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Editorial Board/Reviewing Committee
doi : 10.1016/S0901-5027(21)00223-X
Volume 50, Issue 8, August 2021, Page i
Do we have a robust method for preoperative tumour depth assessment for oral cavity tumours with clinically negative necks?
H.CockerO.FranciesA.AdamsI.SassoonC.Schilling
doi : 10.1016/j.ijom.2020.11.002
Volume 50, Issue 8, August 2021, Pages 981-988
Tumour depth is an important prognostic factor in head and neck cancer and has recently been included in the eighth edition of the Union for International Cancer Control TNM classification of malignant tumours for oral squamous cell carcinoma (OSCC). It is important to appraise the accuracy of depth assessments; however, there is little current evidence in the literature. Accurate depth assessment is particularly pertinent in cT1–T2N0 OSCC where it may influence neck management. A retrospective study was performed at two tertiary referral centres, in which surgically treated patients with cT1–T4N0 OSCC were audited. Preoperative tumour depth assessments from multimodality radiological staging scans were compared with the final histopathological depth. The predictive accuracy of intraoral ultrasound (IOUS), computed tomography (CT), and magnetic resonance imaging (MRI) for tumour depth was evaluated. Accuracy to within 3 mm of the histopathological depth was seen in 56.7% of MRI scans and 57.1% of CT scans. IOUS appeared to have superior prediction, with 78.2% of measurements within 3 mm. Over one third of CT and MRI imaging failed to detect a lesion; IOUS scans detected the lesions in all of these case. In conclusion, the reliability of preoperative imaging assessment of tumour depth should be considered when recommending treatment.
Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic
T.K.Batra1M.R.Tilak1E.Pai2N.Verma3B.K.Gupta3G.Yadav3R.K.Dubey3N.J.Francis1M.Pandey1
doi : 10.1016/j.ijom.2020.12.002
Volume 50, Issue 8, August 2021, Pages 989-993
Surgical practice during the coronavirus disease 2019 (COVID-19) pandemic has changed significantly, without supporting data. With increasing experience, a dichotomy of practice is emerging, challenging existing consensus guidelines. One such practice is elective tracheostomy. Here, we share our initial experience of head and neck cancer surgery in a COVID-19 tertiary care centre, emphasizing the evolved protocol of perioperative care when compared to pre-COVID-19 times. This was a prospective study of 21 patients with head and neck cancers undergoing surgery during the COVID-19 pandemic, compared to 193 historical controls. Changes in anaesthesia, surgery, and operating room practices were evaluated. A strict protocol was followed. One patient tested positive for COVID-19 preoperatively. There was a significant increase in pre-induction tracheostomies (28.6% vs 6.7%, P = 0.005), median hospital stay (10 vs 7 days, P = 0.001), and postponements of surgery (57.1% vs 27.5%, P = 0.01), along with a significant decrease in flap reconstructions (33.3% vs 59.6%, P = 0.03). There was no mortality and no difference in postoperative morbidity. No healthcare personnel became symptomatic for COVID-19 during this period. Tracheostomy is safe during the COVID-19 pandemic and rates have increased. Despite increased rescheduling of surgeries and longer hospital stays, definitive cancer care surgery has not been deferred and maximum patient and healthcare worker safety has been ensured.
A pilot study for presence of circulating tumour cells in adenoid cystic carcinoma
B.M.Fisher1aK.D.Tang2aM.E.Warkiani34C.Punyadeera2M.D.Batstone1
doi : 10.1016/j.ijom.2020.11.012
Volume 50, Issue 8, August 2021, Pages 994-998
Adenoid cystic carcinoma (ACC) is a rare salivary gland neoplasm with a poor long-term prognosis due to multiple recurrences and distant metastatic spread. Circulating tumour cells (CTCs) are tumour cells shed from a primary, recurrent, or metastatic cancer that are detectable in the blood or lymphatics. There is no literature to date confirming the presence of CTCs in ACC. The aim of this study was to determine whether CTCs are detectable in ACC. Blood samples were collected from eight patients with histologically confirmed ACC. The TNM stage of the tumour was recorded, as well as any prior treatment. CTCs were isolated by spiral microfluidics and detected by immunofluorescence staining. Three of the eight patients recruited (32.5%) had staining consistent with the presence of CTCs. Of these three patients with detectable CTCs, one had confirmed pulmonary metastasis, one had suspected pulmonary metastasis and was awaiting confirmation, and one had local recurrence confirmed on re-resection. One patient with known isolated pulmonary metastasis had previously undergone a lung metastasectomy and did not have CTCs detected. CTCs are detectable in ACC. In this small patient sample, CTCs were found to be present in those patients with recurrent local disease and known distant metastatic disease. CTCs in ACC should be investigated further for their potential use as an adjunct in staging, prognosis, and the detection of recurrence.
