Pub Date : 2024-02-01Epub Date: 2023-04-24DOI: 10.1007/s12663-023-01920-9
Tim Van Cleemput, Xander Jackers, Maria Piagkou, Constantinus Politis
Purpose: Odontogenic keratocysts (OKCs) have high recurrence rates. We aimed to identify recurrence patterns in OKCs and the onset of second primary OKCs in non-syndromic and syndromic patients.
Material and methods: Patients with OKCs reporting to our department from 1998 to 2021 (23 years) were retrospectively evaluated using demographic, clinical (age, sex, location, and size), histopathological, radiographic, and treatment data. All patients were followed-up for > 3 years and evaluated for OKC recurrence. Patients with naevoid basal cell carcinoma syndrome (NBCCS) were evaluated separately.
Results: We included 38 and 13 patients in the non-syndromic and syndromic OKC groups, respectively. The recurrence rates were 15.8 and 21.4% in the non-syndromic and syndromic groups, respectively; 8.9% of patients exhibited a second recurrence and 1.8% a third recurrence. No second primary OKCs were observed in the non-syndromic group; 76.9% of patients in the syndromic group developed at least one.
Conclusion: We found a higher recurrence rate in patients with NBCCS compared with patients with non-syndromic OKCs (21.4 versus 15.8%). The probability of developing a second primary OKC in patients with NBCCS was higher compared with that in patients with non-syndromic OKCs (76.9 versus 0%). No statistically significant risk factors for OKC recurrence were identified.
{"title":"Recurrence Patterns of Odontogenic Keratocysts in Syndromic and Non-Syndromic Patients.","authors":"Tim Van Cleemput, Xander Jackers, Maria Piagkou, Constantinus Politis","doi":"10.1007/s12663-023-01920-9","DOIUrl":"10.1007/s12663-023-01920-9","url":null,"abstract":"<p><strong>Purpose: </strong>Odontogenic keratocysts (OKCs) have high recurrence rates. We aimed to identify recurrence patterns in OKCs and the onset of second primary OKCs in non-syndromic and syndromic patients.</p><p><strong>Material and methods: </strong>Patients with OKCs reporting to our department from 1998 to 2021 (23 years) were retrospectively evaluated using demographic, clinical (age, sex, location, and size), histopathological, radiographic, and treatment data. All patients were followed-up for > 3 years and evaluated for OKC recurrence. Patients with naevoid basal cell carcinoma syndrome (NBCCS) were evaluated separately.</p><p><strong>Results: </strong>We included 38 and 13 patients in the non-syndromic and syndromic OKC groups, respectively. The recurrence rates were 15.8 and 21.4% in the non-syndromic and syndromic groups, respectively; 8.9% of patients exhibited a second recurrence and 1.8% a third recurrence. No second primary OKCs were observed in the non-syndromic group; 76.9% of patients in the syndromic group developed at least one.</p><p><strong>Conclusion: </strong>We found a higher recurrence rate in patients with NBCCS compared with patients with non-syndromic OKCs (21.4 versus 15.8%). The probability of developing a second primary OKC in patients with NBCCS was higher compared with that in patients with non-syndromic OKCs (76.9 versus 0%). No statistically significant risk factors for OKC recurrence were identified.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44564928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2022-08-22DOI: 10.1007/s12663-022-01773-8
Nidhi Bhatia, Tarush Gupta, Sourabha Patro, S P S Aswin Ram, Dias Queenie Valerian, Kajal Jain
Maxillofacial fractures with the nasal/skull base fractures may preclude nasotracheal intubation, and oro-tracheal intubation may obstruct surgical access. In these cases, submental intubation is a safe and well-accepted alternative, associated with low morbidity and complication rate. We report a case of one such rare complication, wherein following submental intubation, the patient presented with a sublingual sialocele, associated with dilatation of the submandibular duct with surrounding fibrosis. The secondary sublingual sialocele we encountered could have been due to errors in the technique of submental intubation. Hence, thorough knowledge of the submental and submandibular region's anatomy is important to avoid complications.
