This study aimed to evaluate the usefulness of bioresorbable miniplates by comparing the three-dimensional maxillary stability of poly L-lactic acid and titanium miniplate systems in Le Fort I osteotomy.
Methods
Fifty patients with jaw deformities underwent Le Fort I or bilateral sagittal split osteotomies. The patients were divided into two groups: the first group received the polylactic acid miniplate system for bone fixation, while the second group received the titanium miniplate system. Cone-beam computed tomography (CBCT) was performed before surgery and at 1 and 6 months after surgery. The acquired images were overlapped to quantify the extent of maxillary relapse by calculating the difference in the distance moved between 1 and 6 months after surgery.
Results
There was no significant difference in maxillary stability between the two groups 6 months after surgery.
Conclusions
The postoperative stability achieved using the poly L-lactic acid miniplate system for maxillary fixation was comparable to that achieved using the titanium miniplate system.
方法50例下颌畸形患者接受了Le Fort I或双侧矢状劈开截骨术。患者被分为两组：第一组接受聚乳酸迷你板系统进行骨固定，第二组接受钛迷你板系统。在术前、术后 1 个月和 6 个月时进行锥形束计算机断层扫描（CBCT）。结果两组患者术后 6 个月的上颌骨稳定性无明显差异。结论使用聚左旋乳酸迷你板系统进行上颌骨固定的术后稳定性与使用钛迷你板系统的术后稳定性相当。
{"title":"Comparative three-dimensional maxillary stability assessment: Bioresorbable miniplate vs. titanium miniplate systems in Le Fort I osteotomy","authors":"Koki Takamatsu , Sunao Shiogama , Yosuke Ikehata , Arisa Yasuda , Yuji Kurihara , Tatsuo Shirota","doi":"10.1016/j.ajoms.2024.06.003","DOIUrl":"10.1016/j.ajoms.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the usefulness of bioresorbable miniplates by comparing the three-dimensional maxillary stability of poly L-lactic acid and titanium miniplate systems in Le Fort I osteotomy.</div></div><div><h3>Methods</h3><div>Fifty patients with jaw deformities underwent Le Fort I or bilateral sagittal split osteotomies. The patients were divided into two groups: the first group received the polylactic acid miniplate system for bone fixation, while the second group received the titanium miniplate system. Cone-beam computed tomography (CBCT) was performed before surgery and at 1 and 6 months after surgery. The acquired images were overlapped to quantify the extent of maxillary relapse by calculating the difference in the distance moved between 1 and 6 months after surgery.</div></div><div><h3>Results</h3><div>There was no significant difference in maxillary stability between the two groups 6 months after surgery.</div></div><div><h3>Conclusions</h3><div>The postoperative stability achieved using the poly L-lactic acid miniplate system for maxillary fixation was comparable to that achieved using the titanium miniplate system.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 56-63"},"PeriodicalIF":0.4,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ewing sarcoma (ES) is a rare malignant tumor, particularly in the head and neck region. Its incidence tends to be higher in pediatric patients than in adults. Occasionally, curative treatment of ES requires extensive resection of the primary lesion, which can result in postoperative aesthetic or functional disorders. In recent years, advances have been made in reconstructive surgery of the maxillofacial region. Broad mandibular defects are a prime indication for several types of vascularized free bone grafts. Similarly, the treatment of ES has progressed in the field of systemic chemotherapy. We report a multidisciplinary surgical case of ES in the mandible of a 12-year-old patient who underwent extensive mandibular resection and fibula free flap (FFF) reconstruction with preoperative and postoperative chemotherapy. In brief, after conducting a multidisciplinary clinical conference, perioperative chemotherapy was planned by pediatric oncologists, and the operation was performed by a head and neck cancer team consisting of head and neck, oral and maxillofacial, and plastic surgeons. Five months after the operation, prosthodontists applied an intraoral prosthesis. The reconstructed mandible demonstrated good development, and the quality of life was maintained both aesthetically and functionally for eight years after treatment. Our efficient multidisciplinary medical collaboration demonstrated that mandibular reconstruction using FFF is a suitable method for treating pediatric patients and leads to long-term survival with satisfactory outcomes.