‘Out of house’ virtual surgical planning for mandible reconstruction after cancer resection: is it oncologically safe?
C.P.Barry123C.MacDhabheid1K.Tobin24L.F.Stassen12P.Lennon12M.Toner35E.O’Regan25J.R.Clark678
doi : 10.1016/j.ijom.2020.11.008
Volume 50, Issue 8, August 2021, Pages 999-1002
The purpose of this study was to investigate whether the time delay between ‘out of house’ proprietary virtual surgical planning (OH-VSP) of the mandibular resection for oral cancer and the actual surgery results in compromised margins and oncological disadvantage for the patient. Outcomes of patients who had OH-VSP of their mandibular resection and reconstruction were compared with those of patients who had the same surgery using a conventional non-VSP approach. The groups were similar in patient demographics, tumour stage and size, nodal status, and reconstruction complexity. VSP resulted in a significant reduction in operating time (P < 0.01). VSP did not affect bony (P = 0.49) or soft tissue (P = 0.22) margin status. In summary, VSP reduced the operating theatre time, and despite the time interval between bony resection planning and surgery, there was no compromise to the oncological safety of the operation.
Islanded facial artery osteomyomucosal/osseous flap in head and neck reconstruction
NaveenB.S.1M.T.Mohan1J.Tharayil1S.T.Joseph2
doi : 10.1016/j.ijom.2020.11.010
Volume 50, Issue 8, August 2021, Pages 1003-1008
A local pedicled vascularized bone flap can prevent the morbidity and cost of free bone flap surgery in small segmental bone defects or long cartilaginous defects of the head and neck. Such flaps can also be useful in patients who are high risk for surgery. The periosteal vascularity of the mandible can be used to design islanded facial artery-based bone flaps, which can be utilized to that extent. Two patients with a small segmental mandibulectomy defect and one patient with a long cricotracheal resection defect underwent reconstruction using three different designs of islanded facial artery osteomyomucosal/osseous flap (iFOMM). The patients had a minimum follow-up period of 18 months. All flaps were successful, with satisfactory healing and without any functional deficit or disease at last follow-up.
Mandible reconstruction using a vascularized fibula flap from a post-polio paralytic limb?
S.R.Selva SakthipalanaK.SridharbS.K.PandianbS.RajaSundaramc
doi : 10.1016/j.ijom.2020.11.020
Volume 50, Issue 8, August 2021, Pages 1009-1011
The case of 69-year-old man with a post-polio paralytic limb who was diagnosed with carcinoma of the lower alveolus is presented. A successful mandible reconstruction was performed using a vascularized fibula osteocutaneous flap harvested from the polio-affected limb. The skin perfusion and quality of the bone were good. The donor defect healed uneventfully. Harvesting the flap from the polio-affected limb also significantly reduced the donor site morbidity. This case is novel in presenting the successful use of a free fibula flap harvested from a leg affected by paralytic poliomyelitis.
Surgical resection of clinically benign tumours in the maxillomandibular deep lobe of the parotid gland via sternocleidomastoid muscle–parotid space approach
D.-c.Wang1aZ.-p.Sun2aX.Peng1Y.-d.Zhao3C.-l.Ni4C.Mao1Y.-x.Guo1C.-b.Guo1
doi : 10.1016/j.ijom.2020.11.005
Volume 50, Issue 8, August 2021, Pages 1012-1018
This article reports the surgical resection of clinically benign tumours in the maxillomandibular deep lobe of the parotid gland via sternocleidomastoid muscle–parotid space (SPS) approach. The use of maxillary–mandibular planes to subdivide the deep lobe of the parotid gland in order to establish the tumour location and accessibility is introduced. This approach, which does not raise a skin flap, may preserve the superficial lobe. Ten patients with clinically benign tumours in the maxillomandibular deep lobe of the parotid gland were treated via the SPS approach. The patients were followed up for 3–5 years and the surgical outcomes were analysed. All tumours were completely enucleated via the SPS approach with an optimal aesthetic outcome. No permanent facial weakness or tumour recurrence was identified during the 3–5 years of follow-up. The SPS approach to surgical resection is an ideal option for clinically benign tumours in the maxillomandibular deep lobe of the parotid gland and demonstrates good results.
