Journal of Maxillofacial & Oral Surgery最新文献

Bone augmentation procedures are a crucial component of modern dental implantology enabling the restoration of adequate bone volume and soft tissue quality to support a successful implant placement. This review aims to provide a comprehensive analysis of the current techniques employed in bone augmentation, the scientific evidence substantiating their efficacy and the outcomes of these procedures in implantology.

Tooth extraction requires techniques that minimize tissue damage, yet alveolar bone fracture remains a common complication. The complexity increases when extracting mandibular molars with compromised wall support. This technical note introduces a novel forceps that combines a thin cowhorn like beak with a conventional mandibular third molar beak, enabling secure furcation engagement and controlled force application. The design aims to simplify extractions of grossly decayed mandibular molars, minimize trauma, and improve ease of use for both novice and experienced clinicians, offering a potential atraumatic alternative to conventional methods.

Introduction: Scars on the hair-bearing mustache area can be cosmetically disfiguring and interfere with adult male cleft patients social lives. Mustache reconstruction animates a male face, provides confidence, and interrupts the cycle of self-pity, providing a sense of completion. The purpose of this study was to examine and evaluate hair regrowth in the mustache region after hair restoration utilizing follicular unit extraction and follicular unit transplant procedures in individuals with secondary cleft lip scars.

Materials and methods: This was a prospective, double-blind, randomized controlled trial included 40 male patients presenting with either unilateral or bilateral cleft lip scars. Patients were randomly assigned to one of two groups: follicular unit extraction or follicular unit transplant. Macro Photographs were taken before surgery, as well as immediately after, 1, 3, 6, 9, and 12 months thereafter to evaluate the hair using the Madura et al. 10-point objective scale.

Results: At the end of the 1st month (p < 0.0001), 9th month (p < 0.0001), and 1 year (p < 0.0001), a statistically highly significant difference was observed between the compared groups, with higher values reported with the follicular unit extraction group at the 1st month (7.50 ± 1.581), 9th month (6.80 ± 1.229), and 1 year (7.50 ± 1.179). At the end of the 3rd month [p = 0.012] and 6th month [p = 0.002], a statistically significant difference was observed between the compared groups, with higher values reported with the follicular unit extraction group at the 3rd month (6.70 ± 1.337) and 6th month (7.20 ± 1.476).

Conclusion: The follicular unit extraction group has significantly better clinical changes and less adverse effects than the follicular unit transplant group.

Aims and objectives: The purpose of this study was to evaluate the size of the neck of mandibular condyle in Indian population using computed tomography (CT) scans and compare the same with that of hybrid plates.

Methods: A total of 172 mandibular condyles were studied which included both males and females belonging to age groups between 21 and 50 years. Independent sample t test was done for the comparison of condylar neck size between genders and comparing the same with that of size of miniplates.

Result: The average width of condylar neck in the most constricted region was 7.28 ± 1.38 mm ranging from 3.93 to 11.22 mm. Average condylar base width was 17.36 ± 1.44 mm ranging from 11.79 to 22.37 mm. All the hybrid plates except the trapezoidal plate were narrower than the average condylar neck dimensions. No significant difference was found in average condylar neck length and width between males and females.

Conclusion: In majority of cases of condylar neck fracture, fixation using two four holed with gap miniplates may not be possible; however, a hybrid plate can be used. Plates with width of 4 mm at superior border and 12 mm at inferior border would be the widest plate that could be accommodated in all the mandibular condyles.

Background: Cleft lip and palate and the resulting morphologic and functional deficits can cause a great deal of distress to patients and their families. Cleft lip deformity not only affects the lip but also extends to the nose and maxillary, with the severity varying according to the degree of the cleft. The main goal of surgery is to reconstruct the anatomy. Symmetry is a critical factor in evaluating the success of cleft lip surgeries. The previous evaluation methods were preoperative and postoperative comparisons by various methods to evaluate symmetry and the results of the surgery, such as the patient's feeling, data measurement, and other methods. So far, there is no simple and effective method to perform evaluation during surgery.

Methods and materials: This study was carried out between 2023 and 2024 and involved 12 unilateral cleft lip patients. Antera 3D® (Miravex, Dublin, Ireland) is used for image acquisition and image analysis (depression, medium/large). The 3D photographs were taken before, after, and at any point during the procedure. Different colours are used to show elevations and depressions, avoiding interference from the naked eye and light. And it can display a comparison graph of any two points in time on the screen at the same time. It allows the surgeon to more accurately determine the extent of deformity correction.

Results: All patients completed the repair of nasolabial. The duration of the operation has not increased. The appearances of almost all the patients were significantly improved, and all the patients and their families were satisfied with the outcome of the operation.

Conclusions: The system of the Antera 3D® was reliable and was a suitable technique for lip and nose analysis at any point in time during the operation.

Introduction: Anterior maxillary subapical osteotomy (AMSO) followed by premaxillary advancement is an orthognathic surgical procedure which has been undertaken rather infrequently in the recent past, owing to its being overtaken by premaxillary distraction osteogenesis (DO). It is most often employed in cleft cases with anteroposterior maxillary deficiency.

Material and methods: The procedure and technique of AMSO is also found to be amenable to modification, adaptation and incorporation as per specific requirements of individual cases. This case report describes its employment as an unusual and novel approach to treat a non-cleft maxillary deficiency case, as a case-specific technique.

