Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Objectives: The study aimed to estimate the incidence of flap dehiscence and/or necrosis (FD/N) following standard rotational flap (SRF) surgery for cranial vault osteomyelitis without intracranial involvement (CVO) and to identify factors associated with these complications.

Methods: A retrospective study was conducted using chart reviews of patients who underwent SRF to cover CVO defects over a 10-year period. Twenty-one predictor variables were analysed, categorised into demographic, health status, anatomic, and surgical factors. The primary outcome was the occurrence of FD/N. Descriptive, bi- and multivariate regression analyses were used to identify variables significantly associated with FD/N (P ≤ 0.05).

Results: The study included 154 subjects who underwent SRF (26.6 % female), with a mean age of 75.6 ± 12.8 years (range, 26-94). The incidence of FD/N was 5.2 %. Multivariate analysis revealed that smoking (odds ratio [OR] 1.07; P = 0.04), second surgery (OR 1.18; P < 0.001), compromised scalp vascularity (OR 1.1; P = 0.007), and defects at the central scalp and vertex (OR 1.08; P = 0.02) were statistically significantly associated with an increased risk of FD/N.

Conclusions: FD/N is an infrequent complication following SRF for CVO. Significant modifiable risk factors included smoking, multiple flap operations, compromised scalp vascularity, and defects at the central scalp and vertex. Addressing these factors may help reduce the risk of FD/N in this patient population. Future research should investigate outcomes among different flap types for CVO defects.

Objective: Coronectomy is an alternative to traditional mandibular third molar extraction when the inferior alveolar nerve (IAN) is closely associated with the roots of these molars. Given the paucity of research on the long-term outcomes after coronectomy, we conducted this study to evaluate clinical and radiographic outcomes at least 5 years post-coronectomy.

Methods: This retrospective study enrolled all patients with impacted mandibular third molars treated with coronectomy at our institution who were willing to return for follow-up evaluation 5 years or more after their original procedure. Patient data were obtained retrospectively from hospital records and during oral examinations at the follow-up study appointment. We assessed the following postoperative clinical outcomes: injury to the IAN, root migration distance, root exposure in the oral cavity, non-healing sockets, pain or sensitivity in the coronectomy area, and the presence of periapical pathology.

Results: Of the 196 patients invited to participate, 66 patients (male, 32 %; female, 68 %) who underwent a total of 75 coronectomies were included in this study. No persistent hypoesthesia of the lower lip were reported during follow-up. Two patients required reoperation because of root eruption into the oral cavity. Approximately two-thirds of residual roots migrated from their position on preoperative radiographs; the mean migration distance was 3.2 ± 1.3 mm. Two patients (2.6 %) had pain in the soft tissues around the coronectomy site.

Conclusion: Our findings confirm that coronectomy is an effective treatment option for preventing IAN injury when the nerve is in close proximity to the roots of these molars.

Tongue tip defects cause severe dysfunction of speech and swallowing, yet there are few techniques of reconstruction for tongue tip defects. This report describes the effectiveness of a sliding tongue flap for tongue tip reconstruction following anterior partial glossectomy.

Background: Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity, which is mainly a series of atypical hyperplasia of oral epithelial cells, and the overall prognosis remains poor.

Methods: GSE37991 and GSE38517 were downloaded from gene expression omnibus (GEO) to identify differentially expressed genes (DEGs). Functional enrichment analysis of DEGs was performed, weighted gene co-expression network analysis (WGCNA) was used. Protein-protein interaction (PPI) network was constructed. Core gene expression was visualized using a heatmap. Comparative toxicogenomics database (CTD) and miRNA analyses identified related diseases and regulatory miRNAs. Western blot (WB) was conducted to examine expression of COL11A1 and TGF-SMAD signaling components in OSCC samples.

Results: 5163 DEGs were identified. DEGs were enriched in metabolic processes and signaling pathways, including TGF-β/SMAD and PI3K-Akt. WGCNA identified 11 core modules. PPI network analysis revealed five core genes: COL11A1, AURKA, MELK, CCNA2, and BUB1. Heatmap analysis showed that COL11A1 is highly expressed in OSCC. CTD analysis indicated that COL11A1 is associated with OSCC. miRNA prediction identified potential regulatory factors. Western blot analysis demonstrated that COL11A1 is overexpressed in OSCC and is associated with TGF-SMAD signaling, inflammation, and cell cycle progression.

Conclusion: COL11A1 is highly expressed in OSCC and may serve as a target gene interacting with the TGF-SMAD signaling pathway.

Ossifying fibroma (OF) is a rare benign fibro-osseous neoplasm developing mostly in maxillo-facial bones. OF is divided in cemento-ossifying fibroma (COF), juvenile trabecular ossifying fibroma (JTOF) and psammomatoid ossifying fibroma (PSOF). The aim of this systematic review was to synthetize the existing literature on OF, investigating the clinical and radiological parameters related to the different forms of the disease, and to compare the treatment modalities according to their associated recurrence rate. Three databases were searched in March 2024, with an update in September 2024. Eligibility criteria included studies reporting on patients with OF, surgical treatment and follow-up data. Of the 2016 studies identified, 22 were retained after eligibility assessment. A total of 492 patients were included. Most OF presented with painless swelling. COF affected 61.1 % of women with a mean age of 29.5, JTOF presented in 55.7 % of male children, and PSOF had no predilection for sex with a mean age of 19.5 years. Enucleation and curettage were associated with an elevated recurrence rate in JTOF (12/30) and PSOF (10/16). PSOF (6 cases) and JTOF (15 cases) showed no recurrence with radical surgery. Same recurrence rates in COF were seen for conservative and radical surgery. Although radical surgery seemed to avoid recurrence in JTOF and PSOF, conservative surgery such as enucleation and curettage with additional peripheral ostectomy should be considered primarily to lessen the morbidity induced by radical resection. Close clinical and radiological follow-up should be undertaken to diagnose early recurrence.