Denosumab for the management of central giant cell granuloma of the jaws—a case series
M.A.Pogrel1†M.Hossaini-Zadeh2†
doi : 10.1016/j.ijom.2020.12.013
Volume 50, Issue 8, August 2021, Pages 1019-1022
Denosumab has been suggested as a medical treatment for central giant cell granuloma of the jaws. This study included eight patients, seven female and one male, aged between 19 and 32 years, with biopsy-proven central giant cell granuloma of the mandible. The patients were treated with subcutaneous injections of 120?mg of denosumab in a regime consisting of three injections at weekly intervals followed by five injections at monthly intervals over a 6-month period. They were followed up for between 60 and 71 months clinically and radiographically with panoramic radiographs and cone beam computed tomography scans. All of the lesions became calcified radiographically and asymptomatic clinically. They did not reduce in size, but to date only one patient has requested surgical remodeling. There has been no recurrence or regrowth in over 5 years.
Recurrent adamantinoma of the mandible
G.-H.ZhangW.-J.WuM.-W.Huang
doi : 10.1016/j.ijom.2020.10.010
Volume 50, Issue 8, August 2021, Pages 1023-1026
Adamantinoma is an extremely rare tumour originating from bone that can be divided into classical and osteofibrous dysplasia (OFD)-like adamantinoma. This low-grade malignancy almost exclusively occurs in long bones, and only few cases of mandibular adamantinoma have been reported. Here, we report the case of a 30-year-old female with a 2-year history of right mandible tenderness. Radiological examinations showed a lytic lesion involving the right mandible without a well-defined margin. Biopsy confirmed the diagnosis of adamantinoma. She underwent a segmental mandibulectomy and reconstruction with a fibula flap. The definitive diagnosis was OFD-like adamantinoma. However, the tumour recurred after 5 years. The residual mandible and fibula flap were widely involved. A total mandibulectomy was performed. Five years later, there is no evidence of recurrence or metastasis. We recommend that adamantinoma be treated by radical resection with clear margins, and long-term surveillance is necessary due to the likely high local recurrence rate and the potential for late tumour metastasis.
Traumatic maxillofacial and brain injuries: a systematic review
E.Z.Goh1N.Beech12N.R.Johnson123
doi : 10.1016/j.ijom.2020.12.003
Volume 50, Issue 8, August 2021, Pages 1027-1033
Concomitant traumatic brain injury (TBI) and maxillofacial fractures carry the risk of significant morbidity and mortality. The aim of this review was to explore the demographics, types of injury, and complications of traumatic maxillofacial and brain injuries, in order to contribute to comprehensive health strategies. The PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating combined traumatic maxillofacial and brain injuries. Exclusion criteria were duplicates, non-English publications, non-full-text publications, publication date before 1990, and studies with insufficient data. Of the 754 articles identified, 15 eligible articles representing 1421 cases were included. The mean age was 38.3 years. Most cases were male (79%). The most common mechanism of injury was traffic accidents (53.4%). The most common fracture pattern was middle third fractures (52.4%). Seven studies had an explicit definition for TBI, using the Glasgow Coma Score (GCS), radiological evidence, and/or specific symptoms. There were 147 complications reported in 62 of 253 cases (24.5%), with the most common being infection (n = 54, 36.7%). Significant risk factors for complications included delayed surgical repair, low GCS, and upper third fractures. Robust longitudinal evaluations with clear definitions of TBI are required. Gaps in knowledge include risk factors for complications and fracture pattern–GCS correlations.
