Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Accurately recording the deficiency of the three-dimensional position of dental implants and the predetermined occlusal relationship of edentulous jaws presents a significant challenge. This study aimed to achieve a truly digital workflow of immediate full-arch implant restoration by combinedcone-beam computed tomography (CBCT), photogrammetry (PG) devices, and intraoral scanners (IOS). This approach significantly reduces patient tooth loss time, minimizes the overall "chair time", and provides precise, comfortable, and efficient implant restoration treatment. A total of 11 edentulous patients (mean age 64.72 ± 9.83 years) were treated, and outcomes such as implant survival, prosthesis survival rates, marginal bone resorption, and incidences of complications were evaluated. The results demonstrated that immediate full-arch rehabilitation of edentulous jaws on 4 or 6 implants using a PG system is an effective, safe, and efficient approach to rehabilitation.

Purpose: This study aims to document the experiences of the authors during a maxillofacial humanitarian mission in Angola, with a focus on assessing the challenges faced by local maxillofacial surgeons. Additionally, the study evaluates the role of internet-based tools in planning and executing such missions to enhance the efficiency and impact of future interventions.

Material and methods: THE STUDY INVOLVED TWO PARTS: (1) An online survey conducted with maxillofacial surgeons across various regions of Angola to assess local needs, difficulties, and obstacles before the mission. The survey, administered via Google Forms®, included demographic questions and queries about specific challenges. (2) The humanitarian mission itself, which took place in March 2023 at Hospital Josina Machel in Luanda. During the mission, the researchers documented maxillofacial disorders treated and outcomes for the patients attended by Angolan surgeons. Data collected from medical charts included demographic variables, types of maxillofacial disorders, and treatment outcomes.

Results: The survey revealed significant challenges, including a lack of materials in surgical centers and outpatient clinics, and the need for more specialized professionals. The humanitarian mission involved treating 26 emergency cases and 17 inpatients, with significant educational sessions conducted for local surgeons. Despite resource limitations, complex surgeries were successfully performed, demonstrating the potential for online collaboration and meticulous planning to overcome logistical challenges.

Conclusions: This study underscores the significant challenges faced by maxillofacial surgeons in Angola. It demonstrates how online tools and international collaboration were crucial in improving mission planning and execution.

Purpose: To clarify the effects of preoperative nutritional evaluation on the prognosis of patients with tongue squamous cell carcinoma.

Methods: This retrospective cohort study involves 126 consecutive patients who underwent radical surgery as their initial treatment and received treatment for more than 3 years. The markers considered in this study are GGT (γ-GTP), CAR (C-reactive protein (CRP)-to-Alb Ratio), GLR (GGT-to-Lymphocytes Ratio), GPR (GGT-to-Platelet ratio), GNR (GGT-to-Neutrophil ratio), NLR (Neutrophil-to-Lymphocyte ratio), PLR (platelet-to-lymphocytes ratio), OPNI (Onodera`s prognostic nutritional index), PINI (Prognostic Immune and Nutritional Index) and Albumin (Alb). Each marker was calculated from blood test results up to one month before the initial surgery to assess overall survival (OS) and disease-free survival (DFS).

Results: Univariate analysis of OS identified the depth of invasion (DOI P=0.004), stage classification (P<0.001), Body mass index (BMI) (P=0.007), OPNI (P=0.005), prognostic inflammatory and nutritional indices (PINI, P=0.011), and albumin (Alb) (P = 0.006) as significant predictors. Cox regression analysis revealed significant differences in BMI, pathological grade, and OPNI. The OPNI cut-off value was 51.05, indicating its effectiveness in predicting tongue cancer prognosis. With regard to DFS, only BMI showed a significant difference, with no notable difference among other markers.

Conclusion: The OPNI may be a useful prognostic factor for tongue cancer.

