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Surgical success includes a planned incision, achieving haemostasis, good mechanical closure and optimal maintenance of the surgical wound. New materials, as tissue adhesives, have been suggested as substitutes for sutures, to overcome their disadvantages. This study aimed at gathering the differences of using surgical adhesives in oral surgery compared with the conventional method of using sutures as a wound closure technique. PRISMA analyses, PICO criteria and PubMed/Medline database, EBSCO and Cochrane Library were used for research. Inclusion criteria included prospective, randomized controlled trials and case–control studies published in English with full access, where clinical advantages and demerits/limitations were reported in patients who underwent oral surgical incisions, without time restrictions. Exclusion criteria comprised literature with lower level of evidence. A total of 15 studies were assessed and analysed 15 parameters as alternatives to sutures (100%), cost‐effectiveness (6,6%), postoperative pain (53,3%), time consumption (73,3%), haemostasis (46,6%), homeostasis (13,3%), aids healing (26,6%), tissue inflammation (26,6%), safety (6,6%), graft dimension (3,13), biocompatibility (13,3%), adhesion to tissue (6,6%), bacteriostatic effect (20%), oedema (13,3%) and ease of application (26,6). Selected articles' results indicate that surgical glues can be a suitable alternative and/or adjuvant to oral sutures, presenting numerous advantages. [ABSTRACT FROM AUTHOR]

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development. [ABSTRACT FROM AUTHOR]

Background: Numerous studies in the literature have aimed to evaluate the difficulty level of removing third molars. However, most of these studies have focused on the lower third molars, which can lead to complications. There is a lack of a method to determine the complexity of upper third molar extraction. Therefore, this study's objective was to develop an equation using multiple linear regression to estimate the extraction time of an upper third molar based on its complexity. Methods: This study involved patients enrolled in the Master of Oral Surgery program at the University of Seville. To determine their relationship with surgical time, the researchers analyzed various factors, such as depth, root morphology, and the need for odontosection. They then validated their findings by studying patients treated at Palmaplanas Hospital in Mallorca. Results: The cohort analysis from the University of Seville revealed significant associations between surgical time and the identified factors. A regression equation design was performed to predict the total duration of surgical intervention for wisdom teeth extraction. This equation incorporates several independent variables, represented by Xi, together with a constant term, C, and the corresponding coefficients, Bi, which weight the impact of each variable on the intervention time. The results are as follows: −0.312 (spatial relationship), 0.651 (depth), −0.443 (bone and mucosa integrity), 0.214 (roots), −0.745 (ostectomy), 0.713 (odontosection), and −0.426 (suture). Upon application of the statistical methodology to the Palmaplanas Hospital cohort, a regression coefficient of 0.770 was determined. This indicates a strong correlation between the input data and the estimated surgical time. Conclusions: In conclusion, the proposed formula demonstrates notable validity in predicting the surgical time required to extract upper third molars. [ABSTRACT FROM AUTHOR]

Background: Intraosseous myofibroma of the jaw is a rare neoplasm of mesenchymal origin with limited comprehensive understanding. It typically affects patients in the first two decades of life with a male predilection. Case presentation: This study presents a rare case of myofibroma mimicking an odontogenic lesion in a 2-year-old boy. The patient presented with an incidental finding of a painless swelling of the right mandibular ramus of unknown etiology. Imaging analysis revealed a solid, expansile lesion adjacent to the germinal zone of the right mandibular first molar. Histopathologic analysis and immunohistochemistry after incisional biopsy suggested a possible central odontogenic fibroma, and the patient underwent total enucleation, leading to the final diagnosis of intraosseous myofibroma. Follow-up examinations showed no evidence of recurrence. Conclusions: This report contributes to the understanding of myofibroma in pediatric patients and underscores the critical role of meticulous histopathologic examination for effective surgical planning and optimal patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose. The aim of this study was to develop a competency framework based on entrustable professional activities (EPAs) in oral cancer management by postgraduate trainees in oral and maxillofacial surgery through expert consensus. Materials and Methods. The study design was based on a modified Delphi technique and involved iterative online surveys with two rounds of data collection and analysis. Initial development of the questionnaire identified five EPAs based on 42 competencies along with supervision level and assessment strategies. The first Delphi round involved administration of the survey questionnaire online to maxillofacial surgeons meeting the inclusion criteria for experts. Consensus was achieved on five EPAs and 36 competencies (≥80% response rate). Six competencies were rephrased and sent again in the Round 2 questionnaire to achieve a consensus. Results. A total of 45 experts participated in Round 1 followed by input from 27 experts in Round 2 of the Delphi panel. Following two iterative rounds of online surveys and feedback, expert consensus was achieved to develop an EPA framework in five EPA domains focused on the management of oral cancer by postgraduate trainees in maxillofacial surgery including 38 specific competencies, supervision level, and assessment strategies. High content validity of the study was established through a comprehensive literature search, and expert feedback was evidenced by an excellent response rate (93.34%, and 64.28%) and a stringent criteria of response agreement amongst experts (≥80%). Conclusion. In conclusion, this study employed expert consensus to identify five EPAs with 38 competencies along with the required supervision level of postgraduate maxillofacial trainees for the management of oral cancer. This EPA framework provides a roadmap for training supervisors to map the learning outcomes in oral oncology for postgraduate trainees in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Background: The Surgical Tool for Auditing Records scoring system [STAR] focuses on surgical record auditing with promising outcomes. It offers a structured approach to evaluating the quality of surgical notes. Aims and objectives: This study aimed to assess the effectiveness of the STAR in evaluating oral surgical records and identifying areas for improvement in documentation practices. Materials and methods: The data was obtained from the Dental Information Archival Software (DIAS) of our institution. The sample size was determined using G*Power 3.1.9.4 software. Fifty consecutive oral surgery clinical records of oral squamous cell carcinoma patients were evaluated using STAR. Each record was reviewed for adherence to documentation standards including Initial Assessment (10 points), Follow-up Entries (8 points), Consent Documentation (7 points), Anesthesia Report (7 points), Surgical Log (9 points), and Discharge Synopsis (9 points). compiling a total STAR score (50 points). The data was tabulated in Google Sheets. The descriptive statistics with inter-observer agreement and the mean score were recorded. Results: We observed that each of the 50 records received a score of 49/50 points on the STAR. Deductions were necessary in the Operative record section due to the lack of information regarding the sutures used. Conclusion: To summarize, this study emphasizes the effectiveness of the STAR scoring system in evaluating the quality of oral surgical records. Identifying deficiencies, particularly in documenting operative details, can improve the completeness and accuracy of patient records. It can ultimately enhance patient care and facilitate better communication among healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block. Methods: Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic. Results: The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P < 0.001) and reduced NSAIDs use (12 patients needed analgesic in experimental vs. 17 patients in control group, P = 0.038). The application of experimental block was less painful (VAS = 2) than the application of intraoral inferior alveolar nerve block (VAS = 4, P = 0.011). In 8/18 patients in the experimental group US-guided extraoral mandibular nerve block solely achieved adequate surgical anesthesia. Conclusion: US-guided extraoral mandibular nerve block prolonged pain-free period and reduced the use of NSAIDs after lower third molar alveolectomy, thus proving to be successful analgesia method for this dental surgery. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT06009302, identification number: NCT06009302, date of registration: 18/08/2023. [ABSTRACT FROM AUTHOR]