Tomographic analysis of nasomaxillary and zygomaticomaxillary buttress bone thickness for the fixation of miniplates
Y.L.Medeiros1A.O.Loures1B.N.Silva1P.Reher2K.L.Devito1M.F.Carvalho1
doi : 10.1016/j.ijom.2020.11.006
Volume 50, Issue 8, August 2021, Pages 1034-1039
The purpose of this study was to evaluate the bone thickness of the nasomaxillary and zygomaticomaxillary buttresses to identify the most favourable region for the installation of miniplates. Bilateral tomographic images of 103 individuals were evaluated, for a total of 206 nasomaxillary and zygomaticomaxillary buttresses. Measurements of bone thickness were performed in the parasagittal reconstructions along three vertical lines on the nasomaxillary buttress (21 measurement points) and four vertical lines on the zygomaticomaxillary buttress (28 measurement points). The vertical line measurements for each buttress were compared using the Kruskal–Wallis test. Spearman’s correlation coefficient was used to determine the correlation between the thicknesses obtained and patient sex and side (right/left). The level of significance adopted was 5%. The nasomaxillary and zygomaticomaxillary buttresses presented statistical differences in thickness at their respective points (P = 0.001). The analysis of the nasomaxillary buttress showed that the thicker bone for the installation of miniplates follows the long axis of the upper canine at a distance of 3 mm from the root apex. For the zygomaticomaxillary buttress, thicker bone to install miniplates was found distal to the distobuccal root of the first molar, at a distance of 3.5 mm from the limit of the infraorbital foramen.
Distinguishing craniomorphometric characteristics and severity in metopic synostosis patients
L.Chandler1aK.E.Park1aO.Allam1M.A.Mozaffari1S.Khetpal1J.Smetona1N.Pourtaheri2X.Lu1J.A.Persing1M.Alperovich1
doi : 10.1016/j.ijom.2020.11.022
Volume 50, Issue 8, August 2021, Pages 1040-1046
The decision about which metopic synostosis patients should undergo surgery remains controversial. Multiple measures for radiographic severity have been developed in order to determine the optimal criteria for treatment. The aim of this study was to perform an extensive craniomorphometric analysis of patients who underwent surgery for metopic synostosis to validate and compare the various severity scales developed for this non-syndromic craniosynostosis. A comparative morphometric analysis was performed using computed tomography scans of preoperative metopic synostosis patients (n = 167) and normal controls (n = 44). Measurements included previous and newly developed metopic severity indices. Volumetric and area analyses were used to determine the degree of anterior cranial area and potential volume restrictions. Of the severity indices measured, the frontal angle, endocranial bifrontal angle (EBF), adjusted EBF (aEBF), anterior cranial fossa angle, horizontal cone angle, and bitemporal/biparietal distance ratio were significantly different in the metopic subjects relative to controls overall. However, metopic index, orbital rim angle, foramen ovale distance, and cranial volume exhibited no significant difference from controls. Only the frontal angle and aEBF correlated with the changes in anterior cranial dimensions observed in metopic synostosis. In conclusion, the frontal angle and aEBF provide the most accurate measures of severity in metopic synostosis.
Revisiting straight-line repair in unilateral complete cleft lip: a comparison with rotation-advancement repair
J.H.Ha1Y.T.Koo2S.O.Park3I.-K.Kim4J.-H.Chung5aS.Kim67a
doi : 10.1016/j.ijom.2021.01.001
Volume 50, Issue 8, August 2021, Pages 1047-1054
Rotation-advancement repair (RAR) has been the most widely used technique for unilateral cleft lip repair. We recently used a straight-line repair with medial orbicularis muscle lengthening (SLR-ml) technique, based on the hypothesis that it could minimize the postoperative scar appearance without causing s short-lip deformity when muscle reorientation is performed correctly. A retrospective cohort study was conducted on unilateral complete cleft lip patients who underwent cheiloplasty between 2009 and 2017. Two cheiloplasty techniques were compared: RAR and SLR-ml. Outcomes were evaluated by assessing follow-up photographs using three methods: (1) glance impression on a five-point scale, (2) Manchester Scar Scale, and (3) indirect anthropometry. Seventy-one patients were analysed: 41 in the RAR group (28 male, 13 female) and 30 in the SLR-ml group (15 male, 15 female). The glance impression (P = 0.506) and Manchester Scar Scale (P = 0.347) scores did not differ between the groups. According to the symmetry ratio (cleft side value/non-cleft side value), vertical lip height (P = 0.804), horizontal lip length (P = 0.881), and Cupid’s bow width (P = 0.122) did not differ significantly between the groups. The preoperative lip height discrepancy was not correlated with the postoperative vertical lip height. The SLR-ml method can be regarded as a successful tool for symmetric repair of unilateral cleft lip.
