| 1. |
- Englesson-Sahlström, Lotta, et al.
(författare)
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Lavage question in treatment of painful reduced mouth opening capacity
- 2008
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - 1010-5182 .- 1878-4119. ; 36:Suppl 1, s. 162-163
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: To compare treatment with local anaesthetics and local anaesthetics and lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. METHODS: Forty-one women and four men (mean age 35 years) participated. All patients had had TMJ pain för more than 3 months, had reduced mouth opening capacity, and had non-reducin disc displacement confirmed by magnetic resonance imaging. The patient were randomized to treatment with extra-articular local anaesthetics alone (control) or with extra-articular local anaesthetics and lavage (treatment). All patients were examined at basline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm visual analog scale (VAS). RESULTS: At baseline, mean pain intensity (VAS) on movement of the TMJ was 58 among the controls and 61 in the treatment group. At the 3-month folow-up, treatment was considered succesful in 76% of the controls and 50% of the treatment group. Mouth opening capacity without assistance was 34 mm and 33 mm at baseline and 43 mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in median pain intesity, successful treatment outcome, and mouth opening capacity with assistance were nonsignificant. CONLUSIONS: Use of lavage to supplement extra-articular local anaesthetic treatment of painful reduced mouth opening at non-reducing discs does not appear to improve treatment outcome.
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| 2. |
- Chrcanovic, Bruno, et al.
(författare)
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Calcifying epithelial odontogenic tumor : An updated analysis of 339 cases reported in the literature
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 45:8, s. 1117-1123
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to integrate the available data published on calcifying epithelial odontogenic tumors (CEOT) into a comprehensive analysis of its clinical and radiologic features. Materials and Methods: An electronic search was undertaken in May 2016. Eligibility criteria were publications having enough clinical, radiological and/or histological information to confirm definite diagnosis. Results: A total of 362 lesions were found, 339 with enough information were analyzed. Variants clear cells (n=33) and Langerhans cells (n=10) were rarely described in the literature, as well as lesions with malignant transformation (n=8). Central lesions (n=264) were more prevalent than their peripheral counterparts (n=24). A higher prevalence characterized the mandible, posterior region, and third and fourth decades. About 40% of the peripheral lesions showed signs of underlying bone erosion, and about half of the central ones showed signs of cortical bone perforation. Recurrence was found in all lesions (12.6%), peripheral lesions (18.8%), central lesions (11.6%), clear cell (10.7%), Langerhans cell (0%), and those with malignant transformation (42.9%). Excision or curettage was associated with the highest recurrence rate. None of the variables showed a statistically significant influence on the recurrence rate. Conclusions: The possible locally aggressive behavior of the lesions recommends a less conservative management than simple curettage. The clear cell variant shows similar demographic data and biological behavior compared to the non-variant lesions, suggesting that the presence of clear cells does not have an important clinical significance.
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| 3. |
- Chrcanovic, Bruno, et al.
(författare)
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Cementoblastoma : an updated analysis of 258 cases reported in the literature
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 45:10, s. 1759-1766
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To investigate the recurrence rate of cementoblastomas for different variables aside from the clinical/radiologic features. Methods: An electronic search was undertaken in November/2016. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. Results: 141 publications (258 cementoblastomas) were included. There was an equal sex distribution. There was a high prevalence in the second/third decades of life, in the posterior regions, and in mandibular first molars. Lesions were commonly associated with bone expansion (74.9%), presence of clinical symptoms (70.2%), vital teeth (78%), root resorption (59.8%). Observations not as frequent: cortical bone perforation (16.3%), inferior displacement of the mandibular canal (23.6%). Treatment was reported for 229 cases. Twenty (11.8%) out of 170 recurred. Preservation of the involved teeth and location seem to not influence the recurrence rate, but there was a 687% higher probability (odds ratio 7.875; p=0.048) of recurrence for lesions associated with bone expansion, and a 217% higher probability (odds ratio 3.173; p=0.023) of recurrence for lesions presenting cortical bone perforation. Conclusions: Although the recurrence rate of cementoblastomas is not as high as previously believed, it is a relevant phenomenon (11.8%). The presence of bone expansion and cortical bone perforation seem to influence the recurrence rate.
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| 4. |
- Bazsefidpay, Nikoo, 1984-, et al.