尤文肉瘤（ES）是一种罕见的恶性肿瘤，尤其多发于头颈部。儿童患者的发病率往往高于成人。根治性治疗 ES 有时需要对原发病灶进行大面积切除，这可能会导致术后美观或功能障碍。近年来，颌面部整形手术取得了长足的进步。下颌骨宽大缺损是多种血管化游离骨移植的主要适应症。同样，ES 的治疗在全身化疗领域也取得了进展。我们报告了一例 12 岁下颌骨 ES 的多学科手术病例，患者接受了广泛的下颌骨切除术和腓骨游离瓣（FFF）重建术，并接受了术前和术后化疗。简而言之，在召开多学科临床会议后，儿科肿瘤专家制定了围手术期化疗计划，由头颈部、口腔颌面部和整形外科医生组成的头颈部癌症团队实施了手术。手术五个月后，口腔修复医生为患者安装了口内假牙。重建后的下颌骨发育良好，治疗后八年的生活质量在美观和功能上都得以保持。我们高效的多学科医疗合作证明，使用 FFF 重建下颌骨是治疗儿童患者的一种合适方法，并能带来令人满意的长期生存效果。
{"title":"Segmental mandibular resection and reconstruction using a multidisciplinary approach in adolescent and young adult patients: A case of Ewing sarcoma with a eight-year follow-up","authors":"Sumitaka Hagiwara , Ikuo Hyodo , Daisuke Nishikawa , Masashi Ando , Naoko Maeda , Shogo Ozawa , Yasuhisa Hasegawa , Nobuhiro Hanai","doi":"10.1016/j.ajoms.2024.06.002","DOIUrl":"10.1016/j.ajoms.2024.06.002","url":null,"abstract":"<div><div>Ewing sarcoma (ES) is a rare malignant tumor, particularly in the head and neck region. Its incidence tends to be higher in pediatric patients than in adults. Occasionally, curative treatment of ES requires extensive resection of the primary lesion, which can result in postoperative aesthetic or functional disorders. In recent years, advances have been made in reconstructive surgery of the maxillofacial region. Broad mandibular defects are a prime indication for several types of vascularized free bone grafts. Similarly, the treatment of ES has progressed in the field of systemic chemotherapy. We report a multidisciplinary surgical case of ES in the mandible of a 12-year-old patient who underwent extensive mandibular resection and fibula free flap (FFF) reconstruction with preoperative and postoperative chemotherapy. In brief, after conducting a multidisciplinary clinical conference, perioperative chemotherapy was planned by pediatric oncologists, and the operation was performed by a head and neck cancer team consisting of head and neck, oral and maxillofacial, and plastic surgeons. Five months after the operation, prosthodontists applied an intraoral prosthesis. The reconstructed mandible demonstrated good development, and the quality of life was maintained both aesthetically and functionally for eight years after treatment. Our efficient multidisciplinary medical collaboration demonstrated that mandibular reconstruction using FFF is a suitable method for treating pediatric patients and leads to long-term survival with satisfactory outcomes.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 123-129"},"PeriodicalIF":0.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.1016/j.ajoms.2024.06.001
Hu Longfei, Zhou Shangyin, Zhang Ju
Objective
Radiotherapy combined with chemotherapy or radiotherapy alone is an important treatment for locally advanced oral squamous cell carcinoma. We performed a meta-analysis of published reports about these two treatments.
Methods
We performed an extensive exploration of various databases, such as Embase, PubMed, and the Cochrane Library. The study included research on the comparison between postoperative chemoradiotherapy (POCRT) and postoperative radiotherapy (PORT) for oral cancer, with a restriction on the search language to English. The included endpoints consisted of disease-free survival (DFS), overall survival (OS), locoregional control (LRC), and distant metastasis-free survival (DMFS).
