Elisabeth Goetze, Alexander-N Zeller, Andreas Pabst
{"title":"Approaching 3D printing in oral and maxillofacial surgery - suggestions for structured clinical standards.","authors":"Elisabeth Goetze, Alexander-N Zeller, Andreas Pabst","doi":"10.1007/s10006-024-01208-3","DOIUrl":"10.1007/s10006-024-01208-3","url":null,"abstract":"<p><strong>Purpose: </strong>With respect to the European Union 2017 amendment of the Medical Device Regulations (MDR), this overview article presents recommendations concerning medical 3D printing in oral and maxillofacial surgery (OMFS).</p><p><strong>Methods: </strong>The MDR were screened for applicability of the rules to medical in-house 3D printing. Applicable regulations were summarized and compared to the status of medical use of 3D printing in OMFS in Germany. Recommendations were made for MDR concerning medical 3D printing.</p><p><strong>Results: </strong>In-house printed models, surgical guides, and implants fall under the category of Class I-III, depending on their invasive and active properties. In-house medical 3D printing for custom-made medical devices is possible under certain prerogatives: (1) the product is not being used in another facility, (2) appropriate quality systems are applied, (3) the reason for omitting commercial products is documented, (4) information about its use is supplied to the responsible authority, (5) there is a publicly accessible declaration of origin, identification, and conformity to the MDR, (6) there are records of manufacturing site, process and performance data, (7) all products are produced according to the requirements proclaimed before, and (8) there is an evaluation of clinical use and correction of possible issues.</p><p><strong>Conclusion: </strong>Several aspects must be addressed for in house medical 3D printing, according to the MDR. Devising MDR related to medical 3D printing is a growing challenge. The implementation of recommendations in OMFS could help practitioners to overcome the challenges and become aware of the in-house production and application of 3D printed devices.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139430199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of anatomical relationships in the mandibular third molar region based on its angulation and depth of impaction: a CBCT-based study.","authors":"Zahra Vasegh, Pedram Bakhshaei, Morteza Jahanbani, Reza Mahmoudi Anzabi","doi":"10.1007/s10006-023-01178-y","DOIUrl":"10.1007/s10006-023-01178-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate the relationship between the inclination/impaction depth and root proximity to the inferior alveolar canal/lingual plate on a millimeter scale using CBCT scans.</p><p><strong>Methods: </strong>340 CBCT scans of the mandibular third molar (M3) of 219 patients were evaluated for this cross-sectional study. After adjustment of the 3D orientation of the individual's jaws, the study variables including the angulation between M3 and second molar (M2)/occlusal plane (OP), and the distance of mesial (M)/distal (D) roots of M3 from the inferior alveolar canal (IAC) and lingual plate (LP) were measured. Winter's classification was used for the specification of teeth angulation. The vertical position of each M3 was then evaluated using the 3D view window (based on Pell & Gregory classification). The Spearman correlation coefficient was used for reporting the correlation between quantitative variables. The One-way ANOVA test and the Welch analysis were used for inter-group comparisons. Finally, a multivariant analysis of variances was performed.</p><p><strong>Results: </strong>Most third molars had a mesioangular inclination (52.1%), and vertical inclination (25.9%) was in second place. There was no significant correlation between angulation and age or the D/LP. A strong positive correlation between M3:M2 and M3:OP was observed (0.983). Furthermore, there was a weak negative correlation between M/IAC or M/LP and angulation (- 0.16 and - 0.13, respectively). Concerning Winter's classification, the relationship between D/IAC and angulation was statistically significant (P = 0.003). Furthermore, teeth in position A had lesser inclination compared to those with B or C positions. Multivariate analysis revealed that there was no statistically significant relationship between particular combinations of inclination-impaction depth and proximity of the M3 roots to the IAC or LP (P = 0.211).</p><p><strong>Conclusions: </strong>The findings of the current study revealed that there is a strong correlation between M3:M2 and M3:OP. The D/IAC was the only variable that had a significant relationship with the angulation of these teeth. Moreover, the roots of horizontally inclined teeth with position A were the closest to the LP and the farthermost to the IAC.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10443962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surendra N Daware, Abhay N Datarkar, Vandana Gadve, Bhavna Valvi
