Oral and Maxillofacial Surgery-Heidelberg最新文献

Purpose of review: Multiple primary tumours (MPTs) are a rare clinical entity, and the co-occurrence of synchronous and metachronous MPTs in a single patient is even more exceptional. In the context of Erdheim-Chester Disease (ECD), an already uncommon disorder, the presentation of this disease in the oral cavity is notably rare. Furthermore, the simultaneous presence of ECD in the oral cavity and a Giant Cell Tumour (GCT) in a long bone has not been previously reported in medical literature.

Recent findings: This case report presents the first documented instance of such a unique clinical scenario. The marked histological disparities between GCT and ECD further underscore the enigmatic nature of this case. The intricate interplay of genetic, environmental, and pathophysiological factors that led to the simultaneous development of two distinct neoplasms in the same patient is yet to be fully elucidated. This case not only challenges our understanding of the etiology of these conditions but also emphasizes the importance of a multidisciplinary approach to the evaluation and management of such complex cases. The confluence of rare entities, the diagnostic complexities they introduce, and the imperative need for tailored treatment strategies exemplify the intricate landscape of oncological care. This case serves as a compelling reminder of the many unknown facets of disease etiology and the significance of collaborative medical efforts in offering the best possible care for patients confronting exceptionally rare clinical presentations.

Purpose: Surgical resection of oral cancers requires meticulous planning to achieve clear margins and minimize potential morbidity. This study aimed to compare postoperative surgical and functional outcomes following central and lateral lip-split approaches used for resection and reconstruction of oral tumours.

Methods: A retrospective review of 79 cases involving lip-split procedures for head and neck cancers was conducted. Data were collected from a prospectively recorded database (December 2015 to December 2022). Statistical analyses compared patient demographics, intraoperative characteristics, and postoperative outcomes between central and lateral lip-split cohorts.

Results: Lateral lip splits were associated with higher rates of postoperative complications (p = 0.008), including return to theatre (p = 0.015), and functional issues including asymmetric smile (p = 0.009). No significant differences were observed in readmission rates, length of stay, or time to oral diet commencement (p > 0.05).

Conclusions: Lip-split procedures remain valuable for resection and reconstruction of oral and oropharyngeal tumours. Lateral lip splits are associated with poorer outcomes when compared to central approaches. Appropriate selection of lip splitting approaches should consider tumour location, resection margins, patient comorbidities and preferences, and surgical preferences.

Purpose: X, formerly known as Twitter, is a popular social media platform that facilitates oral and maxillofacial surgeons to disseminate a wide array of information to a global audience. The purpose of this study is to identify the top influencers in oral and maxillofacial surgery on X, characterize who they are, and relate their social media influence to academic influence.

Methods: We utilized the "BuzzSumo" Application Programming Interface to identify the most followed accounts for the topic search "oral and maxillofacial surgery." A secondary calculator from the Mention API was used to assign a numerical score of "influence" based on their algorithm. The top 100 accounts associated with the highest engagement scores were characterized by name, status as an oral and maxillofacial surgeon/organization, location, and academic h-index.

Results: We found that 52/100 (52%) of users/organizations were oral and maxillofacial surgeons/residents. There was no significant correlation between the h-index and the X engagement score, R² = 0.8316 (P = 0.088). In comparison, other specialties have a higher percentage of practitioners using X and have found a correlation between h-index and X engagement score.

Conclusion: Our results indicate there is a demonstrated need for the creation of more educational content from high-ranking academic sources.

Purpose: To evaluate and compare, using finite elements three-dimensional (3D) analysis, two techniques of stable internal fixation in 2 patterns of sagittal split ramus osteotomy (SSRO) and the repercussions of occlusal load distribution in the postoperative period.

Methods: A 3D finite element model of a hemimandible was created. The models were divided into 2 split patterns of SSRO advanced 5 mm forward, a split pattern (1) following the Epker osteotomy design and another split pattern (2) following Posnick osteotomy design, simulated by CAD (Computer Aided Engineering) Rhinoceros 3D^®. Two internal fixation techniques were simulated by HyperMesh: A- one titanium miniplate of the Arnett system (1 mm) for orthognathic surgery fixed with four monocortical screws; B- one titanium plate fixed with four monocortical screws and one bicortical screw. Resistance, stress and displacement were analyzed applying a 200 N vertical load to the occlusal surface region of the mandibular first molar and a 100 N to the incisal surface of the mandibular central incisor.

Results: The results were presented through the von Mises stress analysis. A difference in the displacement of the models fixed with only one miniplate and four monocortical screws was observed. The models with split pattern (2) presented smaller displacements when compared to the split pattern (1). For metallic components, the split pattern (2) exhibits lower strain values, although it has no significant difference.

Conclusion: The fixation technique B proved to be more rigid and lower stress values both in the bone and in the plate, as well as lower deformation and displacements were shown in comparison to fixation technique A for all mandibular movements and forces.

Aim: In recent years, stereotactic ablative radiotherapy (SABR) has been created. Using one or a small number of dosage fractions, SABR enables the hypofractionated treatment of extracranial tumours, delivering a high biologically effective dose with little damage. This review article explores role of stereotactic ablative radiotherapy in head neck cancers.

Material methods: Using the search parameters SABR, stereotactic radiotherapy, and targeted radiation, the publications were found on PubMed and Scopus. For this review, the closest publications to SABR were consulted from the search results that were returned.

