Journal of Maxillofacial & Oral Surgery最新文献

Purpose: Despite there being different materials for orbital floor reconstruction available today, outcomes are still not satisfying. In recent years, ultra-high molecular weight polyethylene (UHMWPE) has gained popularity in the field of orthopedic surgery due to its good biocompatibility and low infection rate. With its three-dimensional compound structure, it combines high stability and ductility, making it a potential material to be used for orbital floor reconstruction.

Methods: In a cadaver study, an overall of eighteen orbits were included. Fractures of the inferior wall were induced and then reconstructed using Polyglactin 910/PDS composite (Ethisorb) and UHMWPE (marPOR). Orbits were scanned by cone-beam CT in each condition: Intact, fractured and reconstructed with Ethisorb, marPOR 0.85 mm and marPOR 1.5 mm. Segmented orbital volumes were calculated by specialized software (Disior bonelogic CMF).

Results: All materials led to sufficient reconstruction of the initial orbital volumes (Ethisorb: p < 0.001; marPOR 0.85 mm: p = 0.003; marPOR 1.5 mm: p < 0.001). Orbits that were reconstructed with marPOR 0.85 mm showed the least mean volume difference from intact orbital volumes.

Conclusion: UHMWPE (marPOR) offers reliable reconstruction of orbital floor fractures combined with good stability, ductility and biocompatibility.

Osteoradionecrosis (ORN) is a nemesis of radiotherapy which adversely affects the life of an individual. It is more often seen with conventional external beam radiotherapy using telecobalt machine. Newer radiotherapy techniques are being used in developed nations to circumvent its inherent disadvantages. A higher incidence of ORN is seen in dentate jaws because of extractions done for odontogenic infections in the post radiation period. Systematic evaluation of oral tissues and instituting appropriate therapeutic and prophylactic measures before, during and after completion of radiotherapy is mandatory. In our hospital since we use telecobalt radiotherapy it was deemed necessary to design our own protocol to reduce the incidence of this debilitating complication. Our protocol is based on recommended guidelines and which has been customized to our patient strata. We present the findings of a retrospective study on patients undergoing radiotherapy in whom this oral management protocol was used. This protocol has been effective in reducing the frequency of osteoradionecrosis at our tertiary care hospital.

Introduction: In this review, we aim to assess the categorical distribution of publications in 3 leading general OMS journals, British Journal of Oral and Maxillofacial Surgery (BJOMS), International Journal of Oral and Maxillofacial Surgery (IJOMS), Journal of Oral and Maxillofacial Surgery (JOMS) over the span of 21-years.

Method: We examined all full-length publications between 1998 and 2018 in 3 OMS journals (IJOMS, BJOMS, JOMS) and categorised into 16 pre-determined categories. These included facial aesthetic, anatomical, craniofacial, implantology, pre-prosthetic, oncology, orthognathic, pathology, pharmacology, radiology, reconstruction, obstructive sleep apnoea (OSA), technical notes, third molar, temporomandibular joint, and trauma. Statistical analysis was conducted to analyse the proportional changes in these categories over 2 time periods.

Results: A total of 14,324 articles were analysed. This included 3745 articles in IJOMS, 7229 from JOMS, and 3745 from BJOMS. The areas of greatest change were seen with a statistically significant increase in the field of orthodontics, OSA, and implantology in 2 of the 3 journals. There was a marked reduction proportion of case reports/series over this period.

Conclusions: The subject areas where there has been a proportional increase in publications included orthognathics, implantology, and sleep-related studies. Most other subject areas remain unchanged with a decrease noted in pathology-related articles.

Objective: The purpose of this study was to assess the epidemiologic factors associated with maxillofacial infections in a sample of Iranian patients.

Methods and materials: A number of 209 patients, who admitted to Kamyab hospital due to maxillofacial infections, were recruited in this 5-year cross-sectional study. Multiple variables including the offending tooth, type of abscess, clinical signs and symptoms, the type of prescribed antibiotic, type of anesthesia, employed surgical technique, period of hospitalization, and postoperative complications were analyzed using SPSS software.

Results: 123 males and 86 females, with an average age of 35.45 ± 14.19 years, were studied. It was noticed that 27.8% of patients had a habit of smoking or tobacco use, 16.8% had been diagnosed with an underlying disease and 12.4% were alcohol consumers. It was reported that the mandibular third molar was the most offending tooth (26.8%) and the submandibular area was most infected site (51.6%). Swelling and Ludwig's angina were the most frequent symptom and complication, respectively. Clindamycin was the empirical antibiotic of choice.

Conclusion: Facial space abscesses can rapidly progress and cause irreversible consequences. Patients with a systemic disease and also those suffering from pterygomandibular and submasseteric infections had a longer hospital stay compared to others.

Purpose: The purpose of the present study was to translate and culturally validate the University of Washington Quality of Life Questionnaire, Version 4.1 (UW-QOL v4.1) in Malayalam, a language commonly used in the state of Kerala in India.