Background: Venous malformations are congenital developmental abnormalities that consist of enlarged dysplastic blood vessels. The tongue is a common site of venous malformations in the head and neck region. The aim of the present study was to evaluate the therapeutic effect of using electrochemical therapy (ECT) combined with local injection of pingyangmycin (PYM) for venous malformations in the tongue. Methods: 60 patients (20 male and 40 female; age range, 8 to 68 yr) with venous malformations in the tongue were treated with a combination of ECT and PYM injection or with local injection of PYM alone in the department of oral and maxillofacial surgery of the stomatological hospital of China Medical University from January 2013 through June 2019. Among them, 30 patients (group A) were treated with ECT combined with PYM injection for tongue venous malformations and 30 patients (group B) were treated with local injection of PYM alone for tongue venous malformations. The size of the lesions in the two groups varied from 3.5 x 3 x 3 to 8 x 6 x 5 cm. There was no statistical difference in the volume of the lesions between group A and group B (p > 0.05). There was no statistical difference in the age between the two groups (p > 0.05). A repeated treatment of ECT combined with PYM injection or PYM injection alone was administered for venous malformations of tongue in the group A and group B. According to the size of the lesions, the amount of ECT was 5--10 C/cm² . The injection dose of PYM was 3 - 5 mL and the injection concentration of PYM was 1.6 mg/mL for adults and 1.0 mg/mL for children. Glucocorticoids were given to prevent postoperative swelling. The therapeutic interval was 3 months for ECT combined with PYM injection and 2 to 4 weeks for PYM injection alone. Hemisphere measurements were used to measure the size of the lesions. 4-scale score and feedback from the patients were used to evaluate the clinical efficacy. Results: During the follow-up period from 6 months to 3 years, 60 patients achieved different degree of improvement, with a total effective rate of 85%. 30 patients in the group A received ECT combined with local injection of PYM, with an effective rate of 97%. 30 patients in the group B received local injection of PYM alone, with an effective rate of 73%. The effectiveness of ECT combined with PYM injection in the group A was significantly higher than that of PYM injection alone in the group B (p < 0.05). Postoperative symptoms such as local pain, swelling and fever often occurred in the patients, and the symptoms generally disappeared after 5 to 7 days. No mucosa necrosis or nerve damage was found. Postoperative subjective sensation and function of the tongue were normal. Conclusion: Electrochemical therapy combined with local injection of pingyangmycin was a reliable, safe and minimally invasive method for the treatment of venous malformation in the tongue. The treatment modality has fewer complications and is worth of further promotion in clinic. [ABSTRACT FROM AUTHOR]

Objective: The goal of this systematic review was to identify the mechanisms associated with the enzymatic degradation of collagen and gelatin biomaterials and the possible associated flaws. Methods: Four databases (PubMed, B-On, Cochrane Library, and ResearchGate) were used for the bibliographic search of articles. The research question was formulated using the PCC method, (P): collagen or gelatin sponges, hydrogels, and scaffolds; concept (C): enzymatic degradation of collagen or gelatin sponges, hydrogels, and scaffolds; and context (C): effect of enzymatic action on degradation time of collagen or gelatin sponges, hydrogels, and scaffolds. The search was contextualized according to PRISMA recommendations. The identification and exclusion of evidence followed the PRISMA criteria, with specific inclusion and exclusion factors being stipulated for the selection of articles. The risk of bias assessment was performed using the QUIN Scale. Results: The initial search was composed of 13,830 articles after removing duplicates; 56 articles followed for the full-text reading; 45 were excluded; then, 11 articles were obtained, constituting the results of this systematic review. All studies evaluated the materials using gravimetric analysis, and collagenases were the proteases used for the degradation solution. The materials tested were as follows: human-like collagen (HLC) hydrogel with microbial transglutaminase (MTGase), gelatin sponges subjected to different types of crosslinking, and collagen scaffolds with different types of crosslinking. The period of analysis varied between 0.25 h and 35 days. It was possible to highlight the lack of uniformity in the protocols used, which varied largely, thus influencing the degradation times. The risk of bias was low in nine studies and medium in two studies. Conclusions: This systematic review identified a gap in the literature, highlighting the absence of in vitro studies using human saliva and a collagenase concentration close to the physiological levels to simulate oral dynamics. However, based on existing literature, the mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials were comprehensively understood, answering the first research question postulated. In response to the second research question, the main shortcomings identified in the laboratory evaluation of mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials included the lack of standardization in degradation test protocols; this limited inter-study comparisons, which increased heterogeneity. Additionally, variations in collagenase concentrations and types influenced collagen degradation rates, and inappropriate evaluation intervals hindered the identification of total degradation time. [ABSTRACT FROM AUTHOR]