Three-dimensional creation of the peak of Cupid’s bow by muscle tension line group reconstruction in secondary cleft lip repair
W.SunH.MaN.Yin
doi : 10.1016/j.ijom.2020.11.013
Volume 50, Issue 8, August 2021, Pages 1055-1058
The peak of Cupid’s bow is a unique three-dimensional structure. Traditional reconstructive techniques focus only on the correction of vermillion border malalignment and the vertical discrepancy between Cupid’s bow peaks from a two-dimensional perspective. The aim of this study was to introduce a novel technique – the muscle tension line group reconstruction technique – to recreate the Cupid’s bow peak three-dimensionally in secondary cleft lip repair. With this technique the orbicularis oris muscle is divided into two flaps: a lateral one composed of pars marginalis and a medial one composed of pars peripheralis. The full thickness of the medial flap is sutured to the deep layer of the lateral flap, and the end of the lateral flap is then sutured to the dermis lateral to the philtral dimple to accentuate a depression. In this way, the two muscle flaps exert opposing skin traction on each side of the peak, which improves the vertical height as well as the lateral projection of the Cupid’s bow peak. The postoperative outcomes indicate that this is a reliable technique for three-dimensional restoration of the Cupid’s bow peak, with a stable and natural reconstructive appearance.
Nasomaxillary effects of miniscrew-assisted rapid palatal expansion and two surgically assisted rapid palatal expansion approaches
A.S.Jesus1C.B.Oliveira1W.H.Murata2E.S.Gonçales3V.A.Pereira-Filho4A.Santos-Pinto1
doi : 10.1016/j.ijom.2020.12.014
Volume 50, Issue 8, August 2021, Pages 1059-1068
This retrospective study was performed to evaluate nasomaxillary changes in 36 patients at an advanced stage of skeletal maturity who underwent miniscrew-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE) with/without an alar base cinch. Cone beam computed tomography images taken before and after expansion were analysed. Changes in the width of the dental arch (D66S, D66I), maxillary base (MxMol), and nasal floor and nasal cavity in the molar and canine regions (NaFMol, NaFCan, NaCMol, NaCCan) were compared, as well as changes in the choanal aperture (CA) and nasal soft tissue (NW). The MARPE technique produced smaller dental changes (D66S; P = 0.025) and greater nasomaxillary expansion (MxMol, P = 0.010; NaCMol, P = 0.016; NaCCan, P = 0.017; NaFMol, P = 0.001; CA, P = 0.002) than both SARPE techniques. Changes in NW did not differ significantly between the groups (P = 0.200). MARPE uniformly increased the anterior and posterior widths of the nasal cavity. SARPE expanded the nasal cavity in a ‘V-shape’ pattern. Changes in the nasal cavity and choanal aperture related to the amount of dental arch expansion were greater for MARPE than for SARPE. All three approaches increased the width of the nasal soft tissue, although the cinch in SARPE limited this increase.
Longitudinal recovery pattern of neurosensory deficit after Le Fort I osteotomy
A.B.Alolayan1Y.Y.Leung2
doi : 10.1016/j.ijom.2020.12.015
Volume 50, Issue 8, August 2021, Pages 1069-1074
The purpose of this study was to investigate the incidence and recovery pattern of neurosensory deficit (NSD) following Le Fort I osteotomy, and to identify the possible risk factors that might contribute to the complication. A prospective longitudinal observational study on the incidence of NSD was conducted on patients who received Le Fort I osteotomy. Subjective and objective standardized neurosensory assessments were performed preoperatively as the baseline, and postoperatively at 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months. Possible risk factors for NSD including patient age and sex, surgeon experience, and Le Fort I osteotomy with or without multi-segmentation were analysed. Sixty-six patients (43 female, 23 male) with 132 sides of Le Fort I osteotomy were recruited. The incidence of NSD at 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months was 81.8%, 59.8%, 39.4%, 19.7%, 7.6%, and 3.2%, respectively. Subjective severity of NSD improved with time. Older age was found to be a risk factor for NSD in the early postoperative period, but there was no difference in the long-term. Patient sex, surgeon experience, and the need for multi-segmentation were not found to be related to the incidence of NSD after Le Fort I osteotomy.
Efficient in-house 3D printing of an orthognathic splint for single-jaw cases
W.Mascarenhas1N.Makhoul12
doi : 10.1016/j.ijom.2020.12.016
Volume 50, Issue 8, August 2021, Pages 1075-1077
The purpose of this paper is to outline a simple and effective digital protocol for in-house 3D-printing of orthognathic splints for use during single-jaw orthognathic surgery. Using this protocol, an intraoral scanner, and virtual planning software, computer-designed splints were fabricated by a rapid prototyping machine in-house. The protocol was utilized for 35 consecutive patients requiring single-jaw orthognathic surgery between January 2019 and March 2020. The total time from initial scan to splint fabrication for each case was between 5 and 9 hours, including 3 minutes for scanning of models, 4.5 minutes for development of the splint, and 4–8 hours for rapid prototyping and post-processing. This time varied based on the complexity of the design and the number of splints printed simultaneously. The average cost of raw materials for each splint was $0.73 Canadian dollars.
