Journal of Oral and Maxillofacial Surgery最新文献

Background: It has been determined that oxytocin (OT), a hormone primarily involved in childbirth and lactation, has anabolic effects on bone metabolism.

Purpose: The purpose of the study was to measure and compare radiographic and clinical fracture healing between the OT-treated and control groups.

Study design, setting, and sample: This is an in vivo animal study using a mandibular fracture model in 42, 6-month-old male Wistar rats. The fracture line was created and fixed using mini plates and screws.

Predictor variables: The predictor variable was OT exposure. The animals were randomly assigned to OT or control groups (C). The animals were sacrificed on days 10 (OT-10, C-10), 20 (OT-10, C-10), and 30, (OT-30, C-30) to evaluate the effect of OT on fracture healing at different stages. Thus, two groups and six subgroups were formed.

Outcome variables: The outcome variable was fracture healing measured using gray values (GV), fracture healing scores (FHS), and the ratio of new bone area to total fracture area (NB/TF.) For an objective assessment of radiographic images, the average GV of the region can be calculated. FHS is a scoring system that evaluates bone healing. NB/TF is the ratio used to evaluate new bone formation.

Covariates: None.

Analyses: The differences between groups were analyzed using the independent samples test or the Mann-Whitney U test, depending on the distributional characteristics of the data. Comparisons between the control and experimental groups at each time point were performed using the independent samples test. Additionally, Pearson's or Spearman's correlation tests were used according to the distribution of the variables (P < .05).

Results: Compared to the C groups, OT groups consistently showed higher recovery outcomes. Although no significant difference was observed on day 10, on day 20, OT-20 subgroup demonstrated significantly higher GV (OT-20 = 1.35 ± 0.39, C-20 = 0.77 ± 0.24) (P = .011 < 0.05), FHS values (OT-20 = 7.83 ± 0.75, C-20 = 5.67 ± 1.21) (P = .004 < 0.05), and NB/TF ratios (OT-20 = 80.19 ± 4.93, C-20 = 31.40 ± 3.87) (P = .001 < 0.05). On day 30, OT-30 maintained this superiority, showing significantly higher GV, FHS, and NB/TF values compared to C-30 (all P < .05).

Conclusions: In this study, the groups treated with OT showed higher mean healing scores. Oxytocin improved the healing of mandibular bone fractures.

Background: Neurosensory disturbances are common after Le Fort I osteotomy, often transient but clinically relevant, highlighting the need for strategies to enhance recovery. Photobiomodulation (PBM) using low-level diode lasers has been proposed to accelerate nerve recovery.

Purpose: The purpose of study was to compare midface sensory recovery and subject satisfaction between PBM with an 810-nm diode laser and a control side (inactive probe) following Le Fort I osteotomy.

Study design, setting, sample: A prospective triple-blind, split-face randomized controlled trial was conducted from 2021 to 2022 at 2 tertiary hospitals in Tehran. Eligible participants aged 18-40 years who underwent bimaxillary surgery with Le Fort I osteotomy. Exclusion criteria included trauma history, oral diseases, uncontrolled systemic diseases, and contraindications to laser therapy.

Predictor variable: The predictor variable was the PBM treatment (810-nm GaAlAs diode laser). Treatments were randomly assigned to 1 side of the midface (PBM) while the contralateral side served as the control (inactive probe).

Main outcome variable(s): The primary outcome variable was time to functional sensory recovery (FSR), defined as Medical Research Council Scale S3+. It was measured using a composite of standardized neurosensory tests (2-point discrimination, brush stroke directional, and thermal and sharp/blunt discrimination). Secondary outcomes included subject satisfaction, measured with a 10-point visual analog scale.

Covariates: Covariates included age, sex, and time since surgery.

Analyses: Descriptive statistics, Kaplan-Meier survival analysis, repeated-measures analysis of variance, and Mann-Whitney U tests were used. Statistical significance was set at P < .05.

Results: The study included 15 subjects (mean age 29.3 ± 7.0 years), with a 35-day follow-up. Median time to FSR was 28 days (interquartile range: 24-32) for the upper lip and 35 days (interquartile range: 30-40) for the nasolabial fold, with no statistically significant differences between PBM and control sides (Log-rank P > .05). Sensory function improved statistically significantly over time, but recovery trajectories did not differ between sides. Subject satisfaction was similar between groups.

Conclusion and relevance: Postoperative PBM at 810 nm did not statistically significantly accelerate FSR compared to the control side. However, it was safe and associated with improved subject satisfaction at the final follow-up, suggesting a potential role in enhancing the subjective postoperative experience.