Analysis of Road Traffic Crashes-Related Maxillofacial Injuries Severity and Concomitant Injuries in 201 Patients Seen at the UCH, Ibadan.

PubMed

Aladelusi, Timothy; Akinmoladun, Victor; Olusanya, Adeola; Akadiri, Oladimeji; Fasola, Abiodun

2014-12-01

The objective of this study was to determine the prevalence of road traffic crashes (RTC)-related maxillofacial injuries, the concomitant injuries occurring with them, and to assess the relationship between the severity of maxillofacial and concomitant injuries. This was a prospective study involving 201 victims of RTC seen at the Accident and Emergency Department of the University College Hospital, Ibadan with maxillofacial injuries during the study period. Demographic data of the patients, the types of maxillofacial injuries, and concomitant injuries sustained were recorded. Severity of maxillofacial injury was determined using the maxillofacial injury severity scale (MFISS), while the severity of concomitant injuries was based on the ISS. Correlations between types and severity of maxillofacial injury and types and severity of concomitant injury were conducted to determine the predictability of concomitant injuries based on maxillofacial injury severity. Data were processed using SPSS Statistical software (SPSS, version 20.0 for windows, IBM SPSS Inc, Chicago, IL). Maxillofacial injuries constituted 25.4% of RTC-related admission by the Accident and Emergency Department. A total of 151 (75.1%) patients who presented with concomitant injuries participated in the study. Eighty-one (53.6%) sustained injuries to more than one body region. Head injury was the commonest (99, 65.6%) concomitant injury, followed by orthopedic injury (69, 45.7%). Increasing severity of maxillofacial injury showed a positive correlation with increasing ISS. Also, positive correlation was noted with increasing severity of maxillofacial injury and presence of polytrauma (p = 0.01), traumatic brain injury (p = 0.034), and eye injuries (p = 0.034). There was a high prevalence of maxillofacial injuries in victims of RTC. There was a high incidence of concomitant injuries noted with these maxillofacial injuries. Significantly, this study showed a direct relationship between the severity of maxillofacial injury and head, ocular and polytrauma. This study further emphasizes the need for thorough examination of patients presenting with RTC-related maxillofacial injuries.

An Automatic Registration Algorithm for 3D Maxillofacial Model

NASA Astrophysics Data System (ADS)

Qiu, Luwen; Zhou, Zhongwei; Guo, Jixiang; Lv, Jiancheng

2016-09-01

3D image registration aims at aligning two 3D data sets in a common coordinate system, which has been widely used in computer vision, pattern recognition and computer assisted surgery. One challenging problem in 3D registration is that point-wise correspondences between two point sets are often unknown apriori. In this work, we develop an automatic algorithm for 3D maxillofacial models registration including facial surface model and skull model. Our proposed registration algorithm can achieve a good alignment result between partial and whole maxillofacial model in spite of ambiguous matching, which has a potential application in the oral and maxillofacial reparative and reconstructive surgery. The proposed algorithm includes three steps: (1) 3D-SIFT features extraction and FPFH descriptors construction; (2) feature matching using SAC-IA; (3) coarse rigid alignment and refinement by ICP. Experiments on facial surfaces and mandible skull models demonstrate the efficiency and robustness of our algorithm.

Maxillofacial prostheses challenges in resource constrained regions.

PubMed

Tetteh, Sophia; Bibb, Richard J; Martin, Simon J

2017-10-24

This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.

Maxillofacial injuries in infants and preschools: a 2.5-year study.

PubMed

Yang, Rong-Tao; Li, Zhi; Li, Zu-Bing

2014-05-01

This study aims to evaluate the epidemiology of maxillofacial injuries in infants and preschools. The data from 110 infants and preschools with maxillofacial injuries from October 2010 to March 2013 were analyzed retrospectively. The male-to-female ratio was 1.89:1. The peak age was 1 to 3 years (53.64%). Accident falls (76.36%) were the major cause. A total of 166 soft-tissue injuries were found in 103 patients, 102 dental traumas in 36 patients, and 53 maxillofacial fractures in 33 patients. The most common sites of soft-tissue injuries included the gingiva (17.47%), lower lip (13.86%), upper lip (13.25%), and chin (12.05%), and the majority were lacerations (77.71%). Dental traumas occurred mainly in incisors (81.37%) and the lower arch (60.78%). Of the 53 fractures, the most common sites were the condyle (45.28%), symphysis (22.64%), and mandibular body (16.98%); 28 (52.83%) were treated by operation and 25 (47.17%) by conservative treatment. Maxillofacial injuries in infants and preschools exhibit specific epidemiological features. These are related to anatomic, physiologic, and psychologic development in infants and preschools.

Maxillofacial fractures: twenty years of study in the department of maxillofacial surgery in kosovo.

PubMed

Loxha, Mergime Prekazi; Sejfija, Osman; Salihu, Sami; Gjinolli, Fellanza; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida Namani; Gecaj-Gashi, Agreta

2013-01-01

The aim of this study was to analyze maxillofacial region fractures during the past 20 years in the Department of Maxillofacial Surgery in Prishtina. We have analyzed the histories of all patients with trauma who were hospitalized in the Department of Maxillofacial Surgery in Prishtina since the opening of the clinic in 1983 through 2005. Narrowing the subject of our research, we concentrated on fractures of the maxillofacial region treated at the Clinic of Maxillofacial Surgery for the period 2001-2005. We have analyzed those fractures and compared them with the period from 1983 to 2005 only when it was reasonable. During this period, 1,945 patients were treated for trauma in the maxillofacial region by the Department of Maxillofacial Surgery. This group included 19.8% females and 80.2% males. The largest age group were those between 20 and 20 years of age. Causes of trauma for both periods were predominantly traffic accidents; however, during the period 2001-2005, interpersonal conflicts were increasingly the cause of fractures. Interpersonal conflict as a cause of maxillofacial trauma has risen in recent years. With this increase the methods of treating fractures in this region are also changing.

Maxillofacial Fractures: Twenty Years of Study in the Department of Maxillofacial Surgery in Kosovo

PubMed Central

Loxha, Mergime Prekazi; Sejfija, Osman; Salihu, Sami; Gjinolli, Fellanza; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida Namani; Gecaj-Gashi, Agreta

2013-01-01

The aim: The aim of this study was to analyze maxillofacial region fractures during the past 20 years in the Department of Maxillofacial Surgery in Prishtina. Methods: We have analyzed the histories of all patients with trauma who were hospitalized in the Department of Maxillofacial Surgery in Prishtina since the opening of the clinic in 1983 through 2005. Narrowing the subject of our research, we concentrated on fractures of the maxillofacial region treated at the Clinic of Maxillofacial Surgery for the period 2001–2005. We have analyzed those fractures and compared them with the period from 1983 to 2005 only when it was reasonable. Results: During this period, 1,945 patients were treated for trauma in the maxillofacial region by the Department of Maxillofacial Surgery. This group included 19.8% females and 80.2% males. The largest age group were those between 20 and 20 years of age. Causes of trauma for both periods were predominantly traffic accidents; however, during the period 2001-2005, interpersonal conflicts were increasingly the cause of fractures. Conclusion: Interpersonal conflict as a cause of maxillofacial trauma has risen in recent years. With this increase the methods of treating fractures in this region are also changing. PMID:24167433

The temporalis muscle flap and temporoparietal fascial flap.

PubMed

Lam, Din; Carlson, Eric R

2014-08-01

The temporal arterial system provides reliable vascular anatomy for the temporalis muscle flap and temporoparietal fascial flap that can support multiple reconstructive needs of the oral and maxillofacial region. The minimal donor site morbidity and ease of development of these flaps result in their predictable and successful transfer for reconstructive surgery of the oral and maxillofacial region. Copyright © 2014 Elsevier Inc. All rights reserved.

The Influence of Socioeconomic Factors on the Epidemiology of Maxillofacial Fractures in Southern Italy.

PubMed

Sbordone, Carolina; Barca, Ida; Petrocelli, Marzia; Dell'Aversana Orabona, Giovanni; Vaira, Luigi Angelo; Colangeli, Walter; Cristofaro, Maria Giulia; Giudice, Mario; Giudice, Amerigo; Cassandro, Francesco Maria; Attanasi, Federica; Iaconetta, Giorgio; Califano, Luigi

2018-05-15

Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable and its analysis is crucial to establish effective treatment and prevention of these injuries. The aim of this multicentric retrospective study was to analyze causes, demographics, incidence, characteristics of 987 patients diagnosed with maxillofacial trauma between 2011 and 2015 at Complex Operative Unit of Maxillofacial Surgery of Federico II University of Naples and Magna Graecia University of Catanzaro, Italy; 657 male and 310 female patients were admitted in the study. The most frequently observed fracture involved the mandible (399 patients, 35.4%), followed by zygomatic complex (337 patients, 29.9%), orbital walls (160 patients, 14.2%), and nasal bones (129 patients, 11.4%). The most frequent cause of fracture was assaults (30.4%), followed by road traffic injuries (27.2%), falls (23.2%), sport accidents (15.4%), and others causes (2.6%). Significant variations of etiology have been detected between the 2 hospitals in relationship with different migration flow trends and cultural and socioeconomic features. Epidemiological analysis of maxillofacial fractures is crucial to identify the trauma burden and to help in developing a more efficient system to plan resource allocation and to deliver care and preventive measures establishing clinical and research priorities for effective treatment and prevention of these injuries.

[Statistical considerations of isolated maxillofacial fractures in Sao Paulo].

PubMed

Crivello, O; Luz, J G; Lemos, J B; Rezende, J R

1989-01-01

Statistical analysis of 550 isolated maxillo-facial fractures is presented. Data obtained illustrated the important number of maxillo-facial fractures in Sao Paulo, the automobilistics accidents were responsible for most maxillo-facial trauma, the jaw and the malar were more predominant than the others structures and the conservative treatment was the most used one.

Features of cranio-maxillofacial trauma in the massive Sichuan earthquake: analysis of 221 cases with multi-detector row CT.

PubMed

Chu, Zhi-gang; Yang, Zhi-gang; Dong, Zhi-hui; Chen, Tian-wu; Zhu, Zhi-yu; Deng, Wen; Xiao, Jia-he

2011-10-01

In a massive earthquake, cranio-maxillofacial trauma was common. The present study was to determine the features of cranio-maxillofacial trauma sustained in the massive Sichuan earthquake by multi-detector row computed tomography (MDCT). The study included 221 consecutive patients (123 males and 98 females; age range, 1-83 years; median age, 35 years) with cranio-maxillofacial trauma in the Sichuan earthquake, who underwent cranio-maxillofacial MDCT scans. The image data were retrospectively reviewed focusing on the injuries of the cranio-maxillofacial soft tissue, facial bones and cranium. All patients had soft tissue injuries frequently with foreign bodies. Ninety-seven (43.9%) patients had fractures (1.5 involved sites per patient, range from 1 to 8) including single cranial fractures in 36 (37.1%) cases, single maxillofacial fractures were seen in 48 (49.5%) and cranio-maxillofacial fractures in 13 (13.4%). Single bone fracture was more common than multiple bone fractures (p<0.05). Nasal, ethmoid bones and the orbits were the most commonly involved sites of the craniofacial region. Thirty-eight (17.2%) patients had intracranial injuries, the commonest being subarachnoid haemorrhage and the commonest sites were the temporal and frontal regions. Coexisting intracranial injuries were more common in patients with cranial fractures than in patients with maxillofacial fractures (p<0.05). Our results indicate that the cranio-maxillofacial trauma arising from the massive Sichuan earthquake had some characteristic features, and a significant number of individuals had the potential for combined cranial and maxillofacial injuries, successful management of which required a multidisciplinary approach. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Contemporary management of maxillofacial ballistic trauma.

PubMed

Breeze, J; Tong, D; Gibbons, A

2017-09-01

Ballistic maxillofacial trauma in the UK is fortunately relatively rare, and generally involves low velocity handguns and shotguns. Civilian terrorist events have, however, shown that all maxillofacial surgeons need to understand how to treat injuries from improvised explosive devices. Maxillofacial surgeons in the UK have also been responsible for the management of soldiers evacuated from Iraq and Afghanistan, and in this review we describe the newer types of treatment that have evolved from these conflicts, particularly that of damage-control maxillofacial surgery. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

[Development of Chinese oral and maxillofacial surgery reflects the great achievements of China's reform and opening to the world for 30 years].

PubMed

Qiu, Wei-Liu

2009-02-01

China's policy of reform and opening to the world provides unlimited vitality for Chinese oral and maxillofacial surgery. The academic organization is increasingly perfecting, the professional team is expanding, and international exchanges are increasingly active. However, new challenges are emerging accordingly. To overcome the current problems and difficulties, some constructive beneficial recommendations were proposed and discussed in this paper.

Knowledge and Awareness of Medical Practitioners of Jazan City towards Oral and Maxillofacial Surgery as a Specialty.

PubMed

Ali, Fareedi Mukram; Al-Iryani, Ghassan M; Namis, Sultan Mohammed; Hezam, Asma Ali; Swaid, Salma Abdu; Alomar, Anas Esam

2018-03-15

In many health services communities the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness towards OMFS among different branches of health services providers is essential for better referral strategies and will be for the benefit of the patient. The cross-sectional study was done using a specially prepared questionnaire distributed randomly to 125 general medical practitioners working in Jazan province. In this questionnaire, there were also some close-ended questions to evaluate awareness regarding a variety of conditions treated by the oral and maxillofacial surgeons. Out of 125 participants, 105 (84%) were aware of the oral and maxillofacial surgery as a speciality branch of dentistry. Only 52 (41.6%) participants were aware of the different treatment modalities coming under the scope of oral and maxillofacial surgery. Also in the referral of cases to the oral and maxillofacial surgeon, 50 (40%) participants referred their oral and maxillofacial region cases to OMS. Tooth removal was the only procedure where most of the medical practitioners knew it is a speciality procedure of the oral and maxillofacial surgeon. For facial fractures, 76 medical practitioners believe it comes under the scope of the orthopaedic surgeon. Similarly, for facial abscesses, 81 and 36 practitioners responded that it is a job of a general surgeon and OMS respectively. There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.

Update of patient-specific maxillofacial implant.

PubMed

Owusu, James A; Boahene, Kofi

2015-08-01

Patient-specific implant (PSI) is a personalized approach to reconstructive and esthetic surgery. This is particularly useful in maxillofacial surgery in which restoring the complex three-dimensional (3D) contour can be quite challenging. In certain situations, the best results can only be achieved with implants custom-made to fit a particular need. Significant progress has been made over the past decade in the design and manufacture of maxillofacial PSIs. Computer-aided design (CAD)/computer-aided manufacturing (CAM) technology is rapidly advancing and has provided new options for fabrication of PSIs with better precision. Maxillofacial PSIs can now be designed using preoperative imaging data as input into CAD software. The designed implant is then fabricated using a CAM technique such as 3D printing. This approach increases precision and decreases or completely eliminates the need for intraoperative modification of implants. The use of CAD/CAM-produced PSIs for maxillofacial reconstruction and augmentation can significantly improve contour outcomes and decrease operating time. CAD/CAM technology allows timely and precise fabrication of maxillofacial PSIs. This approach is gaining increasing popularity in maxillofacial reconstructive surgery. Continued advances in CAD technology and 3D printing are bound to improve the cost-effectiveness and decrease the production time of maxillofacial PSIs.

Maxillofacial trauma due to work-related accidents.

PubMed

Hächl, O; Tuli, T; Schwabegger, A; Gassner, R

2002-02-01

Even though numerous reports on maxillofacial trauma exist, only a few give detailed information about work-related maxillofacial injuries. The purpose of this study was to reveal the significance of maxillofacial injuries related to accidents occurring at work by evaluating a large number of patients with maxillofacial injuries over a 9-year period. Out of the 8704 trauma patients treated between 1991 and 1999 in the Department of Oral and Maxillofacial Surgery at the University of Innsbruck, Austria, 463 (5.4%) were injured at work. All charts were reviewed and analyzed according to age, gender, cause of accident, occupation, type of injury, location and frequency of fractures. The highest incidence of maxillofacial injury was found among construction workers (a total of 124 patients, 26.8%), followed by craftsmen (102 patients, 22.0%) and office employees (69 patients, 14.9%). The sex distribution showed an overall male-to-female ratio of 11.8:1 and those in the age group most affected were between 20 and 29 years of age. The most frequent cause of injury was a blow in 48.4%, followed by falls and falls over obstacles, accounting for 27.9% and 7.1%, respectively. Of all trauma, 45.4% (210 persons) sustained 423 maxillofacial fractures, 31.7% (147 patients) suffered 232 dento-alveolar injuries, and 21.2% (98 people) showed 430 soft-tissue injuries. One-fifth (20.7%) of all patients displayed concomitant injuries with cerebral and cranial trauma being the most common. The probability of sustaining maxillofacial trauma at work is correlated to the nature of the occupation. Individuals (mostly men) using tools or machines at work are exposed to a much higher risk of work-related maxillofacial trauma.

An Overview of Maxillofacial Trauma in Oral and Maxillofacial Tertiary Trauma Centre, Queen Elizabeth Hospital, Kota Kinabalu, Sabah

PubMed Central

Lee, Chee Wei; Foo, Qi Chao; Wong, Ling Vuan; Leung, Yiu Yan

2016-01-01

The aims of this study were to provide an overview of maxillofacial trauma and its relationship to patient's demographic data and alcohol consumption within the state of Sabah. It was a retrospective study of maxillofacial trauma cases treated by Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, from January 1, 2009, until December 31, 2013. A total of 630 maxillofacial trauma cases were included. Details of the trauma were collected from patients' record, including patients' cause of injuries, injuries suffered, treatment indications, and treatment received. Patients' demographic data (age, gender), alcohol consumption in relation to causes, and type of maxillofacial injury were analyzed. There were 538 male (85.4%) and 92 female (14.6%) patients (ratio: 5.8:1), with mean age of 31.0 years. Most common causes of maxillofacial injury were motor vehicle accident (MVA; 66.3%), followed by fall (12.4%) and assault (11.6%). Motorcyclists made up more than half of the total cases (53.1%). Cases referred were primarily due to soft-tissue injury (458 cases). Other cases were dentoalveolar and maxillofacial bone fractures. Treatment provided for the fractures included open reduction and internal fixation (22.9%), closed reduction (28.7%), and conservative management (48.4%). Toilet and suturing were done for all patients with soft-tissue injury. Maxillofacial trauma is a major problem in Sabah. It affects mostly males in the age group of 21 to 30 years. Most of the MVA patients were motorcyclists. Mandibular fracture with parasymphysis involvement recorded the highest number. Most of the patients preferred conservative management, probably due to financial and logistic issue. PMID:28210403

Bibliometric analysis of oral and maxillofacial cytology-related articles published in a cytology journal from India.

PubMed

Shamim, Thorakkal

2018-01-01

There is a paucity of information about the oral and maxillofacial cytology-related articles published in a cytology journal. Journal of Cytology (JOC) is the official publication of Indian Academy of Cytologists. This study aimed to audit the oral and maxillofacial cytology-related articles published in JOC from 2007 to 2015 over a 9-year period. Bibliometric analysis of issues of JOC from 2007 to 2015 was performed using web-based search. The articles published were analyzed for type of article and individual topic of oral and maxillofacial cytology. The articles published were also checked for authorship trends. Of the total 93 published articles related to oral and maxillofacial cytology, original articles (43) and case reports (33) contribute the major share. The highest number of oral and maxillofacial cytology-related articles was published in 2014 with 17 articles and the least published year was 2010 with three articles. Among the oral and maxillofacial cytology-related articles published in JOC, diseases of salivary gland (26) followed by oral exfoliated cells (17), soft tissue tumors (7), round cell tumors (6) and spindle cell neoplasms (5) form the major attraction of the contributors. The largest numbers of published articles related to oral and maxillofacial cytology were received from Postgraduate Institute of Medical Education and Research, Chandigarh (5), and Jawaharlal Nehru Medical College, Aligarh (5). This paper may be considered as a baseline study for the bibliometric information regarding oral and maxillofacial cytology-related articles published in India.

Pattern of maxillofacial fractures in severe multiple trauma patients: a 7-year prospective study.

PubMed

Alves, La-Salete; Aragão, Irene; Sousa, Maria-José Carneiro; Gomes, Ernestina

2014-01-01

The incidence of facial trauma is high. This study has the primary objective of documenting and cataloging maxillofacial fractures in polytrauma patients. From a total of 1229 multiple trauma cases treated at the Emergency Room of the Santo Antonio Hospital - Oporto Hospital Center, Portugal, between August 2001 and December 2007, 251 patients had facial wounds and 209 had maxillofacial fractures. Aged ranged form 13 to 86 years. The applied selective method was based on the presence of facial wound with Abbreviated Injury Scale ≥1. Men had a higher incidence of maxillofacial fractures among multiple trauma patients (86.6%) and road traffic accidents were the primary cause of injuries (69.38%). Nasoorbitoethmoid complex was the most affected region (67.46%) followed by the maxilla (57.42%). The pattern and presentation of maxillofacial fractures had been studied in many parts of the world with varying results. Severe multiple trauma patients had different patterns of maxillofacial injuries. The number of maxillofacial trauma is on the rise worldwide as well as the incidence of associated sequelae. Maxillofacial fractures on multiple trauma patients were more frequent among males and in road traffic crashes. Knowing such data is elementary. The society should have a key role in the awareness of individuals and in prevention of road traffic accidents.

Evaluation of direct and indirect additive manufacture of maxillofacial prostheses.

PubMed

Eggbeer, Dominic; Bibb, Richard; Evans, Peter; Ji, Lu

2012-09-01

The efficacy of computer-aided technologies in the design and manufacture of maxillofacial prostheses has not been fully proven. This paper presents research into the evaluation of direct and indirect additive manufacture of a maxillofacial prosthesis against conventional laboratory-based techniques. An implant/magnet-retained nasal prosthesis case from a UK maxillofacial unit was selected as a case study. A benchmark prosthesis was fabricated using conventional laboratory-based techniques for comparison against additive manufactured prostheses. For the computer-aided workflow, photogrammetry, computer-aided design and additive manufacture (AM) methods were evaluated in direct prosthesis body fabrication and indirect production using an additively manufactured mould. Qualitative analysis of position, shape, colour and edge quality was undertaken. Mechanical testing to ISO standards was also used to compare the silicone rubber used in the conventional prosthesis with the AM material. Critical evaluation has shown that utilising a computer-aided work-flow can produce a prosthesis body that is comparable to that produced using existing best practice. Technical limitations currently prevent the direct fabrication method demonstrated in this paper from being clinically viable. This research helps prosthesis providers understand the application of a computer-aided approach and guides technology developers and researchers to address the limitations identified.

Bibliometric analysis of oral and maxillofacial cytology-related articles published in a cytology journal from India

PubMed Central

Shamim, Thorakkal

2018-01-01

Background: There is a paucity of information about the oral and maxillofacial cytology-related articles published in a cytology journal. Journal of Cytology (JOC) is the official publication of Indian Academy of Cytologists. Objective: This study aimed to audit the oral and maxillofacial cytology-related articles published in JOC from 2007 to 2015 over a 9-year period. Materials and Methods: Bibliometric analysis of issues of JOC from 2007 to 2015 was performed using web-based search. The articles published were analyzed for type of article and individual topic of oral and maxillofacial cytology. The articles published were also checked for authorship trends. Results: Of the total 93 published articles related to oral and maxillofacial cytology, original articles (43) and case reports (33) contribute the major share. The highest number of oral and maxillofacial cytology-related articles was published in 2014 with 17 articles and the least published year was 2010 with three articles. Among the oral and maxillofacial cytology-related articles published in JOC, diseases of salivary gland (26) followed by oral exfoliated cells (17), soft tissue tumors (7), round cell tumors (6) and spindle cell neoplasms (5) form the major attraction of the contributors. The largest numbers of published articles related to oral and maxillofacial cytology were received from Postgraduate Institute of Medical Education and Research, Chandigarh (5), and Jawaharlal Nehru Medical College, Aligarh (5). Conclusion: This paper may be considered as a baseline study for the bibliometric information regarding oral and maxillofacial cytology-related articles published in India. PMID:29731569

Missile injuries in head - neck and maxillo-facial region - an experience in eastern nepal.

PubMed

Wakode, P T; Ghimire, Anand; Acharya, Roshan

2008-06-01

Ballistic injuries to head-neck and maxillofacial region is quite common problem nowadays. Most of the time the injuries seem to be dreadful but the mechanism of the injuries caused by ballistics and the anatomical conditions of maxillofacial and head-neck region mitigate the severity of the injuries. Proper primary management followed by reconstruction and management of associated injuries decreases the mortality and morbidity of missile injuries in head-neck and maxillofacial region. Eleven cases of missile injuries in head-neck and maxillofacial region are included in the present study. The mechanism of the injury and the ideal management strategy for the ballistics injuries in the region has been discussed in the article.

The successful oral and maxillofacial surgery practice.

PubMed

Bell, Colin S

2008-02-01

Oral and maxillofacial surgery has been and will continue to be one of the premiere health care specialties in the United States. Incomes of oral and maxillofacial surgeons are among the highest of any profession in the country. With efficient scheduling, organized business systems, efficient fee schedules, and appropriate use of consultants, oral and maxillofacial surgery can lead to a lifestyle that is relatively stress free, allows a direct route to financial independence, and provides a great public service.

An innovative virtual reality training tool for orthognathic surgery.

PubMed

Pulijala, Y; Ma, M; Pears, M; Peebles, D; Ayoub, A

2018-02-01

Virtual reality (VR) surgery using Oculus Rift and Leap Motion devices is a multi-sensory, holistic surgical training experience. A multimedia combination including 360° videos, three-dimensional interaction, and stereoscopic videos in VR has been developed to enable trainees to experience a realistic surgery environment. The innovation allows trainees to interact with the individual components of the maxillofacial anatomy and apply surgical instruments while watching close-up stereoscopic three-dimensional videos of the surgery. In this study, a novel training tool for Le Fort I osteotomy based on immersive virtual reality (iVR) was developed and validated. Seven consultant oral and maxillofacial surgeons evaluated the application for face and content validity. Using a structured assessment process, the surgeons commented on the content of the developed training tool, its realism and usability, and the applicability of VR surgery for orthognathic surgical training. The results confirmed the clinical applicability of VR for delivering training in orthognathic surgery. Modifications were suggested to improve the user experience and interactions with the surgical instruments. This training tool is ready for testing with surgical trainees. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Weapon and Sighting System Compatibility Assessment for Prototype Maxillofacial Protection Devices

DTIC Science & Technology

2013-03-01

No Maxillofacial Protection, No Visor (figure 38) ...........................22 7.2 Sighting System Compatibility – Bradley Fighting Vehicle ( BFV ...23 Figure 39. FASTBAC, bracket only ( BFV ...23 Figure 40. FASTBAC bracket and maxillofacial protection ( BFV ). ............................................24 Figure 41. FIREBALL

A possible mechanism of maxillofacial abscess formation: involvement of Porphyromonas endodontalis lipopolysaccharide via the expression of inflammatory cytokines.

PubMed

Murakami, Y; Hanazawa, S; Tanaka, S; Iwahashi, H; Yamamoto, Y; Fujisawa, S

2001-12-01

In a previous study, we developed a specific monoclonal antibody against Porphyromonas endodontalis lipopolysaccharide, and demonstrated that this lipopolysaccharide was detected in bacterially infected root canal fluid. We suggest here that P. endodontalis lipopolysaccharide in the infectious materials plays a stimulatory role in maxillofacial abscess formation via the expression of inflammatory cytokines. Our epidemiological study showed that this lipopolysaccharide was detected in significant levels the infectious material of patients with periapical periodontitis and odontogenic abscesses. Interestingly, infectious material-induced expression of tumor necrosis factor-alpha, interleukin-1beta, or neutrophil chemoattractant KC genes in mouse macrophages, was significantly neutralized by monoclonal antibody against the lipopolysaccharide. In addition, we also detected a significant amount of tumor necrosis factor-alpha in the infectious material. These results suggest that P. endodontalis lipopolysaccharide plays an important role in the pathogenic mechanism of maxillofacial abscess formation via the expression of inflammatory cytokines.

Developing psychological services following facial trauma.

PubMed

Choudhury-Peters, Deba; Dain, Vicky

2016-01-01

Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress.

Developing psychological services following facial trauma

PubMed Central

Choudhury-Peters, Deba; Dain, Vicky

2016-01-01

Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

History of the Oral and Maxillofacial Surgery Residency Program at Universidad el Bosque, Bogotá, Colombia.

PubMed

Castro-Núñez, Jaime

2012-01-01

The formal training of oral and maxillofacial surgeons in Colombia started in 1958 at Hospital Sanjos6, thanks to the titanic work of Waldemar Wilhelm, a German-born surgeon who settled in BogotA in 1950. Today there are seven institutions in Colombia that offer residency programs in oral and maxillofacial surgery. The aim of this article is to describe the history of the Oral and Maxillofacial Surgery Residency Program at Universidad El Bosque in Bogota.

Oral and maxillofacial surgery: what are the French specificities?

PubMed

Herlin, Christian; Goudot, Patrick; Jammet, Patrick; Delaval, Christophe; Yachouh, Jacques

2011-05-01

Oral and maxillofacial surgery has expanded rapidly over the past century. Recognition in France has grown since the first face transplantation in the world performed by Professor Bernard Devauchelle. This speciality, which seems to correspond to a narrow scope of services, actually involves oral, plastic, reconstructive, and cosmetic surgeries of the face. French training for maxillofacial surgeons differs from the Anglo-Saxon course of study. After examining surveys carried out in Great Britain, the United States, and Brazil, the perception of this speciality in the general public and among regular correspondents (general practitioners and dental practitioners) was ascertained. More than 4,000 questionnaires were sent to health care workers and patients attending dental practices. The returned questionnaires concerning recognition of this profession in France were analyzed. Evaluating awareness of maxillofacial surgery among practitioners and the public was of particular interest because it can overlap with several other specialities (ear, nose, and throat; plastic surgery; odontology). The questionnaire included the 20 items used in other similar studies so the results could be compared. Several fields of expertise were identified in maxillofacial surgery, in particular traumatology, surgery for facial birth defects, and orthognathic surgery. Moreover, dental practitioners were found to be the most regular correspondents of maxillofacial surgeons compared with general practitioners. Compared with Anglo-Saxon and Brazilian peers, French recognition of maxillofacial surgery was better. Despite encouraging results, maxillofacial surgery remains a somewhat obscure speciality for health care workers and the general public. Better awareness is necessary for this speciality to become the reference in facial surgery. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

How do general dentists and orthodontists determine where to refer patients requiring oral and maxillofacial surgical procedures?

PubMed

Schlieve, Thomas; Funderburk, Joseph; Flick, William; Miloro, Michael; Kolokythas, Antonia

2015-03-01

This study investigated the influence of specific criteria on referral selection among general dentists and orthodontists in deciding referrals to oral and maxillofacial surgeons. A cross-sectional study was designed to examine the importance of criteria used by 2 groups of practitioners, general dentists and orthodontists, for deciding on referrals to oral and maxillofacial surgeons. Data were collected by 2 multiple-choice surveys. The surveys were e-mailed to general dentists and orthodontists practicing in the state of Illinois and to graduates from the University of Illinois at Chicago (UIC) College of Dentistry and the UIC Department of Orthodontics. Participants were asked to rate referral criteria from most important to least important. Analysis of variance was used to examine the data for any differences in the importance of the criteria for each question and linear regression analysis was used to determine whether any 1 criterion was statistically meaningful within each group of practitioners. In total, 235 general dental practitioners and 357 orthodontists completed the survey, with a 100% completion rate. The most important criterion for referral to oral and maxillofacial surgeons in the general dentist group was the personal and professional relationship of the referring doctor to the specialist. In the orthodontist group, no single criterion was statistically meaningful. General dentists tend to develop long-term relationships with their patients, and when deciding the appropriate referrals it appears that personal and professional relationships that promote trust and open communication are key elements. General dentists favor these relationships when making referral decisions across a wide spectrum of procedures. Orthodontists do not place a substantial value on a specific criterion for referral and therefore may not develop the same relationships between patient and doctor and between doctors as general dentists. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Motorcycle accident is the main cause of maxillofacial injuries in the Penang Mainland, Malaysia.

PubMed

Hashim, Hasnah; Iqbal, Syed

2011-02-01

Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia. This was a cross-sectional study that recruited cases reported within a period of 1 year. The source population was maxillofacial injury patients presenting to the Oral and Maxillofacial Surgery Department of an urban hospital in the Penang Mainland, North Malaysia between May 2007 and May 2008. Cases of patients involved in accidents that occurred outside the reference vicinity were excluded. A case report form was developed and completed by the attending clinicians. Data were analyzed using spss version 12.0. A total of 194 cases were studied, with the mean patient age being 27.8 (SD 15.20) years. The majority of patients were Malay men between 20 and 29 years of age. The main cause of injury was motorcycle accident (53.6%). The commonest injury (in isolation/combination with other injuries) involved the soft tissues (87.2%), dentoalveolar region (33.4%), and facial bones (23.9%). Laceration was the commonest soft tissue injury, and crown fracture was the most frequent dentoalveolar injury. The facial bone that was most highly involved in the injury was the zygoma. Subjects involved in motorcycle accidents had a significantly higher incidence of sustaining facial bone fractures. Motorcycle accidents were the commonest cause of maxillofacial injuries in the Penang Mainland, Malaysia. Most patients were young men. Hence, it is prudent to reinforce appropriate road safety and awareness interventions particularly focusing young male motorcyclists so as to reduce the risk of accidents. © 2011 John Wiley & Sons A/S.

Changing pattern of pediatric maxillofacial injuries at the Accident and Emergency Department of the University Teaching Hospital, Ibadan--a four-year experience.

PubMed

Okoje, Victoria N; Alonge, Temitope O; Oluteye, Olufemi A; Denloye, Obafunke O

2010-01-01

Maxillofacial injuries are common among polytraumatized patients, and in Nigeria, the incidence seems to be on the increase. This probably is related to the drive of industrialization and the increase in the number of road traffic accidents. Delays in attending to severe maxillofacial injuries can be grave because of concomitant injuries that can be life threatening. This is a prospective review of maxillofacial injuries in patients less than or equal to 16 years of age who were seen at the Accident and Emergency Department between October 2002 and December 2006. In all the patients, the accident and emergency physicians carried out initial resuscitation, and thereafter, they were referred to the maxillofacial unit on call. A total of 611 patients with maxillofacial injuries were seen during the study period and of this, 134 (22%) were less than or equal to 16 years old. The male:female ratio was 1.1:1.0. Road traffic accident (RTA) was the most common etiological factor in 73 (54.5%) cases, while gunshot injuries accounted for 6 (4.4%) cases. Soft tissue lacerations were the most common maxillofacial injuries occurring in 90 (55.9%) cases; mandibular fractures were the most common bony injury in 17 (13.4%). The upsurge in maxillofacial gunshot injuries in the pediatric age group is alarming and this may be a reflection of the global changes (westernization and drug-related offenses like armed robberies) and the harsh economic conditions in this community.

ADAM10 is essential for cranial neural crest-derived maxillofacial bone development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, Yu, E-mail: tanyu2048@163.com; Fu, Runqing, E-mail: furunqing@sjtu.edu.cn; Liu, Jiaqiang, E-mail: liujqmj@163.com

Growth disorders of the craniofacial bones may lead to craniofacial deformities. The majority of maxillofacial bones are derived from cranial neural crest cells via intramembranous bone formation. Any interruption of the craniofacial skeleton development process might lead to craniofacial malformation. A disintegrin and metalloprotease (ADAM)10 plays an essential role in organ development and tissue integrity in different organs. However, little is known about its function in craniofacial bone formation. Therefore, we investigated the role of ADAM10 in the developing craniofacial skeleton, particularly during typical mandibular bone development. First, we showed that ADAM10 was expressed in a specific area of themore » craniofacial bone and that the expression pattern dynamically changed during normal mouse craniofacial development. Then, we crossed wnt1-cre transgenic mice with adam10-flox mice to generate ADAM10 conditional knockout mice. The stereomicroscopic, radiographic, and von Kossa staining results showed that conditional knockout of ADAM10 in cranial neural crest cells led to embryonic death, craniofacial dysmorphia and bone defects. Furthermore, we demonstrated that impaired mineralization could be triggered by decreased osteoblast differentiation, increased cell death. Overall, these findings show that ADAM10 plays an essential role in craniofacial bone development. -- Highlights: •We firstly reported that ADAM10 was essentially involved in maxillofacial bone development. •ADAM10 cKO mice present craniofacial dysmorphia and bone defects. •Impaired osteoblast differentiation,proliferation and apoptosis underlie the bone deformity.« less

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1981-08-01

necessary and Identify byv block number) MAXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS: MICROCAPSULES : SOFT FILLERS; ELASTOMER COMPOSITES 2,. ABSTRACT...used as fillers in the fabrication of maxillofacial prostheses. The projected systems are elastomeric-shelled, liquid-filled microcapsules . Improvements...elastomeric-shelled, liquid-filled microcapsules . Experiments continued on the interfacial polymerization process, with spherical, sealed, capsules

Maxillofacial injuries in the workplace.

PubMed

Burnham, Richard; Martin, Tim

2013-04-01

Over a 2-year period we reviewed patients who presented to a UK maxillofacial unit with facial injuries sustained at work. We looked at links between the mechanism, injury, and characteristics of such injuries. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Magnetic Resonance Angiography Using Fresh Blood Imaging in Oral and Maxillofacial Regions

PubMed Central

Oda, Masafumi; Tanaka, Tatsurou; Kito, Shinji; Habu, Manabu; Kodama, Masaaki; Kokuryo, Shinya; Miyamoto, Ikuya; Yoshiga, Daigo; Yamauchi, Kensuke; Nogami, Shinnosuke; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Ishikawa, Ayataka; Nishida, Ikuko; Saeki, Katsura; Morikawa, Kazumasa; Matsuo, Kou; Seta, Yuji; Yamashita, Yoshihiro; Maki, Kenshi; Tominaga, Kazuhiro; Morimoto, Yasuhiro

2012-01-01

The present paper provides general dentists with an introduction to the clinical applications and significance of magnetic resonance angiography (MRA) in the oral and maxillofacial regions. Specifically, the method and characteristics of MRA are first explained using the relevant MR sequences. Next, clinical applications to the oral and maxillofacial regions, such as identification of hemangiomas and surrounding vessels by MRA, are discussed. Moreover, the clinical significance of MRA for other regions is presented to elucidate future clinical applications of MRA in the oral and maxillofacial regions. PMID:23118751

Biomechanical characterization of a low density silicone elastomer filled with hollow microspheres for maxillofacial prostheses.

PubMed

Liu, Q; Shao, L Q; Xiang, H F; Zhen, D; Zhao, N; Yang, S G; Zhang, X L; Xu, J

2013-01-01

An ideal material for maxillofacial prostheses has not been found. We created a novel material: silicone elastomer filled with hollow microspheres and characterized its biomechanical properties. Expancel hollow microspheres were mixed with MDX4-4210 silicone elastomer using Q7-9180 silicone fluid as diluent. The volume fractions of microspheres were 0, 5, 15, and 30% v/v (volume ratio to the total volume of MDX4-4210 and microspheres). The microspheres dispersed well in the matrix. The physical properties and biocompatibility of the composites were examined. Shock absorption was the greatest by the 5% v/v composite, and decreased with increasing concentrations of microspheres. The density, thermal conductivity, Shore A hardness, tear and tensile strength decreased with increasing concentrations of microspheres, while elongation at break increased. Importantly, the tear strength of all composites was markedly lower than that of pure silicone elastomer. Cell viability assays indicated that the composite was of good biocompatibility. The composite with a volume fraction of 5% exhibited the optimal properties for use as a maxillofacial prosthesis, though its tear strength was markedly lower than that of silicone elastomer. In conclusion, we developed a novel light and soft material with good flexibility and biocompatibility, which holds a promising prospect for clinical application as maxillofacial prosthesis.

Incidence and severity of maxillofacial injuries during the Second Lebanon War among Israeli soldiers and civilians.

PubMed

Levin, Liran; Zadik, Yehuda; Peleg, Kobi; Bigman, Galya; Givon, Adi; Lin, Shaul

2008-08-01

To analyze the incidence and severity of maxillofacial injuries in the Second Lebanon War, that occurred during the summer of 2006, among Israeli soldiers and civilians. This is a retrospective cohort study of patients recorded in the Israel National Trauma Registry during the Second Lebanon War. Data refer to all general hospitals throughout the country. Data were analyzed according to the etiology of the injury, severity of trauma using the Injury Severity Score, trauma location, and duration of hospital stay. Cases with multiple injuries that included maxillofacial injuries were separated and further analyzed according to the above parameters. Patients with only dental injuries and superficial facial soft tissue lacerations were excluded because they were referred to the military dental clinics and not to general hospitals. Maxillofacial injuries were found in 36 (6.4%) of the 565 wounded. Patients with maxillofacial injuries ranged in age from 20 to 44 years (mean age, 25.5 +/- 5.7 years). Greater than 50% of the injuries required more than 3 hospitalization days. Mortality rate of the maxillofacial injured was 2.8%. Most of the maxillofacial injuries (33; 91.7%) were combined with other organ injuries; 9 (25%) patients also had dental injuries. In the Second Lebanon War, the incidence and severity of true maxillofacial injuries, without dental injuries alone, were relatively low compared with previous reports of other conflicts. However, because most injuries involved multiple organs, special attention is required when planning and providing emergency, as well as secondary and tertiary medical care to war wounded.

Health Manpower Information System (HMIS)

DTIC Science & Technology

1986-03-10

Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111 Public Health Dentistry 3112 Prosthodontics...Executive Dentistry 3103 Endodontics 3102 Oral Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111...Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111 Public Health Dentistry 3112 Prosthodontics

Occupational stress in oral and maxillofacial surgeons: tendencies, traits, and triggers.

PubMed

LaPorta, Lauren D

2010-11-01

Health professionals are subject to higher levels of stress than the average worker. Little has been written on these subjects, specifically in oral and maxillofacial surgeons. Anecdotally, dentists have been singled out as the health care professionals more likely to be subjected to severe stress, burnout, failed marriages, depression, substance abuse, and commit suicide. However, with oral and maxillofacial surgery being a particularly high-stress specialty of dentistry, a study of the dental literature regarding stress may be relevant. This article explores the myths and realities of stress and burnout in oral and maxillofacial surgeons and the coping skills, both adaptive and maladaptive used by practitioners to deal with their stress. This article also offers some practical suggestions for improving both the mental and physical health of oral and maxillofacial surgeons. Copyright © 2010 Elsevier Inc. All rights reserved.

Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

PubMed Central

Lee, Jong-Ho

2016-01-01

PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required. PMID:27350859

The Benefit of the Smartphone in Oral and Maxillofacial Surgery: Smartphone Use Among Maxillofacial Surgery Trainees and iPhone Apps for the Maxillofacial Surgeon.

PubMed

Carey, Elinor; Payne, Karl Frederick Braekkan; Ahmed, Nabeela; Goodson, Alexander

2015-06-01

The use of smartphones has soared among healthcare professionals in recent years, with estimated figures reporting that the majority of clinicians own and use smartphones in the workplace. Smartphones allow the clinician to carry textbooks in their pocket, write documents on the move and use email and internet to enhance productivity and clinical decision making. These advances in smartphone technology have enabled access to healthcare information for the clinician and transfer of data between team members, giving rise to the phenomenon of telemedicine. With the ability to instantly transfer clinical data to the off-site surgeon, combined with purpose-built medical apps, the smartphone is rapidly becoming an invaluable tool for the modern surgeon. Many studies have linked the benefits of smartphones and apps in other surgical specialities, but no article to date has highlighted the merits and full scope of this technology to the Oral and Maxillofacial Surgeon. We report that 94 % of British maxillofacial surgery trainees own a smartphone, with 61 % owning an iPhone. 89 % of trainees questioned had downloaded medical apps and used them regularly during clinical activities. We discuss the clinical application of the smartphone in the field of oral and maxillofacial surgery and review a list of useful and relevant apps for the modern maxillofacial surgeon using the iPhone as an example platform.

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1979-08-01

block number) MAXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS; MICROCAPSULES ; SOFT FILLERS; ELASTuMER COMPOSITES 20,_ ABSTRACT ’Continue on reverse side...approaches were pursued toward making such microcapsules . One approach involves coaxial extrusion of a catalyzed elastomer precursor and core liquid into a...fabrication of maxillofacial prostheses. The projected composite systems are elastomeric-shelled, liquid-filled microcapsules . Two experimental approaches were

Oral-Maxillofacial Injury Surveillance of U.S. Military Personnel in Iraq and Afghanistan, 2001 to 2014.

PubMed

Mitchener, Timothy A; Chan, Rodney; Simecek, John W

2017-03-01

Cranial and oral-maxillofacial injuries accounted for 33% of military visits to in-theater (Level III) military treatment facilities for battle injuries during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Even after years of conflict, the size and scope of oral-maxillofacial injuries in military armed conflict is still not fully understood. This study reports U.S. Department of Defense (DoD) rates of oral-maxillofacial injuries that can be used for further surveillance and research. The populations studied were military personnel deployed to Afghanistan in OEF or Iraq in OIF and Operation New Dawn (OND), who sought care at a Level III military treatment facility for one or more oral-maxillofacial injuries. Injuries were identified in the DoD Trauma Registry (DoDTR) using diagnosis codes associated with oral-maxillofacial battle and nonbattle injuries. All oral-maxillofacial injuries incurred from October 19, 2001, to June 30, 2014, were included. The Defense Manpower Data Center provided DoD troop strength numbers to serve as the study denominators. Battle injuries accounted for 80% of oral-maxillofacial injuries in OEF. There were 2,504 oral-maxillofacial injuries in OEF. The Army accounted for 1,820 (72.7%), the Marines 535 (21.3%), the Air Force 75 (3.0%), and the Navy 74 (3.0%). The oral-maxillofacial injury rates in OEF for the Army ranged from 1.10 to 4.90/1,000 person years (PY), for the Marines from 0.57 to 9.39/1,000 PY, for the Navy from 0 to 3.29/1,000 PY, and for the Air Force from 0 to 3.38/1,000 PY. The Army tended to have the highest incidence of all services in the early and latter part of the conflict, whereas Marines tended to have the highest incidence in the middle years. The Marines, Army, and Navy all had their individual highest incidences in 2009, the first year of the 2009 to 2011 OEF troop surge. Battle injuries accounted for 75% of oral-maxillofacial injuries in OIF/OND. There were 3,676 oral-maxillofacial injuries in OIF/OND. The Army accounted for 2,798 (76.1%), the Marines 731 (19.9%), the Navy 91 (2.5%), and the Air Force 56 (1.5%). The injury rates in OIF/OND for the Army ranged from 0.66 to 8.69/1,000 PY, for the Marines from 0.88 to 42.7/1,000 PY, for the Navy from 0.35 to 19.16/1,000 PY, and for the Air Force from 0.24 to 1.13/1,000 PY. In OIF/OND, the Marines had the highest overall oral-maxillofacial injury rate (42.70/1,000 PY) in 2003. The other services had their individual peak incidences in either 2003 or 2004. This is the first study, which quantified the incidence of oral-maxillofacial injury in theaters of conflict over prolonged periods. The Army has the highest number of injuries. The Marines had the highest incidences during the initial stages of OIF and the OEF troop surge. Intensity of the conflict could account for the upswing in rates. These increases in injury rates highlight the need for additional health care personnel to be deployed near the battlefield to treat these injuries. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Maxillofacial trauma - Underestimation of cervical spine injury.

PubMed

Reich, Waldemar; Surov, Alexey; Eckert, Alexander Walter

2016-09-01

Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery. A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed. Additionally a search of relevant international literature was conducted in PubMed by terms "maxillofacial" AND "cervical spine" AND "injury". Of 3956 patients, n = 3732 (94.3%) suffered from craniomaxillofacial injuries only, n = 174 (4.4%) from cervical spine injuries only, and n = 50 (1.3%) from both craniomaxillofacial and cervical spine injuries. In this study cohort the most prevalent craniofacial injuries were: n = 41 (44%) midfacial and n = 21 (22.6%) skull base fractures. Cervical spine injuries primarily affected the upper cervical spine column: n = 39 (58.2%) vs. n = 28 (41.8%). Only in 3 of 50 cases (6%), the cervical spine injury was diagnosed coincidentally, and the cervical spine column was under immobilised. The operative treatment rate for maxillofacial injuries was 36% (n = 18), and for cervical spine injuries 20% (n = 10). The overall mortality rate was 8% (n = 4). The literature search yielded only 12 papers (11 retrospective and monocentric cohort studies) and is discussed before our own results. In cases of apparently isolated maxillofacial trauma, maxillofacial surgeons should be aware of a low but serious risk of underestimating an unstable cervical spine injury. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Dracunculiasis in oral and maxillofacial surgery.

PubMed

Kim, Soung Min

2016-04-01

Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider.

Facial trauma.

PubMed

Peeters, N; Lemkens, P; Leach, R; Gemels B; Schepers, S; Lemmens, W

Facial trauma. Patients with facial trauma must be assessed in a systematic way so as to avoid missing any injury. Severe and disfiguring facial injuries can be distracting. However, clinicians must first focus on the basics of trauma care, following the Advanced Trauma Life Support (ATLS) system of care. Maxillofacial trauma occurs in a significant number of severely injured patients. Life- and sight-threatening injuries must be excluded during the primary and secondary surveys. Special attention must be paid to sight-threatening injuries in stabilized patients through early referral to an appropriate specialist or the early initiation of emergency care treatment. The gold standard for the radiographic evaluation of facial injuries is computed tomography (CT) imaging. Nasal fractures are the most frequent isolated facial fractures. Isolated nasal fractures are principally diagnosed through history and clinical examination. Closed reduction is the most frequently performed treatment for isolated nasal fractures, with a fractured nasal septum as a predictor of failure. Ear, nose and throat surgeons, maxillofacial surgeons and ophthalmologists must all develop an adequate treatment plan for patients with complex maxillofacial trauma.

Dracunculiasis in oral and maxillofacial surgery

PubMed Central

2016-01-01

Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider. PMID:27162746

Management of retained foreign bodies in missile injuries of the maxillofacial region.

PubMed

Bede, Salwan Yousif Hanna; Ahmed, Firas Taha

2011-07-01

This study evaluates 22 patients with retained foreign bodies in the maxillofacial region that were all caused by penetrating missile injuries. Surgical intervention for the retrieval of the foreign bodies was carried out in 20 patients through the existing wounds and through separate incisions; all patients were followed up for a minimum of 2 months during which all the complications were registered and managed. Preoperative imaging is a prerequisite for the accurate localization of the foreign body and the subsequent successful removal of it. All patients developed complications that were categorized in this study into those that result from the injury itself and those that occur because of the retrieval procedure, the latter category being mostly easily managed. In general, all foreign bodies in the maxillofacial region should be removed; the surgeon involved should weigh the benefits and the perils of the removal, and the patient should be well informed about the possibility of the failure of removal of the foreign body.

Pediatric Odontogenic Cysts of the Jaws.

PubMed

Arce, Kevin; Streff, Christopher S; Ettinger, Kyle S

2016-02-01

Odontogenic cysts represent a common form of pathology of the jaws, and the natural history, clinicopathologic findings, and appropriate management strategies are important to the oral and maxillofacial surgeon. Odontogenic cysts in the pediatric populations are important pathologic entities given their potential impact on the growth and development of the maxillofacial complex. Inappropriate management strategies can severely affect the form and function of the growing child. Categorizing pediatric odontogenic cysts into inflammatory or developmental causes provides a convenient way of conceptualizing these various entities and helps facilitate the appropriate diagnosis and the subsequent management. Copyright © 2016 Elsevier Inc. All rights reserved.

[3D planning in maxillofacial surgery].

PubMed

Hoarau, R; Zweifel, D; Lanthemann, E; Zrounba, H; Broome, M

2014-10-01

The development of new technologies such as three-dimensional (3D) planning has changed the everyday practice in maxillofacial surgery. Rapid prototyping associated with the 3D planning has also enabled the creation of patient specific surgical tools, such as cutting guides. As with all new technologies, uses, practicalities, cost effectiveness and especially benefits for the patients have to be carefully evaluated. In this paper, several examples of 3D planning that have been used in our institution are presented. The advantages such as the accuracy of the reconstructive surgery and decreased operating time, as well as the difficulties have also been addressed.

The spirit of professor Iacob Iacobovici in the development of education in dentistry and maxillofacial surgery.

PubMed

Rotaru, Alexandru; Rotaru, Horatiu

2015-01-01

Founder of the Surgical Clinic in Cluj-Napoca and of Medical Education in Romanian, Rector of Dacia Superior University, Professor Iacob Iacobovici was one of the outstanding medical personalities in the first half of the twentieth century, in Romania. His scientific contributions have been recognized by the European great personalities of his time. A remarkable bright mind, with an overarching comprehension of things, Professor Iacob Iacobovici contributed, in an essential way, to the diversification of surgical education, stimulating the emergence of new specialties. This paper illustrates the contribution of Professor Iacob Iacobovici to the development of Education of Dentistry and Oral and Maxillofacial Surgery in Romania as well as his support for the Romanian Society of Dentistry.

The spirit of professor Iacob Iacobovici in the development of education in dentistry and maxillofacial surgery

PubMed Central

ROTARU, ALEXANDRU; ROTARU, HORATIU

2015-01-01

Founder of the Surgical Clinic in Cluj-Napoca and of Medical Education in Romanian, Rector of Dacia Superior University, Professor Iacob Iacobovici was one of the outstanding medical personalities in the first half of the twentieth century, in Romania. His scientific contributions have been recognized by the European great personalities of his time. A remarkable bright mind, with an overarching comprehension of things, Professor Iacob Iacobovici contributed, in an essential way, to the diversification of surgical education, stimulating the emergence of new specialties. This paper illustrates the contribution of Professor Iacob Iacobovici to the development of Education of Dentistry and Oral and Maxillofacial Surgery in Romania as well as his support for the Romanian Society of Dentistry. PMID:26733759

[Rational antimicrobial therapy in patients with purulent inflammatory diseases of maxillofacial area].

PubMed

Bogatov, B B; Denis, A G; Koliadov, N F

2015-01-01

The aim of the study was to reveal optimal antimicrobial agents in patients with purulent inflammatory diseases of maxillofacial area according to bacteriological study results. One hundred twenty-one culture samples from 32 patients aged from 21 to 68 years admitted to Nurnberg Maxillofacial Surgery Clinic. Pathogenic flora was mostly mixed with 66.9% of anaerobic germs in the majority of cases irresponsible to ampicillin (1.3%) and clindamycin (0.7%). The drugs of choice are ampicillin/sulbactam and amoxicillin/clavulanate. Bacteriological study should be included as a useful tool in treatment protocols of patients with purulent inflammatory diseases of maxillofacial area.

Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide.

PubMed

Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen

2015-10-01

Microvascular surgery following tumor resection has become an important field of oral maxillofacial surgery (OMFS). Following the surveys on current reconstructive practice in German-speaking countries and Europe, this paper presents the third phase of the project when the survey was conducted globally. The DOESAK questionnaire has been developed via a multicenter approach with maxillofacial surgeons from 19 different hospitals in Germany, Austria and Switzerland. It was distributed in three different phases to a growing number of maxillofacial units in German-speaking clinics, over Europe and then worldwide. Thirty-eight units from Germany, Austria and Switzerland, 65 remaining European OMFS-departments and 226 units worldwide responded to the survey. There is wide agreement on the most commonly used flaps, intraoperative rapid sections and a trend towards primary bony reconstruction. No uniform concepts can be identified concerning osteosynthesis of bone transplants, microsurgical techniques, administration of supportive medication and postoperative monitoring protocols. Microsurgical reconstruction is the gold standard for the majority of oncologic cases in Europe, but worldwide, only every second unit has access to this technique. The DOESAK questionnaire has proven to be a valid and well accepted tool for gathering information about current practice in reconstructive OMFS surgery. The questionnaire has been able to demonstrate similarities, differences and global inequalities. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Prosthetic reconstruction of a patient with an acquired nasal defect using extraoral implants and a CAD/CAM copy-milled bar.

PubMed

Vera, Carolina; Barrero, Carlos; Shockley, William; Rothenberger, Sandra; Minsley, Glenn; Drago, Carl

2014-10-01

Traditionally, patients with maxillofacial defects have been challenging to treat. A multitude of challenges associated with maxillofacial prosthetic treatment are not typically seen with patients who need conventional prosthodontic treatment. These types of patients generally require replacement of significant amounts of hard and soft tissues than do conventional prosthodontic patients. Most maxillofacial patients also warrant more emotional support than do conventional prosthodontic patients. Successful maxillofacial prosthetics still need to embrace the traditional goals of prosthodontic treatment: stability, support, retention, and esthetics. It is unlikely that a maxillofacial prosthesis will exactly duplicate the anatomy and function of missing or damaged structures. Although craniofacial implants (CFI's) have lower cumulative survival rates (CSR's) than intraoral endosseous implants, osseointegrated CFI's have proven to be significant adjuncts to improving retention of maxillofacial prostheses. However, CSR's of CFI's have been reported to be lower than CSR's for intraoral endosseous implants. Lately, computer-assisted design and computer-assisted machining (CAD/CAM) has been used in dentistry to facilitate fabrication of implant-supported frameworks. CAD/CAM protocols have numerous advantages over conventional casting techniques, including improved accuracy and biocompatibility, and decreased costs. The purpose of this paper is to review the literature on cumulative survival rates (CSR's) reported for CFI's and to illustrate the treatment of a maxillofacial patient using CFI's and a CAD/CAM copy-milled framework for retention and support of a nasal prosthesis. © 2014 by the American College of Prosthodontists.

Maxillofacial injuries in Calabar south-south, Nigeria: a 5 year study of jawbone fractures.

PubMed

Bassey, G O; Anyanechi, C E; Chukwuneke, F N

2011-01-01

The aim of this study is to highlight the overall uniqueness of the pattern of presentation of maxillofacial injuries seen at the Department of Oral and Maxillofacial Surgery of the University of Calabar Teaching Hospital, Calabar south-south Nigeria between January 2000 and December 2004 and to share our experience in terms of occurrence, seasonal fluctuations and the adequacy of treatment methods in our environment. Case notes of all. the 200 maxillofacial trauma patients were retrieved, examined and analyzed with regards to age, gender and cause of injury, socio-demographic data, diagnosis, pattern of presentation, distribution and treatment. A male-to-female ratio of 3.65:1 was obtained. Out of the 200 patients the highest incidence of injury was in the 20-30 year age group 85 (n=85; 42.5%). The major causes of injuries were motorcycle (n=74; 37%), vehicle (n=62; 31.5%) and assault (n=40; 20%). Six (3%) river-related or boat accidents were recorded. Industrial and sports related accidents contributed the least (n=5; 2.5%). Road traffic accident had the highest proportion of the entire maxillofacial injuries with more males affected than females. Seasonal distribution showed a bimodal peak variation of May-June and September-January. This paper calls for the reinforcement of measures for the prevention of automobile accident and the establishment of more maxillofacial specialist centers with modern equipment for effective management of maxillofacial injuries.

African Americans in Oral and Maxillofacial Surgery: Factors Affecting Career Choice, Satisfaction, and Practice Patterns.

PubMed

Criddle, Thalia-Rae; Gordon, Newton C; Blakey, George; Bell, R Bryan

2017-12-01

There are few data available on the experience of minority surgeons in the field of oral and maxillofacial surgery (OMS). Therefore, the purpose of this study was to 1) explore factors that contribute to African Americans choosing OMS as a career, 2) examine satisfaction among minority oral and maxillofacial surgeons with the residency application and training process, 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency organizations to foster diversity. A 19-item survey was sent to 80 OMS practitioners by use of information from the mailing list of the National Society of Oral and Maxillofacial Surgeons, an American Association of Oral and Maxillofacial Surgeons-affiliated organization. All surveys were sent by mail and were followed by a reminder mailing after 8 weeks. Responses returned within 16 weeks were accepted for analysis. Of the 80 mailed surveys, 41 were returned within the 16-week parameter, representing a return rate of 51%. Most of the minority surgeon respondents were married men with a mean age of 60 years who worked as private practitioners. Most respondents practiced on the eastern and western coasts of the United States. Exposure in dental school was the most important factor in selecting OMS as a specialty. Location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to a residency program and did not currently affect the success of their practice. However, 25 to 46% of participants experienced race-related harassment, and 48 to 55% of participants believed there was a bias against African Americans in OMS. Our data suggest that a substantial number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it does not appear to affect professional success. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of tulle on the mechanical properties of a maxillofacial silicone elastomer.

PubMed

Gunay, Yumushan; Kurtoglu, Cem; Atay, Arzu; Karayazgan, Banu; Gurbuz, Cihan Cem

2008-11-01

The purpose of this research was to investigate if physical properties could be improved by incorporating a tulle reinforcement material into a maxillofacial silicone elastomer. A-2186 silicone elastomer was used in this study. The study group consisted of 20 elastomer specimens incorporated with tulle and fabricated in dumbbell-shaped silicone patterns using ASTM D412 and D624 standards. The control group consisted of 20 elastomer specimens fabricated without tulle. Tensile strength, ultimate elongation, and tear strength of all specimens were measured and analyzed. Statistical analyses were performed using Mann-Whitney U test with a statistical significance at 95% confidence level. It was found that the tensile and tear strengths of tulle-incorporated maxillofacial silicone elastomer were higher than those without tulle incorporation (p < 0.05). Therefore, findings of this study suggested that tulle successfully reinforced a maxillofacial silicone elastomer by providing it with better mechanical properties and augmented strength--especially for the delicate edges of maxillofacial prostheses.

The role of maxillofacial radiologists in gunshot injuries: a hypothesized missile trajectory in two case reports

PubMed Central

Sansare, K; Khanna, V; Karjodkar, F

2011-01-01

Gunshot injuries are an emerging form of trauma that oral radiologists increasingly have to deal with. There are two main types of gunshot injuries: high-velocity and low-velocity bullet injuries. The outcome of high-velocity gunshot injury is usually fatal; however, a non-fatal low-velocity injury to the maxillofacial region is more likely to be encountered by the oral and maxillofacial radiologist. It is therefore important to up-to-date knowledge of ballistic science and its implications in the field of maxillofacial radiology. The ability of oral and maxillofacial radiologists to predict the missile trajectory will aid the assessment and localization of the damage caused by the bullet and its splinters. Predicting the missile trajectory may also be of help to law enforcement agencies and forensic scientists in determining the type of firearm used and direction of fire. This article, which examines two cases, attempts to highlight to the oral radiologist this emerging form of trauma and its implications. PMID:21159916

Maxillofacial injuries due to work-related accidents in the North West of Italy.