Results
Sixteen studies were included, including 3 prospective studies and 13 retrospective studies, with 3364 patients. For patients with locally advanced oral cancer, compared with PORT, POCRT had better DFS (HR 0.64; 95 % confidence interval [CI],0.48–0.84; P = 0.001), OS (HR 0.76;95 %CI 0.65–0.89; P = 0.0005), and LRC (HR 0.65;95 %CI 0.44–0.95; P = 0.02). There was a tendency for DMFS (RR 0.95;95 %CI 0.90–1.01; P = 0.09) to exhibit a marginal statistical distinction. The risks of grade 3 or higher acute toxicity, such as oral mucositis (RR 1.36; p = 0.44), dysphagia (RR 1.57; p = 0.13), and severe skin (RR 0.71; p = 0.17), were more frequent in the POCRT group, but the difference was not statistically significant.
Conclusions
For patients with oral squamous cell carcinoma, POCRT is beneficial in terms of DFS, OS, and LRC, but there is no significant benefit in DMFS. The group receiving POCRT exhibited a slightly increased likelihood of experiencing oral mucositis and dysphagia, although the disparity did not attain statistical significance.
{"title":"Outcomes of postoperative radiotherapy combined with or without chemotherapy for locally advanced oral cancer: A systematic review and meta-analysis","authors":"Hu Longfei, Zhou Shangyin, Zhang Ju","doi":"10.1016/j.ajoms.2024.06.001","DOIUrl":"10.1016/j.ajoms.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>Radiotherapy combined with chemotherapy or radiotherapy alone is an important treatment for locally advanced oral squamous cell carcinoma. We performed a meta-analysis of published reports about these two treatments.</div></div><div><h3>Methods</h3><div>We performed an extensive exploration of various databases, such as Embase, PubMed, and the Cochrane Library. The study included research on the comparison between postoperative chemoradiotherapy (POCRT) and postoperative radiotherapy (PORT) for oral cancer, with a restriction on the search language to English. The included endpoints consisted of disease-free survival (DFS), overall survival (OS), locoregional control (LRC), and distant metastasis-free survival (DMFS).</div></div><div><h3>Results</h3><div>Sixteen studies were included, including 3 prospective studies and 13 retrospective studies, with 3364 patients. For patients with locally advanced oral cancer, compared with PORT, POCRT had better DFS (HR 0.64; 95 % confidence interval [CI],0.48–0.84; P = 0.001), OS (HR 0.76;95 %CI 0.65–0.89; P = 0.0005), and LRC (HR 0.65;95 %CI 0.44–0.95; P = 0.02). There was a tendency for DMFS (RR 0.95;95 %CI 0.90–1.01; P = 0.09) to exhibit a marginal statistical distinction. The risks of grade 3 or higher acute toxicity, such as oral mucositis (RR 1.36; p = 0.44), dysphagia (RR 1.57; p = 0.13), and severe skin (RR 0.71; p = 0.17), were more frequent in the POCRT group, but the difference was not statistically significant.</div></div><div><h3>Conclusions</h3><div>For patients with oral squamous cell carcinoma, POCRT is beneficial in terms of DFS, OS, and LRC, but there is no significant benefit in DMFS. The group receiving POCRT exhibited a slightly increased likelihood of experiencing oral mucositis and dysphagia, although the disparity did not attain statistical significance.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 141-150"},"PeriodicalIF":0.4,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcified epithelial odontogenic tumour (CEOT) are rare benign tumours that tend to arise in the mandible. Calcifications of amyloid-like substances produced by these tumours present as irregular radiopacities on the radiographs. Herein, we report a rare case of a CEOT in the maxillary premolar, which was largely composed of massive calcification and the presence of an impacted tooth. The patient was a 37-year-old male with a chief complaint of tooth mobility and pain in the left maxillary molar. Panoramic X-rays and computed tomography imaging showed an irregular radiopaque lesion with tooth-like structures in the left maxillary premolar. An excisional biopsy was performed after a clinical diagnosis of a benign tumour was suspected. The lesion was histopathologically diagnosed as a CEOT. The postoperative course was good, and the patient is currently under observation.