{"title":"Injury to the Submandibular Duct and Secondary Fibrosis Causing Sialocele: An Unusual Complication of Submental Intubation.","authors":"Nidhi Bhatia, Tarush Gupta, Sourabha Patro, S P S Aswin Ram, Dias Queenie Valerian, Kajal Jain","doi":"10.1007/s12663-022-01773-8","DOIUrl":"10.1007/s12663-022-01773-8","url":null,"abstract":"<p><p>Maxillofacial fractures with the nasal/skull base fractures may preclude nasotracheal intubation, and oro-tracheal intubation may obstruct surgical access. In these cases, submental intubation is a safe and well-accepted alternative, associated with low morbidity and complication rate. We report a case of one such rare complication, wherein following submental intubation, the patient presented with a sublingual sialocele, associated with dilatation of the submandibular duct with surrounding fibrosis. The secondary sublingual sialocele we encountered could have been due to errors in the technique of submental intubation. Hence, thorough knowledge of the submental and submandibular region's anatomy is important to avoid complications.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47541109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The odontogenic keratocyst (OKC) is a benign but locally aggressive growing lesion that infiltrates the bone and surrounding tissue. It is characterized by high rates of recurrence along with rapid growth. Different forms of partly successful treatment therapies are reported. The retrospective study at hand examined 114 patients with OKC treated over a period of 20 years. Data extracted includes gender, age, location, previous treatment for the lesion, surgery, outcome, recurrence rate and follow-up. 63.1% of the patients underwent cystectomy, 22.5% by cystectomy and carnoy solution, 7.2% by cystectomy, and curettage, 4.5% by cystostomy and 2.7% by partial resection. In this study, no significant differences could be observed regarding the surgical method. Most recurrences occurred with 91.9% in the mandible with an average size of 5.5 cm2 and increased in women. Within a mean follow-up time of 3.6 years the recurrence rate was 36.9%, on average after 36 months. Recurrences were most frequently diagnosed at the age of 31-50 (43.9%). Despite numerous studies, there is still no unanimous opinion on an effective therapy for OKC. However, precise resection of OKC can be facilitated by preoperative 3D-imaging and virtual planning.
{"title":"Comparison of Five Different Treatment Approaches of Mandibular Keratocystic Odontogenic Keratocyst (OKC): A Retrospective Recurrence Analysis of Clinical and Radiographic Parameters.","authors":"Henriette L Moellmann, Aida Parviz, Marcia Goldmann-Kirn, Madiha Rana, Majeed Rana","doi":"10.1007/s12663-023-01929-0","DOIUrl":"10.1007/s12663-023-01929-0","url":null,"abstract":"<p><p>The odontogenic keratocyst (OKC) is a benign but locally aggressive growing lesion that infiltrates the bone and surrounding tissue. It is characterized by high rates of recurrence along with rapid growth. Different forms of partly successful treatment therapies are reported. The retrospective study at hand examined 114 patients with OKC treated over a period of 20 years. Data extracted includes gender, age, location, previous treatment for the lesion, surgery, outcome, recurrence rate and follow-up. 63.1% of the patients underwent cystectomy, 22.5% by cystectomy and carnoy solution, 7.2% by cystectomy, and curettage, 4.5% by cystostomy and 2.7% by partial resection. In this study, no significant differences could be observed regarding the surgical method. Most recurrences occurred with 91.9% in the mandible with an average size of 5.5 cm<sup>2</sup> and increased in women. Within a mean follow-up time of 3.6 years the recurrence rate was 36.9%, on average after 36 months. Recurrences were most frequently diagnosed at the age of 31-50 (43.9%). Despite numerous studies, there is still no unanimous opinion on an effective therapy for OKC. However, precise resection of OKC can be facilitated by preoperative 3D-imaging and virtual planning.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45913264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2023-03-14DOI: 10.1007/s12663-023-01885-9
A Romano, G Norino, G Dell'Aversana Orabona, S Barone, D Ordano, C Calvanese, S Troise, L Califano, G Iaconetta
Background: The standard treatment for a dentigerous cyst of maxilla is a surgical enucleation, the extraction of the tooth. In the case of cysts involving the maxillary sinus, a Caldwell-Luc approach is used. In case of large cysts, its marsupialization is carried out in order to reduce the bone defect, followed by enucleation and extraction of the tooth.
