Journal of Maxillofacial & Oral Surgery最新文献

Objective: This study aims to present surgical experience and clinical outcomes regarding the reconstruction for malignancy-induced midfacial skin defects using varying patterns of cervicofacial advancement-rotational flaps (CARFs).

Methods: This is a descriptive study, and 25 patients with midfacial skin defect participated in this study. Defect repair was performed using CARF and descriptive statistics were used in data analysis.

Results: The CARF was designed over perforators arising from branches of the anterior-based external carotid artery in all patients. 48% of the patients developed midfacial skin defects due to basal cell carcinoma, and 40% due to squamous cell carcinoma. Two patients developed ectropion, one patient developed base positivity, and one patient developed necrosis distal to the flap.

Discussion: The CARF has a good pattern and minimal tension, thus closing midface skin defects without bunching. The reconstruction for midfacial skin defects with CARF decreases both functional and aesthetic morbidity and improves patient outcomes.

Introduction: Current management of oral potentially malignant disorders (OPMDs) based on dysplasia grading is controversial. The malignant transformation rate of OPMDs does not correlate well with dysplasia grading, resulting in non-standardized treatment for patients. A quantitative biomarker-based risk score (qBRS; trade name StraticyteTM) was previously developed to address shortcomings related to the current standard of care. A multicenter, retrospective cohort study consisting of biopsied OPMDs was used to validate qBRS for predicting transformation of OPMDs to OSCC.

Materials & methods: Three hundred and two cases were immunostained, imaged, and analyzed via qBRS. A binary prognostic risk was determined using a receiver operating characteristic curve optimizing sensitivity and specificity. Kaplan-Meier analysis was used to estimate the cumulative probability of lack of malignant transformation for patients with elevated or normal biomarker-based risk.

Results: The results demonstrated very high sensitivity (96.2%) and negative predictive value (96.2%) for qBRS. Elevated risk scores had higher predicted probabilities of transformation to cancer, independent of dysplasia grade.

Conclusions: qBRS can be a useful clinical adjunct tool to dysplasia grading for the assessment of malignant transformation potential, providing a quantitative metric in OPMDs. The addition of qBRS to current histological techniques should improve early detection rates of OSCC, enhancing the effectiveness of treatment.

Objective: To systematically review the effect of applying mesenchymal stem cells (MSCs) and gene-therapy approach on the bone formation of the distracted area in the maxillofacial region.

Study design: Studies that delivered genetically modified or unmodified MSCs or used gene-therapy methods without MSCs delivery for the mandibular or maxillary distraction osteogenesis (DO) treatment in both human and animal models were included.

Results: From a total of 720, 32 animal studies and one human study were included. Results of human study showed that the injection of bone marrow MSCs has no significant complications and can induce significant bone formation. Results of animal studies showed that applying of MSCs as the study group results in higher values of bone formation variables, namely new bone formation and volume, bone volume/total tissue volume, bone mineral density and thickness of the new trabeculae compared to control group. Meta-analysis revealed that in rabbit models, significant increase was observed in the bone formation percentage after MSCs injection. In the goat models, stem cell injection showed significant increase in trabecular thickness.

Conclusion: In animal models, the use of MSCs in distraction osteogenesis (DO) treatment of the maxillofacial region did not result in significant complications and showed potential positive outcomes on bone formation. However, more clinical and animal studies with a lower risk of bias are required to fully establish the efficacy and safety of this approach.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-025-02434-2.

Introduction: A good anesthetic and analgesic effect is crucial for any minor surgical treatment to be successful. 2% Lignocaine hydrochloride with Adrenaline (1:80,000) is the most commonly used local anesthetic. However, it is not recommended for long procedures or in patients with cardiovascular diseases, where adrenaline is not desirable. Hence, need arises for a local anesthetic which has longer duration of action and adequate analgesic effect with minimal adverse reaction. 0.5% Ropivacaine is a long-acting amide local anesthetic with vasoconstrictive properties. It is considered to have superior properties compared to lignocaine in terms of duration of action and need for analgesics. This study compared the efficacy of 0.5% Ropivacaine versus 2% Lignocaine Hydrochloride with Adrenaline (1:80,000) in the surgical removal of impacted mandibular third molars.

Materials and method: A prospective, randomized, split mouth, cross over study was conducted amount 33 patients indicated for surgical extraction of impacted mandibular third molar. Extraction of one side was done using 2% Lignocaine with Adrenaline (1:80,000) and the opposite side was extracted one week later using 0.5% Ropivacaine. Parameters assessed were, pain on injection, time of onset of the local anesthetic, the depth and duration of anesthesia, intensity of pain and need for analgesics postoperatively.

Results: There was no statistically significant difference between the two groups in terms of pain on injection. Time of onset was noted to be faster in the Lignocaine group. Ropivacaine was found to be superior to Lignocaine in terms of depth and duration of anesthesia and the postoperative analgesic effect. No adverse effect were noted in either of the two study groups.

Conclusion: 0.5% Ropivacaine can be a suitable alternative to 2% Lignocaine in minor surgical procedures of long duration and in conditions, where the use of vasoconstrictor is contraindicated. It also provides an added benefit of greater depth of penetration into the bone along with a postoperative analgesic effect, thereby increasing the patient comfort. However, further study on a larger sample size is necessary to determine the overall effectiveness and practicality of using Ropivacine as an alternative to lignocaine in minor oral surgical procedures.