{"title":"Management of bilateral condylar agenesis by distraction osteogenesis: a rare case report.","authors":"Surendra N Daware, Abhay N Datarkar, Vandana Gadve, Bhavna Valvi","doi":"10.1007/s10006-024-01220-7","DOIUrl":"10.1007/s10006-024-01220-7","url":null,"abstract":"<p><p>Condylar agenesis is a rare case involving developmental disturbances related to growth of mandible, facial aesthetics, dentition development, muscle deformation, and occlusal problems. As such, this is a rare condition, and there is no internationally accepted protocol for the same. Underdevelopment or defective formation of condyle may be congenital or acquired. Condylar agenesis is congenital non formation of condyle, while hypoplasia is poor development. We report a case of bilateral condylar agenesis in a 30-year-old female patient.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joao Victor Borges Leal, Luciano Mauro Del Santo, Omar Nasim Mohamed Nasim Khan Mahboob, Thiago Martins Magalhães Ramos, Mateus Barros Cavalcante, José Valdir Pessoa Neto
{"title":"Correction to: Mandibular reconstruction with TMJ prosthesis: Management of osteomyelitis after orthognathic surgery (Case Report).","authors":"Joao Victor Borges Leal, Luciano Mauro Del Santo, Omar Nasim Mohamed Nasim Khan Mahboob, Thiago Martins Magalhães Ramos, Mateus Barros Cavalcante, José Valdir Pessoa Neto","doi":"10.1007/s10006-023-01186-y","DOIUrl":"10.1007/s10006-023-01186-y","url":null,"abstract":"","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kale B McMillan, Dane C McMillan, Omair Shariq, Christine Lohse, Benzon Dy, Melanie Lyden, Kevin Arce
{"title":"Association of hyperparathyroidism and benign fibro-osseous jaw tumors: a 25-year retrospective study at Mayo Clinic.","authors":"Kale B McMillan, Dane C McMillan, Omair Shariq, Christine Lohse, Benzon Dy, Melanie Lyden, Kevin Arce","doi":"10.1007/s10006-023-01195-x","DOIUrl":"10.1007/s10006-023-01195-x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the association between hyperparathyroidism (PHPT), parathyroid hormone levels, and calcium levels in patients diagnosed with benign fibro-osseous lesions such as fibrous dysplasia (FD), ossifying fibroma (OF), central giant cell granulomas (GCG).</p><p><strong>Methods: </strong>This is a retrospective, single-center study from a sample of patients who underwent surgical treatment of FD, OF, and GCG at Mayo Clinic between 1996 and 2021. Patient demographics, history of PHPT, histopathological diagnosis, and relevant laboratory values such as parathyroid hormone (PTH), serum calcium, vitamin D, and alkaline phosphatase were collected.</p><p><strong>Results: </strong>Of the patients diagnosed with FD (n = 64), OF (n = 24), and GCG (n = 5), a diagnosis of PHPT was found in 2 patients (3.1%), 1 patient (4.2%), and 0 patients (0%), respectively. Elevated PTH levels (>65 pg/mL) were observed in 3 patients (4.7%) with FD, 1 patient (4.2%) with OF, and 1 patient (20%) with GCG. Mean (standard deviation) calcium levels were 9.3 (0.6) mg/dL in the FD group, 9.4 (0.5) mg/dL in the OF group, and 9.3 (0.6) mg/dL in the GCG group. Patients with fibro-osseous jaw tumors including FD, OF, and GCG may have increased risk of PHPT compared to the general population.</p><p><strong>Conclusion: </strong>Patients with benign jaw tumors including FD, OF, and GCG may have increased risk of PHPT compared to the general population. Surgeons treating these benign tumors need to be cognizant of these findings, obtain appropriate laboratory studies, and incorporate multidisciplinary care including endocrinologists, endocrine surgeons, and maxillofacial surgeons.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheryl Ker Jia Lee, Chee Weng Yong, Leonardo Saigo, Yi Jin Ren, Ming Tak Chew
