Journal of Maxillofacial & Oral Surgery最新文献

Background: Present study has compared local anaesthetic efficacy of two agents, 5% tramadol with adrenaline 1:80,000 and 2% lignocaine with adrenaline 1:80,000 for bilateral maxillary premolar extraction under supra-periosteal injection.

Materials and methods: This prospective, split-mouth, double-blinded, randomised, clinical study was conducted on 69 patients requiring extraction of maxillary premolars bilaterally for orthodontic reasons. The study group received 5% tramadol hydrochloride, and the control group received 2% lignocaine hydrochloride. Parameters evaluated were pain on injection, onset and duration of anaesthesia, and post-extraction analgesia.

Results: Current study observed longer duration of anaesthesia for lignocaine than that of tramadol, p < 0.001. Lesser perception of post-extraction pain and longer duration of analgesia was observed on tramadol side compared to lignocaine, p = 0.001. Consumption of analgesic tablets was more in lignocaine group, p = 0.022.

Conclusion: Tramadol can be safely employed as an alternative to conventional local anaesthetic agents through supra-periosteal injection due to its dual local anaesthetic and analgesic action.

Materials and methods: Patients satisfying the inclusion and exclusion criteria underwent arch bar application followed by either closed reduction or open reduction with internal fixation. Pre-operatively: OHI, GI, radiographically displacement, no. of fractures, Perioperatively: Duration of procedure, glove perforation, wire prick injuries, screw loosening/wire breakage, stability, and comfort intraoperatively. Postoperatively: OHI index and GI index, screw loosening/wire breakage, arch bar removal time and glove perforation, wire stick injury, root perforation. Chi-square test was used for categorical data in tabular and graphical forms.

Results: A statistically significant difference was observed in the postoperative OHI score, GI score, mean placement time, and mean removal time between Group A and Group B. The stability of the arch bar was matched between the groups. Screw loosening was non significant, Glove perforation was significant between Group A and B. Wire stick injury was non-significant between group A and B.

Conclusion: The Hybrid Arch Bar proved to be superior to Erich's Arch Bar in terms of time efficiency, stability, comfort, and oral hygiene. Overall, the benefits of the Hybrid Arch Bar outweigh its disadvantages.

Purpose: Patients with skeletal malocclusions undergo orthognathic surgery to achieve a superior facial esthetic profile. However, stable occlusion following orthognathic surgery is also paramount. This study was thus designed to conduct a functional analysis of occlusion, in terms of relative distribution of bite force in patients who underwent bi-jaw orthognathic surgeries using a T-Scan device.

Materials and methods: A prospective study was carried out on 40 patients between the age group of 18-32 years having skeletal malocclusions requiring bi-jaw orthognathic surgeries. The relative difference in bite force between the right and left side was measured using a T-Scan pre-operatively and at third month post-operatively. The data were analyzed statistically.

Results: The study included 40 patients (14 males and 26 females) with a mean age of 22.7 years. The mean difference in bite force pre-operatively was 27.95% and reduced post-operatively to 16.85%.

Conclusion: The significant decrease in the relative bite force between the left and right side post-operatively implies an improved balance of occlusal load between the two sides and hence a more balanced occlusion post-orthognathic surgery.

Background: This systematic review aims to shed some light on the expression of the EBV-associated LMP-1 oncoprotein and its association with oral squamous cell carcinoma and potentially malignant oral disorder.

Method: An extensive literature search was done in databases including PubMed, Google Scholar, Scopus, ScienceDirect, ProQuest, Cochrane, and Web of Science using the keywords "EBV-associated LMP1 in oral squamous cell carcinoma and oral potentially malignant disorders" for case-controlled studies in English.

Results: The extracted data gathered 21 studies with 1,138 OSCC cases and 448 OPMD cases, out of which 9 studies were eligible for the meta-analysis to determine the association between OSCC and LMP-1, with a total of 444 OSCC cases and 313 controls, and 6 studies were eligible for the meta-analysis to find the association between OPMD and LMP-1, with a total of 367 cases of OPMD and 158 cases of control. After gathering and tabulating the data in Microsoft Excel, the JBI tool was used to analyze the bias risk. The pooled data showed a positive association between EBV LMP-1, OSCC, and OPMD.

Conclusion: The collected data confirm that EBV LMP-1 plays a role in the progression of OSCC and OPMD. Extended research regarding the initiation and progression patterns needs to be further evaluated, which might help in the prognosis.

Objectives: Facial artery aneurysms are rare vascular anomalies that may manifest as pseudoaneurysms following trauma or iatrogenic injury or as true aneurysms due to vascular degeneration. This systematic review aims to summarize the available evidence on the diagnosis, management, and complications of these lesions to guide clinical decision-making.

Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant case reports, case series, and observational studies published up to October 2024 were included. Data extraction focused on patient demographics, aneurysm characteristics, diagnostic modalities, treatment approaches, and clinical outcomes.

Results: Seventy studies reporting on 74 patients with a mean age of 35 years met the inclusion criteria. Iatrogenic events, particularly post-tonsillectomy, accounted for approximately 39% of cases, while trauma was responsible for 36%. Pseudoaneurysms constituted the majority of lesions. Treatment strategies included surgical removal, endovascular embolization, combined techniques, and conservative management. Surgical intervention demonstrated a high success rate with minimal complications (3.8% complication rate), whereas endovascular procedures were associated with a higher incidence of adverse events (21.4% complication rate), including embolic events and coil extrusion. No standardized management approach was identified, highlighting the need for individualized treatment decisions based on lesion size, location, and patient-specific factors.

