| 1. |
- Bengtsson, M., et al.
(author)
-
Is there a difference in judgement of facial appearance depending on ethnic background? Photographic evaluation of facial appearance in orthognathic surgery
- 2020
-
In: British Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 58:7, s. 812-818
-
Journal article (peer-reviewed)abstract
- Is there a variation in facial ideals depending on ethnic background that affects judgements of outcome in orthognathic surgery? How does the evaluation correlate with patient-reported outcome measures? Two evaluation panels, Singaporean and Swedish, judged photographs of patients undergoing orthognathic surgery taken before and after operation. Improvement in facial aesthetics was calculated between the two ratings. The result was compared between the panels and correlated with health-related quality of life (QoL) measures. Thirty male and 27 female patients aged between 18 and 28 years (mean 21) were included, and 52 subjects were eligible for comparison of health-related QoL. The photographic evaluation showed that both panels judged there to be significant improvement in facial aesthetics after treatment (p < 0.001). The Singaporean panel rated the overall facial appearance higher than the Swedish panel when evaluating photographs both before (p = 0.025) and after (p = 0.032) operation. Improvement of the overall facial appearance showed no significant difference between the panels (p > 0.30). No correlation between health-related QoL and improvement of facial appearance was found by either panel. Subjective evaluation of facial aesthetics in orthognathic surgery is unaffected by the observer's ethnic origin. Independently of their ethnicity, the evaluation juries found that facial aesthetics improved after orthognathic surgery. Improvement reported by the juries corresponded to that reported by patients. © 2020 The British Association of Oral and Maxillofacial Surgeons
|
|
| 2. |
- Klinge, Anna, et al.
(author)
-
Craniofacial height in relation to cross-sectional maxillary and mandibular morphology
- 2017
-
In: Progress in Orthodontics. - : Springer. - 1723-7785 .- 2196-1042. ; 18:32
-
Journal article (peer-reviewed)abstract
- Background In order to gain a better understanding of how growth of the alveolar bone is linked to the vertical development of the face, the purpose of this study was to investigate if there is an association between the cross-sectional morphology of the maxillary and mandibular bodies with the craniofacial height, using images from cone beam computed tomography (CBCT). Methods From 450 pre-treatment CBCT scans, 180 were selected to be included in the study. Lateral head images were generated from the CBCT scans and were used to categorise subjects into three groups based on their vertical craniofacial height. Cross-sectional images from CBCT volumes were reformatted of the maxillary and mandibular bodies at five locations in the maxilla and five in the mandible. Each image was measured at one height and two width measurements. Statistical analysis performed was the one-way analysis of variance with a Tukey post hoc test. A significance level of 5% was used in all comparisons. Results Patients with large vertical craniofacial height had a significantly higher cross-sectional area both in the maxilla and in the mandible. In the same group, the cross-sectional area was significantly thinner in the mandible compared with the other two groups, especially in the anterior region. Conclusions This study further highlights the close relationship between craniofacial height and alveolar bone dimensions and contributes with important knowledge for planning and follow-up of comprehensive dental- and orthodontic treatments.
|
|
| 3. |
|
|
| 4. |
- Bengtsson, M., et al.
(author)
-
A comparison of cost-effectiveness of computer-assisted 2-and 3-dimensional planning techniques in orthognathic surgery
- 2019
-
In: British Journal of Oral & Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 57:4, s. 352-358
-
Journal article (peer-reviewed)abstract
- The aim of this randomised controlled trial was to compare the costs and benefits of computer-based 2-dimensional and 3-dimensional predictions in orthognathic surgery. Subjects aged 18-30 years with severe class III malocclusion had their treatment planned with both 2- and 3-dimensional techniques. They were randomised in a 1: 1 ratio for one or other planning technique. Costs (financial, time, and dose of radiation) were compared with benefits (accuracy and health-related quality of life (HRQoL)). In total, 57 subjects (27 women and 30 men, mean (range) age 21 (18-28) years) completed the study. Comparisons showed no significant difference in total time spent, but a large advantage for the 2-dimensional technique in financial costs (p < 0.001); it also required a significantly lower dose of radiation (p < 0.001). The cost-effectiveness analysis showed a reduction in time of 0.53 minutes/HRQoL-point gained, and an increased economic cost of US$15/HRQoL point gained for the 3-dimensional technique. It also showed that the two techniques consumed an equal amount of time, but that the 2-dimensional technique had lower financial costs, and the 3-dimensional technique a larger dose of radiation. (C) 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
|
|
| 5. |
- Bengtsson, Martin, et al.
(author)
-
Mandibular Access Osteotomy for Tumor Ablation : Could a More Tissue-Preserving Technique Affect Healing Outcome?