PubMed

Roccia, Fabio; Boffano, Paolo; Bianchi, Francesca Antonella; Gerbino, Giovanni

2013-09-01

The aim of this study was to assess the incidence and patterns of work-related maxillofacial injuries, identifying worker categories with a high risk of injury. From a systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients with work-related injuries were considered. Occupation, mechanism of injury, and demographic and clinical data were analyzed. Work-related facial injuries represented the fifth most common cause of injury, with a percentage of 6.3 %. Maxillofacial fractures were most often seen in construction workers (37.9 %). The middle third was involved in 67 % of the cases; the mandible was the most frequently injured site. Work-related maxillofacial trauma is rare, but it is often complex and challenging as Facial Injury Severity Scale values show. In agreement with the few published reports, construction workers, together with farm and forestry workers, are at the highest risk of injuries, mainly because of struck by a thrown, projected, or falling object.

The role of maxillofacial radiologists in gunshot injuries: a hypothesized missile trajectory in two case reports.

PubMed

Sansare, K; Khanna, V; Karjodkar, F

2011-01-01

Gunshot injuries are an emerging form of trauma that oral radiologists increasingly have to deal with. There are two main types of gunshot injuries: high-velocity and low-velocity bullet injuries. The outcome of high-velocity gunshot injury is usually fatal; however, a non-fatal low-velocity injury to the maxillofacial region is more likely to be encountered by the oral and maxillofacial radiologist. It is therefore important to up-to-date knowledge of ballistic science and its implications in the field of maxillofacial radiology. The ability of oral and maxillofacial radiologists to predict the missile trajectory will aid the assessment and localization of the damage caused by the bullet and its splinters. Predicting the missile trajectory may also be of help to law enforcement agencies and forensic scientists in determining the type of firearm used and direction of fire. This article, which examines two cases, attempts to highlight to the oral radiologist this emerging form of trauma and its implications.

Smartphone photography in oral and maxillofacial surgery.

PubMed

Jamil, F

2016-01-01

An increasing number of staff in oral and maxillofacial surgery (OMFS) departments take clinical photographs with their personal phones. We report the results of a survey on the use of smartphone photography in OMFS departments in the United Kingdom, and highlight the guidelines that govern their use and the associated ethical and medicolegal implications. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Maxillofacial injuries among trauma patients undergoing head computerized tomography; A Ugandan experience.

PubMed

Krishnan, Ullas Chandrika; Byanyima, Rosemary Kusaba; Faith, Ameda; Kamulegeya, Adriane

2017-01-01

The aim of this study was to investigate epidemiological features of maxillofacial fractures within trauma patients who had head and neck computed tomography (CT) scan at the Mulago National referral hospital. CT scan records of trauma patients who had head scans at the Department of Radiology over 1-year period were accessed. Data collected included sociodemographic factors, type and etiology of injury, and concomitant maxillofacial injuries. A total of 1330 trauma patients underwent head and neck CT scan in the 1-year study period. Out of these, 130 were excluded due to incomplete or unclear records and no evidence of injury. Of the remaining 1200, 32% (387) had maxillofacial fractures. The median age of the patients with maxillofacial fractures was 28 (range = 18-80) years and 18-27 age group was most common at 47.5%. Road traffic accidents constituted 49.1% of fractures. The single most affected isolated bone was the frontal bone (23%). The number of maxillofacial bones fractured was predicted by age group (df = 3 F = 5.358, P = 0.001), association with other fractures (df = 1 F = 5.317, P = 0.03). Good matched case-control prospective studies are needed to enable us tease out the finer difference in the circumstances and pattern of injury if we are to design appropriate preventive measures.

Duplicate publications and related problems in published papers on oral and maxillofacial surgery.

PubMed

Le, A; Moran, C M P; Bezuhly, M; Hong, P

2015-07-01

As duplicate publication is unethical, our aim was to find out how common it is among published papers on oral and maxillofacial surgery. We used PubMed to identify index articles published in 2010 in the Journal of Oral and Maxillofacial Surgery, the British Journal of Oral and Maxillofacial Surgery, and the European Journal of Cranio-Maxillo-Facial Surgery, and searched for possible duplicate publications from 2008 to 2012 using the first or second and last authors' names. Suspected duplicates were categorised into "non-duplicate" (no overlap), "duplicate" (identical results and conclusions), or "salami-sliced" publications (part of the index article repeated or continued). Of the 589 index articles, 17 (3%) had some form of duplication, but specifically, we found 3 duplicate, and 15 salami-sliced publications. Most redundant articles originated from China (n=4), followed by Italy, Japan, and Germany (3 from each) and the United States and Denmark (2 each). Of the 18 redundant publications, 9 did not reference the related index article. Duplicate material is still being published, and salami-slicing is relatively common among publications on oral and maxillofacial surgery. Further research is required into the extent and impact of this finding. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Marathon of eponyms: 7 Gorlin-Goltz syndrome (Naevoid basal-cell carcinoma syndrome).

PubMed

Scully, C; Langdon, J; Evans, J

2010-01-01

The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarizes data about Gorlin-Goltz syndrome.

Maxillofacial Prosthetic Materials- An Inclination Towards Silicones

PubMed Central

Choudhary, Sunita; Garg, Hemlata; H.G., Jagadeesh

2014-01-01

There have been constant searches and researches which are taking place in the field of dental materials to best suit the ideal selection criteria to satisfy the functionality, biocompatibility, aesthetics as well as the durability as a maxillofacial material. Among all the different materials, Silicone is the most popularly used, but still studies are carried out to overcome their weaknesses and to come out with a material which can be labeled as the “ideal maxillofacial prosthetic material”. This article comprises the materials which were and are in use and the reason for their unpopularity. It also gives us a scope to understand the major fields where the materials lack and thus needs improvement to render an individual with the best maxillo-facial prosthesis. PMID:25654054

Marathon of eponyms: 17 Quincke oedema (Angioedema).

PubMed

Scully, C; Langdon, J; Evans, J

2011-04-01

The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarizes data about Quincke's oedema. © 2011 John Wiley & Sons A/S.

Marathon of eponyms: 2 Bell palsy (idiopathic facial palsy).

PubMed

Scully, C; Langdon, J; Evans, J

2009-05-01

The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185-186). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarises data about Bell paralysis.

Applying aviation factors to oral and maxillofacial surgery--the human element.

PubMed

Seager, Leonie; Smith, Dave W; Patel, Anish; Brunt, Howard; Brennan, Peter A

2013-01-01

There are many similarities between flying commercial aircraft and surgery, particularly in relation to minimising risk, and managing potentially fatal or catastrophic complications, or both. Since 1979, the development of Crew Resource Management (CRM) has improved air safety significantly by reducing human factors that are responsible for error. Similar developments in the operating theatre have, to a certain extent, lagged behind aviation, and it is well recognised that we can learn much from the industry. An increasing number of publications on aviation factors relate to surgery but to our knowledge there is a lack of research in our own specialty. We discuss how aviation principles related to human factors can be translated to the operating theatre to improve teamwork and safety for patients. Clinical research is clearly needed to develop this fascinating area more fully. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Investigation of nutritional status using the Mini Nutritional Assessment-Short Form and analysis of the relevant factors in patients with head and neck tumour.

PubMed

Yanagi, Ayaka; Murase, Mai; Sumita, Yuka I; Taniguchi, Hisashi

2017-06-01

The aims of this study were to reveal the nutritional status of patients after head and neck tumour treatment by using the Mini Nutritional Assessment-Short Form (MNA-SF) and to analyse the factors affecting nutritional status in patients with head and neck tumour. Elderly patients with loss of teeth and maxillary/mandibular bone due to head and neck tumour treatment could be at high risk of malnutrition. However, there are few reports on the nutritional status of these patients. Forty-six participants (average age 74.7 years) were selected from patients who visited the maxillofacial prosthetics clinic of Tokyo Medical and Dental University Hospital Faculty of Dentistry in Japan. Nutritional status was evaluated using the MNA-SF. Multiple regression analysis was used to identify predictors affecting MNA-SF score. The candidate explanatory variables were age, sex, maxillofacial prosthesis use, number of residual teeth, resection side, neck dissection and treatment option. The results showed that approximately half of the patients were at risk of malnutrition, and a regression equation for MNA-SF score was developed using two predictors: maxillofacial prosthesis use and neck dissection. Use of a maxillofacial prosthesis can improve nutritional status. On the other hand, a medical history of neck dissection can decrease nutritional status. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Evaluation of patients' attitudes to their care during oral and maxillofacial surgical outpatient consultations: the importance of waiting times and quality of interaction between patient and doctor.

PubMed

Dimovska, E O F; Sharma, S; Trebble, T M

2016-06-01

Knowing what patients think about their care is fundamental to the provision of an effective, quality service, and it can help to direct change and reduce costs. Much of the work in oral and maxillofacial departments concerns the treatment of outpatients, but as little is known about what they think about their care, we aimed to find out which aspects were associated with satisfaction. Consecutive patients (n=244) who attended the oral and maxillofacial outpatient department at Southampton University Hospital NHS Foundation Trust over a 7-day period were given a questionnaire to complete before and after their consultation. It included questions with Likert scale responses on environmental, procedural, and interactive aspects of the visit, and a 16-point scale to rank their priorities. A total of 187 patients (77%) completed the questionnaires. No association was found between expected (p=0.93) or actual (p=0.41) waiting times, and 90% of patients were satisfied with their visit. Seeing the doctor, having confidence in the treatment plan, being listened to, and the ability of the doctor to recognise their personal needs, were ranked as important. Environmental and procedural aspects were considered the least important. These findings may be of value in the development of services to improve patient-centred care. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Oral and Maxillofacial Lesions Diagnosed in Older People of a Brazilian Population: A Multicentric Study.

PubMed

Silva, Leorik P; Leite, Rafaella B; Sobral, Ana P V; Arruda, José A; Oliveira, Leni V; Noronha, Mariana S; Kato, Camila O; Mesquita, Ricardo A; Schuch, Lauren F; Gomes, Ana P N; Vasconcelos, Ana C U; Souza, Lélia B

2017-07-01

The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among older adults (≥60 years) from representative regions in Brazil. Retrospective descriptive cross-sectional study. Biopsy records were obtained from the archives of four Brazilian referral centers of oral diagnosis between 2000 and 2016. A total of 45,506 biopsy records of all patients were analyzed, of these 7,259 persons aged 60 and older were selected. Data such as gender, age, race, anatomical location, and histopathological diagnosis were collected and categorized. Pearson's chi-square test (P < .005) was used to evaluate differences in the frequency of the several groups of oral lesions. Oral and maxillofacial lesions were diagnosed in 7,259 older people, including 59.4% women (P < .001) and 61.3% white patients (P = .07). The most commonly affected sites were the cheek mucosa (20.3%) and mandible (8.9%) (P < .001). Reactive and inflammatory lesions were the most common lesions, followed by neoplasms. Oral squamous cell carcinoma was the most prevalent neoplasm (83.4%) (P < .001). Knowledge of oral diseases obtained from biopsy records provides more accurate data about the diagnosis and oral health of elderly patients. These indicators thus support the development of specific health policies for the prevention and treatment of oral and maxillofacial lesions that affect this population. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction-mandibular setback surgery in patients with cleft lip and palate.

PubMed

Susami, T; Mori, Y; Ohkubo, K; Takahashi, M; Hirano, Y; Saijo, H; Takato, T

2018-03-01

Maxillary distraction is increasingly used for the correction of severe maxillary retrusion in patients with cleft lip and palate. However, control of the maxillary movement is difficult, and the need to wear visible distractors for a long period of time causes psychosocial problems. A two-stage surgical approach consisting of maxillary distraction and mandibular setback was developed to overcome these problems. In this study, changes in maxillofacial morphology and velopharyngeal function were examined in 22 patients with cleft lip and palate who underwent this two-stage approach. Lateral cephalograms taken just before the first surgery, immediately after the second surgery, and at completion of the active post-surgical orthodontic treatment were used to examine maxillofacial morphology. Velopharyngeal function was evaluated by speech therapists using a 4-point scale for hypernasality. The average forward movement of the maxilla with surgery at point A was 7.5mm, and the average mandibular setback at pogonion was 8.6mm. The average relapse rate during post-surgical orthodontic treatment was 25.2% for the maxilla and 11.2% for the mandible. After treatment, all patients had positive overjet, and skeletal relapse was covered by tooth movement during postoperative orthodontics. Velopharyngeal function was not changed by surgery. This method can shorten the period during which the distractors have to be worn and reduce the patient burden. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Rare, Unusual Presentation of Primary Tuberculosis in the Temporomandibular Joint.

PubMed

Towdur, Geetha N; Upasi, Amarnath P; Veerabhadrappa, Umashankara Kagathur; Rai, Kirthikumar

2018-04-01

Tuberculosis (TB) is a very common health problem in developing nations such as India. It can present as its primary form or as secondary forms (extrapulmonary TB). Maxillofacial manifestations of TB compose nearly 10% of all extrapulmonary manifestations of the disease. Extrapulmonary TB involving the maxillofacial region is very rare and can present in any tissues in this region. These infections generally involve the head and neck through hematogenous or lymphatic routes. Very few cases of primary TB of the temporomandibular joint (TMJ) have been reported in the literature. The presentation of TB infection of the TMJ can resemble arthritis, osteomyelitis, or any other kind of chronic joint disease. It is very important to diagnose this disease at an early stage. If left untreated, it can prove fatal within 5 years in more than half the cases. Therefore, early diagnosis and management of these cases is critical. This article describes a case of primary TB of the TMJ that presented as a preauricular swelling. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Importance of maternal diabetes on the chronological deregulation of the intrauterine development: an experimental study in rat.

PubMed

Salazar García, Marcela; Reyes Maldonado, Elba; Revilla Monsalve, María Cristina; Villavicencio Guzmán, Laura; Reyes López, Alfonso; Sánchez-Gómez, Concepción

2015-01-01

We investigated whether maternal diabetes induced in rats using streptozotocin (STZ) on Day 5 of pregnancy affects the intrauterine developmental timeline. A total of 30 pregnant Sprague-Dawley diabetic rats (DRs) and 20 control rats (CRs) were used to obtain 21-day fetuses (F21) and newborn (NB) pups. Gestational age, weight, and body size were recorded as were the maxillofacial morphometry and morphohistological characteristics of the limbs. In DRs, pregnancy continued for ∼1.7 days, and delivery occurred 23 days postcoitus (DPC). In this group, the number of pups was lower, and 13% had maxillofacial defects. F21 in the DR group had lower weights and were smaller; moreover, the morphological characteristics of the maxillofacial structures, derived from the neural crest, were discordant with their chronological gestational age, resembling 18- to 19-day-old fetuses. These deficiencies were counterbalanced in NB pups. We conclude that hyperglycemia, which results from maternal diabetes and precedes embryo implantation, deregulates the intrauterine developmental timeline, restricts embryo-fetal growth, and primarily delays the remodeling and maturation of the structures derived from neural crest cells.

[Application of negative molds technology based on three-dimensional printing in digital maxillofacial prostheses].

PubMed

Gu, X Y; Chen, X B; Jiao, T; Zhang, F Q; Jiang, X Q

2017-06-09

Objective: To explore a digital negative molds technique based on three-dimensional (3D) printing to assist in the manufacture of maxillofacial prostheses, and to improve the deficiency of the current clinical treatment. Methods: Seventeen patients with maxillofacial defects (including nasal defects, orbital defects, cheek defects, auricle defect) were scanned by means of facial optical scanning and computer tomography (CT). The 3D models were then reconstructed and global registration was made to merge the reconstructed models into a new digital model for 3D design. The 3D design of the prostheses was implemented in software. The mechanical connection structure was designed by forward engineering technology for 3 patients with intra-oral defects in maxilla who needed to make removable partial dentures, so that the silicone prostheses and removable partial denture could be combined. The removable partial dentures were made by conventional method and connected with the prostheses. According to the 3D data of the prostheses, the digital negative molds were designed, and the 3D printing technology was used to finish the processing of the resin molds. Silicone for prostheses were filled and cured in the resin molds to fabricate the clinical restorations for the patients. The margin adaptation and retention of the prostheses was detected. Results: Twenty patients with varying degrees of maxillofacial defects were rehabilitated using the courses developed in the study. All patients reported no pain or discomfort during the treatment; and they were satisfied with the final prostheses of the shape, color, retention, stability, etc. Eighteen of the prostheses showed good marginal adaptation, and sixteen of the prostheses showed good retention effect. Conclusions: The digital negative molds technique used in this study could greatly reduce the intensity of manual operation and provided a good therapeutic effect for patients with maxillofacial defects.

Isolated tympanic plate fracture frequency and its relationship to mandibular trauma.

PubMed

Altay, Canan; Erdoğan, Nezahat; Batkı, Ozan; Eren, Erdem; Altay, Sedat; Karasu, Sebnem; Mete, Berna; Uluç, Engin

2014-11-01

This study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT). We retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists. The maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side (P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found (P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined (P > .05). Sex had no impact on the presence of tympanic plate fracture (P > .05). The frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Etiology, distribution, treatment modalities and complications of maxillofacial fractures

PubMed Central

Pham-Dang, Nathalie; Barthélémy, Isabelle; Orliaguet, Thierry; Artola, Alain; Mondié, Jean M.

2014-01-01

Purpose: This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital. Material and Methods: This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etiology, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined. Results: Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible. Conclusions: Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophylaxis associated with dental hygiene care can be indicated to prevent postoperative infections. Key words:Maxillofacial fractures, Epidemiology, Trends, Influencing factors, Fall, Age, Gender, Antibiotic prophylaxis. PMID:24316696

Maxillofacial injuries among trauma patients undergoing head computerized tomography; A Ugandan experience

PubMed Central

Krishnan, Ullas Chandrika; Byanyima, Rosemary Kusaba; Faith, Ameda; Kamulegeya, Adriane

2017-01-01

Aim: The aim of this study was to investigate epidemiological features of maxillofacial fractures within trauma patients who had head and neck computed tomography (CT) scan at the Mulago National referral hospital. Methods: CT scan records of trauma patients who had head scans at the Department of Radiology over 1-year period were accessed. Data collected included sociodemographic factors, type and etiology of injury, and concomitant maxillofacial injuries. Results: A total of 1330 trauma patients underwent head and neck CT scan in the 1-year study period. Out of these, 130 were excluded due to incomplete or unclear records and no evidence of injury. Of the remaining 1200, 32% (387) had maxillofacial fractures. The median age of the patients with maxillofacial fractures was 28 (range = 18–80) years and 18–27 age group was most common at 47.5%. Road traffic accidents constituted 49.1% of fractures. The single most affected isolated bone was the frontal bone (23%). The number of maxillofacial bones fractured was predicted by age group (df = 3 F = 5.358, P = 0.001), association with other fractures (df = 1 F = 5.317, P = 0.03). Conclusions: Good matched case–control prospective studies are needed to enable us tease out the finer difference in the circumstances and pattern of injury if we are to design appropriate preventive measures. PMID:29291177

Changing pattern and etiology of maxillofacial fractures during the civil uprising in Western Libya

PubMed Central

Elarabi, Mohammed S.

2018-01-01

Background The purpose of the present study was to evaluate changing pattern in characteristics of maxillofacial fractures and concomitant injuries in Western Libya During revolution and to assess the association between mechanism of injury and fracture patterns. Material and Methods A retrospective review of medical records and radiographs of 187 patients treated for maxillofacial fractures from January 2010 to December 2012 was performed, there were 326 fractures in 187 patients. Results The male: female ratio was 6:1. Most fractures occurred in patients aged 11 to 40 years, and few injuries occurred in patients aged > 50 years. Most fractures occurred from motor vehicle accidents, and other most frequent causes included assault, gunshot, and fall injuries. Most maxillofacial fractures involved the mandible, zygomatic complex, or maxilla. Most mandibular fractures occurred at the parasymphysis, angle, or condyle. Associated injuries most frequently involved the head, chest, and extremities. Most patients were treated with open reduction (132 patients [71%]), and 26 patients (14%) were treated nonoperatively. There were 21 complications (11%). Conclusions In summary, motor vehicle accidents were the most frequent cause of maxillofacial fracture in western Libya, possibly because of the lack of seat belt legislation. Interpersonal violence was a less frequent cause of maxillofacial fracture, possibly because of the religious restriction on alcohol consumption. Key words:Tauma, mandible, zygomatic complex, maxilla, treatment, complications. PMID:29476683

Treatment cost of patients with maxillofacial fractures at the University Hospital in Mostar 2002-2006.

PubMed

Jurić, Mario; Novakovic, Josip; Carapina, Mirela; Kneiević, Ervin

2010-03-01

The aim of this study was to establish the costs structure of medical treatment for the patients with maxillofacial fractures, to perform a treatment cost evaluation, describe the factors which considerably influence the costs and discover the ways of achieving financial savings in treated patients. The study group consisted of patients with maxillofacial fractures who were admitted and treated at the Department of Maxillofacial Surgery of the University Hospital Mostar in the period from January 2002 until December 2006. Data for the study were collected from the patients' databases, case histories and data obtained on the basis of individual payments for the treatment that was collected by Finance Department of the University Hospital of Mostar Most patients in this study were men (83%), of average age 34 +/- 19 years. Zygomatic bone fracture was the commonest injury. Open surgical procedure was performed in 84.7% of treated cases. The costs for the open procedure were considerably higher than conservative treatment. Medication cost made up a total of 37.9% and cost of hospital accommodation 27.3% out of total hospital charge. Cost reduction in treated patients with maxillofacial fractures should be achieved through protocols of urgent treatment of maxillofacial trauma patients immediately after sustaining an injury and with earlier discharge of the patients when postoperative complications are not expected.

[Modern concepts of trauma care and multiple trauma management in oral and maxillofacial region].

PubMed

Tan, Yinghui

2015-06-01

Multiple trauma management requires the application of modem trauma care theories. Optimal treatment results can be achieved by reinforcing cooperation and stipulating a treatment plan together with other disciplines. Based on modem theories in trauma care and our understanding of the theoretical points, this paper analyzes the injury assessment strategies and methods in oral and maxillofacial multiple trauma management. Moreover, this paper discusses operating time and other influencing factors as well as proposed definitive surgical timing and indications in comprehensive management of oral and maxillofacial multiple trauma patients associated with injuries in other body parts. We hope that this paper can help stomatological physicians deepen their understanding of modem trauma care theories and improve their capacity and results in the treatment of oral and maxillofacial multiple trauma.

Aggression directed towards members of the oral and maxillofacial surgical team.

PubMed

Mannion, C J; Gordon, C

2018-06-06

Oral and maxillofacial surgery (OMFS) is an acute surgical specialty, and members of the surgical team may be exposed to challenging incidents. We have evaluated the experiences of members of OMFS teams and their experiences of aggressive and abusive behaviour. Education and training in the resolution of such conflicts should be offered to all members of the team to allow a safe and secure working environment. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Povidone-iodine and hydrogen peroxide mixture soaked gauze pack: a novel hemostatic technique.

PubMed

Arakeri, Gururaj; Brennan, Peter A

2013-11-01

Persistent oozing of blood is a common occurrence in maxillofacial surgery, and occasionally it hampers visibility and delays or even prevents continuation of the procedure. This report describes a novel method of controlling blood ooze using swabs soaked with povidone-iodine and hydrogen peroxide (PI-HP pack) that is particularly useful in relatively inaccessible areas of the maxillofacial region. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Fractures of the growing mandible.

PubMed

Kushner, George M; Tiwana, Paul S

2009-03-01

Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.

Manufacturing implant supported auricular prostheses by rapid prototyping techniques.

PubMed

Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

2011-08-01

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses.

Maxillofacial reconstruction using custom-made artificial bones fabricated by inkjet printing technology.

PubMed

Saijo, Hideto; Igawa, Kazuyo; Kanno, Yuki; Mori, Yoshiyuki; Kondo, Kayoko; Shimizu, Koutaro; Suzuki, Shigeki; Chikazu, Daichi; Iino, Mitsuki; Anzai, Masahiro; Sasaki, Nobuo; Chung, Ung-il; Takato, Tsuyoshi

2009-01-01

Ideally, artificial bones should be dimensionally compatible with deformities, and be biodegradable and osteoconductive; however, there are no artificial bones developed to date that satisfy these requirements. We fabricated novel custom-made artificial bones from alpha-tricalcium phosphate powder using an inkjet printer and implanted them in ten patients with maxillofacial deformities. The artificial bones had dimensional compatibility in all the patients. The operation time was reduced due to minimal need for size adjustment and fixing manipulation. The postsurgical computed tomography analysis detected partial union between the artificial bones and host bone tissues. There were no serious adverse reactions. These findings provide support for further clinical studies of the inkjet-printed custom-made artificial bones.

Oral and maxillofacial surgery with computer-assisted navigation system.

PubMed

Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko

2010-01-01

Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.

Evaluation of effect of laser etching on shear bond strength between maxillofacial silicone and acrylic resin subjected to accelerated aging process.

PubMed

Rhea, Antonette; Ahila, S C; Kumar, B Muthu

2017-01-01

Maxillofacial prosthesis are supported by implants, require a retentive matrix to retain the suprastructure. The retentive matrix is made up of acrylic resin to which the silicone prostheses are anchored by micro-mechanical bond. The delamination of silicone away from the retentive matrix is a persisting problem in implant-supported maxillofacial prosthesis. This study aimed to evaluate the effect of laser etching on the shear bond strength (BS) between acrylic resin and maxillofacial silicone, after 24 h of fabrication and after 200 h of accelerated aging. The samples were prepared according to ISO/TR 11405:1994 in maxillofacial silicone and polymethyl methacrylate resin. The untreated samples were Group A (control), Group B (silicon carbide [SiC] paper abrasion 80 grit size), and Group C (erbium-doped yttrium aluminum garnet laser etching). Then, the samples were coated with primer and bonded to maxillofacial silicone. The samples were subjected to shear BS test in an universal testing machine after 24 h of fabrication and after 200 h of accelerated aging. The results were statistically analyzed using one-way ANOVA and Tukey's HSD post hoc test. The shear BS test after 24 h of fabrication showed better BS in SiC paper abrasion. The shear BS test after 200 h of accelerated aging showed better BS in laser etching compared to SiC abrasion. Laser etching produced better shear BS compared to conventional SiC paper abrasion after 200 h of accelerated aging process.

Portfolio: a comprehensive method of assessment for postgraduates in oral and maxillofacial surgery.

PubMed

Kadagad, Poornima; Kotrashetti, S M

2013-03-01

Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a skill based specialty and deliberate practice enhances skill. But the traditional system of assessment of post graduates emphasizes their performance on the summative exam which fails to evaluate the integral picture of the student throughout the course. Emphasis on competency and holistic growth of the post graduate student during training in recent years has lead to research and evaluation of assessment methods to quantify students' progress during training. Portfolio method of assessment has been proposed as a potentially functional method for post graduate evaluation. It is defined as a collection of papers and other forms of evidence that learning has taken place. It allows the collation and integration of evidence on competence and performance from different sources to gain a comprehensive picture of everyday practice. The benefits of portfolio assessment in health professions education are twofold: it's potential to assess performance and its potential to assess outcomes, such as attitudes and professionalism that are difficult to assess using traditional instruments. This paper is an endeavor for the development of portfolio method of assessment for post graduate student in oral and maxillofacial surgery.

Takotsubo cardiomyopathy precipitated by maxillofacial surgery and general anesthesia: a case report and review of literature.

PubMed

Bruckman, Karl C; Taub, Daniel I; McNulty, Stephen E

2013-12-01

Takotsubo cardiomyopathy (TCM) is a syndrome characterized by a transient episode of heart failure. The specific etiology of this condition is widely speculated. The purpose of this case report and literature review was to investigate the incidence of TCM with regard to general anesthesia, especially those cases involving operative procedures within the realm of oral and maxillofacial surgery. It is intended that the present case serve as a guide for fellow surgeons to identify and manage this syndrome. The present case was explained and a review of the literature was performed. PubMed was used to search for articles involving surgical procedures under general anesthesia, including oral and maxillofacial surgery. It was determined that TCM rarely occurs in conjunction with surgical procedures under general anesthesia, especially those of the head and neck region. TCM is an uncommon medical condition with significant morbidity and mortality when managed incorrectly. The occurrence of this syndrome in relation to oral and maxillofacial procedures is also rare, although it is imperative that surgeons be able to recognize and treat this condition appropriately. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Prototyping for surgical and prosthetic treatment.

PubMed

Goiato, Marcelo Coelho; Santos, Murillo Rezende; Pesqueira, Aldiéris Alves; Moreno, Amália; dos Santos, Daniela Micheline; Haddad, Marcela Filié

2011-05-01

Techniques of rapid prototyping were introduced in the 1980s in the field of engineering for the fabrication of a solid model based on a computed file. After its introduction in the biomedical field, several applications were raised for the fabrication of models to ease surgical planning and simulation in implantology, neurosurgery, and orthopedics, as well as for the fabrication of maxillofacial prostheses. Hence, the literature has described the evolution of rapid prototyping technique in health care, which allowed easier technique, improved surgical results, and fabrication of maxillofacial prostheses. Accordingly, a literature review on MEDLINE (PubMed) database was conducted using the keywords rapid prototyping, surgical planning, and maxillofacial prostheses and based on articles published from 1981 to 2010. After reading the titles and abstracts of the articles, 50 studies were selected owing to their correlations with the aim of the current study. Several studies show that the prototypes have been used in different dental-medical areas such as maxillofacial and craniofacial surgery; implantology; neurosurgery; orthopedics; scaffolds of ceramic, polymeric, and metallic materials; and fabrication of personalized maxillofacial prostheses. Therefore, prototyping has been an indispensable tool in several studies and helpful for surgical planning and fabrication of prostheses and implants.

Subsequent publication of oral and maxillofacial surgery meeting abstracts.

PubMed

Rodriguez, Joseph L; Laskin, Daniel M

2012-05-01

Previous studies in various medical specialties have shown that fewer than 50% of abstracts presented at meetings are subsequently published. The purpose of the present study was to determine the publication rate of abstracts presented at the annual meetings of the American Association of Oral and Maxillofacial Surgeons. The titles and authors of the abstracts from all oral abstract session presentations and posters by American contributors were collected from the Final Programs of the American Association of Oral and Maxillofacial Surgeons annual meetings for 2006 to 2009. A PubMed search for published articles through December 2010 was then performed using the authors' names, abstract titles, and key words. A total of 311 abstract presentations were done at the 4 annual meetings. Of these, only 85 (24%) were subsequently published. No difference was found between abstracts from oral or poster presentations. Most of the articles were published in the Journal of Oral and Maxillofacial Surgery. Because of deficiencies that can occur in abstracts and the need to disseminate the information they contain, it is important to take the appropriate measures to ensure that full articles are subsequently published. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The Partnership of Medical Genetics and Oral and Maxillofacial Surgery When Evaluating Craniofacial Anomalies.

PubMed

Lin, Angela E

2015-12-01

A medical geneticist who has an interest in craniofacial anomalies forms a natural partnership with an oral and maxillofacial surgeon, which facilitates patient care. Using complementary diagnostic and therapeutic skills, the search for a recognizable pattern can lead to a syndrome diagnosis. After the initial examination, there is usually genetic testing to confirm the clinical diagnosis. Once established, care coordination and genetic counseling can be provided for the parents and the patient. Enrolling the patient into a research study could be helpful to understand the diagnosis but, in some circumstances, might not have immediate clinical relevance. A multidisciplinary craniofacial team is generally necessary for long-term management. This article discusses illustrative patients evaluated from 2007 through 2011 with the senior oral and maxillofacial surgeon at the Massachusetts General Hospital (Leonard B. Kaban, DMD, MD). These include single patients with the Nablus mask-like facies syndrome and auriculo-condylar syndrome and a series of 20 patients with Gorlin syndrome followed by a multispecialty team. A successful collaboration between a medical geneticist and an oral and maxillofacial surgeon optimizes the treatment of patients with craniofacial anomalies. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Cone beam computed tomography: basics and applications in dentistry.

PubMed

Venkatesh, Elluru; Elluru, Snehal Venkatesh

2017-01-01

The introduction of cone beam computed tomography (CBCT) devices, changed the way oral and maxillofacial radiology is practiced. CBCT was embraced into the dental settings very rapidly due to its compact size, low cost, low ionizing radiation exposure when compared to medical computed tomography. Alike medical CT, 3 dimensional evaluation of the maxillofacial region with minimal distortion is offered by the CBCT. This article provides an overview of basics of CBCT technology and reviews the specific application of CBCT technology to oral and maxillofacial region with few illustrations.

Consent for third molar tooth extractions in Australia and New Zealand: a review of current practice.

PubMed

Badenoch-Jones, E K; Lynham, A J; Loessner, D

2016-06-01

Informed consent is the legal requirement to educate a patient about a proposed medical treatment or procedure so that he or she can make informed decisions. The purpose of the study was to examine the current practice for obtaining informed consent for third molar tooth extractions (wisdom teeth) by oral and maxillofacial surgeons in Australia and New Zealand. An online survey was sent to 180 consultant oral and maxillofacial surgeons in Australia and New Zealand. Surgeons were asked to answer (yes/no) whether they routinely warned of a specific risk of third molar tooth extraction in their written consent. Seventy-one replies were received (39%). The only risks that surgeons agreed should be routinely included in written consent were a general warning of infection (not alveolar osteitis), inferior alveolar nerve damage (temporary and permanent) and lingual nerve damage (temporary and permanent). There is significant variability among Australian and New Zealand oral and maxillofacial surgeons regarding risk disclosure for third molar tooth extractions. We aim to improve consistency in consent for third molar extractions by developing an evidence-based consent form. © 2016 Australian Dental Association.

Advanced Implant-Prosthetic Rehabilitation: How to Obtain a Correct Restoration of Both Functions and Aesthetics in Patients with Complex Combined Dental and Maxillofacial Trauma: A Case Report and Topical Review of the Literature.

PubMed

Figliuzzi, M M; Giudice, A; Fortunato, L

2017-01-01

Aim . This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma. Material and Methods . A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A "Le Fort" type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis. After 6 months, the patient performed numerous clinical investigations, aimed at a proper planning of implant-prosthetic rehabilitation of the upper dental arch. Conclusion . With the planning of the case, as well as respecting the surrounding biological structures, the surgery of implants can be carried out with the most appropriate procedure. Lastly, new dental implants with highly bioactive surfaces have been developed, providing an excellent and rapid bone integration.

Improving the Medical Curriculum in Predoctoral Dental Education: Recommendations From the American Association of Oral and Maxillofacial Surgeons Committee on Predoctoral Education and Training.

PubMed

Dennis, Matthew J; Bennett, Jeffrey D; DeLuke, Dean M; Evans, Erik W; Hudson, John W; Nattestad, Anders; Ness, Gregory M; Yeung, Allison

2017-02-01

Dental procedures are often performed on patients who present with some level of medical fragility. In many dental schools, the exercise of taking a medical history is all too often a transcription of information to the dental chart, with little emphasis on the presurgical risk assessment and the development of a treatment plan appropriate to the medical status of the dental patient. Changes in dentistry, driven by an increasingly medically complex population of dental patients, combined with treatment advances rooted in the biomedical sciences necessitate the adaptation of our dental education to include a stronger background in systemic health. Many predoctoral educators in the American Association of Oral and Maxillofacial Surgeons (AAOMS) have expressed concern about the medical preparedness of our dental students; therefore, the AAOMS and its Committee on Predoctoral Education and Training have provided recommendations for improving the medical curriculum in predoctoral dental education, including a strengthening of training in clinical medicine and biomedical sciences, with specific recommendations for improved training of our dental students and dental faculty. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing.

PubMed

Oh, Ji-Hyeon

2018-12-01

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

Importance of Maternal Diabetes on the Chronological Deregulation of the Intrauterine Development: An Experimental Study in Rat

PubMed Central

Salazar García, Marcela; Reyes Maldonado, Elba; Revilla Monsalve, María Cristina; Villavicencio Guzmán, Laura; Reyes López, Alfonso; Sánchez-Gómez, Concepción

2015-01-01

We investigated whether maternal diabetes induced in rats using streptozotocin (STZ) on Day 5 of pregnancy affects the intrauterine developmental timeline. A total of 30 pregnant Sprague-Dawley diabetic rats (DRs) and 20 control rats (CRs) were used to obtain 21-day fetuses (F21) and newborn (NB) pups. Gestational age, weight, and body size were recorded as were the maxillofacial morphometry and morphohistological characteristics of the limbs. In DRs, pregnancy continued for ∼1.7 days, and delivery occurred 23 days postcoitus (DPC). In this group, the number of pups was lower, and 13% had maxillofacial defects. F21 in the DR group had lower weights and were smaller; moreover, the morphological characteristics of the maxillofacial structures, derived from the neural crest, were discordant with their chronological gestational age, resembling 18- to 19-day-old fetuses. These deficiencies were counterbalanced in NB pups. We conclude that hyperglycemia, which results from maternal diabetes and precedes embryo implantation, deregulates the intrauterine developmental timeline, restricts embryo-fetal growth, and primarily delays the remodeling and maturation of the structures derived from neural crest cells. PMID:25756053

Survey of Current Practice Patterns in the Management of Frontal Sinus Fractures

PubMed Central

Choi, Kevin J.; Chang, Bora; Woodard, Charles R.; Powers, David B.; Marcus, Jeffrey R.; Puscas, Liana

2017-01-01

The management of frontal sinus fractures has evolved in the endoscopic era. The development of functional endoscopic sinus surgery (FESS) has been incorporated into management algorithms proposed by otolaryngologists, but the extent of its influence on plastic surgeons and oral and maxillofacial surgeons is heretofore unknown. A cross-sectional survey was performed to assess the practice pattern variations in frontal sinus fracture management across multiple surgical disciplines. A total of 298 surveys were reviewed. 33.5% were facial plastic surgeons with otolaryngology training, 25.8% general otolaryngologists, 25.5% plastic surgeons, and 15.1% oral and maxillofacial surgeons. 74.8% of respondents practiced in an academic setting. 61.7% felt endoscopic sinus surgery changed their management of frontal sinus fractures. 91.8% of respondents favored observation for uncomplicated, nondisplaced frontal sinus outflow tract fractures. 36.4% favored observation and 35.9% favored endoscopic sinus surgery for uncomplicated, displaced frontal sinus outflow tract fractures. For complicated, displaced frontal sinus outflow tract fractures, obliteration was more frequently favored by plastic surgeons and oral and maxillofacial surgeons than those with otolaryngology training. The utility of FESS in managing frontal sinus fractures appears to be recognized across multiple surgical disciplines. PMID:28523084

Evaluation of Depression Associated With Post-Traumatic Stress Disorder After Maxillofacial Injuries-A Prospective Study.

PubMed

Ranganathan, Vatsala; Panneerselvam, Elavenil; Chellappazham, Saravanan; Balasubramaniam, Sasikala; Raja V B, Krishnakumar

2018-06-01

Maxillofacial injuries can result in psychological derangement, leading to post-traumatic stress disorder (PTSD), which is characterized by continual re-experiencing of any traumatic event in addition to numerous systemic complications. The objective of this study was to assess the incidence and severity of "PTSD-related depression" in patients with maxillofacial injuries and to identify the risk factors involved. This prospective study involved 88 patients with maxillofacial trauma who had only cosmetic deficits (group A), only functional deficits (group B), or cosmetic and functional deficits (group C). The psychological status of all patients was assessed before and after surgery using Zung's Self-Rating Depression Scale. Remission time also was analyzed. Data were analyzed with SPSS 22.0 using parametric methods. Comparison of mean values among groups was performed using 1-way analysis of variance followed by Tukey honest significance difference post hoc tests for multiple pairwise comparisons. To compare proportions, the χ 2 test was applied. The number of patients in groups A, B, and C was 11, 34 and 43, respectively. In the immediate post-trauma stage, all patients in group A showed severe depression; the percentages of patients with severe depression in groups B and C were 8.8 and 81.4%, respectively, which was statistically relevant. Depression scores of patients of all groups decreased gradually in the postsurgical phase. Patients with cosmetic defects consistently recorded higher depression scores at all intervals. The time taken for recovery from depression (remission time) was shorter for patients with only functional deficits (group B). Patients with maxillofacial injuries are prone to PTSD-related depression from functional and cosmetic deficits. The objectives of trauma management must be aimed at restoring pre-trauma form and function of the maxillofacial skeleton and the patient's psychological status. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Oral and maxillofacial surgery residency training in the United States: what can we learn].

PubMed

Ren, Y F

2017-04-09

China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

New maxillofacial infrared detection technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reshetnikov, A. P.; Kopylov, M. V.; Nasyrov, M. R., E-mail: marat.1994@me.com

At the dental clinic the infrared range radiation spectrum of tissues was used to study the dynamics of local temperature and structure of the skin, subcutaneous fat, and other tissues of the maxillofacial area in adult healthy volunteers and patients. In particular, we studied the dynamics of local temperature of mucous membranes of the mouth, teeth, and places in the mouth and dental structures in the norm and in various pathological conditions of the lips, gums, teeth, tongue, palate, and cheeks before, during and after chewing food, drinking water, medication, and inhalation of air. High safety and informational content ofmore » infrared thermography are prospective for the development of diagnostics in medicine. We have 3 new methods for infrared detection protected by patents in Russia.« less

New maxillofacial infrared detection technologies

NASA Astrophysics Data System (ADS)

Reshetnikov, A. P.; Kopylov, M. V.; Nasyrov, M. R.; Soicher, E. M.; Fisher, E. L.; Chernova, L. V.

2015-11-01

At the dental clinic the infrared range radiation spectrum of tissues was used to study the dynamics of local temperature and structure of the skin, subcutaneous fat, and other tissues of the maxillofacial area in adult healthy volunteers and patients. In particular, we studied the dynamics of local temperature of mucous membranes of the mouth, teeth, and places in the mouth and dental structures in the norm and in various pathological conditions of the lips, gums, teeth, tongue, palate, and cheeks before, during and after chewing food, drinking water, medication, and inhalation of air. High safety and informational content of infrared thermography are prospective for the development of diagnostics in medicine. We have 3 new methods for infrared detection protected by patents in Russia.

Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

PubMed Central

Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

2011-01-01

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses. PMID:21912504

A one-year review of maxillofacial sports injuries treated at an accident and emergency department.

PubMed

Hill, C M; Burford, K; Martin, A; Thomas, D W

1998-02-01

To assess the aetiology and demand for oral and maxillofacial surgery services associated with sports injuries, a prospective study was undertaken. Data were collected from consecutive patients (with maxillofacial injuries associated with sports) attending the accident and emergency department at the Cardiff Royal Infirmary in the UK during a 12-month period and analysed. Data relating to demography, aetiology, site and extent of injury, treatment and outcome were collected. There were 790 attendances (695M:85F) arising principally from injuries related to rugby (n = 206), cycling (n = 189) and football (n = 109) but few from recognized contact sports (n = 26). The principal causes of these injuries were direct bodily contact (n = 260) and falls (n = 219). The commonest injury was soft-tissue laceration (n = 604); 80 patients had dentoalveolar fractures and 64 patients had fractures of the facial skeleton. Injuries were located in the upper- (n = 257), middle- (n = 201) and lower third of the face (n = 124) with 188 lip/intraoral injuries. Repair of lacerations (n = 600) was the commonest treatment; only 46 fractures required interventive treatment. Follow-up was performed for most of these patients at the Department of Oral and Maxillofacial Surgery at the Dental Hospital (n = 404) and general medical/dental practitioners (n = 258). These data highlight the importance of oral and maxillofacial surgery staff in the management of sports injuries in accident and emergency departments. Moreover, they suggest the need for prioritization of rule and legislation changes and the continuing need to improve safety standards to prevent maxillofacial injuries.

Racial diversity in American oral and maxillofacial surgery.

PubMed

Aziz, Shahid R

2010-08-01

Health care disparity in the United States is a significant problem. Part of the solution is to improve the diversity of health care providers. The purpose of this study is to review the racial demographic of American oral and maxillofacial surgery as it compares with the racial demographic of the United States. Additionally, the racial demographic of the American dental and medical professions are reviewed. Databases from the American Association of Oral and Maxillofacial Surgeons, American Dental Association, and Association of American Medical Colleges were analyzed, specifically reviewing racial demographic data of academic oral and maxillofacial surgery, dentistry, and medicine. Of the 349 full-time faculty, 248 were white (71.1%), 24 black (6.9%), 18 Hispanic (5.1%), 30 Asian (8.6%), and 29 other/unknown (8.3%); there were no full-time faculty of American Indian or Alaska Native descent. Of the 991 oral and maxillofacial surgery residents, whites comprised 701 (70.7%), blacks 43 (4.3%), Hispanics 42 (4.2%), Asians 197 (19.9%), and unknown 8 (0.8%). There are currently no residents of American Indian/Alaska Native origin. A 2006 American Dental Association survey of the distribution of race among the 179,594 professionally active dentists in the United States revealed 86.2% white, 3.4% black, 3.4% Hispanic, 6.9% Asian, and 0.12% American Indian. In 2004, whites comprised 36.7% (344,821) of US physicians, blacks 3.3% (30,598), Hispanics 2.8% (26,094), and Asians 5.7% (53,799); 27.6% (258,950) of US physicians were listed as unknown, and 23.6% (221,633) were listed as international medical graduates without demographic information. American oral and maxillofacial surgery's racial demographic (just as dentistry and medicine) does not remotely resemble the racial demographic of the United States. To improve health care disparity in this nation, diversifying the health care professional workforce is essential. Oral and maxillofacial surgery, a unique surgical specialty connecting medicine to dentistry, is positioned to make an impact on the oral health care disparity in this nation and as such should make a concerted effort to improve the racial diversity of the specialty. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Trends and characteristics of maxillofacial fractures sustained during sports activities in Japan.

PubMed

Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki

2018-03-11

Sports activity increases the risk of maxillofacial fractures. The aim of this study was to analyze trends and characteristics of maxillofacial fractures sustained during sports activity to develop more effective treatments and possibly to prevent injury. Data of 248 patients with maxillofacial fractures sustained during sports activity were retrospectively analyzed based on their clinical records and radiographs. The patients were 226 males (91.1%) and 22 females (8.9%). Their ages ranged from 6 to 70 years and the majority were in their second decade. The fractures were sustained in various sports which included baseball in 85 patients (34.3%), rugby in 40 (16.1%), soccer in 30 (12.1%), softball in 22 (8.9%), golf in 10 (4.0%), hockey in 8 (3.2%), combat sports in 28 (11.3%), and others in 29 (11.7%). The cause of injuries was collision with another player in 97 patients (39.1%), hit by a ball in 89 (35.9%), intended attack in 20 (8.1%), hit by equipment of another player in 15 (6.0%), a fall in 14 (5.6%), and collision with ground equipment in 13 (5.2%). The site of fractures was the mandible in 145 patients (58.5%), midface in 100 (40.3%), and both in 3 (1.2%). Among 210 fracture sites in the mandible, 77 (36.6%) were in the angle, 68 (32.4%) in the symphysis, and 65 (30.9%) in others. Among 103 fractures in the midface, 58 (56.3%) were in the zygoma, 26 (25.2%) in alveolar bone, and 19 (18.4%) in others. Treatment was observation in 67 patients (27.0%), maxillomandibular fixation in 64 (25.8%), open reduction and internal fixation in 63 (25.4%), intramaxillary splinting in 40 (16.1%), transcutaneous reduction in 10 (4.0%), and other procedures in 4 (1.6%). Maxillofacial fractures sustained during sports activity showed characteristic features dependent on the type of sport and cause of injury. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Our Treatment Approaches in Severe Maxillofacial Injuries Occurring After Failed Suicide Attempts Using Long-Barreled Guns.

PubMed

Kucuker, Ismail; Şimşek, Tekin; Keles, Musa Kemal; Yosma, Engin; Aksakal, Ibrahim Alper; Demir, Ahmet

2016-03-01

Maxillofacial traumas with long-barreled guns may sometimes cause catastrophic results by means of smashing in facial structures. In these patients, reconstruction strategies of both fragmented/lost soft and hard tissues still remain controversial. In their clinic, the authors treated 5 patients with severely injured face after failed suicide attempt between 2008 and 2013. In this study, the authors aimed to present their clinical experiences on these severely injured maxillofacial gunshot traumas and offer a treatment algorithm to gain a result as possible as satisfactory in terms of functionality and appearance.

Obtaining consent to oral and maxillofacial surgery.

PubMed

Poswillo, D

1989-09-01

The question of whether or not a patient has consented to treatment has recently become significant to all who practise oral and maxillofacial surgery. It is often linked to professional negligence when the outcome differs from the patient's perception or expectation of the operation. Consent may be oral or written, applies to referred patients and all those with physical and mental handicap and religious restrictions. Examples of procedure in discussing consent assist the surgeon to inform without creating fear. Knowledge of the benefits of informed consent and current legal opinion assist the oral and maxillofacial surgeon to avoid the pitfalls of failure to inform.

Surgical management of pediatric mandibular trauma.

PubMed

Aldelaimi, Tahrir N; Khalil, Afrah A

2013-05-01

Surgical treatment of pediatric maxillofacial region is a complex and challenging task to maxillofacial surgeons. Incorrect and inappropriate treatment of trauma will end with a secondary deformity that is very difficult to correct. Twenty-eight children with mandibular trauma were seen at the maxillofacial surgery department of Ramadi Teaching Hospital during the period from July 2009 to June 2012. Age, sex, etiology, associated injuries, pattern of fractures, and treatments were reviewed. Road traffic accident was the most common cause for pediatric mandibular trauma. Significant advances have been made in the management of these injuries, decreasing the incidence of secondary deformities.

Patient satisfaction with maxillofacial prosthesis. Literature review.

PubMed

Goiato, Marcelo Coelho; Pesqueira, Aldiéris Alves; Ramos da Silva, Cristina; Gennari Filho, Humberto; Micheline Dos Santos, Daniela

2009-02-01

Obturators and facial prostheses are important not only in rehabilitation and aesthetics, but also in patient re-socialisation. The level of reintegration is directly related to the degree of satisfaction with rehabilitation. So, the maxillofacial prosthetics must provide patient satisfaction during treatment. This study aimed to search information in database and conduct a literature review on patient satisfaction with maxillofacial prosthesis. The problems experienced by these patients may decrease when specialists keep the patient on regular inspection. Rehabilitation through alloplasty or prosthetic restoration provides satisfactory conditions in aesthetics and well-being and reinstates individuals in familial and social environment.

Maxillofacial injuries associated with intimate partner violence in women.

PubMed

Saddki, Norkhafizah; Suhaimi, Adlin A; Daud, Razak

2010-05-23

The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV) in women treated at a single facility in Malaysia. A retrospective review of 242 hospital records of female IPV victims who were seen at the One-Stop Crisis Centre (OSCC) in Hospital Raja Perempuan Zainab II, Kelantan over a two-year period (January 1, 2005 to December 31, 2006) was performed. A structured form was used for data collection. Information regarding the anatomical sites of injuries, types of injuries, and mechanisms of assault were obtained. Most victims were married (85.1%), were injured by the husband (83.5%), and had at least one previous IPV episode (85.5%). Injury to the maxillofacial region was the most common (50.4%), followed by injury to the limbs (47.9%). In 122 cases of maxillofacial injuries, the middle of the face was most frequently affected (60.6%), either alone or in combination with the upper or lower third of the face. Injury to soft tissues (contusions, abrasions and lacerations) was the most common (87.7%). This study indicates there is a high prevalence of maxillofacial injuries associated with IPV among women treated at the OSCC in Kelantan, Malaysia.

Pattern and treatment of facial trauma in pediatric and adolescent patients.

PubMed

Muñante-Cárdenas, Jose Luis; Olate, Sergio; Asprino, Luciana; de Albergaria Barbosa, Jose Ricardo; de Moraes, Márcio; Moreira, Roger W F

2011-07-01

Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.

Maxillofacial Injuries in Children: A 10 year Retrospective Study.

PubMed

Kambalimath, H V; Agarwal, S M; Kambalimath, Deepashri H; Singh, Mamta; Jain, Neha; Michael, P

2013-06-01

Fractures of facial bones in children are relatively uncommon although both children and adults are subjected to similar types of injuries. This study aims to evaluate the epidemiology of facial bone fractures among children under 14 years, their management and outcome. This retrospective study included maxillofacial injuries treated in 112 children under 14 years admitted due to maxillofacial injuries during the period from 2001 to 2011. Of them ten (8.93 %) were below 5 years, 44 (39.29 %) between 6 and 10 years and 58 (51.78 %) between 11 and 14 years of age. Male to female ratio was 1.8:1. Fall from a height was the most common etiology. The most common jaw involved in the fracture was the mandible. Conservative management was done in 83.04 % of cases and open reduction and internal fixation was performed in 16.96 % of cases. Five (4.46 %) cases accounted for post-operative wound infection. Fracture of the mandible is the most common maxillofacial injury in children, most often caused by fall from a height. The osteogenic potential of the mandible in children leads to conservative management of these fractures. Opportunities for prevention of maxillofacial trauma should be taken into consideration by parents and care takers.

Management of mandibular fractures in a developing country: a review of 314 cases from two urban centers in Nigeria.

PubMed

Adeyemo, Wasiu L; Iwegbu, Innocent O; Bello, Seidu A; Okoturo, Eyituoyo; Olaitan, Ademola A; Ladeinde, Akinola L; Ogunlewe, Mobolanle O; Adepoju, Adegbenga A; Taiwo, Olanrewaju A

2008-12-01

This study was designed to establish the current demographic and treatment patterns of mandibular fractures in two urban centers (Lagos University Teaching Hospital, Lagos, and National Hospital, Abuja) in Nigeria. All cases of mandibular fractures diagnosed and treated at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos (1998-2007) and Department of Oral and Maxillofacial Surgery, National Hospital, Abuja, Nigeria (2001-2007) were reviewed. Data collected included age, sex, etiology of fracture, anatomic site of fracture, associated maxillofacial fracture, types of treatment, and postoperative complications. The highest incidence of mandibular fractures (49.3%) occurred in the age group 21-30 years and the lowest in the age group 0-10 years, with male preponderance in nearly all age groups. Road traffic crashes (RTC) were the leading cause (67.5%), followed by assault (18.8%), and gunshot. Of the RTC cases, 85 (40%) were sustained from motorcycle-related crashes. The commonest site of fracture was the body of the mandible (n = 137), followed by the angle (n = 114). The majority (83.1%) were treated by closed reduction using intermaxillary fixation, 13.1% by open reduction and internal fixation, and 3.8% had conservative treatment. Mandibular fractures are commonest during the third decade of life and in men, with almost half of the cases due to of road traffic crashes. RTC was the leading cause of mandibular fractures in all age groups. Motorcycle-related mandibular fractures seem to be increasing in Nigeria. There is a need to enforce legislation designed to prevent RTC to reduce maxillofacial fractures in Nigeria.

[Application of anaerobic bacteria detection in oral and maxillofacial infection].

PubMed

Bao, Zhen-ying; Lin, Qin; Meng, Yan-hong; He, Chun; Su, Jia-zeng; Peng, Xin

2016-02-18

To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection. Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were identified. The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method. The clinical data and antibacterial agents for the treatment of the 61 cases were collected, and the final outcomes were recorded. The bacteria cultures were isolated from all the specimens, with aerobic bacteria only in 6 cases (9.8%), anaerobic bacteria only in 7 cases (11.5%), and both aerobic and anaerobic bacteria in 48 cases (78.7%). There were 55 infected cases (90.2%) with anaerobic bacteria, and 81 anaerobic bacteria stains were isolated. The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus, Bifidobacterium and Pemphigus propionibacterium. No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphyromonas and Prevotella. No metronidazole, cefoxitin, amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria. In the study, 48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing, and the clinical cure rate was 81.3%. Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofacial infection patients. Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.

Physician Assistants Improve Efficiency and Decrease Costs in Outpatient Oral and Maxillofacial Surgery.

PubMed

Resnick, Cory M; Daniels, Kimberly M; Flath-Sporn, Susan J; Doyle, Michael; Heald, Ronald; Padwa, Bonnie L

2016-11-01

To determine the effects on time, cost, and complication rates of integrating physician assistants (PAs) into the procedural components of an outpatient oral and maxillofacial surgery practice. This is a prospective cohort study of patients from the Department of Plastic and Oral Surgery at Boston Children's Hospital who underwent removal of 4 impacted third molars with intravenous sedation in our outpatient facility. Patients were separated into the "no PA group" and PA group. Process maps were created to capture all activities from room preparation to patient discharge, and all activities were timed for each case. A time-driven activity-based costing method was used to calculate the average times and costs from the provider's perspective for each group. Complication rates were calculated during the periods for both groups. Descriptive statistics were calculated, and significance was set at P < .05. The total process time did not differ significantly between groups, but the average total procedure cost decreased by $75.08 after the introduction of PAs (P < .001). The time that the oral and maxillofacial surgeon was directly involved in the procedure decreased by an average of 19.2 minutes after the introduction of PAs (P < .001). No significant differences in postoperative complications were found. The addition of PAs into the procedural components of an outpatient oral and maxillofacial surgery practice resulted in decreased costs whereas complication rates remained constant. The increased availability of the oral and maxillofacial surgeon after the incorporation of PAs allows for more patients to be seen during a clinic session, which has the potential to further increase efficiency and revenue. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The sensitivity and specificity of frozen-section histopathology in the management of benign oral and maxillofacial lesions.

PubMed

Aronovich, Sharon; Kim, Roderick Y

2014-05-01

The management of odontogenic cysts and tumors typically requires a biopsy, which may present significant challenges and prompt an additional visit to the operating room before definitive treatment. The aim of this study was to determine the validity of frozen-section diagnosis in the management of benign oral and maxillofacial lesions, allowing intraoperative diagnosis followed by definitive treatment under the same general anesthetic. A retrospective chart review of patients treated at the University of Michigan Health System was performed. Patients of all ages who had a diagnosis of a benign maxillofacial lesion by frozen-section and permanent histopathology reports were included for analysis. Patients were identified using the Current Procedural Terminology code for enucleation and curettage and International Classification of Diseases, Ninth Revision codes for benign cysts or tumors of skull, face, or lower jaw. Of 450 patients reviewed, 214 had intraoperative frozen-section examination available for comparison with permanent histopathology. There were 121 men (56.5%) and 93 women (43.5%), with a mean age of 41 years. Compared with final permanent histopathology, the overall sensitivity of frozen sections was 92.1%. Frozen-section histopathology had a sensitivity greater than 90% and a specificity greater than 95% for the diagnosis of dentigerous cyst and keratocyst odontogenic tumor. In this study of 214 patients with benign maxillofacial lesions, frozen-section histopathology was found to be a valid diagnostic modality with high sensitivity, specificity, and positive and negative predictive values. These results and analysis support the use of frozen-section histopathology for the treatment of benign maxillofacial lesions and underscore its value in the management of these lesions. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Pattern of oral-maxillofacial trauma from violence against women and its associated factors.

PubMed

da Nóbrega, Lorena Marques; Bernardino, Ítalo de Macedo; Barbosa, Kevan Guilherme Nóbrega; E Silva, Jéssica Antoniana Lira; Massoni, Andreza Cristina de Lima Targino; d'Avila, Sérgio

2017-06-01

Violence against women is a global public health problem. The aim of this study was to characterize the profile of women victims of violence and identify factors associated with maxillofacial injuries. A cross-sectional study was performed based on an evaluation of 884 medico-legal and social records of women victims of physical aggression treated at the Center of Forensic Medicine and Dentistry in Brazil. The variables investigated were related to the sociodemographic characteristics of victims, circumstances of aggressions, and patterns of trauma. Descriptive and multivariate statistics using decision tree analysis by the Chi-squared automatic interaction detector (CHAID) algorithm, as well as univariate and multivariate Poisson regression analyses were performed. The occurrence of maxillofacial trauma was 46.4%. The mean age of victims was 29.38 (SD=12.55 years). Based on decision tree, the profile of violence against women can be explained by the aggressor's gender (P<.001) and sociodemographic characteristics of victims, such as marital status (P=.001), place of residence (P=.019), and educational level (P=.014). Based on the final Poisson regression model, women living in suburban areas were more likely to suffer maxillofacial trauma (PR=1.752; CI 95%=1.153-2.662; P=.009) compared to those living in rural areas. Moreover, aggression using a weapon resulted in a lower occurrence of maxillofacial trauma (PR=0.476; CI 95%=0.284-0.799; P=.005) compared to cases of aggression using physical force. The prevalence of oral-maxillofacial trauma was high, and the main associated factors were place of residence and mechanism of aggression. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Use of a virtual learning environment for training in maxillofacial emergencies: impact on the knowledge and attitudes of staff in accident and emergency departments.

PubMed

Elledge, Ross; McAleer, Sean; Thakar, Meera; Begum, Fathema; Singhota, Sanjeet; Grew, Nicholas

2016-02-01

Many graduates will take up junior roles in accident and emergency (A&E) departments to which a large proportion of patients present with facial injuries caused by interpersonal violence. However, it is widely recognised that undergraduates and postgraduates have few opportunities for training in oral and maxillofacial surgery. We aimed to assess the impact of a specifically designed maxillofacial emergencies virtual learning environment (VLE) on the knowledge and confidence of junior doctors in two A&E departments. They were given free access to the VLE for one month, and were asked to complete multiple choice questions and to rate their confidence to deal with 10 common situations on visual analogue scales (VAS) at baseline and one month after training. A total of 29 doctors agreed to pilot the website, 21 (72%) completed both sets of questions, and 18 (62%) completed both VAS assessments. The mean (SD) multiple choice score improved from 10 (2.52) to 13 (3.56) out of a maximum of 20 (p=0.004) and the mean (SD) VAS improved from 29.2 (19.2) mm to 45.7 (16.6) mm out of a maximum of 100 mm (p=0.007). This was a small pilot study with limited numbers, but it showed improvements in the knowledge of maxillofacial emergencies and in confidence, although the latter remained low. Further work is needed to examine how these brief educational interventions affect the attitudes of frontline staff to maxillofacial emergencies. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Magnetic resonance angiography with fresh blood imaging for identification of hemangiomas and blood vessels around hemangiomas in oral and maxillofacial regions.