(författare)
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Did temporomandibular gap arthroplasty with temporalis interpositional flap improve function and pain in patients with end-stage joint disease? A 5-year retrospective follow-up
- 2024
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Churchill Livingstone. - 1010-5182 .- 1878-4119. ; 52:5, s. 578-584
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to investigate whether patients with end-stage temporomandibular joint (TMJ) disease treated with gap arthroplasty with temporalis interpositional flap (GAT) had improved maximal interincisal opening (MIO) and TMJ pain in a long-term perspective. All patients with severe osteoarthritis, or fibrous or bony ankyloses, and subjected to GAT between 2008 and 2015 were included. The criteria of treatment success were TMJ pain VAS score ≤4 and MIO ≥30 mm. Reoperation was considered as a failure. Forty-four patients (mean age 47 years) were included in this retrospective descriptive case series and followed up for up to 7 years (mean 4.5). Comorbidities were frequent (n = 34) and most commonly rheumatic disease (n = 17). The indications for surgery were ankylosis (n = 32) or severe osteoarthritis (n = 12). Of the 44 included patients, 84% (n = 37) had a history of earlier TMJ surgery. The preoperative mean values for TMJ pain and MIO (VAS 7 and 23 mm, respectively) changed significantly (p < 0.001) to postoperative means of VAS 3 and 34 mm, respecitvely. The success rate was 59% (n = 26). When compared with a previous 2-year follow-up, the success rate was found to have decreased over time (p = 0.0097). The rate of successful treatment outcome in terms of MIO alone was 82% (n = 36). The most common reason for treatment failure was residual pain. In conclusion, the success-rate after GAT did not show long-term stability and continued to drop over time in this patient cohort. TMJ pain seems to be the main reason for failure.
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| 5. |
- Bengtsson, M., et al.
(författare)
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Treatment outcome in orthognathic surgery - A prospective comparison of accuracy in computer assisted two and three-dimensional prediction techniques
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182. ; 46:11, s. 1867-1874
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Tidskriftsartikel (refereegranskat)abstract
- The main objective of the present study was to assess the accuracy of two- and three-dimensional prediction techniques in orthognathic surgery. It was also a test of the very planning sequence. The scientific question was how well does the software support the surgeon in his way to find the perfect correction of the facial appearance while normalizing the occlusion? Thirty patients with a class III occlusion were included in this prospective study. Surgical planning with both techniques were undertaken for all patients. Surgery was performed according to the two-dimensional technique. The cephalometric measurements from two-dimensional and three dimensional predictions were compared with the postoperative results at the 12 months follow-up respectively. Together with an analysis of tracing error, placements of 2020 markers, 1860 measurements and 1280 comparisons was performed. The analysis showed an equally high accuracy for the studied techniques. The highest accuracy was found in the anterior maxilla. There was a tendency for an overestimation for the three-dimensional technique and an underestimation for the two-dimensional technique. Conclusions: The present study indicates an equal high accuracy in predicting facial outcome for both studied techniques. However, in those patients with asymmetric malocclusion and/or facial appearance the three-dimensional technique has an obvious advantage. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery.
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| 6. |
- Bengtsson, Martin, et al.
(författare)
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Treatment outcome in orthognathic surgery-A prospective randomized blinded case-controlled comparison of planning accuracy in computer-assisted two- and three-dimensional planning techniques (part II)
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182. ; 45:9, s. 1419-1424
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study was to compare the accuracy of two-dimensional (2D) and three-dimensional (3D) prediction methods. The hypothesis was that a 3D technique would give a more accurate outcome of the postoperative result. Material and methods: Patients with severe class III occlusion were included and planed with both a 2D and 3D prediction technique. They were there after randomly subdivided into a control (2D) and test (3D) group and treated according to the technique randomized for. Cephalometric measurements from 2D and 3D predictions were compared with 12-month follow-up respectively. Together with an analysis of tracing error, placements of 3580 cephalometric markers, 2460 measurements, 680 intra-individual analyses and 1200 preop/postop comparisons were performed in 57 individuals. Results: Statistically significant differences for accuracy between the two groups were seen for 11/NSL112/NSL2 and for A-A2 (p < 0.05). Both groups showed a high level of accuracy for SNA and SNB. The test group also showed a relatively high level of accuracy for 11/NSL and for the A-point. No prediction method achieves a perfect accuracy. As expected from this, measuring accuracy within each group showed statistically significant difference for all markers and cephalometric measurements (p < 0.001). Mandibular markers showed greater differences than maxillary markers. Conclusion: The present study indicates an equal high accuracy in predicting facial outcome for both studied techniques. However, in patients with asymmetry the three-dimensional technique has an obvious advantage. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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| 7. |
- Bertl, Kristina, et al.
(författare)
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MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla
- 2015
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 43:6, s. 961-968
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Tidskriftsartikel (refereegranskat)abstract
- In the severely atrophied maxilla, implant anchorage in the zygomatic bone is considered a viable alternative to conventional dental implants with preceding bone augmentation procedures. The present microCT-based study compared the trabecular bone quality of the maxilla and zygomatic bone. MicroCT scanning was conducted in 12 halves of cadaver heads (5 male, 7 female) with edentulous, atrophied maxillae. Relevant trabecular bone quality parameters were determined in the anterior and posterior maxilla and in the zygomatic bone and compared by region and sex. Any difference in mean values between the anterior maxilla and the zygomatic bone was insignificant. Comparison of both with the posterior maxilla presented significantly higher values for bone volume fraction, surface density, and trabecular thickness and number, and significantly lower values for specific bone surface, structure model index, and trabecular separation. A significant sex-specific difference was not detected. The present microCT-based analysis is, to the best of our knowledge, the first intra-individual comparison of different implant anchorage sites for masticatory rehabilitation of the maxilla. The trabecular compartment of the zygomatic bone offered bone quality and, thus, an implant bed comparable with those of the anterior maxilla, and both were superior to the posterior maxilla.
