Seung-Hwan Jeon, Seung-Weon Lim, Ki-Hyun Jung, Jae-Yun Jeon, Sang-Yoon Kim, Ji-Young Kim, Yoon-Young Choi, Kyung-Gyun Hwang
{"title":"The clinical effectiveness of fused image of single-photon emission CT and facial CT for the evaluation of degenerative change of mandibular condylar head.","authors":"Seung-Hwan Jeon, Seung-Weon Lim, Ki-Hyun Jung, Jae-Yun Jeon, Sang-Yoon Kim, Ji-Young Kim, Yoon-Young Choi, Kyung-Gyun Hwang","doi":"10.1186/s40902-023-00399-1","DOIUrl":"10.1186/s40902-023-00399-1","url":null,"abstract":"<p><strong>Background: </strong>The primary objective of this study was to assess the clinical effectiveness of fused images obtained from single-photon emission computed tomography (SPECT) and facial computed tomography (CT) for evaluating degenerative changes in the mandibular condylar head. This assessment was accomplished by comparing the Technetium-99 m methylene diphosphonate (<sup>99m</sup>Tc-MDP) uptake ratio with the results of clinical and radiographic findings.</p><p><strong>Methods: </strong>The study included 17 patients (3 males and 14 females) with suspected osteoarthritis of the mandibular condyle, totaling 34 temporomandibular joints (TMJs). Based on clinical and radiographic examinations, the TMJs were categorized into four groups: normal (group N), internal derangement (group ID), osteoarthritis (group OA), and osteoarthritis sequelae (group OA<sub>seq</sub>). For each patient, bone SPECT and facial CT scans were registered and reconstructed to create fused SPECT/CT images. The <sup>99m</sup>Tc-MDP uptake levels in the TMJs were statistically compared among the four groups.</p><p><strong>Results: </strong>The <sup>99m</sup>Tc-MDP uptake ratio showed a gradual increase in the order of the following: group N, group OA<sub>seq</sub>, group ID, and group OA. There was a significant difference observed among groups (p = 0.003), mainly driven by the disparity between group OA and both group N (p < 0.001) and group OA<sub>seq</sub> (p = 0.048).</p><p><strong>Conclusion: </strong>Fused SPECT/CT image can be an effective tool for evaluating degenerative changes in the mandibular condylar head. The technique demonstrated the ability to differentiate between normal TMJs and those with internal derangement, osteoarthritis, or osteoarthritis sequelae. This approach holds promise as a valuable method in clinical assessments of TMJ degeneration.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"33"},"PeriodicalIF":2.3,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santhiya Iswarya Vinothini Udayakumar, Dohyoung Kim, So-Young Choi, Tae-Geon Kwon
{"title":"3D simulation of interosseous interference in sagittal split ramus osteotomy for mandibular asymmetry.","authors":"Santhiya Iswarya Vinothini Udayakumar, Dohyoung Kim, So-Young Choi, Tae-Geon Kwon","doi":"10.1186/s40902-023-00400-x","DOIUrl":"10.1186/s40902-023-00400-x","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the pattern of predicted interosseous interference and to determine the influencing factor to volume of bony interference using a computer-assisted simulation system. This retrospective study recruited 116 patients with mandibular prognathism who had undergone sagittal split ramus osteotomy (SSRO) with or without maxillary osteotomy. The patients were divided into 3 groups according to the amount of menton (Me) deviation: less than 2 mm (Group 1), 2-4 mm (Group 2), and more than 4 mm (Group 3). Changes in the distal segments following BSSRO and the volume of the interosseous interference between the proximal and distal segments were simulated after matching preoperative occlusion and postoperative expected occlusion with the cone-beam computed tomography data. Ramal inclinations and other skeletal measurements were analyzed before surgery, immediately after surgery, and at least 6 months after surgery.</p><p><strong>Results: </strong>The anticipated interosseous interference was more frequently noted on the contralateral side of chin deviation (long side) than the deviated site (short side) in Groups 2 and 3. More interference volume was predicted at the long side (186 ± 343.9 mm<sup>3</sup>) rather than the short side (54.4 ± 124.4 mm<sup>3</sup>) in Group 3 (p = 0.033). The bilateral difference in the volume of the interosseous interference of the osteotomized mandible was significantly correlated with the Me deviation (r = - 0.257, p = 0.009) and bilateral ramal inclination (r = 0.361, p < 0.001). The predictor variable that affected the volume of the osseous interference at each side was the amount of Me deviation (p = 0.010).</p><p><strong>Conclusion: </strong>By using the 3D simulation system, the potential site of bony collision could be visualized and successfully reduced intraoperatively. Since the osseous interference can be existed on any side, unilaterally or bilaterally, 3D surgical simulation is necessary before surgery to predict the osseous interference and improve the ramal inclination.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"32"},"PeriodicalIF":2.3,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yong-Dae Kwon, Hyunmi Jo, Jae-Eun Kim, Joo-Young Ohe