Methods: This is a case of a large follicular dentigerous cyst of upper jaw with 18 ectopic tooth within the maxillary sinus, treated in our Unit.
Results: We decided to perform a multi-portal access, the intraoral endoscopic-assisted technique; an intraoral approach has been performed, but less demolishing than the routine intraoral approach, through the anterior wall of the maxillary sinus, already eroded by the lesion. The lesion was very large, occupying the entire maxillary cavity. For this reason, by means of the intraoral approach alone, it was extremely difficult to remove the lesion in its entirety. The endoscopic-assisted technique was combined with intraoral approach. The lesion extended to the maxillary ostium. This did not allow to reach the ostium through the classic endoscopic approach. Endonasal endoscopic access was used both to enucleate the cyst, that was adherent to the orbital floor and soft tissues of the OMC (osteomeatal complex), and to restore the physiological drainage of the maxillary sinus.
Conclusions: We decided to perform a combined intraoral and endoscopic approach to allow a complete excision of the cystic lesion, without being very demolishing and taking advantage of the bone erosion already caused by the large cyst.
{"title":"A Large Follicular Dentigerous Cyst: A New Multi-portal Access: Intraoral and Endoscopic Technique.","authors":"A Romano, G Norino, G Dell'Aversana Orabona, S Barone, D Ordano, C Calvanese, S Troise, L Califano, G Iaconetta","doi":"10.1007/s12663-023-01885-9","DOIUrl":"10.1007/s12663-023-01885-9","url":null,"abstract":"<p><strong>Background: </strong>The standard treatment for a dentigerous cyst of maxilla is a surgical enucleation, the extraction of the tooth. In the case of cysts involving the maxillary sinus, a Caldwell-Luc approach is used. In case of large cysts, its marsupialization is carried out in order to reduce the bone defect, followed by enucleation and extraction of the tooth.</p><p><strong>Methods: </strong>This is a case of a large follicular dentigerous cyst of upper jaw with 18 ectopic tooth within the maxillary sinus, treated in our Unit.</p><p><strong>Results: </strong>We decided to perform a multi-portal access, the intraoral endoscopic-assisted technique; an intraoral approach has been performed, but less demolishing than the routine intraoral approach, through the anterior wall of the maxillary sinus, already eroded by the lesion. The lesion was very large, occupying the entire maxillary cavity. For this reason, by means of the intraoral approach alone, it was extremely difficult to remove the lesion in its entirety. The endoscopic-assisted technique was combined with intraoral approach. The lesion extended to the maxillary ostium. This did not allow to reach the ostium through the classic endoscopic approach. Endonasal endoscopic access was used both to enucleate the cyst, that was adherent to the orbital floor and soft tissues of the OMC (osteomeatal complex), and to restore the physiological drainage of the maxillary sinus.</p><p><strong>Conclusions: </strong>We decided to perform a combined intraoral and endoscopic approach to allow a complete excision of the cystic lesion, without being very demolishing and taking advantage of the bone erosion already caused by the large cyst.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47789783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2022-10-07DOI: 10.1007/s12663-022-01804-4
Ravina Dharamsi, Kumar Nilesh, C D Mouneshkumar, Pankaj Patil
Background: Internal derangement (ID) of temporomandibular joint (TMJ) is a common temporomandibular disorder (TMD) which causes hypomobility of the joint. Minimally invasive treatment modality like arthrocentesis is used as first-line of management having low morbidity and high efficacy. This prospective randomized comparative study was carried to compare the efficacy of intra-articular injection with sodium hyaluronate (SH) and triamcinolone acetonide (TA) after arthrocentesis in ID of TMJ.
Materials and methods: A total 40 patients diagnosed with ID (stage 1-4) were included in the study and randomly divided in two groups. Twenty patients (group A) received intra-articular injection of SH while 20 patients (group B) received intra-articular injection of TA, after arthrocentesis. The clinical parameters of pain (VAS), Maximum mouth opening (MMO) (mm) and clicking sound (present/absent) were evaluated pre-operatively and at seventh day, 1 month and 3 months post-operatively.
