Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Background: The thin anterolateral thigh flap (tALTF) is gaining attention in reconstructive surgery due to its aesthetic and functional advantages. However, its clinical safety and outcomes compared to other commonly used free soft flaps (CUFSFs) remain unclear.

Methods: Studies were systematically searched from PubMed, EMBASE, Medline, Cochrane, Web of Science, and China National Knowledge Infrastructure Database up to November 2, 2024. Flap failure, donor and recipient site morbidity, secondary salvage surgery, and patient satisfaction were evaluated.

Results: A total of 416 cases from 7 studies were included in our analysis. No significant difference was observed between the two groups in flap failure and secondary salvage surgery. However, tALTF showed significant advantages over CUFSFs in skin grafting, donor and recipient site morbidity, and patient satisfaction.

Conclusion: This meta-analysis highlights the clinical safety and superior outcomes of tALTF compared to CUFSFs in reconstructive surgery, suggesting its viability as a preferred option for surgeons. However, the retrospective design of the included studies and limited sample sizes necessitate further large-scale prospective studies to validate these results.

Introduction: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous condition that includes a spectrum of oral clinical manifestations ranging from mild painless white lesions to painful erosions and ulcers. The purpose of this European multicenter study is to describe the general characteristics of OLP lesions, the clinical and histopathological diagnosis, and the management of OLP at different European Oral Medicine and Maxillofacial Surgery centers, in order to minimize selections biases and provide information about the current trends in the treatment of OLP across Europe.

Materials and methods: Data and histopathological records of patients with OLP were retrospectively revised and only those patients that fulfilled the diagnostic criteria from the 2016 position paper by American Academy of Oral and Maxillofacial Pathology were included. The following data were recorded for each patient: gender, age, voluptuary habits, risk factors for OLP (psychological stress, medications, systemic diseases), location of OLP lesions, clinical presentation, patterns of clinical expression, symptoms, treatment, possible clinical improvement, and malignant transformation.

Results: A total of 565 OLP patients (422 females, 143 males) fulfilled the inclusion criteria. The mean age of the study population at diagnosis was 60.11 years. In 262 patients (46.4 %), just a site of OLP was identified: in 186 of these "one-site" patients, OLP was diagnosed just in buccal mucosa. The most frequently observed clinical pattern was reticular. When evaluating the treatment received, 294 patients were kept in follow up with a Wait-and-see approach. The most frequent treatment regimen was the use of topical corticosteroids (123 patients). A significant statistical association was found between the prescription of topical corticosteroids (P < .0005) or retinoids (P < .000005) and symptoms improvement. Squamous cell carcinoma associated with OLP lesions was observed during the follow-up in 9 OLP patients out of 565 (1.6 %).

Conclusions: Reticular and mixed clinical patterns are the most frequent subtypes of OLP. The use of topical corticosteroids and retinoids for the management of OLP seems to allow good improvement results of symptoms and signs. A clinical long-term follow-up is fundamental due to the chronic nature of OLP and possible malignant transformation.

Oral submucosal fibrosis is a highly malignant oral condition that necessitates the use of sophisticated therapeutic procedures. OSF is a multifactorial precancerous condition induced by areca nut chewing, deficiencies in vitamins and trace minerals, immunological aspects, and hereditary factors. Adipose tissue-derived mesenchymal stem cells possess the capability for multidirectional activation and are extensively distributed throughout the body. They have minimal immunogenicity and are extensively utilized in cancer treatment. Exosomes are extracellular vesicles produced by the intracellular route. They are biological carriers comprising microRNA, messenger RNA, lipids and proteins crucial for intercellular communication. ADSC exosomes, serving as a vehicle for miRNA, possess accessibility and little immunogenicity. They can significantly contribute to adipose tissue regrowth, angiogenesis, immunological modulation, and tissue repair. ADSC-Exo exhibits antifibrotic properties and may serve as a potential treatment for OSF. This review presents a novel therapeutic approach and clarifies the precise mechanisms involved in the clinical management of OSF using ADSC-Exo.