{"title":"Atypical radiological presentations of a calcified epithelial odontogenic tumour in the maxilla: A rare case composed of massive calcification","authors":"Norihiko Furuta , Yoshikazu Harada , Aki Miyawaki , Emi Sugiyama , Kazuhiro Tominaga","doi":"10.1016/j.ajoms.2024.06.004","DOIUrl":"10.1016/j.ajoms.2024.06.004","url":null,"abstract":"<div><div>Calcified epithelial odontogenic tumour (CEOT) are rare benign tumours that tend to arise in the mandible. Calcifications of amyloid-like substances produced by these tumours present as irregular radiopacities on the radiographs. Herein, we report a rare case of a CEOT in the maxillary premolar, which was largely composed of massive calcification and the presence of an impacted tooth. The patient was a 37-year-old male with a chief complaint of tooth mobility and pain in the left maxillary molar. Panoramic X-rays and computed tomography imaging showed an irregular radiopaque lesion with tooth-like structures in the left maxillary premolar. An excisional biopsy was performed after a clinical diagnosis of a benign tumour was suspected. The lesion was histopathologically diagnosed as a CEOT. The postoperative course was good, and the patient is currently under observation.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 251-254"},"PeriodicalIF":0.4,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1016/j.ajoms.2024.05.007
Brunno Santos de Freitas Silva , Eleazar Mezaiko , Reuber Mendes Rocha , Hélen Kaline Farias Bezerra , Pablo Agustin Vargas , Fernanda Paula Yamamoto-Silva
Oncocytic metaplasia refers to a metaplastic alteration occurring in duct and acinar cells, typically found in major or minor salivary glands, commonly associated with aging. Despite being infrequently reported, it appears to be an underrecognized phenomenon that may be linked to inflammatory fibrous hyperplasia (IFH). A 66-year-old caucasian female, who is a non-smoker and abstains from alcohol, presented with longstanding multiple nodular lesions along the mucosa of the maxillary alveolar ridge. Clinical examination led to a diagnosis of IFH, which was confirmed through excisional biopsies. Histopathological examination revealed characteristic features of IFH alongside ductal structures exhibiting notable cell hyperplasia with oncocytic metaplasia. These cells displayed an irregular arrangement of single and double-layered structures with cystic dilatation. Additionally, some excretory ducts exhibited focal hyperplasia and thickening. This case underscores the co-occurrence of oncocytic metaplasia with IFH, emphasizing the significance for pathologists to identify such features to prevent misdiagnosis and unwarranted investigations.
{"title":"Oncocytic metaplasia as a histopathological feature in a case of inflammatory fibrous hyperplasia: A case report","authors":"Brunno Santos de Freitas Silva , Eleazar Mezaiko , Reuber Mendes Rocha , Hélen Kaline Farias Bezerra , Pablo Agustin Vargas , Fernanda Paula Yamamoto-Silva","doi":"10.1016/j.ajoms.2024.05.007","DOIUrl":"10.1016/j.ajoms.2024.05.007","url":null,"abstract":"<div><div>Oncocytic metaplasia refers to a metaplastic alteration occurring in duct and acinar cells, typically found in major or minor salivary glands, commonly associated with aging. Despite being infrequently reported, it appears to be an underrecognized phenomenon that may be linked to inflammatory fibrous hyperplasia (IFH). A 66-year-old caucasian female, who is a non-smoker and abstains from alcohol, presented with longstanding multiple nodular lesions along the mucosa of the maxillary alveolar ridge. Clinical examination led to a diagnosis of IFH, which was confirmed through excisional biopsies. Histopathological examination revealed characteristic features of IFH alongside ductal structures exhibiting notable cell hyperplasia with oncocytic metaplasia. These cells displayed an irregular arrangement of single and double-layered structures with cystic dilatation. Additionally, some excretory ducts exhibited focal hyperplasia and thickening. This case underscores the co-occurrence of oncocytic metaplasia with IFH, emphasizing the significance for pathologists to identify such features to prevent misdiagnosis and unwarranted investigations.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 248-250"},"PeriodicalIF":0.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Plasmablastic lymphoma (PBL) is a type of non-Hodgkin lymphoma commonly associated with human immunodeficiency virus (HIV) infection. In rare cases, PBL occurrence is noted in the oral cavity of elderly individuals who are HIV negative and EBV positive. The present report describes a case of oral mucosa-type PBL that occurred in the maxillary gingiva of the oral cavity. A 91-year-old male came to our clinic with enlarged swelling of the palatal gingiva of the right maxillary molar. The initial examination showed a smooth-surfaced extraordinary swelling with a diameter of approximately 20 mm. Cytology findings led to a class V determination and the patient was clinically diagnosed with a right-sided maxillary malignant tumor. Imaging studies also revealed a tumor in the right-side submandibular lymph node. For further confirmation of the diagnosis, a tissue biopsy was performed and a diagnosis of PBL determined, based on the histopathological and immunohistological findings of the specimen. Blood test results showed that the patient was HIV negative and EBV positive. Two years after the biopsy, there was no recurrence or enlargement in the affected area noted.