- 2016
-
In: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 74:10, s. 2085-2092
-
Journal article (peer-reviewed)abstract
- Purpose: Paramedial mandibulotomy facilitates access for the resection of tumors in the oral and oropharyngeal space; however, severe complications related to surgical techniques and radiotherapy have been reported for this procedure. This study evaluated whether preservation of the periosteum during a mandibulotomy would decrease postoperative complications owing to the increased healing capacity provided by preserving more tissue. Materials and Methods: Patients who underwent mandibulotomy for surgical tumor ablation from 2007 through 2012 were included in a retrospective controlled cohort study. The trial was comprised of 2 groups: 1 group underwent subperiosteal and 1 group underwent supraperiosteal surgical dissection in the area of the mandibulotomy. The primary predictor variable was surgical technique and the primary outcome variable was surgical complications. The groups were matched according to tumor type, age, and gender. Clinical and radiographic follow-up was performed 12 months after surgery. Complications regarding bone exposure, plate exposure, osteoradionecrosis, nonunion, infection of the soft tissue flap, abscesses, fistulas, and gingival necrosis were recorded. Recordings of other factors, such as age, smoking habits, and timing of radiotherapy and chemotherapy, were performed and the 2 groups were compared for postoperative complications. Data analysis used the c2 test (Fisher exact test) to compare the sub- and supraperiosteal groups for postoperative complications. Results: Thirty-two patients were included (16 per group; 14 women and 18 men; mean age, 56 yr). Thir- teen patients in the subperiosteal group and 7 in the supraperiosteal group showed complications during the first 12 months. Seven patients had complications that persisted to the 12-month follow-up (6 in the subperiosteal group and 1 in the supraperiosteal group); however, the difference was not statistically relevant. Conclusion: This study found more persistent complications in the subperiosteal group compared with the supraperiosteal group at 12-month follow-up, which could imply that a more tissue-preserving surgical technique promotes mandibular healing in patients undergoing mandibular access osteotomy in combination with radiotherapy.
|
|
| 6. |
- Bengtsson, M., et al.
(author)
-
Outcome of photographic evaluation of facial appearance in orthognathic surgery: how does it correlate with planning of treatment and patient-reported outcome?
- 2019
-
In: British Journal of Oral & Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 57:4, s. 345-351
-
Journal article (peer-reviewed)abstract
- The outcome of treatment in orthognathic surgery is dependent on preoperative surgical planning. The main purpose of the present study was to evaluate from photographs the improvement in facial appearance after orthognathic surgery. In addition, the outcomes of two different planning techniques, 2-dimensional and 3-dimensional, were compared and the correlation between the outcome and health-related quality of life (HRQoL) assessed. The study was a randomised controlled trial with the intervention being either 2-dimensional or 3-dimensional treatment planning. An evaluation panel compared photographs taken before and after operation on patients with severe class III malocclusion. The change in facial appearance was rated, the two planning techniques compared, and the result correlated with previously published findings on cephalometric accuracy and HRQoL in the same group. Completed 12-month follow-up resulted in the inclusion of 57 subjects aged between 18 and 28 years at the time of operation (mean 21 years). We found significant differences between the two evaluations (p = 4.4E-9) but no significant difference in facial improvement between the planning techniques (p = 0.54). However, there was a correlation between cephalometric measurement of accuracy in the anterior maxilla and evaluation of improvement of facial appearance (p = 0.024, r = 0.30), but we found no correlation + between HRQoL and the evaluation of facial appearance (p = 0.31, r = -0.14). We conclude that there was an improvement in facial aesthetics after orthognathic surgery that was independent of the planning technique used. (C) 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
|
|
| 7. |
- Bengtsson, Martin, et al.
(author)
-
Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2-or 3-dimensional planning : A randomized double-blind active-controlled clinical trial
- 2018
-
In: American Journal of Orthodontics and Dentofacial Orthopedics. - : Elsevier. - 0889-5406 .- 1097-6752. ; 153:6, s. 786-796
-
Journal article (peer-reviewed)abstract
- Introduction: Thorough treatment planning is essential for a good clinical outcome in orthognathic treatment. The planning is often digital. Both 2-dimensional (2D) and 3-dimensional (3D) software options are available. The aim of this randomized 2-arm parallel double-blinded active-controlled clinical trial was to comprae the outcomes of computer-based 2D and 3D planning techniques according to patient-reported health related quality of life. The hypothesis was that a 3D technique would give a better treatment outcome compared with a 2D technique. Methods: Orthognathic treatment for 62 subjects, aged 18 to 28 years, with severe Class III malocclusion was planned with both 2D and 3D techniques. After treatment planning but before surgery, the patients were randomly allocated via blind collection of 1 enveloped card for each subject in a 1:1 ratio to the test (3D) or the control (2D) group. Thus, the intervention was according to which planning technique was used. The primary outcome was patient-reported outcome measures. The secondary outcome was relationship between patient-reported outcome measures and cephalometric accuracy. Questionnaires on the patient's health-related quality of life (HRQoL) were distributed preoperatively and 12 months after surgical treatment. The questionnaires were coded, meaning blinding throughout the analysis. Differences between groups were tested with the Fisher permutation test. The HRQoL was also compared with measurements of cephalometric accuracy for the 2 groups. Results: Three subjects were lost to clinical follow-up leaving 57 included. Of these, 55 subjects completed the questionnaires, 28 in the 2D and 27 in the 3D groups. No statistically significant difference regarding HRQoL was found between the studied planning techniques: the Oral Health Impact Profile total showed -3.69 (95% confidence interval, -19.68 to 12.30). Consistent results on HRQoL and cephalometric accuracy showed a difference between pretreatment and postreatment that increased in both groups but to a higher level in the 3D group. A difference between pretreatment and posttreatment HRQoL was shown for both groups, indicating increased quality of life after treatment. This supports recent findings comparing 3D and 2D planning techniques. No serious harm was observed during the study. Conclusions: Improvements of HRQoL were shown after treatment independent of which planning technique, 2D or 3D, was used. No statistically significant difference was found between the planning techniques. Registration: This trial was not registered. Protocol: The protocol was not published before trial commencement.
