Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Purpose: It remains to be determined whether dental implantation treatment in solid organ transplant (SOT) recipients and non-organ transplant patients yields similar clinical outcomes. This review summarizes related data for existing cases and presents a meta-analysis of the outcomes of dental implants in SOT recipients and non-organ transplant patients.

Material and methods: An electronic literature search was conducted in the PubMed, Web of Sciences, Cochrane Library and China National Knowledge Infrastructure databases covering articles published from inception to December 2024. This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was designed based on the Population, Intervention, Comparison, Outcome and Study design (PICOS) framework. The risk of bias was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist or the Newcastle-Ottawa Scale (NOS). The certainty of findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Meta-analysis was performed using a fixed effects model to estimate the combined performance measures and 95 % confidence intervals for the implant survival rate, marginal bone loss (MBL), and probing depth (PD).

Results: A total of 12 articles were included in the systematic review. The implant survival rate of 290 implants in 110 SOT recipients was 99.3 %. The meta-analysis of four case-control studies revealed no significant differences in the implant survival rate and PD between SOT recipients and non-organ transplant patients (P = 0.45 and P = 0.49, respectively), while there was slightly less MBL in SOT recipients (P = 0.02), possibly caused by confounding factors and bias.

Conclusions: Organ transplantation does not impair implant survival in the short and mid-long term. Dental implantation can serve as a treatment option for tooth loss in SOT recipients.

Background: In cervico-facial oncology, reconstructive procedures aim to ensure patient survival, restore orofacial functions, and maintain esthetic outcomes. The ultimate goal of these interventions is to provide functional rehabilitation. However, dental rehabilitation following bone-free flap reconstructions remains underutilized. This study evaluates current practices in France and identify the challenges reconstructive surgeons face in implementing dental implant rehabilitation after free bone flap reconstruction in an oncological setting.

Methods: A nationwide survey was conducted across 52 French hospitals to assess practices related to free bone flap reconstructions and dental implant rehabilitation. An online questionnaire collected data on the epidemiology, rehabilitation practices, team organization, and willingness towards increasing the number of rehabilitated patients following oncological surgeries.

Results: Nineteen centers responded, highlighting diverse practices. While most centers perform over 20 free bone flap reconstructions annually, the number of patients receiving implants post-reconstruction was relatively low, with most centers reporting between one and five implant procedures in the past year. Key obstacles to implant rehabilitation included patient irradiation (61 %), lack of financial support (61 %), absence of a practitioner network (50 %), insufficiently trained team members (33 %), risk of oncological recurrence (28 %), extended operating times for primary implantations (22 %), and difficulties with radiological follow-up due to artifacts (17 %) CONCLUSION: Despite its potential to enhance patient quality of life, dental implant rehabilitation in oncological patients remains marginal in France. This study highlights the need for standardized protocols and improved collaboration between reconstructive surgeons and dental specialists to increase the rate of rehabilitation following free bone flap reconstructions.

This study investigates the effect of miR-141 overexpression on the proliferation and apoptosis of tongue squamous cell carcinoma (TSCC) cell lines (Tscca and Tca8113). TSCC cells were stably transfected with a miR-141 lentivirus (Ubi-miR-141-SV40-EGFP-IRES-puromycin, miR-141 group) or an empty vector (Ubi-MCS-SV40-EGFP-IRES-puromycin, miR-NC group), with untreated cells serving as the Blank group. miR-141 expression was evaluated by rt-qPCR, transfection efficiency and apoptosis were assessed by flow cytometry, and cell proliferation was measured using the CCK-8 assay. Western blot and rt-qPCR were used to analyze the protein and mRNA expression of phosphatase and tensin homolog (PTEN) and B-cell lymphoma-2 (BCL2). Results: Flow cytometry confirmed successful establishment of stably transfected cell lines. The CCK-8 assay showed no significant difference in proliferation between the miR-NC and Blank groups (P > 0.05), while proliferation was significantly reduced in the miR-141 group. Apoptosis was significantly higher in the miR-141 group compared to both the miR-NC and Blank groups. Western blot and rt-qPCR analyses revealed upregulation of pten gene and PTEN protein expression, as well as downregulation of bcl2 gene and BCL2 protein expression in the miR-141 group relative to the miR-NC and Blank groups. Conclusion: In TSCC cells with high miR-141 expression, pten gene and PTEN protein levels were elevated, while bcl2 gene and BCL2 protein levels were reduced. These findings indicate that miR-141 may regulate the expression of PTEN and BCL2 at both the gene and protein levels, thereby influencing cell proliferation, migration, and apoptosis. To our knowledge, this is the first study to explore the effects of miR-141 transfection in TSCC, providing valuable insights into its role in tumor progression and potential regulatory targets.

