National journal of maxillofacial surgery最新文献

Context: Short implants are acceptable treatment options for atrophic ridges; however, they increase the crown-to-implant (C/I) ratio compared to regular length implants. The study aimed to assess the correlation between the C/I ratio and marginal bone loss (MBL) in single short implants at the posterior of the mandible.

Aims: The study aimed to assess the correlation between the C/I ratio and MBL in single short implants at the posterior of the mandible.

Settings and design: Cross-sectional study.

Materials and methods: This cross-sectional study assessed short implants with 6 mm lengths at the posterior of the mandible. The long-cone peri-apical digital radiographs were taken immediately after loading and 24 months later. Age, gender, implant diameter, gingival biotype, and implant brands were the study variables, and the C/I ratio was the predictive factor. The mean MBL at 2 years was considered the study outcome.

Statistical analysis used: The Pearson correlation test was applied to assess the correlation between MBL and C/I.

Results: Seventy implants (36 Straumann and 34 SGS implants) were studied. A significant difference was observed in the mean MBL between the two implant brands (P < 0.001). Besides, a correlation was found between MBL and the C/I ratio (P = 0.002).

Conclusions: It seems that the C/I ratio is associated with an MBL increase in single short implants at the posterior of the mandible.

Quite often, it is seen that the number of special care individual in the dental OPD/clinics is quite low, as compared to their population. This can be due to specific barriers that restrict them in availing dental treatment. Our aim was to identify different barriers to dental care of persons with special needs through a systematic review and to quantify them. A systematic review was carried out according to PRISMA guidelines. PubMed data was searched with predefined keywords leading to retrieval of 576 records. Full length studies published in English language from 2010 onwards with mention of proportion of persons citing a barrier to dental care were included. Three studies published in peer reviewed journals from other data sources were also identified while retrieving the full length texts. Out of a total of 576 PubMed and three additional records, a total of 22 studies were included in the systematic review. Cost, communication, physical facilities, fear/uncooperativeness, unawareness, distant location/inaccessibility, unwilling dentist, transportation, and difficulty in getting appointment were identified as nine major barriers. Pooled proportions for different barriers ranged from 22.75% (Accessibility; 95%CI = 19.96-25.54) to 44.35% (Communication; 95% CI = 32.63-56.07A). There was a high heterogeneity across different studies for both fixed effects and random effects models. Communication, physical facilities, and unawareness were identified as the three most common barriers showing minimum heterogeneity in random effects model.

Purpose: Various surgical techniques are described in the literature to manage gingival recession defects but the histopathologic evidence to support the current available techniques, is scarce. Recently periosteal pedicle graft (PPG) has proven to be an effective treatment option to treat gingival recession defects (GRD) with results comparable to subepithelial connective tissue graft (SCTG).

Objective: The present histopathological study was done to evaluate the healing pattern of periosteal pedicle autogenous graft along with coronally advanced flap in the treatment of gingival recession defects.

Materials and methods: The present study was performed on 10 sites in 5 rabbits. Two sites were selected in each animal and gingival recession defects were surgically created and then treated using periosteal pedicle pedicle graft along with coronally advanced flap procedure. Healing pattern was assessed histopathologically at pre-defined intervals till 6 months.

Results: On the 7th day of healing, dilated blood vessels with inflammatory cells were seen, while rudimentary rete-pegs appeared on 14th day. Between 3 months to 6 months, advanced histological repair with connective tissue organization with initiation of junctional epithelium, cementum and bone formation were observed.

Conclusion: Gingival recession defects treated with PPG had evidences of regeneration of cementum, bone and periodontal ligament fibers with new connective tissue attachment.

Most tongue squamous cell carcinoma (TSCC) classified as T3 require reconstructive surgery, which inevitably causes problems with oral functions. We propose new induction chemotherapy using intra-arterial infusion for TSCC classified as T3 to avoid reconstructive surgery. This chemotherapy regimen consists of intra-arterial infusion of docetaxel and cisplatin and systemic administration of 5-fluorouracil. As a result of this treatment, the therapeutic effect was a complete response in five patients and a partial response in one patient, and the overall response rate was 100%. All six patients underwent partial resection because their tumors shrank with this induction chemotherapy. In addition, adverse events of grade 3 or more did not occur in all six patients. The median follow-up duration for all patients was 34 months, and they are alive. This intra-arterial chemotherapy regimen was shown to be highly efficacious and safe.

Distant metastasis to salivary glands is a very rare event and most often associated with primary malignancies of the skin. Only 1-4% of all salivary gland tumours manifest with metastasis. Carcinomas of the breast, lung, kidney and prostate are those primaries that may also potentially metastasize to salivary glands. Literature has documented several studies analysing metastatic tumours in the oral region. However, very little research work has been published to date to analyse solely the Breast cancer metastasizing to the salivary glands. Thus, this review was conducted to examine the published cases of Breast cancer metastasizing to salivary glands from March 1975 to March 2023. An electronic search of the published literature was performed without publication year limitation in PubMed/ Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like ('Breast cancer' OR 'Breast carcinoma') AND ('Metastasis' OR 'Metastases'), And ('Salivary glands' OR 'Parotid gland' OR 'Submandibular gland' OR 'Sublingual gland'). We also searched all related journals manually. The reference list of all articles was also checked. Our research revealed a total of 48 relevant papers with 55 patients. Parotid was the most predominantly affected salivary gland. 14.5% of patients died with a mean survival time of 7 months. It can be concluded from this research that Breast cancer metastasizing to salivary glands is a rare occurrence. Careful evaluation of these cases is needed in order to raise awareness of these lesions and gain a better understanding of their characteristics.