Methods: The tool underwent translation and adaptation. The translated instrument then underwent a pretest survey in 30 patients. The intention was to identify any problems with the questionnaire when applied to the participants and make any minor changes if required. This was followed by validation in 100 patients. The reliability was tested for internal consistency with Cronbach's alpha. Concurrent validity was tested by correlating it with the concurrently administered FACT-HN questionnaire scores. Construct validity was tested using 'Known-group validity.'

Results: Pretest survey did not identify any major problems. There was a moderate to strong correlation between the PF, SEF subscales and the composite scores on UW-QOL scores and the Head and Neck Cancer subscale and the FACT-H&N Total score. QOL scores were more in early staged patients and those who underwent no reconstructive procedure. This proved the construct validity.

Conclusion: This study validates the Malayalam version of the UW-QOL instrument. It is reliable, valid and culturally adapted.

Tuberculosis (TB) manifests in various forms, including extrapulmonary tuberculosis (EPTB), which poses diagnostic dilemmas due to its wide-ranging clinical presentations. When TB affects the bones of the hands and feet, it can present a diagnostic labyrinth for clinicians. In such cases, the differential diagnosis may include Jungling's bone disease, adding complexity to the diagnostic process. We present the case of a 12-year-old female with an 8-week history of swelling over the left lower eyelid, initially suggestive of an osteolytic lesion. There was no family history of tuberculosis. The vaccination status was completed as per the age of the patient. Further investigations revealed mesenteric and retroperitoneal lymphadenopathy, raising suspicion of Langerhans cell histiocytosis. However, histopathological examination confirmed granulomatous inflammation consistent with tuberculosis. Concurrently, the patient developed swelling over the distal metaphyseal joint of the right foot with early onset pain, prompting consideration of Jungling's bone disease in the differential diagnosis. Scrofuloderma, a rare manifestation of tuberculosis (TB), mimicked ocular TB (OTB) in our case, underscoring the complexity of diagnosis. Orbital involvement of TB, especially in pediatric patients, is uncommon, making it challenging to recognize. The manifestation of Jungling's bone disease further contributes to the rarity and complexity of the diagnosis. Additionally, the presence of submandibular lymphadenopathy added to the diagnostic challenge, emphasizing the necessity for comprehensive evaluation in such cases. This case underscores the importance of considering unusual presentations of TB, especially in endemic regions. Prompt diagnosis and treatment are crucial to prevent morbidity and highlight the significance of a multidisciplinary approach in managing such cases.

Introduction: Sinus augmentation requires careful manipulation of the Schneider membrane. Perforation of the membrane can be a challenging complication.

Objectives: The objective of this study is to evaluate the sexual dimorphism of Schneider membrane (sinus membrane) using cone-beam computed tomography (CBCT) imaging modality and discuss its clinical applications vis-à-vis the sinus lift procedure for dental implants and also its forensic implications.

Materials and methods: One hundred CBCT scans in the maxillary first molar region of fifty men and fifty women in the age group of 25-50 years were examined at two standardized points on the floor and lateral wall of maxillary sinus, and its mean was obtained. Measurements were taken for thickness of sinus membrane at most prominent antero-posterior and mesio-distal dimensions. The mean sinus membrane thickness and correlation in age groups (25-35 and 36-50 years) of both the genders were evaluated statistically.

Results: The results showed a thicker sinus membrane in women, especially in 36-50 age group than that of men.

Conclusion: This study correlates the thickness of the sinus membrane with gender dimorphism and delves on its association with the risk of perforation during sinus lift procedures and also its forensic implications.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-021-01531-2.

Background: Syndromic craniosynostosis is characterized by premature fusion of cranial sutures resulting in midface deficiency. Lefort III Distraction Osteogenesis (DO) has emerged as an effective surgical intervention for addressing this complex condition. This case series outlines the outcomes, encountered difficulties, and insights gained through the utilization of Lefort III Distraction Osteogenesis (DO). Six patients (age range: 8-18 years) diagnosed with syndromic craniosynostosis underwent Lefort III DO for midface deficiency correction.

Methods: Comprehensive preoperative orthodontic preparation and meticulous surgical planning were executed. The present paper highlighted the promising outcomes with Lefort III DO, such as significant advancements in midface projection, enhanced posterior pharyngeal space, improved ocular position, and the establishment of functional occlusion.

Results: However, some complications such as CSF blepharocele, pin-tract infection, cranial pin perforation, and loosening of the halo frame were encountered. These challenges were addressed with prompt intervention and close postoperative monitoring. Lefort III DO emerges as a valuable approach in effectively addressing midface deficiency in syndromic craniosynostosis patients. While yielding favorable outcomes in terms of facial aesthetics and function, it requires meticulous surgical technique and vigilant postoperative care to address potential complications.

Conclusion: This paper contributes insights into the effective management and potential challenges associated with Lefort III DO in treating midface deficiency in syndromic craniosynostosis patients.