Necrotizing fasciitis (NF) is a life-threatening soft-tissue infection affecting the deep fascia and subcutaneous tissue. It is characterized by a fulminant course and high mortality rates. NF of the head and neck is very rare, with most cases being odontogenic in origin. The purpose of this study is to comprehensively review the most important features of cervical necrotizing fasciitis (CNF) in adults and add our experience in the management of this entity. The most common isolated organisms are Streptococcus spp. and Staphylococcus spp. If the infection progresses to descending mediastinitis, the prognosis becomes very poor. Since the initial clinical features can be similar to those of a non-necrotizing deep cervical infection, a high degree of suspicion is critical for an early diagnosis. A computed tomography scan is essential for the diagnosis and to define the extent of the infection/rule out descending mediastinitis. Early and aggressive surgical debridement of all compromised tissue and antibiotic therapy and fluid resuscitation are essential and should not wait for bacterial culture results. Despite prompt and adequate treatment, the mortality of CNF can be as high as 35%. [ABSTRACT FROM AUTHOR]

A healthy man in his 40s was referred to the Oral Surgery and Implantology Unit of Geneva University Hospital for diagnosis and management of facial swelling affecting the right side of his lower jaw. The patient's history revealed that the patient had been hit by several punches to the face a few months earlier. To investigate the swelling, an intra-oral radiograph, an orthopantomographic radiograph, and computed tomography were performed, which revealed no fracture of the lower jaw but the presence of a partly impacted fractured wisdom tooth (third molar). This finding, together with the clinical status, indicated cellulitis most likely related to the presence of a fractured wisdom tooth. The decision was made to proceed with tooth extraction, and follow-up at 3 weeks showed good healing and complete resolution of facial swelling. This case highlights that odontogenic infection can also occur as a result of necrosis following the fracture of an impacted wisdom tooth. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the outcomes of combined Ear, Nose, and Throat (ENT) and oral surgical interventions in managing moderate to severe Obstructive Sleep Apnea (OSA) in patients intolerant or unresponsive to Continuous Positive Airway Pressure (CPAP) therapy. Methods: This prospective cohort study involved 60 patients with moderate to severe OSA who underwent combined ENT and oral surgical procedures. Preoperative assessments included polysomnography and cephalometric analysis. Surgeries were tailored to individual anatomical abnormalities and included Uvulopalatopharyngoplasty (UPPP), Genioglossus Advancement (GA), Maxillomandibular Advancement (MMA), and nasal surgeries. Outcomes were measured by changes in the Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), quality of life (QoL), and postoperative complications. Results: The mean AHI decreased from 38.2 to 16.5 events per hour (p < 0.001). ESS scores improved from 16.3 to 8.1 (p < 0.001), and QoL scores increased from 48.5 to 65.4 (p < 0.001). The surgical success rate was 75%, with a complication rate of 28.3%. Conclusion: Combined ENT and oral surgical interventions effectively reduce OSA severity and improve patient outcomes in those intolerant to CPAP, offering a viable alternative with an acceptable safety profile. [ABSTRACT FROM AUTHOR]

Objective: While connective tissue graft shrinkage is a well‐documented post‐transplantation reaction, there is a literature gap concerning hyperplastic tissue response. Despite its infrequent occurrence, investigation is warranted due to its capacity to compromise esthetics, disrupt lip dynamics, and promote food retention. Moreover, efforts to mitigate hyperplastic tissue response often prove challenging, and there is a potential risk of exacerbating gingival tissue rebound. Clinical Considerations: This report presents a potential solution to managing tissue overgrowth after connective tissue grafting in five clinical cases. The patients underwent corrective surgery involving internal excision of excessive tissue while preserving the overlying mucosa. The surgical approach was tailored to excise hyperplastic tissue with minimal trauma, aiming to optimize esthetic outcomes. Subsequent follow‐up assessments spanning 1–5 years demonstrated stable results, with no indications of relapse or recurrence of tissue overgrowth. Conclusions: Within the limitations of this case series, surgical internal excision holds promise as a viable treatment modality for addressing post‐transplantation hyperplastic tissue response. Clinical Significance: This case series addresses the challenge of uncontrolled tissue overgrowth following connective tissue grafting, a concern for which previous attempts have proven unsuccessful. Internal in‐toto excision emerges as a promising approach for effectively eliminating overgrown tissue, offering potential advancements in the clinical management of this complication. [ABSTRACT FROM AUTHOR]

Introduction Information from published studies describing dental treatment of nonmilitary personnel in a military theater of operations is sparse. The primary objective of this study is to determine the number of dental emergencies (DEs) and the types of dental treatment rendered on non-U.S. military (civilian) personnel treated by Navy dentists in 2007-2008 in Iraq and 2009 in Afghanistan. The second objective is to compare the type of DE treatment procedures provided to civilian personnel to the type of DE treatment procedures performed on U.S. military personnel. Materials and Methods Navy Dental Officers documented the diagnoses of unscheduled DEs. All treatment provided was described at the time of treatment using the Current Dental Terminology codes of the American Dental Association. Current Dental Terminology Code A0145 (2007 and earlier) and A0199 (2008 onward) in the patient encounter indicated a DE. This study is limited to DE occurring in (1) patient categories: U.S. civilian employees, other beneficiaries of the U.S. Government, foreign national civilian/dependents, and civilian, no government connection and (2) U.S. military service members. Chi-square analysis was performed to compare the proportion of dental treatment category procedures on civilian patients compared to those on U.S. military patients. Results During the reporting period, 308 patients were treated for DE in Afghanistan. Civilians treated accounted for 18.5% (n  = 57) of all DEs. Nearly 93.0% of civilians who were treated were U.S. (DoD) civilian employees. Of the 57 civilian patients treated for DE, 61.4% of patients (n  = 35) received oral surgery. There were 251 U.S. military patient encounters (81.5% of all DEs). Restorative dentistry was the most common dental procedure for military personnel DE. When comparing civilian and military patients, civilian patients are statistically more likely than military patients to receive oral surgery treatment for DE (P  < .00001). In Iraq, 3,198 patients were treated for DE during the reporting period. Civilians treated accounted for 18.8% (n  = 601) of all DEs. About 56.9% (n  = 342) of civilians who were treated were U.S. contract employees. Of the 601 civilian patients treated for DE, 37.1% (n  = 223) received oral surgery. There were 2,597 U.S. military patient DE encounters, and restorative dentistry was the most common dental procedure. When comparing civilian and U.S. military patients in Iraq, civilians are statistically less likely to have their DE treated by restorative dentistry (P  < .00001) and are more likely have it treated by oral surgery/extractions (P  < .00001). It is significantly more likely for civilians to have multiple categories of DE that must be treated (P < .00001). Conclusions The primary group of civilians treated for DE in Afghanistan was U.S. civilian employees. The primary group of civilians treated for DE in Iraq were contract employees of the U.S. Government. The primary dental treatment of civilian beneficiaries in both the theaters of operation was oral surgery. This brings into question what dental fitness standards are there for primarily U.S. civilian and contract employees. [ABSTRACT FROM AUTHOR]

