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Background: Tuberous sclerosis complex (TSC) is a rare, complex genetic disorder characterized by hamartomas and neoplastic lesions in various organ systems. With the development of radiology and gene testing, the diagnostic criteria for TSC were updated in 2012 at the International Consensus Conference. Intraoral fibromas have long been associated with TSC. However, the incidence of giant cell angiofibroma (GCA) in TSC patients is extremely rare. Here, we report the first case of GCA in the gingival tissue of a patient with TSC. Case presentation: A 41-year-old woman first visited the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, complaining of gingival enlargement. Clinical examination revealed several manifestations associated with TSC, including intraoral fibromas, facial angiofibromas, dental enamel pits, ungual fibromas, "confetti" skin lesions, hypomelanotic macules, and a shagreen patch. Intraoral examination revealed a 6.0 × 5.0 cm gingival overgrowth on the left mandible. Surgical excision was performed, and subsequent histopathological examination confirmed the diagnosis of GCA. There was no evidence of recurrence within the 24- months of surgery. Conclusions: We report the first case of GCA in the gingival tissue of a patient with TSC. This report would contribute to an improved understanding of this rare disease. However, further case reports are necessary to clarify the relationship between GCA and TSC. [ABSTRACT FROM AUTHOR]

Peri-implantitis is an inflammatory lesion leading to bone destruction resulting from bacterial infection and biofilm formation. Treatments of peri-implantitis aim at bacterial controls and decontamination to promote re-osseointegration. The present study aimed to assess the decontamination of biofilm and the osseointegration of titanium discs in a rabbit tibia model. Discs were immersed in culture medium inoculated with Staphylococcus aureus and incubated at 37 °C for 24 h and allocated to different treatments (n = five per group). The decontamination methods were an air-polishing system, 0.12% chlorhexidine rinse, and Er:Yag laser treatments. Each disc from the experimental groups was observed using scanning electron micrography. The rest of the discs were then implanted in four male New Zealand rabbits. Histological and radiographic evaluations were performed. For the quantification of bone density in radiographic data, the fractal dimension (FD) and mean grayscale value (GV) were measured. The Kruskal–Wallis test was used to compare bone density (p < 0.05). Statistically significant differences in FD were observed between the air-polishing treatment with chlorhexidine rinse and the air-polishing treatment with chlorhexidine rinse and Er:Yag laser treatment compared to the contaminated group (p < 0.05). Also, there were statistically significant differences in the results obtained for the group undergoing air-polishing treatment with chlorhexidine rinse and Er:Yag laser treatment compared to the contaminated group (p < 0.05). The decontamination method using air polishing treatment, chlorhexidine rinse, and Er:Yag treatment showed favorable osseointegration with good bone quality. [ABSTRACT FROM AUTHOR]

Reactive oxygen species (ROS)-sensitive polymer nanoparticles were synthesized for tumor targeting of an anticancer drug, doxorubicin (DOX). For this purpose, chitosan-methoxy poly(ethylene glycol) (mPEG) (ChitoPEG)-graft copolymer was synthesized and then DOX was conjugated to the backbone of chitosan using a thioketal linker. Subsequently, the chemical structure of the DOX-conjugated ChitoPEG copolymer (ChitoPEGthDOX) was confirmed via 1H nuclear magnetic resonance (NMR) spectra. Nanoparticles of the ChitoPEGthDOX conjugates have spherical shapes and a size of approximately 100 nm. Transmission electron microscopy (TEM) has shown that ChitoPEGthDOX nanoparticles disintegrate in the presence of hydrogen peroxide and the particle size distribution also changes from a monomodal/narrow distribution pattern to a multi-modal/wide distribution pattern. Furthermore, DOX is released faster in the presence of hydrogen peroxide. These results indicated that ChitoPEGthDOX nanoparticles have ROS sensitivity. The anticancer activity of the nanoparticles was evaluated using AT84 oral squamous carcinoma cells. Moreover, DOX-resistant AT84 cells were prepared in vitro. DOX and its nanoparticles showed dose-dependent cytotoxicity in both DOX-sensitive and DOX-resistant AT84 cells in vitro. However, DOX itself showed reduced cytotoxicity against DOX-resistant AT84 cells, while the nanoparticles showed almost similar cytotoxicity to DOX-sensitive and DOX-resistant AT84 cells. This result may be due to the inhibition of intracellular delivery of free DOX, while nanoparticles were efficiently internalized in DOX-resistant cells. The in vivo study of a DOX-resistant AT84 cell-bearing tumor xenograft model showed that nanoparticles have higher antitumor efficacy than those found in free DOX treatment. These results may be related to the efficient accumulation of nanoparticles in the tumor tissue, i.e., the fluorescence intensity in the tumor tissue was stronger than that of any other organs. Our findings suggest that ChitoPEGthDOX nanoparticles may be a promising candidate for ROS-sensitive anticancer delivery against DOX-resistant oral cancer cells. [ABSTRACT FROM AUTHOR]