{"title":"Virtual surgical planning in orthognathic surgery: a dental hospital's 10-year experience.","authors":"Cheryl Ker Jia Lee, Chee Weng Yong, Leonardo Saigo, Yi Jin Ren, Ming Tak Chew","doi":"10.1007/s10006-023-01194-y","DOIUrl":"10.1007/s10006-023-01194-y","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective of this study was to evaluate how the utilization of virtual surgical planning (VSP) and the epidemiological profile of patients undergoing orthognathic surgery (OGS) have changed in the past decade.</p><p><strong>Methods: </strong>The records of patients who had undergone orthognathic surgery at a national dental hospital were reviewed. Trends in VSP, epidemiological data, presentation of dentofacial deformity, and management details were recorded.</p><p><strong>Results: </strong>A total of 1184 patients were included in this study. The majority of the patients seeking treatment in this dental hospital were young Chinese adults with dentofacial deformities requiring bimaxillary surgeries. Most patients presented with a skeletal Class III pattern (79.0%), and asymmetry was diagnosed in 80.8% of all cases.</p><p><strong>Conclusion: </strong>There was an initial slow pick-up rate for VSP, but this rapidly increased to a high adoption rate of 98.7-100% between 2019 and 2021. Together with an increasing body of evidence suggesting greater accuracy in VSP, utilization in this technology can be enhanced with greater familiarity with the technology and improvements in the VSP services.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of parenteral and local application of tramadol in mandibular third molar extraction: a qualitative systematic review of current evidence.","authors":"Maria-Markella Gounari, Georgia Tsaousi, Lampros Zouloumis, Dimitrios Kouvelas, Chryssa Pourzitaki","doi":"10.1007/s10006-023-01179-x","DOIUrl":"10.1007/s10006-023-01179-x","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of perioperative parenteral administration or submucosal infiltration of tramadol for perioperative pain control on the basis of pain intensity or analgesics consumption and perioperative outcomes in mandibular third molar surgery.</p><p><strong>Material-methods: </strong>An electronic database search was conducted up to 10 November 2022 to retrieve all randomized controlled trials (RCTs), assessing the analgesic efficacy of parenteral use of tramadol implemented as an adjunct to local anesthesia or intraoperative sedation/general anesthesia, in surgical extraction of mandibular third molars. Modified Jadad scale and Cochrane bias tool were used for the qualitative appraisal.</p><p><strong>Results: </strong>Nineteen RCTs were selected for qualitative analysis. Nine studies involved intravenous, and 5 intramuscular administration of tramadol, while 5 evaluated submucosal infiltration with tramadol. Intravenous or intramuscular tramadol provided a weaker analgesic effect compared with non-steroidal anti-inflammatory drugs (NSAIDs), while intravenous tramadol induced an enhanced analgesic effect than oral tramadol. Parenteral administration of tramadol improved the quality of postoperative analgesia versus placebo. No notable adverse effects were recorded.</p><p><strong>Conclusions: </strong>Parenteral or submucosal infiltration of tramadol constitutes an effective and safe alternative analgesic approach in surgical extraction of mandibular third molars, yet the nociceptive effect of this analgesic modality could not supersede that of NSAIDs.</p><p><strong>Trial registration: </strong>PROSPERO No CRD42021227574.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10108440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joao Victor Borges Leal, Luciano Mauro Del Santo, Omar Nasim Mohamed Nasim Khan Mahboob, Thiago Martins Magalhães Ramos, Mateus Barros Cavalcante, José Valdir Pessoa Neto
{"title":"Mandibular reconstruction with TMJ prosthesis: management of osteomyelitis after orthognathic surgery (Case Report).","authors":"Joao Victor Borges Leal, Luciano Mauro Del Santo, Omar Nasim Mohamed Nasim Khan Mahboob, Thiago Martins Magalhães Ramos, Mateus Barros Cavalcante, José Valdir Pessoa Neto","doi":"10.1007/s10006-023-01184-0","DOIUrl":"10.1007/s10006-023-01184-0","url":null,"abstract":"<p><p>This case report presents a mandible reconstruction with temporomandibular joint (TMJ) prothesis for treatment of osteomyelitis infection following a bimaxillary orthognathic and genioplasty surgeries. The patient, a 41-year-old female, presented with facial pain, difficulty in opening her mouth, and mandibular deviation four months after the initial orthognathic surgery. During the four months, the patient had experienced two more surgerys post-operative for treatment of the complications. Examination revealed mobility between osteotomy segments of the right mandibular osteotomomie between body and ramus, and Computer Tomographic scan analysis revealed osteomyelitis and non-union within the osteotomy side of the right mandible from the previous surgery. Due to the advanced state of the disease and significant bone resorption, treatment was planned in two stages, involving bone debridement and then reconstruction with a custom made extended temporomandibular joint prosthesis. The patient had no postoperative complications and achieved satisfactory functional and aesthetic outcomes. This case emphasizes the importance of careful monitoring and prompt management of postoperative complications following orthognathic surgery to prevent rare but serious complications such as osteomyelitis.