PubMed

Oda, Masafumi; Tanaka, Tatsurou; Kito, Shinji; Matsumoto-Takeda, Shinobu; Otsuka, Kozue; Hayashi, Yuki; Wakasugi-Sato, Nao; Yoshioka, Izumi; Habu, Manabu; Kokuryo, Shinya; Kodama, Masaaki; Nogami, Shinnosuke; Miyamoto, Ikuya; Yamamoto, Noriaki; Ishikawa, Ayataka; Zhang, Min; Matsuo, Kou; Shiiba, Shunji; Seta, Yuji; Yamashita, Yoshihiro; Takahashi, Tetsu; Tominaga, Kazuhiro; Morimoto, Yasuhiro

2012-04-01

To evaluate fresh blood imaging (FBI), a magnetic resonance imaging technique that does not use contrast, for identifying hemangiomas and feeding arteries in the oral and maxillofacial regions. For 16 patients with hemangiomas, FBI visualizations of hemangiomas and feeding arteries in the oral and maxillofacial regions were compared with those from 3-dimensional (3D) phase-contrast magnetic resonance angiography (PC-MRA). Comparisons were based on the conspicuities of blood vessels and the 3D relationships of hemangiomas with the surrounding blood vessels. The conspicuity of hemangiomas, feeding arteries, and blood vessels were significantly better with FBI than with PC-MRA. After differentiating arteries from veins, 3D visualizations of hemangiomas and arteries or veins could be performed with FBI. FBI is a useful method in oral and maxillofacial regions for identifying the relationships between hemangiomas and the surrounding arteries or veins. Crown Copyright © 2012. Published by Mosby, Inc. All rights reserved.

Leading article: how can I optimise my role as a leader within the surgical team?

PubMed

Green, B; Mitchell, D A; Stevenson, P; Kane, T; Reynard, J; Brennan, P A

2016-10-01

Leadership is uncommonly taught formally at any level in surgical training, and is not often evaluated formally either within assessment programmes or during appraisal. Good leadership skills in oral and maxillofacial surgery (OMFS) include professionalism, technical competence, motivation, innovation, ability to communicate, resilience, and effective teaching. They also include the recognition of when and how to "follow" when appropriate. Such skills can be developed through experience, observation, and education using a framework that can include mentoring, coaching, and feedback. This review provides some guidance in how to improve leadership skills in OMFS, which we hope will to improve the quality of training and care of patients. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Retrospective Audit: Does Prior Assessment by Oral and Maxillofacial Surgeons Reduce the Risk of Osteonecrosis of The Jaw in Patients Receiving Bone-Targeted Therapies for Metastatic Cancers to the Skeleton?--Part II.

PubMed

Turner, Bruce; Ali, Sacha; Pati, Jhumur; Nargund, Vinod; Ali, Enamul; Cheng, Leo; Wells, Paula

2016-01-01

Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers.

Regenerative nanotechnology in oral and maxillofacial surgery.

PubMed

Shakib, Kaveh; Tan, Aaron; Soskic, Vukic; Seifalian, Alexander M

2014-12-01

Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Cone beam tomographic imaging anatomy of the maxillofacial region.

PubMed

Angelopoulos, Christos

2008-10-01

Multiplanar imaging is a fairly new concept in diagnostic imaging available with a number of contemporary imaging modalities such as CT, MR imaging, diagnostic ultrasound, and others. This modality allows reconstruction of images in different planes (flat or curved) from a volume of data that was acquired previously. This concept makes the diagnostic process more interactive, and proper use may increase diagnostic potential. At the same time, the complexity of the anatomical structures on the maxillofacial region may make it harder for these images to be interpreted. This article reviews the anatomy of maxillofacial structures in planar imaging, and more specifically cone-beam CT images.

The role of diagnostic ultrasound as a new diagnostic aid in oral and maxillofacial surgery

PubMed Central

Venkataraman, Siva Subramaniyam; Aravind, Ramraj Jayabalan; Kavin, Thangavelu

2012-01-01

Only very few studies have been done in the past to evaluate the usefulness and limitations of ultrasonography in oral and maxillofacial surgery. This study, though in an embryonic stage, has been done to bring this technique to limelight and to put forth the importance of its use and limitations in the branch of oral surgery. The purpose of this study was to investigate and study the characteristic pattern of the oral tissues on gray scale ultrasonography and to assess the practical applicability of this new diagnostic technique in diagnosing various tissue pathologies in the field of oral and maxillofacial surgery. PMID:23066231

Oral and Maxillofacial Anatomy.

PubMed

Sadrameli, Mitra; Mupparapu, Mel

2018-01-01

This article deals with identification and descriptions of intraoral and extraoral anatomy of the dental and maxillofacial structures. The anatomic landmarks are highlighted and described based on their radiographic appearance and their clinical significance is provided. Cone beam CT-based images are described in detail using the multiplanar reconstructions. The skull views are depicted via line diagrams in addition to their normal radiographic appearance to make identification of anatomic structures easier for clinicians. The authors cover most of the anatomic structures commonly noted via radiographs and their descriptions. This article serves as a clinician's guide to oral and maxillofacial radiographic anatomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre

PubMed Central

Braimah, Ramat Oyebunmi; Ibikunle, Adebayo Aremu; Taiwo, Abdurrazaq Olanrewaju

2016-01-01

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines. PMID:27162440

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre.

PubMed

Braimah, Ramat Oyebunmi; Ibikunle, Adebayo Aremu; Taiwo, Abdurrazaq Olanrewaju

2016-01-01

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines.

Addressing Gender Discrimination in Oral and Maxillofacial Surgery via the Social Norms Approach.

PubMed

Uppgaard, Rachel

2018-03-28

Gender discrimination continues to be a challenge faced by women in oral and maxillofacial surgery. The discrimination itself is perpetrated by a small number of individuals, but it is lack of support and intervention by other surgeons that allows this to continue. The social norms approach is one means to break this cycle: first by identifying misperceptions and then by encouraging individuals to intervene instead of remaining bystanders. To move forward as a specialty, we must actively intervene when discrimination and harassment occur. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

A novel augmented reality system for displaying inferior alveolar nerve bundles in maxillofacial surgery

PubMed Central

Zhu, Ming; Liu, Fei; Chai, Gang; Pan, Jun J.; Jiang, Taoran; Lin, Li; Xin, Yu; Zhang, Yan; Li, Qingfeng

2017-01-01

Augmented reality systems can combine virtual images with a real environment to ensure accurate surgery with lower risk. This study aimed to develop a novel registration and tracking technique to establish a navigation system based on augmented reality for maxillofacial surgery. Specifically, a virtual image is reconstructed from CT data using 3D software. The real environment is tracked by the augmented reality (AR) software. The novel registration strategy that we created uses an occlusal splint compounded with a fiducial marker (OSM) to establish a relationship between the virtual image and the real object. After the fiducial marker is recognized, the virtual image is superimposed onto the real environment, forming the “integrated image” on semi-transparent glass. Via the registration process, the integral image, which combines the virtual image with the real scene, is successfully presented on the semi-transparent helmet. The position error of this navigation system is 0.96 ± 0.51 mm. This augmented reality system was applied in the clinic and good surgical outcomes were obtained. The augmented reality system that we established for maxillofacial surgery has the advantages of easy manipulation and high accuracy, which can improve surgical outcomes. Thus, this system exhibits significant potential in clinical applications. PMID:28198442

A novel augmented reality system for displaying inferior alveolar nerve bundles in maxillofacial surgery.

PubMed

Zhu, Ming; Liu, Fei; Chai, Gang; Pan, Jun J; Jiang, Taoran; Lin, Li; Xin, Yu; Zhang, Yan; Li, Qingfeng

2017-02-15

Augmented reality systems can combine virtual images with a real environment to ensure accurate surgery with lower risk. This study aimed to develop a novel registration and tracking technique to establish a navigation system based on augmented reality for maxillofacial surgery. Specifically, a virtual image is reconstructed from CT data using 3D software. The real environment is tracked by the augmented reality (AR) software. The novel registration strategy that we created uses an occlusal splint compounded with a fiducial marker (OSM) to establish a relationship between the virtual image and the real object. After the fiducial marker is recognized, the virtual image is superimposed onto the real environment, forming the "integrated image" on semi-transparent glass. Via the registration process, the integral image, which combines the virtual image with the real scene, is successfully presented on the semi-transparent helmet. The position error of this navigation system is 0.96 ± 0.51 mm. This augmented reality system was applied in the clinic and good surgical outcomes were obtained. The augmented reality system that we established for maxillofacial surgery has the advantages of easy manipulation and high accuracy, which can improve surgical outcomes. Thus, this system exhibits significant potential in clinical applications.

Knowledge, attitude and awareness of speciality of oral and maxillofacial surgery amongst medical consultants of vadodara district in gujarat state.

PubMed

Shah, Navin; Patel, Nameeta; Mahajan, Amit; Shah, Rishabh

2015-03-01

Aim of this study was to survey the knowledge, attitude and awareness of the subject of oral and maxillofacial surgery speciality amongst the consultants and practitioners of medicine in district of Vadodara. List of members of various specialities in medical faculty were obtained from Indian Medical Association, Baroda branch and staff members of medical colleges of Vadodara district. A questionnaire survey was made which was distributed and their options were noted. Surgical removal of third molar, oral submucous fibrosis and implants were the problems where oral surgeons were preferred. For maxillofacial trauma plastic surgeons and orthopaedic surgeons were preferred than oral surgeons. For maxillofacial pathology E.N.T surgeons were mostly preferred. There is low awareness regarding oral and maxillofacial surgery amongst the general practitioners and medical consultants in Vadodara district. Survey shows that our training needs to be upgraded and revamped so that our trainees (post graduates in oral surgery) and have a greater "hands-on" exposure during their postgraduate training. They will then be able to handle increasingly complex cases in a multispecialty setup when they graduate and earn the mutual respect of the medical and dental fraternity and also the general public. MBBS students during their dental postings should be made aware of the depth and scope of oral surgery branch.

COMPLICATIONS OF ORAL AND MAXILLOFACIAL SURGERY UNDER GENERAL ANESTHESIA IN TUBE-FED CHILDREN: A RETROSPECTIVE ANALYSIS.

PubMed

Nguyen, Trang D; Freilich, Marshall M; Macpherson, Bruce A

2016-06-01

To assess morbidity and mortality associated with oral and maxillofacial surgery procedures requiring general anesthesia among children with aspiration tendency requiring enteral feeding. A retrospective chart review was conducted of children surgically treated under general anesthesia by the oral and maxillofacial surgery service at the Hospital for Sick Children in Toronto, Canada. Medical and dental records over a 9-year period (January 1, 2000 to January 1, 2010) were reviewed. Data were collected on demographics, primary illness, coexisting medical conditions, procedures performed, medications administered, type of airway management used, duration of general anesthesia, American Society of Anesthesiologists' physical status classification and adverse events. During the period reviewed, 28 children underwent 35 oral and maxillofacial surgery procedures under general anesthesia. The mean patient age was 12 years (range 4-17 years). No deaths occurred. Of the 35 surgeries, 10 (29%) were associated with at least 1adverse event. Adverse events included 1incident of respiratory distress, 2incidents of fever, 5incidents of bleeding, 1incident of seizure and 4incidents of oxygen saturation below 90% for more than 30s. Children with a history of aspiration tendency that necessitates enteral feeding, who undergo oral and maxillofacial surgery under general anesthesia, are at increased risk of morbidity. Before initiating treatment, the surgeon and parents or guardians of such children should carefully consider these risks compared with the anticipated benefit of surgery.

Maxillofacial injuries associated with intimate partner violence in women

PubMed Central

2010-01-01

Background The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV) in women treated at a single facility in Malaysia. Methods A retrospective review of 242 hospital records of female IPV victims who were seen at the One-Stop Crisis Centre (OSCC) in Hospital Raja Perempuan Zainab II, Kelantan over a two-year period (January 1, 2005 to December 31, 2006) was performed. A structured form was used for data collection. Information regarding the anatomical sites of injuries, types of injuries, and mechanisms of assault were obtained. Results Most victims were married (85.1%), were injured by the husband (83.5%), and had at least one previous IPV episode (85.5%). Injury to the maxillofacial region was the most common (50.4%), followed by injury to the limbs (47.9%). In 122 cases of maxillofacial injuries, the middle of the face was most frequently affected (60.6%), either alone or in combination with the upper or lower third of the face. Injury to soft tissues (contusions, abrasions and lacerations) was the most common (87.7%). Conclusions This study indicates there is a high prevalence of maxillofacial injuries associated with IPV among women treated at the OSCC in Kelantan, Malaysia. PMID:20492720

Prosthetic management of patients with oro-maxillo-facial defects: a long-term follow-up retrospective study

PubMed Central

GASTALDI, G.; PALUMBO, L.; MORESCHI, C.; GHERLONE, E.F.; CAPPARÉ, P.

2017-01-01

SUMMARY Introduction The aim of this study is to determine the outcome of maxillofacial prosthetic rehabilitation after oncological resections, including both intra- and extra-oral prosthetic devices. Methods In this study were included 72 patients, who have undergone an intra or extra-oral maxillofacial prosthetic rehabilitation after an oncologic resection. Tumors on the head and neck were analyzed and the defects of these resections have been divided in two different groups: intra and extra-oral defects. Results 72 participants were treated with maxillofacial prosthesis, 3 of which with post-traumatic wounds and 69 with resections of tumors on the head and neck. Of the 69 treated for neoplastic disease, 43 received an intraoral prosthesis (palatal obturator) and 29 with an extraoral epithesis (18 with nasal prostheses, 8 with orbital implants and 3 with ear implants). The group included patients with different types of tumors. All the patients were evaluated in terms of aesthetic appearance after the construction of the prostheses and the results were satisfactory. Conclusion Within the limitations of this study, after the use of maxillofacial protheses patients feel more confident and self-assured. Maxillofacial protheses are a good solution in order to improve the life’s quality in patients with tumors resections: prostheses are easy to handle and provide a satisfying social interaction for the patients. PMID:29285330

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach.

PubMed

Andreu-Arasa, V Carlota; Chapman, Margaret N; Kuno, Hirofumi; Fujita, Akifumi; Sakai, Osamu

2018-01-01

Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications. Online supplemental material is available for this article. © RSNA, 2018.

Colour stability of maxillofacial silicone elastomers: a review of the literature.

PubMed

Kulkarni, R S; Nagda, S J

2014-09-01

Colour degradation is a serious limitation of maxillofacial silicone elastomers and most silicone facial prostheses have to be remade within 1 year due to colour deterioration. A comprehensive review of the literature was completed using MEDLINE and PubMed Library databases. This was supplemented with a manual search of selected journals and textbooks. English language articles published in peer-reviewed journals from 1966 to January 2012 in which colour stability of silicone elastomers was evaluated using standard research protocols were included. In all, 127 articles were identified and 23 met the inclusion criteria. Current literature reveals that average colour stability of maxillofacial silicone prostheses is 6-12 months, and inherent unstable nature of silicones is responsible for the color degradation. Opacifiers, oil pigments and inorganic colourants may have a protective effect on colour stability of prostheses. Organic colourants, ultraviolet (UV) light, cleansing solutions, dust and aging can adversely affect colour stability of silicone prostheses. A direct comparison between studies has not been possible, because of the differences in experimental set-up such as materials tested, colourants used, or method of aging. There appears to be a need for a standardised test protocol for colour stability of maxillofacial materials. Colour degradation limits the useful lifespan of maxillofacial silicones. Improvements in colour stability is possible with the use of certain nano opacifiers, UV absorbers, photoprotective agents, and use of inorganic pigments and metal oxides.

[History of the German Society of Oromaxillofacial Surgery].

PubMed

Schwenzer, N

2000-05-01

The German Society of Oral and Maxillofacial Surgery was founded by Martin Wassmund in 1951. One of the main reasons was the need for scientific representation in the council at a medical convention. The Society, originally composed of 52 members, was first called "The German Society of Maxillofacial Surgery". In 1972, it extended its title to include the term "oral" ("Mund") and currently comprises 620 members. A scientific conference is held annually on a specific topic. The lectures given there have been published since 1954 in "Fortschritte der Kiefer- und Gesichts-Chirurgie" (Progress in Maxillofacial Surgery) by Thieme Verlag; since 1997, they have appeared as a Springer-Verlag supplement. Topics of choice are published in "Mund-, Kiefer- und Gesichtschirurgie" ("Oral and Maxillofacial Surgery"), originally by Hanser in Munich and now by Springer-Verlag in Heidelberg. In this manner, it was possible to completely document the scientific activities and progress in this specialty. Each year since 1957, a prize named after M. Wassmund, has been given for outstanding scientific accomplishment. The presidents, convention locations, topics, and prizewinners are listed in a table. Since the founding of the Society of Oral and Maxillofacial Surgery, close cooperation has existed with the National Association of German Oral and Maxillary-Facial Surgeons (Bundesverband der Deutschen Arzte für Mund-Kiefer-Gesichts-Chirurgie). In order to intertwine scientific and political interests, a fusion of these two organizations is planned for the year 2000.

Recent Developments of Functional Scaffolds for Craniomaxillofacial Bone Tissue Engineering Applications

PubMed Central

Kinoshita, Yukihiko; Maeda, Hatsuhiko

2013-01-01

Autogenous bone grafting remains a gold standard for the reconstruction critical-sized bone defects in the craniomaxillofacial region. Nevertheless, this graft procedure has several disadvantages such as restricted availability, donor-site morbidity, and limitations in regard to fully restoring the complicated three-dimensional structures in the craniomaxillofacial bone. The ultimate goal of craniomaxillofacial bone reconstruction is the regeneration of the physiological bone that simultaneously fulfills both morphological and functional restorations. Developments of tissue engineering in the last two decades have brought such a goal closer to reality. In bone tissue engineering, the scaffolds are fundamental, elemental and mesenchymal stem cells/osteoprogenitor cells and bioactive factors. A variety of scaffolds have been developed and used as spacemakers, biodegradable bone substitutes for transplanting to the new bone, matrices of drug delivery system, or supporting structures enhancing adhesion, proliferation, and matrix production of seeded cells according to the circumstances of the bone defects. However, scaffolds to be clinically completely satisfied have not been developed yet. Development of more functional scaffolds is required to be applied widely to cranio-maxillofacial bone defects. This paper reviews recent trends of scaffolds for crania-maxillofacial bone tissue engineering, including our studies. PMID:24163634

Intra-articular corticosteroid injections to the temporomandibular joints are safe and appear to be effective therapy in children with juvenile idiopathic arthritis.

PubMed

Stoll, Matthew L; Good, Jennifer; Sharpe, Tyler; Beukelman, Timothy; Young, Daniel; Waite, Peter D; Cron, Randy Q

2012-08-01

The purpose of this study was to evaluate the safety and efficacy of intra-articular corticosteroid injections (IACIs) of the temporomandibular joint (TMJ) in children with juvenile idiopathic arthritis (JIA) when administered by an oral and maxillofacial surgeon without imaging guidance. This was a retrospective study of children with JIA, seen at a single center, who were selected based on having received IACIs of the TMJ. All subjects received the intervention, which consisted of referral to a single oral and maxillofacial surgeon for TMJ IACI with 5 to 10 mg triamcinolone hexacetonide, under general anesthesia. Primary outcomes assessed in all subjects were the safety of the procedure and efficacy as determined by the change in maximal incisal opening (MIO). In addition, a subset of 31 subjects underwent repeat magnetic resonance imaging of the TMJ, permitting analysis of the change in the acute and chronic findings of arthritis in those patients. Sixty-three patients (68% female) received 137 IACIs. The mean age for diagnosis of JIA was 8.5 years, and the mean age at presentation for TMJ injections was 10 years. The injections were well tolerated: only 1 patient developed the steroid complication of hypopigmentation, and none developed degeneration or ankylosis. In terms of efficacy, the mean MIO increased from 40.8 ± 0.93 to 43.5 ± 0.90 mm (P = .001); in addition, changing the unit of analysis to individual joints, in patients who underwent repeat magnetic resonance imaging examination, 51% of TMJs showed magnetic resonance imaging evidence of improvement of arthritic changes, of whom 18% had complete resolution of TMJ arthritis. The results indicate that IACI of the TMJ can be safely performed by experienced oral and maxillofacial surgeons without a requirement for computed tomographic guidance. In addition, these results show that IACI may be effective in the management of TMJ arthritis, although further studies are required. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Spark erosion implant prosthetics in the management of an acquired maxillofacial defect.

PubMed

Bloem, T J; Baxter, W D; Vivas, J

1996-03-01

The concept and use of spark erosion (EDM) prosthetics in implant prosthodontics has been described and demonstrated in its application to a patient suffering maxillofacial trauma. The advantages and disadvantages of this technology have been discussed for the edification of the restorative and surgical provider.

Pre-Cancerous Lesions in the Oral and Maxillofacial Region: A Literature Review with Special Focus on Etiopathogenesis

PubMed Central

Irani, Soussan

2016-01-01

Many types of cancers develop in the oral and maxillofacial region. Squamous cell carcinoma is the most common cancer and constitutes over 90 percent of these tumors. Malignant transformation is a genetic process, which later makes a phenotyping change at the cellular level. Some cancers such as oral squamous cell carcinomas (OSCCs) develop from pre-malignant lesions and conditions. Despite advances in the treatment of OSCC, the 5-year survival rate remains approximately 50% due to inability of early detection of OSCC and precursor lesions. Early detection of oral cancer, especially in the premalignant stage, can decrease mortality and morbidity significantly. This article reviews some clinical, histopathological features and etiopathogenesis of pre-cancerous lesions of the oral cavity and skin of face and lip vermilion. A relevant English literature search in Pubmed, Science Direct, and Google Scholar was performed from 1930 to 2015. Full text of 191 articles met the specific inclusion criteria for this review. PMID:28855922

Virtual transplantation in designing a facial prosthesis for extensive maxillofacial defects that cross the facial midline using computer-assisted technology.

PubMed

Feng, Zhi-hong; Dong, Yan; Bai, Shi-zhu; Wu, Guo-feng; Bi, Yun-peng; Wang, Bo; Zhao, Yi-min

2010-01-01

The aim of this article was to demonstrate a novel approach to designing facial prostheses using the transplantation concept and computer-assisted technology for extensive, large, maxillofacial defects that cross the facial midline. The three-dimensional (3D) facial surface images of a patient and his relative were reconstructed using data obtained through optical scanning. Based on these images, the corresponding portion of the relative's face was transplanted to the patient's where the defect was located, which could not be rehabilitated using mirror projection, to design the virtual facial prosthesis without the eye. A 3D model of an artificial eye that mimicked the patient's remaining one was developed, transplanted, and fit onto the virtual prosthesis. A personalized retention structure for the artificial eye was designed on the virtual facial prosthesis. The wax prosthesis was manufactured through rapid prototyping, and the definitive silicone prosthesis was completed. The size, shape, and cosmetic appearance of the prosthesis were satisfactory and matched the defect area well. The patient's facial appearance was recovered perfectly with the prosthesis, as determined through clinical evaluation. The optical 3D imaging and computer-aided design/computer-assisted manufacturing system used in this study can design and fabricate facial prostheses more precisely than conventional manual sculpturing techniques. The discomfort generally associated with such conventional methods was decreased greatly. The virtual transplantation used to design the facial prosthesis for the maxillofacial defect, which crossed the facial midline, and the development of the retention structure for the eye were both feasible.

Current concepts of oral and maxillofacial rehabilitation and treatment in aviation.

PubMed

Yuce, Esra; Koçer, Gulperi; Çini, Turan Atila

2016-01-01

Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

ADAM10 is essential for cranial neural crest-derived maxillofacial bone development.

PubMed

Tan, Yu; Fu, Runqing; Liu, Jiaqiang; Wu, Yong; Wang, Bo; Jiang, Ning; Nie, Ping; Cao, Haifeng; Yang, Zhi; Fang, Bing

2016-07-08

Growth disorders of the craniofacial bones may lead to craniofacial deformities. The majority of maxillofacial bones are derived from cranial neural crest cells via intramembranous bone formation. Any interruption of the craniofacial skeleton development process might lead to craniofacial malformation. A disintegrin and metalloprotease (ADAM)10 plays an essential role in organ development and tissue integrity in different organs. However, little is known about its function in craniofacial bone formation. Therefore, we investigated the role of ADAM10 in the developing craniofacial skeleton, particularly during typical mandibular bone development. First, we showed that ADAM10 was expressed in a specific area of the craniofacial bone and that the expression pattern dynamically changed during normal mouse craniofacial development. Then, we crossed wnt1-cre transgenic mice with adam10-flox mice to generate ADAM10 conditional knockout mice. The stereomicroscopic, radiographic, and von Kossa staining results showed that conditional knockout of ADAM10 in cranial neural crest cells led to embryonic death, craniofacial dysmorphia and bone defects. Furthermore, we demonstrated that impaired mineralization could be triggered by decreased osteoblast differentiation, increased cell death. Overall, these findings show that ADAM10 plays an essential role in craniofacial bone development. Copyright © 2016 Elsevier Inc. All rights reserved.

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1983-02-01

the most promise for producing elastomeric-shelled microcapsules containing an inert liquid. While much of the diverse field of microencapsulation is...Processes and Applications, Chicago, 28 August 1973. 11. Gutchko, M. H., Microcapsules and Microencapsulation Techniques. Noyes Data Corporation, Park Ridge...necesaryv and identify by block number) * MAXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS: MICROCAPSULES : * SOFT FILLERS; ELASTOMER COMPOSITES 2L

Surgical modalities in gunshot wounds of the face.

PubMed

Firat, Cemal; Geyik, Yilmaz

2013-07-01

Maxillofacial traumas caused by gunshot wounds may cause quite varied defects. The objective of this study was to evaluate the reconstruction methods in 12 patients with gunshot wound-related mandibular and maxillofacial bony and soft tissue defects. Twelve patients who were operated on for maxillofacial gunshot wounds at our clinic between 2002 and 2012 were included in the study. Seven patients were wounded in a suicide attempt, and 5 were wounded as a result of an accident or in assaults. Two patients underwent reconstruction using free fibula osteocutaneous flap, 4 patients received the free radial forearm osteocutaneous flap, 2 patients received costal bone graft, and 3 patients received iliac bone grafts. Satisfactory functional and aesthetic outcomes were achieved in cases where staged secondary reconstruction, balloon treatment, and consecutive fat and steroid injections into the depressed scar areas were applied. In conclusion, the basic goal in maxillofacial reconstruction is the functional and aesthetic reconstruction of the contours. Because it is not easy to get perfect results with only 1 clinical approach or 1 method, the proper timing and reconstruction method should be selected.

Application of computer-aided three-dimensional skull model with rapid prototyping technique in repair of zygomatico-orbito-maxillary complex fracture.

PubMed

Li, Wei Zhong; Zhang, Mei Chao; Li, Shao Ping; Zhang, Lei Tao; Huang, Yu

2009-06-01

With the advent of CAD/CAM and rapid prototyping (RP), a technical revolution in oral and maxillofacial trauma was promoted to benefit treatment, repair of maxillofacial fractures and reconstruction of maxillofacial defects. For a patient with zygomatico-facial collapse deformity resulting from a zygomatico-orbito-maxillary complex (ZOMC) fracture, CT scan data were processed by using Mimics 10.0 for three-dimensional (3D) reconstruction. The reduction design was aided by 3D virtual imaging and the 3D skull model was reproduced using the RP technique. In line with the design by Mimics, presurgery was performed on the 3D skull model and the semi-coronal incision was taken for reduction of ZOMC fracture, based on the outcome from the presurgery. Postoperative CT and images revealed significantly modified zygomatic collapse and zygomatic arch rise and well-modified facial symmetry. The CAD/CAM and RP technique is a relatively useful tool that can assist surgeons with reconstruction of the maxillofacial skeleton, especially in repairs of ZOMC fracture.

Scheduling terminology for oral and maxillofacial surgery. Are we speaking a universal language?

PubMed

Howe, T E; Varley, I; Allen, J E; Glossop, A; McKechnie, A

2017-05-01

Use of a universal vocabulary to assist with the scheduling of operations has been shown to considerably reduce delays and improve the use of theatre resources. Within the UK the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has established a classification to assist with the triage of both emergency and non-emergency operating lists. We completed a survey to assess the uptake and understanding of this classification when scheduling maxillofacial operations. From a list of eight scheduling terms, respondents had to choose one each for 20 different clinical situations (that represented equally) immediate, urgent, expedited, and elective operations as defined by them. A total of 50 surveys were collated. Only 65% of answers selected represented NCPOD terms. 25% of answers represented a term higher and 18% a term lower, on the scale of intervention for the same category of situation. Current NCEPOD terms do not seem to be used universally and are poorly understood. Considerable variation in terminology exists when scheduling maxillofacial operations. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

PubMed

Vadepally, Ashwant Kumar; Sinha, Ramen

2018-06-01

To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p  < 0.001). An overall awareness level of oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.

Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study

PubMed Central

Samieirad, Sahand; Aboutorabzade, Mohammad-Reza; Tohidi, Elahe; Shaban, Baratollah; Khalife, Hussein; Salami, Hamid-Reza

2017-01-01

Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma. PMID:28809369

Professional perceptions of plastic and reconstructive surgery: what primary care physicians think.

PubMed

Tanna, Neil; Patel, Nitin J; Azhar, Hamdan; Granzow, Jay W

2010-08-01

The great breadth of the specialty of plastic surgery is often misunderstood by practitioners in other specialties and by the public at large. The authors investigate the perceptions of primary care physicians in training toward the practice of different areas of plastic and reconstructive surgery. A short, anonymous, Web-based survey was administered to residents of internal medicine, family medicine, and pediatrics training programs in the United States. Respondents were asked to choose the specialist they perceived to be an expert for six specific clinical areas, including eyelid surgery, cleft lip and palate surgery, facial fractures, hand surgery, rhinoplasty, and skin cancer of the face. Specialists for selection included the following choices: dermatologist, general surgeon, ophthalmologist, oral and maxillofacial surgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon. A total of 1020 usable survey responses were collected. Respondents believed the following specialists were experts for eyelid surgery (plastic surgeon, 70 percent; ophthalmologist, 59 percent; oral and maxillofacial surgeon, 15 percent; dermatologist, 5 percent; and otolaryngologist, 5 percent); cleft lip and palate surgery (oral and maxillofacial surgeon, 78 percent; plastic surgeon, 57 percent; and otolaryngologist, 36 percent); facial fractures (oral and maxillofacial surgeon, 88 percent; plastic surgeon, 36 percent; otolaryngologist, 30 percent; orthopedic surgeon, 11 percent; general surgeon, 3 percent; and ophthalmologist, 2 percent); hand surgery (orthopedic surgeon, 76 percent; plastic surgeon, 52 percent; and general surgeon, 7 percent); rhinoplasty (plastic surgeon, 76 percent; otolaryngologist, 45 percent; and oral and maxillofacial surgeon, 18 percent); and skin cancer of the face (dermatologist, 89 percent; plastic surgeon, 35 percent; oral and maxillofacial surgeon, 9 percent; otolaryngologist, 8 percent; and general surgeon, 7 percent). As the field of plastic surgery and other areas of medicine continue to evolve, additional education of internal medicine, pediatrics, and family practice physicians and trainees in the scope of plastic surgery practice will be critical.

Application of Additive Manufacturing in Oral and Maxillofacial Surgery.

PubMed

Farré-Guasch, Elisabet; Wolff, Jan; Helder, Marco N; Schulten, Engelbert A J M; Forouzanfar, Tim; Klein-Nulend, Jenneke

2015-12-01

Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data, which is a promising technology in oral and maxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a challenge to oral and maxillofacial surgeons. Many strategies have been proposed for the management of such defects, but autogenous bone grafts remain the gold standard for reconstructive bone surgery. Nevertheless, cell-based treatments using adipose stem cells combined with osteoconductive biomaterials or scaffolds have become a promising alternative to autogenous bone grafts. Such treatment protocols often require customized 3D scaffolds that fulfill functional and esthetic requirements, provide adequate blood supply, and meet the load-bearing requirements of the head. Currently, such customized 3D scaffolds are being manufactured using additive manufacturing technology. In this review, 2 of the current and emerging modalities for reconstruction of oral and maxillofacial bone defects are highlighted and discussed, namely human maxillary sinus floor elevation as a valid model to test bone tissue-engineering approaches enabling the application of 1-step surgical procedures and seeding of Good Manufacturing Practice-level adipose stem cells on computer-aided manufactured scaffolds to reconstruct large bone defects in a 2-step surgical procedure, in which cells are expanded ex vivo and seeded on resorbable scaffolds before implantation. Furthermore, imaging-guided tissue-engineering technologies to predetermine the surgical location and to facilitate the manufacturing of custom-made implants that meet the specific patient's demands are discussed. The potential of tissue-engineered constructs designed for the repair of large oral and maxillofacial bone defects in load-bearing situations in a 1-step surgical procedure combining these 2 innovative approaches is particularly emphasized. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The most-cited articles in dental, oral, and maxillofacial traumatology during 64 years.

PubMed

Jafarzadeh, Hamid; Sarraf Shirazi, Alireza; Andersson, Lars

2015-10-01

Citation analysis helps to identify the research trends within a research field and helps to identify the most frequently occurring parameters. The aim of this study was to identify the 100 most-cited articles in the field of dental, oral, and maxillofacial traumatology over the past 64 years. A comprehensive list of the most-cited articles in dental, oral, and maxillofacial trauma was compiled using 'All Databases' section of the ISI Web of Knowledge. Related articles were considered to be those articles in which part or all of the experiment or study was related to dental and/or oral and maxillofacial trauma. In case reports, if a part of a treatment plan was related to the topic, that article was considered to be relevant. The characteristics analyzed included number of citations, authors, journals, institution, country of origin, publication year, article type, study material, and topic. The number of citations for each article ranged from 69 to 229. The journal Dental Traumatology was the most represented, followed by the journal Oral and Maxillofacial Surgery. Of the 100 articles, 83% were original articles, 15% were review articles, and 2% were case report/case series. Therapy and prognosis-related topics were the most common topics. Most articles came from institutions in the United States, followed by the Scandinavian countries. University Hospital of Copenhagen was the source of the highest number (34) of the most-cited articles; the same author wrote or co-wrote 22 of the 100 most-cited articles. The list of most-cited articles in the field of dental, oral, and maxillofacial traumatology gives a good scientometric picture of trauma research in the world. A large number of the most-cited articles are mainly from the field of dental traumatology and originate from a few research teams. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improving the Quality of Oral and Maxillofacial Surgical Notes in an Indian Public Sector Hospital in Accordance with the Royal College of Surgeons Guidelines: A Completed Audit Loop Study.

PubMed

Krishnan, B; Prasad, G Arun; Madhan, B

2016-09-01

Proper and adequate documentation in operation notes is a basic tool of clinical practice with medical and legal implications. An audit was done to ascertain if oral and maxillofacial surgery operative notes in an Indian public sector hospital adhered to the guidelines published by the Royal College of Surgeons England. Fifty randomly selected operative notes were evaluated against the guidelines by RCS England with regards to the essential generic components of an operation note. Additional criteria relevant to oral and Maxillofacial Surgery were also evaluated. Changes were introduced in the form of Oral and Maxillofacial Surgery specific consent forms, diagram sheets and a computerized operation note proforma containing all essential and additional criteria along with prefilled template of operative findings. Re-audit of 50 randomly selected operation notes was performed after a 6 month period. In the 1st audit cycle, excellent documentation ranging from 94 to 100 % was seen in 9 essential criteria. Unsatisfactory documentation was observed in criteria like assistant name, date of surgery. Most consent forms contained abbreviations and some did not provide all details. Additional criteria specific to Oral and Maxillofacial Surgery scored poorly. In the 2nd Audit for loop completion, excellent documentation was seen in almost all essential and additional criteria. Mean percentage of data point inclusion improved from 84.6 to 98.4 % (0.001< P value <0.005). The use of abbreviations was seen in only 6 notes. Regular audits are now considered a mandatory quality improvement process that seeks to improve patient care and outcomes. To the best of our knowledge, this is the first completed audit on operation notes documentation in Oral and Maxillofacial Surgery from India. The introduction of a computerized operation note proforma showed excellent improvement in operation note documentation. Surgeons can follow the RCS guidelines to ensure standardization of operation notes.

Maxillofacial Fractures and Dental Trauma in a High School Soccer Goalkeeper: A Case Report

PubMed Central

Mihalik, Jason P; Myers, Joseph B; Sell, Timothy C; Anish, Eric J

2005-01-01

Objective: To present the case of a 17-year-old male soccer goalkeeper who sustained maxillofacial fractures and dental trauma after being struck in the face by an opponent's knee. Background: Because of the nature of the sport and a lack of protective headgear, soccer players are at risk for sustaining maxillofacial trauma. Facial injuries can complicate the routine management of on-field medical emergencies often encountered by certified athletic trainers. The appropriate management of maxillofacial trauma on the playing field may help to reduce both the immediate and long-term morbidity and mortality associated with these injuries. Differential Diagnosis: Lacerated superior labial artery, lacerated upper lip, dental fractures, maxillofacial fractures, orbital blowout fracture, closed head injury, cervical spine injury, cerebrovascular accident. Treatment: The athlete received immediate on-field medical care and was subsequently transported to the hospital, where diagnostic testing was performed and further treatment was provided. Hospital inpatient management included dental and plastic surgery. After discharge from the hospital, the athlete underwent several additional dental procedures, including gingival surgery and nonsurgical endodontic treatments. The fractures were followed closely to assure that adequate healing had occurred. The athlete did not return to soccer. Uniqueness: Certified athletic trainers need to be prepared for on-field medical emergencies. Bleeding associated with maxillofacial trauma can complicate basic medical interventions such as airway maintenance. Inappropriate on-field management may result in unnecessary morbidity and mortality for the injured athlete. Therefore, immediate recognition of the severity of the injury is needed in order to institute appropriate airway-management strategies. Conclusions: It is sometimes necessary to consider nonstandard methods of airway management in order to first address heavy bleeding that may be associated with facial trauma. Achieving hemostasis is essential in order to prevent potentially life-threatening complications related to hemorrhage, such as airway obstruction and hypovolemic shock. PMID:15970958

Dental student perceptions of oral and maxillofacial surgery as a specialty.

PubMed

Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

2013-05-01

The specialty of oral and maxillofacial surgery (OMS) encompasses the diagnosis and surgical management of a variety of pathologic, functional, and esthetic conditions of the oral and maxillofacial region. Despite the specialty's prominent role in the field of dentistry, a lack of complete understanding still remains among dental and medical health professionals as to the exact scope and expertise of the oral and maxillofacial surgeon. The present study aimed to analyze a population of dental students' perceptions of OMS as a specialty with respect to treatment rendered, referral patterns, and a general opinion of the specialty as a whole. A survey consisting of 10 multiple-choice questions was compiled and distributed to dental students through an on-line polling service (SurveyMonkey). A total of 5 dental student classes at a single dental school were polled using school-based electronic mail, including the graduating seniors. All answers were kept confidential, and no individual students were identified. The students were not able to retake the survey once completed. The final tallies of the survey results were compiled and submitted for statistical analysis. Statistically significant associations between the year of dental education and student perceptions of OMS were determined. As dental students progress through their undergraduate studies, their perceptions change with regard to the referral of dental implants. Periodontists were found to have statistically significantly greater rates of referral than oral and maxillofacial surgeons from dental students in the fourth year and recent graduates compared with younger dental students from the first, second, and third years for placement of dental implants. Statistically insignificant in terms of a changing dental student perception was the finding that third molar removal was within the domain of the oral and maxillofacial surgeon, as well as the management of cleft lip and palate deformities and mandibular fracture repair. Almost all the dental classes believed that the specialty of OMS was both medical and dental in nature and that it is a very important dental specialty. Dental student perceptions of OMS change throughout their undergraduate training. The reasons for such a change are multivariate and might include factors such as the amount of didactic training and clinical exposure. It is vital to both recognize and address this change at an undergraduate level of training in an effort to increase educated referrals to a surgeon who might provide the best treatment options for the patient. A stronger understanding of the dental students' perception of OMS provides an opportunity for the oral and maxillofacial academic faculty to better educate students and, ultimately, strengthen our specialty. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Clinical phase I/II research on ultrasound thermo-chemotherapy in oral and maxillofacial-head and neck carcinoma

NASA Astrophysics Data System (ADS)

Shen, Guofeng; Ren, Guoxin; Guo, Wei; Chen, Yazhu

2012-11-01

The principle of a ultrasound thermo-chemotherapy instrument and the clinical phase I/II research on short-term and long-term therapeutic effect and main side-effect of ultrasound hyperthermia combined with chemotherapy in oral and maxillofacial-head & neck carcinoma by the instrument will be presented in this paper.

Submental Orotracheal Intubation in Maxillofacial Fracture Surgery: Report of Two Cases

PubMed Central

Tekelioğlu, Ümit Yaşar; Karabekmez, Furkan Erol; Demirhan, Abdullah; Akkaya, Akcan; Bayır, Hakan; Koçoğlu, Hasan

2013-01-01

Two patients, aged 18 and 28 years, with maxillofacial trauma due to motor vehicle accident, were operated upon by a team of plastic surgeons. In this report we aimed to present our experience with submental intubation procedure in these cases, in which orotracheal or nasotracheal intubation was impossible due to panfacial fracture. PMID:27366379

Tissue differentiation by diffuse reflectance spectroscopy for automated oral and maxillofacial laser surgery: ex vivo pilot study

NASA Astrophysics Data System (ADS)

Zam, Azhar; Stelzle, Florian; Tangermann-Gerk, Katja; Adler, Werner; Nkenke, Emeka; Schmidt, Michael; Douplik, Alexandre

2010-02-01

Remote laser surgery lacks of haptic feedback during the laser ablation of tissue. Hence, there is a risk of iatrogenic damage or destruction of anatomical structures like nerves or salivary glands. Diffuse reflectance spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from seven various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the seven tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerves and salivary glands as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating tissues as guidance for oral and maxillofacial laser surgery by means of diffuse reflectance.

Intranasal tooth: ectopic eruption 1 year after maxillofacial trauma

PubMed Central

Agrawal, Mamta; Khan, Tayyeb Sultan; Gupta, Tulika; Khanna, Shally

2014-01-01

Injury to the permanent central incisors due to trauma in the maxillofacial region, though common, may result in an uncommon sequel. We report a case of traumatic injury in a 5-year-old child with displacement of the tooth bud into the nasal floor. The identification of ectopic tooth buds poses little diagnostic challenge due to the available imaging facilities, however, in the present case the ectopic bud remained unnoticed and resulted in ectopic eruption of the tooth in the nasal cavity 1 year later. This report highlights a rare case of nasal eruption of a permanent tooth and places stress on the need for close attention to detail during maxillofacial trauma for early detection and proper management. PMID:25103317

Intranasal tooth: ectopic eruption 1 year after maxillofacial trauma.

PubMed

Agrawal, Mamta; Khan, Tayyeb Sultan; Gupta, Tulika; Khanna, Shally

2014-08-06

Injury to the permanent central incisors due to trauma in the maxillofacial region, though common, may result in an uncommon sequel. We report a case of traumatic injury in a 5-year-old child with displacement of the tooth bud into the nasal floor. The identification of ectopic tooth buds poses little diagnostic challenge due to the available imaging facilities, however, in the present case the ectopic bud remained unnoticed and resulted in ectopic eruption of the tooth in the nasal cavity 1 year later. This report highlights a rare case of nasal eruption of a permanent tooth and places stress on the need for close attention to detail during maxillofacial trauma for early detection and proper management. 2014 BMJ Publishing Group Ltd.

[Guided maxillofacial surgery: Simulation and surgery aided by stereolithographic guides and custom-made miniplates.

PubMed

Philippe, B

2013-08-05

We present a new model of guided surgery, exclusively using computer assistance, from the preoperative planning of osteotomies to the actual surgery with the aid of stereolithographic cutting guides and osteosynthetic miniplates designed and made preoperatively, using custom-made titanium miniplates thanks to direct metal laser sintering. We describe the principles that guide the designing and industrial manufacturing of this new type of osteosynthesis miniplates. The surgical procedure is described step-by-step using several representative cases of dento-maxillofacial dysmorphosis. The encouraging short-term results demonstrate the wide range of application of this new technology for cranio-maxillofacial surgery, whatever the type of osteotomy performed, and for plastic reconstructive surgery. Copyright © 2013. Published by Elsevier Masson SAS.

Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature

PubMed Central

Yoav, Leiser; Abu el-Naaj, Imad

2015-01-01

Steady blood pressure within normal limits during surgery is one of the markers of the ideal and skillful anesthesia. Yet, reduced blood pressure is advantageous in some settings because it can contribute to a reduction in overall blood loss and improve the surgical field conditions. Controlled hypotension during anesthesia or hypotensive anesthesia is often used in major maxillofacial operations. Since hypotensive anesthesia carries the risk of hypoperfusion to important organs and tissues, mainly the brain, heart, and kidneys, it cannot be applied safely in all patients. In this paper we review the medical literature regarding hypotensive anesthesia during major maxillofacial surgery, the means to achieve it, and the risks and benefits of this technique, in comparison to normotensive anesthesia. PMID:25811042

Use of bioreactors in maxillofacial tissue engineering.

PubMed

Depprich, Rita; Handschel, Jörg; Wiesmann, Hans-Peter; Jäsche-Meyer, Janine; Meyer, Ulrich

2008-07-01

Engineering of various oral tissues is a challenging issue in contemporary maxillofacial reconstructive research. In contrast to the classic biomaterial approach, tissue engineering is based on the understanding of cell driven tissue formation, and aims to generate new functional tissues, rather than just to implant non-living space holders. Researchers hope to reach this goal by combining knowledge from biology, physics, materials science, engineering, and medicine in an integrated manner. Several major technical advances have been made in this field during the last decade, and clinical application is at the stage of first clinical trials. A recent limitation of extracorporally engineered cellular substitutes is the problem of growing enlarged tissues ex vivo. One of the main research topics is therefore to scale up artificial tissue constructs for use in extended defect situations. To overcome the monolayer inherent two-dimensional cell assembly, efforts have been made to grow cells in a three-dimensional space. Bioreactors have therefore been in focus for a considerable time to build up enlarged tissues. The shift from the ex vivo approach of cell multiplication to the generation of a real tissue growth is mirrored by the development of bioreactors, enabling scientists to grow more complex tissue constructs. This present review intends to provide an overview of the current state of art in maxillofacial tissue engineering by the use of bioreactors, its limitations and hopes, as well as the future research trends.

"Flipped classrooms" in training in maxillofacial surgery: preparation before the traditional didactic lecture?

PubMed

Elledge, Ross; Houlton, Samantha; Hackett, Stephanie; Evans, Martin J

2018-04-28

While virtual learning environments (VLE) can be used in medical education as stand-alone educational interventions, they can also be used in preparation for traditional "face-to-face" training sessions as part of a "flipped classroom" model. We sought to evaluate the introduction of this model in a single module on maxillofacial radiology from a course on trauma skills. Course delegates were randomised into two groups: one was given access to an e-learning resource (test group) and the other attended a traditional didactic lecture (control group). Knowledge and confidence were assessed before and after the course with a 20-question single-best-answer paper and a 10-situation 100mm visual analogue scale (VAS) paper, respectively. All participants were then given free access to the VLE for 30days and were invited to take part in an e-survey. Neither group showed improvements in the single-best-answer scores, but both groups showed comparable improvements in VAS (control: median (range) values improved from 40.8 (17.7-82.5) mm to 62.8 (35.3-88.7) mm, p=0.001; test group: from 47.7 (10.9-58.1) mm to 60.5 (32.4-75.6) mm, p=0.005). Half of the respondents stated that they preferred the "flipped classroom" approach, and 22/22 stated that they would be "likely" or "very likely" to use an e-learning resource with expanded content. The "flipped classroom" approach was well received and there were comparable improvements in confidence. As maxillofacial radiology lends itself to online instruction with its reliance on the recognition of patterns, and problem-based approach to learning, a piloted e-learning resource could be developed in this area. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Conservative orthodontic treatment of mandibular bilateral condyle fracture.

PubMed

Gašpar, Goran; Brakus, Ivan; Kovačić, Ivan

2014-09-01

Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis.

Preparation of an Adhesive in Emulsion for Maxillofacial Prosthetic

PubMed Central

Sánchez-García, Judith A.; Ortega, Alejandra; Barceló-Santana, Federico H.; Palacios-Alquisira, Joaquín

2010-01-01

Maxillofacial prostheses is a dental medicine specialty aimed at restoring anatomical facial defects caused by cancer, trauma or congenital malformations through an artificial device, which is commonly attached to the skin with the help of an adhesive. The purpose of our research was to develop a pressure-sensitive adhesive (PSA) based on acrylic monomers, characterizing and determining its drying kinetics, that is to say the time it takes to lose 50 to 90% of its moisture. The adhesive synthesis was realized by means of emulsion polymerization; the composition of formulations was: (AA-MMA-EA) and (AA-MMA-2EHA) with different molar ratios. The formulation based on (AA-MMA-2EHA) with 50 w% of solids, presented good adhesive properties such as tack, bond strength, and short drying time. We propose this formulation as a PSA, because it offers an alternative for systemically compromised patients, by less irritation compared to organic solvent-based adhesives. PMID:21152308

A review of haptic simulator for oral and maxillofacial surgery based on virtual reality.

PubMed

Chen, Xiaojun; Hu, Junlei

2018-06-01

Traditional medical training in oral and maxillofacial surgery (OMFS) may be limited by its low efficiency and high price due to the shortage of cadaver resources. With the combination of visual rendering and feedback force, surgery simulators become increasingly popular in hospitals and medical schools as an alternative to the traditional training. Areas covered: The major goal of this review is to provide a comprehensive reference source of current and future developments of haptic OMFS simulators based on virtual reality (VR) for relevant researchers. Expert commentary: Visual rendering, haptic rendering, tissue deformation, and evaluation are key components of haptic surgery simulator based on VR. Compared with traditional medical training, virtual and tactical fusion of virtual environment in surgery simulator enables considerably vivid sensation, and the operators have more opportunities to practice surgical skills and receive objective evaluation as reference.

[Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)].

PubMed

Agudelo-Suárez, Andrés A; Duque-Serna, Francisco Levi; Restrepo-Molina, Lucas; Martínez-Herrera, Eliana

2015-09-01

To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Do Quantitative Measures of Research Productivity Correlate with Academic Rank in Oral and Maxillofacial Surgery?

PubMed

Susarla, Srinivas M; Dodson, Thomas B; Lopez, Joseph; Swanson, Edward W; Calotta, Nicholas; Peacock, Zachary S

2015-08-01

Academic promotion is linked to research productivity. The purpose of this study was to assess the correlation between quantitative measures of academic productivity and academic rank among academic oral and maxillofacial surgeons. This was a cross-sectional study of full-time academic oral and maxillofacial surgeons in the United States. The predictor variables were categorized as demographic (gender, medical degree, research doctorate, other advanced degree) and quantitative measures of academic productivity (total number of publications, total number of citations, maximum number of citations for a single article, I-10 index [number of publications with ≥ 10 citations], and h-index [number of publications h with ≥ h citations each]). The outcome variable was current academic rank (instructor, assistant professor, associate professor, professor, or endowed professor). Descriptive, bivariate, and multiple regression statistics were computed to evaluate associations between the predictors and academic rank. Receiver-operator characteristic curves were computed to identify thresholds for academic promotion. The sample consisted of 324 academic oral and maxillofacial surgeons, of whom 11.7% were female, 40% had medical degrees, and 8% had research doctorates. The h-index was the most strongly correlated with academic rank (ρ = 0.62, p < 0.001). H-indexes of ≥ 4, ≥ 8, and ≥ 13 were identified as thresholds for promotion to associate professor, professor, and endowed professor, respectively (p < 0.001). This study found that the h-index was strongly correlated with academic rank among oral and maxillofacial surgery faculty members and thus suggests that promotions committees should consider using the h-index as an additional method to assess research activity.

Surgeon Reimbursements in Maxillofacial Trauma Surgery: Effect of the Affordable Care Act in Ohio.

PubMed

Khansa, Ibrahim; Khansa, Lara; Pearson, Gregory D

2016-02-01

Surgical treatment of maxillofacial injuries has historically been associated with low reimbursements, mainly because of the high proportion of uninsured patients. The Affordable Care Act, implemented in January of 2014, aimed to reduce the number of uninsured. If the Affordable Care Act achieves this goal, surgeons may benefit from improved reimbursement rates. The authors' purpose was to evaluate the effects of the Affordable Care Act on payor distribution and surgeon reimbursements for maxillofacial trauma surgery at their institution. A review of all patients undergoing surgery for maxillofacial trauma between January of 2012 and December of 2014 was conducted. Insurance status, and amounts billed and collected by the surgeon, were recorded. Patients treated before implementation of the Affordable Care Act were compared to those treated after. Five hundred twenty-three patients were analyzed. Three hundred thirty-four underwent surgery before implementation of the Affordable Care Act, and 189 patients underwent surgery after. After implementation of the Affordable Care Act, the proportion of uninsured decreased (27.2 percent to 11.1 percent; p < 0.001) and the proportion of patients on Medicaid increased (7.8 percent to 25.4 percent; p < 0.001). Overall surgeon reimbursement rate increased from 14.3 percent to 19.8 percent (p < 0.001). After implementation of the Affordable Care Act, we observed a significant reduction in the proportion of maxillofacial trauma patients who were uninsured. Surgeons' overall reimbursement rate increased. These trends should be followed over a longer term to determine the full effect of the Affordable Care Act.

Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis.

PubMed

Nkenke, Emeka; Seemann, Rudolf; Vairaktaris, Elefterios; Schaller, Hans-Günter; Rohde, Maximilian; Stelzle, Florian; Knipfer, Christian

2015-07-01

The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users.

PubMed

Goulart, Douglas Rangel; Durante, Letícia; de Moraes, Márcio; Asprino, Luciana

2015-11-01

The aim of the current study was to identify and compare the characteristics of maxillofacial trauma in alcohol and drug users with those of nonusers. A retrospective study was conducted using the medical records of patients treated for facial trauma between April 1999 and March 2012 at the Maxillofacial Surgery Division of the Piracicaba Dental School. The data were analyzed by descriptive analysis, binary logistic regression, and correlational analysis using SPSS 18.0 software. The results were considered relevant at P < 0.05. Medical records of 3724 patients with facial trauma were analyzed, of which 173 were illicit drug users and 19.36% reported alcohol intake. The use of illicit drugs was reported by 4.64%. The prevalent etiological factor among drug and alcohol users was interpersonal violence. The mandible was the face part most affected by fractures. Male patients exhibited increased odds of experiencing fractures (OR = 1.43), as did users of illicit drugs (OR = 1.62), when compared with nonusers. When faced with maxillofacial trauma, male drug users exhibited an increased chance of experiencing fractures. This knowledge should be used as a baseline to implement more efficient prevention strategies for this population.

Oral Surgical Procedures Performed Safely in Patients With Head and Neck Arteriovenous Malformations: A Retrospective Case Series of 12 Patients.

PubMed

Karim, Abdul Basit; Lindsey, Sean; Bovino, Brian; Berenstein, Alejandro

2016-02-01

This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents. Direct puncture sclerotherapy at the base of surgical sites was performed using Surgiflo or n-butylcyanoacrylate glue. Surgical procedures were carried out in routine fashion. A hemostatic packing of FloSeal, Gelfoam, and Avitene was adapted to the surgical sites. Direct puncture sclerotherapy with Surgiflo or n-butylcyanoacrylate glue resulted in minimal blood loss intraoperatively. Local application of the FloSeal, Gelfoam, and Avitene packing sustained hemostasis and produced excellent healing postoperatively. Patients with arteriovenous malformations can safely undergo routine oral and maxillofacial surgical procedures with minimal blood loss when appropriate endovascular techniques and local hemostatic measures are used by the interventional radiologist and oral and maxillofacial surgeon. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The routine use of pediatric airway exchange catheter after extubation of adult patients who have undergone maxillofacial or major neck surgery: a clinical observational study.

PubMed

Dosemeci, Levent; Yilmaz, Murat; Yegin, Arif; Cengiz, Melike; Ramazanoglu, Atilla

2004-12-01

We conducted the present study to determine the usefulness of routinely inserting a pediatric airway exchange catheter (PAEC) before tracheal extubation of adult patients who had undergone maxillofacial or major neck surgery and have risk factors for difficult reintubation. A prospective, observational and clinical study was performed in the 25-bed general intensive care unit of a university hospital. Thirty-six adult patients who underwent maxillofacial or major neck surgery and had risk factors for difficult reintubation were extubated after insertion of the PAEC. Four of 36 (11.1%) patients required emergency reintubation after 2, 4, 6 and 18 hours after tracheal extubation, respectively. Reintubation of these patients, which was thought to be nearly impossible by direct laryngoscopy, was easily achieved over the PAEC. The PAEC can be a life-saving device during reintubation of patients with risk factors for difficult reintubation such as laryngeo-pharyngeal oedema due to surgical manipulation or airway obstruction resulting from haematoma and anatomic changes. We therefore suggest the routine use of the PAEC in patients undergoing major maxillofacial or major neck surgery.

TPS-guided interstitial Iodine-125 implantation in patients with oral cavity and maxillofacial carcinomas.

PubMed

Meng, J; Zhang, J; Zhuang, Q-W; Wang, X; Li, Z-P; Gu, Q-P

2014-10-01

To investigate the efficacy as well as the complications involved in the use of interstitial Iodine-125 implantation for the treatment of oral cavity and maxillofacial carcinomas. Fifteen patients with oral cavity and maxillofacial carcinomas received treatment planning system (TPS)-guided interstitial Iodine-125 implantation. The apparent activity per particle ranged from 0.6 mCi (2.22MBq) to 0.7 mCi (2.59MBq). The matched peripheral dose delivered by radioactive seeds ranged from 90 to 120 Gy. The efficacy of the treatment and the postoperative complications were evaluated during follow-up. The seeds were implanted successfully in all 15 patients and median number of seeds implanted was 36.53. CT scans were performed in all patients at 1-6 months postoperatively. During follow-up at 6-27 months, seed migration occurred and a good local tumor control was achieved with an overall response of 86.7%. No severe side effects were observed. TPS-guided interstitial Iodine-125 implantation is an effective and safe procedure with minimal invasiveness for the treatment of oral cavity and maxillofacial carcinomas, and it effectively prevents the recurrence of cancer and short-term lymphatic metastasis.

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

PubMed

Dos Santos, Denise Takehana; Costa e Silva, Adriana Paula Andrade; Vannier, Michael Walter; Cavalcanti, Marcelo Gusmão Paraiso

2004-12-01

The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

Adhesion of maxillofacial silicone elastomer to a fiber-reinforced composite resin framework.

PubMed

Kantola, Rosita; Lassila, Lippo; Vallittu, Pekka

2011-01-01

Recently, fiber-reinforced composite resin (FRC) has been introduced as a framework material for maxillofacial silicone prostheses. The purpose of this research was to study the tensile bond strength between a room temperature-polymerized maxillofacial silicone elastomer and a unidirectional FRC. Three different bonding agents were compared. Specimens were loaded in tension mode according to ISO 22401 in a universal testing device with a crosshead speed of 10 mm/min until bonding failure occurred. The influence of the surface characteristics (ground vs intact) was also studied. The highest tensile bond strength was seen with Gold Platinum Primer A-330-G, followed by Sofreliner primer. One-way analysis of variance revealed that the surface treatment of the FRC and the adhesive used had a significant effect on tensile bond strength between silicone and FRC (P < .05). Grinding enhanced adhesion, especially with Gold Platinum Primer A-330-G and Sofreliner primer. The fracture type also changed to more cohesive in nature. The FRC substructure can successfully be bonded to maxillofacial silicone elastomer by using primer containing methyl ethyl ketone and dichloromethane solvent. Bonding can be improved by roughening the FRC substrate via grinding.

Computer-aided trauma simulation system with haptic feedback is easy and fast for oral-maxillofacial surgeons to learn and use.

PubMed

Schvartzman, Sara C; Silva, Rebeka; Salisbury, Ken; Gaudilliere, Dyani; Girod, Sabine

2014-10-01

Computer-assisted surgical (CAS) planning tools have become widely available in craniomaxillofacial surgery, but are time consuming and often require professional technical assistance to simulate a case. An initial oral and maxillofacial (OM) surgical user experience was evaluated with a newly developed CAS system featuring a bimanual sense of touch (haptic). Three volunteer OM surgeons received a 5-minute verbal introduction to the use of a newly developed haptic-enabled planning system. The surgeons were instructed to simulate mandibular fracture reductions of 3 clinical cases, within a 15-minute time limit and without a time limit, and complete a questionnaire to assess their subjective experience with the system. Standard landmarks and linear and angular measurements between the simulated results and the actual surgical outcome were compared. After the 5-minute instruction, all 3 surgeons were able to use the system independently. The analysis of standardized anatomic measurements showed that the simulation results within a 15-minute time limit were not significantly different from those without a time limit. Mean differences between measurements of surgical and simulated fracture reductions were within current resolution limitations in collision detection, segmentation of computed tomographic scans, and haptic devices. All 3 surgeons reported that the system was easy to learn and use and that they would be comfortable integrating it into their daily clinical practice for trauma cases. A CAS system with a haptic interface that capitalizes on touch and force feedback experience similar to operative procedures is fast and easy for OM surgeons to learn and use. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

Oral, Maxillofacial and Dental Diseases in Captive Cheetahs (Acinonyx jubatus).

PubMed

Steenkamp, G; Boy, S C; van Staden, P J; Bester, M N

2018-01-01

Descriptions of several oral, maxillofacial and dental conditions/diseases exist for a variety of captive large felids, but little is reported on the pathology of free roaming large felids. Apart from focal palatine erosions (FPEs) as initially described by Fitch and Fagan (1982) and some reference to absent incisor teeth, few data exist on diseases affecting the oral, maxillofacial and dental structures of cheetahs (Acinonyx jubatus), regardless of their captivity status. This study reports 18 different conditions affecting the teeth, bone and oral cavity soft tissue of cheetahs, based on initial assessment of 256 animals over 11 years (2002-2012) in South Africa and Namibia. This report excludes oral tumours or FPEs, but includes several acquired and developmental conditions never described before. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tissue Engineering: Step Ahead in Maxillofacial Reconstruction.