Conclusion: In the treatment of patients with recurring and/or previously irradiated head and neck malignancies, SABR is technically possible, well-tolerated, and performs comparably to other salvage therapy options. It also offers the benefit of a quicker course of therapy. Timetable, increased adherence, and secure delivery in the outpatient context. This presents a chance to provide SABR as a therapy option for a limited number of patients. In order to properly administer a highly conformal ablative dosage to targets (or tumours) in the body, SBRT requires sophisticated technologies in radiation planning and imaging guiding. Because of its highly conformal dose distributions and stereotactic spatial precision in administration, SABR is being employed more and more to treat a range of head and neck tumours.

Purpose: This observational, cross-sectional study evaluated healthy Caucasian Brazilian individuals' normal lip dimensions according to sex and age (20-50 years) using stereophotogrammetry.

Methods: A total of 130 individuals divided into four groups according to sex and age were analyzed using stereophotogrammetry. Ten linear lip, five angular lip, and three lip surface measurements (upper, lower, and total lip vermilion) were obtained. Comparisons were performed using two-way ANOVA.

Results: Mouth width, philtrum width, and lower lip cutaneous height were significantly greater in men than women. The upper lip height, upper lip cutaneous height, and average lower vermilion lip angle were significantly larger in men than women and increased with age (group), with medium or large effect sizes. A sex × group interaction was present for total vermilion height, upper vermilion height, total lip height, lower lip height, average upper vermilion lip angle, average Cupid's bow angle, mentolabial angle, and upper and total vermilion lip areas. When factors interact (sex/group), one affects the outcome of the other.

Conclusions: Relevant linear lip measures were greater in men than women and increased with age in a mixed population from 20 to 50 years old. Thus, the lip and mouth are severly impacted by aging.

Purpose: The bizarre parosteal osteochondromatous proliferation (bpop) is a rare lesion that affects long tubular bones of the feet and hands. Since these lesions are even rarer in the jaws, this systematic review aimed to summarize the up-to-date scientific evidence that can guide health professionals on the diagnosis and treatment of bpop in the jaws.

Methods: This prisma-guided and prospero-registered (crd42024524576) review included case reports with confirmed anatomopathological diagnosis of bpop. The articles were searched in november 2024 in the pubmed, scopus, web of science, scielo, cochrane library, embase, and livivo databases and the academic repositories (proquest, open grey, ibict/bdt, and google scholar) without language or publication date restrictions.

Results: Twelve cases of patients aged between 2 and 72 years (mean 26.5 ± 19.8 years) with equal gender distribution were included. Most lesions were clinically described as nodules or swellings (83.5%), asymptomatic (58.3%), with a mean diameter of 15.8 ± 16.2 mm, located in the mandible (58.3%) and anterior region of the jaws (75%). Radiographically, 66.7% of the lesions had well-defined borders and 91.7% were in continuity with the cortical bone. Histopathological findings revealed pleomorphic chondrocytes (83.3%), hypercellular cartilage (83.3%), and 'blue bone' (50%). All bpop lesions were surgically excised and recurrence was observed in 41.7% of cases with a mean follow-up of 8.8 months.

Conclusion: Since bpop demonstrates a recurrent behavior, further investigations with long-term follow-up periods are needed to address its malignancy potential.

Objective: To assess the currently applied regimens of antithrombotic therapy after microvascular reconstruction.

Methods: A systematic literature review was performed using the MEDLINE/PubMed Database for work published until September 2022. Data synthesis and risk of bias were reported in accordance with NIH Study Quality Assessment Tools guidelines.

Results: 204 articles were found including the keywords either in the abstract or in the title. After screening their abstracts and titles, 41 articles were identified as suitable and the full texts were retrieved. 23 studies were included in this review. No gold standard could be shown; on the contrary, the applied antithrombotic regimens varied widely. A broad consensus could be obtained that Dextran should no longer be used after an increased complication rate was proven. The most commonly used agents are unfractionated (UFH) as well as low molecular weight (LMWH) heparin and acetylsalecylic acid (ASA), although the literature results are partly contradictory.

Conclusions: A consensus could be found that it is useful to perform thromboprophylaxis when the patient is immobilized, but there is no evidence for a survival advantage of the flap by chemical prophylaxis. On the contrary, it has been shown that there is an increased rate of bleeding complications and flap loss combined with the simultaneous use of multiple chemical anticoagulants. In conclusion the generalized use of anticoagulation is explained less by microvascular grafting than by general medical risk factors. Thus, large prospective RCTs will be needed to establish a gold standard therapeutic regimen.

Purpose: The aim of this study was to evaluate the alveolar repair process in rats exposed to nicotine after tooth extraction, using ozonised water and low-power laser therapy (LPLT) as therapeutic adjuvants.

Materials and methods: Thirty wistar rats (Rattus Norvegicus) were used and given the nicotine solution via subcutaneous tissue. After 7 days, the upper right central incisor was surgically extracted. Three days after the surgical procedure, the animals continued to receive nicotine until the day of euthanasia, totalling 21 days after extraction.

Results: The result was that the groups that received coadjuvant therapy had neoformed mature bone, unlike the group that did not receive it.

Conclusions: Based on the literature and the results obtained, we can conclude that nicotine negatively influenced the healing process and bone repair in the alveoli; however, the use of ozonised water and LPLT, even in the presence of nicotine, was effective, as it enhanced the repair process, making them good options for surgical procedures in patients who smoke.