Timing of arthrocentesis in the management of temporomandibular disorders: an integrative review and meta-analysis
D.T.S.Li1N.S.M.Wong1S.K.Y.Li2C.P.McGrath3Y.Y.Leung1
doi : 10.1016/j.ijom.2021.01.011
Volume 50, Issue 8, August 2021, Pages 1078-1088
The aim of this study was to assess the best timing to perform arthrocentesis in the management of temporomandibular disorders with regard to conservative treatment. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, reference list search, and manual search was performed. Relevant articles were selected after three search rounds for final review based on six predefined inclusion criteria, followed by a round of critical appraisal. Eleven publications, including eight randomized controlled trials and three prospective clinical studies, were included in the review. The studies were divided into three groups based on the timing of arthrocentesis: (1) arthrocentesis as the initial treatment; (2) early arthrocentesis; and (3) late arthrocentesis. Meta-analysis was carried out to compare the efficacy of improvement in mouth opening and pain reduction in the three groups. All three groups showed improvement in mouth opening and pain reduction, with forest plots suggesting that arthrocentesis performed within 3 months of conservative treatment might produce beneficial results. We conclude that there is a knowledge gap in the current literature regarding the preferable timing to perform arthrocentesis in the management of temporomandibular disorders, and more high-quality randomized controlled trials are required to shed light on this subject.
Surgical complications related to temporomandibular joint arthroscopy: a prospective analysis of 39 single-portal versus 43 double-portal procedures
D.F.?ngelo12R.A.D.Ara?jo1D.Sanz1
doi : 10.1016/j.ijom.2020.07.020
Volume 50, Issue 8, August 2021, Pages 1089-1094
Temporomandibular joint (TMJ) arthroscopy is a minimally invasive surgical procedure proposed for diverse TMJ intra-articular disorders. A prospective study was designed with the aim of investigating intraoperative and postoperative surgical complications for single and double-portal TMJ arthroscopy. All interventions were performed by one surgeon with the same surgical protocol. A total of 55 patients were enrolled, resulting in 82 TMJ arthroscopies (28 unilateral and 27 bilateral). A total of 39 single portal (47.57%) and 43 double-portal (52.43%) arthroscopies were performed. No severe and irreversible complications were observed. Most complications were resolved after 4 weeks. Double-portal was associated with more complications (n = 23) compared with single-portal TMJ arthroscopy (n = 14), with a statistically significant difference found between single and double-portal TMJ arthroscopy in two intraoperative complications: intra-articular bleeding (P = 0.044) and oedema of the preauricular area (P = 0.042). This study confirms the safety of TMJ arthroscopy for single and double-portal procedures, with the authors suggesting a multicentre study, in an effort to minimize any possible bias.
Fabrication of a three-dimensional temporomandibular joint model for arthrocentesis and arthroscopy simulation
Q.C.FooF.HaririZ.A.Abdul Rahman
doi : 10.1016/j.ijom.2020.12.007
Volume 50, Issue 8, August 2021, Pages 1095-1099
Arthrocentesis and arthroscopy are relatively safe treatments for arthrogenic temporomandibular disorders. Hands-on training in both procedures is essential for surgeons to become competent. In this study, a three-dimensional (3D) temporomandibular joint (TMJ) prototype was developed at a relatively low cost, and arthrocentesis and arthroscopy were performed successfully on the model. Despite its limitations, this model is a viable adjunct to TMJ surgical training and can be fabricated easily by any training centre with a 3D printer.
