National journal of maxillofacial surgery最新文献

Introduction: Oral squamous cell carcinoma (OSCC) ranks as the sixth most prevalent cancer globally, with approximately one third of cases originating from India. Carbonic anhydrase IX (CA IX) is expressed essentially in tumor cells and is considered as a marker for tumor hypoxia. The present study aims to assess the association between immunohistochemical expression of CA IX in the tumor cells and the clinicopathological parameters of OSCC.

Materials and methods: The present study is a 1 year retrospective study performed in a tertiary care teaching hospital. All radical specimens of OSCC were included in the study, and histopathological and immunohistochemical analysis for CA IX expression was performed manually in all cases. Statistical analysis was done using Statistical Package for the IBM Social Sciences (SPSS) software (version 26) (Armonk, New York, USA). The Chi squared test was used to calculate the value of significance (P).

Results: Of the 39 OSCCs included in the present study, 41.02% cases showed expression of CA IX. CA IX expression was seen to be significantly associated with presence of lymphovascular invasion, higher T and N stages, and higher depth of invasion.

Conclusion: High CA IX expression in OSCC is a poor prognostic factor, and in view of availability of CAIX targeted therapeutic agents, it is essential to further study its use in treatment of such cases.

Background and objectives: Oral lichen planus (OLP) is a chronic inflammatory, autoimmune, and potentially malignant disorder of the oral mucosa. Photobiomodulation (PBM) aids tissue repair, while photodynamic therapy (PDT) selectively targets diseased cells and modulates cytokines. This study compares the effectiveness of PDT (660 nm) and triamcinolone acetonide 0.1% in managing symptomatic OLP. It evaluates their impact on serum and salivary biomarkers (IL-1Beta, IL-6, TNF-alpha, and MDA) at baseline and at 3 months and correlates these markers with pain and clinical scores (VAS and RAE) to determine their therapeutic efficacy.

Materials and methods: A randomized controlled trial on 28 OLP patients compared two treatments: Group I received 0.1% TA (3 times/day for 1 month); Group II underwent PDT with 1% toluidine blue and 660 nm diode laser (100 mW, 60 sec/cm², 2 times/week for 1 month). Pain with VAS and lesion size with RAE were assessed at baseline and 1, 2, and 3 months. Biomarkers were evaluated using ELISA and thiobarbituric acid tests.

Results: Both treatments significantly reduced pain and lesion size. PDT demonstrated greater pain reduction than TA and slightly more lesion size reduction, though not statistically significant. Biomarkers showed no significant changes except a correlation between salivary IL-1β and VAS in the TA group.

Conclusion: PDT and TA effectively managed pain and lesion size in OLP, with PDT showing a trend toward greater improvement. PDT is a promising alternative for OLP management.

Osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaws (MRONJ) are debilitating complications that compromise bone repair in patients, who have undergone radiotherapy or treatment with anti-resorptive/anti-angiogenic drugs. Once established, these lesions are difficult to manage and reduce patients' quality of life. The combination of low- and high-power lasers, through photo biomodulation therapy and antimicrobial photodynamic therapy preceding surgical laser debridement, can provide satisfactory results in the treatment of these patients. Thus, the purpose of this work is to describe three cases associating these therapies for the management and treatment of ORN and ONMRM, offering an alternative, safe and effective therapy for these conditions.

Temporomandibular joint disorders (TMDs) are nonodontogenic conditions affecting the temporomandibular joint (TMJ), supporting tissues, and masticatory muscles. TMD is linked to occlusal interferences which can cause degenerative changes in the TMJ. TMD is also linked to occlusal characteristics, such as unilateral lingual cross bites and deep bites, and can be influenced by implant therapy, craniofacial morphology, and psychosocial factors. The aim of this document is to examine available data related to occlusal characteristics and form a consensus on each characteristic. The methodology involved an extensive review of in vivo studies on TMD and malocclusion, covering publications from 1990 to June 2024. Keywords and Mesh terms were used to search databases, focusing on occlusal schemes, interferences, vertical jaw relations, craniofacial morphology, and stress. The search yielded 253 citations, later refined to 117 relevant studies. Filtering for clinical trials, reviews, and meta analyses resulted in 30 pertinent articles. Manual searching of bibliographies and cross referencing identified additional studies, ensuring comprehensive coverage. All selected articles were critically reviewed for evidence. Dental occlusion issues are a top priority for dentists treating patients with TMD. A thorough analysis of the relationship between dental occlusion and TMD has to be examined by the clinician before starting treatment of TMD. Some dental practitioners overlook potential involvement of abnormal skeletal structure or TMJ disease as a causal factor of TMD. As TMD is a multilinked process, the clinician should be well aware of all the parameters. Future teaching on occlusal dental occlusion should be integrated for academic and clinical purpose, with a thorough TMJ examination mandatory before patient treatment, and any predisposing factors highlighted in the examination porforma.