Discussion: The report thereby attempts to re-popularize the procedure, by elaborating its ease, efficacy, reliability, predictability, expedient outcome as well as long-term stability in premaxillary advancements. It can offer several advantages in treating mild to moderate Skeletal Class III Dentofacial Disharmony cases with marked Anterior Crossbite & Reverse Overjet, with its novelty lying in simplicity and straightforwardness of the procedure; immediately apparent esthetic results post-surgery; with practically nil complication and relapse rates.

Results and conclusion: Its results, in terms of correction of both, the esthetic deformity and functional impairment (in speech and mastication), are almost immediately apparent. Additionally, it can be modified to a 'Surgery First, Orthodontics After (SFOA)' protocol, to further reduce the total treatment duration and yield a speedy outcome, which is of particular benefit in young adult patients with an active lifestyle, offering a distinct psychological advantage by an immediate improvement in facial appearance, enunciation as well as masticatory function. This facilitates a ready patient acceptance for treatment and also encourages optimal patient compliance during the post-surgical orthodontic phase.

Objectives: To evaluate the reliability and quality of YouTube videos focused on coronectomy using DISCERN, Video Information and Quality Index (VIQI), and Global Quality Scale (GQS) tools.

Study design: Two reviewers independently identified 53 videos for final analysis and classified based on their quality and content relevance using DISCERN, VIQI, and GQS.

Results: Most videos were targeted to the general public (81.1%) and uploaded by non-profit organizations or professional doctors (45.3%). The average DISCERN score was 37.31 ± 8.95 (poor quality), the average VIQI score was 9.92 ± 3.29 (fair quality). Longer videos showed higher DISCERN scores (P = 0.036) and received more engagement (likes: P = 0.024; comments: P < 0.001). Non-patient uploaders produced videos with higher VIQI scores (P < 0.001), whereas Patient-uploaded videos generated more comments (P = 0.001). Higher content quality was correlated with higher likes (p = 0.013).

Conclusions: Coronectomy-related YouTube videos generally lack sufficient information and reliability. Videos by professionals were higher in quality, whereas those by patients generated more engagement. High-content videos showed superior quality and popularity, but were limited in number. Dental professionals need to improve accessible educational content, influencing patient acceptance of this surgical alternative.

Introduction: Elective neck dissection (END) has become a standard procedure in contemporary clinical practice for patients with node-negative oral cancer, offering a notable improvement in overall survival for early-stage disease. Despite advancements, the 5-year survival rate remains stable, and regional recurrence, albeit infrequent, poses a significant challenge.

Materials and methods: This retrospective single-centre study aimed to evaluate the echelon node in patients with the pathologically node-negative disease who experienced regional and distant failures. Serial step sectioning (SSS) was utilized to identify occult metastasis features, including Isolated Tumor Cells (ITC) and micrometastases (miMets).

Results: Clinical and pathological characteristics of 96 patients were analyzed, revealing significant associations between adverse pathological features like LVI, PNI, DOI, and nodal recurrence. While no micrometastases were detected in this analysis, further investigation with a larger cohort may be warranted.

Conclusions: The study underscores the importance of meticulous pathological assessment and the potential role of adjuvant therapy in mitigating recurrence risks in node-negative oral cancer patients. Additionally, it highlights the need for standardized reporting protocols and adequate lymph node yield in neck dissection procedures to optimize patient outcomes.

Objective: This prospective, randomized, split-mouth, single-blinded clinical study compared the efficacy of simvastatin and melatonin in promoting alveolar bone regeneration and postoperative healing after mandibular third molar extraction.

Methods: Thirty healthy patients undergoing bilateral mandibular third molar extractions were recruited. Simvastatin (10 mg) was applied to one extraction site, and melatonin (3 mg) to the contralateral site using a gelatin sponge carrier. Pain, soft tissue healing, and bone regeneration were evaluated using the visual analog scale (VAS), Landry's Healing Index, and grayscale histogram analysis of digital radiographs over 12 weeks.

Results: Simvastatin-treated sockets demonstrated significantly higher grayscale values at weeks 1 (P < 0.001) and 4 (P = 0.009), indicating enhanced bone regeneration. VAS pain scores were also significantly lower in the simvastatin group at week 1 (P = 0.004). No significant differences were observed in soft tissue healing.

Conclusion: Simvastatin demonstrated superior early osteogenic potential and pain reduction compared to melatonin in third molar extraction sockets. Its accessibility and cost-effectiveness support its clinical utility in socket preservation.

Purpose: A varied list of reasons for lingual hematoma is listed in literature. These are allergic reaction, post-traumatic, spontaneous in patients on anticoagulants or antiplatelets, viral or bacterial infections, self-inflicted injuries, tongue bite during seizures, child abuse and iatrogenic. In the present review, the authors have concentrated on post-traumatic lingual hematoma and its management.

Material and methods: The authors have systematically searched the literature reporting post-traumatic lingual hematoma following the PRISMA guidelines. The search was performed in PubMed, Google Scholar, Semantic Scholar and the Cochrane library database from 1985 to 2023.

Results: 38 studies {41 patients (27 males and 14 females)} were included and analyzed in the present systematic review. All patients, except 2 (succumbs due to their medical condition), reported complete resolution of hematoma. The age range was 70 days-79 years. In all the reported studies, the airway was managed with either intubation and/or tracheostomy. Treatment varied from only observation, airway maintenance (intubation/tracheostomy), steroids administration, antibiotic coverage, reversal of antiplatelet or anticoagulant drugs, embolization or surgical intervention.

Conclusion: Prompt recognition and management of the airway are the crucial step in these patients. Acute lingual hematoma is a clinical diagnosis, and to prevent related complications, a detailed history of preexisting comorbidities and medication is crucial. Most importantly, repeated examination of oral cavity in case of lingual hematoma is mandatory.