Although the overall prognosis for early-stage oral tongue squamous cell carcinoma is good, a significant portion of patients still experience locoregional recurrence and affect the disease-specific survival. At present, whether more aggressive postoperative radiation therapy in this particular patient population should be taken is still controversial. The analysis exhibited that disease-free survival (OR=0.53, 95% CI:0.35-0.81; P=0.003) and locoregional recurrence-free survival (OR=0.59, 95% CI:0.38-0.93; P=0.022) was significant improved in patients received radiotherapy compared to surgery alone. However, radiotherapy failed to improve overall survival (HR=1.06 95% CI:0.42-2.64, P=0.901). Furthermore, two studies reported overall survival based on depth of invasion as well. The pooled OR was 1.65 (95% CI:0.31-8.91, P=0.221) and no survival benefit was observed for early-stage patients underwent adjuvant radiotherapy according to depth of invasion. Current evidence is insufficient to independently support the depth of invasion as an effective indication for radiotherapy of early tongue cancer.

Introduction: Facemask(FM) is an orthopedic appliance with extraoral and intraoral anchoring units used in treatment of maxillary retrognathia. Aim of this study was to assess effects of tooth-supported FM application via fixed orthodontic appliances on craniofacial structures with finite element stress analysis.

Materials and methods: A model was constructed on maxillary teeth with Roth brackets (0.018"slot), 0.018"x0.025" stainless steel archwire, and crimpable hooks placed distal to upper lateral incisors. The scenario included application of FM with 350g force, forming 30⁰ angle with occlusal plane. Stress distributions and displacements on craniofacial bones, sutures, intraoral anchoring unit and maxillary teeth were evaluated.

Results: High stress distributions were observed in anterior maxilla, pterygomaxillary region, zygomatic arch, and frontal process of zygomatic bone. Zygomaticotemporal, zygomaticofrontal, pterygomaxillary sutures and intraoral anchoring unit showed high stress distributions too. Stresses along maxillary teeth were not uniform, declaring increased stress distributions at the anterior region, but tended to decrease to posterior. Forward displacement was observed in all landmarks and counterclockwise rotation of maxilla and dentition were observed vertically. Narrowing in maxillary dental arch was observed.

Discussion: Tooth-supported FM application over the brackets created stresses on craniofacial bones and sutures. Increased stress distribution were evident at the anterior maxillary region close to the force application points. Displacements were observed in all directions, drawing special attention to transversal narrowing and counterclockwise rotation of maxilla. In this respect, clinical attention should be made during FM application anchored from fixed braces, with either using rigid archwires or supporting mechanics with transpalatal arches.

Aim: There remains no consensus on the definition or value of early oral feeding after head and neck surgery. The main objective of this study was to determine how immediate oral feeding (IOF) with soft diet within 2 days following free-flap reconstruction of the oral cavity affected severe post-operative morbidity within 30 days and length of hospital stay (LoS).

Methods: A retrospective cohort study was carried out in 2021-2023 in our tertiary hospital center. The associations between severe post-operative morbidity and LoS with the independent variable of IOF were analyzed by multivariate regression analysis. We also examined the factors associated with delayed oral feeding (DOF); lack of oral feeding within 10 post-operative days. The confounding variables adjusted for were demographic-related (age, sex), comorbidity-related (ASA score, undernutrition, prior history), and surgery-related (substance loss type/location, flap type).

Results: Inclusion was 132 patients: n = 29/132 (22 %) IOF patients versus n = 103/132 (78 %) patients undergoing oral feeding after ≥3 post-operative days. IOF was found independently associated with reduced severe post-operative morbidity within 30 days (AOR 0.3[0.1-0.8], p = 0.01) and shorter length of stay (AEE -6.7 [-11.8--1.6], p = 0.01) compared to oral feeding after ≥3 post-operative days. DOF was found positively associated with cardiovascular history (AOR 2.7[1.1-7.3], p = 0.04) but negatively associated with a history of head and neck surgery with radiotherapy (AOR 0.4[0.1-0.8], p = 0.05).

Conclusion: Protocols for post-operative oral feeding should consider IOF. Criteria for good candidates for IOF require further definition for surgeons to implement IOF more widely.

Background: Oral cancer is always a global burden. It is the sixteenth most common cancer. It leads to metastasis since it is often diagnosed at late stages. To monitor the progress of this condition, various biomarkers are being utilized. Osteopontin is one such biomarker and its level in bodily fluids can be used as a reliable biomarker.

Aims and objectives: The current study aims to review and evaluate the prognostic role of osteopontin in oral squamous cell carcinoma.

