidly, progressive, widespread, multiple-organ disorder which is often fatal. Eosinophilic granuloma (EG) accounts for 60–70% of all cases of Langerhans’ cell histiocytosis and can present as solitary (50–75%) or multifocal defects in bone. It occasionally presents as a localized soft-tissue lesion. Multiple treatment options are available but the response is unpredictable. However, no studies show complete resolution following a conservative modality of treatment in the management of EG of condyle and ramus. We describe a case, treated with intralesional injections of triamcinolone acetonide (Tricort 40 mg/ml, 6 injections at weekly intervals over 6 weeks), leading to complete resolution of the lesion, along with a brief mention of the review of literature.

The calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic tumour, firstly described by Pindborg in 1955. It is most commonly intraosseous. To our knowledge, only 16 cases of peripheral CEOTs have been reported in the English literature. We present a rare case of peripheral CEOT observed in a 55-year-old woman. The lesion was seen as a small, painless, soft tissue nodule on the lingual gingiva, clinically diagnosed as epulis or papilloma and subsequently proved to be CEOT histologically. A review of the pertinent reports in the literature concerning this specific lesion is included.