Results: There was statistically significant improvement in pain scores in both the groups at all time intervals with SH being superior (p value 0.0086). All the patients showed improved mouth opening at all time intervals, TA being superior but statistically insignificant (p value 0.59). There was reduction in the clicking sound in both the groups which was statistically insignificant at all time intervals.
Conclusions: Arthrocentesis followed by intra-articular injection with SH is superior to TA in terms of pain reduction, while TA showed superiority in terms of improved mouth opening.
背景:颞下颌关节(TMJ)内错位(ID)是一种常见的颞下颌关节疾病(TMD),会导致关节活动度减低。关节腔穿刺术等微创治疗方式被作为一线治疗方法,具有发病率低、疗效高的特点。这项前瞻性随机比较研究旨在比较关节腔穿刺术后关节内注射透明质酸钠(SH)和曲安奈德(TA)治疗颞下颌关节紊乱症的疗效:研究共纳入 40 名确诊为 ID(1-4 期)的患者,并将其随机分为两组。20 名患者(A 组)在关节穿刺术后接受 SH 的关节内注射,20 名患者(B 组)接受 TA 的关节内注射。术前、术后第七天、1 个月和 3 个月对疼痛(VAS)、最大张口度(MMO)(毫米)和咔嗒声(有/无)等临床参数进行评估:在所有时间间隔内,两组患者的疼痛评分均有明显改善,其中 SH 组更优(P 值为 0.0086)。所有患者在各时间段的张口情况均有所改善,TA 组较好,但无统计学意义(P 值 0.59)。两组患者的咔嗒声均有所减少,但在所有时间间隔内均无统计学意义:结论:关节穿刺术后关节内注射SH在减轻疼痛方面优于TA,而TA在改善张口方面更胜一筹。
{"title":"Use of Sodium Hyaluronate and Triamcinolone Acetonide Following Arthrocentesis in Treatment of Internal Derangement of Temporomandibular Joint: A Prospective Randomized Comparative Study.","authors":"Ravina Dharamsi, Kumar Nilesh, C D Mouneshkumar, Pankaj Patil","doi":"10.1007/s12663-022-01804-4","DOIUrl":"10.1007/s12663-022-01804-4","url":null,"abstract":"<p><strong>Background: </strong>Internal derangement (ID) of temporomandibular joint (TMJ) is a common temporomandibular disorder (TMD) which causes hypomobility of the joint. Minimally invasive treatment modality like arthrocentesis is used as first-line of management having low morbidity and high efficacy. This prospective randomized comparative study was carried to compare the efficacy of intra-articular injection with sodium hyaluronate (SH) and triamcinolone acetonide (TA) after arthrocentesis in ID of TMJ.</p><p><strong>Materials and methods: </strong>A total 40 patients diagnosed with ID (stage 1-4) were included in the study and randomly divided in two groups. Twenty patients (group A) received intra-articular injection of SH while 20 patients (group B) received intra-articular injection of TA, after arthrocentesis. The clinical parameters of pain (VAS), Maximum mouth opening (MMO) (mm) and clicking sound (present/absent) were evaluated pre-operatively and at seventh day, 1 month and 3 months post-operatively.</p><p><strong>Results: </strong>There was statistically significant improvement in pain scores in both the groups at all time intervals with SH being superior (<i>p</i> value 0.0086). All the patients showed improved mouth opening at all time intervals, TA being superior but statistically insignificant (<i>p</i> value 0.59). There was reduction in the clicking sound in both the groups which was statistically insignificant at all time intervals.</p><p><strong>Conclusions: </strong>Arthrocentesis followed by intra-articular injection with SH is superior to TA in terms of pain reduction, while TA showed superiority in terms of improved mouth opening.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46598791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2022-09-30DOI: 10.1007/s12663-022-01799-y
Akshaya Subramanian, B M Rudagi, Puja Londhe, Chinmayee Palande
Purpose: To evaluate and compare the efficacy of three osteosynthesis systems in fixation of mandibular angle fractures using Finite Element Analysis.