{"title":"A clinical retrospective study of implant as a risk factor for medication-related osteonecrosis of the jaw: surgery vs loading?","authors":"Yong-Dae Kwon, Hyunmi Jo, Jae-Eun Kim, Joo-Young Ohe","doi":"10.1186/s40902-023-00398-2","DOIUrl":"10.1186/s40902-023-00398-2","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for developing medication-related osteonecrosis of the jaw (MRONJ) include the general condition of the patient, smoking habit, poor oral hygiene, and the type, duration, and administration route of the drug, dentoalveolar surgery, such as implant placement. This study aimed to discuss whether implants may induce osteonecrosis in older patients receiving long-term medication and to analyze the radiological pattern of the bone necrosis.</p><p><strong>Methods: </strong>This study included 33 patients diagnosed with dental implant-associated medication-related osteonecrosis of the jaw. Data regarding the medical history, type of medication used, durations of administration, laboratory test results, onset of bone necrosis since implant placement, type of opposing teeth, and radiological pattern of the bone necrosis on cone-beam computed tomography were recorded in patients with and without implants.</p><p><strong>Results: </strong>The most commonly used drug was bisphosphonate, with an average duration of use of 61.37 (± 53.72) months. The laboratory results showed average serum C-terminal cross-linking telopeptide (CTX) level of 0.23 ng/mL, vitamin D, 23.42 ng/mL, and osteocalcin, 4.92 ng/mL. Osteonecrosis occurred after an average of 51.03 (± 39.75) months following implant placement. Radiological evaluation revealed obvious sequestration in the implant-absent group, and the formation of a unit sequestration with an implant fixture (en bloc) was observed in the implant-present group. The patients underwent surgical treatment of sequestrectomy and explantation.</p><p><strong>Conclusion: </strong>Implant placement, especially loading, may be considered a potential risk factor for the development of osteonecrosis in patients undergoing antiresorptive treatment.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"31"},"PeriodicalIF":2.3,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10261070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feasibility analysis of bone density evaluation with Hounsfield unit value after fibula flap reconstruction of jaw defect.","authors":"Yihui Yang, Yifan Kang, Yifan Yang, Mengkun Ding, Xiaofeng Shan, Zhigang Cai","doi":"10.1186/s40902-023-00397-3","DOIUrl":"10.1186/s40902-023-00397-3","url":null,"abstract":"<p><strong>Background: </strong>Implant-supported dentures have become an essential means of restoring occlusal function after jaw reconstruction. Bone mineral density (BMD) may influence the success rate of implant denture restorations. This study aimed to explore whether the Hounsfield unit (HU) value can be used to monitor the changing trend of fibular BMD after jaw reconstruction.</p><p><strong>Results: </strong>A total of 54 patients who underwent maxillar/mandibular reconstruction with a fibula flap were included in this study. There was a significant correlation between the HU value and BMD at 1 week, 3 months, and 6 months after surgery, and both were significantly correlated with follow-up time. The difference between each pair of absorption rates (DAR) was less than 10% in 66.7% and 75.9% of patients at 3 and 6 months; however, the DAR was more than 20% in 12% and 13.8% of patients at 3 and 6 months, respectively.</p><p><strong>Conclusions: </strong>There is a significant correlation between HU value and BMD. The HU value can be used to roughly reflect the fibular BMD changing trend in a group of patients as opposed to an individual, and the HU value is not equivalent to BMD.</p><p><strong>Trial registration: </strong>ChiCTR, ChiCTR2300069661, retrospectively registered on 22 March 2023. Retrospectively registered, https://www.chictr.org.cn/showproj.html?proj=188953 .</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"30"},"PeriodicalIF":2.3,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zaid B Al-Bitar, Ahmad M Hamdan, Abedalrahman Shqaidef, Umberto Garagiola, Farhad B Naini