Unicystic ameloblastoma (UA) arising from a dentigerous cyst often leads to misinterpretation and undertreatment because of its higher recurrent potential, although it has a better prognosis than that of a solid or multicystic variant. This case is unique as UAs commonly develop in the posterior mandible and second decade of life. Here we report a case of 12-month-old infant with tumorous growth of the maxilla, making it difficult to diagnose because of varied clinical presentation. It also poses a treatment dilemma as the mural type of UA is notorious for recurring often requiring aggressive surgical resection or other adjuncts like chemical cauterization not routinely employed for dentigerous cysts. Conservative treatment further adds to the burden of misdiagnosis, thus requiring a longer follow-up period.

Objectives: The aim of the present study was to evaluate bone maturation in a standardized bone defect model after the application of a treated tooth graft (TTG) formed from demineralized dentin loaded with statin.

Materials and methods: In this study, 30 adult male rabbits (weight 2 kg to 2.5 kg) were used, and they were divided equally into two groups: control and TTG groups. In each rabbit, two standardized round bone defects were created (one in each tibia), where the defects were left without grafting in the control group and were packed with TTG slices in the study group. TTG is formed of demineralized dentin matrix slices loaded with statin. The fifteen rabbits in each group were separated into three subgroups based on postoperative evaluation intervals (2, 4, and 6 weeks). The animals were euthanized at 2, 4 and 6 weeks postoperatively, and half of the bone specimens were processed for histological examination using Masson's trichrome special stain, while the other half was prepared for analysis using energy-dispersive X-ray spectroscopy (EDX).

Results: The histomorphometry analysis results showed a significantly greater mean of red-staining bone matrix area for the TTG group, suggesting that the new bone matrix was more mature. Enhanced collagen maturation appeared histologically coupled with an increase in mineral contents, as indicated by SEM-EDX results, where the concentrations of Ca and P increased significantly with time in TTG group (P ≤ 0.05).

Conclusion: TTG group consistently showed higher levels of Ca and P and lower C/(Ca+P) ratios compared to the Control group. TTG was able to fasten the maturation of bone formation during bone defect healing.

Introduction: Chronic periodontitis is an inflammatory condition of the periodontium and is highly prevalent in pregnant women due to poor oral hygiene and hormonal changes associated with pregnancy, producing serious ill effects on newborn babies. Preterm term low birth weight (PTLBW) is a serious issue associated with maternal periodontitis.

Aims: The purpose of this study is to evaluate the effect of periodontal treatment given during the third trimester of pregnancy on preterm labor and low birth weight.

Materials and methods: Fifty-six patients were chosen according to the inclusion criteria and divided into two groups. Group one (case group) underwent supragingival and sub gingival scaling, root planning, and were given amoxicillin, mouthwash (0.2% Chlorhexidine), and instructions for warm saline gargles. The intervention for group two (control group) included only supragingival scaling with a placebo. The effect on preterm low birth weight was assessed after parturition, and clinical parameters such as plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment loss (CAL) were also recorded at baseline and after parturition.

Statistical analysis: Paired t-test used for analysis, ***Wilcoxon Non-parametric test of significance and unpaired t-test used for analysis, ***Mann Whitney U Non-parametric test of significance applied.

Results: The clinical parameters such as BOP, CAL and PPD all showed a significant difference in the case and control group after parturition, with a P-value = 0.000 of all the three parameters. There was a significant difference in the mean values of weight in the case (2.92 kg) and control (2.63 kg) groups, with a P-value of 0.011.

Conclusion: According to this study, periodontal treatment is safe among women with chronic periodontitis during the third trimester, as it improves their oral hygiene status and could be a factor in avoiding preterm labor and low birth weight of infants. Furthermore, no deleterious effects were seen neither in maternal nor in infant health. Further research with a large sample size is advised to support the above statement.

