National journal of maxillofacial surgery最新文献

Aim: The purpose of this study was to look into the relationship between the levels of interferon (IFN) and interleukin-4 (IL-4) in individuals with oral lichen planus (OLP)'s serum and saliva.

Materials and methods: The study included a total of 80 participants, separated into two groups: the case group comprising patients diagnosed with OLP and the control group consisting of healthy individuals. Saliva samples (5 ml) were collected from each patient, and blood was extracted from each participant to obtain serum. IFN-γ and IL-4 levels in serum and saliva were measured quantitatively using cytokine enzyme-linked immunosorbent assays. Statistical analysis was conducted using the SPSS software.

Results: In the case group, the IL-4 mean level in serum was 11.8 ± 7.29, while the control group showed a mean of 15.08 ± 7.5. The overall mean of IL-4 for both groups was 13.44 ± 7.55. With a P value of 0.012, the variation in mean IL-4 levels between the case and control groups was statistically significant. Similarly, for IFN-γ, the mean level in the serum of the case group was 32.99 ± 33.24, while in the control group, it was 15.46 ± 7.98. The overall mean of IFN-γ for both groups was 24.22 ± 25.59. With a P value of 0.001, the difference in mean IFN- levels between the case and control groups was statistically significant. However, no significant association was observed between cytokine levels and age in the study population.

Conclusion: These findings provide important new understandings of the immunological pathways that may play a role in the etiology of oral lichen planus, highlighting the possible involvement of IL-4 and IFN-γ in this condition. In order to fully comprehend how these cytokines contribute to the onset and progression of oral lichen planus, more investigation is required.

Background and objective: The "Universal Smart lock Hybrid IMF" system was designed to combine the mechanical strength and benefits of Erich arch bar (EAB) fixation with the speed and safety of intermaxillary fixation (IMF) screws. This study was done to compare the stability and efficacy of the "Smart lock Hybrid IMF System" with that of "IMF Screws" for the management of maxillomandibular trauma.

Materials and methods: This comparative prospective study involved 20 randomly selected patients, of which 10 patients had received IMF with Hybrid Arch bars (group A) and 10 patients had received IMF with IMF screws (group B) along with open reduction if required. The outcome variables were IMF stability, tooth root impingement, surgical time taken, soft tissue overgrowth, post-op pain, and postop occlusion. The groups were compared using independent test, chi-square test. The differences were considered significant at P < 0.05.

Results: The mean percentage of screws loosened in group A was less than group B. The mean application time was significantly longer in group A than in group B. The number of roots impinged with Hybrid group having higher as compared to IMF screw group. The intergroup comparison of soft tissue overgrowth was higher in group B than in group A. The results of the chi-square test revealed non-significant difference in terms of occlusion between the two groups with a P value of 0.998.

Conclusion: Hybrid arch bars are the best option in comparison with IMF screws on the basis of stability, soft tissue overgrowth and also it has versatility in application.

Background: Cone-beam computed tomography (CBCT) is an objective approach for determining the thickness of both soft and hard tissues, while digital intraoral scanner (DIS) is the most advanced method for evaluating the surface of soft tissues. The periodontal biotype, which includes gingival thickness, width, and alveolar bone morphology, is fundamental for clinicians to understand how the periodontium responds to physical, chemical, or bacterial stress, or during procedures like periodontal surgeries, implants, and orthodontics.

Objective: This study aims to identify the differences among the three methods for evaluating the hard and soft tissues in the maxillary anterior region in individuals with a healthy systemic condition and free from any dental defects.

Materials and methods: The datasets from the 20 patients who fulfilled the study criteria, obtained from the scans, were saved in CBCT format and DIS format and subsequently analyzed using three different methods: M1 was applied using Galileos software version 1.8; M2 was utilized on Ondema 3D software version 2022; M3 combined DIS with CBCT using 3Shape software version 2.0.