Introduction: Precise volumetric measurement of newly formed bone after maxillary sinus floor augmentation (MSFA) can help clinicians in planning for dental implants. This study aimed to introduce a novel modular framework to facilitate volumetric calculations based on manually drawn segmentations of user-defined areas of interest on cone-beam computed tomography (CBCT) images MATERIAL & METHODS: Two interconnected networks for manual segmentation of a defined volume of interest and dental implant volume calculation, respectively, were used in parallel. The volume data of dental implant manufacturers were used for reference. The efficacy of this framework was demonstrated through practical applications for collecting CBCT data from patients after MSFA with the same quantity of two different bovine-derived bone substitutes: xenohybrid composite bone (Group I, n = 10) and hydroxyapatite (Group II, n = 10). The study was approved by the central Ethical Review Board of the federal state of Lower Austria (approval number: GS4-EK-4/451-2021). The volumes were measured immediately (T1) and 6 months (T2) after MSFA and before insertion of the dental implant. All measurements were analyzed for inter- and intravariability. P-values of >0.05 were obtained from the t-test analysis RESULTS: The manual delineation of Group II (n = 10) was easier than that of Group I (n = 10) due to the visual contrast of the CBCT scan. The mean volume was 861.65 ± 290.02 mm³ at T1 and 875.9 ± 288.96 mm³ at T2. This shows a moderate dispersion around the mean value, which indicates variability of the analyzed data DISCUSSION: The proposed network may be useful for the development of computer-based diagnostic systems for assessing the success of MSFA with bone replacement materials. The volumetric stability achieved with the two bone replacement materials were comparable.

Objective: To establish an automatic reduction method for unilateral zygomatic fractures based on Iterative Closes Point (ICP) algorithm.

Material and methods: 60 patients with unilateral type B zygomatic fractures were included. After acquiring CT images, zygomatic fragments were segmented using self-developed software MICSys. Mid-Sagittal-Plane (MSP) was manually defined using anatomical skull landmarks. Surface of zygoma on the healthy side was then "mirrored" according to MSP. Referring to mirror image, the fragments were reduced by both automatic and manual methods. In automatic group, fragments were registered onto mirror images by ICP algorithm in MICSys. In manual group, an experienced maxillofacial surgeon translated and rotated fragments until coincided with mirror images. Operating time of each group was recorded. RMSE between reduced fragment and mirror image was calculated to evaluate accuracy. Operating time and accuracy between the two groups were compared using T-test.

Results: Virtual bone reduction was conducted for all 60 patients by the two methods. Operating time of automatic group and manual group were 3.06 ± 1.93 s and 65.45 ± 32.19 s, with significant difference (P < 0.0001). RMSE of automatic group and manual group were 1.94 ± 0.59 mm and 2.33 ± 0.57 mm, with significant difference (P < 0.0001).

Conclusion: Automatic reduction method based on ICP Algorithm for unilateral zygomatic fractures was initially established and clinically acceptable.

Purpose: The purpose of this study was to assess and compare the efficacy of Erich Arch Bar (EAB), Inter Maxillary Fixation (IMF) screws and SMART Lock Hybrid arch bar (HABs) in the treatment of mandibular fractures.

Materials and methods: A prospective randomized clinical study was carried out in the Department of Dentistry at ESIC Hospital in Hyderabad from August 2021 to August 2023. The study comprised of three groups (EAB group (31), IMF screw group (33) and HABs group (29)).Primary outcome variable was occlusal stability. Secondary outcome variables were time taken to apply the device, glove perforation, oral hygiene assessment by Modified Turskey Gilmore Plaque index, Quality of life (QOL) assessment by General Oral Health Assessment Index (GOHAI), mucosal growth and dental injuries.

Results: The average application time for EAB, IMF screws and HABs was 78 min, 15 min and 19 min respectively. No significant difference was noticed in occlusal stability at the end of 1 week and 4 weeks follow-up period. There was no statistically significant difference in instances of dental injury among the three groups. However, there were statistically significant differences (P < 0.05) in the time taken to apply, glove perforation, oral hygiene levels, mucosal overgrowth and total GOHAI score among the 3 groups.

Conclusion: HABs and IMF screws may be recommended over EABfor MMF inmandibular dentate segment fracture management due to their advantages including quick application, enhanced occlusal stability, and QOL, all of which are required for a better functional outcome.