Purpose: This study investigates the influence of vertical facial growth patterns on the morphology of the zygomatic buttress (ZB) donor site and its implications for preoperative planning in bone grafting.

Materials and methods: A total of 100 adult Cone beam computed tomography (CBCT) scans were analyzed and categorized into hypodivergent, normodivergent, and hyperdivergent groups based on SN-GoGn angles. Three-dimensional ZB models were created using semi-automatic segmentation, with key parameters-volume, surface area, thickness, and anteroposterior protrusion-measured using stable anatomical landmarks. Statistical analyses included descriptive statistics, one-way analysis of variance (ANOVA), Tukey's post-hoc tests, and Kruskal-Wallis H tests where necessary. A p-value < 0.05 was considered statistically significant.

Results: ZB morphology varied significantly across facial growth types. Hypodivergent faces exhibited the highest bone volume (533.25 ± 129.58 mm³), surface area (560.70 ± 99.76 mm²), total thickness (4.68 ± 1.91 mm), and bulge thickness (9.75 ± 2.51 mm). Normodivergent faces showed intermediate values for bone volume (394.39 ± 141.62 mm³), surface area (504.27 ± 108.54 mm²), and thickness (2.79 ± 1.05 mm total, 5.42 ± 2.45 mm bulge). Hyperdivergent faces had the lowest bone volume (259.00 ± 86.28 mm³), surface area (422.64 ± 95.59 mm²), total thickness (1.70 ± 0.49 mm), and bulge thickness (3.57 ± 1.66 mm). Anteroposterior protrusion also differed significantly, with hypodivergent faces showing the largest protrusion (21.56 ± 3.24 mm).

Conclusion: The ZB is a reliable donor site with morphology influenced by facial growth patterns. Preoperative radiographic assessment facilitates optimized surgical planning and tailored grafting strategies.

Transverse maxillary deficiency requires surgical maxillary expansion when the midpalatal suture is closed. The midline osteotomy of the maxilla can lead to significant dental, gingival and bone complications. Technically, this osteotomy is usually performed using osteotomes, a burr or an oscillating saw, but is increasingly being replaced by piezosurgery. There are no published studies on the impact of piezoelectric devices on complications. This study tries to evaluate complications after median inter-incisors osteotomy (gingival recession, tooth loss, bone loss) with piezosurgery, and then to compare them with complications associated with osteotomes. A single-center retrospective study of 57 patients who underwent surgical maxillary expansion was conducted. Dental complications (mobility, color and loss), gingival and papilla recession and bone defect were assessed before and at least 6 months after surgery. Two groups were compared: the piezosurgery P group (49 patients) and the osteotomes O group (8 patients). In piezosurgery group, 16.3 % of patients developed central papilla recession and 8 % bone defect, against 12.5 % and 0 % respectively in osteotomes group. No statistically significant difference was found between both groups in the incidence of gingival or bone complications.

Background: The oral cavity poses challenges in surgical interventions due to its microbial flora. Maxillofacial trauma surgeries are vulnerable to infections, complicating recovery. Traditional methods, including antibiotic prophylaxis, have limitations, highlighting the need for complementary strategies.

Objective: This study evaluated the impact of professional oral hygiene protocol on infection rates, mucosal health, and pain levels in maxillofacial trauma patients.

Material and methods: A retrospective study analyzed 529 patients treated for maxillofacial trauma at the Maxillo-Facial Surgery Unit of "Azienda Ospedaliera Ospedali Riuniti" in Ancona, Italy, from 2018 to 2023. Patients were divided into two groups: Period 1 (2018-2020, no protocol) and Period 2 (2021-2023, protocol implemented). All patients were in good general health, with no systemic diseases compromising immunity or influencing surgical outcomes. The protocol included supragingival scaling 48 h preoperatively, chlorhexidine 0.20 % three times daily postoperatively, and standardized antibiotic and analgesic regimens. Data included infection rates, modified Beck Oral Assessment Scores and Numerical Rating Scale pain scores. Statistical analyses included independent t-tests and Chi-square tests, with significance set at p < 0.05.