Results: When considering the central incisors at three positions 2 mm, 4 mm, and 6 mm below the cementoenamel junction, the pairwise comparison of palate gingival thickness of each pair all show no statistically significant (P > 0.05). A significant difference was observed in the pairwise comparisons between M1-M2 and M2-M3 for the measurement of labial gingival thickness (LGT) (P < 0.001). When considering labial bone thickness (LBT), only the pair of M1-M2 had statistically significant (P < 0.05).

Conclusion: The combination of DISs and CBCT has not been proven to provide higher accuracy, despite its more complex technique. The direct measurement method using CBCT data remains a reliable tool for assessing both soft and hard tissues.

Introduction: Ameloblastoma is quite a rare, slow growing and locally invasive benign odon¬togenic tumour of epithelial origin with a high propensity to recur. Large tumours in the mandible can give rise to large defects after radical tumour resection with resultant impairment of form and function such as mastication, swallowing, speech as well as cosmesis due to asymmetry or abnormal projection. Therefore adequate mandibular reconstruction is of utmost importance. Immediate reconstruction after resection can be provided with the free fibula osteo-cutaneous flap amongst several other vascularised bone flaps.

Material and methods: We have found immediate reconstruction with fibula free flap to be a reliable option and report our experi¬ences and outcomes of radical surgical treatment of ameloblas¬toma, followed by immediate mandibular reconstruction with the same in this paper. All patients were followed up for a minimum of 3 years to a maximum of 5 years for outcome and recurrence.

Results: There were no flap loss reported. None of the patients required a second re-exploration surgery. 5 patients underwent subsequent prosthetic rehabilitation with dental implants.

Conclusion: Large mandibular ameloblastomas should be treated radically with segmental mandibulectomy with a judicious surgical margin of at-least 1 cm from its radiographic margin as it has a high propensity to recur. The defects should be immediately reconstructed with a vascularised osteo-cutaneous flap to restore the pre-operative form function and cosmesis as far as possible. Postsurgical follow-up should be done at least annually for half a decade, as most cases recur within 5 years but some may show late recurrences as well.

Background: Oral submucous fibrosis (OSMF) is a chronic, progressive condition characterized by fibrosis of the oral mucosa, leading to restricted mouth opening and significant impairment in quality of life. Current treatment modalities lack a universally accepted protocol, prompting the need for adjunctive therapies to enhance treatment outcomes.

Objective: To compare the efficacy of spirulina and lycopene as antioxidant adjuvants to intralesional corticosteroid therapy in the management of OSMF.

Materials and methods: A prospective, double-blinded, randomized controlled trial was conducted with 30 participants diagnosed with Grade III OSMF. Patients were randomly assigned to two groups: Group I received spirulina 500 mg tablets daily, and Group II received lycopene 8 mg tablets daily. Both groups received weekly intralesional corticosteroid injections (Triamcinolone Acetonide 40 mg/ml) for 8 weeks. Clinical parameters, including mouth opening, burning sensation, recurrent ulceration, cheek flexibility, and the presence of fibrous bands, were assessed at baseline and at 3- and 6-month follow-ups.

Results: Spirulina demonstrated a statistically significant improvement in mouth opening (33.60 ± 3.20 mm) compared to lycopene (30.73 ± 3.05 mm) (P = 0.01). Spirulina also showed superior results in reducing the burning sensation and enhancing cheek flexibility. No significant difference was observed in the reduction of fibrous bands between the groups. Both groups showed improvement in recurrent ulceration, but no significant difference was noted at the 6-month follow-up.

Conclusion: Spirulina, due to its potent antioxidant and anti-inflammatory properties, is a more effective adjuvant to corticosteroid therapy in the management of OSMF compared to lycopene. Future research with larger, more diverse populations is warranted to validate these findings.

Introduction: Conventional mini-plating systems for maxillofacial fractures have greatly aided in the reduction and fixation of fractures to anatomical positions with minimal post-operative complications. However, it was insignificant in terms of the management of comminuted or complicated fractures of the maxillofacial region.

