National journal of maxillofacial surgery最新文献

Background: Mandibular angle fractures constitute a significant proportion (23%-42%) of all mandibular fractures. A persistent controversy surrounds the optimal approach for the fixation of mandibular angle fractures: whether to employ a single miniplate or two miniplates. This study aims to assess the comparative efficacy of employing a single miniplate versus two miniplates for the fixation of mandibular angle fractures.

Material and methods: Twenty male patients diagnosed with mandibular angle fractures were randomly assigned to either group I or group II. Group I received treatment with a single miniplate positioned at the superior border, while group II underwent fixation with two miniplates, one at the superior border and the other at the lateral aspect of the mandibular angle. Postoperatively, patients were evaluated for occlusal stability, infection, pain, trismus, and mediolateral flaring of the fracture segments at the lower border.

Results: Group I, with a mean age of 33.90 years (range: 25-45 years), and group II, with a mean age of 28.60 years (range: 20-45 years), did not exhibit any complaints of malocclusion. In group II, infection occurred in two patients (20%), whereas no infections were observed in group I, and this difference was not statistically significant (X ² = 2.22, P = 0.13). Neither group showed mediolateral flaring of the lower border, with (X ² = 0.00; P = 1.00). Both groups experienced pain and trismus, but the differences were not statistically significant.

Conclusion: The utilization of two miniplates for the treatment of mandibular angle fractures does not confer any discernible advantage over the use of a single plate.

[This retracts the article on p. 24 in vol. 16, PMID: 40510716.].

Introduction: The anatomic relationship between the mandibular canal, cortices and molar apices are critical in preventing nerve damage during various mandibular orthognathic surgeries. The purpose of this study was to determine the relationship between the position of the inferior alveolar canal and the buccal cortex. Analyzing the variation of the nerve position in patient with different mandibular skeletal relationships like prognathic and retrognathic mandible is critical for better prognosis of the surgery.

Methods: A total of 45 patients including 15 in class I, class II & class III skeletal mandibular relationships were included in this study. The measurement of buccal and lingual cortical plate thickness was done using CBCT.

Results: For the distance from the outer buccal cortex to the IAN canal at the level of the mandibular first, second and third molar regions, the mean distance was observed to be 4.605±0.98, 738±1.313, 4.994±1.584 respectively. The distance from the outer lingual cortex to IAN canal at the level of the mandibular first, second and third molars were observed to be 1.848±0.399, 1.550±0.307 and 1.370±0.395 respectively.

Conclusion: The mean buccal cortical thickness was least in the class III group at mandibular first, second, and third molar regions. The lingual cortical thickness was least in the class II group, suggesting that the cut maybe given at the second molar region where the buccal cortical thickness is highest in order to prevent IAN injury. Hence, suggesting that precise osteotomy cuts may be customized to each patient using CBCT as an analyzing tool.

Introduction: Oral squamous cell carcinoma (OSCC) is sixth most common cancer in Indian subcontinent with a high morbidity and mortality rate. It is frequently preceded by oral potentially malignant disorders (OPMD). Early diagnosis of OSCC might halt the poor prognosis. Therefore, present study was aimed to evaluate the diagnostic significance of preoperative hematological parameters and serum lipid indices in OSCCs and OPMDs.

Material and methods: Study included 75 cases each of OSCC, OPMD, and controls. Mean and standard deviation of various hematological and lipid parameters were evaluated, including: a) RBC metrics: RBC count, hemoglobin (Hb%), hematocrit, MCV, MCH, RDW. b) WBC metrics: WBC count, neutrophils, lymphocytes, monocytes, atypical lymphocytes, immature leukocytes count, NLR. c) Platelet metrics: Platelet count, MPV, PDWSD, PCT, PLCR. d) Lipid metrics: Total Cholesterol, Triglycerides, HDL, LDL, VLDL, Non-HDL. The parameters were statistically analyzed using one-way ANOVA.