To review the literature on the effect of mandibular advancement therapy (MAT) on inflammatory biomarkers in obstructive sleep apnea (OSA). The present systematic review addresses the following focus question: What is the effect of MAT on inflammatory biomarkers in OSA? Electronic and manual literature searches were conducted on databases: PubMed/MEDLINE, Web of Science, and Cochrane Library for studies published until September 2021 to collect information about the effect of mandibular advancement therapy, a non-continuous positive airway pressure alternative measurement of OSA. A systematic literature review was performed following the PRISMA guidelines to identify studies evaluating the effect of MAT in patients suffering from OSA. Randomized clinical trials were included, and case reports, retrospective studies, literature reviews, in-vitro studies, observational studies, authors' opinions, letters to the editor, and engineering articles were excluded. Fifty-nine articles published before September 2021 were identified. Fifty-four articles met the inclusion criteria. After assessing inclusion criteria, three clinical trials were included with 148 patients suffering from OSA and treated with mandibular advancement therapy. The follow-up period ranged from two to three months, with the average follow-up being 1.66 months. The mean age of the patients was observed to be 53.11 ± 2.65 years. The mean Epworth Sleepiness Scale observed in patients in all three clinical trials was 9.75 ± 0.89. MAT in patients with moderate or severe OSA reduced apnea-hypopnea index but has less effect on inflammatory and metabolic biomarkers.

Purpose: To determine the efficacy and longevity of patient-specific implants (PSIs) with strut abutment design to rehabilitate bilateral maxillectomy defect.

Materials and methods: Finite Element Analysis was performed on a PSI with strut abutments to repair a patient's bilateral maxillectomy defect due to COVID associated mucormycosis.

Results: The von Mises stress recorded was maximum in the zygomaticomaxillary buttress region, and displacement values were noted to be highest in the posterior-most strut, although both parameters were within acceptable limits, which is favorable.

Conclusion: The authors draw the conclusion that a PSI with strut abutments is a workable therapeutic modality for patients with these kinds of abnormalities based on this information.

Background: Peripheral neurectomy(PN)is a minimally invasive procedure, for the management of trigeminal neuralgi (TN)consisting of surgical avulsion of terminal branches of the trigeminal nerve.

Aim: To assess the efficacy of PN in the treatment of refractory TN and their recurrences in a follow up of 18 months.

Materials and methodology: Retro-prospective and prospective study was conducted on randomly selected 30 TN patients irrespective of age, gender and socio-economic status. The branch of trigeminal nerve involved was identified according to the site of pain. Then the PN procedure was performed under local or general aesthesia. The follow up of each patient was done for next 18 months.

Results: Mean age of the TN patients 53.17 ± 13.84 years, with 66.7% of patients were within 60 years of age. Male to female ratio was 1:1.5. All patients showed unilateral TN. Mostly 26.7% trigger point was located in lower lip followed by 13.3% in upper lip. After 3,6 and 9 months follow-up, none of the TN patients treated with PN had pain and none had any effect on general activity. However, from 12 months till 18 months' follow up, 2 (6.7%) patients reported of pain.

Conclusion: PNs are viable treatment alternative for TN, although peripheral neurectomy has chances of reoccurrence but still offer better quality of life in patients for many years without relaps.

To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search was executed according to PRISMA guidelines for studies published till December 2021. Studies were included based on the pre-eligibility criteria. The risk of bias was assessed using the Cochrane risk of bias tool. The heterogeneity was evaluated, and a random effect model was used for meta-analysis. A total of five studies were included from an initial search of 96 studies. The included studies were randomized controlled trials and comparative studies assessing pre-operative and post-operative administration of antibiotics among patients undergoing third molar extraction surgery. For comparison between pre-operative and post-operative groups, interincisal distance, complications, pain, and swelling were systematically reviewed and meta-analysis was done for interincisal distance and complications. The mean change in interincisal distance ranged from 5.5 to 47.9 and from 4.56 to 46.1 in the pre-operative and post-operative amoxicillin groups, respectively. Complications reported were infections, alveolar osteitis, nausea, diarrhea, gastric pain, rash, and headache with a pooled incidence of 4.3-33% in the pre-operative amoxicillin group and 0-22.7% in the post-operative amoxicillin group. Quantitative synthesis of data carried out from meta-analysis shows a significant difference in the pre-operative and post-operative amoxicillin groups in improving the interincisal distance and incidence of complications post surgery. The qualitative synthesis of data derived from systematic review for pain provides favoring results for post-operative amoxicillin administration. In case of swelling, a non-conclusive result was obtained.

Hemangiomas are benign soft tissue tumors which are congenital and occur due to abnormal proliferations of blood vessels. Most common location of hemangiomas is subcutaneous adipose tissue, but skeletal muscle hemangiomas are very rare which make up to 0.8% of all hemangiomas. Usually, the intramuscular lesions are common in thigh region and calf muscles and are relatively rare in the facial muscles. Long-standing lesions results in phleboliths, and this may cause some symptoms. Conventional treatment of these isolated lesions may not yield satisfactory results. Hence, surgical excision of the lesion in toto results in aesthetically pleasing results with low chances of recurrence. In this article, we report a case of a left masseter intramuscular hemangioma in 19-year-old patient which was successfully managed by complete surgical excision.