Materials and methods: A literature search was conducted across various databases such as Scopus, PubMed and Google Scholar. It yielded 18 articles totally using MeSH terms. The inclusion criteria were original research articles written only in English language involving both tissue and plasma osteopontin on oral cancer patients. Of these, only two articles which met the inclusion criteria were added into this systematic review. The search had no time restriction.

Results: The studies showed that osteopontin play a vital role in the prognosis of the OSCC patients. One study from Taiwan and other from India proved the osteopontin expression in plasma and tissue can help to predict the prognosis of patients with oral cancer. Also, the level of plasma osteopontin was correlated with aggressiveness of OSCC. Tissue osteopontin expression was significantly lower in stage I OSCC patients when compared with stage II and III. Since there were only two studies, there is limited evidence of results.

Conclusion: From these findings, osteopontin can also be used as a reliable biomarker to predict the prognosis of oral cancer. Since there were only two studies to substantiate the finding, there is limited evidence and more studies are warranted to confirm the results.

Although the bifid or trifid mandibular condyle is a rare entity, the tetrafid mandibular condyle is a more rare entity. This article presents the first case of tetrafid and trifid mandibular condyle of a 31-year-old patient with a history of previous trauma. The patient had with symptoms such as crepitus of the right temporomandibular joint and pain upon palpation in the preauricular region and masseter muscle. This rare entity was diagnosed on a panoramic radiograph and confirmed using computed tomography and magnetic resonance imaging. As there were symptoms, a hard stabilization appliance was applied to the patient.

Background: To analyze causes of recurrence following radical mandibular resection of ameloblastoma, and to propose surgical variation.

Methods: We conducted a retrospective analysis of patients treated for ameloblastoma from 2012 to 2024, specifically those who underwent radical mandibular resection followed by reconstruction with autologous bone flaps, focusing on cases of recurrence.

Results: Six patients were included in the study, all with primary tumors located in the mandible. Recurrence occurred 5 to 23 years post-surgery. Two patients had recurrence within the residual mandible due to insufficient margins, necessitating further resection and reconstructed with bone flaps Three patients had recurrences associated with residual tumor cells in the soft tissue, which affected the grafted bone: two required extensive resection and additional bone flap reconstruction, while one had a limited recurrence that was managed by soft tissue excision. Additionally, one patient had an isolated soft tissue recurrence that was addressed through resection.

Conclusion: Adequate resection margins are vital to minimizing recurrence risk. Invasive procedures should be avoided to prevent tumor spread, and thorough excision of affected areas during surgery is essential.

Introduction: Submandibular gland (SMG) excision can be achieved by conventional approach (Conv) through a cervical incision or endoscopic surgery (Endo). The aim of this study was to propose a new concept and technique of full endoscopic SMG excision through the retroauricular hairline incision and investigate its safety and feasibility.

Materials and methods: A total of 141 patients with SMG diseases treated at our department from 2021 to 2024 were retrospectively enrolled in the Endo group (n = 74) and the Conv group (n = 67). Interested variables included age, sex, pathological diagnosis, incision length, intraoperative bleeding, operation duration, hospitalization stay, complications, and aesthetic satisfaction score. SPSS software 26.0 and G power 3.1.9 were used for analysis.

Results: There were no significant differences between the two groups in age, sex, follow-up period, pathological type, incision length or postoperative complications. Significant differences were found for the amount of bleeding [Endo: 12.5 (10.0) mL; Conv: 20.0 (20.0) mL, P < 0.001] and aesthetic satisfaction score [Endo: 8.8 ± 1.3; Conv: 7.5 ± 1.8, P < 0.001]. The operation duration of the Endo group was longer for early cases [Endo: 110.0 (27.5) min; Conv: 87.0 (40.0) min, P < 0.001], yet there was no significant difference from the thirtieth case [Endo: 85.0 (20.0) min; Conv: 89.0 (52.5) min, P = 0.894]. No recurrence of SMG diseases occurred during the follow-up period.

Discussion: Full endoscopic SMG excision through the retroauricular hairline approach results in less intraoperative bleeding, invisible scars, and greater patient satisfaction, achieving ideal clinical and cosmetic outcomes.