Result: Mean values of neutrophil count, immature leucocytic cells, NLR, MPV, PDWSD, PLCR, and VLDL were found to be significantly increased (P < 0.00), while, mean values of RBC count, Hb%, atypical lymphocytes, platelet count and HDL were observed to be significantly decreased (P < 0.05) in OPMD and OSCC groups as compared to control. However, the remaining indices were found to be non-significant.

Conclusion: Present study findings corroborate the role of hematological and serum lipid profile parameters in the etiology and progression of OPMDs and OSCCs. This highlights their potential as early diagnostic predictive markers to forecast the occurrence of high-risk OPMD and OSCC cases and also guiding personalized treatment strategies.

Context: Understanding variations in mandibular condyle head shape, glenoidal fossa depth, and articular eminence inclination is essential for diagnosing and managing temporomandibular joint disorders.

Aims: This study aimed to analyze the shape of the mandibular condyle head, inclination of the articular eminence, and depth of the glenoidal fossa in adult Bugis-Makassar tribe using panoramic radiography.

Settings and design: This was a prospective study conducted at the Dental and Oral Hospital, Hasanuddin University, using a purposive sampling method.

Methods and material: This study used a prospective study conducted at Dental and Oral Hospital Hasanuddin University. The sample approach used was purposive sampling. A total of 60 panoramic radiographs of patients aged 18 years and above, of Bugis-Makassar ethnicity, who met the inclusion and exclusion criteria, were collected from the Dental and Oral hospital, Hasanuddin University during the period February-April 2024. The shape of the condyle head, the depth of the glenoidal fossa, and the inclination of the articular eminence were measured using the EzDent-i application and the ImageJ software application. Data were processed using the Microsoft Excel program and presented in the form of tables and distribution diagrams.

Statistical analysis used: Descriptive statistics were used to analyze the distribution of condyle shapes, mean glenoidal fossa depth, and mean inclination of the articular eminence.

Results: The majority of condyle head shapes were oval (82.54%), followed by angled (14.13%), flat (1.67%), crooked finger (0.83%), and bifid (0.83%), with no mixed shapes observed. The mean glenoidal fossa depth was 7.5 mm, and the mean inclination of the articular eminence was 49.9°, classified as normal.

Conclusions: The shape of the condyle head in the Bugis-Makassar tribe of adult age is mostly oval, angled, flat, crocked finger, and bifid. Mixed condyle head shape was not found in this study. The depth of the glenoidalis fossa in the Bugis-Makassar tribe of adult age is classified as deep, and most of the inclination of the articular eminence is classified as normal.

Introduction: The primary stability of the implant plays a pivotal role in its success of the implant. This depends largely on the bone quality, drilling protocol, and shape of the fixture. In low-density bone (D3, D4 bone), achieving primary implant stability is extremely challenging. The aim of this study was to compare and evaluate the primary stability of the implants with the proposed drilling technique, the standard drilling protocol, and the osseodensification technique (OT) in low-density bone through the ex-vivo study.

Material and method: A total of 60 dental implants, with 20 dental implants in standard drilling protocol, OT, and proposed drilling technique, were placed on a fresh, humid bovine bone. The insertion torque value and implant stability quotient value were measured to evaluate the primary stability of the implant.

Results: The insertion torque value in the standard drilling technique was in the range of 20-30 N cm in 80% of the dental implants placed, whereas it was greater than 40 N cm in 65% of implants with the OT and 90% with the proposed drilling technique. The mean implant stability quotient in the standard drilling protocol was 65.51 ± 2.65, the OT was 68.06 ± 3.14, and the proposed drilling technique was 68.31 ± 3.22. This difference in the insertion torque value (P < 0.001) and mean implant stability quotient (P = 0.008) between three techniques was statistically significant. The OT and the proposed drilling technique produced similar results.

