Oral and Maxillofacial Surgery-Heidelberg最新文献

Aim: The aim of this study is to assess the efficacy of the stereolithographic surgical guide in reducing intraoperative and postoperative complication during lateral sinus lift operation.

Materials and methods: A parallel randomized controlled prospective clinical study was conducted on fourteen patients requiring thirty dental implants in the posterior maxilla and diagnosed with reduced vertical bone height. Lateral Maxillary Sinus Lift procedure with simultaneous implant placement was performed to all patients. Stereolithographic surgical guides for lateral window osteotomy and implant drilling and placement were used in the study group, while lateral osteotomy and implant drilling and placement was done freehand in the control group. A cone beam computed tomography was taken immediately and six months post-sinus lifting. Intraoperative and postoperative complications were assessed, pain and edema were assessed using visual analogue scale and vertical bone was assessed using fusion module of cone beam computed tomography.

Results: All dental implants demonstrated high survival rates with no statistically significant difference observed in intraoperative or postoperative complications. In terms of new vertical bone gain, both groups exhibited satisfactory and successful outcomes. Concerning pain, there was no statistically significant difference between the two groups except after two days, the study group showed statistically significantly lower pain score than the control group. While regarding the severity of edema, the study group showed statistically significantly higher prevalence of moderate and severe edema than control group which showed higher prevalence of mild edema.

Conclusion: According to the current study it has been concluded that there was no remarkable difference between the outcomes of both methods. The study protocol and its consent form were approved by the ethical committee of Suez Canal University (No.432/2021); and registered retrospectively on 23 April 2024 on PACTR (PACTR20240875463218) (pactr.samrc.ac.za/TrialDisplay.aspx?TrialID = 30442).

Purpose: To evaluate the electromyographic activity of the masseter, temporal, and buccinator muscles, as well as anxiety levels, aesthetic satisfaction, and quality of life following bichectomy.

Methods: Nine patients were included. Electromyography of the masseter, anterior temporal, and buccinator muscles was performed, along with assessment of the number of masticatory cycles and mastication time until swallowing. Anxiety levels (Generalized Anxiety Disorder-7), the impact of surgery on quality of life (Glasgow Benefit Inventory - GBI), and patient aesthetic satisfaction were evaluated using questionnaires. Assessments were conducted before surgery (T0), 60 days after surgery (T1), and 120 days after surgery (T2). A 2-way repeated measures ANOVA was used and when the analyzed data were not considered normal, the Friedman test was used (p < 0.05).

Results: The activity of the masseter and buccinator muscles increased significantly after 30 days (T1) and 120 days (T2) after bichectomy compared to T0. The number of chewing cycles and time until swallowing and anxiety did not change significantly over time. Aesthetic satisfaction increased significantly after 30 days.

Conclusion: Removing the main body of the Bichat ball increased the electrical activity of the masseter and buccinator muscles during chewing of the tested foods. The participants' anxiety level over time was considered clinically acceptable. Buccal fat pad removal did not influence the number of chewing cycles and chewing time until swallowing. Aesthetic satisfaction increased 60 days after bichectomy. After 120 days of buccal fat pad removal, there was an improvement in the quality of life of the individuals.

Purpose: Identifying nasal deviation in patients requiring orthognathic surgery is critical for developing an accurate treatment plan, particularly in the axial plane. This study aimed to evaluate the prevalence and degree of nasal and septal deviation in patients requiring orthognathic surgery, and to assess their relationship with maxillary, mandibular, and chin asymmetries, as well as dento-skeletal class.

Material and methods: A retrospective study was conducted on patients who required orthognathic surgery between July 2020 and February 2021. Exclusion criteria included congenital craniofacial anomalies, history of mandibular condylar hyperplasia, or prior rhino-septoplasty procedures.

Results: Of the 103 patients studied, 97.1% exhibited some degree of nasal deviation, and all presented with septal deviation. Nasal septum deviation correlated significantly with nasal tip deviation (r = 0.44, p < 0.001) and dorsum deviation (r = 0.41, p < 0.001). A combination of nasal, maxillary, mandibular, and chin deviations was present in 77.3%, 83.5%, and 88.3% of patients, respectively. Significant correlations were found between the directions of maxillary (r = 0.21, p = 0.032), mandibular (r = 0.25, p = 0.012), and chin deviations (r = 0.19, p = 0.050).