浆细胞性淋巴瘤（PBL）是一种非霍奇金淋巴瘤，通常与人类免疫缺陷病毒（HIV）感染有关。在极少数情况下，HIV 阴性、EBV 阳性的老年人口腔中也会出现浆细胞性淋巴瘤。本报告描述了一例发生在口腔上颌龈的口腔黏膜型 PBL。一名 91 岁的男性因右侧上颌臼齿腭龈肿大来我院就诊。初步检查显示，肿物表面光滑，直径约 20 毫米。细胞学检查结果为 V 级，患者被临床诊断为右侧上颌恶性肿瘤。影像学检查还发现右侧颌下淋巴结有肿瘤。为了进一步确诊，医生对患者进行了组织活检，并根据标本的组织病理学和免疫组织学检查结果，确定其诊断为 PBL。血液检测结果显示，患者的 HIV 阴性，EBV 阳性。活检两年后，患处没有复发或增大。
{"title":"Epstein-Barr virus-positive plasmablastic lymphoma in maxillary gingiva of HIV-negative patient – Case report","authors":"Yoshio Otake , Atsumu Kouketsu , Shinnosuke Nogami , Hiroyuki Kumamoto , Tsuyoshi Sugiura , Kensuke Yamauchi","doi":"10.1016/j.ajoms.2024.05.003","DOIUrl":"10.1016/j.ajoms.2024.05.003","url":null,"abstract":"<div><div>Plasmablastic lymphoma (PBL) is a type of non-Hodgkin lymphoma commonly associated with human immunodeficiency virus (HIV) infection. In rare cases, PBL occurrence is noted in the oral cavity of elderly individuals who are HIV negative and EBV positive. The present report describes a case of oral mucosa-type PBL that occurred in the maxillary gingiva of the oral cavity. A 91-year-old male came to our clinic with enlarged swelling of the palatal gingiva of the right maxillary molar. The initial examination showed a smooth-surfaced extraordinary swelling with a diameter of approximately 20 mm. Cytology findings led to a class V determination and the patient was clinically diagnosed with a right-sided maxillary malignant tumor. Imaging studies also revealed a tumor in the right-side submandibular lymph node. For further confirmation of the diagnosis, a tissue biopsy was performed and a diagnosis of PBL determined, based on the histopathological and immunohistological findings of the specimen. Blood test results showed that the patient was HIV negative and EBV positive. Two years after the biopsy, there was no recurrence or enlargement in the affected area noted.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 215-220"},"PeriodicalIF":0.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-29DOI: 10.1016/j.ajoms.2024.05.008
T. Paipongna , P. Saenthaveesuk
The incidence of complex maxillomandibular injuries resulting from the intraoral explosion of spherical firecrackers is rare. Restoring oral function, aligning teeth, and achieving optimal aesthetic and functional outcomes are challenging. This case report presents a 34-year-old male patient who self-lit firecrackers in his mouth and suffered comminuted mandibular fracture, dentoalveolar fracture (upper and lower anterior segment), multiple soft tissue injuries, and laceration of lip, adjacent skin, tongue, and oropharyngeal area. Before transferring the patient to oral and maxillofacial surgery unit, urgent intubation, fluid resuscitation, and bleeding control were performed. These traumas require considerable debridement and immediate reconstruction. The patient underwent debridement, irrigation, open reduction, and internal fixation with miniplates. Postoperative functional outcomes were assessed using the University of Washington Quality of Life Questionnaire (UW-QOL) at 3-month, 6-month and 1-year. Functional outcomes, especially swallowing and speech, were satisfactory. The facial soft tissue scar was well hidden, with no functional impairment. Occlusal alignment was achieved, and an acrylic partial denture was used for rehabilitation. The patient did not experience any post-surgical complications such as trismus or microstomia.