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| 8. |
- Boffano, P., et al.
(författare)
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The epidemiology and management of ameloblastomas: A European multicenter study
- 2021
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182. ; 49:12, s. 1107-1112
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Tidskriftsartikel (refereegranskat)abstract
- The present study aimed at assessing the epidemiology including demographic variables, diagnostic features, and management of ameloblastomas at several European departments of maxillofacial and oral surgery. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, site, size, radiographic features, type, histopathological features, kind of treatment, length of hospital stay, complications, recurrence, management and complications of the recurrence. A total of 244 patients, 134 males and 110 females with ameloblastomas were included in the study. Mean age was 47.4 years. In all, 81% of lesions were found in the mandible, whereas 19% were found in the maxilla. Mean size of included ameloblastomas was 38.9 mm. The most frequently performed treatment option was enucleation plus curettage/peripheral ostectomy in 94 ameloblastomas, followed by segmental resection (60 patients), simple enucleation (46 patients), and marginal resection (40 pa-tients). A recurrence (with a mean follow up of 5 years) was observed in 47 cases out of 244 ameloblastomas (19.3%). Segmental resection was associated with a low risk of recurrence (p = 0003), whereas enucleation plus curettage/peripheral ostectomy was associated with a high risk of recurrence (p = 0002). A multilocular radiographic appearance was associated with a high risk of recurrence (p < .05), as well as the benign solid/multicystic histologic type (p < .05). Within the limitations of the study it seems that the management of ameloblastomas will probably remain controversial even in the future. Balancing low surgical morbidity with a low recurrence rate is a difficult aim to reach. (c) 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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| 9. |
- Bächli, Heidi, et al.
(författare)
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Skull base and maxillofacial fractures : two centre study with correlation of clinical findings with a comprehensive craniofacial classification system
- 2009
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 37:6, s. 305-11
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: A comprehensive classification based on high resolution computed tomography (CT) of the whole craniofacial region was correlated with clinical findings of combined skull base and maxillofacial fractures. MATERIAL AND METHODS: In a study of two clinical centres, 70 patients with such injuries were admitted at the Universities of Basel (n=29) and Uppsala (n=41). Clinical signs (rhinorrhoea, periorbital haematoma and pneumencephalus) and surgical versus conservative treatment were correlated with a cranio-maxillofacial injury severity score (CMF-ISS) calculated from the classification system. Fracture classifications were decided in consensus on the basis of CT and semiautomatic classification software. The classification system defined 3 fracture types (A, B, C), 3 groups (A1, A2, A3), and 3 subgroups (A1.1, A1.2, A1.3) with increasing severity from A1.1 (lowest) to C3.3 (highest). RESULTS: Of 70 patients, 43 were operated upon and 27 conservatively treated. The operated patients had significantly higher severity scores than non-operated. Patients with or without periorbital haematoma do not differ significantly in the severity score. The severity of the CMF-ISS score was significantly associated (two sample T-test P<0.01) with the occurrence of pneumencephalus, rhinorrhoea and treatment approach. CONCLUSION: Based on our present results, this system seems to be clinical useful for operative decisions and interventions.
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| 10. |
- Chrcanovic, Bruno
(författare)
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Dental implants in patients with ectodermal dysplasia : a systematic review
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 46:8, s. 1211-1217
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Forskningsöversikt (refereegranskat)abstract
- Purpose. To assess the clinical outcome and survival rate of oral implants placed in individuals with ectodermal dysplasia (ED), based on previously published studies. Methods. An electronic search without time restrictions was undertaken in 5 databases (PubMed/Medline, Web of Science, ScienceDirect, J-Stage, Lilacs). Descriptive statistics, Kaplan Meier estimator and implant failure probability were calculated. Results. 90 publications included, reporting 228 ED patients that received 1472 implants (1392 conventional, 47 zygomatic, 33 mini-implants). Mean age of the patients was 20.2±6.8 years (2-56). Patients had a mean of 3.2±2.5 maxillary and 2.1±2.6 mandibular permanent teeth (min-max, 0-14). Patients received a mean of 8.2±3.8 implants (1-20). Most implants were placed in the third decade of life, 24.6% of the implants were placed in children (0-17 years of age). 1391 implants had information on follow-up (72 failures, 5.2%). The 20-year CSR was 84.6%. The probability of failure was 4.5% (95%CI 3.5%-5.6%, p<0.001). Additional treatments performed: Le Fort I (99 implants, 20 patients, 3.5% failed), grafting (497 implants, 77 patients, 5.2% failed), distraction osteogenesis (79 implants, 16 patients, 10.1% failed). Mean follow-up 42.9±41.9 months (min-max, 2-240). Conclusions. Dental implants placed in ED patients, either infants or adults, present a high survival rate (20-year CSR 84.6%).
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| 11. |
- Chrcanovic, Bruno, et al.