PubMed

Rai, Raj; Raval, Rushik; Khandeparker, Rakshit Vijay Sinai; Chidrawar, Swati K; Khan, Abdul Ahad; Ganpat, Makne Sachin

2015-09-01

Within the precedent decade, a new field of "tissue engineering" or "tissue regeneration" emerge that offers an innovative and exhilarating substitute for maxillofacial reconstruction. It offers a new option to supplement existing treatment regimens for reconstruction/regeneration of the oral and craniofacial complex, which includes the teeth, periodontium, bones, soft tissues (oral mucosa, conjunctiva, skin), salivary glands, and the temporomandibular joint (bone and cartilage), as well as blood vessels, muscles, tendons, and nerves. Tissue engineering is based on harvesting the stem cells which are having potential to form an organ. Harvested cells are then transferred into scaffolds that are manufactured in a laboratory to resemble the structure of the desired tissue to be replaced. This article reviews the principles of tissue engineering and its various applications in oral and maxillofacial surgery.

[Evaluation of flipped classroom teaching model in undergraduates education of oral and maxillofacial surgery].

PubMed

Cai, Ming; Cao, Xia; Fang, Xiao; Wang, Xu-dong; Zhang, Li-li; Zheng, Jia-wei; Shen, Guo-fang

2015-12-01

Flipped classroom is a new teaching model which is different from the traditional teaching method. The history and characteristics of flipped classroom teaching model were introduced in this paper. A discussion on how to establish flipped classroom teaching protocol in oral and maxillofacial surgery education was carried out. Curriculum transformation, construction of education model and possible challenges were analyzed and discussed.

[COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER].

PubMed

Yang, Heping; Zhang, Hongwu; Chen, Haidi; Yang, Shuxiong; Wang, Jun; Hu, Dawang

2016-04-01

To compare the effectiveness of complex defects repair between using chimeric anterolateral thigh flap and series-wound flaps after resection of oral and maxillofacial cancer. After resection of oral and maxillofacial cancer, defect was repaired with chimeric anterolateral thigh flap in 39 patients between January 2011 and July 2014 (chimeric anterolateral thigh flap group); and defect was repaired with series-wound flaps in 35 patients between January 2009 and December 2010 (series-wound flaps group). There was no significant difference in gender, age, duration of disease, tumor type, tumor staging, defect location, and defect area between 2 groups (P > 0.05). The operation time, flap harvesting and microvascular anastomosis time, stomach tube extraction time, and oral feeding time were recorded and compared between 2 groups, and postoperative complications were observed; the effectiveness was evaluated according to clinical efficacy evaluation table of bone and soft tissue defects reconstruction surgery in oral and maxillofacial region. Vascular crisis occurred in 2 cases of chimeric anterolateral thigh flap group, and 4 cases of series-wound flaps group. Partial necrosis appeared at distal end of a series-wound flaps, and oral fistula and infection developed in 3 series-wound flaps. The other flaps and the grafted skin at donor site survived; wounds at recipient site healed by first intention. The operation time, stomach tube extraction time, and oral feeding time of chimeric anterolateral thigh flap group were significantly shorter than those of series-wound flaps group (P < 0.05), while the flap harvesting and microvascular anastomosis time was significantly longer than that of series-wound flaps group (P < 0.05). The patients were followed up 1-5 years (mean, 2.5 years). At 3 months after operation, the appearance, patients' satisfaction, working conditions, oral closure function, chew, language performance, and swallowing scores of the chimeric anterolateral thigh-flap group were significantly better than those of the series-wound flaps group (P < 0.05), while there was no significant difference in diet, mouth opening degree, oral cavity holding water test, and occlusion scores between the 2 groups (P > 0.05). Using chimeric anterolateral thigh flap for defect repair after resection of oral and maxillofacial cancer can significantly shorten the operation time, accelerate postoperative rehabilitation, and help the functional recovery of oral closure, chewing, language performance, swallowing function when compared with the series-wound flaps.

Quality management and work environment in Swedish oral and maxillofacial surgery.

PubMed

Pilgård, Göran

2009-01-01

This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. Explore the opinion of the employees about quality work. Describe how the employees of OMFS clinics in Sweden perceive good work, i.e., their image of the dimensions that the profession should contain to be really good work. Investigate whether there is a discrepancy between ideal and reality for this group. Describe how the employees of OMFS clinics in Sweden perceive their health. Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86%. Only at two clinics did all the respondents agree on their system. Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. There were significant differences between maxillofacial. surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not. More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant nurses had a much more positive view on the potential of quality work as a means to improve their work than had the maxillo-facial surgeons. For a majority of the dental nurses the working situation concerning the physical environment was more important than for the maxillo-facial surgeons. The employees emphasized free, influential, and intellectually stimulating work, but the dissonance between ideal and reality was rather wide concerning good work. OMFS employees are feeling unhealthy, but no worse than other high-risk-groups in human service working and better than female general practice dentists. The women of OMFS employees feel worse than the men.

Role of the maxillofacial surgeon in the management of severe ocular injuries after maxillofacial fractures

PubMed Central

Roccia, Fabio; Boffano, Paolo; Guglielmi, Valeria; Forni, Paolo; Cassarino, Emanuele; Nadalin, Juri; Fea, Antonio; Gerbino, Giovanni

2011-01-01

Aim: This study was designed to evaluate the incidence of severe ocular injuries associated to maxillofacial fractures and report their management in the Emergency Department. Patients and Methods: Among the 1779 patients admitted for maxillofacial fractures, those with partial or total loss of vision at the time of emergency consultation were included in the study. Data collected from the patients’ medical records included age, gender, mechanism of injury, location and type of facial fractures, type of ocular injuries and cause of blindness, methods of treatment, and days of hospitalization. Results: Forty patients (2.2%), 32 men and 8 women, ranging from 17 to 85 years of age, presented with severely reduced vision or blindness associated to fractures of the facial middle third with involvement of one or more orbital walls, mainly caused by motor vehicle and work accidents. In 18 patients, severe ocular injuries were determined by direct lesion of the globe, in 14 by direct or indirect traumatic optic neuropathy and in 8 by a retrobulbar hematoma. Direct lesion of the eyeball was treated by prompt repair or enucleation of the globe, though no or little recovery of vision was obtained. Ophthalmologic and/or maxillofacial treatment of the anterior compartment lesions of the eye allowed a partial or total recovery of the vision. A partial or total recovery of the vision was observed in almost all the patients with indirect traumatic optic neuropathy after administration of steroids according to NASCIS II protocol. Likewise, an evident improvement of the vision was obtained by immediate drainage of retrobulbar hematoma. Conclusions: Early diagnosis of the nature of the ophthalmic injury and treatment are important, and involvement of the ophthalmologist is mandatory. PMID:21769204

Management of oral and maxillofacial infections in a regional unit: a seven day service?

PubMed

Cabral, Marta; Kapasi, Farhana T; Ameerally, Phillip

2018-05-24

The provision of a seven-day National Health Service (NHS) has been proposed as a means to halt the weekend delay in treatment that has been described in some studies. We tested the emergency services in the Oral and Maxillofacial Surgery Department at Northampton General Hospital to find out whether they provided a seven-day service. Data were collected prospectively and retrospectively for all patients admitted to the Oral and Maxillofacial Department at Northampton General Hospital with infections of the head and neck during a period of 29months (January 2014-May 2016). Duration of hospital stay and waiting time for operation were compared for weekday and weekend admissions to find out if there were changes in either outcomes or waiting times. The severity of infection between the two periods was also assessed using the serum C reactive protein (CRP) concentration as a marker. A total of 293 patients were admitted with head and neck infections, and the mean (range) duration of stay for those admitted on weekdays was 3 (1-14) days and for patients admitted at a weekend was 3 (1-17) days (p=0.14). However, the waiting times for operation were significantly longer during the week (mean (range) 0.6 (0-8) days) than at the weekend (0.5 (0-3) days, p=0.04). We know of no other published studies about provision of a seven-day service in oral and maxillofacial surgery. Our results show that we are already working to that standard, and this raises the question of whether any changes are required to current practice in the NHS, with their associated costs and upheaval. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Usefulness of myofascial flap without skin in contemporary oral and maxillofacial reconstruction.

PubMed

Wada, Takeshi; Nakatani, Ken; Hiraishi, Yukihiro; Negoro, Kenji; Iwagami, Yoshinobu; Fujita, Shigeyuki

2011-06-01

Pedicle myofascial graft should be considered in contemporary oral and maxillofacial reconstruction for the following reasons: 1) the pedicle myofascial unit is reliable and easily handled; 2) on the grafted myofascia in the oral cavity, the mucosa regenerates naturally with regard to suppleness and surface characteristics; and 3) vascularized myofascial coverage of tissues or materials is useful in some clinical situations. The purpose of this retrospective study was to evaluate the usefulness of this graft material. Using myofascial flaps from the pectoralis major muscle in 15 patients and from the platysma muscle in 11 patients, several types of reconstructive procedures were conducted in the Department of Oral and Maxillofacial Surgery, Wakayama Medical University. Myofascial tissue was used to cover the surgical defect and for regeneration of oral mucosa (24 patients), to prevent exposure of the mandibular reconstruction plate (4 patients), for prevention of wound breakdown and secondary infection in the oral cavity (2 patients), for vascularized coverage of free grafted autologous bone (2 patients), and for protection of large vessels after radical neck dissection (9 patients). Although partial flap necrosis or wound dehiscence was noticed in 3 patients with a platysma-myofascial graft, the healing process of all patients was favorable and required no additional operations. This procedure is most suitable for the reconstruction of small to medium-sized soft tissue defects in the oral cavity, because it induces the formation of nearly normal mucosa through epithelial regeneration without clear scar formation. Myofascial flap is a useful option in certain oral and maxillofacial reconstruction cases in which mucosal regeneration and/or vascularized soft tissue coverage are required. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study

PubMed Central

Bali, Rishi K.; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

2013-01-01

Aims: The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. Materials and Methods: This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inion CPS) using standard plating principles and observed for a total period of 24 weeks. Characteristics of the fractures, ease of use of bioresorbable plate/screw system and post operative complications were assessed. Results: Of total 10 patients, eight patients were of midface fracture and two pediatric patients with mandibular fracture, with nine male and one female. The mean age was 32.8 years. Out of 20 plates and 68 screws applied to the 10 fractures sites; there were three incidences of screw breakage with no other intraoperative difficulties. Paresthesia of the infraorbital nerve was present in two patients, and recovered completely in four weeks after surgery. Fracture reduction was considered to be satisfactory in all cases. One patient developed postsurgical infection and was managed with oral antibiotics and analgesics. Conclusions: Favorable healing can be observed through the use of biodegradable plates and screws to stabilize selected midface fractures in patients of all ages, as well as mandible fractures in early childhood, however further studies with more sample size are required. PMID:24665170

To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study.

PubMed

Bali, Rishi K; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

2013-07-01

The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inion CPS) using standard plating principles and observed for a total period of 24 weeks. Characteristics of the fractures, ease of use of bioresorbable plate/screw system and post operative complications were assessed. Of total 10 patients, eight patients were of midface fracture and two pediatric patients with mandibular fracture, with nine male and one female. The mean age was 32.8 years. Out of 20 plates and 68 screws applied to the 10 fractures sites; there were three incidences of screw breakage with no other intraoperative difficulties. Paresthesia of the infraorbital nerve was present in two patients, and recovered completely in four weeks after surgery. Fracture reduction was considered to be satisfactory in all cases. One patient developed postsurgical infection and was managed with oral antibiotics and analgesics. Favorable healing can be observed through the use of biodegradable plates and screws to stabilize selected midface fractures in patients of all ages, as well as mandible fractures in early childhood, however further studies with more sample size are required.

Singly-qualified medical senior house officer in oral and maxillofacial surgery: perspectives from a unit.

PubMed

Solanki, Kohmal; Bhatti, Nabeel; Bridle, Christopher

2016-06-01

Despite constituting a minority of senior house officers (SHO) in oral and maxillofacial surgery (OMFS), the number of singly-qualified medical trainees is growing. We describe the experience of a singly qualified medical trainee in OMFS and the unique benefits and opportunities for potential trainees and the department. Overall, the advantages of synergistic training outweigh any deficiencies in knowledge, and in our experience, having both medical and dental trainees in our unit has maximised training opportunities and provided a more holistic approach to patient care. Increased exposure to conditions in the head and neck also benefits trainees who wish to pursue careers in other specialties such as ear, nose, and throat (ENT), neurosurgery, ophthalmology, and plastic surgery. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

PubMed

Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

2008-09-01

We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

Precautions against cross-infection during operations for maxillofacial trauma.

PubMed

Pigadas, N; Avery, C M

2000-04-01

One hundred oral and maxillofacial units in the UK were sent a postal questionnaire. Surgical staff of all grades were asked which infection-control measures were taken during the treatment of maxillofacial fractures. Two hundred and ninety-four questionnaires were completed, a response rate of 49%. If the patient was known to be infected by a blood-borne viral disease, significantly more surgeons used standard barrier precautions such as eye protection, fluid-resistant gowns, drapes, ball-ended clips, adhesive tapes and intermediate trays (P<0.0001). Bone-plating techniques were used in preference to wire osteosynthesis (P<0.0001). Only 31 (10.5%) of surgeons routinely used double gloves but 250 (85%) did so if the patient was an infection risk (P<0.0001). Universal precautions were not applied equally to all patients. Copyright 2000.

[Dento-facial orthopedics and kinesthetic therapy: partners in patient management].

PubMed

Alvarado-Faysse, Caroline

2014-09-01

Orthodontic treatment alone, or combined with maxillo-facial surgery, can benefit from a kinesthetic therapy approach. This method of functional management, set in place as soon as the orthodontic diagnosis is made, will allow for a comprehensive therapeutic approach to patients, marked by a dialogue, between the different players involved in treatment, orthodontists and maxillofacial surgeons who intelligently work in concert. © EDP Sciences, SFODF, 2014.

Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries

DTIC Science & Technology

2011-08-01

REVIEW ARTICLE Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries Kyle Petersen, DO, FACP, FIDSA...Marcus H Colyer, MD, David K. Hayes, MD, FACS, Robert G. Hale, DDS, R. B1yan Bell, DDS, MD, FACS, and the Prevention of Combat-Related Infections ...article reviews recent data from military and civilian studies to support evidence-based recommendations for the prevention of infections associated

Applications of cone beam computed tomography for a prosthodontist.

PubMed

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R B

2016-01-01

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.

Clinical Comparison of Scapular, Fibular, and Iliac Crest Osseal Free Flaps in Maxillofacial Reconstructions.

PubMed

Wilkman, T; Husso, A; Lassus, P

2018-05-01

This study compared the three most used composite flaps in maxillofacial reconstructions in our institute. Between 2000 and 2012, a total of 163 patients with mandibular, maxillary, and orbital defects received either scapular, fibular, or iliac crest osseal reconstructions in Helsinki University Hospital, Departments of Plastic Surgery and Maxillofacial Surgery. Data regarding the patient demographics, complications, and outcomes were analyzed. There were 92 deep circumflex iliac artery flaps (56%), followed by 42 scapular (26%) and 29 fibular flaps (18%). The rate of flap loss was the highest in the deep circumflex iliac artery group (p = 0.001). Reconstructions using fibula were fastest (p = 0.001) and had lowest perioperative blood loss (p = 0.013). There were no significant differences in the number of early or late complications between the flaps, but donor site complications were more severe in deep circumflex iliac artery. Osteotomies as well as dental implants were safely performed in all flaps with equal results. All three flaps of this study can be performed with awareness of the deep circumflex iliac artery flap being the least reliable alternative. The knowledge of the advantages and disadvantages of several osseal-free flap alternatives is beneficial in selecting the best suitable method for each individual patient requiring maxillofacial osseal reconstruction.

Applications of cone beam computed tomography for a prosthodontist

PubMed Central

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.

2016-01-01

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice – from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors’ clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:27134420

[Microvascular injury effects and possibility of early anastomosis in the maxillofacial region following high velocity missile wound: an experimental study in dogs].

PubMed

Yan, Y

1990-02-01

In order to provide the basis of microvascular anastomosis for reconstruction of maxillofacial defects from firearm injury by using vascularized free tissue transplantation, we studied the mechanism and pathology of microvascular injuries and the possibility of their early anastomosis. The dogs' face were wounded by 0.7 g or 1.03 g steel spheres whose muzzle velocity were 1300 m/s or 1500 m/s. The injury effects of microvascular angiograms were recorded through high speed X-ray camera at the impacting moment the specimens of small vessel were collected for light and electron microscopy at different times after wound. Some dogs were used for performing microvascular anastomosis in the wound region at different times after wound. We found that there were temporary cavity effects in maxillofacial firearm wounds, in and around which small vessel blunt injuries were found, which spread 3 cm from the wound edge. Microvascular anastomosis 3 days after the wound could get higher shortterm patency rate. These results support the conclusion that if we use microsurgical methods to repair defects in maxillofacial firearm wound region, the pedicles of the flap should be laid beyond 3 cm from the wound edge, and the reconstructive operation should be done 3 days after the wound.

An overview on autologous fibrin glue in bone tissue engineering of maxillofacial surgery

PubMed Central

Khodakaram-Tafti, Azizollah; Mehrabani, Davood; Shaterzadeh-Yazdi, Hanieh

2017-01-01

The purpose of this review is to have an overview on the applications on the autologous fibrin glue as a bone graft substitute in maxillofacial injuries and defects. A search was conducted using the databases such as Medline or PubMed and Google Scholar for articles from 1985 to 2016. The criteria were “Autograft,” “Fibrin tissue adhesive,” “Tissue engineering,” “Maxillofacial injury,” and “Regenerative medicine.” Bone tissue engineering is a new promising approach for bone defect reconstruction. In this technique, cells are combined with three-dimensional scaffolds to provide a tissue-like structure to replace lost parts of the tissue. Fibrin as a natural scaffold, because of its biocompatibility and biodegradability, and the initial stability of the grafted stem cells is introduced as an excellent scaffold for tissue engineering. It promotes cell migration, proliferation, and matrix making through acceleration in angiogenesis. Growth factors in fibrin glue can stimulate and promote tissue repair. Autologous fibrin scaffolds are excellent candidates for tissue engineering so that they can be produced faster, cheaper, and in larger quantities. In addition, they are easy to use and the probability of viral or prion transmission may be decreased. Therefore, autologous fibrin glue appears to be promising scaffold in regenerative maxillofacial surgery. PMID:28584530

Etiopathogenesis of Mandibulofacial and Maxillofacial Abscesses in Mice

PubMed Central

2010-01-01

The etiologic agent of mandibulofacial and maxillofacial abscesses in mice is reportedly coagulase-positive Staphylococcus aureus. Although suggested to be through the oral cavity, the exact route of entry has not been documented. Among the clinical cases of mandibulofacial and maxillofacial abscess we report here, each case that was cultured yielded coagulase-positive S. aureus. Histologically, all of the abscesses examined were directly associated with intralesional hair shafts, both vibrissae and pelage, that were introduced into the submucosa via the maxillary or mandibular molar gingival sulci. Grossly, a variable amount of hair was imbedded in the lingual, buccal, or mesial gingival sulci of the maxillary or mandibular molars or both. Computed tomography revealed that the presence of the hair resulted in inflammation and resorption of alveolar bone. With these findings, we propose that mandibulofacial and maxillofacial abscesses are induced by the mastication and fragmentation of hair ingested during the barbering process. From the resulting foreign body periodontitis, abscess formation originates at the maxillary lingual, buccal, or mesial gingival sulci, resulting in infection of the maxillary molar tooth roots with swelling or rupture through the skin inferior to the eye, or at the mandibular lingual, buccal, and or mesial gingival sulci, resulting in infection of the mandibular molar tooth roots and osteomyelitis with drainage through the skin of the ventral mandible. PMID:20579435

Digital multimedia instruction enhances teaching oral and maxillofacial suturing.

PubMed

Weaver, J M; Lu, Mei; McCloskey, K L; Herndon, E S; Tanaka, W

2009-12-01

To develop digital multimedia instruction on intraoral suturing. A DVD was developed to describe instruments, materials, and techniques. Two groups of dental students were asked to close an incision in a simulated model. One used written materials only and another used additional DVD. The performance was evaluated using 10 grading criteria. Students who used the DVD performed better than students who did not. This DVD could be used widely in teaching dental students.

Development of Repair Materials for Avulsive Combat-Type Maxillofacial Injuries.

DTIC Science & Technology

1981-11-01

sone. A sample of 0.2702 grams of the resulting corn- nitic acid. tsocitric acid, alpha - ketoglutaric acid. suc- position was shaped into the form of a...polylactic acid and inorganic materials such as calcium carbonate or calcium sulfate. The chemistry of the system proposed for development includes...acid and high molecular weight poly(propylene fumarate) were synthesized at Dynatech to be used as organic fillers. Inorganic fil- lers such as calcium

Septic Arthritis of the Temporomandibular Joint--Unusual Presentations.

PubMed

Lohiya, Sapna; Dillon, Jasjit

2016-01-01

This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment. On day 30, contrast-enhanced magnetic resonance imaging (MRI) confirmed SATMJ. Incision and drainage yielded 6 mL of pus and produced clinical improvement. Cultures grew methicillin-resistant Staphylococcus aureus, which was treated with amoxicillin plus clavulanate and sulfamethoxazole plus trimethoprim for 30 days. On day 59, the patient still had slight preauricular pain and CT-proved TMJ osteoarthritic changes. A 56-year-old woman developed right-side facial pain after a crown procedure on her right mandibular second molar. Oral prednisone (and clindamycin) produced partial relief. Her primary physician suspected temporal arteritis, but its biopsy result on day 11 was normal. Gradually, the patient developed trismus and malocclusion refractory to various medicines. On day 49, she presented to the ED. A contrast-enhanced maxillofacial CT scan suggested SATMJ. Incision and drainage yielded 30 mL of pus and produced clinical improvement. During days 50 to 57, the patient received intravenous ampicillin plus sulbactam and metronidazole. However, preauricular tenderness and drainage from the surgical incision persisted. On day 55, CT scan showed a residual abscess. Secondary debridement yielded 5 mL of pus. Culture grew coagulase-negative S aureus. On day 141, the patient still had slight preauricular pain and TMJ osteoarthritic changes on MRI. In these cases, the SATMJ diagnosis was delayed owing to the mildness of local and systemic manifestations, the possibility of confounding conditions, and the rarity of SATMJ. Contrast-enhanced CT and MRI facilitated the diagnosis. Abscess drainage alleviated the symptoms. Postinfectious osteoarthritis developed possibly from treatment delay. SATMJ should be considered in all patients with enigmatic preauricular pain, trismus, or malocclusion. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Leading Others Toward Excellence.

PubMed

Hupp, James R

2015-12-01

This essay puts forth the proposition that academic program excellence does not arise by accident. Effective leadership is required. To support this proposition, the essay discusses the characteristics common to effective leaders. It then proceeds to use the example of a successful academic oral-maxillofacial surgery department and characteristics of its leader to provide evidence that excellence derives from effective leadership. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Hypnosis as a Valuable Tool for Surgical Procedures in the Oral and Maxillofacial Area.

PubMed

Montenegro, Gil; Alves, Luiza; Zaninotto, Ana Luiza; Falcão, Denise Pinheiro; de Amorim, Rivadávio Fernandes Batista

2017-04-01

Hypnosis is a valuable tool in the management of patients who undergo surgical procedures in the maxillofacial complex, particularly in reducing and eliminating pain during surgery and aiding patients who have dental fear and are allergic to anesthesia. This case report demonstrates the efficacy of hypnosis in mitigating anxiety, bleeding, and pain during dental surgery without anesthesia during implant placement of tooth 14, the upper left first molar.

Wound ballistics of firearm-related injuries--part 2: mechanisms of skeletal injury and characteristics of maxillofacial ballistic trauma.

PubMed

Stefanopoulos, P K; Soupiou, O T; Pazarakiotis, V C; Filippakis, K

2015-01-01

Maxillofacial firearm-related injuries vary in extent and severity because of the characteristics and behaviour of the projectile(s), and the complexity of the anatomical structures involved, whereas the degree of tissue disruption is also affected by the distance of the shot. In low-energy injuries there is limited damage to the underlying skeleton, which usually dominates the clinical picture, dictating a more straightforward therapeutic approach. High-energy injuries are associated with extensive hard and soft tissue disruption, and are characterized by a surrounding zone of damaged tissue that is prone to progressive necrosis as a result of compromised blood supply and wound sepsis. Current treatment protocols for these injuries emphasize the importance of serial debridement for effective wound control while favouring early definitive reconstruction. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Criteria for the request of preoperative tests among oral and maxillofacial surgeons.

PubMed

da Silva, Luiz Carlos Ferreira; Oliveira, Ana Carla de Assunção; dos Santos, Jadson Alípio Santana Sousa; Santos, Thiago de Santana

2012-10-01

The aim of this study was to analyze the criteria employed for the requesting of preoperative tests among maxillofacial surgeons. Thirty maxillofacial surgeons working in Aracaju (Brazil) received a questionnaire to fill out. The study inquired about the practice of requesting preoperative tests for healthy patients scheduled to undergo elective surgery. Most of the surgeons interviewed requested tests that are not recommended for the case in question. The highest frequency of requests was a complete blood count, coagulation test, blood glucose test and chest radiograph. The absence of strict rules for the requesting of preoperative tests causes uncertainty and a lack of criteria regarding pre-surgical conduct. It was not possible to clearly define the criteria used by surgeons for requesting such tests, as the clinical characteristics of the hypothetical case presented suggest a smaller number of tests. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Clinical Application of Diode Laser (980 nm) in Maxillofacial Surgical Procedures.

PubMed

Aldelaimi, Tahrir N; Khalil, Afrah A

2015-06-01

For many procedures, lasers are now becoming the treatment of choice by both clinicians and patients, and in some cases, the standard of care. This clinical study was carried out at Department of Maxillofacial Surgery, Ramadi Teaching Hospital, Rashid Private Hospital and Razi Private Hospital, Anbar Health Directorate, Anbar Province, Iraq. A total of 32 patients including 22 (≈ 70%) male and 10 (≈ 30%) female with age range from 5 months to 34 years old. Chirolas 20 W diode laser emitting at 980 nm was used. Our preliminary clinical findings include sufficient hemostasis, coagulation properties, precise incision margin, lack of swelling, bleeding, pain, scar tissue formation and overall satisfaction were observed in the clinical application. The clinical application of the diode (980 nm) laser in maxillofacial surgery proved to be of beneficial effect for daily practice and considered practical, effective, easy to used, offers a safe, acceptable, and impressive alternative for conventional surgical techniques.

Robotic surgical systems in maxillofacial surgery: a review

PubMed Central

Liu, Hang-Hang; Li, Long-Jiang; Shi, Bin; Xu, Chun-Wei; Luo, En

2017-01-01

Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery. However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless, robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems. PMID:28660906

[The research of biodegradation of a composite material used in reconstructive and reparative surgery of maxillofacial area].

PubMed

Malanchuk, V O; Astapenko, O O; Halatenko, N A; Rozhnova, R A

2013-09-01

Dates about the research of biodegradation of epoxy-polyurethane composite material used in reconstructive and reparative surgery of maxillofacial area are reflected in the article. Was founded: 1) notable biodegradation of species from epoxy-polyurethane composition in the term of observation up to 6 months was not founded. That testifies their preservation of physical and mechanical properties. 2) founded, that in species from epoxy-polyurethane composition, which contain levamisole, processes of biodegradation are faster then in species from pure epoxy-polyurethane composition and in species from epoxy-polyurethane composition with hydroxyapatite; 3) material from epoxy-polyurethane composition, which contains levamisole and hydroxyapatite, stays in biological environment in small quantity of petty fragments during the incubation in term of 2 years. So, it biodegrades practically totally. Authors suggest on the basis of achieved information, that the use of epoxy-polyurethane constructions that biodegrade, is pertinently in reconstructive maxillofacial surgery.

Development and refinement of computer-assisted planning and execution system for use in face-jaw-teeth transplantation to improve skeletal and dento-occlusal outcomes.

PubMed

Hashemi, Sepehr; Armand, Mehran; Gordon, Chad R

2016-10-01

To describe the development and refinement of the computer-assisted planning and execution (CAPE) system for use in face-jaw-teeth transplants (FJTTs). Although successful, some maxillofacial transplants result in suboptimal hybrid occlusion and may require subsequent surgical orthognathic revisions. Unfortunately, the use of traditional dental casts and splints pose several compromising shortcomings in the context of FJTT and hybrid occlusion. Computer-assisted surgery may overcome these challenges. Therefore, the use of computer-assisted orthognathic techniques and functional planning may prevent the need for such revisions and improve facial-skeletal outcomes. A comprehensive CAPE system for use in FJTT was developed through a multicenter collaboration and refined using plastic models, live miniature swine surgery, and human cadaver models. The system marries preoperative surgical planning and intraoperative execution by allowing on-table navigation of the donor fragment relative to recipient cranium, and real-time reporting of patient's cephalometric measurements relative to a desired dental-skeletal outcome. FJTTs using live-animal and cadaveric models demonstrate the CAPE system to be accurate in navigation and beneficial in improving hybrid occlusion and other craniofacial outcomes. Future refinement of the CAPE system includes integration of more commonly performed orthognathic/maxillofacial procedures.

Assessing the level of matrix metal proteinases 1,8,9, their tissue inhibitor, type I, in cases of odontogenic phlegmons.

PubMed

Markelova, E V; Romanchuk, A L; Prosekova, E V; Krasnikov, V E; Beniova, S N

2017-01-01

The article considers the measured values of the level of MMP-1, MMP-8 and MMP-9, and of their tissue inhibitor Type I (TIMP-1) in the blood serum and mixed saliva samples of 78 patients (31 women - 36.2 %, 47 men - 63.8 %) suffering from odontogenic phlegmons in the oral and maxillofacial region. The study indicators were assessed through the enzyme-linked immunosorbent assay using diagnostic sets RandD Diagnostics Inc. (USA). An uncontrolled hyperactivation of metal proteinases as one of the components of the systemic inflammatory response in case of phlegmon-related complications in the oral and maxillofacial region, as well as development of the sepsis syndrome were studied and it was determined that it results in distortion of the processes of reparative hystogeny and compel us to employ new approaches to the treatment of this type of patients (Tab. 2, Fig. 1, Ref. 13).

Development of Biodegradable Implants for Use in Maxillofacial Surgery.

DTIC Science & Technology

1981-10-28

PAGE(WhM D .m4m 20 Abstract - continued -to obtain the desired composite material properties. In vitro -- experiments with these materials showed that...the composites were capable of retaining sufficient strength and integrity, in a pseudo-physiological environment, throughout the period normally...VII. Mechanical Properties of Reinforcing Fibers .......... .23 VIII. Effect of Sterilization on High-viscosity Polylactide Composites

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1982-11-01

1(AXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS: MICROCAPSULES : SOFT FILLERS; ELASTOMER COMPOSITES *ASTRAC7 lCofIflU Ir F*vsda Side It neceOaeen anud...composite systems are elastomeric-shelled, liquid-filled microcapsules . Experiments continued on the interfacial polymerization process, with spherical...sealed, capsules achieved. The diamine bath has been E] improved and an automatic system has been developed for producing the microcapsules . The one

Reconstructive surgery for complex midface trauma using titanium miniplates: Le Fort I fracture of the maxilla, zygomatico-maxillary complex fracture and nasomaxillary complex fracture, resulting from a motor vehicle accident.

PubMed

Nicholoff, T J; Del Castillo, C B; Velmonte, M X

Maxillofacial injuries resulting from trauma can be a challenge to the Maxillo-Facial Surgeon. Frequent causes of these injuries are attributed to automobile accidents, physical altercations, gunshot wounds, home accidents, athletic injuries, work injuries and other injuries. Motor vehicle accidents tend to be the primary cause of most midface fractures and lacerations due to the face hitting the dashboard, windshield and steering wheel or the back of the front seat for passengers in the rear. Seatbelts have been shown to drastically reduce the incidence and severity of these injuries. In the United States seatbelt laws have been enacted in several states thus markedly impacting on the reduction of such trauma. In the Philippines rare is the individual who wears seat belts. Metro city traffic, however, has played a major role in reducing daytime MVA related trauma, as usually there is insufficient speed in traffic areas to cause severe impact damage, the same however cannot be said for night driving, or for driving outside of the city proper where it is not uncommon for drivers to zip into the lane of on-coming traffic in order to overtake the car in front ... often at high speeds. Thus, the potential for severe maxillofacial injuries and other trauma related injuries increases in these circumstances. It is however unfortunate that outside of Metro Manila or other major cities there is no ready access to trauma or tertiary care centers, thus these injuries can be catastrophic if not addressed adequately. With the exception of Le Fort II and III craniofacial fractures, most maxillofacial injuries are not life threatening by themselves, and therefore treatment can be delayed until more serious cerebral or visceral, potentially life threatening injuries are addressed first. Our patient was involved in an MVA in Zambales, seen and stabilized in a provincial primary care center initially, then referred to a provincial secondary care center for further stabilization before his transfer to Manila and then ultimately to our Maxillo-Facial Unit. There was a two week-plus delay in the definitive management because of this. As a result of the delay, fibrous tissue and bone callus formation occurred between the various fracture lines, thus once definitive fracture management was attempted, it took on a more reconstructive nature. Hospital based Oral and Maxillo-Facial Surgeons are uniquely trained to manage all aspects of the maxillo-facial trauma, and their dental background uniquely qualifies them in functional restoration of lower and midface fractures where occlusion plays a most important role. Likewise, their training in clinical medicine which is usually integrated into their residency education (12 months or more) puts them in a unique position to comfortably manage the basic medical needs of these patients. In instances where trauma may affect other regions of the body, an inter-multi-disciplinary approach may be taken or consults called for. In this instance, an opthalmology consult was important. In fresh trauma, often seen in major trauma centers (i.e. overseas), a "Trauma Team" is on standby 24 hours a day, and is prepared to assess and manage trauma patients almost immediately upon their arrival in the ER. The trauma team is usually composed of a Trauma Surgeon who is a general surgeon with subspecialty training in traumatology who assesses and manages the visceral injuries, an Orthopedic Surgeon who manages fractures of the extremities, a Neurosurgeon for cerebral injuries and an Oral and Maxillo-Facial Surgeon for facial injuries. In some institutions, facial trauma call is alternated between the "three major head and neck specialty services", namely Oral and Maxillo-facial Surgery, Otolaryngology-Head & Neck Surgery and Plastic & Reconstructive Surgery. (ABSTRACT TRUNCATED)

Marketing the oral and maxillofacial surgery practice through positive employee relations.

PubMed

Niamtu, Joe

2008-02-01

This article is about marketing. Having superlative acumen on employee relations is much more important to all oral and maxillofacial surgeons than "how to take a referring doc to lunch." Keep a copy of this article handy and distribute it to all new employees. Review the hiring and firing tenets and "Rules of the Game" each time you hire a new employee, fire an established one, or face trying times with staff or partners.

Risk of surgical glove perforation in oral and maxillofacial surgery.

PubMed

Kuroyanagi, N; Nagao, T; Sakuma, H; Miyachi, H; Ochiai, S; Kimura, Y; Fukano, H; Shimozato, K

2012-08-01

Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Evaluation of articulation simulation system using artificial maxillectomy models.

PubMed

Elbashti, M E; Hattori, M; Sumita, Y I; Taniguchi, H

2015-09-01

Acoustic evaluation is valuable for guiding the treatment of maxillofacial defects and determining the effectiveness of rehabilitation with an obturator prosthesis. Model simulations are important in terms of pre-surgical planning and pre- and post-operative speech function. This study aimed to evaluate the acoustic characteristics of voice generated by an articulation simulation system using a vocal tract model with or without artificial maxillectomy defects. More specifically, we aimed to establish a speech simulation system for maxillectomy defect models that both surgeons and maxillofacial prosthodontists can use in guiding treatment planning. Artificially simulated maxillectomy defects were prepared according to Aramany's classification (Classes I-VI) in a three-dimensional vocal tract plaster model of a subject uttering the vowel /a/. Formant and nasalance acoustic data were analysed using Computerized Speech Lab and the Nasometer, respectively. Formants and nasalance of simulated /a/ sounds were successfully detected and analysed. Values of Formants 1 and 2 for the non-defect model were 675.43 and 976.64 Hz, respectively. Median values of Formants 1 and 2 for the defect models were 634.36 and 1026.84 Hz, respectively. Nasalance was 11% in the non-defect model, whereas median nasalance was 28% in the defect models. The results suggest that an articulation simulation system can be used to help surgeons and maxillofacial prosthodontists to plan post-surgical defects that will be facilitate maxillofacial rehabilitation. © 2015 John Wiley & Sons Ltd.

A current overview of materials and strategies for potential use in maxillofacial tissue regeneration.

PubMed

Jazayeri, Hossein E; Tahriri, Mohammadreza; Razavi, Mehdi; Khoshroo, Kimia; Fahimipour, Farahnaz; Dashtimoghadam, Erfan; Almeida, Luis; Tayebi, Lobat

2017-01-01

Tissue regeneration is rapidly evolving to treat anomalies in the entire human body. The production of biodegradable, customizable scaffolds to achieve this clinical aim is dependent on the interdisciplinary collaboration among clinicians, bioengineers and materials scientists. While bone grafts and varying reconstructive procedures have been traditionally used for maxillofacial defects, the goal of this review is to provide insight on all materials involved in the progressing utilization of the tissue engineering approach to yield successful treatment outcomes for both hard and soft tissues. In vitro and in vivo studies that have demonstrated the restoration of bone and cartilage tissue with different scaffold material types, stem cells and growth factors show promise in regenerative treatment interventions for maxillofacial defects. The repair of the temporomandibular joint (TMJ) disc and mandibular bone were discussed extensively in the report, supported by evidence of regeneration of the same tissue types in different medical capacities. Furthermore, in addition to the thorough explanation of polymeric, ceramic, and composite scaffolds, this review includes the application of biodegradable metallic scaffolds for regeneration of hard tissue. The purpose of compiling all the relevant information in this review is to lay the foundation for future investigation in materials used in scaffold synthesis in the realm of oral and maxillofacial surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

[Influential factors analysis of positive psychology in patients with oral and maxillofacial trauma].

PubMed

Li, Li; Yuan, Wei-Jun; Chen, Qiao-Lu; Yao, Yao; Huang, Ying-Bi

2017-02-01

To investigate the positive psychological reaction of patients with oral and maxillofacial trauma and related factors. One hundred and five hospitalized patients with oral and maxillofacial trauma were investigated by self-designed general data questionnaire, positive psychological scale posttraumatic growth evaluation of quantitative PTG, and self-image questionnaire. SPSS 18.0 software package was used to analyze the data. Positive psychological score of the patients was 56.01±17.322, and self-image average score was 51.33±7.306. There were significant differences between male and female patients after trauma in new possibilities, personal power, self transformation and personal feeling (P<0.05); there was no significant difference between different ages in positive psychological reaction.With the improvement of educational level of patients, better personal power (P=0.031) and self transformation (P=0.01), and more positive psychological reaction were observed; Posttraumatic positive psychology of patients was negatively correlated with self-image score (r=-0.318, P<0.001). The male patients with oral and maxillofacial trauma have more positive attitude than female. With the improvement of educational level, more positive psychological reaction was documented in term of personal strength, self-transformation,but no obvious change in relationship with others, new possibilities and personal feeling. The better self image, the more positive psychological reaction was displayed.

A study on posttraumatic experience of road traffic accident afflicted maxillofacial trauma patient at tertiary hospital.

PubMed

Yadav, Santosh Kumar; Shrestha, Suraksha

2017-01-01

Patients are usually left in a vulnerable state after an accident. Because of this, they long for a good encounter when they are brought to the hospital. Physical impairment and psychological morbidities are some of the complications that can occur to them. Traditionally, surgeons tend to pay little attention to a patient's emotional and psychological perspective. The aim of this study was to understand the experience of oral and maxillofacial trauma patients due to road traffic accident right from immediate after the accident till the end of definitive treatment. Phenomenological approach of qualitative study was used to explore these patients' experience. Twenty subjects involved in road traffic accidents without any cognitive impairment aged 18 and above were recruited. Purposive sampling was used to include maximal variation sample regarding age, gender, types of injury, and types of treatment received. Semi-structured and open-ended interview approach was used to obtain in-depth information. Seven themes were identified to describe the patients' response to and experience after meeting with a road traffic accident; they are unreal experiences, emotional responses, need to inform and need for information, need for assistance, their perception toward the maxillofacial injury, their experience on treatment and staff-patient interaction. This qualitative study has provided an in-depth understanding of patients experience during maxillofacial trauma and treatment, which otherwise cannot be obtained by the use of surveys and test questions.

Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study.

PubMed

Elledge, Ross O C; McAleer, Sean

2015-02-01

It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Direct assessment by electron spin resonance spectroscopy of the antioxidant effects of French maritime pine bark extract in the maxillofacial region of hairless mice

PubMed Central

Yoshida, Ayaka; Yoshino, Fumihiko; Tsubata, Masahito; Ikeguchi, Motoya; Nakamura, Takeshi; Lee, Masaichi-Chang-il

2011-01-01

Flavangenol, one of extract of French maritime pine bark, is a complex mixture of bioflavonoids with oligometric proanthocyanidins as the major constituents. These constituents, catechin and procyanidin B1, are water-soluble derivatives of flavangenol. In this study, we investigated the antioxidant effects of flavangenol on reactive oxygen species such as hydroxyl radical, superoxide anion and singlet oxygen using electron spin resonance and spin trapping. The effect of flavangenol on oxidative stress in the skin from the maxillofacial region of hairless mice was investigated using an in vivo L-band electron spin resonance imaging system. Flavangenol attenuated oxidative stress in the maxillofacial skin by acting as a reactive oxygen species scavenger, as demonstrated by in vitro and in vivo electron spin resonance imaging analysis. The absorption and metabolism of flavangenol were also examined. After oral administration of flavangenol in human and rat, most of the catechin in plasma was in the conjugated form, while 45% to 78% of procyanidin B1 was unconjugated, indicating that non-conjugated procyanidin B1 would be active in the circulation. The ability of flavangenol to reduce reactive oxygen species levels in the circulation of the maxillofacial region suggests that this extract may be beneficial for skin protection from exposure to ultraviolet irradiation. PMID:21980222

The adult suicide-prone patient: a review of the medical literature and implications for oral and maxillofacial surgeons.

PubMed

Friedlander, Arthur H; Rosenbluth, Susan C; Rubin, Robert T

2012-05-01

Suicide is the 11th most common cause of death among American adults. Some individuals who commit suicide may have been treated by oral and maxillofacial surgeons in the days preceding the event. Because suicide often is preventable, in this report we review methods that are useful in identifying individuals at risk of imminent suicide and give suggestions for obtaining interventional assistance. A Medline search using the key terms "suicide," "adult," and "oral surgery" was conducted. Articles selected were published in peer-reviewed journals. Individuals who have told their surgeon they have no further reason to live, have developed a suicide plan, have secured a lethal device, and have previously made such an attempt are at extreme risk and require immediate intervention. Additional risk factors include being white, aged older than 45 years, and unemployed; living alone, with poor social supports; having a current mental illness or history of mental illness, including substance abuse; and having a family history of suicide. Specialty-specific patients at highest risk are those treated for oral cancer and cosmetic issues and those with adverse surgical outcomes. With regard to assessment of these individuals, the modified SAD PERSONS acronym can assist surgeons in documenting the presence of major risk factors associated with adult suicide and in facilitating communication with emergency personnel. Suicide is a potentially preventable public health problem. Oral and maxillofacial surgeons can be key in elucidating clinically significant suicide potential in their patients and referring them for timely intervention. Published by Elsevier Inc.

Knife inflicted penetrating injuries of the maxillofacial region: a descriptive, record-based study.

PubMed

Meer, M; Siddiqi, A; Morkel, J A; Janse van Rensburg, P; Zafar, S

2010-01-01

Penetrating knife injuries of the face are more common in South Africa than the rest of the world. These injuries can be life-threatening, especially where the major blood vessels of the face are involved. The approach to treatment should be multidisciplinary, beginning with the trauma unit to provide airway maintenance and haemodynamic stabilisation. An interventional radiologist may be consulted for angiography. The aim of the present study was to retrospectively analyse all cases of knife-inflicted penetrating injuries to the maxillofacial region with the knife in situ and subsequently develop a management protocol to be used by maxillofacial surgery registrars when presented with such cases. It was a retrospective, cross-sectional and record-based study, analysing all penetrating knife injuries reported at various hospitals for a period of 11 years. In this study, 24 cases of knife injuries were analysed. Twenty-one patients (87.5%) in this series were male and three (12.5%) were female. Of these 24 patients, 13 (54.2%) were coloured and 11 (45.8%) were black. There were no white or Indian patients. Post-surgical recovery of all patients was rapid and uneventful, and there were no fatalities. Patients with knife injuries to the face with no definite signs of vascular injury can thus be safely and accurately managed on the basis of physical examination and plain-film radiography. An angiogram is mandatory if the patient presents with excessive bleeding, an expanding haematoma or if the knife blade is in the region of any large vessels.

Surgical Navigation: A Systematic Review of Indications, Treatments, and Outcomes in Oral and Maxillofacial Surgery.

PubMed

Azarmehr, Iman; Stokbro, Kasper; Bell, R Bryan; Thygesen, Torben

2017-09-01

This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications are discussed. A systematic search in relevant electronic databases, journals, and bibliographies of the included articles was carried out. Clinical studies with 5 or more patients published between 2010 and 2015 were included. Traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal were the areas of interests. The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

[Correlations of plasma concentrations of β-amyloid peptide and S-100β with postoperative cognitive dysfunction in patients undergoing oral and maxillofacial cancer surgery].

PubMed

Liang, Bing; Sun, Yuan-Qing; Jiang, Jue; Xu, Hui

2016-12-01

To evaluate the changes of perioperative plasma concentrations of Aβ 1-40 and S-100β to determine the relationship with postoperative cognitive dysfunction in elderly patients undergoing oral and maxillofacial cancer surgeries. One hundred and fifteen patients aged at least 60 years undergoing oral and maxillofacial tumor resection were investigated between May 2014 to December 2014.Neuropsychological tests for detecting postoperative cognitive dysfunction(POCD) were performed one day before surgery and 7 days postoperatively. According to the results of neuropsychological tests on day 7, patients were divided into POCD group and non-POCD group.Plasma values of Aβ 1-40 and S-100β were determined with enzyme linked immunosorbent assay (ELISA) before anesthesia induction, 24 h and 7 days after surgery. The data were analyzed using SPSS 19.0 software package. According to the definition, POCD was present in 37 of 115 (32.3%) patients 1 week after surgery. Compared with pre-anesthesia, S-100β levels in POCD group were significantly increased (P<0.05); the level of Aβ 1-40 was significantly higher 24 h after surgery (P<0.05). Compared with non-POCD group, S-100β levels were significantly increased 24 h postoperatively (P<0.05); Aβ1-40 levels were significantly higher 24 h and 7 days postoperatively (P<0.05). POCD was present in 32.2% of patients on day 7 after oral and maxillofacial surgeries with general anesthesia. The increasing levels of Aβ 1-40 , S-100β may be associated with the occurence of POCD. Patients with long-lasting operation and high concentrations of Aβ 1-40 and S-100β after surgeries were at a higher risk of POCD. The clinical values of Aβ 1-40 and S-100 as predictive measurements of POCD after oral and maxillofacial cancer surgery appear to be reasonable.

Epidemiology and Risk Factors of Maxillofacial Injuries in Brazil, a 5-year Retrospective Study.

PubMed

Conceição, Luciana Domingues; da Silveira, Isadora Augusta; Nascimento, Gustavo Giacomelli; Lund, Rafael Guerra; da Silva, Ricardo Henrique Alves; Leite, Fábio Renato Manzolli

2018-06-01

The etiology and epidemiology of maxillofacial injuries varies widely in different regions of the world due to socioeconomic status, cultural aspects in addition to road traffic and drug consumption. The aim of this study is to determine major causes and epidemiological characteristics of maxillofacial trauma in a 5-year period. Reports of corporal trauma (n = 25,632) from 2007 to 2011 in the Department of Forensic Medicine were analyzed as to the presence of maxillofacial injuries. Data were submitted to Chi square test and to multivariate Poisson regression. 3262 reports referred maxillofacial trauma. The majority were men (55.8%), single (68.9%), most of them white (75.7%). The average age was 28.9 years (SD = 8.42), and victims with age between 16 and 30 years old were the most affected (48.0%). Women comprised 44% of total sample, 67.8% (971) were single, 76% (1.076) white and 46% (691) aged between 16 and 30 years old. Middle third injuries were associated after adjustment with females (PR 1.05; 95% CI 1.01-1.11), non-white subjects (PR 1.06; 95% CI 1.01-1.12) and physical aggression (PR 1.07; 95% CI 1.02-1.13). Injuries in the oral region was more prevalent in men (PR 1.24; 95% CI 1.09-1.41), in those aged between 16 and 30 (PR 1.97; 95% CI 1.48-2.61) and in subjects with injuries caused by traffic accident (PR 1.21; 95% CI 1.02-1.44). The presence of injuries in the lower third of face remained associated in the final model only with traffic accident (PR 1.75; 95% CI 1.43-2.15). Health care practitioners must recognize vulnerable population and most prevalent sites of lesion to identify cases of violence.

The Use of Telemedicine in Oral and Maxillofacial Surgery.

PubMed

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-04-01

To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P < .0001), rural practitioners referred more patients (P = .0038), and rural GPs referred more single-tooth implant cases (P = .0039). GP respondents moderately agreed to statements about the benefits of telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study.

PubMed

Koivisto, J; Schulze, D; Wolff, J; Rottke, D

2014-01-01

The objective of this study was to compare the performance of metal oxide semiconductor field-effect transistor (MOSFET) technology dosemeters with thermoluminescent dosemeters (TLDs) (TLD 100; Thermo Fisher Scientific, Waltham, MA) in the maxillofacial area. Organ and effective dose measurements were performed using 40 TLD and 20 MOSFET dosemeters that were alternately placed in 20 different locations in 1 anthropomorphic RANDO(®) head phantom (the Phantom Laboratory, Salem, NY). The phantom was exposed to four different CBCT default maxillofacial protocols using small (4 × 5 cm) to full face (20 × 17 cm) fields of view (FOVs). The TLD effective doses ranged between 7.0 and 158.0 µSv and the MOSFET doses between 6.1 and 175.0 µSv. The MOSFET and TLD effective doses acquired using four different (FOV) protocols were as follows: face maxillofacial (FOV 20 × 17 cm) (MOSFET, 83.4 µSv; TLD, 87.6 µSv; -5%); teeth, upper jaw (FOV, 8.5 × 5.0 cm) (MOSFET, 6.1 µSv; TLD, 7.0 µSv; -14%); tooth, mandible and left molar (FOV, 4 × 5 cm) (MOSFET, 10.3 µSv; TLD, 12.3 µSv; -16%) and teeth, both jaws (FOV, 10 × 10 cm) (MOSFET, 175 µSv; TLD, 158 µSv; +11%). The largest variation in organ and effective dose was recorded in the small FOV protocols. Taking into account the uncertainties of both measurement methods and the results of the statistical analysis, the effective doses acquired using MOSFET dosemeters were found to be in good agreement with those obtained using TLD dosemeters. The MOSFET dosemeters constitute a feasible alternative for TLDs for the effective dose assessment of CBCT devices in the maxillofacial region.

U.S. Army Institute of Dental Research Annual Progress Report, Fiscal Year 1982 (1 October 1981-30 September 1982)

DTIC Science & Technology

1982-10-01

WOUND HEALING PRINCIPAL INVESTIGA TOR: COL STEPHEN G. WOODYARD, DC Evaluation of Citric Acid Enhancement of Oral Soft Tissue Healing on Previously Denuded...Craniofacial Tissues . 3S162775A825 CCMBAT MAXILLOFACIAL INJURY. AA,AB,AC,AD Oral and Maxillofacial Sciences. iA OE 6022 Preventive" Dentistry Measures of...Biodegradable Materials For the Treatment of 46 Fractures and Soft Tissue Wounds in the Military Situation. 3462734A875 MEDICAL DEFENSE AGAINST CHEMICAL AGENTS

[Orthognathic surgery, master-piece of maxillo-facial surgery].

PubMed

Reychler, H

2001-01-01

Orthognathic surgery is this field of the maxillofacial surgery which aims to reposition the jaws or some segments of these jaws when masticatory dysfunctions are evident. This tridimensional repositioning in the craniofacial skeleton allows to restore the masticatory function by means of osteotomies, which must be followed either by preoperative simulated bony displacements or by callus bone distraction. Not only are the functional benefits evident on the dental, articular and neuromuscular levels, but also a facial esthetic harmony can almost be obtained.

Corpus Hippocraticum: historical source of treatment of craniomaxillofacial trauma.

PubMed

Stathopoulos, P

2017-04-01

The works of Hippocrates known in the Western World as the Corpus Hippocraticum have dominated medical thought and surgical practice for centuries. A substantial part of the Hippocratic Collection is dedicated to the description of injuries pertinent to Cranio-maxillofacial surgery and their management. Hippocrates has reached this level of surgical skill despite the limited pre-recorded knowledge and the restriction of post-mortem dissections. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Accuracy of clinical coding for procedures in oral and maxillofacial surgery.

PubMed

Khurram, S A; Warner, C; Henry, A M; Kumar, A; Mohammed-Ali, R I

2016-10-01

Clinical coding has important financial implications, and discrepancies in the assigned codes can directly affect the funding of a department and hospital. Over the last few years, numerous oversights have been noticed in the coding of oral and maxillofacial (OMF) procedures. To establish the accuracy and completeness of coding, we retrospectively analysed the records of patients during two time periods: March to May 2009 (324 patients), and January to March 2014 (200 patients). Two investigators independently collected and analysed the data to ensure accuracy and remove bias. A large proportion of operations were not assigned all the relevant codes, and only 32% - 33% were correct in both cycles. To our knowledge, this is the first reported audit of clinical coding in OMFS, and it highlights serious shortcomings that have substantial financial implications. Better input by the surgical team and improved communication between the surgical and coding departments will improve accuracy. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Assessment of online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS): a strategic study.

PubMed

Abu-Serriah, M; Wong, L; Dhariwal, D; Banks, R J

2014-02-01

The Internet is a powerful method of acquiring and sharing information. In marketing and business, online visibility is vital for publicity and the reputation of an organisation. To our knowledge, the importance of such visibility in medicine in general, and in Oral and Maxillofacial Surgery (OMFS) services in the UK, has not previously been investigated. We aimed to provide a better understanding of the way that patients use the Internet by asking 450 patients to complete a questionnaire when they attended outpatient OMFS departments at 2 centres. We also assessed the online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and investigated the correlation between the strength of online visibility and professional reputation. Results from the self-administered, anonymous, validated questionnaires showed that 82% of patients agreed that the Internet was a powerful source of information, and two-thirds associated online visibility with a good reputation. However, the perceived online visibility of the BAOMS was poor (2%). This study mirrors findings in business publications, and confirms the link between online visibility and professional reputation. It also shows that there is a gap between patients' perceptions and the level of uptake of professional resources. We propose various strategies to bridge this gap and to promote the online visibility and professional reputation of the BAOMS and of OMFS services in the UK. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The impact of airbags and seat belts on the incidence and severity of maxillofacial injuries in automobile accidents in New York State.

PubMed

Mouzakes, J; Koltai, P J; Kuhar, S; Bernstein, D S; Wing, P; Salsberg, E

2001-10-01

To evaluate the effect driver-side and passenger-side airbags have had on the incidence and severity of maxillofacial trauma in victims of automobile accidents. Retrospective analysis of all automobile (passenger cars and light trucks) accidents reported in 1994. New York State. Of the 595910 individuals involved in motor vehicle accidents in New York in 1994, 377054 individuals were initially selected from accidents involving cars and light trucks. Of this subset, 164238 drivers and 62755 right front passengers were selected for analysis. Each case is described in a single record with approximately 100 variables describing the accident, eg, vehicle, safety equipment installed and utilized or deployed, occupant position, patient demographics, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses, and procedural treatments rendered. A maxillofacial trauma severity scale was devised, based on the ICD-9-CM diagnoses. Individuals using airbags and seat belts sustained facial injuries at a rate of 1 in 449, compared with a rate of 1 in 40 for individuals who did not use seat belts or airbags (P<.001). Those using airbags alone sustained facial injuries at the intermediate rate of 1 in 148, and victims using seat belts without airbags demonstrated an injury rate of 1 in 217 (P<.001). Use of driver-side airbags, when combined with use of seat belts, has resulted in a decrease in the incidence and severity of maxillofacial trauma.

A retrospective study of 51,781 adult oral and maxillofacial biopsies.

PubMed

Dovigi, Edwin A; Kwok, Elaine Y L; Eversole, Lewis R; Dovigi, Allan J

2016-03-01

Few studies have compared patient and anatomic characteristics across the broad scope of oral and maxillofacial disease seen in dental clinics. The authors conducted a study to make these comparisons by surveying a large sample of histologically diagnosed oral and maxillofacial lesions in a US adult population. A total of 51,781 specimens biopsied from 51,781 adult patients were received by an oral pathology service over 13 years (2001-2015) and analyzed. A description of patients' sex and age at diagnosis, as well as the anatomic site of biopsy was given for diagnoses of 10 oral disease types, including malignant neoplasm, benign neoplasm, infectious, reactive, potentially malignant, developmental, healthy tissue, immune dysfunction, physical trauma, and other. The authors reported reactive lesions were the most prevalent disease type found in the sample (74.9%). Malignant diagnoses comprised 1.97% of all biopsies. The 3 most prevalent diagnoses in this study included benign keratosis, chronic apical periodontitis, and radicular cyst. Different anatomic sites, patient age groups, and sexes show different distributions of disease. Certain disease types and diagnoses were found to have a higher prevalence by sex, among particular age groups, and in certain anatomic sites. This information provides clinicians with a detailed and broad scope of the variety of oral and maxillofacial lesions processed at an oral pathology service and may assist practitioners in forming clinical impressions and differential diagnoses. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population.

PubMed

Silva, Leni Verônica de Oliveira; Arruda, José Alcides Almeida; Martelli, Stephanie Joana; Kato, Camila de Nazaré Alves de Oliveira; Nunes, Laiz Fernanda Mendes; Vasconcelos, Ana Carolina Uchoa; Tarquinio, Sandra Beatriz Chaves; Gomes, Ana Paula Neutzling; Gomez, Ricardo Santiago; Mesquita, Ricardo Alves; Silveira, Marcia Maria Fonseca da; Sobral, Ana Paula Veras

2018-03-15

The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

In vitro cytotoxicity of maxillofacial silicone elastomers: effect of accelerated aging.

PubMed

Bal, Bilge Turhan; Yilmaz, Handan; Aydin, Cemal; Karakoca, Seçil; Yilmaz, Sükran

2009-04-01

The purpose of this in vitro study was to evaluate the cytotoxicity of three maxillofacial silicone elastomers at 24, 48, and 72 h on L-929 cells and to determine the effect of accelerated aging on the cytotoxicity of these silicone elastomers. Disc-shaped test samples of maxillofacial silicone elastomers (Cosmesil, Episil, Multisil) were fabricated according to manufacturers' instructions under aseptic conditions. Samples were then divided into three groups: (1) not aged; (2) aged for 150 h with an accelerated weathering tester; and (3) aged for 300 h. Then the samples were placed in Dulbecco's Modified Eagle Medium/Ham's F12 (DMEM/F12) for 24, 48, and 72 h. After the incubation periods, cytotoxicity of the extracts to cultured fibroblasts (L-929) was measured by MTT assay. The degree of cytotoxicity of each sample was determined according to the reference value represented by the cells with a control (culture without sample). Statistical significance was determined by repeated measurement ANOVA (p < 0.01) followed by Duncan's test (p < 0.05). All test materials in each group demonstrated high survival rates in MTT assay (Episil; 93.84%, Multisil; 88.30%, Cosmesil; 87.50%, respectively); however, in all groups, Episil material demonstrated significantly higher cell survival rate after each of the experimental incubation periods (p < 0.05). Accelerated aging for 150 and 300 h had no significant effect on the biocompatibility of maxillofacial silicone elastomers tested (p > 0.05).

3D Printed Surgical Simulation Models as educational tool by maxillofacial surgeons.

PubMed

Werz, S M; Zeichner, S J; Berg, B-I; Zeilhofer, H-F; Thieringer, F

2018-02-26

The aim of this study was to evaluate whether inexpensive 3D models can be suitable to train surgical skills to dental students or oral and maxillofacial surgery residents. Furthermore, we wanted to know which of the most common filament materials, acrylonitrile butadiene styrene (ABS) or polylactic acid (PLA), can better simulate human bone according to surgeons' subjective perceptions. Upper and lower jaw models were produced with common 3D desktop printers, ABS and PLA filament and silicon rubber for soft tissue simulation. Those models were given to 10 blinded, experienced maxillofacial surgeons to perform sinus lift and wisdom teeth extraction. Evaluation was made using a questionnaire. Because of slightly different density and filament prices, each silicon-covered model costs between 1.40-1.60 USD (ABS) and 1.80-2.00 USD (PLA) based on 2017 material costs. Ten experienced raters took part in the study. All raters deemed the models suitable for surgical education. No significant differences between ABS and PLA were found, with both having distinct advantages. The study demonstrated that 3D printing with inexpensive printing filaments is a promising method for training oral and maxillofacial surgery residents or dental students in selected surgical procedures. With a simple and cost-efficient manufacturing process, models of actual patient cases can be produced on a small scale, simulating many kinds of surgical procedures. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Craniomaxillofacial falling bullet injuries and management.

PubMed

Shuker, Sabri T; Sadda, Raid

2010-07-01

The purpose of this study was to bring attention to craniocerebral maxillofacial perforating/penetrating injuries due to AK-47 Kalashnikov falling bullets (FBs); these dangerous injuries to both civilians and soldiers are rare. A review of the literature shows no reports on AK-47 FBs leading to double craniocerebral perforation and settling into the maxillofacial region. The number of victims, the AK-47's availability, the associated morbidity and mortality rates, and the rarity of cases prompted this article. The treatment of injuries to the craniocerebral facial clinical profile due to FBs is challenging, and an understanding of the neurosurgical and maxillofacial management of these low-velocity FB injuries is required. We treated 11 cases due to AK-47 rifle FBs and 1 due to anti-aircraft Dashka 12.7-mm FBs. Craniocerebral facial injuries were treated and lodged bullets removed from different challenging locations in the base of the skull, without increasing morbidity and with avoidance of unnecessary surgical trauma to the affected area by the bullets. The required identification of such injuries can be difficult, and the removal of the lodged bullet to prevent secondary complications and reduce the chance of secondary infection can be graver than in other parts of the body. AK-47 FBs are a major public health concern internationally and require serious attention in terms of protection and management for civilians and soldiers in uniform. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Facial asymmetry quantitative evaluation in oculoauriculovertebral spectrum.