Summary: Background: It is not certain whether the blade geometry of videolaryngoscopes, either a hyperangulated or Macintosh shape, affects glottic view, success rate and/or tracheal intubation time in patients with expected difficult airways. We hypothesised that using a hyperangulated videolaryngoscope blade would visualise a higher percentage of glottic opening compared with a Macintosh videolaryngoscope blade in patients with expected difficult airways. Methods: We conducted an open‐label, patient‐blinded, randomised controlled trial in adult patients scheduled to undergo elective ear, nose and throat or oral and maxillofacial surgery, who were anticipated to have a difficult airway. All airway operators were consultant anaesthetists. Patients were allocated randomly to tracheal intubation with either hyperangulated (C‐MAC D‐BLADE™) or Macintosh videolaryngoscope blades (C‐MAC™). The primary outcome was the percentage of glottic opening. First attempt success was designated a key secondary outcome. Results: We assessed 2540 adults scheduled for elective head and neck surgery for eligibility and included 182 patients with expected difficult airways undergoing orotracheal intubation. The percentage of glottic opening visualised, expressed as median (IQR [range]), was 89 (69–99 [0–100])% with hyperangulated videolaryngoscope blades and 54 (9–90 [0–100])% with Macintosh videolaryngoscope blades (p < 0.001). First‐line hyperangulated videolaryngoscopy failed in one patient and Macintosh videolaryngoscopy in 12 patients (13%, p = 0.002). First attempt success rate was 97% with hyperangulated videolaryngoscope blades and 67% with Macintosh videolaryngoscope blades (p < 0.001). Conclusions: Glottic view and first attempt success rate were superior with hyperangulated videolaryngoscope blades compared with Macintosh videolaryngoscope blades when used by experienced anaesthetists in patients with difficult airways. [ABSTRACT FROM AUTHOR]

Over the past decade, orthodontics has advanced markedly with digital methods, cutting-edge biomechanics, and 3-dimensional diagnostics. However, the rapid adoption of these innovations without rigorous evaluation of their evidential support has led to new unsubstantiated orthodontic-surgical indications. This article explores emerging orthodontic practices, focusing on the interpretation of orthodontic principles and the reliance on imaging-based diagnoses. Strict adherence to mechanistic orthodontic principles and reliance on imaging findings can result in overzealous treatment protocols. It also emphasizes the state of knowledge regarding temporomandibular disorders (TMDs) and the lack of consensus and evidence-based guidelines. There is an urgent need for the profession to integrate TMD knowledge, adopt evidence-based practices, and critically evaluate new methods before implementation. Orthodontists should move away from outdated mechanistic beliefs and integrate clinical knowledge from TMD research into their practices. Increased awareness and potential legal repercussions may drive a necessary reevaluation and stronger adherence to evidence-based methods. [ABSTRACT FROM AUTHOR]

Introduction: This study analyzed oncologic patient management from initial tumor diagnosis to tumor follow-up in oral and maxillofacial surgery (OMFS) in Germany. Material and methods: A dynamic online questionnaire with a total of 44 questions was used to generate general and specific data regarding oncologic patient management with head and neck malignancies, supportive care, and (pre-) rehabilitation from initial tumor diagnosis to tumor follow-up and head and neck cancer center (HNCC) structures in OMFS in Germany. The questionnaire was sent to 81 OMFS departments affiliated with the German-Austrian-Swiss Working Group for Tumors of the Jaw and Facial Region (DÖSAK) and the German Association of Oral and Maxillofacial Surgery (DGMKG). Data analysis was conducted descriptively. Results: Forty-eight OMFS departments participated (response rate 59.26%), of which 36/48 (75%) were certified HNCC. 28/34 (82.4%) reported subjective improvements in oncologic care, most often interdisciplinary collaboration (21/33, 63.64%) and clinic structure changes (21/34, 61.76%). Nearly all OMFS departments present patients in multidisciplinary tumor boards (45/46, 97.83%) and aim for osseous reconstruction post-tumor resection (43/44, 97.73%). Significant discrepancies regarding the frequency of masticatory-functional dental rehabilitation following osseous reconstruction were observed. Before oncologic therapy, patients are offered various supportive services, mostly psychotherapy and psycho-oncological support (24/26, 92.31%). Post-therapy, speech therapy (43/43, 100%), physiotherapy (40/43, 93.02%), lymphatic drainage, and follow-up rehabilitation (39/43, 90.7%, respectively) are most often offered. 17/43 (39.53%) have oncological nursing staff. 36/40 (90%) manage patients and side effects during adjuvant therapy, while 5/41 (12.2%) provide proprietary palliative care. 36/41 (87.8%) offer counseling to patients and families. Conclusion: Oncologic patient care in OMFS is highly standardized and potentially attributable to many certified HNCCs in Germany. Certain treatment aspects are handled differently, possibly due to institution-specific reasons. Clinical relevance: The high homogeneity in treatment protocols reflects the widespread high and comparable treatment quality of head and neck malignancies in OMFS in Germany. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the radiographic outcomes of lateral sinus floor elevation with simultaneous implant placement at sites without sinus membrane perforation (SMP) and sites with SMP managed with a resorbable membrane. Materials and Methods: One hundred and thirty‐nine patients and 170 implants (56 perforation, 114 non‐perforation) were included. Cone‐beam computed tomography (CBCT) images were taken before surgery (T0), immediately after surgery (T1) and 6 months after surgery (T2). Post‐operative augmentation parameters, including endo‐sinus bone gain (ESBG) along the implant axis, mean new bone height (NBH) surrounding the implant and augmentation volume (AV), were measured at T1 and T2. Results: At T1, there were no significant differences in ESBG, NBH and AV between the two groups. At T2, although ESBG did not significantly differ between the two groups, NBH (8.50 ± 1.99 mm vs. 9.99 ± 2.52 mm, p =.039) and AV (519.37 ± 258.38 mm3 vs. 700.99 ± 346.53 mm3, p <.001) were significantly lower in the perforation group. The shrinkage of graft material from T1 to T2, including ΔESBG (p =.002), ΔNBH (p <.001) and ΔAV (p <.001), was higher in the perforation group. Conclusions: SMP during LSFE with simultaneous implant placement is associated with greater resorption of the grafted area at a 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

