Oral and Maxillofacial Surgery-Heidelberg最新文献

Purpose: The purpose of this study was to investigate the aesthetics evaluation of four smile-related characteristics among different genders and professional subgroups, including dental professionals (DPs), non-dental healthcare professionals (NDPs), and laypersons (LPs).

Methods: Smile photographs were selected and digitally manipulated to determine changes in various smile aesthetic parameters (lip thickness ratio, smile line/smile index, upper lip curvature, and smile arc/dental curvature). These altered images were rated by Chinese participants (dental professionals, non-dental healthcare professionals, and laypersons). A total of 1469 subjects were recruited to complete the questionnaire. Smile aesthetics ratings were calculated, and comparisons between groups were made.

Results: All respondents chose 1:1.5 lip thickness ratio, average smile line, upward upper lip curvature, and upward dental curvature (consonant smile arc) parallel to the lower lip curvature smile arc as the most attractive. Dental professionals (DPs) more focus on smile aesthetics compared to the others(p < 0.01). Significant differences were detected in the perception of smile-related characteristics across gender and professional subgroups(p < 0.05). In addition, there were significant differences in the attractiveness ratings for smiles among professional subgroups(p < 0.05). The most important factor influencing smile aesthetics in the present study was smile arc.

Conclusion: The smile-related characteristics of the smile, such as the lip thickness ratio, smile line, upper lip curvature, and smile arc are predominant factors influencing smile attractiveness and should be given priority when considering and managing aesthetic treatment plans. Females and DPs are more critical of smile aesthetics, and DPs are also focused more on smile aesthetics than laypersons. So it is necessary to account for the influence of gender and profession on personal evaluation and treatment plans.

Purpose: The purpose of this study was to evaluate differences in Oral Health-Related Quality of Life (OHRQoL) among orthognathic patients with different skeletal malocclusions before initiating orthodontic treatment.

Methods: 150 patients were evaluated for OHRQoL at the Oral and Maxillofacial Surgery Department at Boston University Goldman School of Dental Medicine. OHRQoL was measured using: (1) Oral Health Impact Profile-14 (OHIP-14) for generic OHRQoL; (2) Orthognathic Quality of Life Questionnaire (OQLQ) for condition-specific OHRQoL; and (3) the 12-item oral quality of life instrument (12-item OQOL) for generic OHRQoL. Cephalometric measurements were used to categorize facial types then two-sample t-tests and one-way ANOVAs were employed to analyze OHRQoL across groups.

Results: OHIP-14, OQLQ, and 12-item OQOL baseline scores were statistically different between skeletal Class I, II, and III patients (p < 0.05), with Class II patients showing the highest scores. No significant differences were found between vertical patterns (p > 0.05).

Conclusion: OHRQoL is different between skeletal Class I, II, and III patients with Class II patients reporting lower quality of life.

Introduction: Cleft lip and/or cleft palate (CLP) is among the most prevalent congenital anomalies, with significant long-term impacts on oral health and psychosocial well-being. Despite multiple surgeries aimed at enhancing both functionality and aesthetics, individuals' perceptions of quality of life (QoL) can vary widely. This study sought to examine the long-term effects of corrective surgeries for orofacial clefts (OFC) on oral health-related quality of life (OHRQoL) in South India, comparing outcomes between treated CLP patients and apparently healthy individuals.

Materials and methods: The study included 200 treated CLP patients and 200 healthy controls. Oral Health Impact Profile (OHIP) -14 scale was utilized to assess OHRQoL.

Results: Data analysis compared OHRQoL between the study group and controls. Treated CLP patients exhibited significantly poorer OHRQoL compared to healthy controls across various parameters. While surgical intervention improved certain aspects, challenges in pronunciation, taste sensation, discomfort, and psychological strain persisted. Internal consistency of the OHIP-14 questionnaire was excellent.

Conclusions: The findings emphasize the need for comprehensive care beyond surgery, including psychological support, to address the enduring effects on OHRQoL among CLP patients. Further research is warranted to explore long-term effects and cultural considerations for better supporting this patient population.

This is a comment on published article on primary surgery of subcondylar mandibular fracture using patient-specific implant.

Aim: Since aging leads to changes in facial angles, the effect of age on impressions of facial appearance involves factors such as face shape, eye color, nose size and placement, and mouth size and placement, as well as skin morphological and tonal characteristics, including wrinkles, spots, and sagging. Identifying the extent of change in facial angles can aid surgeons in interpreting facial landmarks before nasal surgery. Hence, this study evaluated changes in facial angles at different positions in a cohort of older Asian patients.