Materials and methods: In this study, we used a three-dimensional finite element analysis to assess the stress, deformation and strain in three different groups with bite force loads. A three-dimensional finite element model of the mandible with three different plating techniques using modelling software 'Solidworks2018' and was analysed for stress, deformation and strain produced in the bone following biting loads of different magnitude using analysing software 'ANSYS Workbench'.
Results: In this study, we found out that the tensile forces in the matrix miniplate with vertical struts were well distributed in the cortical and cancellous bone on comparison with other two fixation systems in fixation of the mandibular angle fracture and therefore prevents lateral displacement, torsion and bending. The matrix miniplate system revealed less displacement of the fracture segments as compared to the other two plating systems.
Conclusion: The use of matrix miniplate for the treatment of mandibular angle fractures can be considered efficacious. The stress transferred onto the cortical & cancellous bone is least in the matrix plate leading to better stability of the fixation system.
{"title":"A Finite Element Analysis of Single, Double & Matrix Miniplate in Fracture of the Mandibular ANGLE Region: An In Vitro Study.","authors":"Akshaya Subramanian, B M Rudagi, Puja Londhe, Chinmayee Palande","doi":"10.1007/s12663-022-01799-y","DOIUrl":"10.1007/s12663-022-01799-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the efficacy of three osteosynthesis systems in fixation of mandibular angle fractures using Finite Element Analysis.</p><p><strong>Materials and methods: </strong>In this study, we used a three-dimensional finite element analysis to assess the stress, deformation and strain in three different groups with bite force loads. A three-dimensional finite element model of the mandible with three different plating techniques using modelling software 'Solidworks2018' and was analysed for stress, deformation and strain produced in the bone following biting loads of different magnitude using analysing software 'ANSYS Workbench'.</p><p><strong>Results: </strong>In this study, we found out that the tensile forces in the matrix miniplate with vertical struts were well distributed in the cortical and cancellous bone on comparison with other two fixation systems in fixation of the mandibular angle fracture and therefore prevents lateral displacement, torsion and bending. The matrix miniplate system revealed less displacement of the fracture segments as compared to the other two plating systems.</p><p><strong>Conclusion: </strong>The use of matrix miniplate for the treatment of mandibular angle fractures can be considered efficacious. The stress transferred onto the cortical & cancellous bone is least in the matrix plate leading to better stability of the fixation system.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41649942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2022-09-23DOI: 10.1007/s12663-022-01792-5
Yasser Nabil El Hadidi, Alyaa Mahmoud Ahmed Taha, Shaimaa Mohamed Abu El Sadat, Shehabeldin Mohamed Saber
Introduction: Cone beam computed tomography (CBCT) is reliable in the assessment of structures related to teeth. The assessment of the inferior alveolar neurovascular (IAN) bundle location using CBCT is considered one of its prime uses in different mandibular surgeries.
Methodology: Retrospective CBCT data of patients presented to the institute were assessed to measure relations of IAN. Measurements were taken to assess the bone thickness adjacent to IAN, the superior-inferior dimension between the canal and the teeth, and the dimension between the canal and the inferior border of the mandible.
Results: Out of the 170 patients the root apices nearest to the IAN were that of the second molars (1.76 ± 1.86 mm). The IAN was closest to the inferior border of the mandible at the roots of the second molars (8 ± 3.4 mm). The buccal bone thickness had its greater dimension buccal to the IAN at the area of the second molar (5.16 ± 1.26 mm).
Conclusion: Two mini-plates in trauma do not increase the risk of injury. It is advisable in apicectomy not to extend 1.5 mm apically. The thickness of the nerve-lateralization window should not exceed 2 mm. In body osteotomy procedure, perform surgery anterior to premolars as much as possible.