{"title":"Perception of frontal facial images compared with their mirror images: chirality, enantiomorphic discrimination, and relevance to clinical practice.","authors":"Zaid B Al-Bitar, Ahmad M Hamdan, Abedalrahman Shqaidef, Umberto Garagiola, Farhad B Naini","doi":"10.1186/s40902-023-00396-4","DOIUrl":"10.1186/s40902-023-00396-4","url":null,"abstract":"<p><strong>Background: </strong>What we think we see consists of models constructed in our brains, which may be constrained, limited and perhaps modified at a cerebral level. Patients may view their mirror image differently to how others and the clinical team view them. Understanding potential variations in perception between real and mirror images is important in clinical practice. The aims were to assess differences in self-perception between frontal facial and mirrored photographs, comparing the results with selfie photographs.</p><p><strong>Methods: </strong>Facial photographs were taken by one investigator under standardized conditions for preclinical and clinical students. Each student took a selfie photograph at rest and smiling using his/her smartphone. A mirror image was generated for each image. Each student was shown his/her original and mirror image, without being informed which was which. For each pair of images, students were asked to choose which photograph they perceived as more attractive. A set of photographs of a male volunteer was shown to all participants, to choose either the original or mirror image as the more attractive.</p><p><strong>Results: </strong>Most observers preferred the true image of the volunteer (P < 0.05), which may be evidence that most people prefer the true image of others, which is how they normally view them. Most observers preferred their own original photograph in frontal view at rest and smiling (P < 0.05), but preferred the mirror image of their selfie photograph at rest and smiling (P < 0.05).</p><p><strong>Conclusions: </strong>Significant differences in perceptions of attractiveness between true and mirror-reversed frontal and selfie images were found. Observers preferred their image the way they view themselves in a mirror. The selfie is how other people view an individual. If a selfie is flipped horizontally, that is how an individual sees themselves in a mirror. Most observers preferred the mirror image of their selfie, which is how they would view themselves in a mirror.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"29"},"PeriodicalIF":2.3,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The combined application of bleomycin with triamcinolone acetonide in port wine stains: inhibiting proliferation and recurrence of port wine stains.","authors":"Quan-Feng Luo","doi":"10.1186/s40902-023-00395-5","DOIUrl":"10.1186/s40902-023-00395-5","url":null,"abstract":"<p><strong>Background: </strong>Port wine stains slowly grow thicker over time, nodules appear on the surface, and the color slowly deepens from pink to purple. Even after laser treatment, some port wine stains will recur and slowly grow, and the erythema appears again. The purpose of this study was to investigate the effectiveness of bleomycin in combination with triamcinolone acetonide in the treatment of inhibiting the proliferation and recurrence of port wine stains.</p><p><strong>Results: </strong>Histopathological change: Before treatment, dense capillaries were distributed within the lesion, and blood fills the lumen. Lack of normal skin structure: After bleomycin and triamcinolone acetonide injection, the number of capillaries was significantly reduced, and fibrosis occurred in tissues. Changes in facial morphology: After treatment, the port wine stains became thinner, the asymmetry of the face was effectively improved, and the appearance have been significantly improved. After 5 years of follow-up, there were no recurrent cases.</p><p><strong>Conclusion: </strong>Bleomycin and triamcinolone acetonide injection can effectively inhibit the proliferation of port wine stains and prevent port wine stains from recurring after treatment.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"28"},"PeriodicalIF":2.3,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10102327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tong Xi, Shankeeth Vinayahalingam, Stefaan Bergé, Thomas Maal, Tae-Geon Kwon
{"title":"Skeletal structure of asymmetric mandibular prognathism and retrognathism.","authors":"Tong Xi, Shankeeth Vinayahalingam, Stefaan Bergé, Thomas Maal, Tae-Geon Kwon","doi":"10.1186/s40902-023-00393-7","DOIUrl":"10.1186/s40902-023-00393-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry.</p><p><strong>Results: </strong>Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism.</p><p><strong>Conclusion: </strong>Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"27"},"PeriodicalIF":2.3,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jae-Eun Kim, Youngjae Yoon, Ahran Pae, Yong-Dae Kwon
