Journal of Maxillofacial & Oral Surgery最新文献

Ectopic thyroid gland is a rare entity resulting from embryological aberration. We present a rare case of colloid goitre with degenerative changes which appeared as cheek swelling in a euthyroid adult male.

Purpose: This study proposes a novel intraoral approach combined with sub-sigmoid osteotomy to effectively and safely remove of ectopic third molar teeth without complications.

Methods: The procedure included a sub-sigmoid osteotomy to expose and remove the ectopic tooth, followed by fixation of the osteotomized coronoid with titanium plates. Preoperative cone beam computed tomography (CBCT) was used for precise tooth localization.

Results: The ectopic third molar was successfully removed with minimal bone removal. One intraoperative complication, a bad split of the anterior ramus, was observed but managed effectively. Postoperative healing was uneventful, with no nerve injury, infection, or reduced mouth opening.

Conclusion: The transoral sub-sigmoid osteotomy technique is a reproducible, effective method for ectopic third molar removal, avoiding extraoral scars, nerve damage, and extensive dissection. Preoperative planning using CBCT is essential to prevent complications, making this technique a valuable alternative to traditional approaches.

Introduction: Mandibular fractures have significant influence on oropharyngeal and laryngopharyngeal portions of the upper airway. They can be managed by MMF or ORIF.

Aim & objectives: To quantify and compare the effects of MMF with ORIF on the pulmonary functions of the patients undergoing treatment for mandibular fractures.

Method: Total 42 patients with isolated mandibular fractures were randomly divided into two treatment groups. Group A comprised of 21 patients planned for ORIF under LA and Group B comprised of 21 patients planned for MMF under LA. Pulmonary function tests (PFT) were done in all participants preoperatively 24 h before, postoperatively after 24 h, 1 week, 4 weeks and 6 weeks using spirometry. FVC, FEV1, FEV1/FVC, and PEFR were determined and compared.

Results: PFT values in both the groups were comparable preoperatively 24 h before and were significantly lower than their predicted values showing adverse effect of mandibular fractures on airways. Postoperatively after 24 h, 1 week and four weeks, PFT values were significantly lower in group B (MMF) than in group A (ORIF). At six weeks postoperatively, when MMF was removed, there was no statistically significant difference in PFT values of both the groups.

Conclusion: Mandibular fracture patients presented with abnormal PFT values. Patients treated by MMF had obstructive pulmonary pattern, while those treated by ORIF had normal pulmonary pattern concluding that MMF can be dangerous to the patients with limited respiratory reserve and the use of ORIF in pulmonary comorbidity is justified.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-024-02327-w.

Background: This is an observational cohort study on patients affected by malignant parotid tumors treated with total parotidectomy. The aim of our work is to analyze and compare the effects and complications after parotidectomy, using or not SurgiMend ®.

Methods: 40 patients were retrospectively enrolled between September 2014 and June 2020. Basing on the placement of SurgiMend ® for parotid lodge reconstruction, the samples were divided into two groups. Thus, the incidence rate of complications after the surgical procedure was analyzed between the two groups.

Results: Patients in whom SurgiMend ® was used reported a lower rate of complications. The ANOVA test (p = 0.05) revealed a significant difference of Vancouver Scar Scale (VSS) between the two groups, representation as vascularity and pigmentation improvement, changing scar color, scar height reduction, and increased pliability.

Conclusion: Although many techniques are available to fill the parotidectomy defect, improve facial contour and prevent Frey's syndrome, the use of SurgiMend ® matrix is one of most effective and reliable method to address these complications, with the advantage of decreased operative time due to not require an additional surgical donor site.

Purpose: Awareness about the oral and maxillofacial surgery (OMFS) specialty in the Gulf Cooperation Council has increased in recent years with the expanding scope of practice of the specialty. Nevertheless, the perception of OMFS has not yet been investigated among healthcare students. The aim of this study was to compare the perceptions and knowledge of dental and medical students about OMFS.

Materials and methods: A cross-sectional study evaluating 100 dental and 100 medical students attending Kuwait University was conducted using a previously validated survey instrument. Students were instructed to select the most appropriate specialist to treat certain procedures across four disciplines: reconstruction, trauma, pathology and cosmetic procedures. Student year groups were compared statistically using Fisher's exact test.

Results: The responses of both student groups showed disparities, with dental students showing overwhelmingly more awareness of the practice of OMFS. OMFS was preferred overall for most clinical scenarios in trauma (p < 0.001), pathology (p < 0.001), and reconstructive surgery (p < 0.001). Plastic surgery was preferred for cosmetic surgeries (p < 0.001).

Conclusion: Our findings prompt us to revisit our dental and medical school's curriculum to increase the educational content related to OMFS procedures. Additional healthcare promotional campaigns and clinical awareness regarding OMFS are needed among healthcare professionals, university clinics and medical venues.

Aims and objectives: To evaluate the efficacy of treatment following coronectomy on mandibular third molars with inferior alveolar nerve (IAN) involvement.

Methods: A cross-sectional descriptive analysis was done on the mandibular third molars of 37 people (≥ 18 years old, 28 males, and 9 females) who needed a coronectomy and had a confirmed diagnosis of IAN in groups I, II, and III according to the classification of Q. Luo 2018, as found by CBCT.

