Journal of Maxillofacial & Oral Surgery最新文献

Background: Oroantral fistulas are challenging complications that often require surgical intervention for successful closure and long-term healing.

Purpose: To present a modified submucosal connective tissue flap technique that enhances closure stability and healing predictability in oroantral fistulas.

Methods: Following excision of the fistula and sinus debridement, a standard buccal advancement flap was elevated. A subepithelial connective tissue graft was harvested from the palatal mucosa using a partial-thickness dissection and stabilized using resorbable sutures anchored to bone perforations. The overlying buccal flap was then advanced and sutured to complete a bilayered closure.

Results: The technique allowed tension-free closure with improved flap stability and reduced donorsite morbidity. Postoperative healing was uneventful, and complete mucosal regeneration was observed within one month.

Conclusions: This bilayered closure technique, combining mechanical anchorage of a palatal graft with a buccal advancement flap, provides a reliable and predictable solution for oroantral fistula closure, particularly in edentulous or anatomically compromised cases.

Background: Temporomandibular joint reconstruction (TMJR) with standard alloplastic prosthesis is a reliable treatment for TMJ ankylosis, especially for recurrent cases.

Purpose: Long-standing TMJ ankylosis causes morphological changes in the mandible, resulting in ill adaptation of stock TMJ prosthesis over the ramus of the mandible with mediolateral and anteroposterior discrepancy. It makes it cumbersome for the surgeon to adapt the stock prosthesis to an ideal position during the procedure. In unilateral TMJ replacement surgery, the mediolateral inclination of the mandibular component cannot be appreciated under direct vision.

Technique: An intraoperative C-arm was used to visualize, compare and confirm the accurate mediolateral and anteroposterior position of stock TMJ prosthesis in unilateral total TMJ replacement, thereby placing the condylar unit in a near-ideal position. Various positions of C-arm were discussed.

Conclusion: The practice of intraoperative C-arm usage has helped the operating surgeon's ambiguity concerning the near-accurate three-dimensional position of the new condyle within the fossa.

Introduction: Central odontogenic fibroma (COF) manifests as a rare neoplasm of odontogenic ectomesenchyme. It establishes clinically as a progressively growing mass that eventually causes cortical expansion. On a radiograph, it appears as a single or multiple locular radiolucent lesion with occasional root resorption or displacement of adjacent teeth.

Case report: We put forth a case report of a 15-year-old girl who presented with the complaint of a swelling in the lower jaw. Radiographically, a multilocular radiolucency was noticed in relation to the root of the left lower premolar teeth.

Treatment: Surgical excision was performed under general anaesthesia. The lesion appeared to be firm on palpation with appreciable interface between the lesion and the bone. The lesion could be easily enucleated from the osseous com ponent.

Outcome: Painless gingival enlargement could potentially be a clinical manifestation of an COF which usually resembles any other odontogenic cyst or tumor.

Objective: This randomized controlled clinical trial evaluated the efficacy of 980 nm diode laser therapy as an adjunct to conventional treatment for acute pericoronitis.

Materials and methods: Ninety-two patients with acute pericoronitis were divided into a control group (n = 44) receiving standard treatment and a laser group (n = 48) receiving additional 980 nm diode laser therapy (7.07W/cm², pulsed wave mode, 30 s/site, once daily for 3 days). Outcomes including Modified Gingival Index (MGI), Visual Analog Scale (VAS) pain scores, maximum mouth opening (MMO), lymphadenopathy, and body temperature were assessed at baseline and day 4 post-treatment.

Results: The laser group exhibited significantly greater reductions in VAS pain scores (5.62 ± 1.71 to 0.92 ± 0.81 vs. 5.59 ± 1.57 to 1.73 ± 2.4; p < 0.05) and MGI scores (p < 0.05) compared to controls. Both groups showed comparable improvements in MMO (p > 0.05). Lymphadenopathy resolved in 58% of laser patients vs. 64% of controls, though not statistically significant(p > 0.05). All patients achieved normalized body temperature by day 4. Stratified reanalysis by type of impacted tooth revealed that the laser-treated mesially impacted group experienced significant improvements in postoperative pain (VAS; p < 0.001) and gingival inflammation (MGI; p = 0.005) in laser-treated Mesial impactions compared to the control group.

Conclusion: Adjunctive 980 nm diode laser therapy significantly enhances pain relief and reduces gingival inflammation in acute pericoronitis compared to conventional treatment alone, supporting its role as a non-invasive therapeutic adjunct.

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.