Conclusion: The study found proposed drilling protocol produced results in the range similar to the OT. The proposed drilling technique has a possible clinical application in low-density bone.

Breast cancer has been known for its high propensity of metastasis to unusual locations and the jaw bones are one among those sites. Numerous studies examining metastatic tumours to the oral region have been described in the literature. However, the analysis of Breast cancer metastasis to the jaw bones alone has been the subject of relatively few published research studies to date. This review was conducted to examine the published cases of metastasis to jaw bones from breast cancer as the sole primary source from 1954-2023. An electronic search of the published literature was performed without publication year limitation in PubMed/ Medline, Scopus, Google Scholar, Web of Science, Science direct and Embase databases, using mesh keywords like ('Breast cancer', OR 'Breast carcinoma'), AND ('Metastasis' OR 'Metastases'), And ('Jaw' OR 'Maxilla' OR 'Mandible' OR 'Temporomandibular joint' OR 'Condyle'). We also searched all related journals manually. The reference list of all articles was also checked. Our research revealed a total of 63 relevant papers with 74 patients. The mandible was more predominantly affected jaw than the maxilla. 20% of patients died with a mean survival time of 1.8 years. To conclude, Breast cancer metastasis to the jaw bones is a rare occurrence. Careful evaluation of more number of such cases is needed in order to raise awareness of these lesions and gain a better understanding of their characteristics.reful evaluation of such cases is needed to raise awareness of these lesions and gain a better understanding of their characteristics.

Background and aim: Three-dimensional (3-D) miniplates have shown better results in the treatment of mandibular fractures but it is difficult in the treatment of mandibular parasymphysis fracture that involves mental foramen or in close proximity. To overcome this, we have modified the 3-D miniplate with a single vertical bar and assessed its efficacy in the mandibular body or parasymphysis fracture.

Methodology: A clinical prospective study was carried out in 20 patients with mandibular body or parasymphysis fractures involving or near mental foramen and treated with a modified 3D miniplate under general anesthesia (GA). The parameters assessed were state of occlusion, neurosensory disturbances, visual analog scale (VAS) score for pain, infection pus, mobility of fracture segment, operating time for adaptation and fixation of the plate, surgeon's opinion on ease of adaptability of the plate, and union of fracture site radiologically. The patients were assessed pre-operatively, first, second, eighth, and 16^th week postoperatively.

Results: The data obtained was analyzed using McNemar's test and paired t-test. Occlusal derangement was corrected and was statistically significant (P < 0.5). The mean operating time for adaptation and fixation was 8.45 min. Temporary paresthesia of the mental nerve was very minimal (P < 0.5). The rate of infection was significantly less. There was no incidence of mobility or fracture of the modified 3D miniplate.

Conclusion: The modified 3D miniplate was efficient in restoring the occlusion, reducing the incidence of temporary paresthesia of mental nerve, and was easy to adapt which aided in bringing down the treatment duration in the management of mandibular body or parasymphysis fracture.

Hypotensive anesthesia is a commonly used technique that aims to reduce intraoperative blood loss, consequently improving surgical field visibility and the need for blood transfusions post-operatively. It is widely used in major maxillofacial surgeries with a high risk of intraoperative bleeding. The aim is to reduce the patient's systolic blood pressure to 80 to 90 mm Hg and mean arterial pressure (MAP) by at least 30% of preoperative blood pressure or keeping a minimum MAP of 50-65 mmHg. Hypotensive anesthesia not only provides a bloodless surgical field but also helps to identify various anatomical structures. There are various pharmacological and non-pharmacological methods to induce hypotensive anesthesia. The decision to induce hypotensive anesthesia should be based according to the general condition of the patient, the extent of the surgery, and in coordination with the operating surgeon. The target blood pressure should be adjusted according to the patient's preoperative status and coexisting illness. The risk of organ hypoperfusion should be kept in mind. Close intraoperative monitoring with optimal patient selection is important for good patient outcomes.