This case report describes the successful orthodontic treatment of an 11-year-old girl with skeletal Class II malocclusion and congenitally missing mandibular second premolars. To resolve her upper lip protrusion and restore the missing mandibular premolars, extraction of the maxillary first premolars and subsequent autotransplantation of the extracted premolars onto the site of the missing mandibular second premolars were performed. To ensure the success of the autotransplantation and subsequent orthodontic treatment, an orthodontic force was preapplied on the donor teeth, and the recipient sockets were prepared with the aid of replica teeth. Thereafter, comprehensive orthodontic treatment was performed to close the extraction space in the maxilla and align the mandibular dentition, including the transplants. The patient achieved a functional occlusion with an improved facial profile. Results of the orthodontic treatment and autotransplantation were stable during the 5-year follow-up. On the basis of this report, a management protocol for a biomechanically enhanced autotransplantation procedure was suggested. This approach would enable an effective treatment procedure, thereby increasing the usefulness of autotransplantation. [ABSTRACT FROM AUTHOR]

This brief clinical report describes a case of the self-induced cervicofacial emphysema. There are many factors that cause cervicofacial subcutaneous emphysema including air-driven handpieces used in dental clinic, maxillofacial trauma, improper chest tubing, neck surgery, or otic surgery. However, there are rare cases of self-induced subcutaneous emphysema due to dehiscence of external auditory canal. In this study, we reported a patient who developed spontaneously subcutaneous emphysema with persistent otitis externa and communication between external auditory canal and temporomandibular joint. A 66-year-old male visited the emergency room with right facial swelling and had crepitus on palpation at right temporal and TMJ area. Enhanced head and neck CT imaging revealed extensive emphysema in masticatory spaces and subcutaneous space of neck area. Cone-beam CT showed a defect in the anterior wall of the external acoustic canal. This canal was occluded using packing of ciprofloxacin soaking gauze. After that, the emphysema was completely disappeared and there was no recurrence at follow up for 3 years after treatment. [ABSTRACT FROM AUTHOR]

Purpose: The mandibular canal is damaged by the growth of cysts, and remodeling of the mandibular canal is observed as the size of the cyst decreases after decompression procedures. This study aimed to estimate changes in cyst volume and mandibular canal length using cone-beam computed tomography (CBCT) before and after decompression surgery.Materials and Methods: A retrospective cohort study was conducted in patients with a diagnosis of mandibular cyst invading the mandibular canal between 2012 and 2018. All patients underwent CBCT at the initial visit and after decompression. The predictor variable was the period before decompression and before enucleation surgery. The outcome variables were changes in cyst volume and mandibular canal length, which were evaluated 3-dimensionally. The initial volume of the cyst, initial length of the mandibular canal, and patient's age were set as variables of interest that affected the outcome.Results: Decompression was performed in 20 patients (18 male and 2 female patients), and the mean decompression duration was 8.81 ± 2.94 months. The average volume reduction rate after decompression was 60.23%, with an average volume reduction speed of 0.72 mL/month. The average length increase rate after decompression was 50.88%, and the average speed of length increase was 2.68 mm/month. The initial volume of the cyst and initial length of the mandibular canal were the important variables affecting the results. Complete separation of the mandibular canal from the cyst was observed in 11 cases, and incomplete separation was found in 9.Conclusions: Separation from the cyst and regeneration of the mandibular canal using decompression were observed using 3-dimensional CBCT analysis. The results of this study suggest that decompression is effective in separating and preserving important anatomic structures invaded by the cyst. [ABSTRACT FROM AUTHOR]

Peripheral ameloblastoma is a rare benign tumor of the oral and maxillofacial region with similar histologic features to central ameloblastoma. It arises from rests of odontogenic cells and epitheliums and usually found in the tooth-bearing gingival area of the jaw. We report a case of peripheral ameloblastoma in the pterygomandibular space of a 60-year-old male patient. It is important to note that the lesion occurred in the extragingival area is rarely reported. We suggest that the peripheral ameloblastoma might occur outside of the jaw and report its unique clinical features. [ABSTRACT FROM AUTHOR]