{"title":"Clinical outcome of narrow diameter dental implants: a 3-year retrospective study.","authors":"Jae-Eun Kim, Youngjae Yoon, Ahran Pae, Yong-Dae Kwon","doi":"10.1186/s40902-023-00394-6","DOIUrl":"https://doi.org/10.1186/s40902-023-00394-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the clinical outcome and complications of narrow-diameter dental implants (NDIs) (diameter ≤3.5 mm).</p><p><strong>Methods: </strong>The 274 NDIs that met the selection criteria from 2013 to 2018 were included in the retrospective study, and the survival rates (SVR) were compared. Mechanical complications included screw loosening and fractures of the implant components, such as the implant fixture, abutment, and prosthesis. In addition, marginal bone loss (MBL) was measured immediately after surgery and 1 year after loading.</p><p><strong>Results: </strong>The 3-year cumulative SVR was 92.4%. Nineteen fixtures failed during the follow-up. The failure rate was significantly higher (OR=4.573, p<0.05) in smokers and was significantly higher in osteoporosis patients (OR=3.420, p<0.05). The vertical and horizontal values of MBL were 0.33±0.32 mm and 0.18±0.17 mm, respectively. Mechanical complications included screw loosening (5.5%) and porcelain fracture (2.2%), but no fractures of the fixture or components were observed. The choice of titanium and zirconium (TiZr) alloy implant was significantly more frequent in the posterior region. Bone graft was significantly more frequently done in the anterior region.</p><p><strong>Conclusions: </strong>According to the high SVR and stability of NDIs, the findings of the study suggest that NDIs may be a replacement for regular diameter dental implants (RDIs) and the use of TiZr alloy could extend the indication of NDIs. In the esthetic area, contour augmentation may be a reason for increasing the frequency of bone grafts.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"26"},"PeriodicalIF":2.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9986554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Young-Jin Choi, Hoon-Je Chang, Min Jae Kim, Jee-Ho Lee, Bu-Kyu Lee
{"title":"Efficacy of pure beta tricalcium phosphate graft in dentoalveolar surgery: a retrospective evaluation based on serial radiographic images.","authors":"Young-Jin Choi, Hoon-Je Chang, Min Jae Kim, Jee-Ho Lee, Bu-Kyu Lee","doi":"10.1186/s40902-023-00390-w","DOIUrl":"https://doi.org/10.1186/s40902-023-00390-w","url":null,"abstract":"<p><strong>Background: </strong>The use of beta-tricalcium phosphate (beta-TCP) in dental surgery is limited owing to its rapid absorption compared to mixed formulations of hydroxyapatite. However, newly developed pure beta-TCP crystals have demonstrated slow absorption; hence, they last longer within the defect and act as a scaffold until new bone formation. The oral environment is unique and can prove unfavorable for bone grafts due to the high infection rate in the oral cavity and the fragile condition of the oral mucosa. The aim of this study was to evaluate the feasibility of using pure beta-TCP bone grafts in various dental treatments.</p><p><strong>Methods: </strong>Panoramic X-ray images of 25 patients who underwent bone grafting during dental surgery were analyzed. A specially treated pure beta-TCP crystal, Neo Bone® (Neo Bone®, SN Biologics Co., Ltd, Seoul, Korea), was used in this study. The bone density at the graft site was compared with that of the surrounding bone using the ImageJ software (Wayne Rasband, NIH USA).</p><p><strong>Results: </strong>Six months after surgery, the bone graft density was similar to that of the surrounding bone in 20 patients and increased in 5 patients. No adverse effects, such as infection, dehiscence, or graft failure, were observed.</p><p><strong>Conclusion: </strong>The newly developed pure beta-TCP crystal was slowly absorbed and served as support until new bone formation at the defect site, thus demonstrating its potential for use in various oral conditions requiring bone grafting.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"25"},"PeriodicalIF":2.3,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10371935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elahe Tahmasebi, Elham Keykha, Samira Hajisadeghi, Hamidreza Moslemi, Shervin Shafiei, Mohammad Hosein Kalantar Motamedi, Arman Torabizadeh, Reza Tabrizi, Mostafa Alam
{"title":"Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis.","authors":"Elahe Tahmasebi, Elham Keykha, Samira Hajisadeghi, Hamidreza Moslemi, Shervin Shafiei, Mohammad Hosein Kalantar Motamedi, Arman Torabizadeh, Reza Tabrizi, Mostafa Alam","doi":"10.1186/s40902-023-00392-8","DOIUrl":"https://doi.org/10.1186/s40902-023-00392-8","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region.</p><p><strong>Main text: </strong>We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case-control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I<sup>2</sup> test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up.</p><p><strong>Conclusions: </strong>Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"45 1","pages":"24"},"PeriodicalIF":2.3,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}