Journal of the Korean Association of Oral and Maxillofacial Surgeons最新文献

Objectives: Implant success depends on osseointegration that is influenced by macrogeometry, including thread design. Thread macrogeometry has a crucial role in achieving primary stability, particularly in low-density bone. Our study reviews the thread design's impact on implant stability, focusing on Straumann BLX (Straumann Co.) implants for practical insights.

Materials and methods: We searched the PubMed/MEDLINE and Embase for studies released until August 2023 using the following keywords: "implant", "macrogeometry", "thread", "thread depth", "thread pitch", "thread geometry", "macrodesign", "flute", "osseointegration", and "stability". In addition, 58 Straumann BLX implants with dynamic threads, which feature a deep thread design and incorporate a multi-helix flute structure to enhance primary stability across different bone densities, were reviewed retrospectively at our institute.

Results: The literature demonstrated that thread pitch, depth, and flute design significantly affect stress distribution and initial stability, especially in low-density bone. Implants with deep threads and spiral flutes showed improved primary stability and insertion efficiency. Clinically, retrospective data from 58 cases supported favorable outcomes in challenging bone conditions such as posterior maxilla and implant replacement sites.

Conclusion: We need to determine appropriate designs for implants with the consideration of bone quality and implantation bed condition.

Patients with anteroposterior maxillary deficiency and mandibular prognathism associated with a long-face pattern exhibit reduced anterior and lateral projection of the zygomaticomaxillary complex. Several techniques have been combined with orthognathic surgery to enhance the volume and definition of this region, such as zygomatic osteotomy. Two female patients, aged 22 (Case A) and 29 (Case B), with class II (Case A) and III (Case B) malocclusion, respectively, complained about facial aesthetics due to a long face and lack of malar projection. Le Fort I osteotomy to advance the maxilla, bilateral mandibular ramus osteotomy to set back the mandible, mentoplasty for advancement and width reduction, and zygomatic osteotomy were erformed. The patients underwent computed tomography scans, and superimposed images indicated that a volumetric increase in the malar region was achieved through the anterolateral movement of the zygomatic body. Improvements were noted in the paranasal region (Case A), better alignment of the upper and lower lips, the chin region, and an improved chin-neckline ratio (in both cases). The patients were satisfied with the results and are under follow-up. In summary, zygomatic osteotomy combined with orthognathic surgery proved to be a predictable and safe strategy for increasing malar prominence, with satisfactory aesthetic and functional outcomes.

In this paper, we systematically review the literature on papillary thyroid carcinoma (PTC) metastasis to the mandible. This is a rare oc-currence, especially in young, asymptomatic patients. We propose appropriate surgical and adjuvant therapy guidelines based on our findings. A systematic PubMed search (up to July 2023) identified 10 eligible cases of papillary or follicular thyroid carcinoma with metastasis to the mandible. Studies of patients with different histologic types or without confirmed distant metastasis were excluded. A rare case of PTC metastasizing to the mandible in a young male highlights an unusual presentation. Surgical treatment of both primary and metastatic sites, along with aggressive adjuvant therapy after surgery, had a positive impact on survival.

Objectives: : To evaluate changes in bone volume induced by absorbable collagen sponge (ACS) use during maxillary sinus floor elevation and to identify associated factors.

Patients and methods: After elevating the sinus membrane through a crestal approach (CA) or lateral approach (LA), ACS (AteloPlug; Bioland) was inserted, and dental implants were placed simultaneously. Changes in bone volume at 12 months were evaluated by three-dimensional (3D) analyses of cone-beam computed tomography images. Factors including age, sex, smoking status, span, number of ACSs, and perforation were assessed for associations with changes in sinus bone volume using uni- and multivariable analyses based on the generalized estimating equation.

Results: : Medical records of 108 patients were collected and retrospectively evaluated, with 135 regions of interest defined (CA, 45; LA, 90). The changes in bone volume at the sinus floor were 159.38±134.52 mm³ and 486.83±253.14 mm³ in the CA and LA groups, respectively. Bone volume changes in the CA group were significantly affected by the number of ACSs (P<0.001) and perforation of the sinus membrane (P<0.001), whereas bone volume changes in the LA group were significantly affected by the number of ACSs (P=0.001).

Conclusion: : Use of ACS for maxillary sinus elevation resulted in detection of new bone formation in 3D analysis. Clinicians can ensure stable amounts of bone formation by inserting an adequate number of ACSs.

Objectives: : Many three-dimensionally-evaluated difficulty indices for impacted third molars have been suggested; however, their radiological and clinical validation according to the inferior alveolar nerve (IAN) remains unknown. This study aimed to evaluate the association of the difficulty index with IAN proximity and injury risk.