PubMed

Manara, Renzo; Schifano, Giovanni; Brotto, Davide; Mardari, Rodica; Ghiselli, Sara; Gerunda, Antonio; Ghirotto, Cristina; Fusetti, Stefano; Piacentile, Katherine; Scienza, Renato; Ermani, Mario; Martini, Alessandro

2016-03-01

Facial asymmetries in oculoauriculovertebral spectrum (OAVS) patients might require surgical corrections that are mostly based on qualitative approach and surgeon's experience. The present study aimed to develop a quantitative 3D CT imaging-based procedure suitable for maxillo-facial surgery planning in OAVS patients. Thirteen OAVS patients (mean age 3.5 ± 4.0 years; range 0.2-14.2, 6 females) and 13 controls (mean age 7.1 ± 5.3 years; range 0.6-15.7, 5 females) who underwent head CT examination were retrospectively enrolled. Eight bilateral anatomical facial landmarks were defined on 3D CT images (porion, orbitale, most anterior point of frontozygomatic suture, most superior point of temporozygomatic suture, most posterior-lateral point of the maxilla, gonion, condylion, mental foramen) and distance from orthogonal planes (in millimeters) was used to evaluate the asymmetry on each axis and to calculate a global asymmetry index of each anatomical landmark. Mean asymmetry values and relative confidence intervals were obtained from the control group. OAVS patients showed 2.5 ± 1.8 landmarks above the confidence interval while considering the global asymmetry values; 12 patients (92%) showed at least one pathologically asymmetric landmark. Considering each axis, the mean number of pathologically asymmetric landmarks increased to 5.5 ± 2.6 (p = 0.002) and all patients presented at least one significant landmark asymmetry. Modern CT-based 3D reconstructions allow accurate assessment of facial bone asymmetries in patients affected by OAVS. The evaluation as a global score and in different orthogonal axes provides precise quantitative data suitable for maxillo-facial surgical planning. CT-based 3D reconstruction might allow a quantitative approach for planning and following-up maxillo-facial surgery in OAVS patients.

[Robotics].

PubMed

Bier, J

2000-05-01

Content of this paper is the current state of the art of robots in surgery and the ongoing work on the field of surgical robotics at the Clinic for Maxillofacial Surgery at the Charité. Robots in surgery allows the surgeon to transform the accuracy of the imaging systems directly during the intervention and to plan an intervention beforehand. In this paper firstly the state of the art is described. Subsequently the scientific work at the clinic is described in detail. The paper closes with a outlook for future applications of robotics systems in maxillofacial surgery.

In vivo soft tissue differentiation by diffuse reflectance spectroscopy: preliminary results

NASA Astrophysics Data System (ADS)

Zam, Azhar; Stelzle, Florian; Tangermann-Gerk, Katja; Adler, Werner; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schmidt, Michael; Douplik, Alexandre

Remote laser surgery does not provide haptic feedback to operate layer by layer and preserve vulnerable anatomical structures like nerve tissue or blood vessels. The aim of this study is identification of soft tissue in vivo by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Various soft tissues can be identified by diffuse reflectance spectroscopy in vivo. The results may set the base for a feedback system to prevent nerve damage during oral and maxillofacial laser surgery.

AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update.

PubMed

2015-10-01

The following statement was prepared by the Special Committee to Revise the Joint American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology Position on Cone Beam Computed Tomography, and approved by the AAE Board of Directors and AAOMR Executive Council in May 2015. AAE members may reprint this position statement for distribution to patients or referring dentists. Copyright © 2015 American Academy of Oral and Maxillofacial Radiology and American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Management outline of oral and maxillofacial missile injuries in Iraq: the value of the intermediate phase.

PubMed

Maki, Mohammed Hashim

2009-05-01

Oral and maxillofacial surgeons in Iraq are practicing in a paradoxical situation where a high number of extensive injuries are accompanied by limited resources. Steps of management should be followed cautiously in attempts to reduce residual deformities that characterize the end results of severe missile injuries. This study elucidate lessons extirpated from surgical experience in the management of diversity of causalities with special emphasis on the intermediate phase of management as well as different modalities of treatment, trying to get best benefit from available resources.

Continuing Education Needs of Non-Specialty-Trained Army General Dentists

DTIC Science & Technology

1994-01-01

68.25 at the DENTAC level and the supervisor’s view should prevail 15 Q11 Perio - Endo Problems 67.72 at the Dental Corps level. ’Tooic shared in common...69.59 12 Q6 Management of Medically Compromised 73.944 10 Q66 Analgesics 69.18 Patients 11 Q79 Management of Maxillofacial Injuries 69.18 13 Q67...14 Q79 Management of Maxillofacial Injuries 67.76, topics (Management of Military Dental Clinics, Principles of 15 Q90 Motivating Co-Workers 67.54

Cervicothoracic Subcutaneous Emphysema and Pneumomediastinum After Third Molar Extraction.

PubMed

Picard, Maxime; Pham Dang, Nathalie; Mondie, Jean Michel; Barthelemy, Isabelle

2015-12-01

Third molar extraction is one of the most common interventions in dental and maxillofacial surgery. Complications are frequent and well documented, with swelling, pain, bleeding, infection, and lingual or alveolar nerve injury being the most common. This report describes a case of subcutaneous extensive emphysema and pneumomediastinum that occurred 4 days after extraction of an impacted right mandibular third molar. The management and etiology of this case and those reported in the literature are discussed. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Molecular, Cellular and Pharmaceutical Aspects of Biomaterials in Dentistry and Oral and Maxillofacial Surgery. An Internationalization of Higher Education and Research Perspective.

PubMed

Wisniewska, Lidia M; Dohan Ehrenfest, David M; Galindo-Moreno, Pablo; Segovia, Jesus D; Inchingolo, Francesco; Wang, Hom-Lay; Fernandes-Cruz, Manuel

2017-01-01

In dentistry and oral and maxillofacial surgery, the development of implantable biomaterials and the understanding of their molecular, cellular and pharmaceutical aspects are currently major fields of research and education, with a considerable impact on the daily clinical practice and the evolution of therapeutic strategies. In the era of globalized economy of knowledge and science, this scientific domain needs the development of global cooperation and a paradigm evolution in the organizational culture of the dental sciences and related dental industry. Despite political pressure and theoretical efforts, the internationalization of higher education and research today in dentistry and biomaterials remains in general quite superficial and mostly dependent on the efforts of a few leaders of internationalization working through their personal networks, as it was assessed through the FAST scores (Fast Assessment Screening Test) calculated in various dental schools and groups worldwide through the ISAIAS program (Intercultural Sensitivity Academic Index &Advanced Standards). Cooperation in a multipolar multicultural community requires the development of strong intercultural competences, and this process remains limited in most institutions. These limits of international scientific cooperation can be observed through different markers, particularly the difficult and limited production of ISO standards (International Organization for Standardization) and the relatively low SCIENTI scores (Scientific Cooperation Internationalization Effort &Network Test &Index) of the specialized dental literature, particularly in comparison to the most significant medical literature. However, as an analytical tool to assess the scientific international cooperation effort between fields and periods, the SCIENTI screening system also highlighted a significant increase of the internationalization effort in the last years in the best dental biomaterials publications. Finally, an internationalization of higher education and research perspective is a very important approach to assess the evolution of the dental biomaterial science and highlights very clearly the future endeavors of this field, particularly the impact and interferences of private entities and companies in the development of this corpus of knowledge. It also reveals that the concept of independent not-for-profit Cooperation Internationalization Effort Literature (CIEL), in the various informal models that can be found worldwide around diverse leaderships, is the best perspective for a better science and understanding of molecular, cellular and pharmaceutical aspects of biomaterials in dentistry and oral and maxillofacial surgery. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Research and Development of Wound Dressing in Maxillofacial Trauma.

DTIC Science & Technology

1984-11-16

distribution of the microcapsules is shown in Table 6. b. Microencapsulation of Antibiotic Drugs Recently a small microencapsulation unit was designed...TRACT (Coutou a reverawe. fi If nece~uzy amt Identify by block number) ’Three basic formulations, non-woven fabrics, powders, and microcapsules , of...fabrics with powders .and microcapsules . 1473 E~t1O~oINOSSI~BSOETEunclassified SECUmRY CLASSIFICATION OF THIS PAGE fWhen Dauta Enweved)’ unclassified

Research and Development of Wound Dressing in Maxillofacial Trauma.

DTIC Science & Technology

1984-07-11

microencapsulation of this drug did not appear to be warranted. A higher drug loading might be possible with microcapsules , but the maximum loading of the...powders, and microcapsules , of local anesthetic agents, antiseptics, and antibiotics. These formulations were characterized by scanning electron microscopy...were studied Povidone iodine microcapsules released drug in a sustained manner for at leasd 24 hours either as free microcapsules or imbedded in Tegaderm

Biomimetic coatings for bone tissue engineering of critical-sized defects.

PubMed

Liu, Yuelian; Wu, Gang; de Groot, Klaas

2010-10-06

The repair of critical-sized bone defects is still challenging in the fields of implantology, maxillofacial surgery and orthopaedics. Current therapies such as autografts and allografts are associated with various limitations. Cytokine-based bone tissue engineering has been attracting increasing attention. Bone-inducing agents have been locally injected to stimulate the native bone-formation activity, but without much success. The reason is that these drugs must be delivered slowly and at a low concentration to be effective. This then mimics the natural method of cytokine release. For this purpose, a suitable vehicle was developed, the so-called biomimetic coating, which can be deposited on metal implants as well as on biomaterials. Materials that are currently used to fill bony defects cannot by themselves trigger bone formation. Therefore, biological functionalization of such materials by the biomimetic method resulted in a novel biomimetic coating onto different biomaterials. Bone morphogenetic protein 2 (BMP-2)-incorporated biomimetic coating can be a solution for a large bone defect repair in the fields of dental implantology, maxillofacial surgery and orthopaedics. Here, we review the performance of the biomimetic coating both in vitro and in vivo.

Development and evolution of distraction devices: Use of indigenous appliances for Distraction Osteogenesis-An overview

PubMed Central

Andrade, Neelam; Gandhewar, Trupti; Kalra, Rinku

2011-01-01

An attempt has been made to review various devices as well as the outstanding studies done in the past for understanding the methodology of distraction for regeneration of bone. Lengthening of underdeveloped bones inclusive of the maxillofacial complex has been obtained by distraction osteogenesis by many authors. This could be achieved by the use of various extraoral or intraoral devices. Devices used for distraction osteogenesis must have a minimum of 2 important characteristics – they should be able to transfer distraction forces directly to the bone and secondly, should offer adequate rigidity for osseous consolidation to occur. With advanced technology and biomechanical engineering, preformed intraoral distraction devices are now available worldwide. The introduction of these intraoral bone-bourne devices have eliminated the need for bulky, cumbersome extraoral distraction devices which had problems such as external scars, pin tract infections, nerve or tooth bud injuries and poor patient compliance. The design of completely internalized custom made appliance has opened new vistas in the field of Oral and Maxillofacial Surgery. Indigenous internal devices are also economical and locally available. PMID:23482829

Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study

PubMed Central

Schulze, D; Wolff, J; Rottke, D

2014-01-01

Objectives: The objective of this study was to compare the performance of metal oxide semiconductor field-effect transistor (MOSFET) technology dosemeters with thermoluminescent dosemeters (TLDs) (TLD 100; Thermo Fisher Scientific, Waltham, MA) in the maxillofacial area. Methods: Organ and effective dose measurements were performed using 40 TLD and 20 MOSFET dosemeters that were alternately placed in 20 different locations in 1 anthropomorphic RANDO® head phantom (the Phantom Laboratory, Salem, NY). The phantom was exposed to four different CBCT default maxillofacial protocols using small (4 × 5 cm) to full face (20 × 17 cm) fields of view (FOVs). Results: The TLD effective doses ranged between 7.0 and 158.0 µSv and the MOSFET doses between 6.1 and 175.0 µSv. The MOSFET and TLD effective doses acquired using four different (FOV) protocols were as follows: face maxillofacial (FOV 20 × 17 cm) (MOSFET, 83.4 µSv; TLD, 87.6 µSv; −5%); teeth, upper jaw (FOV, 8.5 × 5.0 cm) (MOSFET, 6.1 µSv; TLD, 7.0 µSv; −14%); tooth, mandible and left molar (FOV, 4 × 5 cm) (MOSFET, 10.3 µSv; TLD, 12.3 µSv; −16%) and teeth, both jaws (FOV, 10 × 10 cm) (MOSFET, 175 µSv; TLD, 158 µSv; +11%). The largest variation in organ and effective dose was recorded in the small FOV protocols. Conclusions: Taking into account the uncertainties of both measurement methods and the results of the statistical analysis, the effective doses acquired using MOSFET dosemeters were found to be in good agreement with those obtained using TLD dosemeters. The MOSFET dosemeters constitute a feasible alternative for TLDs for the effective dose assessment of CBCT devices in the maxillofacial region. PMID:25143020

Is Treating Oral and Maxillofacial Trauma Profitable? An Analysis of Hospital and Surgeon Reimbursement at an Academic Medical Center.

PubMed

DeLuke, Dean M; Agarwal, Vickas; Holleman, Trevor; Carrico, Caroline K; Laskin, Daniel M

2017-02-01

During the past 2 decades, there has been a marked decrease in the willingness of community-based oral and maxillofacial surgeons to participate in trauma call. Although many factors can influence the decision not to take trauma call, 1 primary disincentive is the perception that managing facial trauma might be profitable for the hospital, but not profitable for the surgeon. The purpose of this study was to compare the profitability of facial trauma management for the hospital and the surgeon at the Virginia Commonwealth University (VCU) Medical Center (Richmond, VA). In this retrospective cohort study, records were collected for patients who were seen for primary trauma management by the Department of Oral and Maxillofacial Surgery at VCU (VCUOMS) from June 2011 through July 2014. Cost and reimbursement data were analyzed for these patients from the VCU Health System (VCUHS) and the VCUOMS. For the hospital, actual cost data were provided; for the surgeon, cost was calculated based on an average overhead of 50%. For uniformity, patients were excluded if they remained in the hospital for longer than a 23-hour observation period. Patients younger than 18 years also were excluded. In total, 169 patients met the inclusion criteria. There was a statistically relevant difference in the percentage of costs recouped and the actual profit. The average percentage of costs recouped was 230% for the VCUHS versus 47% for the VCUOMS. This amounts to an average profit per case of $3,461 for the hospital versus a loss of $1,162 for the surgeon. The results of this study indicate that in the VCU Medical Center, maxillofacial trauma yields a net profit for the hospital and a net loss for the operating surgeon. Although the results are limited to outpatient management at 1 academic institution, they suggest that hospitals in some settings might be in a position to incentivize surgeons for trauma management. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of Religious Belief on Selecting of Graft Materials Used in Oral and Maxillofacial Surgery.

PubMed

Güngörmüş, Zeynep; Güngörmüş, Metin

2017-11-01

Various graft materials, such as synthetic and biological products, are used routinely in maxillofacial surgery. These materials are usually derived from porcine, bovine, and human tissues; some religious beliefs forbid the dietary use of substances from certain animal sources. The aim of this study was to evaluate the effect of religious belief on selecting different graft types used in maxillofacial surgery. In total, 203 participants were included in this survey. Data were collected using a questionnaire on sociodemographic characteristics and different graft types and the Revised Religious Fundamentalism Scale for religious belief levels of participants. The purpose of the study and the origins of different graft types were explained to participants, and their opinions for the acceptance or rejection of each type were recorded. Data were analyzed using SPSS 20.0 (IBM Corp, Armonk, NY). The most preferred grafts were autologous grafts (88.7%), followed by alloplastic grafts (65%), bovine-derived xenografts (60.1%), allografts (53.2%), and porcine-derived xenografts (7.4%). One hundred fifty-nine participants (84.6%) rejected the porcine-derived xenografts for religious reasons, and there was a statistical difference in religious belief levels between participants who accepted and those who rejected porcine-derived xenografts. Autogenous grafts were the most preferred grafts and porcine-derived xenografts were the least preferred grafts. Porcine-derived xenografts were refused specifically for religious reasons, and religious belief and dietary restrictions affected graft selection. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Mandibular Reconstruction with Lateral Tibial Bone Graft: An Excellent Option for Oral and Maxillofacial Surgery.

PubMed

Miceli, Ana Lucia Carpi; Pereira, Livia Costa; Torres, Thiago da Silva; Calasans-Maia, Mônica Diuana; Louro, Rafael Seabra

2017-12-01

Autogenous bone grafts are the gold standard for reconstruction of atrophic jaws, pseudoarthroses, alveolar clefts, orthognathic surgery, mandibular discontinuity, and augmentation of sinus maxillary. Bone graft can be harvested from iliac bone, calvarium, tibial bone, rib, and intraoral bone. Proximal tibia is a common donor site with few reported problems compared with other sites. The aim of this study was to evaluate the use of proximal tibia as a donor area for maxillofacial reconstructions, focusing on quantifying the volume of cancellous graft harvested by a lateral approach and to assess the complications of this technique. In a retrospective study, we collected data from 31 patients, 18 women and 13 men (mean age: 36 years, range: 19-64), who were referred to the Department of Oral and Maxillofacial Surgery at the Servidores do Estado Federal Hospital. Patients were treated for sequelae of orthognathic surgery, jaw fracture, nonunion, malunion, pathology, and augmentation of bone volume to oral implant. The technique of choice was lateral access of proximal tibia metaphysis for graft removal from Gerdy tubercle under general anesthesia. The mean volume of bone harvested was 13.0 ± 3.7 mL (ranged: 8-23 mL). Only five patients (16%) had minor complications, which included superficial infection, pain, suture dehiscence, and unwanted scar. However, none of these complications decreases the result and resolved completely. We conclude that proximal tibia metaphysis for harvesting cancellous bone graft provides sufficient volume for procedures in oral and maxillofacial surgery with minimal postoperative morbidity.

Laser therapy and sclerotherapy in the treatment of oral and maxillofacial hemangioma and vascular malformations

NASA Astrophysics Data System (ADS)

Crişan, Bogdan; BǎciuÅ£, Mihaela; BǎciuÅ£, Grigore; Crişan, Liana; Bran, Simion; Rotar, Horatiu; Moldovan, Iuliu; Vǎcǎraş, Sergiu; Mitre, Ileana; Barbur, Ioan; Magdaş, Andreea; Dinu, Cristian

2016-03-01

Hemangioma and vascular malformations in the field of oral and maxillofacial surgery is a pathology more often found in recent years in patients. The aim of this study was to evaluate the efficacy of the laser photocoagulation performed with a diode laser (Ga-Al-As) 980 nm wavelength in the treatment of vascular lesions which are located on the oral and maxillofacial areas, using color Doppler ultrasonography for evaluation of the results. We also made a comparison between laser therapy and sclerotherapy in order to establish treatment protocols and recommendations associated with this pathology. We conducted a controlled study on a group of 92 patients (38 male and 54 female patients, with an average age of 36 years) having low flow hemangioma and vascular malformations. Patients in this trial received one of the methods of treatment for vascular lesions such as hemangioma and vascular malformations: laser therapy or sclerotherapy. After laser therapy we have achieved a reduction in size of hemangioma and vascular malformations treated with such a procedure, and the aesthetic results were favorable. No reperfusion or recanalization of laser treated vascular lesions was observed after an average follow-up of 6 to 12 months. In case of sclerotherapy a reduction in the size of vascular lesions was also obtained. The 980 nm diode laser has been proved to be an effective tool in the treatment of hemangioma and vascular malformations in oral and maxillofacial area. Laser therapy in the treatment of vascular lesions was more effective than the sclerotherapy procedure.

Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review.

PubMed

Reddy, Rajgopal R; Gosla Reddy, Srinivas; Vaidhyanathan, Anitha; Bergé, Stefaan J; Kuijpers-Jagtman, Anne Marie

2017-06-01

The number of surgical procedures to repair a cleft palate may play a role in the outcome for maxillofacial growth and speech. The aim of this systematic review was to investigate the relationship between the number of surgical procedures performed to repair the cleft palate and maxillofacial growth, speech and fistula formation in non-syndromic patients with unilateral cleft lip and palate. An electronic search was performed in PubMed/old MEDLINE, the Cochrane Library, EMBASE, Scopus and CINAHL databases for publications between 1960 and December 2015. Publications before 1950-journals of plastic and maxillofacial surgery-were hand searched. Additional hand searches were performed on studies mentioned in the reference lists of relevant articles. Search terms included unilateral, cleft lip and/or palate and palatoplasty. Two reviewers assessed eligibility for inclusion, extracted data, applied quality indicators and graded level of evidence. Twenty-six studies met the inclusion criteria. All were retrospective and non-randomized comparisons of one- and two-stage palatoplasty. The methodological quality of most of the studies was graded moderate to low. The outcomes concerned the comparison of one- and two-stage palatoplasty with respect to growth of the mandible, maxilla and cranial base, and speech and fistula formation. Due to the lack of high-quality studies there is no conclusive evidence of a relationship between one- or two-stage palatoplasty and facial growth, speech and fistula formation in patients with unilateral cleft lip and palate. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Improved mortality from penetrating neck and maxillofacial trauma using Foley catheter balloon tamponade in combat.

PubMed

Weppner, Justin

2013-08-01

The military medical community has promoted use of Foley catheter balloon tamponade in the initial management of vascular injury owing to neck or maxillofacial trauma. The aim of the study was to compare outcomes with Foley catheter tamponade with those obtained with traditional use of external pressure. This retrospective cohort study evaluated all cases of persistent bleeding caused by penetrating neck or maxillofacial trauma received at one forward aid station between December 2009 and October 2011. Cohorts included those who were treated with Foley catheter tamponade and those managed with external pressure. Which treatment option was applied depended solely on the availability of Foley catheters at the time. The effectiveness of each technique in controlling initial and delayed hemorrhage is described, and the impact on mortality is analyzed using the Student's t test and Fisher's exact test. Seventy-seven subjects met the inclusion criteria with 42 subjects in the Foley group and 35 subjects in the external pressure group. A statistically significant difference was found between the groups regarding delayed failure, experienced by three patients (7%) in the Foley group and nine patients (26%) in the external pressure group (p < 0.05). The difference in mortality, 5% (two patients) in the Foley tamponade group and 23% (eight patients) in the external pressure group, was statistically significant (p < 0.05). For penetrating neck and maxillofacial injuries in a combat environment, Foley catheter balloon tamponade significantly reduced mortality when compared with direct pressure techniques through its effect on preventing delayed bleeding.

Fundamentals of cone beam computed tomography for a prosthodontist

PubMed Central

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.

2015-01-01

Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10–70 s) and radiation dosages reportedly up to 15–100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:26929479

Dental Infection and Pregnancy: the Lack of Treatment by the Dental Professional Evolving to a Complex Maxillofacial Infection.

PubMed

Pereira, Rodrigo Dos Santos; Gomes-Ferreira, Pedro Henrique Silva; Bonardi, João Paulo; Silva, Jonathan Ribeiro da; Latini, Gustavo Lima; Hochuli-Vieira, Eduardo

2017-11-01

Infections of the maxillofacial complex caused by caries disease are common in dental practice. The professionals have to have technical knowledge to treat it at the onset of the condition and avoid the spread to deep anatomical spaces of face and neck, which can implicate in a risk of patients' life.In Brazil, current dental professionals usually denied oral surgical treatments in patients with some clinical conditions, not because of fear to resolve it but for lack of knowledge to treat it. An example of these conditionals is pregnancy. It is well known that during the pregnancy period, the patient can be treated in the correct period of gestation. Early diagnosis is crucial for effective therapy in serious infections. The treatment has to be crucial during pregnancy because of the potentially fatal situation that the disease can create to the pregnant woman and the fetus.The aim of this article is to demonstrate a case of dental caries in a pregnant patient, which was evaluated by other professionals and had the treatment denied, evolving to a serious maxillofacial infection.

Interpersonal violence, circumstances of aggressions and patterns of maxillofacial injuries in the metropolitan area of Campina Grande, State of Paraíba, Brazil (2008-2011).

PubMed

Bernardino, Ítalo Macedo; Barbosa, Kevan Guilherme Nóbrega; Nóbrega, Lorena Marques; Cavalcante, Gigliana Maria Sobral; Ferreira, Efigenia Ferreira E; d'Ávila, Sérgio

2017-09-01

The aim of this study was to determine the circumstances of aggressions and patterns of maxillofacial injuries among victims of interpersonal violence. This was a cross-sectional and exploratory study conducted from the analysis of 7,132 medical-legal and social records of interpersonal violence victims seen in a Forensic Medicine and Dentistry Center. Descriptive and multivariate statistics were performed using Multiple Correspondence Analysis. Three groups with different victimization profiles were identified. The first group was mainly composed of men of different age groups, victims of community violence that resulted in facial bones or dentoalveolar fracture. The second group was mainly composed of adolescents (10-19 years) of both sexes, victims of interpersonal violence and without specific pattern of injuries. The third group was composed of adult women (≥ 20 years) victims of domestic violence that resulted in injuries of soft tissues of face or other body regions. The results suggest that sociodemographic and circumstantial characteristics are important factors in victimization by maxillofacial injuries and interpersonal violence.

Mandibular fractures in a group of Brazilian subjects under 18 years of age: A epidemiological analysis.

PubMed

Muñante-Cárdenas, J L; Asprino, L; De Moraes, M; Albergaria-Barbosa, J R; Moreira, R W F

2010-11-01

This study showed a retrospective analysis of the etiology, incidence and treatment of maxillofacial injuries in a pediatric and adolescent population of the State of Sao Paulo. We analyzed 2986 medical records of victims of facial trauma under 18 years, treated between 1999 and 2008 by the Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Sao Paulo - Brazil. During this period, 757 patients under 18 were victims of maxillofacial trauma, of which, 112 patients had 139 lines of fracture in the mandible. The most affected age group were male adolescents. The bicycle accidents constituted the main etiology (34.82%). The conservative treatment was used in 51% of cases, and 49% received surgical treatment. Only 5 cases of postoperative complications were identified. The incidence of trauma and mandible fractures in pediatric and adolescent patients was high in the area of study. Bicycle accidents and falls being the main etiological factors. The group of adolescents was most affected. The conservative and surgical treatment was used almost in the same proportion. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Identification of peripheral vessels in oral and maxillofacial regions on magnetic resonance angiography obtained using a balanced steady-state free-precession sequence with a time-spatial labeling inversion pulse and using fresh blood imaging.

PubMed

Oda, Masafumi; Tanaka, Tatsurou; Yamashita, Yoshihiro; Kito, Shinji; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishimura, Shun; Habu, Manabu; Kodama, Masaaki; Uehara, Masataka; Kaneuji, Tsuyoshi; Kokuryo, Shinya; Miyamoto, Ikuya; Yoshiga, Daigo; Seta, Yuji; Tominaga, Kazuhiro; Yoshioka, Izumi; Morimoto, Yasuhiro

2013-12-01

To elucidate the characteristics of visualizing thin main peripheral vessels in oral and maxillofacial regions of 3-dimensional magnetic resonance angiography (MRA) using a balanced steady-state free-precession (SSFP) sequence with a time-spatial labeling inversion pulse (time-SLIP) and using fresh blood imaging (FBI). The conspicuity of blood vessels and the characteristics on MRA using SSFP with a time-SLIP was compared with those on MRA using FBI in 20 healthy participants. The conspicuity of the main peripheral arteries was significantly higher on MRA using SSFP with a time-SLIP than on MRA using FBI. MRA scans using SSFP were obtained in all participants, and scans using FBI were obtained in 16 of 20 participants. An electrocardiogram was unnecessary when using SSFP but was necessary when using FBI. MRA obtained using SSFP with a time-SLIP is a useful technique to visualize thin main peripheral arteries in the oral and maxillofacial regions without contrast medium. Copyright © 2013 Elsevier Inc. All rights reserved.

[Screening for psychiatric risk factors in a facial trauma patients. Validating a questionnaire].

PubMed

Foletti, J M; Bruneau, S; Farisse, J; Thiery, G; Chossegros, C; Guyot, L

2014-12-01

We recorded similarities between patients managed in the psychiatry department and in the maxillo-facial surgical unit. Our hypothesis was that some psychiatric conditions act as risk factors for facial trauma. We had for aim to test our hypothesis and to validate a simple and efficient questionnaire to identify these psychiatric disorders. Fifty-eight consenting patients with facial trauma, recruited prospectively in the 3 maxillo-facial surgery departments of the Marseille area during 3 months (December 2012-March 2013) completed a self-questionnaire based on the French version of 3 validated screening tests (Self Reported Psychopathy test, Rapid Alcohol Problem Screening test quantity-frequency, and Personal Health Questionnaire). This preliminary study confirmed that psychiatric conditions detected by our questionnaire, namely alcohol abuse and dependence, substance abuse, and depression, were risk factors for facial trauma. Maxillo-facial surgeons are often unaware of psychiatric disorders that may be the cause of facial trauma. The self-screening test we propose allows documenting the psychiatric history of patients and implementing earlier psychiatric care. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

3D cinematic rendering of the calvarium, maxillofacial structures, and skull base: preliminary observations.

PubMed

Rowe, Steven P; Zinreich, S James; Fishman, Elliot K

2018-06-01

Three-dimensional (3D) visualizations of volumetric data from CT have gained widespread clinical acceptance and are an important method for evaluating complex anatomy and pathology. Recently, cinematic rendering (CR), a new 3D visualization methodology, has become available. CR utilizes a lighting model that allows for the production of photorealistic images from isotropic voxel data. Given how new this technique is, studies to evaluate its clinical utility and any potential advantages or disadvantages relative to other 3D methods such as volume rendering have yet to be published. In this pictorial review, we provide examples of normal calvarial, maxillofacial, and skull base anatomy and pathological conditions that highlight the potential for CR images to aid in patient evaluation and treatment planning. The highly detailed images and nuanced shadowing that are intrinsic to CR are well suited to the display of the complex anatomy in this region of the body. We look forward to studies with CR that will ascertain the ultimate value of this methodology to evaluate calvarium, maxillofacial, and skull base morphology as well as other complex anatomic structures.

[Flowcytometry DNA analysis of oral and maxillofacial non-Hodgkin's lymphoma].

PubMed

Ma, Li; He, Zhixiu; Wu, Lanyan; Cai, Yixin; Huang, Hechang; Lei, Song

2002-06-01

The purpose of this study was to investigate the relationship between the results of flowcytometry analyses of different clinical stage, location, pathologic grade and cell origin of oral and maxillofacial non-Hodgkin's lymphoma (NHL), and the diagnostic value of flowcytometry analysis in lymphoma. This study analyzed 50 oral and maxillofacial NHL cases and 10 reactive lymph nodes (formalin fixed and paraffin embedded) by flowcytometry (FCM). Reactive lymph nodes were all diploid. The diploid rate of NHL was 54%, and aneuploidy rate was 46%. There was statistically significant difference between reactive lymph nodes and NHL in the DNA ploidy status and cell cycle data (SPF, CV, S + G2/M, DI). The S phase fraction (SPF) and S + G2/M had close relationship with the grade of NHL. SPF value and DNA ploidy status had no obvious relationship with the prognosis. The results suggested that the FCM had diagnostic value in NHL, especially when the morphological diagnosis was difficult. Although the cell cycle data had no prognostic value, SPF and SPF + G2/M can show the proliferative status of NHL, which can help clinical doctor select therapeutic method.

[Up-to-date approach to treatment of inflammatory infections in the maxillofacial region].

PubMed

Romantsov, M G; Kovalevskiĭ, M A; Iaremenko, A I; Grigorian, S S; Kovalenko, A L

2009-01-01

Cycloferon, a prospective interferon inductor, and the mechanism of its action were characterized. Its formulation for external use as liniment was developed. The pharmacotherapeutic effect of the drug in the treatment of paradontitis was shown. The drug efficacy in herpetic lesions of the mouth and lips mucosa was observed. The use of cycloferon in the treatment of the buccal mucosa affections in HIV-infected subjects was substantiated.

Controversies in Oral and Maxillofacial Pathology.

PubMed

Peacock, Zachary S

2017-11-01

Several benign pathologic entities that are commonly encountered by the oral and maxillofacial surgeon remain controversial. From etiology to treatment, no consensus exists in the literature regarding the best treatment of benign lesions, such as the keratocystic odontogenic tumor, giant cell lesion, or ameloblastoma. Given the need for often-morbid treatment to prevent recurrence of these lesions, multiple less-invasive treatments exist in the literature for each entity with little agreement. As the molecular and genomic pathogenesis of these lesions are better understood, directed treatments will hopefully lessen the contention in management. Copyright © 2017 Elsevier Inc. All rights reserved.

A novel speech prosthesis for mandibular guidance therapy in hemimandibulectomy patient: A clinical report

PubMed Central

Adaki, Raghavendra; Shigli, Kamal; Hormuzdi, Dinshaw M.; Gali, Sivaranjani

2016-01-01

Treating diverse maxillofacial patients poses a challenge to the maxillofacial prosthodontist. Rehabilitation of hemimandibulectomy patients must aim at restoring mastication and other functions such as intelligible speech, swallowing, and esthetics. Prosthetic methods such as palatal ramp and mandibular guiding flange reposition the deviated mandible. Such prosthesis can also be used to restore speech in case of patients with debilitating speech following surgical resection. This clinical report gives detail of a hemimandibulectomy patient provided with an interim removable dental speech prosthesis with composite resin flange for mandibular guidance therapy. PMID:27041917

Comparison of circummandibular wiring with resorbable bone plates in pediatric mandibular fractures.

PubMed

Saikrishna, D; Gupta, Nimish

2010-06-01

Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning as well as in their functional and nutritional needs which are different from that of adult patients. Early literature has advocated conservative closed management of pediatric fractures to prevent complications. However recent advances in maxillofacial surgery has enabled us to use biodegradable plates and screws, which overcomes the limitations of metallic plates. We present a comparison of two cases of parasymphysis fracture treated with circum-mandibular wiring and biodegradable plate fixation their outcome in terms of fracture healing and functional stability.

The lingual splint: an often forgotten method for fixating pediatric mandibular fractures.

PubMed

Binahmed, Abdulaziz; Sansalone, Claudio; Garbedian, Justin; Sándor, George K B

2007-01-01

Maxillofacial fractures are uncommon in the pediatric population, and their treatment is unique due to the psychological, physiological, developmental and anatomical characteristics of children. We present the case of a boy who was treated in an outpatient dental clinic using a lingual splint for the reduction, stabilization and fixation of a mandibular body fracture. This technique is a reliable, noninvasive procedure that dentists may consider in selected cases by referral to an oral and maxillofacial surgeon. It also limits the discomfort and morbidity that can be associated with maxillomandibular fixation or open reduction and internal fixation in pediatric patients.

[Color Doppler ultrasonography--a new imaging procedure in maxillofacial surgery].

PubMed

Reinert, S; Lentrodt, J

1991-01-01

Colour Doppler ultrasonography shows blood flow in real time and colour by combining the features of real time B mode ultrasound and Doppler. At each point in the image the returning signal is interrogated for both amplitude and frequency information. The resulting image shows all non-moving structures in shades of gray and moving structures in shades of red or blue depending on direction and velocity. The technique of colour Doppler ultrasonography and our experiences in 63 examinations are described. The clinical application of this new simple non-invasive method in maxillo-facial surgery is discussed.

Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odontogenic and Maxillofacial Bone Tumors.

PubMed

Wright, John M; Vered, Marilena

2017-03-01

The 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017. This article provides a summary of the changes to Chapter 4 Tumours of the oral cavity and mobile tongue and Chapter 8 Odontogenic and maxillofacial bone tumours. Odontogenic cysts which were eliminated from the 3rd 2005 edition were included in the 4th edition as well as other unique allied conditons of the jaws. Many new tumors published since 2005 have been included in the 2017 classification.

Management of Cleft Maxillary Hypoplasia with Anterior Maxillary Distraction: Our Experience.

PubMed

Chacko, Tojan; Vinod, Sankar; Mani, Varghese; George, Arun; Sivaprasad, K K

2014-12-01

Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment.

Imaging of Dentoalveolar and Jaw Trauma.

PubMed

Alimohammadi, Reyhaneh

2018-01-01

Prior to the invention of cone beam CT, use of 2-D plain film imaging for trauma involving the mandible was common practice, with CT imaging opted for in cases of more complex situations, especially in the maxilla and related structures. Cone beam CT has emerged as a reasonable and reliable alternative considering radiation dosage, image quality, and comfort for the patient. This article presents an overview of the patterns of dental and maxillofacial fractures using conventional and advanced imaging techniques illustrated with multiple clinical examples selected from the author's oral and maxillofacial radiology practice database. Published by Elsevier Inc.

[Dentist's work at the treatment of maxillofacial injuries under extraordinary circumstances].

PubMed

Novosel, M

1990-01-01

In the article the author describes the possibilities of dentist's work with maxillo-facially injured persons in cases of greater mass disasters as earth-quakes, floods, greater traffic accidents, and recently also the accidents at sports stadiums and demonstrations. Owing to extraordinary circumstances and a great number of injured people on a small place, and short time available, simple methods of temporary immobilisation are used, which are carried out from the place of the injury to the transport in a specialist institution, where the final specialist treatment begins. Some of these methods are described by the author.

[Treatment analyses of 143 patients with maxillofacial and cervical venous malformations involved in isthmus faucium area].

PubMed

Ge, C X; Tai, M Z; Chen, T; Li, K L; Qin, Z P

2017-12-07

Objective: To analyze the clinical data and summarize therapeutic experiences of cervicofacial venous malformations involving isthmus faucium area. Methods: Clinical records from 143 patients with venous malformations involving isthmus faucium area treated at our hospital between January 2012 and January 2016 were reviewed. There were 70 males and 73 females. Age ranged from 1 to 52 years old, with a median age of 14.5 years. There were 19 cases with lesions involving in only 1 subanatomic area above and 124 cases with lesions involving in more than 1 subanatomic areas, including 63 cases with lesions involving in more than 2 areas. There were 50 patients presenting with additional maxillofacial and cervical lesions. Clinical symptoms included snoring ( n =98), indistinct phonation ( n =49), and tonsil hypertrophy more than degree Ⅱ ( n =19). Tracheotomy was performed in 3 patients prior to hospitalization, contigency tracheotomy during hospitalization in 10 patients, and oral trachea cannula in other patients. All therapeutic procedures, including single chemical ablation with ethanol injection ( n =94), single lesion resection ( n =9) and both of them ( n =40), were performed under general anesthesia. Treatment remedies included mesh suture, macroglossia reduction and excision of maxillofacial and cervical lesions for patients presenting with extensive malformations extending to maxillofacial and cervical area. Tonsil resection were done in patients having tonsil venous malformations or tonsil hypertrophy more than degree II. Achauer's 4-grade criterion was applied to evaluate the treatment outcomes. SPSS 18.0 software was used to analyze the data. Results: Trachea cannula were not extubated untill 24 to 48 hours after treatment. Emergency tracheotomy was done in 2 cases after extubations because of dyspnea, and successful extubations were obtained in other cases. There were no advents of pulmonary vascular spasm or pulmonary embolism. There was significant difference between before and after operation (snore: χ(2)=105.431, ambiguous pronunciation: χ(2)=59.698, tonsil hypertrophy more than degree Ⅱ: χ(2)=33.530, all P <0.01). The patients were followed-up for 1-4 years, and there were 123 cases at grade Ⅳ (complete disappear of lesions in 62 cases without recurrence), 17 at grade Ⅲ , 3 at grade Ⅱ, and no case at gradeⅠ. Conclusions: Chemical ablation with ethanol injection for venous malformations involving isthmus faucium area is recommended, wheras combined remedies including injection, mesh suture, macroglossia reduction, and excision of cervicofacial lesions are suggested in treatment of extensive lesions extending to maxillofacial and cervical area. Tonsil resection should be done in patients having tonsil venous malformations or tonsil hypertrophy more than degree Ⅱ, which is safe and highly effective, with good reservation of function, in the treatment of maxillofacial and cervical venous malformations involving isthmus faucium area.

Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China.

PubMed

Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping

2017-01-01

Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.

Diagnostic tools in maxillofacial fractures: Is there really a need of three-dimensional computed tomography?

PubMed Central

Shah, Sheerin; Uppal, Sanjeev K.; Mittal, Rajinder K.; Garg, Ramneesh; Saggar, Kavita; Dhawan, Rishi

2016-01-01

Introduction: Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Materials and Methods: Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. Results: CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. Conclusion: 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT. PMID:27833286

Improvement in the repair of defects in maxillofacial soft tissue in irradiated minipigs by a mixture of adipose-derived stem cells and platelet-rich fibrin.

PubMed

Chen, Yuanzheng; Niu, Zhanguo; Xue, Yan; Yuan, Fukang; Fu, Yanjie; Bai, Nan

2014-10-01

To find out if adipose-derived stem cells (ASC) and platelet-rich fibrin (PRF), alone or combined, had any effect on the repair of maxillofacial soft tissue defects in irradiated minipigs, ASC were isolated, characterised, and expanded. Twenty female minipigs, the right parotid glands of which had been irradiated, were randomly divided into 4 groups of 5 each: those in the first group were injected with both ASC and PRF (combined group), the second group was injected with ASC alone (ASC group), the third group with PRF alone (PRF group), and the fourth group with phosphate buffer saline (PBS) (control group). Six months after the last injection, the size and depth of each defect were assessed, and subcutaneous tissues were harvested, stained with haematoxylin and eosin, and examined immunohistologically and for apoptosis. Expanded cells were successfully isolated and identified. Six months after injection the defects in the 3 treated groups were significantly smaller (p<0.001) and shallower (p<0.001) than those in the control group. Those in the combined group were the smallest and shallowest. Haematoxylin and eosin showed that the 3 treated groups contained more subcutaneous adipose tissue than the control group, and also had significantly greater vascular density (p<0.001) and fewer apoptotic cells (p<0.001). Both ASC and PRF facilitate the repair of defects in maxillofacial soft tissue in irradiated minipigs, and their combined use is more effective than their use as single agents. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Contemporary update on the treatment of dog bite: injuries to the oral and maxillofacial region.

PubMed

Foster, Michael D; Hudson, John W

2015-05-01

The purpose of the present retrospective record review was to evaluate the patient demographics, treatment rendered, and long-term outcomes of patients injured in dog bite attacks to the oral and maxillofacial region. In the present study, a retrospective medical record review was conducted of patients treated by the oral and maxillofacial surgery department at the University of Tennessee Medical Center who had presented with injuries to the head, neck, and face region from dog bite attacks from February 1, 2006 to October 31, 2013. Each patient included had to have had at least 1 follow-up visit. The data obtained from the patients' medical records included patient demographics, event details, injuries sustained, and treatment rendered and analyzed. The medical records from 20 patients were included and reviewed. More than one half (60%) of the patients were younger than 12 years old. The dog was owned by the patient or a relative in 58% of the cases. The children sustained injuries requiring hospital admission and repair in an operating room setting more often than did the adults. Pit bulls were more frequently associated with injuries than other breeds (9 of 20). Our patients required a total of 28 hospital inpatient days, 29 total procedures, and follow-up treatment for up to 2 years. Our review has shown the complexity of soft tissue injury treatment and the significant financial impact associated with dog bite injuries owing to the multiple hospital admissions, surgical revisions, and lengthy follow-up period required. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Laser ablation in temporomandibular joint disorders and a case report involving an ossifying fibroma: how optics could potentially advance treatments in oral and maxillofacial surgery

NASA Astrophysics Data System (ADS)

Tandon, Rahul; Stevens, Timothy W.; Stringer, Dale E.; Dean, Jeff S.; Herford, Alan S.

2013-03-01

Introduction: In the field of oral and maxillofacial surgery, there are many applications for lasers and optics. The first part of this manuscript is to discuss laser therapy and garner suggestions on how it can be improved. The second part is to present a case in which complications of a bone graft delayed healing and a return to normalcy for the patient. It is the goal of this paper to utilize the new advancements in optics so that patient care can be improved. Laser Therapy: Laser ablation and low-level laser therapy have been used in a variety of joint adhesion cases, including arthritis of the hand and foot. In the field of oral and maxillofacial surgery, this method has been used to treat pain and mobility dysfunction in patients with temporomandibular joint disease. While the outcomes have been promising, lack of familiarity with the device or doubt about its effects have reduced its use. This reduction in use has left the actual process of laser therapy relatively unchanged. Case Presentation: A 28 year-old female presented for a mandibular resection due to an ossifying fibroma. In the next several months her reconstructed area displayed significant signs of infection, as well as graft failure. X-rays, unfortunately, did not display the actual metabolic activity. Although the patient was reconstructed successfully thereafter, with more advanced technology available the patient could have endured a more comfortable treatment. Conclusion: While there are many more areas of oral and maxillofacial surgery that could potentially benefit from advances in optical technology, we have chosen to highlight these two areas due to their prevalence within our community.

Diagnostic tools in maxillofacial fractures: Is there really a need of three-dimensional computed tomography?

PubMed

Shah, Sheerin; Uppal, Sanjeev K; Mittal, Rajinder K; Garg, Ramneesh; Saggar, Kavita; Dhawan, Rishi

2016-01-01

Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT.

Practice patterns of oral and maxillofacial surgeons in Australia: 1990 and 2000.

PubMed

Brennan, D S; Spencer, A J; Singh, K A; Teusner, D N; Goss, A N

2004-09-01

This study was undertaken to describe practice patterns of oral and maxillofacial surgeons in Australia and compare trends over time. All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. Data were available from 79 surgeons from 1990 (response rate = 73.8%) and 116 surgeons from 2000 (response rate = 65.1%). In both 1990 and 2000 the majority of surgeons worked 80+% of the time in the private sector (64.1 and 71.4%), had 80+% referrals from dental versus medical sources (74.0 and 74.7%), and had 80+% of patients from dentoalveolar rather than major maxillofacial surgery (70.7 and 69.7%). The percentage of dual qualified (dental plus medical degree) surgeons increased from 2.5% in 1990 to 17.1% in 2000 (P < 0.05; chi2). In 2000, surgeons who worked less than 80% in the private sector were more likely to report being overworked (57.9%) and that more surgeons were required in the public sector (65.0%) than those who worked 80% or more private (17.0 and 24.0%, respectively). Multivariate linear regressions of annual non-dentoalveolar surgical procedures per surgeon showed (P < 0.05) higher provision of implant (beta = 0.362), TMJ (beta = 0.267) and bone graft surgery (beta = 0.208) in 2000 compared to 1990, and higher provision of orthognathic (beta = 0.199), implant (beta = 0.194) and bone graft surgery (beta = 0.289) by dual qualified surgeons compared to those with only dental qualifications. Despite the mix of cases remaining predominantly dentoalveolar there was some change over time for selected non-dentoalveolar surgical procedures, with growth in the percentage of medically qualified surgeons and differences in surgery rates by qualification.

A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia.

PubMed

Ramli, Roszalina; Rahman, Normastura Abdul; Rahman, Roslan Abdul; Hussaini, Haizal Mohd; Hamid, Abdul Latif Abdul

2011-04-01

Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia. A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed. Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital. Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods. © 2011 John Wiley & Sons A/S.

Future of bone pathology, bone grafting, and osseointegration in oral and maxillofacial surgery: how applying optical advancements can help both fields

NASA Astrophysics Data System (ADS)

Tandon, Rahul; Herford, Alan S.

2013-03-01

Introduction: In recent years, advances in technology are propelling the field of oral and maxillofacial surgery into new realms. With a relatively thin alveolar mucosa overlying the underlying bone, significant diagnostic and therapeutic advantages are present. However, there remains an enormous gap between advancements in physics, in particular optics, and oral and maxillofacial surgery. Bone Pathology: Improvements in diagnosis, classification, and treatment of the various bone pathologies are still being sought after as advancements in technology continue to progress. Combining the clinical, histological, and pathological characteristics with these advancements, patients with debilitating pathologies may have more promising treatment options and prognosis. Bone Grafting: Defects in the facial bones, in particular the jaws, may be due to a number of reasons: pathology, trauma, infections, congenital deformities, or simply due to atrophy. Bone grafting is commonly employed to correct such defects, and allows new bone formation through tissue regeneration. Osseointegration: Growing use of dental implants has focused attention on osseointegration and its process. Osseointegration refers to the actual process of the direct contact between bone and implant, without an intervening soft tissue layer. The theories proposed regarding this process are many, yet there lacks a clear, unified stance on the actual process and its mechanisms. Further investigation using optical probes could provide that unifying answer. Conclusion: The primary goal of this lecture is to introduce pioneers in the field of optics to the field of oral and maxillofacial surgery. With a brief introduction into the procedures and techniques, we are hopeful to bridge the ever-widening gap between the clinical science and the basic sciences.

Risk factors for intraoperative bradycardia during ear, nose, throat and maxillofacial surgery.

PubMed

Ivošević, Tjaša; Miličić, Biljana; Dimitrijević, Milovan; Ivanović, Branislava; Pavlović, Aleksandar; Stojanović, Marina; Lakićević, Mirko; Stevanović, Ksenija; Kalezić, Nevena

2018-02-01

Intraoperative bradycardia (IOB) is one of the most common cardiac arrhythmias observed in clinical anaesthetic practice. Controlled hypotension, as a strategy of lowering patient's blood pressure during anesthesia has been practiced for decades in head and neck surgery. The aim of our study was to determine the incidence and the risk factors for intraoperative bradycardia in maxillofacial, ear, nose and throat surgery, as well as to determine whether controlled hypotension affects the occurrence of IOB. The retrospective study included 2304 patients who underwent maxillofacial, ear, nose or throat surgery. We studied the influence of: sex, age, comorbidity, type of surgery, duration of anesthesia and controlled hypotension on the occurrence of IOB. IOB was registered in 473 patients (20.5%). Patients with controlled hypotension had IOB significantly more often than patients without controlled hypotension (33.9 vs 15.1%) (p = 0.000). The significant predictors of IOB were: age (OR = 1.158; 95% CI = 1.068-1.256; p = 0.000), sex (OR = 0.786; 95% CI = 0.623-0.993; p = 0.043), ischemic heart disease (OR = 2.016; 95% CI = 1.182-3.441; p = 0.010); ear surgery (OR = 1.593; 95% CI = 1.232-2.060; p = 0.000), anesthesia duration, (OR = 1.006; 95% CI = 1.004-1.007; p = 0.000) and controlled hypotension (OR = 2.204; 95% CI = 1.761-2.758; p = 0.000). IOB is common in maxillofacial, ear, nose and throat surgery, particularly in male, older age and patients with ishemic heart disease. The ear surgery, longer anesthesia duration and controlled hypotension raise the risk for occurrence of IOB.

Facial fractures in football: incidence, site, and mechanism of injury.

PubMed

Kim, S Y; Chan, C L; Hyam, D M

2016-10-01

Football injuries are responsible for many of the maxillofacial injuries sustained during sporting activities. In the Australian Capital Territory (ACT), the four major types of Australian football are played in large numbers and up to a high standard. Our objective was to analyse maxillofacial fractures that were sustained during rugby league, rugby union, Australian rules, and soccer matches. We retrospectively studied 134 patients with maxillofacial fractures during the five-year period 2010-14. All patients were assessed and treated at Canberra Hospital, the major trauma centre in the ACT. Data collected from patients' records included type of football, age, sex, mechanism of injury, site of injury, and treatment. The number of people registered to play was obtained from each football governing body to find out the incidence of fractures. League had the highest incidence of facial fractures, followed by union, Australian rules, and soccer. High speed and high collision football (league and union) had a higher rate of mandibular fractures than high speed and low contact football (Australian rules and soccer) (n=43, 45% compared with n=7, 21%). Australian rules and soccer had a higher incidence of midface fractures than league and union (n=26, 79%, compared with n=52, 55%). Clash of heads was the leading cause of fractures. Collisions against other players' shoulders and forearms were more likely to cause mandible fractures. Ninety-four patients (70%) required surgical intervention. Football-related maxillofacial fractures occur regularly, and different types of football have predictable patterns of injury. Padding of the heads and elbows of players may reduce the number and seriousness of facial fractures. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Prosthetically guided maxillofacial surgery: evaluation of the accuracy of a surgical guide and custom-made bone plate in oncology patients after mandibular reconstruction.

PubMed

Mazzoni, Simona; Marchetti, Claudio; Sgarzani, Rossella; Cipriani, Riccardo; Scotti, Roberto; Ciocca, Leonardo

2013-06-01

The aim of the present study was to evaluate the accuracy of prosthetically guided maxillofacial surgery in reconstructing the mandible with a free vascularized flap using custom-made bone plates and a surgical guide to cut the mandible and fibula. The surgical protocol was applied in a study group of seven consecutive mandibular-reconstructed patients who were compared with a control group treated using the standard preplating technique on stereolithographic models (indirect computer-aided design/computer-aided manufacturing method). The precision of both surgical techniques (prosthetically guided maxillofacial surgery and indirect computer-aided design/computer-aided manufacturing procedure) was evaluated by comparing preoperative and postoperative computed tomographic data and assessment of specific landmarks. With regard to midline deviation, no significant difference was documented between the test and control groups. With regard to mandibular angle shift, only one left angle shift on the lateral plane showed a statistically significant difference between the groups. With regard to angular deviation of the body axis, the data showed a significant difference in the arch deviation. All patients in the control group registered greater than 8 degrees of deviation, determining a facial contracture of the external profile at the lower margin of the mandible. With regard to condylar position, the postoperative condylar position was better in the test group than in the control group, although no significant difference was detected. The new protocol for mandibular reconstruction using computer-aided design/computer-aided manufacturing prosthetically guided maxillofacial surgery to construct custom-made guides and plates may represent a viable method of reproducing the patient's anatomical contour, giving the surgeon better procedural control and reducing procedure time. Therapeutic, III.

Influence of low-level laser therapy on the healing of human bone maxillofacial defects: A systematic review.

PubMed

Santinoni, Carolina Dos Santos; Oliveira, Hiskell Francine Fernandes; Batista, Victor Eduardo de Souza; Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos

2017-04-01

This systematic review evaluates the effectiveness of low-level laser therapy (LLLT) to enhance maxillofacial area bone repair. A comprehensive search of studies published up to February 2017 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The 15 selected studies evaluated a total of 374 patients (mean age, 28.5years) who were treated with LLLT. Gallium-arsenide (GaAs) and gallium aluminium arsenide (GaAlAs) were the most commonly used devices, and LLLT parameters varied greatly. Wavelengths varied from 500 to 1000nm. Tooth extraction, distraction osteogenesis, maxillary expansion, periodontal defects, orthodontic movement and maxillary cystic defects were evaluated. From the 15 selected studies, six evaluated bone repair (primary outcomes). Of these, four studies showed improvement in bone formation after using LLLT, two demonstrated improved results for only one follow up period, and one showed no additional benefits. The other 9 studies evaluated secondary parameters related to healing (secondary outcomes) in the maxillofacial area after applying LLLT, including anti-inflammatory, analgesic, and healing accelerator effects, and quality of life related to oral health. There were no adverse or negative effects of LLLT reported. Within the limitation of this review, a possible improvement in bone density can be found when LLLT is applied postoperatively in maxillofacial bony defects. LLLT also seems to promote anti-inflammatory and analgesic effects and accelerate healing, as well as enhance quality of life related to oral health. However, LLLT use protocols need to be standardized before more specific conclusions can be drawn about this subject. Copyright © 2017 Elsevier B.V. All rights reserved.

Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals.

PubMed

Rahman, Roslan Abdul; Ramli, Roszalina; Rahman, Normastura Abdul; Hussaini, Haizal Mohd; Idrus, Sharifah Munirah Ai; Hamid, Abdul Latif Abdul

2007-06-01

Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia. Patients' records of three selected hospitals in Malaysia (National University of Malaysia Hospital, Kajang Hospital and Seremban Hospital) from January 1999 to December 2001 were reviewed. Data associated with demographics, etiology of injury in relation to age group, type of injuries whether soft tissues of hard tissue in relation to age group and treatment modalities were collected. A total of 521 pediatric patients' records were reviewed. Malays made up the majority of patients with maxillofacial injuries in the three hospitals. Males outnumbered females in all the three hospitals. Injuries commonly occur in the 11-16 years old. MVA was the most common etiology followed by fall and assault. Soft tissue injuries were the most common type of injuries in all the hospitals. In relation to fractures, mandible was the most common bone to fracture with condyle being the most common site. Orbital fracture was the most common fracture in the midfacial area. Most of the fractures were managed conservatively especially in the younger age groups. Open reduction with or without internal fixation was more frequently carried out in the 11-16 years old group. Children exhibit different pattern of clinical features depending on the etiology and stage of their bone maturation. A dedicated team, who is competent in trauma and aware of the unique anatomy, physical and psychological characteristics of children, should manage pediatric patient with trauma.

Patterns of Maxillofacial Fractures in Uttar Pradesh, India

PubMed Central

Agarwal, Padmanidhi; Mehrotra, Divya; Agarwal, Rajul; Kumar, Sumit; Pandey, Rahul

2016-01-01

This study aimed to obtain dependable epidemiologic data of the variation in cause and characteristics of maxillofacial fractures by identifying, describing, and quantifying trauma. This retrospective study was conducted in the state of Uttar Pradesh, India, over 1 year, based on a systematic computer-assisted database search from March 2015 to March 2016 for maxillofacial fractures. The demographics, etiology, geographic distribution, date of injury, site and number of fractures, and type of intervention were recorded for each. The study population consisted of 1,000 patients with 1,543 fractures. The male:female ratio was 8:1. A peak incidence of fractures was seen in the third decade (mean age: 30.3) with maximum patients younger than 40 years (80.8%). The incidence of fractures was highest in spring (42.9%). Road traffic accidents were the most common cause of trauma (64.4%) and mainly involved two wheelers (60.2%). Single-site fractures were most common. Mostly zygomatic (45.1%) and mandibular fractures (44.4%) were encountered, accounting for approximately 90% of all fractures. The main site of mandibular fractures was the body (34.4%); 46.2% of fractures underwent open reduction and internal fixation (ORIF) while 53.8% were treated by closed methods. The study provides important data to contrive future plans for injury prevention. The trend of most traffic-related injuries continues with the increasing traffic on roads. Zygomatic complex and mandibular fractures remain the most frequent. The major populations at risk are young men and those driving two wheelers. The use of helmets could achieve a large reduction in maxillofacial fractures. Awareness for preventive measures and safety guidelines should be propagated and legislation on traffic rules strictly reinforced. PMID:28210408

Use of the Internet by patients attending hospital for oral and maxillofacial procedures.

PubMed

Shafi, A; Dewar, A; Cowan, C; Sood, V; Brennan, P A; Hislop, S

2014-01-01

Information obtained on the Internet regarding medical procedures is largely unregulated and can be confusing. The aims of this study were to assess use of the Internet by patients attending hospital for oral and maxillofacial procedures, and to assess the quality of information provided at consultation. Data were collected prospectively using a confidential questionnaire, which was distributed to consecutive patients attending for elective operations at 2 oral and maxillofacial units: Crosshouse Hospital, Kilmarnock, and Queen Alexandra Hospital, Portsmouth (n=100 at each unit). All the distributed questionnaires were returned. At both units, 95% of patients thought that discussion at the initial consultation was good or very good, and 84% at both units stated that they had access to the Internet. Internet access was consistently high among all age groups up to the age of 65, but in those aged over 65 it was considerably lower. A total of 22/84 patients (26%) at Crosshouse, and 14/84 (17%) at Queen Alexandra used the Internet to gain further information regarding their condition or procedure. All of those (n=14) at Queen Alexandra, and 21/22 at Crosshouse had used Google to search for the information. Those who used the Internet to find information on their medical condition or procedure found it to be a useful resource, but they also stated that the information caused some concerns. With use of the Internet and access to it increasing we highlight the need for regulated and appropriate websites to which patients should be directed. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Usefulness of computed tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality.

PubMed

Toso, Francesco; Zuiani, Chiara; Vergendo, Maurizio; Salvo, Iolanda; Robiony, Massimo; Politi, Massimo; Bazzocchi, Massimo

2005-01-01

To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomic and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients after simulation of the procedure on the stereolithographyc model. The solid prototypes constructed in the difficult cases were sufficiently detailed despite problems related to the artefacts generated by dental fillings an d prostheses. In the remaining cases the MPR/3D images were sufficiently detailed for surgical planning. The surgical results were excellent in all patients who underwent surgery, and the surgeons were satisfied with the improvement in quality and the reduction in time required for the procedure. MDCT enables rapid prototyping using solid replication, which was very helpful in maxillo-facial surgery, despite problems related to artifacts due to dental fillings and prosthesis within the acquisition field; solutions for this problem are work in progress. The protocol used for communication between the different laboratories was valid and reproducible.

Use of maxillofacial laboratory materials to construct a tissue-equivalent head phantom with removable titanium implantable devices for use in verification of the dose of intensity-modulated radiotherapy.

PubMed

Morris, K

2017-06-01

The dose of radiotherapy is often verified by measuring the dose of radiation at specific points within a phantom. The presence of high-density implant materials such as titanium, however, may cause complications both during calculation and delivery of the dose. Numerous studies have reported photon/electron backscatter and alteration of the dose by high-density implants, but we know of no evidence of a dosimetry phantom that incorporates high density implants or fixtures. The aim of the study was to design and manufacture a tissue-equivalent head phantom for use in verification of the dose in radiotherapy using a combination of traditional laboratory materials and techniques and 3-dimensional technology that can incorporate titanium maxillofacial devices. Digital designs were used together with Mimics® 18.0 (Materialise NV) and FreeForm® software. DICOM data were downloaded and manipulated into the final pieces of the phantom mould. Three-dimensional digital objects were converted into STL files and exported for additional stereolithography. Phantoms were constructed in four stages: material testing and selection, design of a 3-dimensional mould, manufacture of implants, and final fabrication of the phantom using traditional laboratory techniques. Three tissue-equivalent materials were found and used to successfully manufacture a suitable phantom with interchangeable sections that contained three versions of titanium maxillofacial implants. Maxillofacial and other materials can be used to successfully construct a head phantom with interchangeable titanium implant sections for use in verification of doses of radiotherapy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

What are we reading? A study of downloaded and cited articles from the British Journal of Oral and Maxillofacial Surgery in 2010.