Methods: This study enrolled 47 patients admitted for nasal surgeries, including 33 men (70.2%) and 14 women (29.8%). The average age was 48.15 ± 18.7. Nasolabial, nasofrontal, nasomental, and nasofacial angles were measured in the sitting, supine, and neck extension positions. Patients were divided into two groups: younger (≤ 60 years, n = 28) and older (> 60 years, n = 19) to evaluate the effect of age on facial angles.

Results: The supine-extension nasofacial (p = 0.031) and nasomental (p = 0.023) angles decreased with age. Concurrently, nasolabial angles increased with age in the sitting-supine position (p = 0.012) and sitting-extension positions (p = 0.019). Additionally, the analysis of variance and regression model demonstrated a decrease of 0.019°/year in nasofacial angle between the supine and neck extension positions, whereas the nasomental angle between these positions declined by 0.032°/year. In contrast, between the sitting and supine postures and the sitting and extension positions, the absolute difference in nasolabial angles increased (0.140°/year and 0.128°/year).

Conclusion: This preliminary study showed that facial angle characteristics changed more between different postures in the older age group; thus, clinicians should exercise caution when performing aesthetic nasal procedures in older patients.

Background: Bone defects, particularly in the mandible, pose significant clinical challenges due to the limited regenerative capacity. Effective bone tissue engineering requires biomaterials that promote both osteogenesis and angiogenesis. This study developed an optimized collagen-nano hydroxyapatite scaffold loaded with dexamethasone and stem cells to enhance bone regeneration.

Methods: The scaffold was fabricated using the freeze-dryer method. Characterization was performed using Fourier Transform Infrared Spectroscopy (FTIR), energy-dispersive X-ray (EDX) analysis, and scanning electron microscopy (SEM). Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) were incorporated into the scaffold, and in vitro and in vivo assessments were conducted.

Results: FTIR and EDX analyses confirmed the successful incorporation of nano-hydroxyapatite and dexamethasone. SEM revealed an interconnected porous structure with an average pore size of 28.55 µm. The scaffold loaded with WJ-MSCs significantly enhanced osteocyte and osteoblast populations, leading to improved mandibular bone formation. Histopathological evaluations demonstrated superior osteogenesis and angiogenesis.

Conclusion: The developed porous nanohybrid scaffold shows potential as a promising biomaterial for bone tissue engineering applications.

Purpose: To evaluate the radioanatomical measurements of the zygoma as a guide for treatment planning of quad zygomatic implant placement.

Methods: This cross sectional study was carried on 17 patients of 34 zygomatic regions reported with atrophic maxilla for placement of zygomatic implants. The zygomatic implants were placed virtually in a quad approach using "Real Guide" version 3.0" and, the following parameters were assessed at 20 points in antero- superior, antero-inferior, postero-superior and postero-inferior regions. The thickness of zygomatic bone, Installation angle of zygomatic implants, Length of the installed zygomatic implants and Distance between the zygomatic implants on each side were measured using Cone Beam Computed Tomography (CBCT) on a virtual planning software "Materialise Mimics" version 15.

Results: The mesial implant can be emerged in antero-superior region and the distal implant can be emerged in antero-inferior region on the right side zygoma since the maximum thickness of zygomatic bone was seen in D2, A1, A3 and D4 directions. Similarly in the left side of zygoma, the mesial implant can emerge in postero-superior region and distal implant can be emerge in postero-inferior region since the maximum thickness was seen in D2 and A3 directions (P > 0.05). The installation angle for mesial implant in right and left side was 45⁰ and the distal implant angle for right and left side was 45⁰ and 46⁰ (P < 0.05). The mesial zygomatic implant length for right and left side was 55.88 mm and 56.18 mm while, the distal zygomatic implant length for right and left side was 44.56 mm and 45.59 mm (P > 0.05). The distance between the two zygomatic implants in right and left side was 5.06 mm and 4.54 mm (P > 0.05).

Conclusion: Virtual planning for placement of implants in quad zygoma approach would be a feasible requirement as it eases out the surgeon's practice and prevents the possibilities of causing intrusion complications intraoperatively. Hence, quad zygoma implants remains a promising viable option for patients presenting with severe atrophic maxilla.

Clinical trial number: Not Applicable.

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.