(författare)
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Recurrence probability for keratocystic odontogenic tumors : An analysis of 6,427 cases
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 45:2, s. 244-251
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To investigate and compare the probability of recurrence of keratocystic odontogenic tumors (KCOTs) for different variables and treatment protocols. Materials and Methods. An electronic search was undertaken in April 2016 that included clinical series of KCOTs reporting recurrences. Untransformed proportions and meta-analyses were performed to estimate the probability/risk of recurrence, according to several variables. Results. A total of 94 publications were included (6,427 KCOTs, 1,464 recurrences). Probability of recurrence: all lesions, 21.1%; nevoid basal cell carcinoma syndrome, 35.4%; males, 20.3%; females, 19.3%; maxilla, 15.3%; mandible, 21.5%; unilocular, 14.7%; multilocular, 24.4%; marsupialization/decompression, 28.7%; decompression+enucleation±additional therapy, 18.6%; enucleation/curettage, 22.5%; enucleation+peripheral ostectomy, 18.6%; enucleation+Carnoy’s solution, 5.3%; enucleation+cryotherapy, 20.9%; marginal/segmental resection, 2.2%. The recurrence was not statistically significantly affected by lesion location (maxilla vs. mandible, risk ratio [RR] 0.92, P=0.32) or patient’s sex (male vs. female, RR 0.94,P=0.44), but by locularity (unilocular vs. multilocular, RR 0.67, P=0.007). Recurrence risk for surgical managements: marsupialization vs. enucleation (RR 1.65,P=0.0006), marsupialization vs. resection (RR 3.17, P=0.009), enucleation alone vs. enucleation+peripheral ostectomy (RR 1.66, P=0.05), enucleation alone vs. enucleation+Carnoy’s solution (RR 1.94, P=0.03), enucleation alone vs. enucleation+cryotherapy (RR 0.88, P=0.56). Conclusions. KCOTs have a considerable rate of recurrence, which varies significantly according to some clinical, radiographic, and histopathological features, as well as surgical management.
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| 12. |
- Chrcanovic, Bruno, et al.
(författare)
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Squamous odontogenic tumor and squamous odontogenic tumor-like proliferations in odontogenic cysts : an updated analysis of 170 cases reported in the literature
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 46:3, s. 504-510
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Forskningsöversikt (refereegranskat)abstract
- Purpose. To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features. Materials and Methods. An electronic search was undertaken in January 2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm a definite diagnosis. Results. A total of 74 publications reporting 110 SOTs (102 central, 8 peripheral) and 60 SOT-LPOC were included. Compared to SOT-LPOC, SOT showed lower mean age, no preference regarding maxilla or mandible localization, significant association with cortical bone perforation, multilocular radiographic appearance, and mobility of the tooth/teeth associated with the lesion. While 5 recurrent SOT were reported after enucleation, no recurrent SOT-LPOC was found. Conclusions. SOT shows a more aggressive biologic behavior than SOT-LPOC, which supports the hypothesis that the two lesions are distinct clinicopathological conditions.
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| 13. |
- Chrcanovic, Bruno, et al.
(författare)
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Survival and complications of implants to support craniofacial prosthesis : A systematic review
- 2016
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:10, s. 1536-1552
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To assess the survival rate of craniofacial implants (CIs) to support facial prosthesis/epithesis and the prevalence of surgical/biological complications based on previously published studies.METHODS: An electronic search was undertaken in March/2016. Only studies with a minimum of 5 patients were included. Untransformed proportions of implant failures for different regions were calculated. A meta-analysis evaluated the influence of radiotherapy on the failure rates. A meta-regression was performed considering the follow-up period as covariate.RESULTS: Seventy publications included 2355 patients and 8184 CIs (545 failures). The probability of a failure was 5.5% for all CIs (95%CI 4.5-6.5, P < 0.001), 1.2% for CIs in the auricular region (95%CI 0.8-1.5, P < 0.001), 12.2% for the nasal region (95%CI 9.0-15.5, P = 0.017), and 12.1% for the orbital region (95%CI 9.3-15.0, P < 0.001). Radiotherapy statistically affected the CIs rates (OR 5.80, 95%CI 3.77-8.92, P < 0.00001). There was no statistically significant influence of the follow-up time on the proportion of implant failures (P = 0.814). Soft tissue adverse reactions were the most common complications.CONCLUSIONS: Implants placed in the auricular region have a lower probability of failure than those in the nasal and orbital regions. Soft tissue adverse reactions were the most common complications. Radiotherapy significantly affected the CIs failure rates.
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| 14. |
- Cornelissen, M. J., et al.