简介锥形束计算机断层扫描(CBCT)是评估牙齿相关结构的可靠方法。使用 CBCT 评估下牙槽神经血管束(IAN)的位置被认为是其在不同下颌骨手术中的主要用途之一:方法:对到该研究所就诊的患者的 CBCT 数据进行回顾性评估,以测量 IAN 的关系。测量结果用于评估 IAN 附近的骨厚度、根管与牙齿之间的上下尺寸以及根管与下颌骨下缘之间的尺寸:在 170 名患者中,离 IAN 最近的根尖是第二磨牙的根尖(1.76 ± 1.86 mm)。第二磨牙根部的 IAN 最接近下颌骨下缘(8 ± 3.4 毫米)。颊骨厚度在第二磨牙区域的 IAN 颊侧最大(5.16 ± 1.26 mm):结论:在创伤中使用两个迷你板不会增加损伤风险。在进行根尖切除术时,最好不要向根尖延伸 1.5 毫米。神经侧窗的厚度不应超过 2 毫米。在体部截骨术中,尽可能在前磨牙前方进行手术。
{"title":"Anatomical Analysis of Inferior Alveolar Nerve Relation to Mandibular Posterior Teeth Using Cone Beam Computed Tomography: A Retrospective Radiographic Analysis Study.","authors":"Yasser Nabil El Hadidi, Alyaa Mahmoud Ahmed Taha, Shaimaa Mohamed Abu El Sadat, Shehabeldin Mohamed Saber","doi":"10.1007/s12663-022-01792-5","DOIUrl":"10.1007/s12663-022-01792-5","url":null,"abstract":"<p><strong>Introduction: </strong>Cone beam computed tomography (CBCT) is reliable in the assessment of structures related to teeth. The assessment of the inferior alveolar neurovascular (IAN) bundle location using CBCT is considered one of its prime uses in different mandibular surgeries.</p><p><strong>Methodology: </strong>Retrospective CBCT data of patients presented to the institute were assessed to measure relations of IAN. Measurements were taken to assess the bone thickness adjacent to IAN, the superior-inferior dimension between the canal and the teeth, and the dimension between the canal and the inferior border of the mandible.</p><p><strong>Results: </strong>Out of the 170 patients the root apices nearest to the IAN were that of the second molars (1.76 ± 1.86 mm). The IAN was closest to the inferior border of the mandible at the roots of the second molars (8 ± 3.4 mm). The buccal bone thickness had its greater dimension buccal to the IAN at the area of the second molar (5.16 ± 1.26 mm).</p><p><strong>Conclusion: </strong>Two mini-plates in trauma do not increase the risk of injury. It is advisable in apicectomy not to extend 1.5 mm apically. The thickness of the nerve-lateralization window should not exceed 2 mm. In body osteotomy procedure, perform surgery anterior to premolars as much as possible.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48394134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The objective was to evaluate the efficacy of biochemical markers (WBC, CRP and fibrinogen) and the course of odontogenic space infections in 50 patients.
Material and methods: Blood samples were taken preoperatively and postoperatively at day 0, day 4, day 8 and day 12 for measuring the levels of all three biomarkers. The trends of the biomarkers were observed and compared with assessment parameters such as dental etiology, number of teeth involved, number of spaces involved, mouth opening and pain. Active pus discharge, dysphagia, hoarseness and swelling were assessed and scored accordingly.
Results: The data were subjected to paired 't' test, McNemar's and Pearson's bivariate correlation as appropriate. Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection. All three biomarkers (WBC, CRP and fibrinogen) are significant markers for hospital stay (p < 0.01). Prospective analysis indicates that only one biomarker cannot be used to rule out specific diagnosis.
Conclusion: The combination of three biochemical markers assessed in the present study (WBC, CRP and fibrinogen) should be used as prognostic factor in assessment, clinical severity and efficacy of treatment regime for patients as these can reliably predict the clinical course of odontogenic infection.