{"title":"An intraoral blast of firecracker caused extensive maxillofacial injury: A rare case report and literature review","authors":"T. Paipongna , P. Saenthaveesuk","doi":"10.1016/j.ajoms.2024.05.008","DOIUrl":"10.1016/j.ajoms.2024.05.008","url":null,"abstract":"<div><div>The incidence of complex maxillomandibular injuries resulting from the intraoral explosion of spherical firecrackers is rare. Restoring oral function, aligning teeth, and achieving optimal aesthetic and functional outcomes are challenging. This case report presents a 34-year-old male patient who self-lit firecrackers in his mouth and suffered comminuted mandibular fracture, dentoalveolar fracture (upper and lower anterior segment), multiple soft tissue injuries, and laceration of lip, adjacent skin, tongue, and oropharyngeal area. Before transferring the patient to oral and maxillofacial surgery unit, urgent intubation, fluid resuscitation, and bleeding control were performed. These traumas require considerable debridement and immediate reconstruction. The patient underwent debridement, irrigation, open reduction, and internal fixation with miniplates. Postoperative functional outcomes were assessed using the University of Washington Quality of Life Questionnaire (UW-QOL) at 3-month, 6-month and 1-year. Functional outcomes, especially swallowing and speech, were satisfactory. The facial soft tissue scar was well hidden, with no functional impairment. Occlusal alignment was achieved, and an acrylic partial denture was used for rehabilitation. The patient did not experience any post-surgical complications such as trismus or microstomia.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 116-122"},"PeriodicalIF":0.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A spectrum of surgical management for temporomandibular joint (TMJ) ankylosis exists ranging from gap arthroplasty to total joint replacement. Reconstruction and rehabilitation of the ramus-condyle unit (RCU) remains a surgical challenge in TMJ ankylosis. Distraction osteogenesis (DO) is a promising technique for joint reconstruction over conventional methods. This review compared the clinically relevant outcomes of transport distraction osteogenesis (TDO) and costochondral graft (CCG) for joint reconstruction in TMJ ankylosis.
Methods
PubMed, Medline, Embase, CENTRAL and ScienceDirect databases were searched from inception till 30th September 2023. Randomized controlled trials (RCTs) and prospective, retrospective studies on TMJ ankylosis patients comparing TDO and CCG for joint reconstruction and reporting outcomes were included. Assessment of the risk of bias was done with the Cochrane Collaboration tool.
Results
Five studies were included in the review. A significant improvement in the postoperative mouth opening with both groups was reported on follow-up and the analysis favored TDO for the joint reconstruction (p = 0.003). TDO group reported up to 6.1 % lower incidence of postoperative reankylosis in comparison to CCG (p = 0.59). Data was insufficient with regard to facial asymmetry, chin deviation and malocclusion.
Conclusion
TDO is a better alternative to CCG for joint reconstruction. Due to paucity of the reported literature and unequal sample distribution between the groups, quality evidence could not be derived regarding long-term stability. Further RCTs are recommended to generate better evidence and evaluate clinically relevant outcomes.