(författare)
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Perinatal complications in patients with unisutural craniosynostosis: An international multicentre retrospective cohort study
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182. ; 45:11, s. 1809-1814
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Craniosynostosis may lead to hampered fetal head molding and birth complications. To study the interaction between single suture craniosynostosis and delivery complications, an international, multicentre, retrospective cohort study was performed. Materials and methods: All infants born between 2006 and 2012 in the Netherlands and Sweden with sagittal or metopic suture synostosis were included. All births were included as a reference population. The primary outcome measure was rate of medically assisted labor. The secondary outcomes included method of conception, term of birth and fetal position. Results: We included 152 trigonocephaly patients, 272 scaphocephaly patients and 1.954.141 controls. A higher rate of assisted reproductive technology (ART) was found in patients with trigonocephaly (13%) and scaphocephaly (7%) compared to controls (3%, p < 0.001). Scaphocephaly resulted in more postterm births (8% vs 4%, p < 0.001). Trigonocephaly patients showed more preterm births (11% vs 6%, p < 0.001), breech position was more frequent (10% vs 4%, p = 0.003) and labor was more often induced. Rate of assisted delivery, including cesarean section, was significantly higher in both patient groups. Conclusions: Scaphocephaly leads to more postterm births and an increased rate of cesarean sections. Trigonocephaly is related to ART, and in addition higher rates of breech position and cesarean section are found. Prenatal detection of single suture craniosynostosis could improve perinatal care. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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| 15. |
- Dasmah, Amir, et al.
(författare)
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Integration of fluoridated implants in onlay autogenous bone grafts - An experimental study in the rabbit tibia.
- 2014
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Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - : Elsevier BV. - 1878-4119 .- 1010-5182. ; 42:6, s. 796-800
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Tidskriftsartikel (refereegranskat)abstract
- Bone augmentation before treatment with endosseous implants is a common procedure for rehabilitation of the edentulous jaw. Both machined and surface modified implants have been used in one-stage and two-stage surgery protocols with varying results and survival rates. The influence of surface modification on the integration of implants has been documented in both non-grafted and grafted bone. The aim of this study was to compare the integration and stability of surface modified fluoridated vs. machined implants when placed simultaneously with an onlay bone graft.
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| 16. |
- Dasmah, Amir, et al.
(författare)
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Particulate vs. block bone grafts : Three-dimensional changes in graft volume after reconstruction of the atrophic maxilla, a 2-year radiographic follow-up
- 2012
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 40:8, s. 654-659
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Extensive alveolar bone resorption in the maxilla limits the possibility of successful placement and osseointegration of endosseous implants for future prosthetic rehabilitation. Autogenous bone from the iliac crest may be used as lateral onlays in the atrophic maxilla, both as block and particulate bone. To our knowledge, there is no three-dimensional 2-year follow-up study measuring the volumetric reduction of the augmented areas comparing particulate and block bone grafts.PURPOSE:The aim of this study was to conduct a radiographic 2-year follow-up study, using computed tomographic (CT) images in order to evaluate and compare the extent of bone graft resorption in the frontal maxillae augmented by particulate (test) and block bone (control).MATERIAL AND METHODS:Eleven patients treated with iliac bone grafts and oral implants in the maxilla were followed with CT examinations directly post grafting and after 2years.RESULT:The volumetric changes after 6months were extensive. Additionally, the changes in particulate bone tended to be larger after 2years compared to block bone, using this protocol. However, the difference was not statistically significant.CONCLUSION:The present follow-up study showed that there is radiographically complete integration and embedding of implants installed in grafted bone despite extensive initial graft resorption. There was no significant difference in the amount of volumetric reduction between particulate bone and block bone grafts.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Khonsari, Roman H., et al.
(författare)
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Fronto-facial advancement and bipartition in Crouzon-Pfeiffer and Apert syndromes : Impact of fronto-facial surgery upon orbital and airway parameters in FGFR2 syndromes
- 2016
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:10, s. 1567-1575
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Tidskriftsartikel (refereegranskat)abstract
- A major concern in FGFR2 craniofaciosynostosis is oculo-orbital disproportion, such that orbital malformation provides poor accommodation and support for the orbital contents and peri-orbita, leading to insufficient eyelid closure, corneal exposure and eventually to functional visual impairment. Fronto-facial monobloc osteotomy followed by distraction osteogenesis aims to correct midfacial growth deficiencies in Crouzon–Pfeiffer syndrome patients. Fronto-facial bipartition osteotomy followed by distraction is a procedure of choice in Apert syndrome patients. These procedures modify the shape and volume of the orbit and tend to correct oculo-orbital disproportion. Little is known about the detailed 3D shape of the orbital phenotype in CPS and AS, and about how this is modified by fronto-facial surgery.Twenty-eight patients with CMS, 13 patients with AS and 40 control patients were included. CT scans were performed before and after fronto-facial surgery. Late post-operative scans were available for the Crouzon–Pfeiffer syndrome group. Orbital morphology was investigated using conventional three-dimensional cephalometry and shape analysis after mesh-based segmentation of the orbital contents.We characterized the 3D morphology of CPS and AS orbits and showed how orbital shape is modified by surgery. We showed that monobloc-distraction in CPS and bipartition-distraction in AS specifically address the morphological characteristics of the two syndromes.
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| 21. |
- Kontio, R, et al.
(författare)
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Craniomaxillofacial osteosarcoma - The role of surgical margins
- 2019
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Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - : Elsevier BV. - 1878-4119. ; 47:6, s. 922-925
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Tidskriftsartikel (refereegranskat)
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| 22. |
- Levasseur, Julie, et al.