Introduction: Osteomyelitis is an inflammatory condition of the bone with a multifactorial etiology, including trauma and odontogenic infections. Despite being a common condition in clinical practice, limited research exists on the clinical and pathological profile of Osteomyelitis of the Jaws (OJ). This 51-year retrospective study aimed to describe the clinical, radiographic, and histopathological features of OJ diagnosed at a single oral pathology referral center.

Material and methods: Clinical, radiographic, and histopathological data of cases diagnosed as OJ were collected and categorized using Zurich Classification System.

Results: Among 17,991 cases diagnosed at the service, 75 (0.004 %) were identified as OJ. Patients were predominantly female (n = 67; 89.3 %), with a mean age of 42.68 years (±21.10) at diagnosis. OJ commonly presented as slow-growing, symptomatic lesions (n = 69; 92.0 %) with a predilection for the mandible. Secondary chronic osteomyelitis (SCO) was the most common subtype (n = 44; 84.0 %). Odontogenic infections were identified as the most common etiological factor associated with OJ (n = 41; 54.7 %). Radiographic analysis frequently revealed generalized, moderate bone loss, while histopathological examination often showed a discrete mononuclear inflammatory infiltrate (n = 29; 38.7 %). Bacterial colonies were observed in 26 cases (34.7 %) and were significantly associated with SCO (p = 0.04).

Conclusion: The findings indicate that OJ is a rare condition in oral pathology centers, predominantly affecting white females in their fifth decade at life, with a predilection for the mandible. Dental infections were the primary causative factor. SCO is the most common OJ subtype in cases requiring surgical management.

Oral Submucous Fibrosis constitutes a severe condition affecting the lining of the mouth, which carries a risk of developing into oral squamous cell carcinoma, and seriously threaten individuals' lives. Currently, no specific treatment has been utilized to prevent OSF. The detailed mechanism of OSF is still elusive, and this study aims to clarify the mechanism of OSF.

Methods: This study was conducted to elucidate the molecular mechanisms of the long noncoding RNA PDIA3P (lncRNA PDIA3P) and FAK/TGF-β pathway in OSF. The OSF mice model was established by injecting with injected with 1000 mg/L arecoline solution, then the blood samples and oral submucosal tissues were collected from all groups of rats for further testing. HE staining, immunofluorescence, Western blot, and qRT-PCR were then used to elucidate the molecular mechanisms of the molecular mechanisms of the lncRNA PDIA3P and FAK/TGF-β pathway in OSF.

Results: The results showed that upregulation of the FAK/TGF-β signaling pathway can accelerate OSF process, while the downregulation of the FAK/TGF-β signaling pathway can prevent the OSF process. Similarly, enhanced activity of the lncRNA PDIA3P is implicated with OSF process, while reducing its level can served as a preventative method against the OSF development.

Conclusion: Upregulating the lncRNA PDIA3P and FAK/TGF-β pathway can accelerate the process of OSF.

Introduction: Ranulas are mucous cysts that arise from the sublingual gland due to ductal obstruction or trauma. Plunging ranulas, a rare variant, extend into the neck and often present diagnostic challenges. Definitive surgical management is necessary to prevent recurrence and ensure successful outcomes.

Case presentation: A 20-year-old female presented with a slowly enlarging, painless mass in the floor of her mouth extending into the submandibular region and anterior neck. The mass had progressively increased in size over five years, affecting her appearance and mastication. MRI confirmed a large plunging ranula. The patient underwent complete surgical excision of the cyst and the sublingual gland under general anesthesia. She recovered well, with no immediate postoperative complications. Follow-up at 12 months showed no recurrence, and the patient reported full resolution of symptoms.

Conclusion: This case highlights the importance of early recognition and accurate diagnosis of plunging ranulas to guide appropriate surgical intervention. Complete excision of the sublingual gland remains the treatment of choice for preventing recurrence. In line with similar cases in the literature, this approach resulted in a successful outcome with no evidence of recurrence during follow-up. The findings underscore the clinical significance of individualized treatment strategies based on the extent of anatomical involvement.