{"title":"Is transport distraction osteogenesis superior to autogenous costochondral graft for joint reconstruction in temporomandibular joint ankylosis? A systematic review and meta-analysis","authors":"Saurabh S. Simre , Sameer Pandey , Ashi Chug , Ram Sundar Chaulagain , Akansha Vyas , Sudarshan Shrestha , Preeti Kolse","doi":"10.1016/j.ajoms.2024.05.006","DOIUrl":"10.1016/j.ajoms.2024.05.006","url":null,"abstract":"<div><h3>Purpose</h3><div>A spectrum of surgical management for temporomandibular joint (TMJ) ankylosis exists ranging from gap arthroplasty to total joint replacement. Reconstruction and rehabilitation of the ramus-condyle unit (RCU) remains a surgical challenge in TMJ ankylosis. Distraction osteogenesis (DO) is a promising technique for joint reconstruction over conventional methods. This review compared the clinically relevant outcomes of transport distraction osteogenesis (TDO) and costochondral graft (CCG) for joint reconstruction in TMJ ankylosis.</div></div><div><h3>Methods</h3><div>PubMed, Medline, Embase, CENTRAL and ScienceDirect databases were searched from inception till 30th September 2023. Randomized controlled trials (RCTs) and prospective, retrospective studies on TMJ ankylosis patients comparing TDO and CCG for joint reconstruction and reporting outcomes were included. Assessment of the risk of bias was done with the Cochrane Collaboration tool.</div></div><div><h3>Results</h3><div>Five studies were included in the review. A significant improvement in the postoperative mouth opening with both groups was reported on follow-up and the analysis favored TDO for the joint reconstruction (p = 0.003). TDO group reported up to 6.1 % lower incidence of postoperative reankylosis in comparison to CCG (p = 0.59). Data was insufficient with regard to facial asymmetry, chin deviation and malocclusion.</div></div><div><h3>Conclusion</h3><div>TDO is a better alternative to CCG for joint reconstruction. Due to paucity of the reported literature and unequal sample distribution between the groups, quality evidence could not be derived regarding long-term stability. Further RCTs are recommended to generate better evidence and evaluate clinically relevant outcomes.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 1-7"},"PeriodicalIF":0.4,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carbonate apatite (CO3Ap)-granules bone substitute exhibits excellent osteoconductivity and replaced by a new bone based on bone remodeling process. However, no improvement has been made so far with respect to the drawbacks of granules; i.e., intraoperative scatter and postoperative migration. The aim of this study was to evaluate the feasibility of fabricating a CO3Ap-granules sponge to overcome these drawbacks. The CO3Ap granules sponge was successfully fabricated by mixing 300–600 µm CO3Ap granules with 3 % atelocollagen, followed by lyophilization at − 70 °C for 24 h and a dehydrothermal treatment at 150 °C for 24 h. The CO3Ap-granules sponge and CO3Ap-granules were implanted into rat calvarial bone defects for 2 and 4 weeks. No significant intraoperative scatter and postoperative migration were evident when the bone defects were reconstructed with the CO3Ap-granules sponge, whereas significant both intraoperative scatter and postoperative migration were observed when the bone defect was reconstructed with CO3Ap granules. Although less osteogenesis was anticipated for the CO3Ap-granules sponge due to the coverage of CO3Ap-granules surface with atelocollagen, no significant differences were observed in bone formation between the CO3Ap-granules sponge and CO3Ap-granules cases because the 3 % atelocollagen and lyophilization kept the CO3Ap granules surface only partially covered. Consequently, the CO3Ap-granules sponge and CO3Ap-granules exhibited similar bone formation at both 2 and 4 weeks after surgery. Thus, the CO3Ap-granules sponge improved the handling performance and retention ability at the bone defects without scarifying the osteogenesis of CO3Ap-granules.
{"title":"Fabrication of a carbonate apatite granules sponge as a new bone substitute and its histological evaluation at rat calvarial bone defects","authors":"Kazuya Akita , Naoyuki Fukuda , Natsumi Takamaru , Keiko Kudoh , Kunio Ishikawa , Youji Miyamoto","doi":"10.1016/j.ajoms.2024.05.004","DOIUrl":"10.1016/j.ajoms.2024.05.004","url":null,"abstract":"<div><div>Carbonate apatite (CO<sub>3</sub>Ap)-granules bone substitute exhibits excellent osteoconductivity and replaced by a new bone based on bone remodeling process. However, no improvement has been made so far with respect to the drawbacks of granules; i.e., intraoperative scatter and postoperative migration. The aim of this study was to evaluate the feasibility of fabricating a CO<sub>3</sub>Ap-granules sponge to overcome these drawbacks. The CO<sub>3</sub>Ap granules sponge was successfully fabricated by mixing 300–600 µm CO<sub>3</sub>Ap