Conclusions: Facial artery aneurysms, though rare, require timely diagnosis and tailored management strategies. Surgical intervention appears to offer a favorable outcome with fewer complications compared to endovascular techniques. However, the findings are limited by the reliance on case reports and small sample sizes, which may introduce selection and publication bias. Clinical implications include the need for careful risk-benefit assessment when selecting endovascular approaches. Future large-scale observational studies or trials are needed to establish standardized guidelines.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-025-02716-9.

Background: Nasopalatine duct cyst (NPDC) is the most common non-odontogenic cyst of the oral and maxillofacial region. It arises from the epithelial remnants of the nasopalatine duct. Despite its prevalence, the clinicopathological features of NPDC remain underreported. The study aimed to evaluate the clinicopathological features of NPDC, including clinical presentation, radiological findings, and histological aspects, in a retrospective cohort of patients treated at a single institution.

Methodology: A retrospective analysis was conducted using clinical records of patients diagnosed with NPDC between 2007 and 2024 after seeking clearance from the institutional ethical clearance board. Data collected included age, gender, clinical presentation (symptoms and size), location, radiological findings, and histopathological characteristics.

Results: Ten cases of NPDC were identified, with a prevalence of 0.15%. The mean age of patients was 32 years, with a higher incidence observed in male patients. The most common presenting symptoms were pain and swelling. Radiologically, all the NPDCs were located in the midline of the anterior maxilla, presenting as a well-defined radiolucent lesion. Histopathological examination revealed a diverse pattern across the cases.

Conclusion: This study provides a comprehensive analysis of the clinicopathological features of NPDC, highlighting the importance of early diagnosis and appropriate management. NPDCs typically present with non-specific symptoms and can be effectively diagnosed through radiological and histological examination.

Introduction: Chronic suppurative osteomylities (CSO) in maxillofacial region most commonly affects mandible and involvement of condyle and coronoid is uncommon. CSO in children is usually misdiagnosed and not treated properly.

Case report: We present a girl child reported with swelling and pus discharge near preauricular region. She had history of extraction in mandible and recurrent swelling and trismus in the past.

Treatment: The case was diagnosed as chronic suppurative osteomyelitis and sequestrectomy was done under general anaesthesia.

Outcome: CSO involving condyle and coronoid is uncommon in children which makes it a unique case. Awareness regarding osteomyelitis in children should be encouraged more in rural areas so that diagnosis and prompt treatment can be given at the earliest.

Background: Orbital contents need to be retracted delicately and effectively during complex orbital floor repairs.

Innovation: We employed gentle retraction of orbital contents during a complex floor repair with the Leyla^TM retractor used to retract brain parenchyma in neurosurgery. This autoclavable retractor is self-retaining and consists of two flexible tension arms as well as a fixation base and spatula supports. This is available in the neurosurgery sets of most Level I Trauma Centres.

Advantage: The advantage of this technique is that it facilitates gentle and controlled retraction of the orbital contents without requiring assistance. The exposure till the posterior floor of the orbit is excellent and enables a precise and thorough assessment of the defect without being concerned about damaging orbital contents. Since it is self-retaining, the retractor remains in place till the end of reconstruction enabling visualisation with conservative incisions. The design of the flexible arms allows for retraction from multiple angles, crucial for navigating complex orbital floor repair. The smooth edges and precision design of the spatula minimize tissue damage during retraction.

Aim: To determine, summarize, assess and compare one-stage with two-stage ridge split procedures by systematically reviewing the existing scientific literature in adults with a novel meta-analysis.

Methods: This review was performed in accordance with Preferred Reporting Items for the Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The PubMed, Google Scholar and EBSCO Host databases were searched from January 2000 to December 2021 for prospective and follow-up studies that compared one-stage and two-stage ridge split procedures and reported the outcome in terms of mean and standard deviation (SD). Quality assessment of included studies was done using Newcastle Ottawa Scale through its domains and that of included case reports was done using the critical checklist recommended by the Joanna Briggs Institute (JBI). The standardized mean difference (SDM) was used as summary statistic measure with random effect model and p value < 0.05 as statistically significant.

Results: Eleven studies fulfilling the eligibility criteria were included in qualitative synthesis, of which, three studies were suitable for meta-analysis. All the included studies had moderate to high risk of bias. The pooled estimate through the Standardized Mean Difference (SMD) on an average favours 0.89 times more to one-stage ridge split compared to two-stage ridge split. In addition, most results of heterogeneity tests were poor and most of the funnel plots showed asymmetry, indicating presence of possible publication bias.

Conclusion: The results of our meta-analysis suggests that one-stage ridge split is superior to two-stage ridge split on a comparative analysis.

Introduction: Fixation of bifocal fractures of the mandible remains an enigma for surgeons as to how much fixation would be able to provide adequate stability. Increasing number of miniplates could lead to more complications. Thus, the aim of the study was to evaluate to minimum amount of fixation required to achieve adequate stability in bifocal fracturees of the mandible.

Materials and methods: The study was carried out in the Department of Oral & Maxillofacial Surgery and the Department of Mechanical Engineering using a finite element analysis. The Von Mises stresses and deformation distribution was analyzed when the mandibular subcondylar fracture and the contralateral parasymphysis or body fracture was fixed using a single or two miniplates. Forces were applied on the incisors, left and right molars.

Results: The results revealed that the mandibular parasymphysis or body fracture with a contralateral mandibular subcondyle fracture showed adequate stability when fixed using a single four-hole with gap titanium miniplate for fixation of both fractures in combination with an arch bar (Von Mises stress on mandible = 555.59 MPa, 558.62 MPa on 150 N incisor load; 545.98 MPa, 545.24 MPa on 300 N left molar load; and 612.99 MPa, 652.85 MPa on 300 N right molar load).

Conclusion: Non-rigid fixation is sufficient to provide adequate stability for bifocal fractures of the mandible involving unilateral mandibular subcondyle with associated contralateral mandibular dentate fracture.