Results: Period 2 showed significantly lower infection rates (13.44 % vs. 19.48 %, p = 0.023), reduced pain scores (mean NRS: 4.6 vs. 5.4, p < 0.01) and improved mucosal health (mean BOAS: 2.91 vs. 3.75, p < 0.001).

Discussion: The professional oral hygiene protocol reduced postoperative complications, improved oral health, and enhanced patient comfort. These findings support the integration of structured oral hygiene measures into standard maxillofacial surgical care to optimize outcomes and quality of life.

Introduction: Alopecia resulting from burns represents a surgical challenge, with significant functional, physical, psychological and social consequences. Current management is based on various techniques. However, the results are most often very disappointing. Hair transplantation could be an option.

Clinical case: A 51-year-old soldier, victim of a plane crash with more than 40% of his body surface burned, was treated with hair autograft.

Conclusion: Hair transplantation could prove to be one of the significant solutions to reconstruct alopecia caused by thermal burns.

The objective of this retrospective study is to examine the clinical, imaging and pathologic features of 10 patients diagnosed with 'primary intraosseous carcinoma (PIOC)' at a single institution and to identify factors affecting the prognosis of PIOC patients. By proposing a new staging system based on tumor size, cortical bone deformation, neck metastasis and histologic grade, the study aims to address the lack of a distinct staging system, which has led to the mixed use of the classification for oral squamous cell carcinoma (OSCC). Furthermore, the study intends to suggest a treatment guideline based on the newly proposed staging system. By sharing the accumulated experience of treating PIOC patients at a single institution, the study seeks to contribute to more accurate diagnosis and appropriate treatment.

Introduction: Stickler syndrome is a rare genetic collagen disorder known for its ophthalmological abnormalities. However, there are several other associated facial features. The aim of this study is to review the literature on the various oral and maxillofacial manifestations of Stickler syndrome.

Methods: This systematic review follow PRISMA guidelines. The search was performed on Pubmed and Web of Science databases, using the following search terms: ["stickler syndrome" AND ("maxillofacial" OR "orofacial" OR "craniofacial")] up to September 2024. All articles describing oral and maxillofacial manifestation in Stickler syndrome were eligible.

Results: Fifteen articles with a total of 1037 patients were included. In these 15 studies, 500 patients had Stickler syndrome. The most frequent clinical manifestation found was the Pierre Robin sequence (PRS) (n = 234; 50.4 %). Common manifestations were cleft palate (n = 183; 42.8 %), retrognathia (n = 22; 41.5 %), flat nasal bridge (n = 19; 48.7 %), midface hypoplasia (n = 9; 25.7 %), elongated philtrum (n = 5; 35.7 %), prominent eyes (n = 5; 19.2 %), and high arched palate (n = 3; 11.1 %).

Discussion: Stickler syndrome should be investigated in all patients with suggestive symptoms, particularly those with a cleft palate or PRS. Precise diagnosis and early referral to an oral and maxillofacial surgeon and an orthodontist are necessary to manage facial growth and maxillomandibular relationships.

Objective: This study aimed to investigate whether NKAP (nuclear factor κB activating protein) serves as a prognostic marker and predictive biomarker for immunotherapy response in head and neck squamous cell carcinoma (HNSCC).

Methods: A retrospective cohort study combined with in vitro analyses was conducted. NKAP mRNA expression levels were assessed in 520 HNSCC tumor tissues and 44 normal tissues from the TCGA dataset and validated in a clinical cohort (n = 32). Clinical correlations with overall survival and immunotherapy outcomes were analyzed. The key pathological variables included tumor stage, grade, HPV status, and TP53 mutation. Appropriate statistics were calculated at a significant level (P<0.05).

Results: In this study, we have collected tissue samples from HNSCC patients (mean age: 52.65 ± 7.76; males 66%, females 34%). NKAP was upregulated in HNSCC tissues compared to adjacent normal tissues (P < 0.001). The high expression of NKAP correlated with advanced tumor stage, grade, and reduced survival (P < 0.05). High expression levels of NKAP were also associated with anti-PD-L1 therapy response (P < 0.05). Functional enrichment analysis revealed NKAP involvement in cell cycle regulation, mRNA processing, and chromatin remodeling pathways critical for cancer progression.

Conclusion: NKAP represents a promising prognostic marker and therapeutic target for immunotherapy in HNSCC. Prospective studies are warranted to confirm these findings.