Result: The most prevalent indication in panoramic photographs was an interruption of the canal sign's white line (45.9%). The coronectomy approach had a success rate of 100%. There were statistically significant differences in the degree of vertical and horizontal face swelling, as well as mouth opening, between the second and third postoperative days. No incidences of paresthesia were reported after surgery. The root migrated the most in the first 3 months following surgery, measuring 2.43 ± 1.08 mm. At 6 months following surgery, the root migrated by 2.95 ± 1.27 mm. At 9 months following surgery, the root migrated 3.04 ± 1.19 mm from its initial location.

Conclusion: The risk of complications after a coronectomy seems to be inadequate, at least in the immediate aftermath of the operations. Coronectomy may be required for molars that are close to the IAN. Due to the roots often receding from the IAN, a second procedure to remove the remaining roots is typically performed with minimal risk of paresthesia.

Introduction: Trauma to the facial region could lead to considerable social, psychological and economic consequences. With the African region being a major contributor to global trauma events, we set out to describe the epidemiology and management of maxillofacial trauma in selected trauma units across Africa.

Materials and methods: This was a six-month prospective multicentre study carried out during March-September 2021.The study involved five major hospitals across the African continent. The patterns of maxillofacial injuries were recorded and patients managed according to local standardized operating protocols. Treatment delays and postoperative complications were recorded at review. Data analysis included descriptive statistics and regression analysis (p < 0.05). PFindings.A total of 195 patients were included in the study. The age range of patients was 1-87 years, with a mean age of 32.4 (SD =  ± 16.1). The study population consisted of 43 (22.1%) females, accounting for a Male:Female ratio of 3.5:1. Lacerations were the most common soft tissue injuries observed, while the prevalence of upper-, mid-, and lower- third fractures were 5.1%, 33.8%, and 19.5% respectively. There was loss of consciousness in 27.2%. Road crashes were the predominant aetiology of injuries, while 33.8% had concomitant injuries. About 38.3% of participants experienced treatment delays. Compared to employed patients, unemployed patients had significantly higher odds of experiencing treatment delays (OR = 3.76; 95%CI: 1.62 - 8.73).

Conclusion: With the overwhelming contribution of road crashes, measures to ensure road safety are needed to significantly reduce maxillofacial injuries in the African region, while also reducing socioeconomic inequality to timely treatment.

Aims and objectives: Dexmedetomidine is a relatively new, potent, and highly selective α2-adrenergic receptor agonist used for perioperative sympatholytic, analgesia, and sedation. We conducted this study to evaluate the effects of dexmedetomidine as an adjunct to local anaesthesia for maxillofacial soft tissue injuries as day care in the emergency department on patient hemodynamics and analgesic efficacy.

Materials and methods: Eighty patients gave informed consent to participate in the study. They were divided into Groups P and D, each of which consisted of 40 participants. Patients received saline injections in Group P, and Group D received dexmedetomidine (DEX) with local anaesthesia infiltration to both groups. Hemodynamic parameters, duration of surgery, pain of first rescue analgesia, Pain score, patient satisfaction, and surgeons satisfaction were recorded and quantified using unpaired t tests or Mann-Whitney and ANOVA tests. Data and qualitative data parameters were compared using Chi-square test. A P value < 0.05 was considered significant.

Results: Our study showed statistically significant reduced heart rate, systolic, and diastolic blood pressures in DEX compared to the placebo group where none had hypotension or bradycardia in clinical settings. The dexmedetomidine group had shorter operative time and decreased need for analgesia due to lower VAS scores. Patient and surgeon satisfaction were superior in the DEX group compared to the other groups.

Conclusion: Dexmedetomidine effectively suppresses the hemodynamic stress response during minor surgical procedures. We conclude that dexmedetomidine is an effective medication to be used in the emergency room for day-care procedures, as a potent analgesic, anxiolytic providing hemodynamically stable patients, with minimal side effects. We summarise that considering the above properties of dexmedetomidine can be incorporated into ERAS (early return after surgery) protocol, making it an optimal drug of choice as an alternative to moderate sedative drugs, in managing soft tissue injuries of maxillofacial region.

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) presents significant clinical challenges with uncertain treatment outcomes. Teriparatide, a fragment of human parathyroid hormone, shows potential in prevention strategies for BRONJ.

Objective: This study investigates the impact of a single local dose of teriparatide on BRONJ prevention in an animal model.

Methods: BRONJ was induced on 26 male Wistar rats via intraperitoneal injections of 0.06 mg/kg Zoledronic acid weekly for four weeks. Following tooth extraction under general anesthesia, rats were divided into two groups: one received teriparatide via Gelatamp in the tooth socket and the other as a local injection in the vestibule. Control groups received the treatment without teriparatide. Histopathological assessments for bone remodeling, osteoclast number, inflammation, angiogenesis, and necrosis were performed after four weeks.

Results: Histopathological analysis indicated a significant improvement in bone remodeling and new bone formation in both treatment groups compared to controls, with notably better outcomes in the injection group (p = 0.01). Necrosis in the Gelatamp group was significantly higher in the control group than in the treatment group (p = 0.01), and bone formation was significantly higher in the injection group compared to the Gelatamp group (p = 0.03).

Conclusion: Local administration of teriparatide significantly enhances bone remodeling and reduces necrosis, suggesting a potential role in the prevention of BRONJ. These findings support further clinical investigation into teriparatide as a preventive strategy against BRONJ.