Journal of Maxillofacial & Oral Surgery最新文献

Background: We present an innovative methodology for the surgical removal of deeply impacted mandibular third molars using the trephine bur.

Method: This approach confers multiple advantages, including the preservation of osseous structures and the utilization of the osteotomized bone segment as an autologous graft, supplemented by the compositional integration of β-tricalcium phosphate and hydroxyapatite as adjunctive materials.

Conclusion: A clinical case is provided to exemplify the application of this trephination technique.

Objective: This study aimed to assess parental perceptions of their children's quality of life (QoL) who had craniofacial clefts, focusing on aesthetics, speech, function and psychology.

Design and setting: The study enrolled parents of children aged 5-15 with craniofacial clefts who had received soft tissue correction. Parents completed a questionnaire evaluating their children's QoL post-surgery.

Outcome: Findings revealed that parents observed a significant improvement in their children's QoL following surgical intervention. Notable enhancements were noted in facial appearance, a substantial reduction in instances of teasing and bullying, improved relationships with friends and family, and increased self-confidence among the affected children.

Conclusion: Surgical intervention showed a positive influence on these children's facial appearance, speech, self-esteem, social integration, physical well-being and psychological functioning. As a result, it contributed to an overall enhancement in their QoL, emphasizing the importance of such procedures in improving the lives of children with facial clefts.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-025-02737-4.

Introduction: Temporomandibular joint (TMJ) hypermobility affects broad demographic, challenging the efficacy of traditional treatments. The aim of this study is to investigate therapeutic potential of autologous blood injections (ABI) vs dextrose prolotherapy in rabbit model, through detailed histopathological & radiological analyses.

Material and methods: After ethical approval from the institutional committee, a hypermobile joint model was established in rabbits through surgery affirmed by MRI. Subsequently, rabbits were randomly divided into two groups i.e. ABI and dextrose solution. In each group, one joint was designated as control, treated with saline. Following surgical induction of TMJ hypermobility, treatments were administered, & outcome was assessed through histological examination for fibrosis grading & CD68 staining for macrophage infiltration.

Results: The ABI group exhibited a higher fibrosis grade (> 75% in 50% of joints) & stronger CD68 staining, indicating a significant fibrotic response & macrophage infiltration compared to dextrose group. In contrast, control joints displayed no fibrosis grades & negative CD68 staining.

Conclusion: The study highlights both ABI & dextrose prolotherapy elicit significant fibrotic responses in treating TMJ hypermobility, indicating their therapeutic mechanisms. ABI in particular, triggers more marked inflammatory reaction, underscoring its potential efficacy. Further evaluation is essential to understand its clinical significance and applicability in managing TMJ disorders.

Aim: To introduce a novel incision design for large advancement genioplasty.

Findings: Our variation extends from the premolar to the premolar, maintaining a 5 mm distance from the root apices and the vestibular sulcus. The incision is V-shaped, with the tip aimed at the midline mento-labial sulcus. A sharp beak haemostat is used to dissect the mental nerve between the mucosa and submucosa at the canine region-premolar region. Tunnelling is done to free the nerve at its insertion into the muscle.

Conclusion: This technique offers excellent healing and large advancement genoplasties can be carried out with ease. Amongst all the cases which were performed, none of them showed any incidence of chin ptosis. There was no incidence of hypertrophic scarring noted.

Background: Frontal sinus fractures involving the frontonasal duct require careful management to prevent complications such as mucoceles, infections, and intracranial extension. Obliteration of the frontonasal duct is essential when duct patency cannot be preserved during cranialization. This technical note presents a minimally invasive method using the buccal fat pad harvested through the temporal extension via a standard coronal approach.

Methods: A 25-year-old male patient with a frontal sinus fracture underwent cranialization using a standard coronal approach. The temporal extension of the buccal fat pad was accessed between the temporalis and superficial temporal fascia. After complete removal of the sinus mucosa and dura repair with adjacent pericranium, the harvested fat was used to obliterate the frontonasal duct and stabilized by suturing to the pericranium.

Results: The technique allowed effective frontonasal duct obliteration without additional incisions or donor site morbidity. It minimized surgical time, avoided alloplastic material use, and preserved facial aesthetics. The patient had an uneventful postoperative recovery.

Conclusions: This method offers a simple, autologous, and minimally invasive alternative for frontonasal duct obliteration during frontal sinus fracture management, reducing operative complexity and potential complications.

Background: Lack of consistent international identification standards has led to various modifications of the classification of odontogenic tumors over the past. As a result, their prevalence and frequency distribution have significantly altered.

Aim and objectives: This study aimed to highlight the effect of shifting classification systems on the prevalence and relative frequency of odontogenic tumors. The secondary goal was to compare the demographics of distinct histological categories of odontogenic tumors to published literature.

Method: The present retrospective observational research obtained data on odontogenic tumors diagnosed between 2010 and 2022. Their prevalence and frequency distribution were re-graded based on 2005, 2017 and 2022 World Health Organization classifications.

Results: Over the past 12 years, there were 226, 145 and 149 cases of odontogenic tumors reported using the three modifications with a prevalence of 4.98%, 3.28% and 3.20%.

Conclusion: The variability in the prevalence of odontogenic tumors is attributed to the continually evolving classification systems. Variations in the relative incidence of different histological types of odontogenic tumors might represent varied populations with diverse genetic and environmental factors.