(författare)
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Orbital volume and shape in Treacher Collins syndrome
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : CHURCHILL LIVINGSTONE. - 1010-5182 .- 1878-4119. ; 46:2, s. 305-311
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Tidskriftsartikel (refereegranskat)abstract
- Orbito-palpebral reconstruction is a challenge in Treacher Collins syndrome (TCS). This study investigates orbital phenotypes in TCS using cephalometry and orbital shape analysis. Eighteen TCS and 52 control patients were included in this study, using the Dr Warehouse database. Orbital cephalometry was based on 20 landmarks, 10 planes, 16 angles, and 22 distances. Orbits were segmented. Registration-based, age-specific mean models were generated using semi-automatic segmentation, and aligned and compared using color-coded distance maps - mean absolute distance (MAD), Hausdorff distance (HD), and Dice similarity coefficient (DSC). Symmetry was assessed by mirroring and DSC computing. Central orbital depth ( COD) and medial orbital depth ( MOD) allowed 100% of orbits to be classified. COD and lateral orbital depth (LOD) were different from the controls. Average MAD between TCS and controls was <= 1.5 mm, while for HD it was > 1.5 mm, and for DSC <1. TCS orbits were more asymmetrical than controls, and orbital volumes were smaller when age was considered as a confounding factor, and had a trend for normalization with age. This report emphasizes the importance of combining different morphometric approaches in the phenotype characterization of non-trivial structures such as the orbit, and supports composite skeletal and soft-tissue strategies for the management of the peri-orbital region.
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| 23. |
- Nilsson, Johanna, et al.
(författare)
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Comparison analysis of orbital shape and volume in unilateral fractured orbits
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 46:3, s. 381-387
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Tidskriftsartikel (refereegranskat)abstract
- Facial fractures often result in changes of the orbital volume. These changes can be measured in three-dimensional (3D) computed tomography (CT) scans for preoperative planning and postoperative evaluation. The aim of this study was to analyze the orbital volume and shape before and after surgical treatment of unilateral orbital fractures using semi-automatic image segmentation and registration techniques. The orbital volume in 21 patients was assessed by a semi-automatic model-based segmentation method. The fractured orbit was compared relative to the contralateral orbit. The same procedure was performed for the postoperative evaluation. Two observers performed the segmentation procedure, and the inter- and intraobserver variability was evaluated. The interobserver variability (mean volume difference ± 1.96 SD) was −0.6 ± 1.0 ml in the first trial and 0.7 ± 0.8 ml in the second trial. The intra-observer variability was −0.2 ± 0.7 ml for the first observer and 1.1 ± 0.9 ml for the second observer. The average volume overlap (Dice similarity coefficient) between the fractured and contralateral side increased after surgery, while the mean and maximum surface distance decreased, indicating that the surgery contributed to a re-establishment of size and shape. In conclusion, our study shows that the semi-automatic segmentation method has precision for detecting volume differences down to 1.0 ml. The combination of semi-automatic segmentation and 3D shape analysis provides a powerful tool for planning and evaluating treatment of orbital fractures.
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| 24. |
- Nilsson, Johanna, et al.
(författare)
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Time matters - Differences between computer-assisted surgery and conventional planning in cranio-maxillofacial surgery : A systematic review and meta-analysis
- 2020
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 48:2, s. 132-140
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Forskningsöversikt (refereegranskat)abstract
- The aim of the study was to assess if there is a time difference (operative time, ischemia time, planning time and hospitalization) between computer-assisted surgery (CAS) and conventional planning in cranio-maxillofacial surgery. An electronic search was performed in June 2018. Studies comparing time difference between CAS and traditional planning were included. 28 publications were included, with 536 patients in the CAS group and 784 in the control group. 18 studies reported on mandibular/maxillary reconstruction and a meta-analysis was conducted on 15 of these studies. This meta-analysis was undertaken to demonstrate the difference between the groups regarding operative time, ischemia time and hospitalization for mandibular/maxillary reconstruction and showed a decreased operative time for the CAS group with a mean difference of -84.61 min, 95% confidence interval [-106.77, -62,45], p <0.001. Ischemia time was also decreased, with a mean difference of -36.14 min, 95% confidence interval [-50.57, -21.71], p < 0.001. This systematic review and meta-analysis suggests that CAS is shortening the operative time and ischemia time for mandibular/maxillary reconstruction. It also leads to a reduction in hospitalization. Additionally, CAS seems to shorten the preoperative planning time for orthognathic surgery.
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| 25. |
- Nilsson, Johanna, et al.
