Journal of Maxillofacial & Oral Surgery最新文献

Background: 'Temporomandibular joint disorders (TMDs)' denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. The indications for the available 'oral splints' or 'oral orthotic occlusal devices' remain ambiguous.

Methods: A joint international consortium was formulated involving the subject experts at TMJ Foundation, to resolve the current ambiguity regarding the use of oral orthotic occlusal appliance therapy for the temporomandibular joint disorders based on the current scientific and clinical evidence.

Results: The recommendations and the conclusion of the clinical experts of the joint international consort has been summarized for understanding the indications of the various available oral orthotic occlusal appliances and to aid in the future research on oral occlusal orthotics.

Conclusion: The use of the oral orthotic occlusal appliances should be based on the current available scientific evidence, rather than the archaic protocols.

Objective: A specific type of mesenchymal stem/progenitor cells (MSPCs), CD105⁺ is reported to aid in cartilage regeneration through TGF-β/Smad2-signalling. The purpose of this study was to identify and characterize CD105⁺ MSPCs in temporomandibular joint (TMJ) cartilage.

Materials and methods: MSPCs were isolated from mouse TMJ condyle explants and evaluated for their clonogenicity and pluripotential abilities. MSPC were examined for CD105 antigen using immunohistochemistry and flow cytometry.

Results: Immunohistochemistry revealed presence of CD105⁺ MSPCs in the proliferative zone of condyle's cartilage. Only 0.2% of isolated MSPCs exhibited CD105, along with the stem cell surface markers CD44 and Sca-1. In CD105⁺ MSPCs, intracellular immunostaining revealed significantly higher (p < 0.05) protein levels of collagen type 1, 2, proteoglycan 4. Ability for chondrogenic differentiation was found to be significantly higher (p < 0.05) after 4 weeks compared to CD105^- cells, using alcian blue staining. CD105⁺ cells were found to resemble an early MSPC subgroup with significantly higher gene expression of biglycan, proteoglycan 4, collagen type 2, Gli2, Sox5 (p < 0.001) and Sox9 (p < 0.05). In contrast, significantly lower levels of Runx2 (p < 0.05), Osterix, Trps1, Col10a1 (p < 0.01), Ihh (p < 0.001) related to chondrocyte senescence and commitment to osteogenic lineage, were observed compared to CD105^- cells.

Conclusion: The study showed the existence of a CD105⁺ MSPC subgroup within TMJ fibrocartilage that may be activated to aid in fibrocartilage repair.

Palatal swellings are a commonly encountered diagnostic entity. They can be infectious, neoplastic, odontogenic, vascular, congenital or secondary manifestation of a systemic disease. While individual palatal lesions are well documented in the literature, there is lack of a comprehensive classification of such entities. Proper classification helps in prompt and accurate diagnosis, facilitating proper management. This article proposes a comprehensive classification of palatal swellings based on their location, clinical findings and aetiology, and describes a case report of pleomorphic adenoma of the minor salivary gland of the palate.

Background: Oral and maxillofacial surgery deals with wide range of oral defects, wound closure, tissue resection, and tissue reconstruction. The purpose of our study is to use amniotic membrane for closure of post surgery defect in patient of oral submucous fibrosis to utilize its growth factor and scaffold nature for effective healing and to evaluate effectiveness of amniotic membrane in treatment outcome. The objectives are to compare post-operative mouth opening, healing of amniotic membrane and buccal fat pad.

Material and method: Diagnosed patients with OSMF are divided into two surgical site Group I (n = 5patients)-Left side buccal mucosa in which resection of fibrous band with coronoidectomy followed by reconstruction of the mucosal defect with BFP. Group II-Right side buccal mucosa in which resection of fibrous band with coronoidectomy followed by reconstruction of the mucosal defect with freeze dried irradiated amniotic membrane.

Result: This study suggested that in comparison to buccal fat pad flap, the HAM graft is a better option for oral reconstruction in terms of infection, graft failure, MMO, inflammation, pain. Outcome indicated that the HAM is biologically ideal graft for oral wounds and could be used as clinical alternative for various repair surgery for oral defects.

Conclusion: The amniotic membrane was found easy to handle and easy to use with inherent hemostatic property which is observed in all patients. No patients had shown any evidence of any complications. Good pain control observed in patients throughout postoperative period.

Objective: The objective of the study was to detect the accuracy of Magnetic Resonance Imaging (MRI) in assessing tumor depth of invasion (DOI) in squamous cell carcinoma (SCC) of the tongue.

Material and methods: The electronic search of PubMed (including MEDLINE), COCHRANE CENTRAL and Google Scholar search engine for articles published from January 1, 2000, to September 31, 2021, was conducted and also searched the lists of references of relevant articles and reviews for studies involving patients with squamous cell carcinoma of the tongue.

Results: A total of 5362 articles were retrieved in the initial search. After the initial search process, 13 full-text articles were reviewed. Out of these 13 articles, seven met the inclusion criteria and were thus included in this systematic review.

Conclusion: The MRI-determined DOI based on T1-weighted sequences increases with increasing T stage. There is the highest correlation between the MRI-derived DOI and the histopathological DOI with increasing T stage. Therefore, MRI provides satisfactory diagnostic accuracy for measuring tumor DOI and, thus, may be considered a predictor of tumor stage.