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Hyperbaric oxygen therapy (HBOT) is utilized as an adjunctive treatment for human and veterinary patients with compromised tissues. Medical records from two veterinary hospitals with HBOT chambers were searched for small animal veterinary dentistry and oral surgery specialty patients. The HBOT records were combined with the medical records from the referring specialty veterinary dentistry and oral surgery services. Clinical indications for HBOT treatments associated with a positive outcome in this case series included resistant bacterial infections, electrical cord injury, bite wound injuries, osteomyelitis, crush/traumatic injuries including mandibular fractures, oral surgery performed at previously irradiated sites, and osteonecrosis, presumably radiation induced. Conditions within this case series that remained unchanged or were associated with partial improvement included preoperative treatment of stomatitis without steroid usage and delayed HBOT treatment for long-term endodontic health of laterally luxated immature permanent mandibular incisors. Eighty-eight percent of the HBOT sessions were tolerated well by the patients in this case series. The most common adverse event was mild anxiety. One patient required oral anxiolytic medications to complete the course of treatment. One patient experienced transient seizure activity and was able to complete that session as well as subsequent sessions at a lower chamber pressure. Future prospective studies are necessary to further evaluate and characterize the potential benefits of HBOT as well as to clarify optimal treatment protocols for specific conditions in veterinary dentistry and oral surgery. [ABSTRACT FROM AUTHOR]

This paper describes the orthodontic treatment of two cases that were successful in winning the William Houston Gold Medal at the Membership in Orthodontics Examinations of the Royal College of Surgeons of Edinburgh in 2022. Both cases discuss the management of palatally impacted maxillary canines and treatment was initiated during the emerging COVID-19 crisis and completed over a 27-month period. The first case describes the management of a 15-year-old female with a Class II division 1 incisor relationship complicated by a palatally impacted upper left canine, moderate upper and lower arch crowding, and a lower centreline discrepancy with an associated right lateral displacement on closure. Treatment involved open surgical exposure of the impacted canine, a quad helix appliance, premolar extractions, and upper and lower fixed appliances. The second case describes the management of a 14-year-old female with a Class III incisor relationship complicated by bilaterally impacted maxillary canines, impeded eruption of the lower right second molar, moderate lower and severe upper arch crowding, and an upper centreline discrepancy. These case reports aim to demonstrate the high standards of care achieved by Orthodontic Specialty Trainee Registrars in the UK and provide aspirational standards for future trainees. [ABSTRACT FROM AUTHOR]

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a fixed mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to analyze a series of patients who underwent full-arch rehabilitation of the atrophic maxilla using additively manufactured subperiosteal implants, between August 2018 and January 2023, at the Universities of Sassari and Poznan. In total, 36 patients and 72 implants were included, with no implants lost during follow-up, and a success rate of 90.3%. Seven (9.7%) of the implants showed class 1 exposure. Bleeding on probing was detected in 10.4% of the abutments at 6 months, 7.9% at 1 year, 10% at 2 years, 7% at 3 years, and 11.4% at 4 years. No significant bone resorption under the abutments was detected during the whole observation period. Based on the findings from this study, additively manufactured subperiosteal implants could represent a safe and reliable technique for full-arch rehabilitation in patients with severe maxillary atrophy. [ABSTRACT FROM AUTHOR]

Salivary collection (SC) following surgery for oral cancer represents an underreported and unrecognized complication. Our study aimed to evaluate the efficacy of parotideomasseteric fascia flap (PFF) in preventing postoperative SC, comparing its effectiveness with other conventional methods. Between November 2019 and January 2023, 221 patients diagnosed with oral squamous cell carcinoma (OSCC) undergoing wide tumor ablation and neck dissection at Xiangya Hospital were included in the study. Patients were randomly allocated into four groups based on different intraoperative techniques to assess the preventive efficacy of PFF against SC. The incidence of SC in the PFF group was only 5.9%, which was significantly lower than the other three groups (p < 0.05). Among the 221 patients, the highest SC incidence occurred in buccal cancer cases (19.6%). However, in the PFF group, the incidence was not significantly different (9.5%; p > 0.05). Univariate analysis revealed a higher SC incidence associated with advanced clinical T stage (p = 0.02), N(+) stage (p = 0.01), low average serum albumin (SA) level (p = 0.00), and a large parotid wound (p = 0.00). In multivariate analysis, only average SA (p = 0.01; odds ratio [OR] 4.104; 95% CI 0.921–11.746) emerged as the most prevalent factor predisposing to SC. The utilization of PFF demonstrated a notable reduction in the incidence of postoperative SC, establishing it as a safe, effective, and convenient method for patients undergoing radical ablation for OSCC. • Salivary collection following surgery for oral cancer represents an underreported and unrecognized complication. • Several postoperative interventions have been proposed; however, consensus is lacking for substantial parotid wounds. • Parotideomasseteric fascia flap can reduce the incidence of SC, which is a secure, efficient, and convenient approach. • Monitoring the average SA levels post-surgery emerges as a promising indicator for assessing the postoperative SC. [ABSTRACT FROM AUTHOR]