PubMed

Brennan, Peter A; Habib, Ahmed

2011-10-01

A large number of papers related to oral and maxillofacial surgery are published in many specialist journals. With the ever-increasing use of the internet it is easy to download them as part of a journal subscription on a fee per paper basis, or in some cases for free. Online access to the British Journal of Oral and Maxillofacial Surgery (BJOMS) is free to British Association (BAOMS) members with a $30 fee per paper download for non-members. Many colleagues use the online version of the journal, and this provides valuable information about downloading trends. Other data on articles that have been cited in subsequent publications are also readily available, and they form the basis for the calculation of a journal's impact factor. We evaluated the top 50 downloaded papers from the BJOMS website in 2010 to ascertain which articles were being read online. We also obtained data on the number of citations for papers published in 2009-2010 to see whether these papers were similar to the articles being downloaded. In 2010 there were over 360000 downloaded articles. The most popular papers were leading articles, reviews, and full length articles; only one short communication featured in the top 50 downloads. The papers most cited in subsequent publications were full length articles and leading articles or reviews, which represent 80% of the total citations of the 50 papers. Ten papers were in both the top 50 downloaded and most cited lists. We discuss the implications of this study for the journal and our readers. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Penetration of flomoxef into human maxillary and mandibular bones.

PubMed

Igawa, H H; Sugihara, T; Yoshida, T; Kawashima, K; Ohura, T

1995-09-01

Penetration of flomoxef into the maxillary and mandibular bones was assayed clinically to provide data about its usefulness for the prevention of postoperative infection after maxillofacial surgery. Twenty-one patients undergoing maxillofacial surgery at our department were given flomoxef 2 g dissolved in 20 ml of physiological saline intravenously over 3 minutes during operation, and the serum, maxillary and mandibular concentrations were measured 1, 3, and 6 hours after injection by the band culture method using Escherichia coli 7437 as the indicator strain. The mean concentrations were 53.4, 16.1, and 2.6 micrograms/ml, respectively, in the serum, 17.6, 7.8, and 1.0 micrograms/g in maxillary bone, and 16.4, 4.2, and 0.9 micrograms/g in mandibular bone. The mean bone:serum ratios at 1, 3, and 6 hours were 33.0%, 48.2%, and 36.8%, respectively, for maxillary bone, and 30.7%, 26.2%, and 35.7% for mandibular bone. When compared with previously reported data on the bone:serum ratios in jaw of various other intravenous antibiotics, our results show that penetration of flomoxef into maxillary and mandibular bone is extremely high. As all the intramaxillary and intramandibular concentrations exceed its MIC80 values against clinical isolates of bacteria frequently isolated in cases of infection in the oral and maxillofacial region, it is apparent that one intravenous shot of flomoxef 2 g allows penetration of the drug into the maxillary and mandibular bones at effective concentrations. Flomoxef is therefore potentially useful for the prevention and treatment of infections in the oral and maxillofacial region, as it has excellent penetration into the maxillary and mandibular bones.

Orthognathic surgery in the management of obstructive sleep apnoea: experience from maxillofacial surgery unit in the United Kingdom.

PubMed

Islam, Shofiq; Uwadiae, Nosa; Ormiston, Ian W

2014-07-01

In the United Kingdom, maxillofacial techniques are underused in the treatment of obstructive sleep apnoea (OSA). We retrospectively analysed the details and relevant clinical data of consecutive patients who had operations for OSA at the maxillofacial unit in Leicester between 2002 and 2012. They had been referred from the local sleep clinic after investigation and diagnosis, and in all cases treatment with continuous positive airway pressure (CPAP) had failed. We compared preoperative and postoperative apnoea/hypopnoea indices (AHI), scores for the Epworth sleepiness scale (ESS), and lowest oxygen saturation to measure surgical success (AHI of less than 15 and a 50% reduction in the number of apnoeas or hypopnoea/hour) and surgical cure (AHI of less than 5). We identified 51 patients (mean age 44 years, range 21-60) with a mean (SD) body mass index (BMI) of 29 (3.4). Most patients had bimaxillary advancement with genioplasty (n=42). Differences in mean (SD) preoperative and postoperative values were significant for all 3 outcome measures (AHI: 42 (17) to 8 (7) p<0.001; ESS: 14 (4) to 5 (4) p<0.001; lowest oxygen saturation: 76% (11%) to 83% (7%); p=0.006). On the postoperative sleep study 85% of patients met the criteria for surgical success. Our experience has confirmed that bimaxillary advancement results in a high rate of success in patients with OSA. The operation has a role in the management of selected patients in the UK who do not adhere to CPAP. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Development of Biodegradable Implants for Use in Maxillofacial Surgery

DTIC Science & Technology

1988-09-23

Previous edit,ons are obsolete EC1_4 ’ Y C ,S ’iCAT ON OF 7±5S aGE I"L{..-. { ~; ABBREVIATIONS poly(DL-lactide) (DL-PLA) poly(L-lactide) (L-PLA...modulus of L-PLA plates ........... ......................... 53 13 Non-coated hydroxyapatite particles after drying .............. 59 14 Hydroxyapatite ...77 (continued) ix LIST OF FIGURES (continued) Fieure age 23 Drawing No. 1 scale: 1/2" - 1" iaterial:alumina (99.7% A1203

Research and Development of Wound Dressing in Maxillofacial Trauma.

DTIC Science & Technology

1983-03-14

Lidocaine 7 Table 4 PVP-1 2 (BASF 17/12) Microcapsule Size Distribution 8 Table 5 Processing Summary of PVP-1 2 (BASF 17/12) Microencapsulation 9 Table...benzalkonium chloride (Maquat LC-12S) was also incorporated into fabrics and powders. The povidone iodine (BASF 17/12) was microencapsulated using the... microcapsules con- taining povidone iodine. At 30% polymer, 70% of the product was between :- 212-600 microns. This material gave in vitro release of

Numb chin syndrome as a manifestation of possible breast cancer metastasis around dental implants.

PubMed

Orhan, Kaan; Bayndr, Hakan; Aksoy, Seçil; Seker, Basak Kusakci; Berberoğlu, Atilla; Ozan, Oğuz

2011-05-01

Numb chin syndrome, sometimes called numb lip syndrome, is an uncommon but well-recognized symptom in medical oncology. It may be a metastatic neurologic manifestation of malignancy, often with no clinically visible pathologic finding. The authors report a numb chin syndrome as a manifestation possible breast cancer metastasis around dental implants in a 69-year-old woman. The patient was presented with complaint of numbness in the lower jaw. Medical anamnesis revealed a metastatic breast carcinoma (CA). Radiographic imaging with conventional panoramic radiography and cone beam computed tomographic examination, revealed a moth-eaten shape, radiolucent, and radiopaque mixed appearance around the dental implants that was related with possible metastasis of the breast cancer. Numb chin syndrome is almost unknown within the dental and oral and maxillofacial community, despite being well reported in the medical literature. General dentists, oral medicine specialists, and oral and maxillofacial surgeons must be aware of this condition to consider metastatic cancer in patients with unexplained facial hypoesthesia. Moreover, although the development of metastatic lesions around implants is an uncommon pathologic finding, the examination of peri-implant lesion should be performed carefully considering the entire pathologic situations.

[Doctor Albéric Pont (1870-1960). Dental surgeon, doctor and creator of the center of maxillo-facial surgery of Lyon in 1914].

PubMed

Riaud, Xavier

2008-01-01

As Stomatologist and Dental Surgeon Albéric Pont founded with six other Dental Surgeons the School of Dentistry in Lyons which he ran for a long time. When he enlisted in the French Army in 1914 he soon became aware of the extent of facial damage that occurred among the injured soldiers. His subsequent decision was to create and run a Centre for maxillofacial surgery in Lyons. He died in 1960 and left a significant scientific work as well as technical elements of surgery, dental index and devices which still bear his name.

New and emerging patient-centered CT imaging and image-guided treatment paradigms for maxillofacial trauma.

PubMed

Dreizin, David; Nam, Arthur J; Hirsch, Jeffrey; Bernstein, Mark P

2018-06-20

This article reviews the conceptual framework, available evidence, and practical considerations pertaining to nascent and emerging advances in patient-centered CT-imaging and CT-guided surgery for maxillofacial trauma. These include cinematic rendering-a novel method for advanced 3D visualization, incorporation of quantitative CT imaging into the assessment of orbital fractures, low-dose CT imaging protocols made possible with contemporary scanners and reconstruction techniques, the rapidly growing use of cone-beam CT, virtual fracture reduction with design software for surgical pre-planning, the use of 3D printing for fabricating models and implants, and new avenues in CT-guided computer-aided surgery.

Soft tissue fibrosarcoma of pre maxillary region in an adult: report of a unique pathological entity

PubMed Central

Naik, Smitha K.; Astekar, Madhusudhan; Rao, Dinesh

2012-01-01

Fibrosarcoma of the oral and maxillofacial region is a rare entity with poor prognosis. Most common sites are the extremities, with only one percent of fibrosarcoma arising in the head and neck area. Oral fibrosarcoma are locally infiltrative and destructive, spreads by haematogenous dissemination. The positive immunostaining for vimentin, together with negativity for muscular immunomarkers help to diagnosis the fibrosarcoma. Surgical management of fibrosarcoma in maxillofacial region is far from satisfactory, because of lack of inadequate clearance. This paper describes an unusual case of soft tissue fibrosarcoma of premaxillary region in an adult aged 71 years. PMID:24765457

Metallic foreign body in the sphenoid sinus after ballistic injury: a case report.

PubMed

Akhaddar, A; Abouchadi, A; Jidal, M; Gazzaz, M; Elmostarchid, B; Naama, O; Rzin, A; Boucetta, M

2008-05-01

Paranasal sinus injuries by foreign bodies have a lower incidence compared with facial injuries. Among them, penetrating maxillofacial injuries to the sphenoid sinus and skull base remain rare. We report the case of a 41-year-old man who presented with, after a missile-related maxillofacial injury, a metallic foreign body enclosed within the sphenoid sinus with carotid-canal fracture. Angiographic evaluation showed a mass in the right internal carotid artery. The foreign object was successfully extracted through a transmaxillary sublabial approach with a good outcome. We discuss the extensive preoperative evaluation and interdisciplinary management of this unusual injury.

Surgical management in dentistry: the interdisciplinary relationship between periodontology and oral and maxillofacial surgery.

PubMed

Tong, Darryl C

2017-06-01

Surgical procedures of the oral cavity can be performed by a number of dental specialists and clinicians. Because of the limited number of surgical procedures that can be performed inside the oral cavity, the boundaries between specialties may become indistinct and lead to confusion for general dentists in terms of patient referrals. In this article, what the two surgical specialties of dentistry (i.e. periodontology and oral and maxillofacial surgery) have to offer is highlighted, together with clinical examples to illustrate the interdisciplinary relationship between them. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Golden proportion for maxillofacial surgery in Orientals.

PubMed

Kawakami, S; Tsukada, S; Hayashi, H; Takada, Y; Koubayashi, S

1989-11-01

The facial position and balance of eyes, nose, and mouth in typical Japanese individuals were investigated, based on the golden proportion for each of these relationships. We found that Japanese tend to have a longer upper lip and shorter chin length compared with Caucasians. We believe that this tendency represents a general facial characteristic of the Oriental population. Each ratio obtained from determinations by our method was used for preoperative and postoperative aesthetic analysis in maxillofacial surgery. This method is considered useful because it permitted us to understand quantitatively the positional relationship and the balance of eyes, nose, and mouth in the face and to make comparisons with typical subjects.

Survey of Australasian oral and maxillofacial surgeons 2011--scope and workforce issues.

PubMed

Ricciardo, P; Bobinskas, A; Vujcich, N; Nastri, A; Goss, A

2015-12-01

This study examined the qualifications, training, and practice patterns of oral and maxillofacial surgeons in Australia in 2011. This information was compared to similar studies performed in 1986 and 1995. It was found that dentoalveolar surgery comprised the greatest proportion of practice. There had been major growth in dental implantology, orthognathic surgery, and management of pathology. These increases were directly related to the standardization and increase in qualifications and training. The workforce had increased at the highest rate predicted, but was only just keeping up with the increases in population and the number of general health practitioners. Copyright © 2015. Published by Elsevier Ltd.

Gorham-Stout syndrome of the facial bones: a review of pathogenesis and treatment modalities and report of a case with a rare cutaneous manifestations.

PubMed

Al-Jamali, Jamil; Glaum, Ricarda; Kassem, Ahmed; Voss, Pit Jacob; Schmelzeisen, Rainer; Schön, Ralf

2012-12-01

Gorham disease is a very rare condition associated with spontaneous destruction and resorption of 1 or more bones anywhere in the body. Many authors have suggested and/or implicated trauma as the initiating factor in the majority of the reported cases. It can affect almost all bones, and a combination of bones has been reported. In the maxillofacial skeleton, the first facial case was reported by Romer in 1928. Until now, only a few cases of Gorham disease affecting the maxillofacial bones, including this case report, have been reported. We present a brief review of the pathogenesis and treatment modalities of the disease and report a very rare clinical picture of the disease affecting a young and otherwise healthy patient with massive osteolysis of the mandibular bone and extensive involvement of the mouth floor and skin of the chin, which to our knowledge, is the only case report with skin manifestation affecting the maxillofacial region. Such skin manifestations play an important role for the diagnosis and add a clue for management of such condition. Copyright © 2012 Elsevier Inc. All rights reserved.

Composition of chitosan-hydroxyapatite-collagen composite scaffold evaluation after simulated body fluid immersion as reconstruction material

NASA Astrophysics Data System (ADS)

Verisqa, F.; Triaminingsih, S.; Corputty, J. E. M.

2017-08-01

Hydroxyapatite (HA) formation is one of the most important aspects of bone regeneration. Because domestically made chitosan-hydroxyapatite-collagen composite scaffolding from crab shell and bovine bone and tendon has potential as a maxillofacial reconstruction material, the material’s HA-forming ability requires evaluation. The aim of this research is to investigate chitosan-hydroxyapatite-collagen composite scaffold’s potential as a maxillofacial reconstruction material by observing the scaffold’s compositional changes. Scaffold specimens were immersed in 37°C simulated body fluid (SBF) for periods of 2, 4, 6, and 8 days. Scaffold composition was then evaluated by using energy dispersive spectroscopy (EDS). The calcium (Ca) and phosphorus (P) percentages of the scaffold were found to increase following SBF immersion. The high Ca/P ratio (3.82) on the scaffold indicated HA formation. Ion exchange played a significant role in the increased percentages of Ca and P, which led to new HA layer formation. The scaffold’s HA acted as a nucleation site of Ca and P from the SBF, with collagen and chitosan as the scaffold’s matrix. Chitosan-hydroxyapatite-collagen composite scaffold shows potential as a maxillofacial reconstruction material, since its composition favors HA formation.

Clinical, retrospective case-control study on the mechanics of obstacle in mouth opening and malocclusion in patients with maxillofacial fractures.

PubMed

Zhou, Hai-Hua; Lv, Kun; Yang, Rong-Tao; Li, Zhi; Yang, Xue-Wen; Li, Zu-Bing

2018-05-16

This study aims to identify and distinguish various factors that may influence the clinical symptoms (limited mouth opening and malocclusion) in patients with maxillofacial fractures. From January 2000 to December 2009, 963 patients with maxillofacial fractures were enrolled in this statistical study to aid in evaluating the association between various risk factors and clinical symptoms. Patients with fractured posterior mandibles tended to experience serious limitation in mouth opening. Patients who sustained coronoid fractures have the highest risk of serious limitation in mouth opening (OR = 9.849), followed by arch fractures, maxilla fractures, condylar fractures, zygomatic complex fractures and symphysis fractures. Meanwhile, the combined fracture of zygomatic arch and condylar process results in normal or mild mouth opening. High risks of sustaining malocclusion are preceded by the fracture of nasal bone (OR = 3.067), mandible, condylar neck/base, combined fracture of zygomatic arch and condylar process, mandibular body, bilateral condylar, dental trauma, mandibular ramus, symphysis, mandibular angle and mid-facial. Patients who experienced serious limitation in mouth opening are treated with surgery more frequently (OR = 2.118). No relationship exists between the treatment options and the patients with malocclusion.

Thirty years of submental intubation: a review.

PubMed

Lim, D; Ma, B C; Parumo, R; Shanmuhasuntharam, P

2018-05-03

Submental intubation has been used as an alternative to conventional intubation in the field of oral and maxillofacial surgery since its introduction by Francisco Hernández Altemir in 1986. A review of submental intubation was performed using data from all case reports, case-series, and prospective and retrospective studies published between 1986 and 2016. The indications, variations in incision length, incision sites, types of endotracheal tube used, methods of exteriorization, and complications were recorded and analyzed. A total of 70 articles reporting 1021 patients were included. The main indication was maxillofacial trauma (86.9%, n=887), followed by orthognathic surgery (5.8%, n=59), skull base surgery (2.8%, n=29), and rhinoplasty and rhytidectomy (1.5%, n=15). The complication rate was relatively low: 91.0% of patients (n=929) were complication-free. The most common complication was infection, occurring in 3.5% (n=36) of the total number of patients, followed by scarring (1.2%, n=12) and formation of an orocutaneous or salivary fistula (1.1%, n=11). In summary, submental intubation is a good alternative airway with minimal complications. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A retrospective analysis of oral and maxillofacial pathology in an Australian paediatric population.

PubMed

Ha, W N; Kelloway, E; Dost, F; Farah, C S

2014-06-01

The prevalence of oral and maxillofacial pathology has not previously been reported in the Australian paediatric population. This study aimed to audit a large pathology service to provide insight into the prevalence of oral and maxillofacial pathology. Written records of a major Australian oral pathology service were imported into an electronic database. Age, gender and histological diagnosis were assessed. Prevalence of histological diagnoses as a percentage of the major diagnostic categories and of the whole sample were calculated, as well as gender predilections and mean age of presentation of disease. A total of 1305 oral pathology specimens, collected from paediatric patients aged 16 and under were included in the analysis. The most common pathology was dental pathology (24.4%), followed by odontogenic cysts (18.5%) and mucosal pathology (17.0%). The most frequently encountered lesion was the dentigerous cyst (9.4%), followed by fibrous hyperplasia (8.3%), radicular cyst (5.2%) and chronic periapical granuloma (5.2%). In the paediatric population, dental pathology and specifically, the dentigerous cyst is the most common pathology type sent for histopathology, suggesting a high prevalence of pathology of dental origin occurring in Australian children. © 2014 Australian Dental Association.

Clinical Evaluation of an Unsintered Hydroxyapatite/Poly-L-Lactide Osteoconductive Composite Device for the Internal Fixation of Maxillofacial Fractures

PubMed Central

Sukegawa, Shintaro; Kanno, Takahiro; Katase, Naoki; Shibata, Akane; Takahashi, Yuka; Furuki, Yoshihiko

2016-01-01

Introduction: OSTEOTRANS MX (Takiron Co, Ltd, Osaka, Japan) is a resorbable osteosynthetic material composed of an unsintered hydroxyapatite/poly-l-lactide composite, and its osteoconductive capacity has been documented. The authors here report their clinical experience using OSTEOTRANS MX. Methods: The authors treated 35 patients (19 men, 16 women; age, 14–88 years; mean ± standard deviation, 38.4 ± 19.9 years) with maxillofacial fractures. The authors used standard surgery to stabilize fractures in all patients, fitting resorbable plates (thickness, 1.0 or 1.4 mm) and screws (diameter, 2 mm) according to Arbeitsgemeinschaft für Osteosynthesefragen/Association (AO) for the Study of Internal Fixation guidelines. Results: All patients eventually achieved satisfactory healing with favorable restoration of form and function without foreign body reaction. Complications occurred in 3 patients—plate exposure in 2 and discomfort in 1. However, fracture sites healed in all patients. Scanning electron microscopy revealed that the devices bonded directly to the bone without interposition of nonmineralized tissue. Conclusion: OSTEOTRANS MX is a useful material with few complications. Its osteoconductive bioactivity is advantageous for the early functional improvement of maxillofacial fractures. PMID:27428913

Comparison of general anaesthesia versus regional anaesthesia with sedation in selected maxillofacial surgery: a randomized controlled trial.

PubMed

Rastogi, Amit; Gyanesh, Prakhar; Nisha, Surbhi; Agarwal, Appurva; Mishra, Priya; Tiwari, Akhilesh Kumar

2014-04-01

The airway is the foremost challenge in maxillofacial surgery. The major concerns are difficulty in managing the patient's airway and sharing it between the anaesthetist and surgeons. General anaesthesia, with endotracheal intubation, is the commonly used technique for maxillofacial procedures. We assessed the efficacy and safety of a regional block with sedation technique in certain maxillofacial operations, specifically temporomandibular joint (TMJ) ankylosis and mandibular fracture cases, and compared it with conventional general anaesthesia. We compared the time to discharge from the post anaesthesia care unit (PACU) and the occurrence of side effects, as well as surgeon and patient satisfaction with the anaesthetic technique, between the two groups. We enrolled 50 patients of ASA grade 1 or 2, aged 15-50 years, scheduled for maxillofacial surgery (mandibular fracture or TMJ ankylosis). The patients were divided into two groups of 25 each, to receive sedation with a regional block with the use of a peripheral nerve stimulator in group I and general anaesthesia in group II. We observed haemodynamic parameters, intraoperative and postoperative complications and the amount of surgical bleeding in the two groups. Total anaesthesia time, patient and surgeon satisfaction, time to rescue analgesia, the number of rescue doses required, and the time to discharge from the PACU were compared. The groups were comparable with respect to demographic profile, intraoperative haemodynamic parameters, surgical time, and amount of blood loss. Postoperative pain was assessed using the visual analogue score (VAS). Patients in group I had lower VAS scores after surgery and remained pain-free for longer than those in group II. The mean pain-free interval in group I was 159.12 ± 43.95 min and in group II was 60.36 ± 19.77 min (p < 0.005). Patients in group I required lower doses of rescue analgesia than those undergoing the surgery under general anaesthesia (p < 0.005). Patients receiving regional blocks also had fewer episodes of postoperative nausea and vomiting (p = 0.005). These results led to earlier discharge of patients in group I from the PACU. Regional block with sedation is a safe alternative technique for patients undergoing surgery for mandible fracture or TMJ ankylosis, with clear advantages over general anaesthesia. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Survey of oral and maxillofacial surgeons' offices in Virginia: anesthesia team characteristics.

PubMed Central

Campbell, Robert L.; Fritz, Gabriel; Campbell, Jeffrey R.

2004-01-01

This survey assesses whether oral and maxillofacial surgeons in the state of Virginia are prepared for inspection of their offices. A survey asking pertinent questions on the availability of specific equipment and the educational qualifications of the anesthesia care team was developed and sent to 155 offices. Seven questions were asked regarding the availability of nurses, types of life support training, (formal or informal), the surgeons and anesthesia care personnel, and the presence of a defibrillator. Questionnaires were short and simple to encourage compliance with the study guidelines. A total of 128 (82.6%) questionnaires were returned. Only 42 of 128 (32.8%) offices employed nurses, and 6 of the 42 nurses were not considered as part of the anesthesia care team. Only 36 of 128 (28.1%) of the offices had assistants with formal anesthesia assistant course training from the American Association of Oral and Maxillofacial Surgeons (AAOMS) or the American Dental Society of Anesthesiology (ADSA). However, 93% of the assistants who participated in the anesthesia had current basic life support training (BLS) training, and 74% of the surgeons had current advanced cardiac life support (ACLS) training. The AAOMS Office Emergency Manual was present in 118 of 128 offices (92.2%), and 124 of 128 offices (96.9%) had defibrillators. The survey suggests that the surgeons are well prepared from the standpoint of having a defibrillator present and the AAOMS Office Emergency Manual available as a template for the team to use in order to answer questions that the inspection team may ask of the primary anesthesia care provider and surgeon. The majority of the surgeons had current ACLS certification, and the office anesthesia assistants had current BLS training. Most of the assistants did not have formal course training, which indicates that on-the-job training is probably the norm. Less than one third of the offices had nurses. PMID:15675260

Oral and cranio-maxillofacial surgery in Byzantium.

PubMed

Mylonas, Anastassios I; Poulakou-Rebelakou, Eleftheria-Fotini; Androutsos, Georgios I; Seggas, Ioannis; Skouteris, Christos A; Papadopoulou, Evangelia Chr

2014-03-01

Byzantine physicians (4th-7th and 8th-12th centuries A.D.), especially those interested in Surgery, developed a number of interesting concepts, views and opinions referring to the field now recognized as Oral and Cranio-maxillofacial Surgery and Pathology. The original texts of Byzantine physicians, written in ancient Greek, and now preserved in the electronic platform Thesaurus Linguae Graecae, at the University of California, Irvine, CA, USA, were investigated in relation to Oral and Cranio-maxillofacial Surgery and Pathology. The most eminent physicians of the Early (4th-7th century A.D.) and Middle (8th-12th century A.D.) Byzantine Period, in particular Oribasius Pergamenus, Aëtius Amidenus, Alexander Trallianus, Theophilus Protospatharius, Paulus Aegineta, Meletius Monachos, and Leo Medicus, in their works deal with topographic and surgical anatomy of the head and neck, and a large list of related topics, including dentoalveolar surgery, oral and cervicofacial infections, trauma of viscerocranium and neurocranium as well as the biomechanics of traumatic brain injuries, temporomandibular joints dysfunction as a consequence of mandibular dislocation, surgical oncology and reconstructive surgery of the head and neck, oral pathology, surgical pathology of salivary glands, therapeutic management of facial nerve dysfunction, preprosthetic surgery, craniofacial surgery, and deformities of the facial skeleton involving anthropologic and craniometric observations. Clinical examination of patients presenting corresponding functional and esthetic problems is considered, using recognizable orthodontic and orthognathic surgical approaches. Finally, specific bandages of the head and neck are described, for treating traumatic injuries of the viscerocranium and neurocranium, diastasis of the cranial sutures, dislocations of the mandible (unilateral and bilateral), as well as inflammatory diseases of the parotids and the neck. Byzantine physicians had been particularly interested in various subjects of the mouth, jaws, face, and head and neck in general, in the frame of course of their general surgery practice. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Research and Development of Wound Dressing in Maxillofacial Trauma.

DTIC Science & Technology

1982-06-23

duplicate samples with and without 0.002% sodium lauryl sulfate . Values in parentheses are assays in CH 2C12/CH 3OH. 16 A representative section of fabric...tested, with and without 0.002% sodium lauryl sulfate as a wetting agent. Since there was no obvious effect of the surfactant, the results are averaged...aqueous). The precipitates were then washed with ethanol. Lidocaine sulfate has a melting point of u 2150C and is slightly soluble in water. Lidocaine

A rare case of intraoral lipoma in a six year-old child: a case report

PubMed Central

Venkateswarlu, Meduri; Geetha, Paramkusam; Srikanth, Mandadi

2011-01-01

One type of soft tissue lesions of the oral cavity is lipoma, which is a kind of benign tumor composed of mature lipid cells. Although the lipoma presents as one of the most common mesenchymal neoplasms, most tend to develop on the trunk and proximal portions of the extremities. However, lipomas in the oral and maxillofacial region are much less frequent. Here we present a case of an intraoral lipoma in a six year-old child. PMID:21449215

Management of mandibular fractures in children.

PubMed

Myall, Robert W T

2009-05-01

To guide surgeons treating mandibular fractures in children, this article first reviews the growth of the mandible, describes how injury can affect such growth, and explains how to harness the process of growth to good effect. This information is important in making therapeutic decisions about the management of such injuries. The article then reviews the various opinions regarding diagnosis, treatment, and outcomes. Then, as a counterpoint, the author presents his own approach developed over 30 years as a pediatric oral and maxillofacial surgeon.

Equipment Safety, Maintenance and Inspection: What the Oral Surgeon Needs to Know.

PubMed

Keeley, Katherine A

2017-05-01

Many oral and maxillofacial surgical procedures are done in an office-based setting, with many oral and maxillofacial surgeons involved in oversight of equipment maintenance. Goals in equipment management are to prevent harm to patients and staff, stay compliant with current regulations, and increase equipment longevity. This article covers the safety, maintenance, and inspection related to electrical equipment used in the treatment of patients, autoclaves, radiograph machines, nitrous oxide and oxygen medical gases, and required back-up power and lighting. An office should always follow manufacturer's recommendations regarding maintenance and inspection and document policies and monitoring so compliance can be assured. Copyright © 2017 Elsevier Inc. All rights reserved.

[Needle breakage during mandibular block anaesthesia: prevention and retrieval].

PubMed

Baart, J A; van Amerongen, W E; de Jong, K J M; Allard, R H B

2006-12-01

Disposable needles for dental local anaesthesia do not break easily. Still, needle breakage does occur, and is mainly caused by unexpected movements of the patient or pre-use bending of the needle by the dentist. If a dental needle breaks while administering local anaesthesia, the dentist should prevent panic. If the patient opens his mouth wide the needle might still be visible. If so, the needle is removed. If the needle is no longer visible, the site where the needle has penetrated the mucosa should be marked with a permanent marker. The dentist will contact a maxillofacial surgeon for immediate consultation. The maxillofacial surgeon will try to retrieve the broken dental needle under general anaesthesia.

Tracheostomy-dependent child with temporomandibular ankylosis and severe micrognathia treated by piezosurgery and distraction osteogenesis: case report.

PubMed

de Castro e Silva, Lucas Martins; Pereira Filho, Valfrido Antonio; Vieira, Eduardo Hochuli; Gabrielli, Mário Francisco Real

2011-10-01

Ankylosis of the temporomandibular joint in children is one the most difficult and complex conditions managed by oral and maxillofacial surgeons, and often leads to some facial deformity. Distraction osteogenesis of the mandible provides an excellent treatment for mandibular airway obstruction in children who do not respond to conservative measures, and allows for early removal of the tracheostomy. We report the case of a 1-year-old boy with severe micrognathia and temporomandibular ankylosis who was dependent on a tracheostomy; he was treated with piezosurgery and mandibular advancement by distraction osteogenesis. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Burnout syndrome in oral and maxillofacial surgeons: a critical analysis.

PubMed

Porto, G G; Carneiro, S C; Vasconcelos, B C; Nascimento, M M; Leal, J L F

2014-07-01

The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[The expert characteristic of the forensic medical documentation for the purpose of investigations of the injuries to the maxillofacial region].

PubMed

Popov, V L; Yagmurov, M O; Troshin, E L

2018-01-01

The injuries to the maxillofacial region (MFR) are among the most frequently occurring problems encountered if the forensic medical practice. The objective of the present study was the analysis of the quality of the medical record documentation of the victims of the injuries to the maxillofacial region for obtaining the information necessary for forensic medical experts to make the well-founded conclusions. We undertook the in-depth analysis of random samples from the materials stored in the archive of living subjects at the Saint-Petersburg Bureau of forensic medical expertise for the period from 2010 to 2014. The results of a total of 438 forensic medical examinations were available for the analysis. The study has demonstrated the generally low forensic medical value of the expert conclusions that frequently fail to conform to the requirements of the departmental instructions on the description of MFR injuries. In all the cases, neurologists and radiologists were counselled. The results of analysis of the drawbacks of forensic medical examinations give evidence that they originate first and foremost from subjective circumstances which opens up the promising prospects for the improvement of expertise quality based on the enhancement of the professional responsibility of the forensic medical experts.

Perception of oral maxillofacial surgery by health-care professionals.

PubMed

Rocha, N S; Laureano Filho, J R; Silva, E D O; Almeida, R C A

2008-01-01

Oral and Maxillofacial Surgery (OMFS), a dentistry specialty recognized by the Federal Dentistry Board in the mid-1960s, is responsible for the diagnosis, and clinical and surgical treatment of traumatic, congenital, developmental and iatrogenic lesions in the maxillofacial complex. Even today, difficulties are experienced owing to the lack of knowledge of the general public and health professionals concerning the scope of OMFS. To investigate recognition of the scope of OMFS, 400 questionnaires were sent to dentistry students, medical students, dentists and doctors, in 4 equal groups. The questionnaire covered 26 clinical situations in four different specialties (OMFS, Plastic Surgery, Ear Nose and Throat Surgery, Head and Neck Surgery) and an option with no specialty specified. Each interviewee had to correlate the clinical situation with the respective specialist. For facial trauma, dento-facial deformities, mandibular reconstruction and temporomandibular joint surgery, most respondents would consult the OMF surgeon for treatment (mean, 90%). In cases of oral biopsy and treatment of benign mandibular tumours the mean referral rate to OMFS was low (48%). On the basis of the questionnaire responses, a good level of knowledge of the scope of OMFS was found. In order to ensure the correct referral of all patients, the specialty needs to broaden its horizons.

Diffuse reflectance spectroscopy for optical nerve identification. Preliminary ex vivo results for feedback controlled oral and maxillofacial laser surgery

NASA Astrophysics Data System (ADS)

Stelzle, Florian; Zam, Azhar; Adler, Werner; Douplik, Alexandre; Tangermann-Gerk, Katja; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schmidt, Michael

Objective: Laser surgery has many advantages. However, due to a lack of haptic feedback it is accompanied by the risk of iatrogenic nerve damage. The aim of this study was to evaluate the possibilities of optical nerve identification by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Materials and Methods: Diffuse reflectance spectra of nerve tissue, skin, mucosa, fat tissue, muscle, cartilage and bone (15120 spectra) of ex vivo pig heads were acquired in the wavelength range of 350-650 nm. Tissue differentiation was performed by principal components analysis (PCA) followed by linear discriminant analysis (LDA). Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis and the area under curve (AUC). Results: Nerve tissue could correctly be identified and differed from skin, mucosa, fat tissue, muscle, cartilage and bone in more than 90% of the cases (AUC results) with a specificity of over 78% and a sensitivity of more than 86%. Conclusion: Nerve tissue can be identified by diffuse reflectance spectroscopy with high precision and reliability. The results may set the base for a feedback system to prevent iatrogenic nerve damage performing oral and maxillofacial laser surgery.

Rehabilitation of a missing ear with an implant retained auricular prosthesis

PubMed Central

Guttal, Satyabodh Sheshraj; Shanbhag, Shruti; Kulkarni, Sudhindra S.; Thakur, Srinath L.

2015-01-01

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient's physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis. PMID:26929490

Maxillofacial fractures among Sudanese children at Khartoum Dental Teaching Hospital.

PubMed

Almahdi, Hatim M; Higzi, Mohammed A

2016-02-23

Maxillofacial fractures in children are less frequent compared to adults but result in special complications affecting the growth, function and esthetics. The study aimed at assessing the characteristics and the pattern of facial fractures among children seen at Khartoum Teaching Dental Hospital (KTDH). The study included 390 patients presenting with maxillofacial trauma at KTDH during a year period (2010-2011). A total of 390 patients, diagnosed with facial fractures, were seen at KTDH; 14.1% (55) were children below 16 years of age with the mean age of 10 years (SD ± 3.9). The ratio of males to females was 2.2:1. Most fractures were due to road traffic accidents (RTA) 56.4%, followed by daily living activities 21.8% and assault 16.4%. The most prevalent anatomic sites of fractures were mandible 77%; combination fractures i.e. more than one site 32.7% and zygomatic-complex (13.5%). Concomitant injuries were found in 9.1%. Almost half of the patients were managed conservatively 49.1%, closed reduction 34.5% and surgical open reduction 16.4%. The findings of this study indicated that pediatric facial fractures constitute 14.1% of the total number of facial fractures. RTA was the main cause, which should be considered in legislative and preventive strategies.

Le Fort-based maxillofacial transplantation: current state of the art and a refined technique using orthognathic applications.

PubMed

Gordon, Chad R; Susarla, Srinivas M; Peacock, Zachary S; Kaban, Leonard B; Yaremchuk, Michael J

2012-01-01

Following encouraging results from the first 6 maxillofacial allotransplants, there has been a dramatic rise in interest worldwide. Numerous groups are now devoting resources to increase the frequency of these complex procedures, and with this, the craniomaxillofacial surgeon should become familiar with the emerging state of the art. This article reviews the evolution of Le Fort-based cadaveric studies pertaining to maxillofacial allotransplantation, briefly describes the clinical reports through 2010, and introduces a refined technique applying orthognathic applications. Preliminary studies over the last 5 years have highlighted the challenges associated with transplanting skeletal components, and clinical results presented thus far have been extremely promising. However, a notable area for improvement is suboptimal facial-skeletal harmony and profile in the context of sagittal skeletal projection and maxillomandibular relation. To our knowledge, orthognathic planning as applied to osteocutaneous face transplantation has not been described. Many recipients seen thus far demonstrate some degree of malocclusion and suboptimal harmony, as expected, given the donor-to-recipient skeletal/jaw discrepancies. Given that the goal is to improve function as well as form, the importance of orthognathic planning cannot be overstated with respect to optimizing harmony, profile, and occlusion. Preoperative planning, including generation of donor/recipient dental cast models, as described herein for the first time, is essential.

The Australian litigation landscape - oral and maxillofacial surgery and general dentistry (oral surgery procedures): an analysis of litigation cases.

PubMed

Badenoch-Jones, E K; White, B P; Lynham, A J

2016-09-01

There are persistent concerns about litigation in the dental and medical professions. These concerns arise in a setting where general dentists are more frequently undertaking a wider range of oral surgery procedures, potentially increasing legal risk. Judicial cases dealing with medical negligence in the fields of general dentistry (oral surgery procedure) and oral and maxillofacial surgery were located using the three main legal databases. Relevant cases were analysed to determine the procedures involved, the patients' claims of injury, findings of negligence and damages awarded. A thematic analysis of the cases was undertaken to determine trends. Fifteen cases over a 20-year period were located across almost all Australian jurisdictions (eight cases involved general dentists; seven cases involved oral and maxillofacial surgeons). Eleven of the 15 cases involved determinations of whether or not the practitioner had failed in their duty of care; negligence was found in six cases. Eleven of the 15 cases related to molar extractions (eight specifically to third molar). Dental and medical practitioners wanting to manage legal risk should have regard to circumstances arising in judicial cases. Adequate warning of risks is critical, as is offering referral in appropriate cases. Preoperative radiographs, good medical records and processes to ensure appropriate follow-up are also important. © 2015 Australian Dental Association.

What causes trainees to leave oral and maxillofacial surgery? A questionnaire survey.

PubMed

Herbert, C; Kent, S; Magennis, P; Cleland, J

2017-01-01

Understanding what causes trainees to leave OMFS is essential if we are to retain them within the specialty. Although these factors have been defined for medicine, we know of no previous study for OMFS. An online survey was distributed to roughly 1500 people who had registered an interest in OMFS during the past seven years. Personal information and details of education and employment were gathered along with personal factors that attracted them to OMFS. Of 251 trainees who responded, 50 (30%) were no longer interested. Factors that significantly correlated with an interest in OMFS included male sex (p=0.020), dual qualification (p=0.024), and (only for women) being single (p=0.024) and having no dependants (p=0.005). We used qualitative analysis to identify work-life balance, duration of training, and financial implications, as significant factors. Identification of key factors that affect OMFS trainees allows us to develop ways to keep them in the specialty. The predominant factor is work-life balance, and for women this included having children and being married. Financial issues related to the junior doctors' contract and competition ratios to second degrees, are also factors for both sexes. Also important are the "sunk costs" fallacy that causes some trainees to stay in training. This information can be used to help develop higher training, in negotiations of contracts, and to attract and retain future OMFS trainees. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Improving Informed Consent for Cleft Palate Repair

ClinicalTrials.gov

2017-03-07

Cleft Palate; Jaw Abnormalities; Maxillofacial Abnormalities; Mouth Abnormalities; Congenital Abnormalities; Jaw Diseases; Musculoskeletal Diseases; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Stomatognathic Diseases; Stomatognathic System Abnormalities

Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training.

PubMed

Lund, Bodil; Fors, Uno; Sejersen, Ronny; Sallnäs, Eva-Lotta; Rosén, Annika

2011-10-12

Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from permanent inclusion of these exercises, especially when used in combination. The results also stress the importance of teaching technical skills and clinical reasoning in concert.

The clinical presentation and management of zygomatic complex fractures in a Nigeria Teaching Hospital.

PubMed

Anyanechi, C E; Charles, E A; Saheeb, B D; Birch, D S

2012-01-01

Fractures of the zygomatic complex occur worldwide and are a component part of injuries that can be sustained in the maxillofacial region. The objective was to analyze the clinical presentation and management ofzygomatic complex fractures. This was a prospective study carried out over a period of five years at the University of Calabar Teaching Hospital, Nigeria. Data documented were patients' age, gender, time of presentation, cause and type of fracture, associated head and maxillofacial injuries, clinical features, types of plain radiographs, treatment methods, duration of follow-up and complications. Majority of the patients (n = 81, 63.3%) were in their third and fourth decades of life while the male to female ratio was 20.3:1. Road traffic accident (n = 111, 86.7%) was the most common cause of fracture. Fractures of the zygomatic complex alone (n = 105, 82.0%) were more common than isolated fractures of the arch (n = 13, 10.2%) and combined fractures of the zygomatic complex and arch (n = 10, 7.8%). While multi-disciplinary approach to treatment is important, majority of the fractures were treated by simple elevation and transosseous wire osteosynthesis. Delay in presentation, associated injuries and non-availability of mini-plating technique contributed to the development of complications.

[Orofacial clinical manifestations in adult patients with variable common immunodeficiency].

PubMed

Chávez-García, Aurora Alejandra; Moreno-Alba, Miguel Ángel; Elizalde-Monroy, Martín; Segura-Méndez, Nora Hilda; Romero-Flores, Jovita; Cambray-Gutiérrez, Julio César; López-Pérez, Patricia; Del Rivero-Hernández, Leonel Gerardo

2015-01-01

Common variable immunodeficiency is the primary immunodeficiency (CVID) frequently found in adults. Its prevalence is estimated from 1:25,000 to 75,000 alive newborns; there are variations by ethnic groups, it is estimated about 50-70% in Caucasian patients. Oral cavity lesions are rarely found in adult patients with CVID, there are reports about lesions on pediatric patients mostly caused by infections. To describe the orofacial lesions (oral, maxillofacial and neck area) affecting adults with CVID. A transversal, prospective study was done in patients with CVID attended at Specialties Hospital, CMN SXXI, Mexico City. Patients where examined by the oral and maxillofacial surgeon and clinical findings were reported, then the descriptive analysis of the lesions was done. We evaluated 26 patients, 16 female and 10 males, average age of 38.6 years. In 18/26 patients we found oral lesions on 7 different types. The most frequent was minor salivary glands hiperplasia (19/26),petechiae (12/26) and herpetic ulcers (7/26). In head and neck, we found 4 different lesions, the most common was lymphadenopathy <2cm (4/26). The immunologic alterations associated to CVID favors the development of lesions mainly of infectious and probably autoinmune origin that affects the oral cavity and head and neck area.

The experiment of magnesium ECAP miniplate as alternative biodegradable material (on male white New Zealand rabbits)

NASA Astrophysics Data System (ADS)

Wiwanto, Siska; Sulistyani, Lilies Dwi; Latief, Fourier Dzar Eljabbar; Supriadi, Sugeng; Priosoeryanto, Bambang Pontjo; Latief, Benny Syariefsyah

2018-02-01

Study of biodegradations of Magnesium ECAP (Equal Channel Angular Pressing) miniplate in the osteosynthesis system has been used as a new material for plate and screw in oral and maxillofacial surgery. This miniplate and screw that were made of Magnesium ECAP were implanted in the femurs of New Zealand rabbits. The degradation process was detected through pocket gas that appeared in hard and soft tissues surrounding in the implanted miniplates and screws. From the changes on the tissues, we can assess the biodegradation process by measuring the gas pocket through micro-CT Scan. Upon the first month of study we euthanized the rabbits and made a micro-CT Scan to see how far the effect of the gas pocket was. Histological analyses were performed to investigate the local tissue response adjacent to the Magnesium ECAP miniplates. We analyzed the femur of a rabbit a month, three months, and five months after implantation. The result showed a degradation rate in the implanted Magnesium ECAP miniplate of 0.61±0.39 mm/year. Unlike the screws, miniplates have higher water content and blood flow than bone, therefore they degrade faster. This study shows promising results for further development of Magnesium ECAP and in the production of osteosynthesis material for rigid fixation in Oral and Maxillofacial skeleton.

Osteo-odonto-keratoprosthesis - a maxillofacial perspective.

PubMed

Narayanan, Vinod; Nirvikalpa, Natarajan; Rao, Srinivas K

2012-12-01

The OOKP (osteo-odonto-keratoprosthesis) is the treatment of choice for conditions like Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, multiple failed grafts and chemical burns which are not amenable to penetrating keratoplasty. The OOKP is an autograft which replaces the cornea with a polymethacrylate cylinder mounted on a tooth-bone complex. The aim of this paper was to retrospectively analyze the records in 26 patients undergoing OOKP surgery between 2007 and 2011. The paper describes our experience with the procedure, with emphasis on its oral and maxillofacial aspects and management of associated complications. The aetiology of blindness in 23 patients was Stevens-Johnson's syndrome and chemical burns in three. Twenty-two patients had their maxillary canines, two had mandibular canines and two had maxillary first premolars as the choice of donor tooth. An oroantral fistula developed in four patients. One patient needed to undergo a surgical procedure for closure of the same. Roots of adjacent teeth were exposed in 12 patients. Twenty-four patients underwent both stages of the procedure with 19 being visually rehabilitated successfully. There was no improvement in the vision of four patients. One patient was lost to follow-up. Two patients have yet to undergo Stage 2. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Maxillary growth in a congenital cleft palate canine model for surgical research.

PubMed

Paradas-Lara, Irene; Casado-Gómez, Inmaculada; Martín, Conchita; Martínez-Sanz, Elena; López-Gordillo, Yamila; González, Pablo; Rodríguez-Bobada, Cruz; Chamorro, Manuel; Arias, Pablo; Maldonado, Estela; Ortega, Ricardo; Berenguer, Beatriz; Martínez-Álvarez, Concepción

2014-01-01

We have recently presented the Old Spanish Pointer dog, with a 15-20% spontaneous congenital cleft palate rate, as a unique experimental model of this disease. This study aimed to describe the cleft palate of these dogs for surgical research purposes and to determine whether congenital cleft palate influences maxillofacial growth. Seven newborn Old Spanish Pointer dogs of both sexes, comprising a cleft palate group (n = 4) and a normal palate group (n = 3), were fed using the same technique. Macroscopic photographs and plaster casts from the palate, lateral radiographs and computer tomograms of the skull were taken sequentially over 41 weeks, starting at week 5. The cleft morphology, the size and the tissue characteristics in these dogs resembled the human cleft better than current available animal models. During growth, the cleft width varies. Most of the transverse and longitudinal measures of the palate were statistically lower in the cleft palate group. The cleft palate group showed hypoplasia of the naso-maxillary complex. This model of congenital cleft palate seems suitable for surgical research purposes. A reduced maxillofacial pre- and post-natal development is associated to the congenital cleft palate in the Old Spanish Pointer dog. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Retrospective health-care associated infection surveillance in oral and maxillofacial reconstructive microsurgery.

PubMed

Patyi, Márta; Sejben, István; Cserni, Gábor; Sántha, Beáta; Gaál, Zoltán; Pongrácz, Júlia; Oberna, Ferenc

2014-12-01

In polymorbid or anaemic patients who receive preoperative radiotherapy or undergo long duration surgery involving potentially infectious sites, perioperative antibiotic prophylaxis (PAP) that is effective against normal oral bacterial flora is mandatory and plays an important role in preventing postoperative infection. In a four-year retrospective analysis, the incidence, outcome, and the efficacy of PAP were evaluated in patients treated at the Department of Oral and Maxillofacial Surgery and Otorhinolaryngology at Kecskemét Hospital. The results were compared with data from the literature to determine if the use of PAP was adequate at the Department.During the study period (between 01/09/2007 and 31/01/2011) 108 patients were evaluated. The mean duration of prophylactic antibiotic treatment was 8.3 ± 5.2 days, with cefotaxime+metronidazole being the most commonly used combination. Surgical site infection occurred in 8 patients (7.5%) in the clean-contaminated category.Our results showed that the perioperative antibiotic prophylaxis administered at our Department was efficient and effective against the oral bacterial flora of patients. Its use is recommended in head and neck microsurgery. To avoid development of antibiotic resistance and to reduce costs, it seems that the duration of antibiotic regimen for primary surgery can be reduced from 8.3 ± 5.2 days to 3 days.

Quality of life in patients with obturator prostheses.

PubMed

Riaz, Nabeela; Warriach, Riaz Ahmad

2010-01-01

Oral cancer has a profound impact on the quality of life for patients and their families. Functionally, the mouth is an important organ for speech, swallowing, chewing, taste and salivation. These functions become compromised due to surgical ablation of the tumour. Obturator prosthesis is a common prosthdontic rehabilitative option for maxillectomy patients. The purpose of this study was to investigate how patients with maxillofacial defects evaluate their quality of life after maxillectomy and prosthodontic therapy with obturator prostheses. Thirty patients were included in the study (11 female, 19 male). The patients were interviewed by using a standardised questionnaire developed by University of Washington (UW-QOL). The detailed questionnaire was adjusted for obturator patients and internalised most parts of obturator functioning scale (OFS). Quality of life after prosthodontic therapy with obturator prostheses was 54 +/- 22.9% on average. Functioning of the obturator prosthesis, impairment of ingestion, speech and appearance, the extent of therapy, and the existence of pain had significant impact on the quality of life (p<0.005). Orofacial rehabilitation of patients with maxillofacial defects using obturator prostheses is an appropriate treatment modality. To improve the situation of patients prior to and after maxillectomy sufficient information about the treatment, adequate psychological care and speech therapy should be provided.

Head and neck cancer surgery provision in England: A current analysis of contributing specialties caseloads.

PubMed

Islam, Shofiq; Wates, Emma; Hayter, Jonathan P

2017-02-01

To ascertain the current provision for surgery for head and neck cancer in England with respect to the operative caseloads of oral and maxillofacial, ear nose and throat (ENT) and plastic surgeons, we analysed data from the 2013 report of the National Head and Neck Audit (DAHNO). Clinicians were grouped by specialty of affiliation and assigned surgical caseloads were compared. There was a wide disparity in the extent of surgical activity between the specialties (p<0.001), and the percentage of those active in head and neck oncology within each specialty similarly varied (p<0.001). Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A case of isolated abducens nerve paralysis in maxillofacial trauma

PubMed Central

Keskin, Elif Seda; Keskin, Ekrem; Atik, Bekir; Koçer, Abdülkadir

2015-01-01

Nervus abducens is a pure motor nerve located in the pons. It retracts the eyeball laterally by stimulating rectus lateralis muscle. In case of their paralysis, diplopia and restriction in the eye movements while looking sideways, are seen. Since the same signs are seen due to the muscle entrapment in blowout fractures, its differential diagnosis has importance in terms of the treatment protocol and avoiding unnecessary operations. In this article, we present a 22-year-old male patient who was referred to our department due to the prediagnosis of blowout fracture following maxillofacial trauma. However, he was diagnosed with abducens nerve paralysis after the consultations and analysis and his restriction of movement was resolved via systemic steroid treatment instead of unnecessary operation. PMID:26981484

CAD/CAM silicone simulator for teaching cheiloplasty: description of the technique.

PubMed

Zheng, Y; Lu, B; Zhang, J; Wu, G

2015-02-01

Techniques of virtual simulation have been used to teach junior surgeons how to do a cheiloplasty, but still do not meet the trainees' demands. We describe a CAD/CAM silicone simulator, which we made using several maxillofacial prosthetic techniques. An optical scanning system was used to collect the data about the cleft lip. Reverse engineering software was then used to build the virtual model, and this was processed in wax by machine. The definitive simulator was made with prosthetic silicone and extrinsic colourants. The surgical trainees practised the basic skills of cheiloplasty on the simulator, and proved its worth. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Educational Utilization of Microsoft Powerpoint for Oral and Maxillofacial Cancer Presentations.

PubMed

Carvalho, Francisco Samuel Rodrigues; Chaves, Filipe Nobre; Soares, Eduardo Costa Studart; Pereira, Karuza Maria Alves; Ribeiro, Thyciana Rodrigues; Fonteles, Cristiane Sa Roriz; Costa, Fabio Wildson Gurgel

2016-01-01

Electronic presentations have become useful tools for surgeons, other clinicians and patients, facilitating medical and legal support and scientific research. Microsoft® PowerPoint is by far and away the most commonly used computer-based presentation package. Setting up surgical clinical cases with PowerPoint makes it easy to register and follow patients for the purpose of discussion of treatment plan or scientific presentations. It facilitates communication between professionals, supervising clinical cases and teaching. It is often useful to create a template to standardize the presentation, offered by the software through the slide master. The purpose of this paper was to show a simple and practical method for creating a Microsoft® PowerPoint template for use in presentations concerning oral and maxillofacial cancer.

Eating disorders and the oral and maxillofacial surgeon.

PubMed

Blitz, Meredith; Rosen, David S

2010-11-01

Perhaps the most challenging of all patients seeking treatment with the oral and maxillofacial surgeon (OMS) are those with eating disorders (EDs). Complex psychiatric illnesses, with their associated and significant medical sequelae, make a thorough knowledge of these disorders critical in the approach, evaluation, treatment planning, and surgical outcome in this expanding population of patients. Whether surgery for patients with EDs is elective in nature or unplanned, challenges are faced in all aspects of their care, from diagnosis to preoperative preparation, surgery, and treatment. This article identifies and outlines issues of importance for the OMS when encountering patients with known or suspected EDs and provides guidance in the management of their outpatient or inpatient treatment. Copyright © 2010. Published by Elsevier Inc.

[Contribution of botulinum toxin to maxillo-facial surgery].

PubMed

Batifol, D; de Boutray, M; Goudot, P; Lorenzo, S

2013-04-01

Botulinum toxin has a wide range of use in maxillo-facial surgery due to its action on muscles, on the glandular system, and against pain. It already has been given several market authorizations as indicated for: blepharospasm, spasmodic stiff neck, and glabellar lines. Furthermore, several studies are ongoing to prove its effectiveness and usefulness for many other pathologies: treatment of pain following cervical spine surgery; action on salivary glands after trauma, hypertrophy, or hyper-salivation; analgesic action (acknowledged but still being experimented) on neuralgia, articular pain, and keloids scars due to its anti-inflammatory properties. Botulinum toxin injections in the cervico-facial area are more and more used and should be to be correctly assessed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Beware of "black swans" and "perfect storms:" the principle of plenitude and office-based anesthesia.

PubMed

Treasure, Trevor E

2014-08-01

A paradigm shift in the training, practice, and study of office-based anesthesia is necessary for our specialty. Practice improvement plans are required to prevent low-probability-high-consequence anesthesia mishaps in our offices. A scarcity of statistical data exists regarding the true risk of office-based anesthesia in oral and maxillofacial surgery. Effective proactive risk management mandates accurate data to correctly outline the problem before solutions can be implemented. Only by learning from our mistakes, will we be able to reduce errors and improve patient safety: "The only real mistake is the one from which we learn nothing"--John Powell. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chronic suppurative osteomyelitis of subcondylar region: a case report.

PubMed

Kumar, G Ravi; Syed, Basheer Ahmed; Prasad, N; Praveen, Sp

2013-05-01

Chronic suppurative osteomyelitis (CSO) of the maxillofacial region is primarily caused by infections of odontogenic microorganisms. It may also arise as a complication of dental extractions, maxillofacial trauma, inadequate treatment of a fracture and irradiation to the mandible. This condition is characterized by areas of devitalized bone (sequestra) which serves as a nidus for recurrent episodes of infection. This case report describes a case of CSO in an untreated right subcondylar fracture of the mandible which was successfully treated with a combination of antibiotic therapy and surgical debridement in an 8-year-old boy. How to cite this article: Kumar GR, Syed BA, Prasad N, Praveen SP. Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report. Int J Clin Pediatr Dent 2013;6(2): 119-123.

Craniofacial reconstruction - series (image)

MedlinePlus

Patients requiring craniofacial reconstruction have: birth defects (such as hypertelorism, Crouzon's disease, Apert's syndrome) injuries to the head, face, or jaws (maxillofacial) tumors deformities caused by treatments of tumors

Salivary gland biopsy

MedlinePlus

... biopsy References Miloro M, Kolokythas A. Diagnosis and management of salivary gland disorders. In: Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. St Louis, ...

Elderly patients with maxillofacial trauma: study of mandibular condyle fractures.

PubMed

Nogami, Shinnosuke; Yamauchi, Kensuke; Yamashita, Toshio; Kataoka, Yoshihiro; Hirayama, Bunichi; Tanaka, Kenko; Takahashi, Tetsu

2015-02-01

The aim of this study was to investigate the trends and characteristic features of mandibular condyle fractures in elderly patients in terms of etiology, patterns, and treatment modalities. Records of 201 patients aged 65 years and older, who were treated for maxillofacial fractures at the Department of Oral and Maxillofacial Surgery, Kyushu Dental University, and Tohoku University from January 2002 to December 2013, were retrospectively analyzed. Patient records and radiographs were examined, with the following information: relevant medical history, cause of fracture, the presence and state of premolars and molars in the maxilla and mandible, number and location of mandible fracture, and method of treatment. As for the state of premolars and molars, premolars or molars in the mandible in contact with the maxilla were regarded as contacted. A fall was responsible for the majority of the fractures (173/201). With condyle fractures, there was a significant difference between the contacted and non-contacted group in regard to incidence. Furthermore, there was a significantly greater number of cases with symphysis and condyle combination fractures in the non-contacted group (70.9%) than in the contacted group (51.9%). As for the method of treatment, arthrocentesis was the most commonly employed. The present findings suggest that contacted molars in the maxilla and mandible have an influence on condyle fractures in elderly individuals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning.

PubMed

Velasco, Ignacio; Vahdani, Soheil; Ramos, Hector

2017-09-01

Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient's maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words: 3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma.

An evaluation of the retromolar space for oral tracheal tube placement for maxillofacial surgery in children.

PubMed

Arora, Suman; Rattan, Vidya; Bhardwaj, Neerja

2006-11-01

The eruption of the first and second permanent molar teeth may influence the size of the retromolar space. In this study we evaluated the adequacy of the retromolar space for retromolar intubation and any effect of eruption of the first and second permanent molar teeth on this space in children. Children 3-15 yr of age, undergoing surgery other than facial surgery were included for evaluation of the retromolar space. After standard oral tracheal intubation, the endotracheal tube was shifted to the retromolar space and the mandible was slowly closed to achieve centric occlusion. At the same time, any increase in airway resistance or decrease in oxygen saturation was noted. In the second part of the study, the feasibility of retromolar intubation in pediatric patients undergoing maxillofacial surgery with intraoperative maxillomandibular fixation was assessed. There was enough space for endotracheal tube placement in the retromolar region. The eruption of the first and second permanent molar teeth did not affect intubation. It was possible to achieve centric occlusion in 79 of 80 children with the endotracheal tube positioned in the retromolar space. Retromolar intubation was successfully accomplished in six pediatric patients undergoing maxillomandibular fixation and maxillofacial surgery. The retromolar space can be safely used for intubation in children when intraoperative maxillomandibular fixation, and simultaneous access to the nose and oral cavity are needed.

Noninvasive identification of peripheral vessels of oral and maxillofacial regions by using electrocardiography-triggered three-dimensional fast asymmetric spin-echo sequences.

PubMed

Tanaka, Tatsurou; Oda, Masafumi; Kito, Shinji; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Otsuka, Kozue; Yoshioka, Izumi; Habu, Manabu; Kokuryo, Shinya; Kodama, Masaaki; Nogami, Shinnosuke; Miyamoto, Ikuya; Yamamoto, Noriaki; Ishikawa, Ayataka; Matsuo, Kou; Shiiba, Shunji; Seta, Yuji; Yamashita, Yoshihiro; Takahashi, Tetsu; Tominaga, Kazuhiro; Morimoto, Yasuhiro

2011-10-01

The aim of this study was to evaluate the 3-dimensional images of thinner main peripheral vessels in oral and maxillofacial regions made without contrast medium by using a new technique, fresh blood imaging (FBI). A second objective was to discern arteries from veins by using the combination of FBI with the subtraction technique. Images from FBI were compared with those from 3-dimensional phase-contrast magnetic resonance angiography (MRA) of blood vessels in 20 healthy subjects. All images were scored for visualization and image quality of the main blood vessels. In addition, appropriate flow-spoiled gradient pulses were applied to differentiate arteries from veins in the peripheral vasculature using a combination of FBI sequences and subtraction between systole- and diastole-triggered images. The scores of MRA using FBI for the visualization of thin blood vessels were significantly better than those using phase contrast, whereas scores for the visualization of main blood vessels were equal. Additionally, we succeeded in our initial attempt to differentiate arteries from veins with a reasonable acquisition time. Our initial experience shows that FBI could be a useful method to identify 3-dimensional vasculature and to differentiate arteries from veins among thinner peripheral vessels in the oral and maxillofacial regions without using contrast medium. Copyright © 2011 Mosby, Inc. All rights reserved.

Biomechanical changes in the head associated with penetrating injuries of the maxilla and mandible: an experimental investigation.

PubMed

Tan, Yinghui; Zhou, Shuxia; Jiang, Hetian

2002-05-01

In this experiment, we studied the craniocerebral injury that occurs due to the transmission of forces when maxillofacial gunshot wounds are sustained by the facial bones and cranium. Forty fresh pigs' heads were wounded by one of the following methods: steel spheres weighing 1.03 g at an impact velocity of 1,400 m/s, steel spheres weighing 1.03 g at an impact velocity of 800 m/s, M193 military bullets, or M56 military bullets. Pressure waves in the brain, acceleration of the head, and stress changes in the facial bones and cranium at the moment of the impact were recorded by pressure and acceleration transducers and strain gauges and were statistically compared. Some obvious differences between the mechanical values obtained from high-and low-velocity missile wounds were found. A negative relationship between the peak value of the pressure wave in the brain and the distance from the point of impact to the transducer was obtained. The acceleration of the head in the direction of the ballistic path was the strongest in absolute value. There were differences in the stress values between the mandible and the temporal bone. Acceleration of the head, pressure wave changes in the brain, and injury from bony stress conduction all play important roles in associated craniocerebral damage after maxillofacial firearm wounds. Copyright 2002 American Association of Oral and Maxillofacial Surgeons

Laser tumor treatment in oral and maxillofacial surgery

NASA Astrophysics Data System (ADS)

Neukam, F. W.; Stelzle, F.