Introduction: The residual post-COVID maxillary mucormycosis defect (PCMMD) were extensive, due to unilateral or bilateral maxillectomies. The Goal of rehabilitation of PCMMD is to deliver a prosthetically driven reconstruction. FEA was to evaluate the biomechanical response of PSI struts (PSI 1), PSI Screw retained (PSI 2) and QZI to masticatory load on virtual simulation to improve accuracy and enhance the design.

Aim: To validate and compare the Biomechanical benefit of the PSI struts, PSI Screw retained, QZI in a case of rehabilitation of post-COVID maxillary mucormycosis defect (PCMMD) by FEA study.

Methodology: The result of stress to masticatory load on virtual simulation for (1) Maximum and minimum stress (Von Mises stress); (2) the Displacement (in three positions) and (3) the Deformation (Plastic strain) was compared on virtual simulation for PSI 1 and PSI 2 and QZI.

Conclusion: The FEA and comparative evaluation of PSI 1, PSI 2 and QZI showed a good resistance to displacement. The stress and strain values are low and acceptable. In comparison QZI shows more stress in the anterior region.

Introduction: Patients affected with mucormycosis of maxilla have been increasing following Covid-19 infections. We followed the reconstruction of the maxilla using 3D manufactured patient-specific implants. The additive manufacturing technology is capable of fabricating custom-made titanium implants precisely for oral and maxillofacial reconstructions.

Aim: To analyse the effectiveness of 3D manufactured patient-specific implants in the reconstruction of maxilla affected by mucormycosis secondary to Covid-19. Methodology: This study was conducted among 20 patients receiving patient-specific implants for surgical and prosthetic reconstruction of the maxilla. The parameters analysed at baseline, 3 months, 6 months, and 12 months were pain, implant exposure, infection, wound dehiscence, fit of implant, postoperative surgical rating scale, and patient experience evaluation rating scale.

Results: Inferential Statistics revealed a positive correlation.

Conclusion: From the present data, it can be concluded that within the limitations of the study, patient-specific implant systems are an effective treatment strategy for the reconstruction of the maxilla affected by mucormycosis secondary to Covid-19. More studies with larger sample size and longer follow-up periods are required to substantiate the results from the present study.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-023-01922-7.

Aim: To systematically review the existing scientific literature, to summarize and assess the efficacy of the nasal floor augmentation on the survival rate of dental implants by systematically reviewing the available literature.

Methodology: Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO-CRD42027289143. Electronic databases like PubMed, google scholar and Ebsco Host were searched from 2000 to December 2021 for studies reporting efficacy of nasal floor augmentation and reporting outcomes in terms of survival rates of dental implants. Quality assessment of included comparative follow-up studies was done using the critical checklist put forward by the Joanna Briggs Institute (JBI) was used.

Results: Only nine studies fulfilled the eligibility criteria and were included in the qualitative synthesis. Of those nine studies, five were case reports and four comparative follow-up studies. A total of 14 implants were placed in five patients with a survival rate of 100% in included case reports, while a total of 408 implants were placed in 130 patients with survival rates ranging from 89% to 100% in included comparative follow-up studies. No complications were observed during follow-ups, and the patients were satisfied with the functional and aesthetic results of the treatment. Quality assessment of included studies showed moderate to low risk of bias with overall high quality of studies.

Conclusion: The results of this systematic review indicate that implant placement by nasal floor augmentation techniques can be considered as a predictable treatment modality. However, due to the scarcity of literature, more studies should be carried out on proving the efficacy of nasal floor augmentation on survival rate or success of dental Implants.

Background: Maxillofacial tuberculosis is a diagnostic challenge for surgeons. The aim of this study was to present a detailed analysis of Xpert test in diagnosing maxillofacial tuberculosis and to analyse the accuracy of Xpert test results for various tissues of maxillofacial region.

Materials and methods: In this cross-sectional study, patients were selected randomly from outpatient department. The patients who had clinical picture and differential diagnosis highly suggestive of maxillofacial tuberculosis were included. Patients were divided into three different groups depending upon the site of involvement. The samples collected from the patients were further subdivided depending upon the type of specimen. Patients were screened first by routine tests, and the negative cases were followed by Xpert test for tuberculosis.

Results: A total of 54 patients were enrolled in the study, 13 patients were found to be positive for maxillofacial tuberculosis on routine screening tests for tuberculosis, and 41 tested negative on routine test and were evaluated further through Xpert test. Specimens from bone (n12), soft tissue and skin biopsy (n15) and aspirates from lymph nodes (n14) were obtained and tested. Twenty-one samples were found to be positive, and 20 were negative upon Xpert testing. There was a statistically significant difference seen between the test groups (p < 0.01) with higher frequency of negative results in routine test. The p value for various specimens containing pus, biopsies and aspirates was 0.045, 0.023 and 0.067, respectively.

Conclusion: Xpert test is more accurate when compared to routine test for diagnosing maxillofacial tuberculosis. Although accuracy of Xpert test is better for pus and biopsy samples in the specimens from bone and soft tissue, it gives poor accuracy for aspirated cells. The aspirates from lymph nodes were more susceptible for false negative test.