Purpose: Surgical robots effectively improve the accuracy and safety of surgical procedures. Current optical-navigated oral surgical robots are typically developed based on binocular vision positioning systems, which are susceptible to factors including obscured visibility, limited workplace, and ambient light interference. Hence, the purpose of this study was to develop a lightweight robotic platform based on monocular vision for oral surgery that enhances the precision and efficiency of surgical procedures. Methods: A monocular optical positioning system (MOPS) was applied to oral surgical robots, and a semi-autonomous robotic platform was developed utilizing monocular vision. A series of vitro experiments were designed to simulate dental implant procedures to evaluate the performance of optical positioning systems and assess the robotic system accuracy. The singular configuration detection and avoidance test, the collision detection and processing test, and the drilling test under slight movement were conducted to validate the safety of the robotic system. Results: The position error and rotation error of MOPS were 0.0906 ± 0.0762 mm and 0.0158 ± 0.0069 degrees, respectively. The attitude angle of robotic arms calculated by the forward and inverse solutions was accurate. Additionally, the robot's surgical calibration point exhibited an average error of 0.42 mm, with a maximum error of 0.57 mm. Meanwhile, the robot system was capable of effectively avoiding singularities and demonstrating robust safety measures in the presence of minor patient movements and collisions during vitro experiment procedures. Conclusion: The results of this in vitro study demonstrate that the accuracy of MOPS meets clinical requirements, making it a promising alternative in the field of oral surgical robots. Further studies will be planned to make the monocular vision oral robot suitable for clinical application. [ABSTRACT FROM AUTHOR]

Adolescents and young adults' active lifestyles make dental trauma a significant medical concern. Aim: This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence. Results: Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241). Conclusions: Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups. [ABSTRACT FROM AUTHOR]

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The article titled "HOW TO AVOID FAILURES IN CORTICO BASAL IMPLANTOLOGY: PART-1" by Dr. Muhammad Shafie discusses the importance of understanding and properly executing corticobasal implantology. The author emphasizes that while this technology offers faster and hassle-free restoration of lost teeth, it requires a good understanding and patience for successful results. The article provides guidance on topics such as basal bone, stabilization of implants, and implant design. It also suggests various methods for stabilizing implants at the abutment level. Overall, the article aims to help clinicians avoid failures in corticobasal implantology by providing essential knowledge and sequencing for successful outcomes. [Extracted from the article]

Purpose: This study aims to conduct a thorough analysis, both quantitative and qualitative, of bibliometric parameters related to preemptive analgesia (PA) in oral surgical procedures (OSP). Methods: Research trends on PA in OSP using ibuprofen were reviewed through bibliometric analysis of 68 journal articles published from 1991 to 2022 in the Web of Science database. Bibliometric indicators were applied to analyze the journal article data, including the annual distribution of publications and literature growth, document types, citation indicators to measure qualitative research performance, and keyword mapping to identify research trends. The results were imported into RStudio, and the Bibliometrix package was used to prepare and analyze the metadata. Results: The 68 included articles received a total of 900 citations, ranging from 1 source to 72 citations with some fluctuations. The papers on PA in OSP using ibuprofen had an average of 16.85 citations per paper. These publications were originated from 25 countries, with the highest contributions from Brazil (n = 17), the USA (n = 13), and Turkey (n = 8). The top five major contributing journals were the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, Journal of Cranio-Maxillo-Facial Surgery, Journal of Periodontology, and Acta Odontologica Scandinavica, representing more than half of all selected papers. Conclusion: Papers focused on PA in OSP received numerous citations. The citation per article correlated with the number of publications at the affiliation, author, country, and journal levels. However, there is still a scarcity of studies in this field. [ABSTRACT FROM AUTHOR]

Purpose: To explore the ability of Dental Students (DS), Medical Students (MS), Trainee Interns (TI) and Pre-vocational Junior Doctors (JD) in identifying procedures performed by Oral and Maxillofacial Surgery (OMS), the scope of practice (SOP) of OMS and ability to differentiate OMS from similar specialities. Methods: The study included 282 complete responses to a survey consisting of: 9 demographic questions, 11 OMS awareness, professional ambition, teaching and exposure, confidence in identifying and referring questions and 70 procedural/scenario questions across four domains. Collected data was qualitatively and statistically analysed using SPSS V29. Results: OMS awareness was limited. 92.2% reported None to Small amount of OMS teaching and exposure during university, with 66.0% preferring to have had a Fair to Significant amount. DS experienced more than medical respondents (2.1 vs. 1.5, p < 0.001). Most respondents reported No to Low confidence in identifying the SOP and procedures performed by OMS (67.7%) and referring to OMS (62.4%) compared to similar specialities (32.4% and 33.2%, respectively). 52.9% of procedures performed by OMS were correctly identified as being performed by OMS. The ability to identify the OMS SOP (8.7%) and differentiate OMS from similar specialities (5.0%) was low, however better among DS than medical respondents (14.9% vs. 6.3%, p = 0.002 and 12.2% vs. 2.2%, p < 0.001). Conclusion: The study has highlighted a deficit in the understanding of OMS with potential implications in the public and private healthcare sector. Identification of procedures, OMS SOP and ability to differentiate OMS from similar specialities is limited however slightly better among DS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to (a) record and evaluate the epidemiological data relevant to the fractures of the atrophic mandible in the Greek population (b) present our experience in the management of these difficult injuries and (c) compare our results to the outcomes of other similar studies and discuss the postoperative complications. Methods: A prospective analysis of all the edentulous patients with fractures of the atrophic mandible treated at the Oral and Maxillofacial Surgery Department of K.A.T General Hospital of Athens in Greece was performed from November 2012 to December 2022. Age, gender and medical history of the patient, etiology and site of the fracture, classification of atrophy, type of surgical approach, type of osteosynthesis and postoperative complication. Results: 34 patients were included in the present study and 48 fractures of the atrophic edentulous mandible were managed surgically. 22 fractures were classified as class II of atrophy, 21 fractures as class III and 5 injuries as class I. In 32 patients we used an extraoral approach and only 2 patients were treated with an intraoral access. 44 fractures were treated with a 2.0 mm locking reconstruction plate and only 4 injuries of class I atrophy were treated with mini plates. Conclusions: Clinical practice has confirmed that for these cases an extraoral approach followed by stable fixation with a 2.0 mm reconstruction locking plate can deliver excellent results. Our findings show that the routine use of primary bone grafts is not necessary and can be reserved for more complex cases. [ABSTRACT FROM AUTHOR]