Three-dimensional measurement of radiographic bone–implant contact lengths of zygomatic implants in zygomatic bone: a retrospective study of 66 implants in 28 patients
T.-Y.Huang1Y.-J.Hsia1M.-Y.Sung2Y.-T.Wu2P.-C.Hsu1
doi : 10.1016/j.ijom.2021.01.004
Volume 50, Issue 8, August 2021, Pages 1100-1106
Zygomatic implant treatment is widely applied for severe maxillary atrophy to help rehabilitate the maxillary dentition. This retrospective study was performed to evaluate the actual radiographic bone–implant contact (rBIC) lengths of zygomatic implants. The records of 28 patients who underwent zygomatic implant surgery and subsequent follow-up examinations between August 2013 and September 2018 in the Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital were reviewed. The surgeries were performed by a single surgeon using the same treatment protocol. All patients had a computed tomography scan at 1 year after the surgery. Using three-dimensional imaging software, an investigator measured the rBIC lengths of 66 implants and documented their clinical status. The implant survival rate was 100%. The mean rBIC length was significantly longer in male patients than in female patients (20.80 ± 5.88 mm versus 17.79 ± 6.34 mm; P = 0.028). The mean rBIC length of double zygomatic implants was significantly longer when compared to that of single implants (21.11 ± 6.23 mm versus 17.75 ± 5.85 mm; P = 0.027). This article is novel in reporting the exact rBIC lengths of zygomatic implants in a clinical setting. The results showed that zygomatic implants are a viable treatment modality for full-mouth rehabilitation.
Anatomical characteristics of maxillary sinus antroliths and their influence on sinus membrane thickness: a retrospective cone beam computed tomography analysis
H.-H.Chen12aC.-A.Yi2aY.-C.Chen2H.-H.Huang134567
doi : 10.1016/j.ijom.2020.12.010
Volume 50, Issue 8, August 2021, Pages 1107-1112
The purpose of this study was to assess the anatomy of antroliths and its influence on the thickness of the maxillary sinus membrane. Cone beam computed tomography (CBCT) was performed on 239 patients (478 sinuses). The prevalence of antroliths per sinus was 8.4%. Regarding their distribution, antroliths were predominantly unilateral (82.5%), single (67.5%), and in a dentate area (60.0%). The antroliths were mainly located in the molar region (95.0%) and in the sinus floor (77.5%). The measured dimensions of the antroliths were as follows: length 5.6 ± 4.4 mm, width 4.1 ± 2.9 mm, height 3.5 ± 2.1 mm. The relationships between the antroliths and the sinus membrane (type 1, 34.1%; type 2, 52.3%; type 3, 13.6%) indicated that sinus membranes tended to encircle antroliths, which resulted in a gradual increase in membrane thickness. The sinus membrane was found to be significantly thicker in the presence of antrolith(s) (P < 0.001). Antroliths which are sufficiently large or are located adjacent to the sinus floor or lateral wall increase the risk of sinus membrane perforation during sinus augmentation procedures. Therefore, a thorough CBCT evaluation is needed to minimize the risk of complications prior to sinus augmentation procedures.
Prevalence of early and late oral implant loss among smokers: a nationwide survey in Japan?
T.Nagao1J.Fukuta2T.Sugai3H.Kawana4A.Matsuo5S.Hamada6K.Miura7K.Seto8
doi : 10.1016/j.ijom.2021.01.006
Volume 50, Issue 8, August 2021, Pages 1113-1119
A cross-sectional, nationwide survey was conducted in Japan to examine the relationship between tobacco smoking and oral diseases including implant failure. A questionnaire survey was sent to designated facilities by post, and 158 answered questions regarding implant loss. Smoking status, number of implant failures, and other related variables were collected from the participating dentists as secondary data. A total of 1966 patients who were treated with dental implants by participating dentists during the survey period were analysed. Among the total sample, 90 (5%) had early implant loss (?12 months) and 153 (8%) had late implant loss (>12 months and ?120 months). The number of pack-years was significantly higher in the total (early and late) implant loss group (31.2 ± 15.9) than in the group with no implant loss (26.1 ± 18.1) (P = 0.026). In the multivariate analysis, the number of implants installed, smoking, and pack-years were significant factors for total implant loss. The adjusted odds ratio for implant failure for current smokers compared with never smokers was 2.07 (95% CI 1.19–3.62) for early implant loss and 1.48 (95% CI 0.92–2.37) for late implant loss. This study reaffirms that current smoking is associated with an increased risk of early implant loss, irrespective of the duration of smoking exposure.
Analysis of the clinicopathological characteristics and prognosis of adenoid cystic carcinoma of the intraoral minor salivary glands: a retrospective study of 40 cases
P.Suton1I.Luksic2
doi : 10.1016/j.ijom.2020.11.009
Volume 50, Issue 8, August 2021, Pages 1120-1121