Cancer treatment is an integral part of oral and maxillofacial surgery. Oral cancer in particular is a highly prevalent neoplasm. Standard treatment for most of the tumors is radical surgery combined with stage-based neo-/adjuvant therapy. Laser surgery has become a reliable treatment option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. However, laser surgery has some major drawbacks: In contrast to conventional incisions with scalpels, the surgeon gets no feedback during laser ablation. There is no depth sensation and no tissue specificity with a laser incision, increasing the risk of iatrogenic damage to nerves and major blood vessels. Future prospects may solve these problems by means of an optical feedback mechanism that provides a tissue-specific laser ablation. First attempts have been made to perform remote optical tissue differentiation. Additionally, real time optical tumor detection during laser surgery would allow for a very precise and straight forward cancer resection, enhancing organ preservation and hence the quality of life for patients with cancer in the head and neck region.

Practice activity trends among oral and maxillofacial surgeons in Australia

PubMed Central

Brennan, David S; Spencer, A John; Singh, Kiran A; Teusner, Dana N; Goss, Alastair N

2004-01-01

Background The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. Methods All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. Results Data were available from 79 surgeons from 1990 (response rate = 73.8%) and 116 surgeons from 2000 (response rate = 65.1%). The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000), reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000). Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000), while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000). Conclusions The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied. PMID:15613233

The impact of cleft lip and palate repair on maxillofacial growth.

PubMed

Shi, Bing; Losee, Joseph E

2015-03-23

Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau's pushback palatoplasty and Langenbeck's palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.

Registration area and accuracy when integrating laser-scanned and maxillofacial cone-beam computed tomography images.

PubMed

Sun, LiJun; Hwang, Hyeon-Shik; Lee, Kyung-Min

2018-03-01

The purpose of this study was to examine changes in registration accuracy after including occlusal surface and incisal edge areas in addition to the buccal surface when integrating laser-scanned and maxillofacial cone-beam computed tomography (CBCT) dental images. CBCT scans and maxillary dental casts were obtained from 30 patients. Three methods were used to integrate the images: R1, only the buccal and labial surfaces were used; R2, the incisal edges of the anterior teeth and the buccal and distal marginal ridges of the second molars were used; and R3, labial surfaces, including incisal edges of anterior teeth, and buccal surfaces, including buccal and distal marginal ridges of the second molars, were used. Differences between the 2 images were evaluated by color-mapping methods and average surface distances by measuring the 3-dimensional Euclidean distances between the surface points on the 2 images. The R1 method showed more discrepancies between the laser-scanned and CBCT images than did the other methods. The R2 method did not show a significant difference in registration accuracy compared with the R3 method. The results of this study indicate that accuracy when integrating laser-scanned dental images into maxillofacial CBCT images can be increased by including occlusal surface and incisal edge areas as registration areas. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Genetics Home Reference: blepharocheilodontic syndrome

MedlinePlus

... Palate American Association of Oral and Maxillofacial Surgeons: Cleft Lip/Palate and Craniofacial Surgery MedlinePlus Encyclopedia: Cleft Lip and Palate Repair General Information from MedlinePlus (5 links) Diagnostic ...

Headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Facial trauma

MedlinePlus

... the face include: Car and motorcycle crashes Wounds Sports injuries Violence Symptoms Symptoms may include: Changes in ... Maxillofacial trauma. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck ...

Pulse granuloma as a complication following dental trauma in children.

PubMed

Padmanabhan, Makkada Yuvaraj; Aparna, Radhakrishnan; Karthikeyani, Shanmugasundaram; Dinakar, Jayakumar; Manickaraj, Menaka

2013-01-01

Contamination and subsequent retention of foreign bodies within wound surfaces may negatively influence healing following maxillofacial injuries. Larger foreign bodies that produce embedded or impalement injuries of soft tissues are easily detected. However, smaller contaminants, such as sand, gravel, food particles, wood splinters, and glass fibers, may not be easily identified in the initial examination, and their remnants may remain within the injury site even after debridement. Tissue reactions depend on the host response, type of foreign body, and nature of the wound surface. The purposes of this report are to: (1) detail the diagnosis and management of a peripheral pulse granuloma following retention of food particles within gingival sulci during a dental injury; and (2) provide a brief review of the diagnosis of foreign body-induced granulomas following maxillofacial injuries in children.

Removal of Supernumerary Teeth Utilizing a Computer-Aided Design/Computer-Aided Manufacturing Surgical Guide.

PubMed

Jo, Chanwoo; Bae, Doohwan; Choi, Byungho; Kim, Jihun

2017-05-01

Supernumerary teeth need to be removed because they can cause various complications. Caution is needed because their removal can cause damage to permanent teeth or tooth germs in the local vicinity. Surgical guides have recently been used in maxillofacial surgery. Because surgical guides are designed through preoperative analysis by computer-aided design software and fabricated using a 3-dimensional printer applying computer-aided manufacturing technology, they increase the accuracy and predictability of surgery. This report describes 2 cases of removal of a mesiodens-1 from a child and 1 from an adolescent-using a surgical guide; these would have been difficult to remove with conventional surgical methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

A summary of trauma and trauma-related papers published in BJOMS during 2008-2009.

PubMed

Kusanale, Atul; Mackenzie, Neil; Arakeri, Gururaj; McLeod, Niall; Brennan, Peter A

2010-09-01

This paper provides a summary of the 49 trauma and related papers published in British Journal of Oral and Maxillofacial Surgery during the period January 2008 to December 2009. 16/49 (32%) of these publications were full length articles, which covered areas such as epidemiology, service provision, materials and operative surgery. In addition there were other articles including short communications, technical notes, letters to the editor and interesting cases. Whilst fewer full length articles were published compared to the other sub-specialties, it was reassuring to see that the studies represent all aspects of trauma. More basic science and randomized control studies relating to trauma need to be encouraged. Copyright 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Oral Pathology in Forensic Investigation.

PubMed

Shamim, Thorakkal

2018-01-01

Forensic odontology is the subdiscipline of dentistry which analyses dental evidence in the interest of justice. Oral pathology is the subdiscipline of dentistry that deals with the pathology affecting the oral and maxillofacial regions. This subdiscipline is utilized for identification through oral and maxillofacial pathologies with associated syndromes, enamel rod patterns, sex determination using exfoliative cytology, identification from occlusal morphology of teeth, and deoxyribonucleic acid profiling from teeth. This subdiscipline is also utilized for age estimation studies which include Gustafson's method, incremental lines of Retzius, perikymata, natal line formation in teeth, neonatal line, racemization of collagen in dentin, cemental incremental lines, thickness of the cementum, and translucency of dentin. Even though the expertise of an oral pathologist is not taken in forensic investigations, this paper aims to discuss the role of oral pathology in forensic investigation.

Oral Pathology in Forensic Investigation

PubMed Central

Shamim, Thorakkal

2018-01-01

Forensic odontology is the subdiscipline of dentistry which analyses dental evidence in the interest of justice. Oral pathology is the subdiscipline of dentistry that deals with the pathology affecting the oral and maxillofacial regions. This subdiscipline is utilized for identification through oral and maxillofacial pathologies with associated syndromes, enamel rod patterns, sex determination using exfoliative cytology, identification from occlusal morphology of teeth, and deoxyribonucleic acid profiling from teeth. This subdiscipline is also utilized for age estimation studies which include Gustafson's method, incremental lines of Retzius, perikymata, natal line formation in teeth, neonatal line, racemization of collagen in dentin, cemental incremental lines, thickness of the cementum, and translucency of dentin. Even though the expertise of an oral pathologist is not taken in forensic investigations, this paper aims to discuss the role of oral pathology in forensic investigation. PMID:29629322

Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report

PubMed Central

Syed, Basheer Ahmed; Prasad, N; Praveen, SP

2013-01-01

ABSTRACT Chronic suppurative osteomyelitis (CSO) of the maxillofacial region is primarily caused by infections of odontogenic microorganisms. It may also arise as a complication of dental extractions, maxillofacial trauma, inadequate treatment of a fracture and irradiation to the mandible. This condition is characterized by areas of devitalized bone (sequestra) which serves as a nidus for recurrent episodes of infection. This case report describes a case of CSO in an untreated right subcondylar fracture of the mandible which was successfully treated with a combination of antibiotic therapy and surgical debridement in an 8-year-old boy. How to cite this article: Kumar GR, Syed BA, Prasad N, Praveen SP. Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report. Int J Clin Pediatr Dent 2013;6(2): 119-123. PMID:25206205

The use of optical coherence tomography in maxillofacial surgery

NASA Astrophysics Data System (ADS)

Al-Obaidi, Mohammed; Tandon, Rahul; Tiwana, Paul

2015-02-01

The ever-evolving medical field continues to trend toward less invasive approaches to the diagnosis and treatment of pathological conditions. Basic sciences research has allowed for improved technologies that are translated to the clinical sciences. Similarly, advancements in imaging modalities continue to improve and their applications become more varied. As such, surgeons and pathologists are able to depend on smaller samples for tissue diagnosis of pathological disease, where once large sections of tissue were needed. Optical coherence tomography (OCT), a high-resolution imaging technique, has been used extensively in different medical fields to improve diagnostic yield. Its use in dental fields, particularly in oral and maxillofacial surgery, remains limited. Our goal is to assess the use of OCT for improving soft tissue analysis and diagnosis, particularly for its applications in the field of oral and maxillofacial surgery. Optical coherence tomography is a modality that uses an optical signal using safe near-infrared light which is reflected off the sub-surface structures. This allows for high-resolution cross-sectional images of the tissue morphology to be obtained. Ophthalmologists have been using OCT to obtain images of the retina to assess for age-related macular degeneration. More recently, OCT has been used by Interventional Cardiology to image coronary arteries, and assess plaque thickness and morphology. This technology is now being investigated in several medical fields as a form of optical biopsy, providing in situ images with high-resolution morphology of tissues. We are particularly interested in its use on epithelial tissues, and therefore performed a literature review on the use of OCT for assessing epithelium. Evaluation of histologically-diagnosed actinic keratosis, for example, was found to correlate well with the imaging discrepancies found on OCT; and the in vivo assessment of atypical keratinocytes was firmly established. Additionally, studies have shown a potential application in that OCT may provide a method for studying the evolution of epithelial lesions OCT's potential in producing high-resolution images of tissue morphology can prove to be a valuable tool for characterizing different soft tissue pathological disorders. Furthermore, it has been shown to measure changes in light intensity at tissue-fluid interfaces, which can provide surgeons the ability to characterize oral mucosal surfaces noninvasively. OCT can also prove to be valuable in detecting oral cancerous and pre-cancerous lesions, as altered epithelium containing increased dysplasia shows differences in light scattering than normal epithelium. Additionally, OCT has been shown to analyze deeper collagen tissues of the oral mucosa and is not limited to the surface epithelium. This can aid in characterizing such inflammatory conditions that alter these tissues. Several tissue samples from the maxillofacial region were obtained and assessed using an OCT device at our institution. The analysis has shown high-resolution images of soft tissue-bone interface, titanium implant-bone interface, and other anatomical sites within the oral cavity. OCT has been shown to be a valuable modality in different medical fields. Its use in oral and maxillofacial surgery can potentially aid in diagnostic techniques. Alongside traditional histological technique, it can be help characterize tissues at the cellular level, which would improve costs, time, and most importantly, patient care. We aim to introduce OCT and its diagnostic abilities to the field of oral and maxillofacial surgery to help aid clinicians and provide improved care for patients.

Physiotherapy Maneuver Is Critical to Recover Mouth Opening After Pediatric Trauma.

PubMed

Khalifa, Ghada Amin; El-Kilani, Naglaa Shawki; Shokier, Hanan Mohamed

2016-12-01

A restricted mouth opening (MO) is predominantly a complication of maxillofacial trauma in pediatric patients and develops in 4 to 26.2% of cases. The purpose of the present study was to quantitatively investigate the influence of patient demographic data, fracture characteristics, and regular vigorous physiotherapy, with either voluntary or forcible MO exercises, on the recovery of a post-traumatic restricted MO in pediatric patients. A prospective cohort study was performed of pediatric patients with maxillofacial injuries who had been referred to Al-Zahraa and El-Fayoum Hospitals from 2013 to 2015. The predictive variables were patient demographic data, fracture characteristics, and regular vigorous physiotherapy. The patients were treated with a closed technique. The MO measurements were the clinical outcome variables and were recorded at the first week and then monthly for 12 months. Regular vigorous physiotherapy was performed until the patients had returned to their preoperative MO. The data were tabulated and statistically analyzed. Eighty-six patients were enrolled in the present study. Males predominated. Falls were the most common cause of fracture. Condylar fractures had the greatest incidence. A restricted MO occurred in 81 patients. The results showed no interaction between MO recovery and age, gender, etiology, or fracture site. After physiotherapy, the patients had returned to their preoperative MO at the fourth month, with the measurements fixed at normal values at the sixth month. The recovery rate was nonlinear, with faster improvement in the months closest to the injury. Physiotherapy is more critical in the recovery of the MO and prevention of bony ankylosis than patient data or fracture characteristics in pediatric trauma. We highly advocate the performance of voluntary mouth exercises, even in the absence of fracture. Forcible MO exercises are mandatory to recover a restricted MO. These exercises should be performed under close supervision of the patient's surgeon with the parents motivated to cooperate for at least 6 months. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Oral and Maxillofacial Surgery Foundation Research and Fellowship Awards: A 26-Year Review at Massachusetts General Hospital and Harvard School of Dental Medicine.

PubMed

Inverso, Gino; Chuang, Sung-Kiang; Kaban, Leonard B

2016-02-01

The purpose of this study was to review outcomes of the Oral and Maxillofacial Surgery (OMS) Foundation's funding awards to members of the OMS department at Massachusetts General Hospital (MGH) in terms of projects completed, abstracts presented, peer-reviewed publications, and career trajectories of recipients. Data were collected from MGH and OMS Foundation records and interviews with award recipients. Primary outcome variables included 1) number of awards and award types, 2) funding amount, 3) project completion, 4) number of presented abstracts, 5) conversion from abstracts to publications, 6) number of peer-reviewed publications, 7) career trajectories of awardees, and 8) additional extramural funding. Eleven Student Research Training Awards provided $135,000 for 39 projects conducted by 37 students. Of these, 34 (87.2%) were completed. There were 30 student abstracts presented, 21 peer-reviewed publications, and a publication conversion rate of 58.8%. Faculty research awards comprised $1,510,970 for 22 research projects by 12 faculty members and two research fellows. Of the 22 funded projects, 21 (95.5%) were completed. There were 110 faculty and research fellow abstracts presented and 113 peer-reviewed publications, for a publication conversion rate of 93.8%. In the student group, 17 of 37 (45.9%) are enrolled in or are applying for OMS residencies. Of the 10 students who have completed OMS training, 3 (30%) are in full-time academic positions. Of the 12 faculty recipients, 9 (75%) remain in OMS academic practice. During this time period, the department received $9.9 million of extramural foundation or National Institutes of Health funding directly or indirectly related to the OMS Foundation grants. The results of this study indicate that 90.2% of projects funded by the OMS Foundation have been completed. Most projects resulted in abstracts and publications in peer-reviewed journals. These grants encouraged students to pursue OMS careers and aided OMS faculty in developing their research programs. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Medics against violence--the development of a new violence prevention intervention for schools.

PubMed

Goodall, Christine A; Devlin, Mark F; Koppel, David A

2010-10-01

This article outlines the rationale, evidence base and development of a new anti-violence intervention for schools delivered in the school setting by healthcare professionals. It is an example of multi-professional and mutli-disciplinary working and demonstrates how all healthcare professionals can be involved in wider healthcare issues. The majority of victims of violence are young men. Most incidents of interpersonal violence involve injury to the head and neck area, including the dentition. The Medics against Violence Schools Project is very relevant to Oral and Maxillofacial Surgeons, Oral Surgeons and General Dental Practitioners all of whom may have to deal with the sequelae of such injuries.

Cluster headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Automated classification of maxillofacial cysts in cone beam CT images using contourlet transformation and Spherical Harmonics.

PubMed

Abdolali, Fatemeh; Zoroofi, Reza Aghaeizadeh; Otake, Yoshito; Sato, Yoshinobu

2017-02-01

Accurate detection of maxillofacial cysts is an essential step for diagnosis, monitoring and planning therapeutic intervention. Cysts can be of various sizes and shapes and existing detection methods lead to poor results. Customizing automatic detection systems to gain sufficient accuracy in clinical practice is highly challenging. For this purpose, integrating the engineering knowledge in efficient feature extraction is essential. This paper presents a novel framework for maxillofacial cysts detection. A hybrid methodology based on surface and texture information is introduced. The proposed approach consists of three main steps as follows: At first, each cystic lesion is segmented with high accuracy. Then, in the second and third steps, feature extraction and classification are performed. Contourlet and SPHARM coefficients are utilized as texture and shape features which are fed into the classifier. Two different classifiers are used in this study, i.e. support vector machine and sparse discriminant analysis. Generally SPHARM coefficients are estimated by the iterative residual fitting (IRF) algorithm which is based on stepwise regression method. In order to improve the accuracy of IRF estimation, a method based on extra orthogonalization is employed to reduce linear dependency. We have utilized a ground-truth dataset consisting of cone beam CT images of 96 patients, belonging to three maxillofacial cyst categories: radicular cyst, dentigerous cyst and keratocystic odontogenic tumor. Using orthogonalized SPHARM, residual sum of squares is decreased which leads to a more accurate estimation. Analysis of the results based on statistical measures such as specificity, sensitivity, positive predictive value and negative predictive value is reported. The classification rate of 96.48% is achieved using sparse discriminant analysis and orthogonalized SPHARM features. Classification accuracy at least improved by 8.94% with respect to conventional features. This study demonstrated that our proposed methodology can improve the computer assisted diagnosis (CAD) performance by incorporating more discriminative features. Using orthogonalized SPHARM is promising in computerized cyst detection and may have a significant impact in future CAD systems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

"Run-through" training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey.

PubMed

Garg, M; Collyer, J; Dhariwal, D

2018-05-01

Training in oral and maxillofacial surgery (OMFS) in the UK has undergone considerable changes during the last 10years, and "core" surgical training has replaced "basic" surgical training. In 2014 a pilot "run-through" training programme from specialist training year one (ST1)-ST7 was introduced to facilitate early entry into the speciality. Run-through training guarantees that a trainee, after a single competitive selection process and satisfactory progress, will be given training that covers the entire curriculum of the speciality, whereas uncoupled training requires a second stage of competitive recruitment after the first one (for OMFS only) or two years of "core" training to progress to higher specialty training. The first two years of run-through training (ST1-ST2) are the same as for core surgical training. Dual-qualified maxillofacial aspirants and those in their second degree course are curious to know whether they should go for the uncoupled core surgical training or the run-through programme in OMFS. The General Medical Council (GMC) has now agreed that run-through training can be rolled out nationally in OMFS. To assess the two pathways we used an online questionnaire to gain feedback about the experience from all OMFS ST3 and run-through trainees (ST3/ST4) in 2016-2017. We identified and contacted 21 trainees, and 17 responded, including seven run-through trainees. Eleven, including five of the run-through trainees, recommended the run-through training programme in OMFS. Six of the seven run-through trainees had studied dentistry first. The overall mean quality of training was rated as 5.5 on a scale 0-10 by the 17 respondents. This survey gives valuable feedback from the current higher surgical trainees in OMFS, which will be useful to the GMC, Health Education England, OMFS Specialist Advisory Committee, and those seeking to enter higher surgical training in OMFS. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effect of nano-oxide concentration on the mechanical properties of a maxillofacial silicone elastomer.

PubMed

Han, Ying; Kiat-amnuay, Sudarat; Powers, John M; Zhao, Yimin

2008-12-01

Contemporary silicone-based elastomeric prostheses tend to degrade over time because of the effect of mechanical loading. Little has been reported on how the mechanical properties of a maxillofacial prosthetic elastomer may be affected by the addition of nanosized oxide particles used as an opacifier. The purpose of this study was to evaluate the effect of different concentrations of nanosized oxides of various composition on the mechanical properties of a commercially available silicone elastomer. Nanosized oxides (Ti, Zn, or Ce) were added in various concentrations (0.5%, 1.0%, 1.5%, 2.0%, 2.5%, or 3.0% by weight) to a commercial silicone elastomer (A-2186), commonly used for fabricating extraoral maxillofacial prostheses. Silicone elastomer A-2186 without nanosized oxides served as a control group. Specimens (n=5) were polymerized according to manufacturer's recommendations and tested for tensile strength (ASTM D412) and tear strength (ASTM D624), and percent elongation in a universal testing machine. Uniformity of particle dispersion within the processed elastomer was assessed using scanning electron microscopic imaging. For each property, a 2-way ANOVA was performed evaluating the effect of oxide type and strength, and Fisher's PLSD test was used for pairwise comparisons (alpha=.05). SEM examination indicated that all 3 nanosized oxides distribute evenly throughout the silicone specimens, except for the 3.0% group, which are partly agglomerated. The 2.0% and 2.5% groups of all nanosized oxides demonstrated significantly higher tensile and tear strengths and percent elongation (P<.001) than the control group. CeO(2) had significantly lower tensile strength than TiO2 and ZnO (P<.05). The ZnO group had significantly higher tear strength than TiO(2) and CeO(2) (P <.05). Most of specimens became somewhat harder when compared with the control group. CeO(2) group had significantly higher Shore A hardness than TiO(2) and ZnO (P<.001). There was no significant difference of percent elongation among the type of nanosized oxides. Incorporation of Ti, Zn, or Ce nano-oxides at concentrations of 2.0% and 2.5% improved the overall mechanical properties of the silicone A-2186 maxillofacial elastomer.

What Factors Influence Community Oral and Maxillofacial Surgeons' Choice to Use Capnography in the Office-Based Ambulatory Anesthesia Setting?

PubMed

Matin, Mehdi B; Gonzalez, Martin L; Dodson, Thomas B

2015-08-01

The American Association of Oral and Maxillofacial Surgeons Board of Trustees mandated monitoring using capnography during moderate sedation (MS) and deep sedation or general anesthesia (DS/GA) delivered in the office setting effective January 1, 2014. The purpose of this study was to estimate the frequency of capnography use and to identify variables associated with a clinician's choice to use capnography before the mandate. To address the research purpose, the authors designed a prospective cohort study and enrolled 2 samples: 1) American private practicing oral and maxillofacial surgeons (OMSs) and 2) all eligible patients for whom these OMSs delivered MS or DS/GA. The predictor variables were categorized as surgeon or patient demographics, anesthesia risk factors, procedure-related variables, and anesthetic medications. The outcome variable was capnography use during MS or DS/GA. Descriptive, bivariate, and forward stepwise multiple logistic regression statistics were computed to evaluate the association between the predictor variables and capnography use, with statistical significance set at a P value less than or equal to .05. The surgeon sample was composed of 95 OMSs and 13.7% reported using capnography. The patient sample included 3,495 patients with a mean age of 30.6 years (standard deviation, 17.8 yr), 43.5% were men, and 5.6% were monitored using capnography. Based on bivariate analyses, 17 variables were associated with capnography use. Forward stepwise regression modeling identified 9 variables statistically associated with capnography use. These variables were patient's age, Mallampati airway score, alcohol consumption, board certification, sevoflurane use, number of monitoring methods, electrocardiogram use, precordial stethoscope use, and number of personnel in operating suite. Although this study might be of historical interest at this time, the results offer insight into OMSs' practice patterns before the mandatory requirement to use capnography. As more OMSs comply with the capnography mandate, their practice patterns involving variables found to statistically correlate with capnography use might become more similar to those of early adopters of this technology. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Gorlin-Goltz syndrome: review of the neuroradiological and maxillofacial features illustrated with two clinical cases].

PubMed

Safronova, Marta Maia; Arantes, Mavilde; Lima, Iva; Domingues, Sara; Almeida, Marta; Moniz, Pedro

2010-01-01

Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is a rare hereditary autosomal-dominant disorder characterized by multiple basal cell carcinomas in young patients, odontogenic keratocysts, palmar or plantar pits, calcification of the falx cerebri and skeletal malformations. This syndrome is due to mutations in PTCH1 (patched homolog 1 da Drosophila), a tumor suppressor gene. Diagnostic criteria were defined by Evans, revised by Kimonis and include major and minor criteria. The authors review in particular the neuroradiological and maxillofacial characteristics of the syndrome. The authors describe the clinical presentation of two children with Gorlin-Goltz syndrome without affected first degree relatives. In both the clinical suspicion of the syndrome is raised by the presence of multiple odontogenic cysts surgically removed. Histopathological exam revealed keratocysts. None of the patients has basal cell carcinomas but both present with skeletal anomalies, namely marked pectus deformity. The absence of major diagnostic criteria like basal cell carcinomas or palmar or plantar pits in young patients delay the early diagnosis and the correct screening for medulloblastoma, basal cell carcinomas and cardiac fibromas. Odontogenic keratocysts are the most consistent clinical finding in Gorlin-Goltz syndrome in the first one or two decades of life. These patients are very sensitive to ionizing radiation, being able to develop basal cell carcinomas and meningiomas. Treatment should accomplish the complete resection of the tumors.

The dental implications of bisphosphonates and bone disease.

PubMed

Cheng, A; Mavrokokki, A; Carter, G; Stein, B; Fazzalari, N L; Wilson, D F; Goss, A N

2005-12-01

In 2002/2003 a number of patients presented to the South Australian Oral and Maxillofacial Surgery Unit with unusual non-healing extraction wounds of the jaws. All were middle-aged to elderly, medically compromised and on bisphosphonates for bone pathology. Review of the literature showed similar cases being reported in the North American oral and maxillofacial surgery literature. This paper reviews the role of bisphosphonates in the management of bone disease. There were 2.3 million prescriptions for bisphosphonates in Australia in 2003. This group of drugs is very useful in controlling bone pain and preventing pathologic fractures. However, in a small number of patients on bisphosphonates, intractable, painful, non-healing exposed bone occurs following dental extractions or denture irritation. Affected patients are usually, but not always, over 55 years, medically compromised and on the potent nitrogen containing bisphosphonates pamidronate (Aredia/Pamisol), alendronate (Fosamax) and zolendronate (Zometa) for non-osteoporotic bone disease. Currently, there is no simple, effective treatment and the painful exposed bone may persist for years. The main complications are marked weight loss from difficulty in eating and severe jaw and neck infections. Possible preventive and therapeutic strategies are presented although at this time there is no evidence of their effectiveness. Dentists must ask about bisphosphonate usage for bone disease when recording medical histories and take appropriate actions to avoid the development of this debilitating condition in their patients.

Microsurgical free flaps: Controversies in maxillofacial reconstruction

PubMed Central

George, Rinku K.; Krishnamurthy, Arvind

2013-01-01

Reconstructive microsurgery for oral and maxillofacial (OMF) defects is considered as a niche specialty and is performed regularly only in a handful of centers. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery. Due to improvement in instrumentation and the development of finer techniques of flap harvesting we can positively state that microsurgery has come of age. Better techniques, microscopes and micro instruments enable us to do things previously unimaginable. Supramicrosurgery and ultrathin flaps are a testimony to this. Years of innovation in reconstructive microsurgery have given us a reasonably good number of very excellent flaps. Tremendous work has been put into producing some exceptionally brilliant research articles, sometimes contradicting each other. This has led to the need for clarity in some areas in this field. This article will review some controversies in reconstructive microsurgery and analyze some of the most common microvascular free flaps (MFF) used in OMF reconstruction. It aims to buttress the fact that three flaps-the radial forearm free flap (RFFF), anterolateral thigh flap (ALT) and fibula are the ones most expedient in the surgeon's arsenal, since they can cater to almost all sizeable defects we come across after ablative surgery in the OMF region. They can thus aptly be titled as the workhorses of OMF reconstruction with regard to free flaps. PMID:23662264

Variation in Post-Injury Antibiotic Prophylaxis Patterns over Five Years in a Combat Zone

PubMed Central

Lloyd, Col Bradley A; Murray, COL Clinton K.; Bradley, William; Shaikh, Faraz; Aggarwal, Deepak; Carson, M. Leigh; Tribble, David R.

2016-01-01

In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a five-year period (June 2009–May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries. Closed injuries had the highest overall compliance (83%), while open fractures and maxillofacial injuries had significant improvement in compliance from 2009–2010 (34% and 50%, respectively) to 2013–2014 (73% and 76%; p<0.05). Part of the improvement with open fractures was a significant reduction of expanded Gram-negative coverage (61% received it in 2009–2010 compared to 7% in 2013–2014; p<0.001). Use of Gram-negative coverage with maxillofacial injuries also significantly declined (37% to 12%; p=0.001). Being injured during 2011–2014 compared to 2009–2010 was associated with CPG compliance (p<0.001), while high injury severity scores (≥10) and admission to the intensive care unit in Germany were associated with noncompliance (p<0.001). Our analysis demonstrates an increasing trend toward CPG compliance with significant reduction of expanded Gram-negative coverage. PMID:28291497

Head, Neck, and Oral Cancer

MedlinePlus Videos and Cool Tools

... Neck Pathology Download Download the ebook for further information Your oral and maxillofacial surgeon (OMS) is the ... well be the key to complete recovery. The information provided here is not intended as a substitute ...

1064-/1319-nm Nd:YAG laser in maxillofacial surgery

NASA Astrophysics Data System (ADS)

Smucler, Roman; Mazanek, Jiri

1998-01-01

Patients feel face destruction as the main problem of oncological treatment in maxillofacial area. Finding a compromise between radicality and esthetic point of view is always problematic. Original Czech 1064/1319 nm Nd:YAG laser--U.S. patient pending--is new precise tool which can give new possibilities. Two wavelengths--with different water absorption--give unique chance to control collateral tissue damage. We can combine vaporization, coagulation and hyperthermic therapy special for every part of face and for every tissue. Thanks to that we use this machine in primary treatment and in palliative therapy independently or in combination with classical knife excision. Thanks to the use of fiber we are able to bit not only superficial lesions but we have opportunity of deep hyperthermic therapy with different collateral penetration. After 20 months we can show interesting results.

Severe macroglossia after posterior fossa and craniofacial surgery in children.

PubMed

Bouaoud, J; Joly, A; Picard, A; Thierry, B; Arnaud, E; James, S; Hennessy, I; McGarvey, B; Cairet, P; Vecchione, A; Vergnaud, E; Duracher, C; Khonsari, R H

2018-04-01

Massive swelling of the tongue can occur after posterior fossa and craniofacial surgery. Several hypotheses have been proposed to explain the occurrence of such severe postoperative macroglossia, but this phenomenon is still poorly understood. Severe postoperative macroglossia can be a life-threatening condition due to upper airway obstruction. Three cases of severe postoperative macroglossia that occurred after cervical spine, craniofacial, and posterior fossa surgical procedures are reported here. These cases required specialized maxillofacial management and a prolonged stay in the intensive care unit. Causal factors involved in this condition are reported, in order to highlight appropriate prevention and treatment options adapted to the management of paediatric patients. An overview of the current literature on severe postoperative macroglossia in paediatric populations is also provided. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Retrospective Radiographic Survey of Pathology Associated with Impacted Third Molars among Patients Seen in Oral & Maxillofacial Surgery Clinic of College of Dentistry, Riyadh.

PubMed

Khawaja, Naveed Ahmad; Khalil, Hesham; Parveen, Kauser; Al-Mutiri, Abdulmajeed; Al-Mutiri, Saif; Al-Saawi, Abdullah

2015-04-01

The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient's records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries, bone resorption and apical pathology are highly significant (P = 0.000) comparing to others. This study also concluded the high frequency of root caries, bone resorption and apical pathology reported in relation to mandibular impacted third teeth. Significant results were also achieved with periodontitis in relation to mesiangular and vertical angulation of left impacted maxillary third molars. Prophylactic removal of impacted third molars is recommended in many studies to avoid future risk of associated pathology. Retained asymptomatic impacted third molars imply pathology that could be difficult in later ages as less morbidity in younger ages.

Reconstruction of attached soft tissue around dental implants by acelluar dermal matrix grafts and resin splint

PubMed Central

Liu, Changying; Su, Yucheng; Tan, Baosheng; Ma, Pan; Wu, Gaoyi; Li, Jun; Geng, Wei

2014-01-01

Objectives: The purpose of this study was to recommend a new method using acellular dermal matrix graft and resin splint to reconstruct the attached soft tissue around dental implants in patients with maxillofacial defects. Materials and methods: Total 8 patients (3 male and 5 female patients) diagnosed with maxillofacial defects and dentition defects caused by tumors, fractures or edentulous jaw, were selected for this study. Dental implants were routinely implanted at the edentulous area. Acellular dermal matrix heterografts and resin splint were used to increase the attached soft tissue. The width of attached gingiva in the labial or buccal surface at edentulous area was measured before surgical procedures and after the completion of superstructures. Paired t-test was applied to assess the change of quantitative variables. All tests were 2-tailed, and P < 0.05 was considered statistically significant. Results: The dense connective tissue around implants could be reconstructed one month after the completion of surgical procedures, and the epithelial cuff around the implant neck established very well. The width of attached gingival tissue in the patients increased significantly from a mean of 0.61 ± 0.75 mm to 6.25 ± 1.04 mm. The patients were fully satisfied with the esthetic and functional results achieved. Conclusions: The acellular dermal matrix graft could be used to increase the attached gingiva around dental implants in these patients with maxillofacial defects. The resin splint could facilitate the healing of graft. PMID:25663964

Secondary reconstruction of maxillofacial trauma.

PubMed

Castro-Núñez, Jaime; Van Sickels, Joseph E

2017-08-01

Craniomaxillofacial trauma is one of the most complex clinical conditions in contemporary maxillofacial surgery. Vital structures and possible functional and esthetic sequelae are important considerations following this type of trauma and intervention. Despite the best efforts of the primary surgery, there are a group of patients that will have poor outcomes requiring secondary reconstruction to restore form and function. The purpose of this study is to review current concepts on secondary reconstruction to the maxillofacial complex. The evaluation of a posttraumatic patient for a secondary reconstruction must include an assessment of the different subunits of the upper face, middle face, and lower face. Virtual surgical planning and surgical guides represent the most important innovations in secondary reconstruction over the past few years. Intraoperative navigational surgery/computed-assisted navigation is used in complex cases. Facial asymmetry can be corrected or significantly improved by segmentation of the computerized tomography dataset and mirroring of the unaffected side by means of virtual surgical planning. Navigational surgery/computed-assisted navigation allows for a more precise surgical correction when secondary reconstruction involves the replacement of extensive anatomical areas. The use of technology can result in custom-made replacements and prebent plates, which are more stable and resistant to fracture because of metal fatigue. Careful perioperative evaluation is the key to positive outcomes of secondary reconstruction after trauma. The advent of technological tools has played a capital role in helping the surgical team perform a given treatment plan in a more precise and predictable manner.

Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning

PubMed Central

Vahdani, Soheil; Ramos, Hector

2017-01-01

Background Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. Material and Methods Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient’s maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. Conclusions MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words:3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma. PMID:29075412

Lymph node staging of oral and maxillofacial neoplasms in 31 dogs and cats.

PubMed

Herring, Erin S; Smith, Mark M; Robertson, John L

2002-09-01

A retrospective study was performed to report the histologic examination results of regional lymph nodes of dogs and cats with oral or maxillofacial neoplasms. Twenty-eight dogs and 3 cats were evaluated. Histologic examination results of standard and serial tissue sectioning of regional lymph nodes were recorded. When available, other clinical parameters including mandibular lymph node palpation, thoracic radiographs, and pre- and postoperative fine needle aspiration of lymph nodes were compared with the histologic results. Squamous cell carcinoma, fibrosarcoma, and melanoma were the most common neoplasms diagnosed in dogs. Squamous cell carcinoma and fibrosarcoma were diagnosed in cats. Of the palpably enlarged mandibular lymph nodes, 17.0% had metastatic disease histologically. Radiographically evident thoracic metastatic disease was present in 7.4% of cases. Preoperative cytologic evaluation of the mandibular lymph node based on fine needle aspiration concurred with the histologic results in 90.5% of lymph nodes examined. Postoperative cytologic evaluation of fine needle aspirates of regional lymph nodes concurred with the histologic results in 80.6% of lymph nodes examined. Only 54.5% of cases with metastatic disease to regional lymph nodes had metastasis that included the mandibular lymph node. Serial lymph node sectioning provided additional information or metastasis detection. Cytologic evaluation of the mandibular lymph node correlates positively with histology, however results may fail to indicate the presence of regional metastasis. Assessment of all regional lymph nodes in dogs and cats with oral or maxillofacial neoplasms will detect more metastatic disease than assessing the mandibular lymph node only.

Systematic review and meta-analysis of the efficacy of hilotherapy following oral and maxillofacial surgery.

PubMed

Bates, A S; Knepil, G J

2016-01-01

Craniofacial surgery causes immediate postoperative pain, oedema, and functional limitations. Hilotherapy delivers cooled water to the face at 15°C and may reduce the postoperative recovery time. This work presents a meta-analysis of short-term postoperative outcomes after hilotherapy. Following a systematic literature search, comparative trials of patients undergoing surgical interventions in the maxillofacial region and receiving either hilotherapy or ice-cooling therapy were included for meta-analysis. Demographics and surgical outcomes were extracted. Data were analysed using Comprehensive Meta-Analysis software. Mean (SEM) data were calculated for demographic variables and standardized mean differences with the 95% confidence interval for surgical outcomes. Five trials were analysed, providing 206 patients for evaluation; mean patient age was 29.4 (9.4) years. Hilotherapy reduced pain (10-point visual analogue scale) at 48 h (P<0.010) and 72 h (P<0.050), as well as postoperative facial oedema (P<0.010), compared to ice-cooling treatment. Trismus and facial neurological scores were also improved (P=0.08). Patients preferred hilotherapy to other cooling methods (P<0.010). Hilotherapy appears to be effective in reducing postoperative facial pain, oedema, and trismus, and in improving patient-reported outcomes. Well-designed randomized controlled clinical trials are required to clarify the procedure-specific efficacy of postoperative hilotherapy and optimal durations of treatment. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Case of Systemic Infection Caused by Streptococcus pyogenes Oral Infection in an Edentulous Patient.

PubMed

Inagaki, Yumi; Abe, Masanobu; Inaki, Ryoko; Zong, Liang; Suenaga, Hideyuki; Abe, Takahiro; Hoshi, Kazuto

2017-08-18

Infections in the oral and maxillofacial region can sometimes extend beyond the oral cavity, with serious consequences. Most oral infections are odontogenic, occurring through the root apex of the tooth or the periodontal pocket. It thus makes sense that edentulous patients have a much lower risk of oral bacterial infection. For this reason, while there are many reports on systemic infections caused by oral infections, few of these describe such infections in edentulous patients. We present a case of oral and maxillofacial cellulitis followed by sepsis due to Streptococcus pyogenes infection in an 89-year-old Japanese edentulous woman. S. pyogenes was detected in the wound of left maxilla and the blood sample. S. pyogenes has been reported to be one of the most common and influential aerobic bacteria associated with deep neck infection and subsequent systemic infection. Left maxillary sinusitis was observed, and this could be the origin of the S. pyogenes infection. S. pyogenes derived from the sinusitis and leaked to the oral cavity might have caused systemic infection through wounding of the oral mucosa. Fortunately, intensive antibiotic therapy was effective, and the patient recovered without any surgical procedures. We experienced a rare case of oral and maxillofacial cellulitis followed by sepsis due to a Streptococcus pyogenes infection in an old edentulous woman. This result indicated that, while edentulous patients are considered to have no risk of odontogenic infection, they still carry a risk of bacterial infection.

The impact of cleft lip and palate repair on maxillofacial growth

PubMed Central

Shi, Bing; Losee, Joseph E

2015-01-01

Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau's pushback palatoplasty and Langenbeck's palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not. PMID:25394591

What are the defining characteristics of the most cited publications in orthognathic surgery?

PubMed

Susarla, S M; Tveit, M; Dodson, T B; Kaban, L B; Hopper, R A; Egbert, M A

2018-05-21

The purpose of this study was to identify the characteristics associated with highly cited papers in orthognathic surgery. This was a cohort study of articles published in the English-language literature from 1900 to 2017. Citation databases were searched for papers related to orthognathic surgery and the most frequently cited papers were identified. For each paper, the following variables were collected: region of origin, time-period of publication, corresponding author specialty, journal of publication, topic area, study design, and number of citations. The outcome variable was the citation index (citations per year). North American investigators published 70% of the 100 most-cited articles in orthognathic surgery. The majority of papers were from oral and maxillofacial surgeons. Frequent content areas were diagnosis, virtual planning, fixation/stability, and complications. The majority (54%) of studies were cohort or case report/series. The mean number of citations was 235.0±126.5; the mean citation index was 9.9±6.1 citations per year. Time-period, content area, and study design were associated with the citation index (all P<0.001). Time-period, content area, and study design predicted the citation index (all P≤0.009). Among frequently cited papers in orthognathic surgery, oral and maxillofacial surgeons had the highest volume of contributions. Diagnosis, treatment planning, and complications were the most common topics studied. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Curriculum Guidelines on Predoctoral Oral and Maxillofacial Surgery.

ERIC Educational Resources Information Center

Journal of Dental Education, 1985

1985-01-01

The American Association of Dental Schools' Curriculum Guidelines include an introduction to the discipline and its interrelationships with other disciplines, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing and faculty. (MSE)

Cervical and facial infections - a real life threat

NASA Astrophysics Data System (ADS)

Rosu, S.; Fratila, M.

2014-03-01

Cervicofacial infections of dental origin are a difficult and complex issue of oral and maxillofacial surgery. Recognizing in due time the situations which are likely to develop a life-threatening condition and medical surgical prompt interventions significantly reduce the rate of the complications. Between January 2009 and March 2013, at the Clinic of Oral and Maxillofacial Surgery of the University of Medicine and Pharmacy "Victor Babes" Timisoara, 17 patients with severe cervicofacial infections were admitted in the emergency department as they needed a complex medical surgical treatment in accordance with protocol established together with the intensive-care department. Assessing the situations, we noticed a difficult, prolonged time of the recovery process which needed a hospitalization period of around 20 days. It recorded two deceased because of cervical necrotizing fasciitis and oral floor phlegmon, the most severe forms of the cervicofacial infections. The severity of the condition of the patients with cervicofacial infections must be figured and as quickly as possible an energetic therapeutic attitude must be adopted. The experience shows a frequent resistance to antibiotics like ampicillin, penicillin and oxacillin. The patients must be guided in due time to a clinic which has an intensive care department, where the surgical treatment must be administrated together with an intensive treatment for supporting the general condition. The reduction of the vital risk of the cervicofacial infections of dental origin will be done through an attentive assessment of the general and local condition (status) of the outpatients, before the dental extraction. The absence of a treatment adapted to the situation and to the clinic development, meaningfully increases the rate of the complications and the length of the hospitalization, the lethal evolution being not excluded.

Comparative study of manufacturing condyle implant using rapid prototyping and CNC machining

NASA Astrophysics Data System (ADS)

Bojanampati, S.; Karthikeyan, R.; Islam, MD; Venugopal, S.

2018-04-01

Injuries to the cranio-maxillofacial area caused by road traffic accidents (RTAs), fall from heights, birth defects, metabolic disorders and tumors affect a rising number of patients in the United Arab Emirates (UAE), and require maxillofacial surgery. Mandibular reconstruction poses a specific challenge in both functionality and aesthetics, and involves replacement of the damaged bone by a custom made implant. Due to material, design cycle time and manufacturing process time, such implants are in many instances not affordable to patients. In this paper, the feasibility of designing and manufacturing low-cost, custom made condyle implant is assessed using two different approaches, consisting of rapid prototyping and three-axis computer numerically controlled (CNC) machining. Two candidate rapid prototyping techniques are considered, namely fused deposition modeling (FDM) and three-dimensional printing followed by sand casting The feasibility of the proposed manufacturing processes is evaluated based on manufacturing time, cost, quality, and reliability.

Rare finding of Eustachian tube calcifications with cone-beam computed tomography.

PubMed

Syed, Ali Z; Hawkins, Anna; Alluri, Leela Subashini; Jadallah, Buthainah; Shahid, Kiran; Landers, Michael; Assaf, Hussein M

2017-12-01

Soft tissue calcification is a pathological condition in which calcium and phosphate salts are deposited in the soft tissue organic matrix. This study presents an unusual calcification noted in the cartilaginous portion of the Eustachian tube. A 67-year-old woman presented for dental treatment, specifically for implant placement, and cone-beam computed tomography (CBCT) was performed. The CBCT scan was reviewed by a board-certified oral and maxillofacial radiologist and revealed incidental findings of 2 distinct calcifications in the cartilaginous portion of the Eustachian tube. To the authors' knowledge, no previous study has reported the diagnosis of Eustachian tube calcification using CBCT. This report describes an uncommon variant of Eustachian tube calcification, which has a significant didactic value because such cases are seldom illustrated either in textbooks or in the literature. This case once again underscores the importance of having CBCT scans evaluated by a board-certified oral and maxillofacial radiologist.

Oral and maxillofacial surgery - a case of mistaken identity?

PubMed

van Gijn, D R

2011-01-08

There are international grumbles from those perturbed by an impending identity crisis within oral and maxillofacial surgery (OMFS). This unrest is further compounded by scattered suggestions that a name change may prove beneficial in raising the profile of OMFS. The purpose of this paper is to consider novel methods of increasing awareness of the specialty amongst the public, primary and secondary care colleagues by collecting a consensus of thoughts and opinions regarding the specialty's identity and the appropriate and holistic nomenclature of OMFS. Approximately 300 eight-point questionnaires were distributed internationally with a response rate, via both email and post, of approximately 25% (72). Thirty-two percent of respondents considered there to be an identity crisis within OMFS although just 18% felt that a specialty name change would be beneficial. The results suggest that the problem with identity relates more to incapacity to convey the message of OMFS rather than nomenclature.

Reconstruction of Facial Defect Using Deltopectoral Flap.

PubMed

Aldelaimi, Tahrir N; Khalil, Afrah A

2015-11-01

Reconstruction of the head and neck is a challenge for otolarygology surgeons, maxillofacial surgeons as well as plastic surgeons. Defects caused by the resection and/or trauma should be closed with flaps which match in color, texture and hair bearing characteristics with the face. Deltopectoral flap is a one such flap from chest and neck skin mainly used to cover the facial defects. This study report a patient presenting with tragic Road Traffic Accident (RTA) admitted to maxillofacial surgery department at Ramadi Teaching Hospital, Anbar province, Iraq. An incision, medially based, was done and deltopectoral fascio-cutaneous flap was used for surgical exposure and closure of defects after RTA. There was no major complication. Good aesthetic and functional results were achieved. Deltopectoral flap is an excellent alternative for the reconstruction of head and neck. Harvesting and application of the flap is rapid and safe. Only a single incision is sufficient for dissection and flap elevation.

Bioactive-glass in Oral and Maxillofacial Surgery

PubMed Central

Profeta, Andrea Corrado; Huppa, Christoph

2015-01-01

The use of synthetic materials to repair craniofacial defects is increasing today and will increase further in the future. Because of the complexity of the anatomy in the head and neck region, reconstruction and augmentation of this area pose a challenge to the surgeon. This review discusses key facts and applications of traditional reconstruction bone substitutes, also offering comparative information. It then describes the properties and clinical applications of bioactive-glass (B-G) and its variants in oral and maxillofacial surgery, and provides clinical findings. The discussion of each compound includes a description of its composition and structure, the advantages and shortcomings of the material, and its current uses in the field of osteoplastic and reconstructive surgery. With a better understanding of the available alloplastic implants, the surgeon can make a more informed decision as to which implant would be most suitable in a particular patient. PMID:26889342

[Surgical approach of internal fixation of maxillofacial fracture].

PubMed

Liu, Dashun; Zhang, Ruizhen; Dong, Xiao

2013-11-01

By summary and analysis of rigid internal fixation for the treatment of maxillofacial fractures incision and exposure, investigate the plate reasonable surgical approach of fracture reduction and fixation titanium. Summary of the 76 surgical cases, Counting the statistics of the number that the surgery ways choose by facial incision and fractures location, analysis of the indications for surgery and the advantages and disadvantages of various surgical approaches. Followed up for more than six months, in order to observe the recovery of occlusal function and the facial cosmetic results. The upper jaw or cheek bone has the more possibility in facial fracture, which used of a small incision hidden under the lip gingival sulcus and lower eyelid. After six months, the facial wound healing recover in good occlusal with no obvious scarring. Reasonable choice of surgical incision can make the fracture site exposure and the facial aesthetic effect into account.

[Surgical correction of cleft palate].

PubMed

Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

1990-04-01

This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

Impacted third molar transplantation on the malpracticed extraction socket.

PubMed

Kim, Soung Min; Amponsah, Emmanuel K

2017-12-01

Autotransplantation with or without endodontic therapy is regarded as an alternative treatment option for the replacement of missing teeth. A primary responsibility of a maxillofacial surgeon is to reverse any malpractice to promote successful outcomes and improve the patient's quality of life. This paper presents a malpractice case of incorrect extraction of the lower second molar instead of the impacted third molar. A simple technique of transplanting the impacted third molar to the site of the extracted second molar is introduced by a maxillofacial specialist in Ghana. By making an intentional root socket and fixation without using additional appliances, a novel second molar was achieved with complete recovery. This patient was followed after transplant for a four-year period with the best satisfaction. A grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea. (HI15C0689).

Assessment of Speech in Primary Cleft Palate by Two-layer Closure (Conservative Management).

PubMed

Jain, Harsha; Rao, Dayashankara; Sharma, Shailender; Gupta, Saurabh

2012-01-01

Treatment of the cleft palate has evolved over a long period of time. Various techniques of cleft palate repair that are practiced today are the results of principles learned through many years of modifications. The challenge in the art of modern palatoplasty is no longer successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. Throughout these periods of evolution in the treatment of cleft palate, the effectiveness of various treatment protocols has been challenged by controversies concerning speech and maxillofacial growth. In this article we have evaluated the results of Pinto's modification of Wardill-Kilner palatoplasty without radical dissection of the levator veli palitini muscle on speech and post-op fistula in two different age groups in 20 patients. Preoperative and 6-month postoperative speech assessment values indicated that two-layer palatoplasty (modified Wardill-Kilner V-Y pushback technique) without an intravelar veloplasty technique was good for speech.

Rare and Severe Maxillofacial Injury Due to Tear Gas Capsules: Report of Three Cases.

PubMed

Çorbacɩoğlu, Şeref Kerem; Güler, Sertaç; Er, Erhan; Seviner, Meltem; Aslan, Şahin; Aksel, Gökhan

2016-03-01

Tear gases are used by police or armed forces for control of riots or social events or by the general population for private self-defense. These agents are used widely throughout the world, but some harmful effects have reported. In addition, despite well-defined chemical side effects documented in the literature, data are insufficient regarding mechanical injury due to tear gas capsules. We report three cases of severe maxillofacial injury in patients who had these capsules fired from tear gas guns directly to their faces. The capsules penetrated the patients' faces, causing potentially fatal injuries. To our knowledge, reports of this kind of injury related to tear gas capsules are very rare in the literature. In conclusion, tear gas guns may be very dangerous in terms of human health and they may cause severe injuries, especially when they are not used according to strict guidelines. © 2015 American Academy of Forensic Sciences.

Computed intraoperative navigation guidance--a preliminary report on a new technique.

PubMed

Enislidis, G; Wagner, A; Ploder, O; Ewers, R

1997-08-01

To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Factors associated to post-operative nausea and vomiting following oral and maxillofacial surgery: a prospective study.

PubMed

Albuquerque, Assis Filipe Medeiros; Queiroz, Salomão Israel Monteiro Lourenço; Germano, Adriano Rocha; da Silva, José Sandro Pereira

2017-03-01

This study aims to address and assess possible factors associated with nausea and vomiting (NV) following oral and maxillofacial surgery. A prospective study was carried out in the period from December 2013 to January 2016 targeting all attended cases in that period. For statistical analysis, Pearson chi-square and Fisher tests were used to verify association and ANOVA and Student's t tests to test for significant difference, p was defined as ≤0.05. The sample group consisted of 207 patients with an average age of 33.56 years (±13.23), and 70.5% of subjects were male. Calculations based on the predictive model showed that a female patient with prior history of nausea and vomiting who used opioids and had intra-oral surgical access would have a 96% chance of experiencing a nausea and vomiting episode. Other factors like age, being overweight, anesthesia, surgery duration, and duration of hospital stay also contribute so that these aspects must be paid careful attention prior to surgery to ensure a suitably orientated treatment that will avoid disturbances caused by post-operative nausea and vomiting. The occurrence of post-operative nausea and vomiting after oral and maxillofacial surgery was found to be more higher incidence associated to female patients who used opioids, who had a prior history of NV, whose surgery involved intra-oral access, who were in the second or third decades of their lives, who have above average weight, and who have long anesthesia when undergoing surgery, resulting in a long hospital stays.

The 100 Most Cited Articles in Facial Trauma: A Bibliometric Analysis.

PubMed

Tahim, Arpan; Patel, Kush; Bridle, Christopher; Holmes, Simon

2016-11-01

The number of citations an article receives has been used as a marker of its influence within a surgical specialty. Currently, there is limited citation analysis in oral and maxillofacial trauma surgery. The purpose of this study was to determine the 100 most cited articles in facial trauma surgery and their characteristics. Articles were identified from the Science Citation Index of the Institute for Scientific Information using the Thomson Reuters Web of Science search engine. All articles until 2015 were included. Then, the 100 most cited articles were assessed for title, author, journal, country of origin, and number of citations. A citation index (number of citations received per year) also was calculated. The 100 most cited articles in facial trauma received 9,933 citations (range, 66 to 297). They were published from 1942 through 2008, with 1990 through 1999 being the commonest decade. Articles were cited on average 4.6 times per year. Articles were published in 28 different journals, with impact factors ranging from 0.94 to 35.3. Most articles were observational research studies. These findings reflect the attention that articles have received during the past half century in oral and maxillofacial trauma research, shedding light on often-read articles in this field. In addition to current bibliometric indices, it could provide a useful evidence base for facial surgeons, represent key educational material for aspiring trainees, and be used to help guide future research efforts. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Retrospective examination of the healthcare 'journey' of chronic orofacial pain patients referred to oral and maxillofacial surgery.

PubMed

Beecroft, E V; Durham, J; Thomson, P

2013-03-01

To gain a deeper understanding of the clinical journey taken by orofacial pain patients from initial presentation in primary care to treatment by oral and maxillofacial surgery. Retrospective audit. Data were collected from 101 consecutive patients suffering from chronic orofacial pain, attending oral and maxillofacial surgery clinics between 2009 and 2010. Once the patients were identified, information was drawn from their hospital records and referral letters, and a predesigned proforma was completed by a single examiner (EVB). Basic descriptive statistics and non-parametric inferential statistical techniques (Krushal-Wallis) were used to analyse the data. DATA AND DISCUSSION: Six definitive orofacial pain conditions were represented in the data set, 75% of which were temporomandibular disorders (TMD). Individuals within our study were treated in nine different hospital settings and were referred to 15 distinct specialties. The mean number of consultations received by the patients in our study across all care settings is seven (SD 5). The mean number of specialities that the subjects were assessed by was three (SD 1). The sample set had a total of 341 treatment attempts to manage their chronic orofacial pain conditions, of which only 83 (24%) of all the treatments attempted yielded a successful outcome. Improved education and remuneration for primary care practitioners as well as clear care pathways for patients with chronic orofacial pain should be established to reduce multiple re-referrals and improve efficiency of care. The creation of specialist regional centres for chronic orofacial pain may be considered to manage severe cases and drive evidence-based practice.

The regenerative medicine in oral and maxillofacial surgery: the most important innovations in the clinical application of mesenchymal stem cells.

PubMed

Tatullo, Marco; Marrelli, Massimo; Paduano, Francesco

2015-01-01

Regenerative medicine is an emerging field of biotechnology that combines various aspects of medicine, cell and molecular biology, materials science and bioengineering in order to regenerate, repair or replace tissues. The oral surgery and maxillofacial surgery have a role in the treatment of traumatic or degenerative diseases that lead to a tissue loss: frequently, to rehabilitate these minuses, you should use techniques that have been improved over time. Since 1990, we started with the use of growth factors and platelet concentrates in oral and maxillofacial surgery; in the following period we start to use biomaterials, as well as several type of scaffolds and autologous tissues. The frontier of regenerative medicine nowadays is represented by the mesenchymal stem cells (MSCs): overcoming the ethical problems thanks to the use of mesenchymal stem cells from adult patient, and with the increasingly sophisticated technology to support their manipulation, MSCs are undoubtedly the future of medicine regenerative and they are showing perspectives unimaginable just a few years ago. Most recent studies are aimed to tissues regeneration using MSCs taken from sites that are even more accessible and rich in stem cells: the oral cavity turned out to be an important source of MSCs with the advantage to be easily accessible to the surgeon, thus avoiding to increase the morbidity of the patient. The future is the regeneration of whole organs or biological systems consisting of many different tissues, starting from an initial stem cell line, perhaps using innovative scaffolds together with the nano-engineering of biological tissues.

Psychiatric analysis of suicide attempt subjects due to maxillofacial gunshot.

PubMed

Oztürk, Serdar; Bozkurt, Ali; Durmus, Muzaffer; Deveci, Mustafa; Sengezer, Mustafa

2006-11-01

The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P < 0.01). Depressive spectrum disorders are the most common causes. It is obvious that untreated or undiagnosed depression may increase risk of committing suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.

Use of rectangular grid miniplates for fracture fixation at the mandibular angle.

PubMed

Hochuli-Vieira, Eduardo; Ha, Thi Khanh Linh; Pereira-Filho, Valfrido Antonio; Landes, Constantin Alexander

2011-05-01

The aim of this study was to evaluate the clinical outcome of patients with mandibular angle fractures treated by intraoral access and a rectangular grid miniplate with 4 holes and stabilized with monocortical screws. This study included 45 patients with mandibular angle fractures from the Department of Oral and Maxillofacial Surgery São Paulo State University, Araraquara, Brazil, and from the Clinic of Oral and Maxillofacial Surgery at the University of Frankfurt, Germany. The 45 fractures of the mandibular angle were treated with a rectangular grid miniplate of a 2.0-mm system by an intraoral approach with monocortical screws. Clinical evaluations were postoperatively performed at 15 and 30 days and 3 and 6 months, and the complications encountered were recorded and treated. The infection rate was 4.44% (2 patients), and in 1 patient it was necessary to replace hardware. This patient also had a fracture of the left mandibular body; 3 patients (6.66%) had minor occlusal changes that have been resolved with small occlusal adjustments. Before surgery, 15 patients (33.33%) presented with hypoesthesia of the inferior alveolar nerve; 4 (8.88%) had this change until the last clinical control, at 6 months. The rectangular grid miniplate used in this study was stable for the treatment of simple mandibular angle fractures through intraoral access, with low complication rates, easy handling, and easy adjustment, with a low cost. Concomitant mandibular fracture may increase the rate of complications. This plate should be indicated in fractures with sufficient interfragmentary contact. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Anatomy of the fasciae and fascial spaces of the maxillofacial and the anterior neck regions.

PubMed

Kitamura, Seiichiro

2018-01-01

This review provides an overview of comprehensive knowledge regarding the anatomy of the fasciae and fascial spaces of the maxillofacial and the anterior neck regions, principally from the standpoint of oral surgery, whose descriptions have long been puzzling and descriptively much too complex. The maxillofacial and the anterior neck regions are divided into four portions: the portions superficial and deep to the superficial layer of the deep cervical fascia (SfDCF) including its rostral extension to the face, the intermediate portion sandwiched by the splitting SfDCF, and the superficial portion peculiar to the face where the deep structures open on the body surface to form the oral cavity. Different fascial spaces are contained in each of the portions, although the spaces belonging to the portion of the same depth communicate freely with each other. The spaces of the superficial portions are adjacent to the oral cavity and constitute the starting point of deep infections from that cavity. The spaces of the intermediate portion lie around the mandible and occupy the position connecting the superficial and deep portions. Among these spaces, the submandibular and prestyloid spaces play an important role as relay stations conveying the infections into the deep portion. The spaces of the deep portion lie near the cervical viscera and communicate inferiorly with the superior mediastinum, among which the poststyloid space plays a role as a reception center of the infections and conveys the infections into the superior mediastinum particularly by way of the retrovisceral space and the carotid sheath.

Use of the Er:YAG laser for improved plating in maxillofacial surgery: comparison of bone healing in laser and drill osteotomies.

PubMed

Lewandrowski, K U; Lorente, C; Schomacker, K T; Flotte, T J; Wilkes, J W; Deutsch, T F

1996-01-01

Surgical reconstruction of bony defects in the maxillofacial region involves fixation of bony fragments with mini and micro plates. Bone stabilization during hole drilling is often challenging due to the need to apply pressure when using a conventional mechanical Hall drill. In addition, fragmentation of the fragile bones may occur and complicate the reconstruction. The pulsed Er:YAG laser offers an attractive alternative drilling modality because it does not require physical contact with the bone in order to drill holes, cuts bone with minimal thermal damage, and allows precise control of bone cutting. The objective of this study was to investigate the pulsed Er:YAG laser as an alternative to the mechanical bur by comparing bone healing using both modalities. Bone healing in an inferior border defect of the rat mandible was examined using either an Er:YAG laser or a mechanical bur for drilling. The healing of osteotomies in facial bones and of screw holes for plate stabilization of free bone fragments was studied. All defects healed by 4 weeks postoperatively. Histologic evaluation demonstrated no difference in the amount of newly formed woven bone at the osteotomy site or screw holes made by either the laser or the drill. The extent of thermal damage at the osteotomy sites was comparable in laser and mechanically cut bone fragments. On the basis of this study we suggest that the Er: YAG laser can be used clinically in thin, fragile bones in the maxillofacial region.

Influence of Head Motion on the Accuracy of 3D Reconstruction with Cone-Beam CT: Landmark Identification Errors in Maxillofacial Surface Model.

PubMed

Lee, Kyung-Min; Song, Jin-Myoung; Cho, Jin-Hyoung; Hwang, Hyeon-Shik

2016-01-01

The purpose of this study was to investigate the influence of head motion on the accuracy of three-dimensional (3D) reconstruction with cone-beam computed tomography (CBCT) scan. Fifteen dry skulls were incorporated into a motion controller which simulated four types of head motion during CBCT scan: 2 horizontal rotations (to the right/to the left) and 2 vertical rotations (upward/downward). Each movement was triggered to occur at the start of the scan for 1 second by remote control. Four maxillofacial surface models with head motion and one control surface model without motion were obtained for each skull. Nine landmarks were identified on the five maxillofacial surface models for each skull, and landmark identification errors were compared between the control model and each of the models with head motion. Rendered surface models with head motion were similar to the control model in appearance; however, the landmark identification errors showed larger values in models with head motion than in the control. In particular, the Porion in the horizontal rotation models presented statistically significant differences (P < .05). Statistically significant difference in the errors between the right and left side landmark was present in the left side rotation which was opposite direction to the scanner rotation (P < .05). Patient movement during CBCT scan might cause landmark identification errors on the 3D surface model in relation to the direction of the scanner rotation. Clinicians should take this into consideration to prevent patient movement during CBCT scan, particularly horizontal movement.