Mesiodens, which emerge towards the nasal cavity, often require consultation in maxillofacial practice. Typically accessed through wide palatal flaps with ostectomy, this method involves limited visibility and poses the risk of damaging the roots and apex of adjacent dental structures. This study advocates a minimally invasive technique that involves vestibulotomy between the central incisors, facilitating direct and rapid access through nasal floor dissection, minimizing comorbidities. A systematic review was performed, following the PRISMA guidelines, apropos on ten clinical cases reported in this study. The MEDLINE/Pubmed and Web of Science databases were searched. Several variables were considered and are presented comprehensively in tables and figures. Additionally, 10 case reports with mesiodens in the maxilla were submitted to surgical treatment using a minimally invasive intraoral transnasal disinclusion. The initial literature search resulted in 37 articles, of which 9 met the inclusion criteria for the analysis. Regarding postoperative complications, no bone exposure, incisor root damage, extensive surgical approach, palatal or vestibular hematoma, or palatal necrosis was observed. However, 10% experienced superficial damage to the nasopalatine neurovascular, while 80% and 20% presented mild and moderate postoperative facial edema, respectively. Hypoesthesia in 20% of patients recovered in the first week, 40% in the first month and 40% at 3 months. The minimally invasive intraoral, transnasal, non-endoscopic approach emerges as a safe and predictable alternative to conventional surgical techniques. Presumes minimal postoperative complications, mitigating the risk of excessive bone removal and damage to adjacent structures. [ABSTRACT FROM AUTHOR]

Objective: The addition of a uvular flap (PFU) was hypothesized to improve outcomes over standard pharyngeal flap (PF) for correction of velopharyngeal dysfunction. We report differences in outcomes of PF vs PFU at our institution. Design: Retrospective cohort study. Setting: Tertiary children's hospital. Patients: Children who underwent PF or PFU with the three highest-volume surgeons at our institution in 2004-2017. Outcome measures: We examined differences in complications between groups, frequency and type of revision surgery, and speech-related measures including nasometry, pressure-flow testing (PFT) and perceptual speech analysis (PSA). Results: 160 patients were included, 41 PF and 119 PFU (including 18 with Hogan technique). Patients undergoing PFU were older (7.6 yr vs 6.0 yr; p = 0.037) and more likely to have cleft palate (63/119 vs 14/41; p = 0.047). There was no significant difference in complications. With PFU, a decrease in airspace contracting revision surgeries was noted, (4/119 vs 8/41; p = 0.002) which drove a reduction in revision surgery of all types (7/119 vs 13/41; p = 0.033). However, patients that did undergo revision surgery after PFU underwent more revision procedures (p = 0.032). PSA scores were found to be lower (less hypernasal) after PFU (p = 0.009) compared to PF. Objective speech measures had varying results, with nasometry demonstrating a significant difference between groups (p = 0.001), while PFT (p = 0.525) did not demonstrate a statistical difference. Conclusion: The use of a uvular lining flap in pharyngeal flap surgery may be associated with improved long term surgical outcomes, including both improvements in subjective and objective testing and a lower rate of revision surgery, without increased complications. [ABSTRACT FROM AUTHOR]

Abstract Orofacial clefts are among the most prevalent birth defects, with severe medical and psychosocial consequences. Cleft lip with or without cleft palate (CL ± P) and cleft palate only (CPO) affect on average nearly 1/700 births worldwide. The cause of most non-syndromic cases is unknown. Maternal factors and disorders are assumed to modify the risk of orofacial clefting. In the present study, we performed a systematic review and meta-analysis to analyze the effects of maternal underweight, obesity, hypertension, diabetes, as well as smoking, and alcohol consumption on the development of orofacial clefts. As CL ± CP and CPO have distinct pathogenetic backgrounds, these cleft subtypes were assessed separately. Altogether, 5,830 studies were identified and 64 of them met the inclusion and exclusion criteria. Obesity significantly elevated the odds of clefting (OR = 1.28, CI:1.08–1.51) (ORCL±CP = 1.23, CI:1.01–1.50; ORCPO = 1.31, CI:0.97–1.77). Maternal underweight also significantly increased the odds of clefting (OR = 1.21 CI:1.06–1.38). In mothers with type 1 diabetes, the odds of cleft development were significantly elevated (OR = 1,75, CI:1.45–2.12). Essential hypertension was also associated with higher odds of developing cleft (OR = 1.55, CI:1.18–2.03). Smoking during pregnancy significantly elevated the odds of cleft development (OR = 1.55, CI:1.34–1.79) (ORCL±CP = 1.58, CI:1.36–1.83; ORCPO = 1.50, CI:1.15–1.96). Passive smoking was even more damaging than active tobacco use, but alcohol consumption had no effect. In conclusion, this study clearly showed the importance of maintaining normal maternal body weight and emphasized the importance of hypertension and type 1 diabetes care in the first months of pregnancy. It also highlighted similarnegative effects of passive and active smoking, while alcohol consumption did not seem to be a significant risk factor for cleft development. However, there is a complete lack of available studies on the interactions of these factors, which is an essential direction for improving prevention.

Aim: Evaluation of the quality of dental information produced by the ChatGPT artificial intelligence language model within the context of oral surgery, preventive dentistry, and oral cancer. Methodology: This study adopted quantitative methods approach. The experts prepared 50 questions (including dimensions of, risk factors, preventive measures, diagnostic methods, and treatment options) that would be presented to ChatGPT, and its responses were rated for their accuracy, completeness, relevance, clarity or comprehensibility, and possible risks using a standardized rubric. To carry out the assessment of the responses by ChatGPT, a standardized scoring rubric was used. Evaluation process included feedback concerning the strengths, weaknesses, and potential areas of improvement in the responses provided by ChatGPT. Results: While achieving the highest score for preventive dentistry at 4.3/5 and being able to communicate the complex information coherently, the tool showed lower accuracy for oral surgery and oral cancer, scoring 3.9/5 and 3.6/5, respectively, with several gaps for post-operative instructions, personalized risk assessments, and specialized diagnostic methods. Potential risks, such as a lack of individualized advice, were shown in 53% of the oral cancer and in 40% of the oral surgery. While showing promise in some domains, ChatGPT had important limitations in specialized areas that require nuanced expertise. Conclusion: The findings point to the need for professional supervision while using AI-generated information and ongoing evaluation as capabilities evolve, for the assurance of responsible implementation in the best interest of patient care.