Introduction: The ZMC complex is crucial for orbital integrity as it forms most of the lateral wall and the floor of the orbit. Therefore, the fracture of the zygomaticomaxillary complex destroys the orbital skeleton causing various types of ophthalmic injuries in about 2.7 to 96% of cases. The variability of clinical features is due to differences in the amount of energy delivered, the impact vector, and the duration of the impact of energy.

Aim: To study the demographic distribution and clinical manifestation of different types of ophthalmic injuries in patients associated with ZMC fractures and to understand the need for evaluation by an ophthalmologist.

Objectives: To study the common fracture patterns, sex and age demographics, and etiology of ZMC fractures. To study the presence of various types of clinical manifestation in ZMC fractures.

Materials & methods: A retrospective study was conducted by the Manipal College of Dental Sciences, Manipal, Karnataka, India, by the Department of Oral and Maxillofacial Surgery studying ophthalmic consideration and clinical manifestation of patients having zygomaticomaxillary complex fracture from February 2019 to December 2022. Data collection was done from patient files and subjected to descriptive statistics.

Results: It was found that the affected population is mainly Indian males in the second decade of their life mostly due to road traffic accidents. A variety of ophthalmic injuries was noted. Periorbital oedema and ecchymosis are the most common ones.

Objective: To examine the effect of Kinesio taping on postoperative trismus, and soft tissue oedema and pain after surgical removal of impacted mandibular third molars.

Materials and methods: Forty patients with impacted mandibular third molars who required surgical extraction were randomly selected and allotted into two groups, a control and a study, and the patients in the study group were applied Kinesio Tape 2m*5m for 3 days postoperatively. In both groups, pain, trismus, and swelling preoperatively and postoperatively on day 3 and day 7 were measured. Facial swelling was measured using a flexible scale, using a five-point measurement, trismus using Vernier callipers, and pain using visual analogue scale.

Results: Forty patients were followed up for 7 days, and swelling, pain, and trismus were measured. Results showed significant improvement in trismus and swelling on postoperative day 3 and 7 in the study group.

Conclusion: The application of Kinesio tape is a non-invasive, easy economical, and medically relevant approach.

Introduction: Sagittal split osteotomy is a standard procedure performed by maxillofacial surgeons. Patients usually present with either aesthetic or functional concerns. Surgical landmark identification is crucial to a successful surgical procedure. Various diagnostic preoperative tools have been used to identify these landmarks, such as imaging studies or cadaveric dissections. The cone-beam computed tomography (CBCT) is currently the most common preoperative tool used.

Aim: This study aims to identify whether the deepest part of the ascending ramus (coronoid notch) distance to the mandibular lingula can be used as a safe reference prior to performing medial horizontal osteotomies.

Materials & methods: Data were extracted from a database of patients who underwent CBCT scanning for various reasons. A total of 313 CBCT scans were included in this study. Patients younger than 18 years, with a history of mandibular pathology, or whose scans were suboptimal were excluded. Statistical analysis was performed via IBM SPSS v29 (IBM Corp., Armonk, NY, U.S.), and the predetermined p-value was < 0.05. Statistical significance was present in both the right and left measurements.

Results: A total of 313 (626 sides) CBCT were included in this study. Most patients were of the female gender, with 171 scans (54.6%) and 142 scans (45.4%) from males. Our study focused on the distance from the specific reference point, the coronoid notch (the most concave point at the ascending ramus in the retromolar area), to the anterior part of the mandibular lingula. For the total sample, the standard deviations for each side were 2.25 (p-value = < 0.001) and 2.07 (p-value = 0.003), left and right, respectively. This finding indicated that the distances on each side were statistically significant.

Conclusion: The authors suggest that the anterior aspect of the ramus can be used as a reference point for horizontal medial osteotomy, as both distances were statistically significant. This finding has important implications for the safety and efficiency of bilateral sagittal split osteotomy procedures, as it provides a reliable reference point for surgeons to use during the procedure, potentially reducing the risk of complications, surgical time, and improving patient outcomes.

Introduction: The preservation of the alveolar ridge following tooth extraction is important for maintaining optimal dental health and ensuring successful future dental interventions. Various techniques for alveolar ridge preservation are done, including socket grafting and the use of biomaterials, membranes, and growth factors, which have a plenty of clinical benefits, such as improved aesthetics and stability for dental implants along with potential cost-effectiveness compared to more invasive procedures, thus optimizing treatment outcomes and promoting long-term dental health.

Aim: To assess the effectiveness of bone graft material and collagen membrane for ridge preservation following tooth extraction compared to tooth extraction alone group.

Materials and method: Ninety patients presenting with the need for extraction were included in this study.They were divided into three groups. In group A, the socket was filled with bone allograft and protected with a fish derived collagen membrane without buccal thickness flap. In group B, buccal/labial thickness flap was elevated, socket was filled with bone allograft and protected with a fish derived collagen membrane barrier, and in group C, no bone graft and collagen membranes were placed.

Results: Showed that group A is much more beneficial and simpler than the group B procedures.

Conclusion: Bone regeneration using collagen membranes and inorganic bovine bone combination seems promising. But, there is obviously a need for long-term studies to confirm the success rate of ridge preservation procedures using buccal full thickness flap and without buccal full thickness flap.

A schwannoma is a benign, slow-growing peripheral nerve sheath tumour that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. Preoperative diagnosis of schwannoma is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumours by CT or MRI and prompt management is warranted to prevent the development of severe complications. Authors would like to present here one such case of orbital schwannoma and management of the same.