| 1. |
- Bengtsson, Martin, et al.
(author)
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Mandibular Access Osteotomy for Tumor Ablation : Could a More Tissue-Preserving Technique Affect Healing Outcome?
- 2016
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In: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 74:10, s. 2085-2092
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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.
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| 2. |
- Chrcanovic, Bruno, et al.
(author)
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Ameloblastic fibrodentinoma and ameloblastic fibro-odontoma : an updated systematic review of cases reported in the literature
- 2017
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In: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 75:7, s. 1425-1437
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Research review (peer-reviewed)abstract
- Purpose: To integrate the available data published on ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO) into a comprehensive analysis of its clinical/radiologic features. Methods: An electronic search was undertaken in August/2016. Eligibility criteria included publications reporting cases of AFD and/or AFO having enough clinical, radiological and histological information to confirm the diagnosis. Demographic data, lesion site and size, treatment approach, and recurrence were analyzed and compared between AFD and AFO. Results: 55 publications reporting 64 AFDs (60 central, 4 peripheral) and 137 publications reporting 215 AFOs (211 central, 3 peripheral, 1 unknown) were included. The difference in recurrence rate (when the information about recurrence was provided) was not statistically significant. The mean age of the patients affected by AFD was not statistically significantly different from those affected by AFO. Conclusions: AFD and AFO presented several similarities: higher prevalence in males and in mandibles, similar patients’ mean age, rate of cortical bone perforation and of the lesions’ association with displaced/unerupted teeth and tooth root resorption, mean lesion size, and recurrence rate. The lesions differed with regard to the presence of radiopacities and locularity. Taken together, our data do not support the concept of progressive maturation of these tumoral conditions.
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| 3. |
- Chrcanovic, Bruno, et al.
(author)
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Survival and complications of zygomatic implants : an updated systematic review
- 2016
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In: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 74:10, s. 1949-1964
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Research review (peer-reviewed)abstract
- Purpose. To assess the survival rate of zygomatic implants (ZIs) and the prevalence of complications based on previously published studies. Methods. An electronic search was performed in December/2015 in three databases and was supplemented by hand-searching. Clinical series of ZIs were included. Interval survival rate (ISR) and cumulative survival rate (CSR) were calculated. The untransformed proportion of complications (sinusitis, soft tissue infection, paresthesia, oroantral fistulas) was calculated, considering the prevalence reported in the studies. Results. Sixty-eight studies were included, comprising 4556 ZIs in 2161 patients, with 103 failures. The 12-year CSR was 95.21%. Most failures were detected within the six-month postsurgical period. Studies (n=26) that exclusively evaluated immediate loading showed a statistically lower ZI failure rate than studies (n=34) evaluating delayed loading protocols (P=0.003). Studies (n=5) evaluating ZIs for the rehabilitation of patients after maxillary resections presented lower survival rates. The probability of presenting postoperative complications with ZIs was as follows: sinusitis 2.4% (95%CI 1.8-3.0), soft tissue infection 2.0% (95%CI 1.2-2.8), paresthesia 1.0% (95%CI 0.5-1.4), oroantral fistulas 0.4% (95%CI 0.1-0.6). However, these numbers may be underestimated, as many studies failed to mention the prevalence of these complications. Conclusion. ZIs present a high 12-year CSR, with most failures occurring at the early stages postoperatively. The main observed complication related to ZIs was sinusitis, which may appear several years after ZI installation surgery.
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| 4. |
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| 5. |
- Larsson Wexell, Cecilia, 1965, et al.
(author)
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A Case Report on Gardner Syndrome With Dental Implant Treatment and a Long-Term Follow-Up.
- 2019
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In: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. - : Elsevier BV. - 1531-5053. ; 77:8, s. 1617-1627
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Journal article (peer-reviewed)abstract
- A case of Gardner syndrome (GS) in a 37-year-old woman is presented in which rehabilitation with dental implant treatment was followed for 7years. The course of diagnostics and treatment is followed through an overview of 45 tissue biopsy and cytology samples during a period of 30years. The patient was diagnosed with GS after a routine review of an oral panoramic radiograph presenting with multiple osteomas and multiple unerupted supernumerary teeth. Biopsy results and surgical procedures with histopathologic diagnoses from 1986 to 2016 are presented. Histologic analysis of the sampled jawbone showed a picture similar to an osteoid osteoma. The installed implant was functionally stable, with no clinical or radiographic events observed at yearly visits, for 7years. In 1991, benign tumors appeared; in 2014, multiple adenomas were found in the small intestine and rectum. This case report shows the potential for dental implant treatment in a patient with GS.