Monoscopic photogrammetry to obtain 3D models by a mobile device: a method for making facial prostheses.

PubMed

Salazar-Gamarra, Rodrigo; Seelaus, Rosemary; da Silva, Jorge Vicente Lopes; da Silva, Airton Moreira; Dib, Luciano Lauria

2016-05-25

The aim of this study is to present the development of a new technique to obtain 3D models using photogrammetry by a mobile device and free software, as a method for making digital facial impressions of patients with maxillofacial defects for the final purpose of 3D printing of facial prostheses. With the use of a mobile device, free software and a photo capture protocol, 2D captures of the anatomy of a patient with a facial defect were transformed into a 3D model. The resultant digital models were evaluated for visual and technical integrity. The technical process and resultant models were described and analyzed for technical and clinical usability. Generating 3D models to make digital face impressions was possible by the use of photogrammetry with photos taken by a mobile device. The facial anatomy of the patient was reproduced by a *.3dp and a *.stl file with no major irregularities. 3D printing was possible. An alternative method for capturing facial anatomy is possible using a mobile device for the purpose of obtaining and designing 3D models for facial rehabilitation. Further studies must be realized to compare 3D modeling among different techniques and systems. Free software and low cost equipment could be a feasible solution to obtain 3D models for making digital face impressions for maxillofacial prostheses, improving access for clinical centers that do not have high cost technology considered as a prior acquisition.

Odontogenic cervical necrotizing fasciitis, etiological aspects.

PubMed

Juncar, M; Bran, S; Juncar, R I; Baciut, M F; Baciut, G; Onisor-Gligor, F

2016-01-01

Cervical necrotizing fasciitis is a rare but very severe infection that affects the soft-tissues of the cephalic extremity. Cervical necrotizing fasciitis most frequently occurs secondarily to inflammatory odontogenic disorders and represents the most severe infection of maxillofacial spaces, with a high lethal potential. In this study, we selected 55 patients with confirmed cervical necrotizing fasciitis of odontogenic origin, treated in the Clinic of Oral and Maxillofacial Surgery in Cluj-Napoca during January 1996-December 2012. In the majority of cases, the disease evolved without the presence of associated systemic disorders (60% [45.49-72.69]), the rest of the patients having 1-4 types of systemic disorders; type 2 diabetes mellitus was the most frequent type of underlying systemic disorder. From the appearance of the first symptoms until the presentation for treatment, a time interval of 2-30 days elapsed. During this time period, 78.18% (95% confidence interval [CI] [65.49-89.06]) of the patients received antibiotic treatment, but without results. Mandibular molars were the most frequent starting point of the disease, and the submandibular space was the first affected by the disease, 47.27% (95% CI [32.76-61.79]). Bacteriological exams showed that facultatively aerobic/anaerobic G + bacteria were the most frequently identified (72.22% [58.21-83.60]). The odontogenic lesions of the lower molars, complicated by submandibular space infections, are the most frequent starting point of odontogenic cervicofacial necrotizing fasciitis. Delayed surgical treatment and strict antibiotic therapy play an important role in favoring the development of odontogenic necrotizing fasciitis.

Maxillofacial Injuries as Markers of Interpersonal Violence in Belo Horizonte-Brazil: Analysis of the Socio-Spatial Vulnerability of the Location of Victim’s Residences

PubMed Central

Silva, Carlos José de Paula; Moura, Ana Clara Mourão; Paiva, Paula Cristina Pelli; Ferreira, Raquel Conceição; Silvestrini, Rafaella Almeida; Vargas, Andréa Maria Duarte; de Paula, Liliam Pacheco Pinto; Naves, Marcelo Drummond; Ferreira, Efigênia Ferreira e

2015-01-01

The aim of the present study was to analyze the spatial pattern of cases of maxillofacial injuries caused by interpersonal violence, based on the location of the victim’s residence, and to investigate the existence of conditions of socio-spatial vulnerability in these areas. This is a cross-sectional study, using the data of victims attended in three emergency hospitals in Belo Horizonte-Brazil between January 2008 and December 2010. Based on the process of spatial signature, the socio-spatial condition of the victims was identified according to data from census tracts. The spatial distribution trends of the addresses of victims were analyzed using Kernel maps and Ripley’s K function. Multicriteria analysis was used to analyze the territorial insertion of victims, using a combination of variables to obtain the degree of socio-spatial vulnerability. The residences of the victims were distributed in an aggregated manner in urban areas, with a confidence level of 99%. The highest densities were found in areas of unfavorable socioeconomic conditions and, to a lesser extent, areas with worse residential and neighborhood infrastructure. Spatial clusters of households formed in slums with a significant level of socio-spatial vulnerability. Explanations of the living conditions in segregated urban areas and analysis of the concentration of more vulnerable populations should be a priority in the development of public health and safety policies. PMID:26274320

Gum biopsy

MedlinePlus

... Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. St Louis, MO: Elsevier Mosby; 2014: ... Wein RO, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, ... & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

Development of a 3D printable maxillofacial silicone: Part I. Optimization of polydimethylsiloxane chains and cross-linker concentration.

PubMed

Jindal, Swati K; Sherriff, Martyn; Waters, Mark G; Coward, Trevor J

2016-10-01

Conventionally, maxillofacial prostheses are fabricated by hand carving the missing anatomic defect in wax and creating a mold into which pigmented silicone elastomer is placed. Digital technologies such as computer numerical control (CNC) milling and 3-dimensional (3D) printing have been used to prepare molds directly or indirectly into which a biocompatible pigmented silicone elastomer is placed. The purpose of this in vitro study was to develop a silicone elastomer by varying composition that could eventually be 3D printed directly without a mold to create facial/body prostheses. The silicone was composed of polydimethylsiloxane (PDMS), filler, catalyst, and cross-linker. Four types of base silicone polymers were prepared with different PDMS molecular weight combinations with long, medium, and short chain length PDMS. The effect of the cross-linker (2.5% to 12.5%) content in these bases was assessed for the effect upon the mechanical properties of the elastomer. Ten readings were made for each formulation, and differences in the means were evaluated with a 2-way ANOVA (α=.05). Variations in silicone composition resulted in hardness from 6.8 to 28.5 durometer, tensile strength from 0.720 to 3.524 kNm -1 and tear strength from 0.954 to 8.484 MPa. Significant differences were observed among all formulations (P<.05). These formulations have mechanical properties comparable with the commercial silicones currently used for the fabrication of facial prostheses. The formulation with 5% cross-linker content and high content of long-chain PDMS chains with optimum mechanical properties was chosen for further development. The optimum combination of mechanical properties implies the use of one of these formulations for further evaluation in a 3D printer capable of actively mixing and extruding 2-component, room temperature vulcanization silicone. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Prevalence and patterns of combat sport related maxillofacial injuries.

PubMed

Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr

2010-10-01

This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ(2), ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Of 120 subjects, 95 male subjects (79.2%), aged 18-25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes. In this study, prevalence of facial injuries from combat sports professionals was significantly high (roughly 80%), especially in kickboxing (in part due to use of less protective gear). Because the nose and teeth sustained the most injuries, they require more attention with regard to prevention. Kickboxing was the most injurious of these combat sports and caused the most significant number of maxillofacial trauma. More safety apparel and protective guards seem warranted in athletes of combat sports if facial injury is to be prevented.

Ectodermal Dysplasia with Anodontia: A Report of Two Cases

PubMed Central

Bani, Mehmet; Tezkirecioglu, Ali Melih; Akal, Nese; Tuzuner, Tamer

2010-01-01

Ectodermal dysplasia is a hereditary disorder that occurs as a consequence of disturbances in the ectoderm of the developing embryo. The triad of nail dystrophy, alopecia or hypotrichosis and palmoplantar hyperkeratosis is usually accompanied by a lack of sweat glands and a partial or complete absence of primary and/or permanent dentition. Two case reports illustrating the prosthetic rehabilitation of 2 young boys with anhidrotic ectodermal dysplasia associated with severe anodontia are presented. Since the oral rehabilitation of these cases is often difficult; particularly in pediatric patients, treatment should be administered by a multidisciplinary team involving pediatric dentistry, orthodontics, prosthodontics and oral-maxillofacial surgery. PMID:20396456

Management of pediatric mandibular fracture using orthodontic vacuum-formed thermoplastic splint: A case report and review of literature.

PubMed

Sanu, O O; Ayodele, Aos; Akeredolu, M O

2017-05-01

Fractures of the mandible are relatively less frequent in children when compared to adults. The anatomic features of children are protected. Children have a higher adaptation to maxillofacial fractures compared to adults. Treatment principles of mandibular fractures in children differ from that of adults due to concerns regarding mandibular growth and the developing dentition. A case of a 6-year-old boy with fractured mandibular symphysis managed by closed reduction using a vacuum formed thermoplastic splint and circummandibular wiring is presented. This article also provides a review of the literature regarding the management of mandibular fracture in young children.

Streptococcus sanguinis brain abscess as complication of subclinical endocarditis: emphasizing the importance of prompt diagnosis.

PubMed

Kassis, Hayah; Marnejon, Thomas; Gemmel, David; Cutrona, Anthony; Gottimukkula, Rajashree

2010-06-01

A 19-year-old male patient was diagnosed with S. sanguinis brain abscess of unknown etiopathology as a complication of subclinical endocarditis. While viridans streptococci are implicated in dental seeding to the heart, S. sanguinis brain abscesses are rare. Six previous cases of S. sanguinis brain abscess in the literature reported dental procedures and maxillofacial trauma. In our patient, there was no obvious source of infective endocarditis preceding the development of brain abscess. This demonstrates the importance of prompt diagnosis and initiation of antimicrobial therapy given the potential for long-term sequelae such as focal deficits and seizures.

Oral submucous fibrosis: an overview of the aetiology, pathogenesis, classification, and principles of management.

PubMed

Arakeri, Gururaj; Brennan, Peter A

2013-10-01

Oral submucous fibrosis (OSMF) is a complex, debilitating, and precancerous condition. Formerly confined to the Indian subcontinent, it is now often seen in the Asian populations of the United Kingdom, USA, and other developed countries, and is therefore a serious problem for global health. The well-known causative agent of the disease, areca-nut is now recognised as a group one carcinogen. We review and discuss all components of OSMF, including the terminology, presentation, aetiology, and pathogenesis, and provide a brief overview of its management. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A novel anchorage technique for transnasal traction in rigid external maxillary distraction.

PubMed

Varol, A; Basa, S

2013-12-01

We describe an effective technique for anchorage of transnasal traction in the management of maxillary rotation during external distraction. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Tongue biopsy

MedlinePlus

... Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. St Louis, MO: Elsevier Mosby; 2014:chap 22. McNamara MJ. Other solid tumors. In: Benjamin IJ, Griggs RC, Wing EJ, Fitz JG, eds. Andreoli and Carpenter's Cecil ... Tongue Disorders Read more A. ...

Quality of Postoperative Pain Management After Maxillofacial Fracture Repair.

PubMed

Peisker, Andre; Meissner, Winfried; Raschke, Gregor F; Fahmy, Mina D; Guentsch, Arndt; Schiller, Juliane; Schultze-Mosgau, Stefan

2018-05-01

Effective pain management is an essential component in the perioperative care of surgical patients. However, postoperative pain after maxillofacial fracture repair and its optimal therapy has not been described in detail. In a prospective cohort study, 95 adults rated their pain on the first postoperative day after maxillofacial fracture repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project. Quality Improvement in Postoperative Pain Management allowed for a standardized assessment of patients' characteristics and pain-related parameters. Overall, the mean maximal pain and pain on activity (numeric rating scales) were significantly higher in patients with mandibular fractures than in patients with midface fractures (P = 0.002 and P = 0.045, respectively). In patients with mandibular fractures, a longer duration of surgery was significantly associated with higher satisfaction with pain intensity (P = 0.015), but was more frequently associated with postoperative vomiting (P = 0.023). A shorter duration of surgery and an absence of preoperative pain counseling in these patients were significantly correlated to desire for more pain medication (P = 0.049 and P = 0.004, respectively). Patients with mandibular fractures that received opioids in the recovery room had significantly higher strain-related pain (P = 0.017). In patients with midface fractures, a longer duration of surgery showed significantly higher levels of decreased mobility (P = 0.003). Patients receiving midazolam for premedication had significantly less minimal pain (P = 0.021). Patients with mandibular fractures seem to have more postoperative pain than patients with midface fractures. Monitoring of postsurgical pain and a procedure-specific pain-treatment protocol should be performed in clinical routine.

Oral and maxillofacial surgery residents have poor understanding of biostatistics.

PubMed

Best, Al M; Laskin, Daniel M

2013-01-01

The purpose of this study was to evaluate residents' understanding of biostatistics and interpretation of research results. A questionnaire previously used in internal medicine residents was modified to include oral and maxillofacial surgery (OMS) examples. The survey included sections to identify demographic and educational characteristics of residents, attitudes and confidence, and the primary outcome-knowledge of biostatistics. In 2009 an invitation to the Internet survey was sent to all 106 program directors in the United States, who were requested to forward it to their residents. One hundred twelve residents responded. The percentage of residents who had taken a course in epidemiology was 53%; biostatistics, 49%; and evidence-based dentistry, 65%. Conversely, 10% of OMS residents had taken none of these classes. Across the 6-item test of knowledge of statistical methods, the mean percentage of correct answers was 38% (SD, 22%). Nearly half of the residents (42%) could not correctly identify continuous, ordinal, or nominal variables. Only 21% correctly identified a case-control study, but 79% correctly identified that the purpose of blinding was to reduce bias. Only 46% correctly interpreted a clinically unimportant and statistically nonsignificant result. None of the demographic or experience factors of OMS residents were related to statistical knowledge. Overall, OMS resident knowledge was below that of internal medicine residents (P<.0001). However, OMS residents were overconfident in their claim to understand most statistical terms. OMS residents lack knowledge in biostatistics and the interpretation of research and are thus unprepared to interpret the results of published clinical research. Residency programs should include effective biostatistical training in their curricula to prepare residents in evidence-based dentistry. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Fiducial-based fusion of 3D dental models with magnetic resonance imaging.

PubMed

Abdi, Amir H; Hannam, Alan G; Fels, Sidney

2018-04-16

Magnetic resonance imaging (MRI) is widely used in study of maxillofacial structures. While MRI is the modality of choice for soft tissues, it fails to capture hard tissues such as bone and teeth. Virtual dental models, acquired by optical 3D scanners, are becoming more accessible for dental practice and are starting to replace the conventional dental impressions. The goal of this research is to fuse the high-resolution 3D dental models with MRI to enhance the value of imaging for applications where detailed analysis of maxillofacial structures are needed such as patient examination, surgical planning, and modeling. A subject-specific dental attachment was digitally designed and 3D printed based on the subject's face width and dental anatomy. The attachment contained 19 semi-ellipsoidal concavities in predetermined positions where oil-based ellipsoidal fiducial markers were later placed. The MRI was acquired while the subject bit on the dental attachment. The spatial position of the center of mass of each fiducial in the resultant MR Image was calculated by averaging its voxels' spatial coordinates. The rigid transformation to fuse dental models to MRI was calculated based on the least squares mapping of corresponding fiducials and solved via singular-value decomposition. The target registration error (TRE) of the proposed fusion process, calculated in a leave-one-fiducial-out fashion, was estimated at 0.49 mm. The results suggest that 6-9 fiducials suffice to achieve a TRE of equal to half the MRI voxel size. Ellipsoidal oil-based fiducials produce distinguishable intensities in MRI and can be used as registration fiducials. The achieved accuracy of the proposed approach is sufficient to leverage the merged 3D dental models with the MRI data for a finer analysis of the maxillofacial structures where complete geometry models are needed.

Surface Coating of Gypsum-Based Molds for Maxillofacial Prosthetic Silicone Elastomeric Material: The Surface Topography.

PubMed

Khalaf, Salah; Ariffin, Zaihan; Husein, Adam; Reza, Fazal

2015-07-01

This study aimed to compare the surface roughness of maxillofacial silicone elastomers fabricated in noncoated and coated gypsum materials. This study was also conducted to characterize the silicone elastomer specimens after surfaces were modified. A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p < 0.05. Roughness was significantly reduced in the silicone elastomers processed against coated gypsum materials (p < 0.001). The AFM and SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers. Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold. © 2014 by the American College of Prosthodontists.

Treatment Protocol for High Velocity/High Energy Gunshot Injuries to the Face

PubMed Central

Peled, Micha; Leiser, Yoav; Emodi, Omri; Krausz, Amir

2011-01-01

Major causes of facial combat injuries include blasts, high-velocity/high-energy missiles, and low-velocity missiles. High-velocity bullets fired from assault rifles encompass special ballistic properties, creating a transient cavitation space with a small entrance wound and a much larger exit wound. There is no dispute regarding the fact that primary emergency treatment of ballistic injuries to the face commences in accordance with the current advanced trauma life support (ATLS) recommendations; the main areas in which disputes do exist concern the question of the timing, sequence, and modes of surgical treatment. The aim of the present study is to present the treatment outcome of high-velocity/high-energy gunshot injuries to the face, using a protocol based on the experience of a single level I trauma center. A group of 23 injured combat soldiers who sustained bullet and shrapnel injuries to the maxillofacial region during a 3-week regional military conflict were evaluated in this study. Nine patients met the inclusion criteria (high-velocity/high-energy injuries) and were included in the study. According to our protocol, upon arrival patients underwent endotracheal intubation and were hemodynamically stabilized in the shock-trauma unit and underwent total-body computed tomography with 3-D reconstruction of the head and neck and computed tomography angiography. All patients underwent maxillofacial surgery upon the day of arrival according to the protocol we present. In view of our treatment outcomes, results, and low complication rates, we conclude that strict adherence to a well-founded and structured treatment protocol based on clinical experience is mandatory in providing efficient, appropriate, and successful treatment to a relatively large group of patients who sustain various degrees of maxillofacial injuries during a short period of time. PMID:23449809

Effects of accelerated artificial daylight aging on bending strength and bonding of glass fibers in fiber-embedded maxillofacial silicone prostheses.

PubMed

Hatamleh, Muhanad M; Watts, David C

2010-07-01

The purpose of this study was to test the effect of different periods of accelerated artificial daylight aging on bond strength of glass fiber bundles embedded into maxillofacial silicone elastomer and on bending strength of the glass fiber bundles. Forty specimens were fabricated by embedding resin-impregnated fiber bundles (1.5-mm diameter, 20-mm long) into maxillofacial silicone elastomer. Specimens were randomly allocated into four groups, and each group was subjected to different periods of accelerated daylight aging as follows (in hours); 0, 200, 400, and 600. The aging cycle included continuous exposure to quartz-filtered visible daylight (irradiance 760 W/m(2)) under an alternating weathering cycle (wet for 18 minutes, dry for 102 minutes). Pull-out tests were performed to evaluate bond strength between fiber bundles and silicone using a universal testing machine at 1 mm/min crosshead speed. Also a three-point bending test was performed to evaluate bending strength of the fiber bundles. One-way ANOVA and Bonferroni post hoc tests were carried out to detect statistical significance (p < 0.05). Mean (SD) values of maximum pull-out forces (in N) for groups 1 to 4 were: 13.63 (7.45), 19.67 (1.37), 13.58 (2.61), and 10.37 (2.52). Group 2 exhibited the highest pull-out force that was statistically significant when compared to the other groups. Maximum bending strengths of fiber bundles were in the range of 917.72 MPa to 1124.06 MPa. Bending strength significantly increased after 200 and 400 hours of aging only. After 200 hours of exposure to artificial daylight and moisture conditions, bond strength between glass fibers and heat-cured silicones is optimal, and the bending strength of the glass fiber bundles is enhanced.

Agreement among orthodontists experienced with cone-beam computed tomography on the need for follow-up and the clinical impact of craniofacial findings from multiplanar and 3-dimensional reconstructed views.

PubMed

Edwards, Ryan; Alsufyani, Noura; Heo, Giseon; Flores-Mir, Carlos

2015-08-01

In this study, we aimed to assess interrater and intrarater agreement among orthodontic clinicians in their assessments of reported incidental findings in regard to both the need for additional follow-up and the impact on future orthodontic treatment in large-field maxillofacial cone-beam computed tomography (CBCT) imaging. The study sample consisted of 18 nonrandomly selected large-field maxillofacial CBCT volumes containing a reported total of 88 radiographic findings. All scans were associated with formal radiologic reports. However, the suggestions of further follow-up were removed from the radiologic reports so as to not bias the 3 evaluating orthodontists in their subsequent decision making. The evaluators had on average 7.6 years of CBCT usage and self-interpretation experience. Reliability was determined by quantifying the level of agreement between the evaluators' assessments for both research questions for all 88 findings using a binary response (yes/no) as the outcome measure. The Cohen kappa statistic was calculated to quantify intrarater and interrater agreement globally for both statements. Although interrater agreement was considerable, potential decisions with clinical impact were not consistent. This needs to be considered when interpreting maxillofacial incidental findings. Evaluators demonstrated higher levels of agreement for dentoalveolar findings compared with all other extragnathic regions when assessing clinical significance. Among the evaluators who were considered experienced in CBCT, "fair-to-good" interrater agreement and "excellent" intrarater agreement were demonstrated in terms of the need for further follow-up and their potential impact on future orthodontic treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Oral and maxillofacial pathology submitted to Rizgary Teaching Hospital: a 6-year retrospective study.

PubMed

Yakin, Muhammed; Jalal, Jalal A; Al-Khurri, Luay E; Rich, Alison M

2016-04-01

The majority of surveys concerning oral pathology accessions have focused on specific pathological categories or particular age groups, and few studies have analysed the whole range of specimens submitted for histopathological examination. An analysis of all oral pathology submitted to the Department of Histopathology in Rizgary Teaching Hospital in Erbil, Iraq, during the 6-year period 2008-2013, was performed. Histopathology samples (excluding smears) from the maxillae, mandible, salivary glands, the lips and oral mucosa, the tongue, the hard and soft palate and uvula, and the pillars of the fauces were included. The specimens were grouped into six diagnostic categories: oral mucosal and skin pathology; benign neoplasms; malignant neoplasms; non-neoplastic salivary gland disorders; cysts; and miscellaneous pathology. The total number of oral and maxillofacial specimens was 616 of 20,571 specimens. One-third of the oral and maxillofacial specimens were in the mucosal and skin pathology category, followed by benign neoplasms (24.2%) - of which 26.8% were odontogenic tumours and 42.6% were salivary gland tumours - and malignant neoplasms (n = 100, 16.2%). Neoplastic (n = 62) and non-neoplastic (n = 41) salivary gland disorders accounted for 16.7% (n = 103) of the specimens submitted, whereas odontogenic cysts (n = 34) and tumours (n = 40) comprised 5.5% and 6.5% of all biopsies. Many of our findings are consistent with those reported in the literature. However, a relatively larger proportion of neoplastic lesions were found in our cohort and in other Iraqi centres. Of concern to practising clinicians in Iraq is that one in 10 biopsies submitted was a squamous cell carcinoma and three in 20 accessions were malignant. © 2016 FDI World Dental Federation.

Analysis of Pediatric Maxillofacial Fractures Requiring Operative Treatment: Characteristics, Management, and Outcomes.

PubMed

Allred, Lindsay J; Crantford, John C; Reynolds, Michael F; David, Lisa R

2015-11-01

Maxillofacial fractures in pediatric trauma patients require significant force and frequently are associated with concomitant injuries. The anatomic and developmental differences between the adult and child that impact patterns of injury also affect management and outcomes. The aim of this study was to analyze fracture location, mechanism, concomitant injuries as well as methods of surgical treatment and outcomes, to improve management of this patient population. A retrospective review was conducted of pediatric patients with maxillofacial fractures presenting to a level-1 trauma center during an 8-year span. Only patients requiring surgical intervention, 204, were included in this study. Data pertaining to the location of injury, mechanism, associated injuries, surgical treatment, outcomes, and complications were analyzed. The most common fracture location was the mandible (36.3%), then the nasal bone (35.3%), followed by the tripod fracture (10.8%). A total of 30.7% of patients were involved in motor vehicle accidents, with the next most common mechanisms being sports (24.4%), and assault (13.7%). A total of 46% of the patients sustained concomitant injuries, with the majority involving cerebral trauma (14.7%) or the extremities (9.3%). Total 75.4% of all fractures, excluding the nose, were treated with open reduction and internal fixation (ORIF). Our complication rate was 11.2%. Pediatric craniofacial trauma remains a frequent presentation to the emergency department of trauma centers. Facial fracture patterns and mechanism of trauma observed in the pediatric population presenting to this facility are consistent with incidences reported in the literature. Knowledge of treatment options and potential complications is an important tool in the management of the pediatric trauma patient.

An institutional experience in the management of pediatric mandibular fractures: A study of 74 cases.

PubMed

Andrade, Neelam N; Choradia, Smriti; Sriram S, Ganapathy

2015-09-01

In maxillofacial surgery, children represent a special group of patients, as they have significant differences from adults as far as the facial skeleton is concerned. The etiology and epidemiology of pediatric trauma involving the facial skeleton has been reported in a large series of patients. Nevertheless, few of these reports review large numbers of pediatric patients, and little is known about treatment protocols for fractures in children. The aims of this study were to retrospectively analyze the treatment methods and outcomes of pediatric mandibular fractures in children and young adolescents up to the age of 15 years, to discuss the findings, and to propose treatment protocols for maxillofacial fractures in childhood. The present study retrospectively analyzed the treatment methods and outcome of the pediatric mandibular fractures in children and young adolescents' up to the age of 15 years over a period of 5 years. All patients were followed up for an average period of 18 months, with a maximum follow-up of 2 years. A total of 74 patients were treated for mandibular and dentoalveolar fractures in children upto the age of 15 years at the Department of Oral and Maxillofacial Surgery at Nair Hospital Dental College, Mumbai from 2007 to 2012. AND CONCLUSIONS: The treatment methods used at our centre had satisfactory outcomes at the end of a follow-up period of 2 years. Reported complications were minimal. Our results confirm the usefulness of open reduction and plate fixation in older children (>12 years of age) and a conservative approach in younger children (≤12 years of age) in treating mandibular fractures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Maxillofacial fracture experiences: a review of 152 cases.

PubMed

Aydin, Osman Enver; Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Barin, Ensar Zafer; Cinal, Hakan; Sarici, Murat; Avsar, Umit

2012-12-01

The fractures of facial structures lead to great morbidity. Cross-sectional studies are needed to evaluate the current state of maxillofacial traumas. Thus, this study aims to evaluate these experiences and to compare these results with the current literature. The medical records of the maxillofacial fracture cases hospitalized between January 2004 and November 2011 were examined. The age, sex, etiology, fracture localization and treatment method for each case were documented. The affected facial bones were grouped as mandible, maxilla, zygoma, naso-orbitoethmoid complex (NOEC) and blow-out. Nasal fractures were excluded. The cases were assigned to 3 groups with respect to age (below 16, above 65 and between 17 and 64). The chi Square test was used to assess the significance of the difference in mandibular fracture rates in the pediatric population compared to others. The total number of cases was 152. The total number of fractures was 185. Of the 152 cases, 117 were male and 35 were female. The average age was 31.4 (±18.3), ranging between 2 and 81. Thirty-one cases were 16 years old or less. Nine cases were 65 years old or more. Mandibular and zygomatic fractures were the most prevalent fractures in the adult group. Mandibular fractures were significantly more common in the pediatric age group compared to rest of the population (X(2), p<0.05). Traffic accidents were the most common etiological factor, with a 55.3% ratio. Open reduction and internal fixation was the most frequently conducted treatment modality in all age groups. Retrospective studies are important for the projection of future prospects. In summary, our results indicate that pediatric fractures are mostly in the lower face and usually affect the condylar region, which is consistent with the literature.

Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery

PubMed Central

Peacock, Zachary S.; Magill, John C.; Tricomi, Brad J.; Murphy, Brian A.; Nikonovskiy, Vladimir; Hata, Nobuhiko; Chauvin, Laurent; Troulis, Maria J.

2015-01-01

Purpose To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model. Methods We describe and test an electromagnetic tracking system (OsteoMark Navigation) that uses simple sensors to determine position and orientation of a hand held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the margins of a tumor on the bone. The accuracy of OsteoMark-Navigation in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In Group 1 (n=3, 6 sides), Osteomark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans In Group 2 (n=3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared to those carried out using fabricated guide-stents. Three metrics were used to document precision and accuracy. In Group 3 (n=1), the system was tested in a standard operating room environment. Results For Group 1, the mean error between points was 0.7mm (horizontal) and 1.7mm (vertical). When compared to the posterior and inferior mandibular border the mean error was 1.2 and 1.7mm, respectively. For Group 2, the mean discrepancy between points marked by Osteomark-Navigation and the surgical guides was 1.9 mm (range 0-4.1 mm). The system maintained accuracy on a live minipig in a standard operating room environment. Conclusion Based on this research OsteoMark-Navigation is potentially a powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to existing clinical applications. PMID:25865717

Association between funding, risk of bias, and outcome of randomised controlled trials in oral and maxillofacial surgery.

PubMed

Oomens, M A E M; Lazzari, S; Heymans, M W; Forouzanfar, T

2016-01-01

The influence of funding on the main outcome of a random control trial (RCT) is important, as it could potentially lead to bias towards industry, and results that are too optimistic. We investigated the association between funding, the published outcome, and the risk of bias in trials in oral and maxillofacial surgery (OMFS) published from January 2000 to May 2013 listed in PubMed. The methods used were scored using the risk of bias items given in a Delphi List. Sources of funding were recorded and categorised five ways: not funded, funded by industry, not funded by industry, supported by industry, and source of funds not clear. A total of 390 RCT met the inclusion criteria, and there was a correlation between funding and favourable main outcomes, although this was not significant. There was no correlation between the risk of bias and favourable results of the main outcome of a trial, or between the risk of bias and the reported source of funding in post-hoc analysis. We were unable to show a significant correlation between funding and a higher likelihood of a favourable result for the primary outcome in RCT in OMFS. We also failed to show a significant correlation between the risk of bias of a trial and its main outcome. In contrast, the source of funding proved to affect the risk of bias of a trial significantly, although not in post-hoc analysis. Funded trials were better organised, and so had a lower risk of bias. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Short communications published online in the British Journal of Oral and Maxillofacial Surgery during 2010-2011.

PubMed

Colbert, S; Southorn, B; Rosenbaum, G; Aldridge, T; Brennan, P A

2012-09-01

The British Journal of Oral and Maxillofacial Surgery (BJOMS) publishes many types of papers including original articles, review articles, and short communications. Many of the latter are isolated case reports of rare or interesting diseases or of difficult or unexpected complications. While case reports are sometimes considered to be of little educational or clinical value, and as such do little to advance medical knowledge, they do have an important role, and many trainees begin their publishing careers writing such papers. There is increasing pressure for space in paper medical journals and, for this reason, some journals either limit or do not publish short publications in print copy but instead put them online. Using established criteria, we previously evaluated all 142 short communications published in the BJOMS during 2008-2009 and found that 48% of them had little or no educational value. As a result, the editorial board of BJOMS took the decision to publish most short communications online only. We have now analysed 48 short communications that were published online only during 2010-2011. Most (80%) were single case reports that covered virtually the whole remit of the specialty, and over half (56%) were published by authors based in the UK. While many of these papers did not add important new information to existing knowledge, these types of article are clearly of value both for trainees and for experienced surgeons. We think that these should continue to be supported as, in addition to their educational value, they are an excellent way for trainees to start to write. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Custom Made Intrinsic Silicone Shade Guide for Indian Population

PubMed Central

Behanam, Mohammed; Ahila, S.C.; Jei, J. Brintha

2016-01-01

Introduction Replication of natural skin colour in maxillofacial prosthesis has been traditionally done using trial and error method, as concrete shade guides are unavailable till date. Hence a novel custom made intrinsic silicone shade guide has been attempted for Indian population. Aim Reconstruction of maxillofacial defects is challenging, as achieving an aesthetic result is not always easy. A concoction of a novel intrinsic silicone shade guide was contemplated for the study and its reproducibility in clinical practice was analysed. Materials and Methods Medical grade room temperature vulcanising silicone was used for the fabrication of shade tabs. The shade guide consisted of three main groups I, II and III which were divided based upon the hues yellow, red and blue respectively. Five distinct intrinsic pigments were added in definite proportions to subdivide each group of different values from lighter to darker shades. A total number of 15 circular shade tabs comprised the guide. To validate the usage of the guide, visual assessment of colour matching was done by four investigators to investigate the consent of perfect colour correspondence. Data was statistically analysed using kappa coefficients. Results The kappa values were found to be 0.47 to 0.78 for yellow based group I, 0.13 to 0.65 for red based group II, and 0.07 to 0.36 for blue based group III. This revealed that the shade tabs of yellow and red based hues matched well and showed a statistically good colour matching. Conclusion This intrinsic silicone shade guide can be effectively utilised for fabrication of maxillofacial prosthesis with silicone in Indian population. A transparent colour formula with definite proportioning of intrinsic pigments is provided for obtaining an aesthetic match to skin tone. PMID:27190946

Dental epidemiology of military operations.

PubMed

Chisick, M C; King, J E

1993-09-01

In this paper we review studies that have been conducted on the epidemiology of oral, dental, and maxillofacial conditions during military deployments. The limitations of our current knowledge base are discussed, as is a proposed research effort to enhance the responsiveness of dental support in theaters of operation.

Toll-Like Receptor Pathway as Mediator of Bisphosphonate Effects in Breast Cancer

DTIC Science & Technology

2005-07-01

Hematology-Oncology, Birmingham, AL 35294-3300, U.S.A 2University of Helsinki, Institute of Dentistry , Department of Oral and Maxillofacial Diseases...at Birmingham, Comprehensive Cancer Center, Biostatistics and Bioinformatics Unit 5Veterans Affairs Hospital, *Send all correspondence to Dr. Katri

Electroconvulsive therapy after maxillofacial metallic implants.

PubMed

Freeman, G Mark; Perry, Matthew T; Manatt, George S; Cristancho, Pilar

2014-03-01

A growing body of literature suggests that electroconvulsive therapy (ECT) can be safely utilized in patients with craniofacial metallic implants. Here we provide radiographic images and the clinical course of a 49-year-old woman with both maxillary and mandibular metallic implants who safely received ECT.

Application of a real-time three-dimensional navigation system to various oral and maxillofacial surgical procedures.

PubMed

Ohba, Seigo; Yoshimura, Hitoshi; Ishimaru, Kyoko; Awara, Kousuke; Sano, Kazuo

2015-09-01

The aim of this study was to confirm the effectiveness of a real-time three-dimensional navigation system for use during various oral and maxillofacial surgeries. Five surgeries were performed with this real-time three-dimensional navigation system. For mandibular surgery, patients wore acrylic surgical splints when they underwent computed tomography examinations and the operation to maintain the mandibular position. The incidence of complications during and after surgery was assessed. No connection with the nasal cavity or maxillary sinus was observed at the maxilla during the operation. The inferior alveolar nerve was not injured directly, and any paresthesia around the lower lip and mental region had disappeared within several days after the surgery. In both maxillary and mandibular cases, there was no abnormal hemorrhage during or after the operation. Real-time three-dimensional computer-navigated surgery allows minimally invasive, safe procedures to be performed with precision. It results in minimal complications and early recovery.

A comparative study of psychosocial data on patients with maxillofacial injuries in an urban population--a preliminary study.

PubMed

Bailey, B M; Carr, R J; Bermingham, D F; Shepherd, R G

1988-06-01

A retrospective study of 75 patients who had sustained maxillofacial injuries was undertaken. These patients were assigned to one of three equal groups consisting of firstly, patients whose injuries had been inflicted by a person who had an established personal relationship to the victim, secondly, where the assailant was completely unknown to the victim, and thirdly, a group where inter-personal conflict was not involved. Psychological, social and clinical data was collected and analysed. A profile emerged of a patient who is 'at risk' from assault by a person well known to them. Two thirds of the victims were female; the victims were exclusively from social classes IV and V, and half of the victims had a previous record of assault against their person. Psychological indices of neuroticism were also higher in this group. This group of patients should be identified, and special consideration offered, including family support and referral to social workers, in addition to alerting their general medical practitioners.

Specific characteristics of the clinical course and treatment of wounds in the maxillofacial region under conditions of acute radiation sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kavrakirov, V.; Georgiev, N.

1973-01-01

Experience with pure traumatic injuries in the maxillofacial region acquired in work at the Higher Military Medical lnstitute and published data on combined radiation-traumatic injuries obtained in animal experiments are discussed. The increased susceptibility to local infection and inflammation in radiation sickness is pointed out. Surgical dressing of wounds in the region in question in cases of radiation sickness should be carried out in such a manner that a minimum trauma is inflicted and should be especially thorough, according to the authors. In the treatment of bone wounds, careful disinfection and complete closing of the wounds from the side ofmore » the oral cavity are essential. In the immobilization of bone fractures, intermaxillary fixation should be carried out during the latent period of radiation sickness. Methods of fixation should be applied that do not damage the mucosa, gingival margin, and periosteum and do not interfere with the maintenance of mouth hygiene or feeding of the patient. (JPRS)« less

SEM and EDS investigation of a pyrolytic carbon covered C/C composite maxillofacial implant retrieved from the human body after 8 years.

PubMed

Sebők, Béla; Kiss, Gábor; Szabó, Péter J; Rigler, Dániel; Molnár, Milán L; Dobos, Gábor; Réti, Ferenc; Szőcs, Hajnal; Joób, Arpád F; Bogdán, Sándor; Szabó, György

2013-03-01

The long term effect of the human body on a pyrolytic carbon covered C/C composite maxillofacial implant (CarBulat(Tm)) was investigated by comparing the structure, the surface morphology and composition of an implant retrieved after 8 years to a sterilized, but not implanted one. Although the thickness of the carbon fibres constituting the implants did not change during the 8 year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Calcium can only be detected on the surface as a trace element implying that the new layer is not formed by bone tissue. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering to implants.

Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update.

PubMed

Khan, Mohammad; Nishi, Shamima Easmin; Hassan, Siti Nazihahasma; Islam, Md Asiful; Gan, Siew Hua

2017-01-01

Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

The influence of sagittal position of the mandible in facial attractiveness and social perception.

PubMed

Sena, Lorena Marques Ferreira de; Damasceno E Araújo, Lislley Anne Lacerda; Farias, Arthur Costa Rodrigues; Pereira, Hallissa Simplício Gomes

2017-01-01

This study aims at comparing the perception of orthodontists, maxillofacial surgeons, visual artists and laypersons when evaluating the influence of sagittal position of the mandible - in lateral view - in facial attractiveness; at a job hiring; and in the perception of socioeconomic profile. A black male, a white male, a black female and a white female with harmonic faces served as models to obtain a facial profile photograph. Each photograph was digitally manipulated to obtain seven facial profiles: an ideal, three simulating mandibular advancement and three simulating mandibular retrusion, producing 28 photographs. These photographs were evaluated through a questionnaire by orthodontists, maxillofacial surgeons, visual artists and laypersons. The anteroposterior positioning of the mandible exerted strong influence on the level of facial attractiveness, but few significant differences between the different groups of evaluators were observed (p < 0.05). The profiles pointed as the most attractive were also pointed as more favorable to be hired to a job position and pointed also as having the best socioeconomic condition.

Biocompatibility evaluation of 3 facial silicone elastomers.

PubMed

França, Diurianne Caroline Campos; de Castro, Alvimar Lima; Soubhia, Ana Maria Pires; Tucci, Renata; de Aguiar, Sandra Maria Herondina Coelho Ávila; Goiato, Marcelo Coelho

2011-05-01

The failure of facial prostheses is caused by limitations in the properties of existing materials, especially the biocompatibility. This study aimed to evaluate the biocompatibility of maxillofacial silicones in subcutaneous tissue of rats. Thirty Wistar rats received subcutaneous implants of 3 maxillofacial silicone elastomers (LIM 6050, MDX 4-4210, and industrial Silastic 732 RTV). A histomorphometric evaluation was conducted to analyze the biocompatibility of the implants. Eight areas of 60.11 mm(2) from the surgical pieces were analyzed. Mesenchymal cells, eosinophils, and foreign-body giant cells were counted. Data were submitted to analysis of variance and Tukey test. Initially, all implanted materials exhibited an acceptable tissue inflammatory response, with tissue reactions varying from light to moderate. Afterward, a fibrous capsule around the silicone was observed. The silicones used in the current study presented biocompatibility and can be used for implantation in both medical and dental areas. Their prosthetic indication is conditioned to their physical properties. Solid silicone is easier to adapt and does not suffer apparent modifications inside the tissues.

Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

PubMed Central

Nishi, Shamima Easmin; Hassan, Siti Nazihahasma

2017-01-01

Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome. PMID:28827979

A novel rotational matrix and translation vector algorithm: geometric accuracy for augmented reality in oral and maxillofacial surgeries.

PubMed

Murugesan, Yahini Prabha; Alsadoon, Abeer; Manoranjan, Paul; Prasad, P W C

2018-06-01

Augmented reality-based surgeries have not been successfully implemented in oral and maxillofacial areas due to limitations in geometric accuracy and image registration. This paper aims to improve the accuracy and depth perception of the augmented video. The proposed system consists of a rotational matrix and translation vector algorithm to reduce the geometric error and improve the depth perception by including 2 stereo cameras and a translucent mirror in the operating room. The results on the mandible/maxilla area show that the new algorithm improves the video accuracy by 0.30-0.40 mm (in terms of overlay error) and the processing rate to 10-13 frames/s compared to 7-10 frames/s in existing systems. The depth perception increased by 90-100 mm. The proposed system concentrates on reducing the geometric error. Thus, this study provides an acceptable range of accuracy with a shorter operating time, which provides surgeons with a smooth surgical flow. Copyright © 2018 John Wiley & Sons, Ltd.

Pediatric maxillofacial fractures.

PubMed

Spring, P M; Cote, D N

1996-05-01

Maxillofacial trauma in the pediatric population is a relatively infrequent occurrence. Studies have demonstrated consistently that 5% of all facial fractures occur in children. The low percentage of facial fractures in this age group has been attributed, in part, to the lack of full pneumatization of the sinuses until later in childhood. Review of the literature indicates that boys are more commonly affected than girls and that the majority of pediatric facial fractures occur in children between 6 and 12 years of age. Motor vehicle accidents, falls, and blunt trauma are responsible for the largest number of pediatric facial fractures. The most common site of facial fracture is the nose and dentoalveolan complex, followed by the mandible, orbit, and midface in most pediatric cohorts. Management of the mandible is often conservative owing to the high percentage of isolated condylar fractures in children. Open reduction and internal fixation of pediatric facial fractures is indicated in complex mandible, midface, and orbital fractures. The effect of rigid fixation on facial skeleton growth is not completely understood.

Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up.

PubMed

Farronato, Giampietro; Garagiola, Umberto; Carletti, Vera; Cressoni, Paolo; Mortellaro, Carmen

2011-01-01

Traditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion. A 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used. : The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives. Postsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.

[Influence of trigeminal nerve lesion on facial growth: study of two cases of Goldenhar syndrome].

PubMed

Darris, Pierre; Treil, Jacques; Marchal-Sixou, Christine; Baron, Pascal

2015-06-01

This cases report confirms the hypothesis that embryonic and maxillofacial growth are influenced by the peripheral nervous system, including the trigeminal nerve (V). So, it's interesting to use the stigma of the trigeminal nerve as landmarks to analyze the maxillofacial volume and understand its growth. The aim of this study is to evaluate the validity of the three-dimensional cephalometric analysis of Treil based on trigeminal landmarks. The first case is a caucasian female child with Goldenhar syndrome. The second case is a caucasian male adult affected by the same syndrome. In both cases, brain MRI showed an unilateral trigeminal nerve lesion, ipsilateral to the facial dysmorphia. The results of this radiological study tend to prove the primary role of the trigeminal nerve in craniofacial growth. These cases demonstrate the validity of the theory of Moss. They are one of anatomo-functional justifications of the three-dimensional cephalometric biometry of Treil based on trigeminal nerve landmarks. © EDP Sciences, SFODF, 2015.

Extraction of impacted mandibular third molars - the effect of osteotomy at two speeds on peripheral bone: a histopathological analysis.

PubMed

Siroraj, A Pearlcid; Giri G V V; Ramkumar, Subramaniam; Narasimhan, Malathi

2016-05-01

The aim of this study was to find out the ideal speed for making a precise osteotomy with minimal damage to the surrounding bone. Thirty-six patients were divided into two groups (n=18 in each) depending on the speed of the handpiece used for osteotomy (slow=20000rpm and fast=40000rpm). Samples were taken from the peripheral bone and examined histologically to measure the margins of the osteotomy, the amount of debris produced, and the degree of thermal osteonecrosis. The osteotomy made with the high speed handpiece was better than that made with the low speed one on all counts. The margins in the high speed group were more or less precisely as required, with less debris and no thermal necrosis, which illustrated the efficacy of a high speed osteotomy. These findings can apply to other procedures that involve osteotomies in maxillofacial surgery. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Video see-through augmented reality for oral and maxillofacial surgery.

PubMed

Wang, Junchen; Suenaga, Hideyuki; Yang, Liangjing; Kobayashi, Etsuko; Sakuma, Ichiro

2017-06-01

Oral and maxillofacial surgery has not been benefitting from image guidance techniques owing to the limitations in image registration. A real-time markerless image registration method is proposed by integrating a shape matching method into a 2D tracking framework. The image registration is performed by matching the patient's teeth model with intraoperative video to obtain its pose. The resulting pose is used to overlay relevant models from the same CT space on the camera video for augmented reality. The proposed system was evaluated on mandible/maxilla phantoms, a volunteer and clinical data. Experimental results show that the target overlay error is about 1 mm, and the frame rate of registration update yields 3-5 frames per second with a 4 K camera. The significance of this work lies in its simplicity in clinical setting and the seamless integration into the current medical procedure with satisfactory response time and overlay accuracy. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Assessment of Speech in Primary Cleft Palate by Two-layer Closure (Conservative Management)

PubMed Central

Jain, Harsha; Rao, Dayashankara; Sharma, Shailender; Gupta, Saurabh

2012-01-01

Treatment of the cleft palate has evolved over a long period of time. Various techniques of cleft palate repair that are practiced today are the results of principles learned through many years of modifications. The challenge in the art of modern palatoplasty is no longer successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. Throughout these periods of evolution in the treatment of cleft palate, the effectiveness of various treatment protocols has been challenged by controversies concerning speech and maxillofacial growth. In this article we have evaluated the results of Pinto's modification of Wardill–Kilner palatoplasty without radical dissection of the levator veli palitini muscle on speech and post-op fistula in two different age groups in 20 patients. Preoperative and 6-month postoperative speech assessment values indicated that two-layer palatoplasty (modified Wardill–Kilner V-Y pushback technique) without an intravelar veloplasty technique was good for speech. PMID:23066454

Endoscopic-assisted resection of peripheral osteoma using piezosurgery.

PubMed

Ochiai, Shigeki; Kuroyanagi, Norio; Sakuma, Hidenori; Sakuma, Hidenobu; Miyachi, Hitoshi; Shimozato, Kazuo

2013-01-01

Endoscopic-assisted surgery has gained widespread popularity as a minimally invasive procedure, particularly in the field of maxillofacial surgery. Because the surgical field around the mandibular angle is extremely narrow, the surrounding tissues may get caught in sharp rotary cutting instruments. In piezosurgery, bone tissues are selectively cut. This technique has various applications because minimal damage is caused by the rotary cutting instruments when they briefly come in contact with soft tissues. We report the case of a 33-year-old man who underwent resection of an osteoma in the region of the mandibular angle region via an intraoral approach. During surgery, the complete surgical field was within the view of the endoscope, thereby enabling the surgeon to easily resection the osteoma with the piezosurgery device. Considering that piezosurgery limits the extent of surgical invasion, this is an excellent low-risk technique that can be used in the field of maxillofacial surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Current thinking in medical education research: an overview.

PubMed

Elledge, R

2018-04-28

Medical education is fast becoming a separate focus, and together with their clinical commitments, many clinicians now seek higher qualifications and professional accreditation in the field. Research is also developing, and there is a need for evidence-based practice in education, just as in clinical work. This review gives an overview of research into medical education, and explains the fundamentals of educational theory and the specific considerations for the quantitative and qualitative research methods that pertain to it. It also explains the application of these methods to two growing areas of research: technology-enhanced learning (TEL) and normative ethics in training. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Complex sleep apnea unmasked by the use of a mandibular advancement device.

PubMed

Kuźniar, Tomasz J; Kovačević-Ristanović, Ružica; Freedom, Thomas

2011-05-01

According to most accepted definitions, complex sleep apnea syndrome (CompSAS) is described as an emergence of central apneas in a patient with obstructive sleep apnea (OSA) upon introduction of continuous positive airway pressure therapy (CPAP). We present two patients who developed comparable central apnea activity when treated with either a CPAP device or a mandibular advancement device. As similar findings have been previously documented in patients with OSA treated with maxillofacial surgery or tracheostomy, we propose that the current definition of CompSAS should broaden to include diagnosis of CompSAS in non-PAP-treated patients, who are managed with either a dental appliance or a surgical procedure.

Markerless laser registration in image-guided oral and maxillofacial surgery.

PubMed

Marmulla, Rüdiger; Lüth, Tim; Mühling, Joachim; Hassfeld, Stefan

2004-07-01

The use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts. Markerless patient registration using laser scan surface registration techniques is a new challenging method. The present study was performed to evaluate the clinical accuracy in finding defined target points within the surgical site after markerless patient registration in image-guided oral and maxillofacial surgery. Twenty consecutive patients with different cranial diseases were scheduled for computer-assisted surgery. Data set alignment between the surgical site and the computed tomography (CT) data set was performed by markerless laser scan surface registration of the patient's face. Intraoral rigidly attached registration markers were used as target points, which had to be detected by an infrared pointer. The Surgical Segment Navigator SSN++ has been used for all procedures. SSN++ is an investigative product based on the SSN system that had previously been developed by the presenting authors with the support of Carl Zeiss (Oberkochen, Germany). SSN++ is connected to a Polaris infrared camera (Northern Digital, Waterloo, Ontario, Canada) and to a Minolta VI 900 3D digitizer (Tokyo, Japan) for high-resolution laser scanning. Minimal differences in shape between the laser scan surface and the surface generated from the CT data set could be detected. Nevertheless, high-resolution laser scan of the skin surface allows for a precise patient registration (mean deviation 1.1 mm, maximum deviation 1.8 mm). Radiation load, logistic costs, and efforts arising from the planning of computer-assisted surgery of the head can be reduced because native (markerless) CT data sets can be used for laser scan-based surface registration.

A porcine model: surgical anatomy of the orbit for maxillofacial surgery.

PubMed

Kyllar, Michal; Štembírek, Jan; Danek, Zdenek; Hodan, Radek; Stránský, Jiří; Machoň, Vladimír; Foltán, René

2016-04-01

Due to its similarity to humans, the pig has proven to be a suitable biomodel for both research purposes and for training medical professionals, particularly in surgical specializations. For example, new implant materials have been tested on pig jaws and pigs have also been used in the development of new surgical techniques. For optimizing the effectiveness of such research or training, detailed data on the anatomy of their particular features are needed. At present, however, only limited information related to surgical and imaging anatomy of the facial and orbital areas of the pig and its comparison to human structures from the experimental surgery point of view is available in the literature. The aim of this study was to obtain such data and to compare the morphological structures of the porcine and human orbital regions and to lay down the foundation for practical use in experimental surgery. Ten pig heads were examined using computed tomography (CT) and magnetic resonance imaging (MRI) and, subsequently, a dissection of the orbit was carried out. Attention was focused on the structure of the orbit (floor, rim and nerves) frequently affected by pathological processes in humans (such as trauma, infection or tumours) and which consequently are frequently the subject of maxillofacial surgery. The porcine orbit is suitable for use in experimental medicine. However, if used in experiments, its anatomical peculiarities must be taken into consideration. Our study presents a foundation of basic knowledge for researchers who plan to use the pig as a biomedical model to investigate alternative treatments in the head region. © The Author(s) 2015.

Establishing cephalometric landmarks for the translational study of Le Fort-based facial transplantation in Swine: enhanced applications using computer-assisted surgery and custom cutting guides.

PubMed

Santiago, Gabriel F; Susarla, Srinivas M; Al Rakan, Mohammed; Coon, Devin; Rada, Erin M; Sarhane, Karim A; Shores, Jamie T; Bonawitz, Steven C; Cooney, Damon; Sacks, Justin; Murphy, Ryan J; Fishman, Elliot K; Brandacher, Gerald; Lee, W P Andrew; Liacouras, Peter; Grant, Gerald; Armand, Mehran; Gordon, Chad R

2014-05-01

Le Fort-based, maxillofacial allotransplantation is a reconstructive alternative gaining clinical acceptance. However, the vast majority of single-jaw transplant recipients demonstrate less-than-ideal skeletal and dental relationships, with suboptimal aesthetic harmony. The purpose of this study was to investigate reproducible cephalometric landmarks in a large-animal model, where refinement of computer-assisted planning, intraoperative navigational guidance, translational bone osteotomies, and comparative surgical techniques could be performed. Cephalometric landmarks that could be translated into the human craniomaxillofacial skeleton, and that would remain reliable following maxillofacial osteotomies with midfacial alloflap inset, were sought on six miniature swine. Le Fort I- and Le Fort III-based alloflaps were harvested in swine with osteotomies, and all alloflaps were either autoreplanted or transplanted. Cephalometric analyses were performed on lateral cephalograms preoperatively and postoperatively. Critical cephalometric data sets were identified with the assistance of surgical planning and virtual prediction software and evaluated for reliability and translational predictability. Several pertinent landmarks and human analogues were identified, including pronasale, zygion, parietale, gonion, gnathion, lower incisor base, and alveolare. Parietale-pronasale-alveolare and parietale-pronasale-lower incisor base were found to be reliable correlates of sellion-nasion-A point angle and sellion-nasion-B point angle measurements in humans, respectively. There is a set of reliable cephalometric landmarks and measurement angles pertinent for use within a translational large-animal model. These craniomaxillofacial landmarks will enable development of novel navigational software technology, improve cutting guide designs, and facilitate exploration of new avenues for investigation and collaboration.

Acute Monocular Blindness Due to Orbital Compartment Syndrome Following Pterional Craniotomy.

PubMed

Habets, Jeroen G V; Haeren, Roel H L; Lie, Suen A N; Bauer, Noel J C; Dings, Jim T A

2018-06-01

We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported. A 65-year-old female who underwent an anterior communicating artery clipping via a pterional approach 4 days before developed proptosis, ocular movement paresis, and irreversible visual impairment following an orthopedic surgery. Computed tomography images revealed an intraorbital cerebrospinal fluid (CSF) collection, which was evacuated via an acute recraniotomy. The next day, proptosis and intraorbital CSF collection on computed tomography images reoccurred and an oral and maxillofacial surgeon evacuated the collection via a blepharoplasty incision and blunt dissection. In addition, the patient was treated with acetazolamide and an external lumbar CSF drainage during 12 days. Hereafter, the CSF collection did not reoccur. Unfortunately, monocular blindness was persistent. We hypothesize the CSF collection occurred due to the combination of a postoperative orbital roof defect and a temporarily increased intracranial pressure during the orthopedic surgery. We plead for more awareness of this severe complication after pterional surgeries and emphasize the importance of 1) strict ophthalmologic examination after pterional craniotomies in case of intracranial pressure increasing events, 2) immediate consultation of an oral and maxillofacial surgeon, and 3) consideration of CSF-draining interventions since symptoms are severely invalidating and irreversible within a couple of hours. Copyright © 2018 Elsevier Inc. All rights reserved.

Dynamic simulation and preliminary finite element analysis of gunshot wounds to the human mandible.

PubMed

Tang, Zhen; Tu, Wenbing; Zhang, Gang; Chen, Yubin; Lei, Tao; Tan, Yinghui

2012-05-01

Due to the complications arising from gunshot wounds to the maxillofacial region, traditional models of gunshot wounds cannot meet our research needs. In this study, we established a finite element model and conducted preliminary simulation and analysis to determine the injury mechanism and degree of damage for gunshot wounds to the human mandible. Based on a previously developed modelling method that used animal experiments and internal parameters, digital computed tomography data for the human mandible were used to establish a three-dimensional finite element model of the human mandible. The mechanism by which a gunshot injures the mandible was dynamically simulated under different shot conditions. First, the residual velocities of the shootings using different projectiles at varying entry angles and impact velocities were calculated. Second, the energy losses of the projectiles and the rates of energy loss after exiting the mandible were calculated. Finally, the data were compared and analysed. The dynamic processes involved in gunshot wounds to the human mandible were successfully simulated using two projectiles, three impact velocities, and three entry angles. The stress distributions in different parts of mandible after injury were also simulated. Based on the computation and analysis of the modelling data, we found that the injury severity of the mandible and the injury efficiency of the projectiles differ under different injury conditions. The finite element model has many advantages for the analysis of ballistic wounds, and is expected to become an improved model for studying maxillofacial gunshot wounds. Copyright © 2011 Elsevier Ltd. All rights reserved.

Four osteotomy methods with piezosurgery to remove complicated mandibular third molars: a retrospective study.

PubMed

Ge, Jing; Yang, Chi; Zheng, Jia-Wei; He, Dong-Mei; Zheng, Ling-Yan; Hu, Ying-Kai

2014-11-01

Piezosurgery has been used widely in oral and maxillofacial surgery, but there has been no report systematically describing an osteotomy method with piezosurgery for complicated mandibular third molar removal. The aim of this study was to introduce 4 osteotomy methods using piezosurgery and evaluate their effects. A retrospective study was conducted of patients with a complicated impacted mandibular third molar requiring extraction. The predictor variable was the extraction technique. Four osteotomy methods using piezosurgery were tested according to different impaction types: method 1 involved complete bone removal; method 2 involved segmental bone removal; method 3 involved bone removal combined with tooth splitting; and method 4 involved block bone removal. Outcome variables were success rate, operative time, major complications (including nerve injury, mandible fracture, severe hematoma, or severe edema), and serious pyogenic infection. Data were analyzed using descriptive statistics. The study was composed of 55 patients with 74 complicated impacted mandibular third molars. All impacted mandibular third molars were removed successfully. The average surgical time was 15 minutes (range, 8 to 26 minutes). Thirty-eight molars (51.4%) were extracted by method 1, 18 molars (24.3%) by method 2, 12 molars (16.2%) by method 3, and 6 molars (8.1%) by method 4. Two cases (2.7%) developed postoperative infections and recovered within 1 week using drainage and antibiotic administration. The 4 osteotomy methods with piezosurgery provide effective ways of removing complicated impacted mandibular third molars. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Cicatricial Pemphigoid

MedlinePlus

... can usually prevent blindness. © 2005 American Academy of Oral and Maxillofacial Pathology 214 North Hale Street Wheaton, IL 60187 Tel.: 630-510-4552 Fax: 630-510-4501 Toll Free: 888-552-2667 Email: ... mucous membranes, that is, the moist linings of the mouth, the eyes, the nose and throat, and the ...

[Features of facioscapulohumeral muscular dystrophy in oral and maxillofacial region and MRI analysis of facial muscles].

PubMed

Liu, Y H; Ma, Y X; Hu, J; Gao, G D; Wu, Y K; Zhang, Z Y

2016-12-09

Objective: To investigate the manifestation of facioscapulohumeral muscular dystrophy (FSHD) in oral and maxillofacial region. Methods: A total of 12 patients diagnosed as FSHD and 20 healthy volunteers were included in the study. Their medical history was collected from these patients. The decayed missing filled teeth (DMFT), calculus index-simplified (CI-S), occlusal relationship, maximal opening of mouth and maximum bite force were recorded. The impressions were taken to measure the maximal hight of palate and the width of palate. The lateral cephalometric radiographs were also taken to measure the mandibular plane-frankfurt horizontal plane angle (MP-FH). They finally received oral and maxillofacial region MRI examination to observe the masseter muscle, medial pterygoid muscle and lateral pterygoid muscle. The data were analyzed by t -test or Wilcoxon signed ranks test. Results: There was no significant gender difference in FSHD group. The average age of treatment was (27.5 ± 8.1) years and the average age of onset was (15.7±7.5) years. Nine patients liked to eat soft foods, 4 patients had difficulties of closing eyes, 8 patients had difficulties of cheek-bulging, 10 patients showed pouty lips and 9 patients had mesio-malocclusion. DMFT (4.0±2.3), CI-S (5.8±2.1), male maximal hight of palate (20.5±2.1) mm , female maximal hight of palate (17.9±1.6) mm, MP-FH (31.8°±2.2°) of FSHD group were greater than those of the control group. Male width of palate (34.8±1.4) mm, female width of palate (33.7±1.5) mm, male maximum bite force (451.7 ± 39.0) N, female maximum bite force (326.7 ± 21.6) N, maximal opening of mouth (3.5 ± 0.4) cm of FSHD group were less than those of the control group ( P <0.05). Maxillofacial MRI showed muscle asymmetr in 11 cases of masseter and 6 cases of medial pterygoid muscle, 5 cases of lateral pterygoid, and these muscle showed mild fatty infiltration mainly concentrating in the grade 0, grade 1 and grade 2. Conclusions: The FSHD patients have poor oral hygiene, low masticatory function, limited mouth opening, high palate and narrow arch and different degree of malocclusion. The patients' masseter muscle, medial pterygoid muscles and lateral pterygoid muscles exhibit asymmetrical atrophy and fatty infiltration.

Characteristics of Applicants to Postdoctoral Dental Education Programs.

ERIC Educational Resources Information Center

Solomon, Eric S.; And Others

1991-01-01

Analysis of characteristics of students (n=1,684) using the Postdoctoral Application Support Service found significant differences in applicants to various program areas. Applicants to pediatric programs had the most varied characteristics; applicants to oral and maxillofacial surgery were the most homogeneous. The study provides baseline data for…