(författare)
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Virtual bite registration using intraoral digital scanning, CT and CBCT : In vitro evaluation of a new method and its implication for orthognathic surgery
- 2016
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:9, s. 1194-1200
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Tidskriftsartikel (refereegranskat)abstract
- Three-dimensional (3D) computer-assisted planning requires detailed visualisation of the craniomaxillofacial region and interocclusal relationship. The aim of this study was to establish and evaluate a method to create a 3D model of the craniomaxillofacial region and to adopt intraoral digital scanning to place the lower jaw into a centric relation (CR) without the need of additional plaster casts and model surgery. A standard plastic skull modified by metallic dental wires and brackets was subjected to computed tomography (CT), cone beam computed tomography (CBCT), and intraoral digital scanning. We evaluated two different virtual bite registrations, a digital scan of the buccal dental surfaces and scanning of the wax bites to position the lower jaw into a CR, and assessed the accuracy of the integration of intraoral scanning to the CT/CBCT scans. The mean registration error of corresponding mesh points for the CT and intraoral scanned images was 0.15 ± 0.12 mm, while this error was 0.18 ± 0.13 mm for the CBCT and intraoral scanned images. The mean accuracy of the two virtual bite registrations ranged from 0.41 to 0.49 mm (buccal scan technique) and from 0.65 to 1.3 mm (virtualised wax bite technique). A method for virtual bite registration was developed. It has the potential to eliminate plaster casts and model surgery and may facilitate 3D computer-assisted planning of orthognathic surgery cases.
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| 26. |
- Nordin, Thomas, et al.
(författare)
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Extraoral or intraoral approach in the oblique sliding osteotomy of the mandibular rami? Clinical experience and results.
- 1987
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - 1010-5182 .- 1878-4119. ; 15:5, s. 233-237
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Tidskriftsartikel (refereegranskat)abstract
- The clinical results of oblique sliding (subcondylar) osteotomy of the mandibular rami performed by the extraoral or intraoral approach were compared. The patient material comprised 40 patients with mandibular prognathism. Twenty patients were operated upon using the extraoral approach and 20 patients were operated on using the intraoral approach. All patients had intermaxillary fixation for 7 weeks. The patients in both groups were followed up for 18 months. The experience of the operations was that the intraoral approach gave a shorter operation time than the extraoral approach. The extraoral approach, however, gave better visibility in the operation field and greater possibilities of manipulating the proximal fragment into an optimal position. In the follow-up evaluation, there were no significant differences between the two surgical techniques with regard to dental relapse, post-operative occlusion and mandibular function.
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| 27. |
- Perheentupa, U, et al.
(författare)
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Frontobasilar fractures: proposal for image reviewing algorithm
- 2014
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Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - : Elsevier BV. - 1878-4119. ; 42:4, s. 305-312
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Tidskriftsartikel (refereegranskat)
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| 28. |
- Perheentupa, U, et al.
(författare)
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Subcranial craniotomy approach for frontobasal fracture correction
- 2014
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Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - : Elsevier BV. - 1878-4119. ; 42:7, s. 1371-1377
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Tidskriftsartikel (refereegranskat)
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| 29. |
- Persson, Johan, et al.
(författare)
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Stiffness and strength of cranioplastic implant systems in comparison to cranial bone
- 2018
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 46:3, s. 418-423
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to evaluate skull replacement options after decompressive craniectomy by systematically investigating which combination of geometrical properties and material selection would result in a mechanical response comparable in stiffness to that of native skull bone and a strength as high or higher than the same. Materials and methods: The study was conducted using a Finite Element Model of the top part of a human skull. Native skull bone, autografts and commercial implants made of PEEK, solid titanium, two titanium meshes and a titanium-ceramic composite were modeled under a set load to evaluate deformation and maximum stress. Results: The computational result showed a large variation of the strength and effective stiffness of the autografts and implants. The stiffness of native bone varied by a factor of 20 and the strength by a factor of eight. The implants span the entire span of the native skull, both in stiffness and strength. Conclusion: All the investigated implant materials had a potential for having the same effective stiffness as the native skull bone. All the materials also had the potential to be as strong as the native bone. To match inherent properties, the best choice of material and thickness is thus patient specific, depending on the quality of the patient's native bone.
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| 30. |
- Ritvanen, A., et al.
(författare)
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Force measurements during posterior calvarial vault osteodistraction : A novel measurement method
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 45:6, s. 981-989
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Tidskriftsartikel (refereegranskat)abstract
- Posterior calvarial vault osteodistraction (PCVO) has become increasingly popular in the correction of craniosynostosis. When compared to cranioplasty, PCVO offers a shorter, less invasive operation, greater intracranial volume advancement and a lower rate of relapse. In general, distraction protocols are based primarily on clinical observations rather than systematic research. Faster distraction protocols may reduce complications. However, distraction protocols producing higher forces can increase complications. Thus, we need to understand these forces in order to improve distraction protocols and devices. We developed a force measurement method that can be used on PCVO devices. Here, we present preliminary data about the forces developed during PCVO. We measured the forces in four bicoronal craniosynostosis patients during PCVO. We observed a linear-like trend between the force increase and the distraction distance within distraction sessions. We also observed a step-wise force increase between distraction sessions and found that the distraction force relaxed rapidly shortly after the distraction session. The mean maximum pre distraction force for one distracter was 20.4 N, while the mean maximum end-distraction force for one distracter was 57.6 N. Our data suggests that current treatment protocols might be re-evaluated favouring shorter distraction distances and more frequent distraction sessions.
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| 31. |
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| 32. |
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| 33. |
- Silva, Ingrid, et al.