Purpose: Reconstruction of bone defects prior to implant installation is a challenge, especially when the patient uses bisphosphonates. Given this difficulty, many studies investigate biomaterials that can improve the bone regeneration process. In this context, this study aimed to investigate the effect of platelet-rich fibrin (PRF) and Bio-Oss (BO) on bone regeneration of rats submitted to critical-sized calvaria defects and treated with ZA.

Methods: Thirty Wistar rats received a single dose of ZA (120 μg/kg) and after 7 days, were submitted to an 8 mm calvaria defect. The animals were divided into 5 groups (n = 6): ZA, BO, PRF or BO+PRF; animals from control group did not receive ZA. All animals were euthanized 12 weeks after surgical procedure and calvaria collected to histological, histomorphometric and micro-CT analyses.

Results: BO+PRF increased the number of osteoblasts (33 %) and osteoclasts (58 %), as well as blood vessels (70 %) and Type I collagen (52 %) (p < 0.05) compared to ZA group.

Conclusion: In summary, the association of BO+PRF improved bone healing of large bone defect in rats receiving ZA and this may be an interesting approach for the treatment to be tested in patients under anti-resorptive therapy.

Head and neck squamous cell carcinoma (HNSCC) poses a significant global health challenge, with over 660,000 new cases diagnosed and more than 325,000 deaths each year. Despite advances in treatment, long-term survival rates for HNSCC patients remain disappointingly low, underscoring the critical need for innovative therapeutic strategies. This review delves into the role of super-enhancers in HNSCC, highlighting their pivotal function in regulating key oncogenes such as KLF4, FOSL1, and ΔNp63, which are crucial for tumor progression and metastasis. Moreover, it explores how super-enhancers contribute to the maintenance of cancer stem cell characteristics by controlling genes like SOX2, BRD4. thereby promoting self-renewal and pluripotency.The study also underscores the potential of BET bromodomain inhibitors, exemplified by JQ1, and CDK7 inhibitors like THZ1, which demonstrate substantial therapeutic promise by effectively disrupting the function of super-enhancers in HNSCC. Overall, this research provides a comprehensive overview of the importance of super-enhancers in HNSCC.

Aim: Compare the efficiency of selenium nanoparticles (SeNPs) and Nano vitamin D3 in modulating alveolar bone osteoporosis induced by anastrozole in albino rats.

Materials and methods: 28 female albino rats were randomly divided into 4 groups (7/group); Control group (GP I): rats were received distilled water orally. Anastrozole group (GP II): rats were orally given anastrozole (1 mg/kg/day) dissolved in distilled water. SeNP treated Anastrozole group (GP III): rats were orally given anastrozole with SeNP (0.5 mg/kg/day). Nano vitamin D3 treated Anastrozole group (GP IV): rats were orally given anastrozole with Nano vitamin D3 (40 IU/kg/day). After 4 weeks of drugs administration, mandibles were prepared and stained with hematoxylin & eosin, Masson trichrome and anti-osteocalcin antibody. New collagen area% in Masson trichrome and positive anti-osteocalcin osteoblasts count were measured and statistically analyzed.

Results: Deleterious changes in the alveolar bone were detected in Gp II, while being markedly improved in treated groups. Moreover, GP II demonstrated large areas of old collagen, with positive anti-osteocalcin immunoreactivity in some osteoblasts and few osteocytes, meanwhile, control and treated groups showed more predominant newly formed collagen with positive immunoreactivity in nearly all osteoblasts, osteocytes, and some areas of bone matrix. Statistically, Gp III and Gp IV showed the significantly highest newly formed collagen mean area% and positive osteoblasts count, then Gp I, while Gp II represented the least recorded data.

Conclusions: SeNPs and Nano Vitamin D3 improve the structural and cellular quality of mandibular alveolar bone in anastrozole-induced osteoporosis of albino rats.

Aim of the study: To analyze the positional changes of the inferior alveolar nerve after sagittal split ramus osteotomy (SSRO) and assess the impact of these changes on postoperative sensory nerve disturbances.

Material and methods: Preoperative and postoperative (one year) spiral CT scans were used to categorize the inferior alveolar nerve into the extended side (n = 30) and retrogressive side (n = 30). Measurement software was used to observe and measure positional changes of the mandibular nerve canal, followed by a comparative analysis.

Results: Post-surgical analysis revealed that the inferior alveolar nerve was displaced laterally and superiorly on the extended side, and medially and inferiorly on the retrogressive side, with statistically significant differences (p < 0.05). Correlation analysis demonstrated a significant association between nerve displacement in the first molar region and sensory nerve impairment (p < 0.05).

Conclusion: Significant positional changes in the inferior alveolar nerve were observed post-surgery, particularly on the extended migration side, with these changes being correlated with the occurrence of neurological symptoms.

Introduction: The buccal fat pad is largely involved to close oro-antral communication (OAC) . The implant rehabilitation of the maxillary posterior area after OAC is a surgical challenge. The difficulty of this rehabilitation remains in the absence of a lateral and crestal bone wall.

Technical note: The buccal fat pad lift was performed under general anaesthesia. This involved lifting the buccal fat pad and the sinus mucosa, which they were fused and filled the gap with a biomaterial. The osteogenic properties of the environment will enable osseointegration of the biomaterial.

Conclusion: This technique requires a relevant surgical experience. It is a reliable and valid surgical solution to rehabilitate the maxillary posterior area for dental implant placement.