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| 6. |
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| 7. |
- Pinotti, Felipe Eduardo, et al.
(author)
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Use of a Non-Crosslinked Collagen Membrane During Guided Bone Regeneration Does Not Interfere With the Bone Regenerative Capacity of the Periosteum
- 2018
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In: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 76:11
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Journal article (peer-reviewed)abstract
- PURPOSE: To assess whether the use of a non-crosslinked porcine collagen type I and III bi-layered membrane inter-positioned between the periosteum and a bone defect would interfere with the bone regenerative capacity of the periosteum. MATERIALS AND METHODS: Sixty rats, each with 1 critical-size calvarial defect (CSD; diameter, 5 mm) in the parietal bone, were randomly allocated to 1 of 3 equal-size groups after CSD creation: 1) the periosteum was excised and the flap was repositioned without interposition of a membrane (no-periosteum [NP] group); 2) the flap including the periosteum was repositioned (periosteum [P] group); and 3) a non-crosslinked collagen membrane was inter-positioned between the flap, including the periosteum, and the bone defect (membrane [M] group). Micro-computed tomography, qualitative histology, immunohistochemistry, and reverse transcription real-time quantitative polymerase chain reaction were performed at 3, 7, 15, and 30 days postoperatively. RESULTS: A markedly increased radiographic residual defect length was observed in the NP group compared with the P group at 30 days. The NP group also presented a smaller radiographic bone fill area than the P group at 15 and 30 days and then the M group at 30 days. The P and M groups exhibited considerably greater expression of bone morphogenetic protein-2 and osteocalcin than the NP group at 7 days; expression of transforming growth factor-beta1 was considerably greater in the NP group at 15 days. Further, the P group presented considerably higher gene expression levels of Runx2 and Jagged1 at 7 days and of alkaline phosphatase at 3 and 15 days compared with the M and NP groups. CONCLUSION: Interposition of this specific non-crosslinked collagen membrane between the periosteum and the bone defect during guided bone regeneration interferes only slightly, if at all, with the bone regenerative capacity of the periosteum.
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| 8. |
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| 9. |
- Sjöström, Mats, et al.
(author)
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Outcomes of Maxillary Orthognathic Surgery in Patientswith Cleft Lip and Palate: A Literature Review
- 2019
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In: Journal of oral and maxillofacial surgery (Print). - : Springer. - 0278-2391 .- 1531-5053. ; 18:4, s. 500-508
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Journal article (peer-reviewed)abstract
- Purpose: Cleft lip and palate (CLP) patients often require orthognathic surgical correction due to maxillary hypoplasia secondary to primary surgeries, through either distraction osteogenesis (DO) or conventional orthognathic surgery (CO). The objective was to evaluate both surgical techniques regarding functional, aesthetics and quality-of-life and stability outcomes for the patient.Materials and Method: The PubMed database was searched with the inclusion criteria: studies in English detailing maxillary orthognathic surgery on non-syndromic patients with CLP. Clinical trials, systematic reviews, meta-analysis, reviews, randomized control trials were included. Studies with less than five patients and studies reporting bimaxillary surgery were excluded. References lists of these studies were consulted for more studies to be included. Studies were then evaluated for relevance, quality checked for risk of bias and divided based on the results studied. In total, 22 studies published between 1997 and 2017 were included.Results: Most studies had low levels of bias. The evidence to support one surgical technique before the other was low. DO offered better stability. No clear evidence exists on which technique had the best aesthetic results and functional improvement. DO may cause higher levels of anxiety and distress in patients compared to CO.Conclusion: Regarding all outcomes studied, the scrutinized literature did not allow for the recommendation of one specific technique. Future multicentre collaboration may enable greater sample size and better statistical comparison of results of both techniques.
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