(författare)
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Quality of life in patients undergoing orthognathic surgery - A two-centered Swedish study
- 2016
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:8, s. 973-978
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Surgical corrections of dentofacial deformities have both physical and psychological impact on quality of life (QoL). The objectives of the present study were to evaluate the impact of oral health related problems on QoL before and after a combination of orthodontic treatment and orthognathic surgery. Additionally, the study aimed to identify correlations between different dentofacial patterns and possible improvements due to treatment. Material and methods: In a prospective study, we evaluated fifty patients before start of treatment, 6 weeks and 6 months postoperatively. The questionnaires used were: OHIP-14 (Short Form Oral Health Impact Profile), a condition-specific QOL approach (Orthognathic Quality of Life Questionnaires; OQLQ) and a social-demographic questionnaire. Results: There was a statistically significant improvement in the OHIP domains from baseline to 6 months follow-up and for the OQLQ the improvement was significant both at 6 weeks and 6 months in relation to the baseline data. Conclusion: Significant improvement of quality of life over time is proved by both OHIP-14 and OQLQ in the present study. Socio-demographic and holistic considerations are important when evaluating treatment outcome after combined orthodontic and orthognatic surgery. However, longer follow-up would be beneficial. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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| 34. |
- Silva, Ingrid, et al.
(författare)
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Stability after maxillary segmentation for correction of anterior open bite: A cohort study of 33 cases.
- 2013
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 41:7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this cohort study was to evaluate the stability after multi-segmentation of the maxilla for correction of anterior open bite deformities. A total of 33 patients who underwent segmented maxillary osteotomy between 1994 and 2006 were included in the study. Rigid fixation with plates and postsurgical intermaxillary fixation for 6 weeks was applied to each patient. All patients were then followed in a standardized examination procedure at months 6, 12, 18 and up to 30 months postoperatively. Vertical and horizontal relation of the incisors was measured both clinically and on cast models. The main finding was that statistically significant relapse was found vertically, whereas the horizontal relationship to the mandible was unchanged. The vertical relapses were predominantly seen in patients with severe open bite evident preoperatively.
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| 35. |
- Starch-Jensen, Thomas, et al.
(författare)
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Radiographic outcome after maxillary sinus floor augmentation with allogeneic adipose tissue-derived stem cells seeded on deproteinized bovine bone mineral. A randomized controlled experimental study.
- 2023
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Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - 1010-5182 .- 1878-4119. ; 51:5, s. 321-331
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to test the hypothesis of no difference in radiographic outcome after maxillary sinus floor augmentation (MSFA) with allogeneic adipose tissue-derived stem cells (ASCs) seeded on deproteinized bovine bone mineral (DBBM) (test) compared with excipient on DBBM (control). Eighteen minipigs were assigned into three groups of six animals and euthanised after one month (T1), two months (T2), and four months (T3), respectively. Each maxillary sinus was randomly allocated to either test or control with an equal volume of graft. Computed tomography scans (CTs) after MSFA (T0) were compared with CTs after euthanasia to evaluate graft volume (GV) changes and bone density (BD) using three-dimensional measurements and Hounsfield units. GV was larger in test compared with control at T1 (P=0.046), whereas GV was larger in control compared with test at T3 (P=0.01). BD increased from T0 to T1-T3 (P<0.001) with both treatments. Higher BD was observed in control compared with test at T3 (P=0.01), while no significant difference was observed at T1 and T2. Conclusively, the present study demonstrate that allogeneic ASCs seeded on DBBM in conjunction with MSFA seemed not to improve the radiographic outcome compared with excipient on DBBM. However, radiological outcomes need to be supplemented by bone histomorphometry before definitive conclusions can be provided about the beneficial use of allogeneic ASCs seeded on DBBM in conjunction with MSFA compared with DBBM alone.
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| 36. |
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| 37. |
- Strbac, Georg D., et al.
(författare)
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Survival rate of autotransplanted teeth after 5 years : A retrospective cohort study
- 2017
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier. - 1010-5182 .- 1878-4119. ; 45:8, s. 1143-1149
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Tidskriftsartikel (refereegranskat)abstract
- Background: Autotransplantation of teeth (TX) is a predictable treatment option, although this type of therapy is often overlooked compared to other types of restorations. Purpose: As current literature contains few long-term studies concerning the outcome of auto-transplanted immature molars, the aim was to evaluate results after a follow-up period of 5 years. Material and methods: This retrospective study enrolled all patients treated with immature auto-transplanted molars after a follow-up period of 5 years. In order to ensure comparable results, survival rate was investigated as well as clinical and radiological parameters. Contralateral teeth (TC) were used as controls for further assessments and for ensuring comparable future results. Results: 52 patients with 66 TX were examined. Mean age at the time of surgery was 19.64 years. Tooth survival rate after 5 years was 89.39%. The results for parameters such as PPD, BOP, mobility, dental caries, periapical pathologies and endodontic treatments showed no differences. In contrast, dental restorations (p < 0.001), occlusal contacts (p = 0.003) and sensitivity (p < 0.001) differed significantly between TX and TC. Conclusions: The current findings clearly confirm that TX is an effective alternative treatment option to fixed prosthodontic restorations and dental implants, and provides for results equivalent to those with the patients' natural teeth. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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| 38. |
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| 39. |
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