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomical research of the clavicular pedicled flap for mandibular reconstruction: vascularization and harvesting technique.","authors":"Imen Mehri Turki","doi":"10.1007/s10006-023-01192-0","DOIUrl":"10.1007/s10006-023-01192-0","url":null,"abstract":"<p><strong>Purpose: </strong>Mandibular reconstruction remains a challenging procedure despite the availability of various flaps and grafts. The ultimate objective is to restore oral functioning and attain acceptable morphological outcomes while considering donor site morbidity. This study describes the vascular supply and harvesting technique of a pedicled clavicular bone. The proximity of the clavicle is conducive to a mandibular replacement and allows the use of vascularized bone with a single surgical field.</p><p><strong>Methods: </strong>The osteoperiosteal clavicular pedicled flap was harvested on the right side of ten fresh cadaver specimens. The cervical transverse artery was injected with colored latex in some cases and methylene blue in others.</p><p><strong>Results: </strong>The vascular periosteal supply of the clavicular flap was highlighted. The clavicular bone was linked to its pedicle which was composed of vascular and adipose-fascial tissues, without any overlying skin paddle. Its vasculature was supplied by a reverse flow from the ascending cervical artery. The pedicled clavicular bone readily reached the mandible in all dissections.</p><p><strong>Conclusion: </strong>The osteoperiosteal vasculature of the clavicular flap is based on the transverse cervical artery which receives a reverse blood supply from the ascending cervical artery. This vascular pattern is reliable because of the existence of the sub-occipital microvascular network named the \"Bosniak node.\" This pedicled clavicular flap seems to be a robust perspective in both mandibular and facial bone reconstruction. We do not claim that it will replace the existing approaches, but it will expand the surgical panel of mandibular reconstruction. Its clinical realisation will judge its functionality.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne Caroline Dos Santos Barbosa, Daniela Ignacia Rivera Palma, Maria Karoline Santos Silva Melo, Ana Karolina Leão Silva Costa, Glória Maria de França
{"title":"Cross-sectional study of sublingual varicosities: systemic exposures.","authors":"Anne Caroline Dos Santos Barbosa, Daniela Ignacia Rivera Palma, Maria Karoline Santos Silva Melo, Ana Karolina Leão Silva Costa, Glória Maria de França","doi":"10.1007/s10006-023-01202-1","DOIUrl":"10.1007/s10006-023-01202-1","url":null,"abstract":"<p><strong>Purpose: </strong>Sublingual varicose veins are a common vascular lesion with different names, such as caviar tongue or vascular malformations. This study aimed to investigate whether there is an association between sublingual varicose veins and cardiovascular diseases by observing arterial hypertension, diabetes, thrombosis, and infarction. In addition, to evaluate a series of thrombi that affected the oral cavity and to analyze their clinical aspects and relate them to possible systemic alterations.</p><p><strong>Methods: </strong>This is a cross-sectional study consisting of a sample of 134 varicosities, 23 vascular malformations, and 4 thrombosis.</p><p><strong>Results: </strong>Lingual varicosities are more frequently observed in women aged 57.4 ± 16.4 years. Hypertension was present in lingual varicosities (n = 73), as well as diabetes (n = 107), reports of thrombosis (n = 41), and infarction (n = 45). Arterial hypertension was decompensated (n = 12). The most frequent underlying diseases were diabetes (p < 0.001), infarction (p = 0.012), and thrombosis (p = 0.004), and the most commonly used drug was losartan.</p><p><strong>Conclusion: </strong>It can be inferred from the present study that lingual varicosities are related to cardiovascular diseases and can serve as a parameter to measure their decompensation.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}