Conclusions: This study highlights that nasal and septal deviations are highly prevalent in patients requiring orthognathic surgery, and their accurate diagnosis is essential for successful orthognathic diagnosis and surgical planning. These findings support the inclusion of nasal assessments in the treatment plans for orthognathic surgery patients.

Objective: To evaluate the influence of crown-to-implant ratio(C/I) on marginal bone level changes and survival rate of implants during function.

Methods: The study included 68 patients with completely or partial edentulous and severe vertical bone atrophy, which were restored with a single crown(46) or a partial fixed(48) denture supported by 152 short implants. Implants were divided into three groups according to the C/I ratio (1.5:1, 1,75:1, 2:1). The results were evaluated: failures of the implant, any complications, implants marginal bone loss (MBL), implants success rates the follow up for 5 years. MBL was assessed by taking x-rays after restoration fixation, after 1,3,5 years post operatively.

Results: During implantation and in the post-implantation period, no serious biological or prosthetic complications were recorded. After 1 years in Group 1 mean MBL 0.86 ± 0.4 mm, after 3 years 0,98 ± 0.2 mm), after 5 years 1.05 ± 0.3 mm. After 1 years in Group 2 mean MBL 0.97 ± 0.3 mm, after 3 years 1,07 ± 0.4 mm), after 5 years MBL was 1.12 ± 0.6 mm.Аfter 1 years in Group 3 mean MBL 1,08 ± 0.6 mm, after 3 years 1,19 ± 0.2 mm, after 5 years MBL was 1.27 ± 0.3 mm. Short implants cumulative success of implantation after 5 years was 97.8% for group 1, 97.6% for group 2, and 97.3% for group 3. Patients were satisfied with the results of treatment.

Conclusions: The study showed that different C/I ratios of short implants did not affect the survival rate and their use can be considered favorable and completely justified.

Clinical trial number: Not applicable.

Purpose: The purpose of this study was to investigate characteristics of mandibular head morphology and temporomandibular joint (TMJ) disorders (TMDs) on the deviation side (DS) and non-deviation side (NDS) in patients with facial asymmetry (FA).

Methods: Thirty patients diagnosed with FA were enrolled. Preoperative and postoperative joint sound and pain were evaluated in terms of clinical symptoms, and pre- and postoperative mandibular head morphology factors shown by computed tomography. In addition, magnetic resonance imaging findings were used to evaluate preoperative joint disc position and joint effusion (JE).

Results: The patients included 12 (40.0%) males and 18 (60.0%) females, with a mean age of 25.8 years. There were no significant differences regarding clinical symptoms between patients affected on the DS and those on the NDS. Preoperatively, the DS group showed a total of 4 joints (13.3%) with mandibular condyle head deformity, while postoperatively those patients had 13 (43.3%) and the NDS group 2 (6.7%), indicating a significant difference for condyle head deformity between patients affected on DS and NDS before and after surgery. The score for JE was 1.1 ± 1.0 in the DS group and 0.6 ± 0.8 in the NDS group, a significant difference (P < 0.05).

Conclusion: As compared to the NDS, the DS in the present class III patients with FA showed a greater number of TMDs, such as condyle head deformity, disc displacement, and JE. It's important for surgeons and orthodontists to be aware of the possibility of TMDs on the DS in class III patients with FA when performing orthognathic surgery.

Purpose: The study assesses the teaching effect of social media on the topic of dental implants.

Methods: A sample of 400 Instagram posts were collected, 100 each for one of the following hashtags #dentalimplants, #implantdentisitry, #implantsurgery and #implantology. They were examined regarding their likes, comments, author (dentist or practice or clinic, dental technician, company, Instagram page, patient), gender, form of presentation (image + text, video, text, image) and purpose of the post. Afterwards all posts were divided into "excellent", "good", "moderate" and "poor" teaching effect regarding dental implantology by 6 different evaluators with different levels of training in dentistry. 400 Instagram posts were collected, each with hashtags related to dental implants, analyzed over a year.

Results: Men authored 48.5% of the posts, women 21.75%, and posts of unknown gender 29.75%. Images were the most common post format at 69.75%, while texts were the least at 0.75%. Dentists posted most frequently (76.5%), followed by dental technicians (11.5%), with educational posts (9.5%) being the least common purpose. Additionally, the evaluation of educational quality by six assessors showed that poor ratings were most common (76.7%), while excellent ratings were the least frequent (3.3%).