The need for the repair of bone defects has been increasing due to various causes of loss of skeletal tissue. High density polyethylenes (HDPE) have been used as bone substitutes due to their excellent biocompatibility and mechanical strength. In the present study, we investigated the preosteoblast cell proliferation and differentiation on the adding nano-hydroxyapatite (n-HAp) particles into HDPE scaffold and treating HDPE/n-HAp scaffolds with nitrogen (N2) plasma. The three-dimensional (3D) HDPE/n-HAp scaffolds were prepared by fused modeling deposition 3D printer. The HDPE/n-HAp was blended with 10 wt% of n-HAp particle. The scaffold surface was reactive ion etched with nitrogen plasma to improve the preosteoblast biological response in vitro. After N2 plasma treatment, surfaces characterizations were investigated using Fourier transform infrared spectroscopy, scanning electron microscopy, and atomic force microscopy. The proliferation and differentiation of preosteoblast (MC3T3-E1) cells were evaluated by MTT assay and alkaline phosphatase (ALP) activity. The incorporation of n-HAp particles and N2 plasma surface treatment showed the improvement of biological responses of MC3T3-E1 cells in the HDPE scaffolds. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective study., Objective: This retrospective study aims to analyze the results of Le Fort I fracture treatment, with a focus on addressing malocclusion related to the fractures., Methods: The study included 43 patients diagnosed with Le Fort I fractures who underwent open reduction and internal fixation. Demographic data, causes of trauma, accompanying facial bone fractures, treatment methods, and complications were analyzed. Fisher's exact test was employed to assess the association between fractures and malocclusion., Results: Postoperative complications included occlusal disorder (6 cases), sensory disturbance (4 cases), and facial deformation (6 cases). Condylar fractures showed a statistically significant association with occlusal disorders ( P = 0.044). Surgeon variability did not significantly impact occlusal outcomes ( P = 0.25)., Conclusions: Proper management of Le Fort I fractures requires a thorough understanding of surgical principles and consideration of concomitant fractures. Achieving anatomical reduction based on occlusion is crucial for successful outcomes, and additional Le Fort I osteotomy may be considered in challenging cases., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction. Patients and., Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography., Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the nonfractured sides during treatment., Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

Aim: To conduct an observational study evaluating the efficacy of a partially guided system for implant surgery., Materials and Methods: The study included 48 implant placements in 24 patients. Following virtual implant planning with designated software, a surgical guide was fabricated using a 3D desktop printer. Each surgically placed implant was compared with its planned position in the software. The coronal and apical distance and angular errors of the implants were evaluated. The correlation between the errors and the variables (residual bone height, surgeon, implant placement site, guide support type, implant diameter) was analyzed using multiple regression analysis., Results: The coronal and apical mean distance errors were 1.28 ± 0.85 and 1.8 ± 0.97 mm, respectively. The mean angular error was 3.66 ± 3.37 degrees. The correlation coefficients (coronal: 0.285; apical: 0.308) indicated a significant linear correlation between the anterior and posterior implant placement positions (P < 0.05)., Conclusion: A partially guided system with in-office guide fabrication using a 3D desktop printer is a useful option for implant placement.

Blow-in fracture of the zygomaticomaxillary complex that was displaced into the orbital cavity could be associated with ophthalmologic injuries, ranging from visual acuity to ocular motility limitation. Appropriate reduction and realignment of the fractured bone is necessary as early as possible for recovery of function and esthetics. However, limitation of accessibility and visibility makes it difficult for delicate surgery and increases the risk of damage of adjacent anatomic structures, such as optic nerve and extraocular muscles. In this report, the removal of fractured fragment was carried out in 2 patients showing limitation of gaze via orbital rim approach to avoid aggressive surgery and reduce the possibility of injury of vital structures. The postoperative process was uneventful and there were no complications associated with removal of displaced lateral wall. In conclusion, the authors propose that the removal of the fragment that was medially displaced lateral wall of the orbit is a simple and safe method as an alternative treatment in a difficult situation of reduction surgery.

The dental occlusion is the important reference for replacement of the temporomandibular joint. If a patient does not have normal occlusion, few considerations are needed for temporomandibular joint replacement. The custom-made prosthesis, typically fabricated with a stereolithographic model, is probably the optimized solution currently available. However the ready-made stock from Biomet Microfixation System (Jacksonville, FL) is the only available product, which is authorized by the government ministry in South Korea, for replacement of the temporomandibular joint. This report presents a patient with the problems that were retrognathic "bird face" profile subsequent to severe bilateral condylar resorption and temporomandibular joint ankylosis without enough natural teeth for occlusion. Bilateral temporomandibular joint replacement using the ready-made prosthesis was done by reestablishing the mandibular position with new occlusion and improved facial profile via the virtual surgical planning and stereolithographic model simulation.