{"title":"To Evaluate the Efficacy of Biomarkers as Monitoring Tool in Patients with Fascial Space Infections of Odontogenic Origin: A Clinical Study.","authors":"Mehak Malhotra, Tejinder Kaur, Sahiba Kukreja, Ramandeep Singh Bhullar, Amit Dhawan, Amneet Sandhu","doi":"10.1007/s12663-022-01722-5","DOIUrl":"10.1007/s12663-022-01722-5","url":null,"abstract":"<p><strong>Introduction: </strong>The objective was to evaluate the efficacy of biochemical markers (WBC, CRP and fibrinogen) and the course of odontogenic space infections in 50 patients.</p><p><strong>Material and methods: </strong>Blood samples were taken preoperatively and postoperatively at day 0, day 4, day 8 and day 12 for measuring the levels of all three biomarkers. The trends of the biomarkers were observed and compared with assessment parameters such as dental etiology, number of teeth involved, number of spaces involved, mouth opening and pain. Active pus discharge, dysphagia, hoarseness and swelling were assessed and scored accordingly.</p><p><strong>Results: </strong>The data were subjected to paired '<i>t</i>' test, McNemar's and Pearson's bivariate correlation as appropriate. Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection. All three biomarkers (WBC, CRP and fibrinogen) are significant markers for hospital stay (<i>p</i> < 0.01). Prospective analysis indicates that only one biomarker cannot be used to rule out specific diagnosis.</p><p><strong>Conclusion: </strong>The combination of three biochemical markers assessed in the present study (WBC, CRP and fibrinogen) should be used as prognostic factor in assessment, clinical severity and efficacy of treatment regime for patients as these can reliably predict the clinical course of odontogenic infection.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41454461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The work of Massarelli et al. is well known for popularizing t-FAMMIF, however to the best of our knowledge bilateral flap has never been harvested and inset together to reconstruct a composite defect. Larger unilateral flaps have been reported in literature but to harvest such a flap in patients of S.E Asian region would entail high propensity for trismus in the post op period as they have tendency for submucosal fibrosis owing to their guthka (chewing tobacco) chewing habits. Oral submucous fibrosis is contra-indication for this flap; however, some of our patients despite being chronic abusers of guthka do not have clinical presentation of OSMF and if the defect post ablation is appropriate are chosen to be candidates for reconstruction with the flap. In this select population harvesting larger flaps can potentially lead to trismus, a fact highlighted in the paper.
{"title":"Bilateral Tunnelized FAMM Islanded Flap for Reconstruction of Composite Defect of Tongue and Floor of Mouth: A Case Report.","authors":"Swagnik Chakrabarti, Abhishek Ghosh, Sandeep Bhukkar, Aseem Mishra","doi":"10.1007/s12663-021-01624-y","DOIUrl":"10.1007/s12663-021-01624-y","url":null,"abstract":"<p><p>The work of Massarelli et al. is well known for popularizing t-FAMMIF, however to the best of our knowledge bilateral flap has never been harvested and inset together to reconstruct a composite defect. Larger unilateral flaps have been reported in literature but to harvest such a flap in patients of S.E Asian region would entail high propensity for trismus in the post op period as they have tendency for submucosal fibrosis owing to their guthka (chewing tobacco) chewing habits. Oral submucous fibrosis is contra-indication for this flap; however, some of our patients despite being chronic abusers of guthka do not have clinical presentation of OSMF and if the defect post ablation is appropriate are chosen to be candidates for reconstruction with the flap. In this select population harvesting larger flaps can potentially lead to trismus, a fact highlighted in the paper.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45596732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2021-01-31DOI: 10.1007/s12663-021-01518-z
Adarsh Kudva, Sunil Upadhyaya, Rajesh Nair
Abstract: Secondary correction for aesthetic purposes can be more challenging as the fractured segments may be united in abnormal positions and would require osteotomy procedures before mobilizing the segments for reconstruction. Such maneuvers require adequate exposure and visibility. The subcranial approach is an effective alternate to classical approaches, which required frontal lobe retraction.
Conclusion: Subcranial approach is a viable alternative to posttraumatic deformity of frontal bone.
{"title":"Subcranial Approach for Management of Secondary Frontal Bone Deformity.","authors":"Adarsh Kudva, Sunil Upadhyaya, Rajesh Nair","doi":"10.1007/s12663-021-01518-z","DOIUrl":"10.1007/s12663-021-01518-z","url":null,"abstract":"<p><strong>Abstract: </strong>Secondary correction for aesthetic purposes can be more challenging as the fractured segments may be united in abnormal positions and would require osteotomy procedures before mobilizing the segments for reconstruction. Such maneuvers require adequate exposure and visibility. The subcranial approach is an effective alternate to classical approaches, which required frontal lobe retraction.</p><p><strong>Conclusion: </strong>Subcranial approach is a viable alternative to posttraumatic deformity of frontal bone.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49210373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}