Background: Ameloblastic carcinoma (AC) represents a rare and aggressive malignant odontogenic tumor that derives from the epithelial tissue of the jawbone, predominantly affecting the mandible. This report describes a case of ameloblastic carcinoma that occurred after removal of a right-sided maxillary ameloblastoma.

Case presentation: A 17-year-old male teenager visited author's affiliation with a complaint of a two-week history of spontaneous pain around upper right premolar area after a primary ameloblastoma resection. Intraoral examination revealed that an ulceroproliferative growth with everted margins was noted over the retromolar region adjacent to #17. An occupying lesion was observed in the right side of maxilla by maxillofacial imaging. The patient underwent partial maxillectomy, elective level I-II neck dissection, and immediate reconstruction with submental island flap. Histopathological assessment post-right maxillectomy identified a high-grade AC with malignant spindle cell transformation. Post-treatment follow-up for 6 months showed no recurrence of the malignancy.

Conclusion: Primary ameloblastoma or AC is increasingly being reported, but secondary AC of the maxilla is rarely described in detail. Although the underlying causes of this condition are still not well understood, intensive treatment and careful follow-up are key steps in preventing the disease from recurrence and malignant changes.

Aim and objective: To evaluate the correlation between the position of inferior alveolar nerve canal and the angulation of impacted mandibular third molars. Also, the bone width and shape of the mandible at impacted third molar region determined precisely from CBCT cross-sectional images.

Material and methods: CBCT data of the impacted mandibular third molar of 89 patients were included in the study where an initial radiographic assessment demonstrated overlap/close proximity of the impacted mandibular third molar and inferior alveolar nerve canal. Using cross-sectional views and adjusting the position in panoramic view, the outline of the inferior alveolar canal was done and its buccolingual position was assessed. All the scans were taken using Carestream 9300 with 5/5 segment FOV size and operated at 75 kV and 8 mA. Scans were evaluated by two Oral and Maxillofacial Radiologist on same computer (Intex^®Core^TMi7-8700 CPU @3.20 GHz, 64-bit operating system with 32.0 GB memory, with use of software CS 3D imaging v 3.8.7), and following parameters were noted: type of impaction, relative position of the mandibular canal, bone contact, shape of mandible, space, width of cortical bone, apex canal distance, width and height of the canal. All the data were analyzed statistically.

Result: Class I position A impactions were found in majority of the cases, where the position of inferior alveolar canal was inferior and lingual to the impacted third molar (61.4%) and the result was statistically significant. 81% of inferior alveolar canal showed bone contact. Of these, 72.8% of the canal exhibit lingual bone contact, inferior to impacted third molar, and the results were statistically significant. Mesioangular impactions were most common in mandible having lingual and inferior position of the IAN canal (67.5%). The morphology of mandible at third molar region was observed as round (63%), lingual concave (25%) and lingual extended (12%) and was significantly associated with the type of impacted third molar. The space and the width of the lingual cortex were significantly associated with type of impactions (p = 0.016 and p = 0.036, respectively).

Conclusion: The type of impacted tooth, morphology of the mandible and location of the IAN canal can be precisely determined on CBCT which can help the surgeon to predict any damage to the canal and to prevent sequelae of numbness.

Introduction: The perception of facial attractiveness (PFA) varies between cultures.

Objectives: This study aimed to assess the PFA in Saudi culture and compare it with the golden proportions (GP).

Materials and methods: A total of 500 survey papers were formulated using the frontal views of different photographs with high beauty scores selected from the universal benchmark dataset. The selected photographs were modified. The different perception questions were formulated, followed by subjective and objective soft tissue analyses of the selected frontal photographs.

Results: A total of 488 participants reported differing opinions on the most important element that determines facial beauty. Male participants scored the eyes, whereas female participants scored the lips; this difference was statistically significant (p value < 0.009). The photograph with the highest score (86%) had an asymmetrical face of more than 4 mm, which was statistically significant between the Saudi participants who lived abroad and those who were not expatriates (p = 0.037).

Conclusion: The participants had higher scores for short facial morphology. The facial analysis proportions reported percentage differences from the GP (1.618). These findings could provide guidelines for clinicians for improving facial aesthetics. Thus, further studies using a local database of the local population should be conducted.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-025-02477-5.

Introduction: p63 is essential for normal proliferation and differentiation of odontogenic epithelium. Since odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) are odontogenic epithelial lesions, p63 may play a role in their pathogenesis and biological behaviour. p63 can preserve keratinocytes with stem cell potential by preventing premature apoptosis and terminal differentiation during wound healing.

Aim: The aim is to explore the role of p63 in pathogenesis, regenerative potential and biological behaviour of various odontogenic cysts.

Materials and method: The study involved 40 samples, which are OKC (n = 10), DC (n = 10), RC (n = 10) and regenerating tissue samples (n = 10), are taken as a comparative measure. p63 protein expression was evaluated by immunohistochemistry. (qualitative, quantitative and topography).

Result: p63 was expressed in basal and parabasal layer in lining epithelium of OKC. In addition, p63 was expressed throughout the lining epithelium in RC and DC.

Conclusion: The present study suggests that p63 overexpression is associated with increased proliferation. Thereby, p63 can be a prognostic biomarker in odontogenic lesions with aggressive phenotype. Henceforth, discerning the pathogenesis of developmental and inflammatory cysts is critical for determining the surgical approach and predicting the prognosis of odontogenic cysts.