Materials and methods: : We retrospectively enrolled patients with cone-beam computed tomography (CBCT) for a fully impacted mandibular third molar from January to December 2020. We evaluated the third molar according to the difficulty index based on panoramic x-ray and the nerve index based on CBCT and analyzed postoperative nerve complications. The relationships among nerve proximity, difficulty indices, and nerve complications were evaluated. Data were analyzed using the Pearson's chi-square test and the Cochran-Armitage test for trends.

Results: : We included 367 subjects (177 males, 28.9±9.8 years) with follow-up of at least 1 month. Twenty-two subjects had nerve complications. Radiologic evaluation showed that third molars with a high nerve index had an increased difficulty index (P=0.001). Nerve complication risk showed a statistically significant correlation with both nerve and difficulty indices.

Conclusion: : In conclusion, the difficulty index of an impacted third molar was valid in terms of its spatial relationship with the IAN and in predicting nerve complications.

Growth differentiation factor 15 (GDF-15), a cytokine within the transforming growth factor-β superfamily, is involved in various malignancies, with implications in oral squamous cell carcinoma (OSCC). Elevated GDF-15 levels are correlated with unfavorable prognosis, tumor progression, and chemotherapy resistance, and the protein has been identified as a potential diagnostic and prognostic biomarker for OSCC. Personalized treatment strategies based on GDF-15 expression could improve treatment outcomes.

Chronic recurrent sialadenitis is characterized by repeated inflammation of the salivary glands, leading to ductal structural abnormalities and salivary stasis, often resulting in megaducts. This study evaluates the efficacy of ultrasonography as a diagnostic and follow-up tool for the management of chronic recurrent sialadenitis. Three patients underwent sialendoscopy, which involved ductal dilation, removal of mucous plugs, and steroid administration. Ultrasonography was used postoperatively to monitor changes in ductal structure, including megaduct size, and to assess clinical outcomes. All three cases showed marked improvement in clinical symptoms after treatment. Ultrasonography demonstrated a reduction in megaduct size and provided real-time visualization of ductal and glandular changes. Compared to traditional imaging methods such as magnetic resonance imaging or sialography, ultrasonography offered a practical and safe option for follow-up assessment. This study highlights the utility of ultrasonography as an accessible, non-invasive, and effective tool for evaluating treatment outcomes in chronic recurrent sialadenitis. By offering detailed visualization of ductal changes and facilitating longitudinal follow-up, ultrasonography can optimize the management of this condition.

Objectives: : Geriatric maxillofacial trauma (GMT) is not an uncommon entity in maxillofacial surgery practice. The aim of the study was to document the experience with GMT cases in a single private dental college and hospital in an effort to uncover the etiology, prevalence, fracture sites, and various types of treatment in GMT.

Materials and methods: : This was a retrospective study conducted at Saveetha Dental College and Hospital in Chennai. Data from patients diagnosed with maxillofacial trauma between January 2019 and December 2023 were retrieved from hospital records, and those aged ≥60 years were included in the study. Patients' basic demographic details and the prevalence, etiology, fracture sites, and various treatments of GMT were recorded and analyzed. The collected data were entered into a structured database and analyzed using IBM SPSS Statistics ver. 23.0 (IBM).

Results: : A total of 867 cases were screened, and 37 (4.04%) GMT patients were finally included in the study. The mean age of the study population was 65±5 years, and there were six females and 31 males. A ground-level fall was the common etiology (n=17), and the most common site of fracture was the mandible (n=15). Open reduction and internal fixation (ORIF) was the most common treatment modality (n=24) among included cases.

Conclusion: : Although the prevalence of GMT was low, ground-level falls were a common reason for trauma; hence, geriatric patients require comprehensive care in home and outdoor settings. Enhanced anesthetic and surgical techniques have made ORIF a suitable treatment approach in the present era.

Objectives: : This study aims to evaluate the accuracy and effectiveness of temporomandibular joint (TMJ) arthrocentesis using the three-dimensional (3D)-printed TMJ injection guide in cases of hemarthrosis caused by condyle fractures.

Materials and methods: : A retrospective chart review was conducted for patients treated with the customized TMJ arthrocentesis guide to address hemarthrosis. Inclusion criteria included adults older than 18 years with condylar fractures not indicated for open reduction and internal fixation. The guide was fabricated using computed tomography or cone-beam computed tomography scans and 3D printing to control the degree and depth of the needle through the guide to aspirate hemarthrosis.

Results: : Six joints from five patients (average age 52.4 years) were treated using the guide. Post-procedural magnetic resonance imaging confirmed complete resolution of hemarthrosis in all cases. A representative case demonstrated successful outcomes with normal healing and no complications at 8 months post-procedure.

Conclusion: : The customized TMJ injection guide, using ear-based reference points, significantly enhances the accuracy and safety of TMJ arthrocentesis. This innovation is expected to increase the accessibility and effectiveness of TMJ-related treatments for clinicians without specialized TMJ expertise.