Conclusion: Currently, social media cannot be used to obtain quality information about dental implants. Nevertheless, social media as an information platform about health-related topics continues to grow and has an increasingly important role in the lives of patients and professionals.

Purpose: Cemento-osseous dysplasia (COD) is a fibro-osseous lesion whose management is highly controversial in the literature. Due to scarcity of comprehensive studies on its management, the aim of this study was to analyse its management and develop a treatment protocol.

Methods: A multi-centre retrospective cohort analysis was conducted at two tertiary referral hospitals on 124 patients diagnosed with COD from 2005 to 2023. Demographic, clinical, and radiological data were analysed and correlated with treatment methods. Post-operative complications such as osteomyelitis or pathological fracture were documented along with follow-up visits to evaluate the need for further treatment. Data was analysed using Student's t-test and Fisher's exact test. Statistical significance was set at P < 0.05.

Results: The patients' ages ranged from 22 to 78 years (mean: 48.5 years), with majority being females (90.4%) and of African descent (95.9%). Radiopaque CODs presented significantly higher rate of symptoms compared to radiolucent or mixed lesions (p = 0.02). The majority of incidental CODs were managed through observation (72%), while six incidental CODs underwent biopsy due to suspicion of more sinister lesions. Symptomatic lesions were mainly treated by curettage (29.7%) or local excision (48.6%), while only one symptomatic case was managed with observation and antibiotics (p = 0.0001).

Conclusion: Biopsy of asymptomatic COD should only be reserved for cases with inconclusive clinico-pathological features. The decision to surgically treat COD should be based on the presence of symptoms and infection. Early curettage or excision of infected COD is the most effective approach to eradicate the disease and prevent progression into osteomyelitis.

Clinical trial number: Not applicable.

Purpose: This study aimed to evaluate the bone repair process of standardized calvaria defects in rats treated with different bone substitute materials.

Methods: Critical size bone defects with 7 mm diameter were created in the right parietal bone of forty-eight rats using a trephine burr. The animals were randomly allocated to four different experimental groups according to the materials used to fill the defect, as follow: (1) Autogenous group: defects were filled with autogenous bone; (2) Bio-Oss group: defects were filled with demineralized bovine bone mineral; (3) EMD group: defects were filled with Emdogain^®; and (4) EMD + Bone group: defects were filled with a combination of both Bone Ceramic^® and Emdogain^®. Euthanasia was performed after 30 and 60 days.

Results: Histometric analysis demonstrated for the 30-day period that all groups presented areas of bone neoformation, with the EMD + Bone group showing increased percentage of bone neoformation. For the 60-day period, there was a trend towards greater bone neoformation compared to the 30-day period, with a statistically significant difference between the EMD + Bone vs. Bio-Oss groups (p = 0.036). The percentage of new bone formation was significantly higher in the autogenous group compared to all the others. Moderate immunostaining of osteocalcin was observed in all groups at 30 days, which increased significantly in the 60-day period.

Conclusion: This study demonstrated suitable biological properties in the association of Emdogain^® with Bone Ceramic^®. However, further laboratory studies are needed to evaluate the osteoinductive properties of these materials, as well as their behavior in humans through clinical studies.

Clinical trial number: Not applicable.

Background: Kasabach-Merritt syndrome (KMS) is a rear but dangerous type of hemangioma, which seriously threatens the life safety of KMS patients. The aim of this study is to explore the therapeutic and side effects of local administration of urea combined with methylprednisolone for the treatment of KMS in the maxillofacial region of infants.

Case presentation: A total of 14 cases of KMS in infants' maxillofacial region were treated with local injection of 40% urea solution and methylprednisone after the external carotid artery ligation. After 10-36 months of follow-up, 13 out of 14 cases were cured and 1 case was improved. Two cases relapsed and were effectively managed with additional urea injections over 6-10 days. Observed over a 1-2-month period post-treatment, external carotid artery catheterization with urea and methylprednisolone injection is effective for the treatment of maxillofacial KMS in infants.

Conclusion: The present study demonstrates that, external carotid artery ligation combined with urea and methylprednisolone can be curative for the treatment KMS in maxillofacial regions of infants, with little trauma and minimal side effect. The combined therapy is recommended for treating severe hemangiomas complicated by Kasabach-Merritt syndrome in maxillofacial region of infants.