Aim/purpose: To evaluate the efficacy of the novel all-rounder hinge plating system in the treatment of complicated maxillofacial fractures.

Materials and methods: A total of 19 patients fulfilling the inclusion criteria were a part of this clinical study and underwent pre-surgical investigations prior to treatment with the novel all-rounder hinge plating system for the management of complicated maxillofacial fractures. The plating system was evaluated for ease of handling, efficiency, stability, clinical function, and aesthetic outcomes intra- and post-operatively.

Results: Based on this study, the novel all-rounder hinge plating system produced satisfactory results in 57.9% of cases and high satisfaction in 42.1% of cases. The operating surgeons expressed 83% satisfaction with the ease of handling the novel plating system and 88% better aesthetic outcomes. The post-operative clinical function was evaluated on days 7, 15, 45, and 6 months. It showed a positive significant difference from day 7 (63.2%) up to day 45 (94.7%) while not significant from day 45 to the 6th month.

Conclusion: The novel all-rounder hinge plating system has shown positive significant differences in terms of clinical function, aesthetic outcomes, and good stability of such complicated maxillofacial fractures. It provides a dual benefit of replacing the existing conventional mini-plating system and also aids in the efficient management of comminuted and complicated maxillofacial fractures.

Soft tissue injuries of the face are associated with serious cosmetic and functional problems such as scars, uneven skin surface, pigmentation, infections, and nerve damage. Conventional dressing materials used to manage abrasions and lacerations are associated with limitations regarding usage, staining, and allergic reactions. This case report presents the management of a patient with abrasions and lacerations over the upper lip, chin, and left lateral alar region following a road traffic accident (RTA) with nanocrystalline silver dressing. The skin texture was restored by day 14, and there was no pain from day 3 (Visual Analog Scale [VAS] - 0). The article highlights the effectiveness of nanocrystalline silver dressing in facilitating favorable wound healing and preventing infection. It is patient-friendly and easy to use.

Tuberculosis (TB) remains a significant public health concern in India, with pulmonary TB being predominant. However, Tubercular Otomastoiditis (TOM) poses a unique challenge due to its rarity and diagnostic complexities. Here, we present a case of a 12-year-old male with TOM, emphasizing the need for heightened awareness among clinicians. The patient exhibited a preauricular swelling, cervical lymphadenopathy, and facial nerve function intact, challenging the classic presentation. Imaging and GeneXpert testing confirmed tuberculous involvement. Prompt initiation of antitubercular therapy led to symptom improvement. TOM diagnosis requires a high index of suspicion, histopathological examination, and advanced imaging. Treatment entails antitubercular chemotherapy, highlighting the importance of early detection and tailored management to prevent complications.

Objective: This study was conducted to evaluate and report the clinicopathological features of oral potentially malignant disorders (OPMDs) among tobacco users and nonusers.

Materials and methods: This descriptive cross-sectional, study was conducted from April 2016 to September 2021 and composed of patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 100 cases were assessed based on the WHO 2005 classification system, namely, epithelial precursor lesions and the binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs.

Results: The male-to-female ratio of OPMD cases was 1.5:1, and the mean age at presentation was 55.7 ± 14.15 (P < 0.031). The most typical OPMD identified was oral leukoplakia (N = 46; 46.0%). Most of the OPMDs were classified histologically as oral epithelial hyperplasia (N = 61; 61.0%) and the remaining (N = 39; 39.0%) as OED. Of the 39 OPMDs with OED, 17 (43.6%) and 22 (56.4%) were categorized as low-risk and highrisk lesions, respectively. The OPMDs and tobacco use characteristics were shown to be significantly related.

Conclusion: A major risk factor for the development of OPMDs is the regular use of tobacco products. Tobacco users made up not only the largest proportion of OPMDs without OED but also OED cases with high-risk lesions.