|
|
| 8. |
- Galindo-Moreno, Pablo, et al.
(author)
-
Clinical and radiographic evaluation of early loaded narrow diameter implants - 1-year follow-up
- 2012
-
In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 23:5, s. 609-616
-
Journal article (peer-reviewed)abstract
- Objective: To evaluate the clinical performance of Astra Tech OsseoSpeed™ TX 3.0S implants using one‐stage surgical procedure and early loading in the anterior region. Material and methods: This is a prospective, single arm, multi‐centre study. Patients missing teeth at positions 12, 22 and 32–42 were eligible to enter the study. The implants (OsseoSpeed™ TX 3.0S) used in the study were of 3 mm diameter and of different lengths. One‐stage surgery was performed, and healing abutments were used during the 6–10 weeks healing period. Clinical and radiographic examinations were assessed at implant installation, loading and at the 6‐ and 12‐month follow‐up visits. Results: Ninety‐seven implants were placed in 69 patients at six different study centres in Denmark, Germany, Italy, Spain, Sweden and the United Kingdom. The survival rate was 95.9%. No implants have been lost after loading (100% survival rate after loading). Mean marginal bone loss 1 year after installation was 0.065 mm (SD = 1.018). The frequency of bone loss ≥1 mm was 6.6% and 51.3% of the implants demonstrated no bone loss or even bone gain from the surgical visit to the first year follow‐up visit. Mean probing pocket depth and gingival zenith score were stable from crown placement to the 6‐ and 1‐year follow‐up visits. Conclusion: Treatment with OsseoSpeed™ TX 3.0S implants is a safe and predictable option in the anterior region where physical space is limited. Minimal marginal bone loss was observed during the first year follow‐up.
|
|
| 9. |
- Hallmer, Fredrik, et al.
(author)
-
Bacterial diversity in medication-related osteonecrosis of the jaw
- 2017
-
In: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 123:4, s. 436-444
-
Journal article (peer-reviewed)abstract
- Objective. The aim was to study the association between microflora and medication-related osteonecrosis of the jaw (MRONJ) by using culture-independent molecular techniques to detect bacteria in necrotic bone lesions. Study Design. Included were 18 consecutive patients with MRONJ, 10 with osteoporosis and 8 cancer patients. Bone biopsies were retrieved from the center of the necrotic bone and from visually healthy bone, and 16 S rRNA gene fragments from bacterial DNA were amplified with polymerase chain reaction. Results. The study revealed a diversity of bacteria represented by 16 S rRNA sequences in all the necrotic bone samples and in 60% of the visually healthy bone. Eight dominating taxa groups were identified at the genus level: Porphyromonas, Lactobacillus, Tannerella, Prevotella, Actinomyces, Treponema, Streptococcus, and Fusobacterium. Conclusions. The necrotic bone lesions contained mainly anaerobic bacteria, representative of periodontal microflora, suggesting that a periodontal infection in combination with antiresorptive treatment could initiate osteonecrosis.
|
|
| 10. |
- Hallmer, Fredrik, et al.
(author)
-
Osteonecrosis of the jaw in patients treated with oral and intravenous bisphosphonates : experience in Sweden
- 2014
-
In: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 118:2, s. 202-208
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To describe the prevalence, inciting factors, and treatment outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) during the 2003-2010 period in southern Sweden (population, approximately 1.2 million people). STUDY DESIGN: Patient records were searched for inflammatory conditions including unspecified inflammation, osteomyelitis, osteonecrosis due to drugs, and other osteonecrosis. Data on underlying disease, type of bisphosphonate (BP), inciting factor, location, stage, treatment, and treatment outcomes were collected. RESULTS: Of the 341 patients identified, 55 had been diagnosed with BRONJ. Those with a malignant disease were treated with intravenous BPs, and those with osteoporosis were treated with oral BPs. All but 5 were treated with antibiotics and 47 with local resection. Healing was recorded in 79% of patients with osteoporosis and in 26% of patients with malignant disease. CONCLUSIONS: Healing in patients with osteoporosis occurred more frequently than in patients with a malignant disease treated with intravenous BPs (P = .00009).
|
|