granules with 3 % atelocollagen, followed by lyophilization at − 70 °C for 24 h and a dehydrothermal treatment at 150 °C for 24 h. The CO<sub>3</sub>Ap-granules sponge and CO<sub>3</sub>Ap-granules were implanted into rat calvarial bone defects for 2 and 4 weeks. No significant intraoperative scatter and postoperative migration were evident when the bone defects were reconstructed with the CO<sub>3</sub>Ap-granules sponge, whereas significant both intraoperative scatter and postoperative migration were observed when the bone defect was reconstructed with CO<sub>3</sub>Ap granules. Although less osteogenesis was anticipated for the CO<sub>3</sub>Ap-granules sponge due to the coverage of CO<sub>3</sub>Ap-granules surface with atelocollagen, no significant differences were observed in bone formation between the CO<sub>3</sub>Ap-granules sponge and CO<sub>3</sub>Ap-granules cases because the 3 % atelocollagen and lyophilization kept the CO<sub>3</sub>Ap granules surface only partially covered. Consequently, the CO<sub>3</sub>Ap-granules sponge and CO<sub>3</sub>Ap-granules exhibited similar bone formation at both 2 and 4 weeks after surgery. Thus, the CO<sub>3</sub>Ap-granules sponge improved the handling performance and retention ability at the bone defects without scarifying the osteogenesis of CO<sub>3</sub>Ap-granules.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 42-49"},"PeriodicalIF":0.4,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1016/j.ajoms.2024.05.005
Abhay K. Kattepur , Deepika Kenkere , C. Deepa , K.S. Gopinath
Objective
Oral cancers have varied clinical presentations, often leading to repeated and multiple biopsies to establish diagnosis and formulate treatment. Use of portable, office- based tools to help in diagnosis and biopsies can result in early diagnosis. We used a fluorescence-based device to study its efficacy in malignant and potentially malignant disorders of oral cavity.
Method
50 individuals including 41 patients and 9 controls were enrolled. Following a thorough clinical examination, the Oralscan® device (with combined autofluorescence and diffuse reflectance) was used for characterization of these lesion and to assist in biopsy taking. The zones (red/yellow/green) in which the lesion(s) fell were noted. Punch biopsies were performed and pathological reports were compared with the zonal category as given by the device.
Results
The most common site of involvement was buccal mucosa (70.7 %). The total number of lesions studied was 59, with 143 images captured in toto. 75.6 % of cases were malignant. The overall sensitivity, accuracy and PPV of the device was 43.24 %, 34.04 % and 61.54 % respectively.
Conclusion
The present study showed that the use of the autofluorescence and diffuse reflectance handheld device had poor sensitivity and specificity for diagnosing oral lesions both malignant and potentially malignant disorders of oral cavity.
{"title":"A prospective study to evaluate the efficacy of a fluorescence based hand-held device in the detection of malignant and potentially malignant disorders (PMD) of the oral cavity","authors":"Abhay K. Kattepur , Deepika Kenkere , C. Deepa , K.S. Gopinath","doi":"10.1016/j.ajoms.2024.05.005","DOIUrl":"10.1016/j.ajoms.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>Oral cancers have varied clinical presentations, often leading to repeated and multiple biopsies to establish diagnosis and formulate treatment. Use of portable, office- based tools to help in diagnosis and biopsies can result in early diagnosis. We used a fluorescence-based device to study its efficacy in malignant and potentially malignant disorders of oral cavity.</div></div><div><h3>Method</h3><div>50 individuals including 41 patients and 9 controls were enrolled. Following a thorough clinical examination, the Oralscan® device (with combined autofluorescence and diffuse reflectance) was used for characterization of these lesion and to assist in biopsy taking. The zones (red/yellow/green) in which the lesion(s) fell were noted. Punch biopsies were performed and pathological reports were compared with the zonal category as given by the device.</div></div><div><h3>Results</h3><div>The most common site of involvement was buccal mucosa (70.7 %). The total number of lesions studied was 59, with 143 images captured in toto. 75.6 % of cases were malignant. The overall sensitivity, accuracy and PPV of the device was 43.24 %, 34.04 % and 61.54 % respectively.</div></div><div><h3>Conclusion</h3><div>The present study showed that the use of the autofluorescence and diffuse reflectance handheld device had poor sensitivity and specificity for diagnosing oral lesions both malignant and potentially malignant disorders of oral cavity.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 50-55"},"PeriodicalIF":0.4,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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