Oral lichen planus (OLP) is the common acute or chronic, potentially malignant disorder of the oral mucosa. Steroids the primary treatment for OLP; however, their chemical composition often leads to significant side effects. Platelet-rich plasma (PRP), an autologous biologically active material has been explored as an alternative treatment option. This systematic review evaluates the effects of autologous platelet-rich plasma compared to injectable steroids for treatment of OLP. A comprehensive search for randomized controlled trials were conducted in PubMed, Web of Science, Google Scholar, and Scopus using search terms such as "oral lichen planus and corticosteroids and platelet rich plasma injection," "oral lichen planus and corticosteroids," "oral lichen planus and corticosteroids and PRP," "oral lichen planus and PRP," "OLP and PRP and steroid." Articles selection followed the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. A meta-analysis was performed to group studies and determine summary effect estimates. A total of nine Randomized Controlled Trials (RCT) involving 266OLP patients were included in the analysis. Both treatment methods demonstrated a statistically significant improvements in outcome parameters including lesion size, pain scores, and burning sensations from baseline to the end of treatment and during follow-up visits. Patients treated with autologous PRP reported lower levels of pain and burning sensations compared to those treated with corticosteroids. A significant difference was observed between the two treatments with PRP showing greater effectiveness in alleviating pain and burning sensation than injectable steroids. Both platelet-rich plasma and injectable steroids effectively reduce lesion size and pain in OLP patients as measured by the Visual Analog Scale (VAS). However, the difference in efficacy between the two treatments was not statistically significant. Nonetheless, platelet-rich plasma can be considered promising alternative treatment to injectable steroids.

Orofacial pain (OFP) affecting the jaw, mouth, or facial area, is a prevalent public health issue globally with a significant burden in low-and middle-income countries (LMICs) due to limited oral health services. The objective of this study is to synthesize evidence on the prevalence of OFP among adults in LMICs and highlight its implications for oral health services and management. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted across multiple bibliographic databases to identify observational studies reporting the prevalence of OFP in LMICs. Study quality was assessed using the Joanna Briggs Institute checklist. A random effects model was employed for meta-analysis, and heterogeneity was quantified using the l2 statistic. Twelve cross-sectional studies were included in the analysis. The pooled prevalence of toothache, a key component of OFP, was estimated at 23.3%. Significant heterogeneity was observed (l2= 99.5%), reflecting the multifaceted nature of OFP and its determinants. The variability in prevalence was influenced by geographical, socio-economic, and health system factors. The findings highlight the significant burden of OFP in LMICs, emphasizing the critical need for improved oral health services and targeted interventions. This study underscores the importance of prioritizing OFP in health policies to enhance management and treatment strategies in resource-constrained settings. Further research is needed to address existing knowledge gaps and develop effective strategies to mitigate OFP's impact.

Introduction: Laryngoscopy and endotracheal intubation are essential in securing the airway but also serve as intense noxious stimuli, which may result in airway morbidity in the postoperative period. Our study aimed to compare the incidence of airway morbidity associated with endotracheal intubation when the tracheal tube cuff was inflated with air, saline, or alkalinized lidocaine in the adult population.

Materials and methods: The study was conducted in a tertiary care hospital in India. American Society of Anesthesiologists Grade I and II patients aged 18-60 years, scheduled for surgeries under general anesthesia, were enrolled in the study. Exclusion criteria were anticipated difficult airway/failed intubation, respiratory tract infections, asthma, chronic obstructive pulmonary disease, pregnancy, and patients with gastroesophageal reflux. Patients were randomly allocated into one of three equal groups n = 40 (air, saline, and 2% lidocaine with 7.5% sodium bicarbonate as endotracheal tube [ETT] cuff inflation media). The primary outcome was postoperative sore throat (POST) and cough evaluated at the time of extubation, followed by 1 h and 24 h. The secondary outcomes were the incidence of hoarseness of voice and post-operative nausea and vomiting (PONV) reported by patients postoperatively at different intervals.

Results: The study showed that the post-extubation incidence of cough was higher in ETT cuffs filled with air or saline than in alkalinized lidocaine at 0 h. POST was statistically significant in ETT cuffs filled with air or saline as compared to alkalinized lidocaine at 1 h. Hoarseness and PONV were lowest in the alkalinized lidocaine group.

Conclusion: Filling the tracheal tube cuff with alkalinized lidocaine resulted in a lesser incidence of undesirable events post-intubation, which contributed to overall airway morbidity.