This study addresses the management of emergency oral surgery during pregnancy, with a special focus on the safety and effectiveness of interventions in this sensitive context. The analysis focuses on identifying best practices and protocols to ensure the protection of both maternal and fetal health. Pregnancy trimesters are examined in detail to determine the optimal times and risks associated with surgery. The judicious use of anesthetics and drugs is also discussed, emphasizing the importance of choosing safe ones for use during pregnancy. Particular attention is paid to X-rays in the dental context, highlighting the need for radiation protection and the prudent use of this technology. The study also proposes patient management strategies, such as planning non-urgent treatments in the second trimester, interdisciplinary consultation, and continuous monitoring. By integrating these approaches, the work aims to improve clinical protocols and ensure optimal care for pregnant women who require emergency oral surgery.

Abstract Background Intraosseous myofibroma of the jaw is a rare neoplasm of mesenchymal origin with limited comprehensive understanding. It typically affects patients in the first two decades of life with a male predilection. Case presentation This study presents a rare case of myofibroma mimicking an odontogenic lesion in a 2-year-old boy. The patient presented with an incidental finding of a painless swelling of the right mandibular ramus of unknown etiology. Imaging analysis revealed a solid, expansile lesion adjacent to the germinal zone of the right mandibular first molar. Histopathologic analysis and immunohistochemistry after incisional biopsy suggested a possible central odontogenic fibroma, and the patient underwent total enucleation, leading to the final diagnosis of intraosseous myofibroma. Follow-up examinations showed no evidence of recurrence. Conclusions This report contributes to the understanding of myofibroma in pediatric patients and underscores the critical role of meticulous histopathologic examination for effective surgical planning and optimal patient outcomes.

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T0) and 1 (T1), 3 (T3), and 6 (T6) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure in horizontal ridge augmentation of posterior mandibular regions using a bone shell onlay grafting technique. Materials and Methods: Sixteen patients (12 female and 4 male; mean age: 46.2 ± 8.7 years) with 18 horizontal bone defects in posterior mandibular regions were included for lateral onlay bone grafting using the bone shell technique. After lateral bone augmentation, the EPP was used for soft tissue closure and was prospectively followed up for wound healing efficacy using a modified scoring index. The scoring index included dichotomous (yes: 0 / no: 1) evaluation of the following items: (1) bleeding on palpation or spontaneously, (2) tissue color difference, (3) presence of hematoma, (4) presence of granulation tissue, (5) incomplete incision margin closure, (6) dehiscence with visible augmentation material, (7) presence of exudation, and (8) presence of suppuration. In addition, a visual analog scale (VAS) was used to quantify and record the amount of pain and swelling (0 = no pain/swelling and 5 = severe pain/swelling); VAS scores of 0, 1, and 2 were rated as 1 in the dichotomous scoring index, and VAS scores of 3, 4, and 5 were rated as 0. A summarized wound healing score consisting of all 10 items was assessed at days 2, 7, and 14 and at months 1 and 4 postoperatively, including a comparison of the follow-up evaluations. Results: The summarized healing score increased significantly (P < .01) between day 2 (score: 6.6 ± 1.1) and day 7 (score: 8.9 ± 1.0) but showed little difference between day 14 (score: 9.6 ± 0.6) and the 1- and 4-month follow-ups (score: 10.0 ± 0). There was no wound dehiscence and no incomplete incision margin adaptation. For the individual parameters evaluated, bleeding on palpation, hematoma, and exudation were the most frequent side effects at day 2 at 50%, 100%, and 22.2%, respectively, and at day 7 at 16.7%, 55.6%, and 22.2%, respectively. The average pain score and the swelling/edema score were initially 4.0 ± 0 and 3.0 ± 0.77 on day 2, with a significant decrease (P < .001) by day 7 (pain: 2.0 ± 0; edema/swelling: 2.0 ± 0.59) and day 14 (pain: 1.0 ± 0.42; edema/swelling: 2.0 ± 0.79) and complete absence (score: 0) at months 1 and 4. Conclusions: Labial split-thickness EPP facilitates flap advancement and enables tight soft tissue coverage in large horizontal posterior mandibular bone augmentations as a result of offset double-layer wound closure. Although this procedure is shown to be surgically demanding, the postoperative complication rate may be reduced significantly. [ABSTRACT FROM AUTHOR]

With increasing age and edentulism, numerous esthetic changes occur to the perioral region. The upper lips lose definition, flatten, and lengthen, the cupid's bow is lost, and the oral commissures descend. The nasolabial folds deepen, marionette lines become prominent, vertical rhytids around the lips form, and chin rhytids form. Chronic exposure to UVA radiation from the sun can lead to photodamage, characterized by wrinkles, lentigines, actinic keratoses, and other pigment changes. In addition, edentulism leads tojaw atrophy, which often compromises soft tissue support. Removable dentures, the conventional treatment to restore missing teeth, not only replace teeth, but also provide support to the lips via the labial flange. Implant-supported Axed prostheses are a very popular option to restore completely edentulous arches; these prostheses are flangeless, providing no bulk to the lips. Addressing changes in the perioral region due to aging and edentulism requires a combination of treatments, with each addressing different issues. Onabotulinum toxin A can be used to treat dynamic perioral and chin rhytids, and upturn the corners of the mouth. Hyaluronic acid filler can be used to treat deep nasolabial folds, marionette lines, and re-volumize the lips. Chemical peels can treat photodamaged skin, static rhytids, and other dermatologic pathologies. The subnasal lip lift, developed by Cardoso and Sperli in 1971, has become an increasingly common technique used to rejuvenate the upper lip in elderly and edentulous patients. This case report describes an elderly patient who was treated with a combination of subnasal lip lift, hyaluronic acid filler, onabotulinum toxin A, and chemical peel to achieve superior perioral esthetics. This case highlights the synergy of each procedure when done in combination to achieve highly effective results. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of root coverage surgery in reducing dentin hypersensitivity (DH) through a systematic review and meta-analysis. Data sources: Unrestricted search of four indexed databases up to September 2022 was performed to identify randomized controlled trials (RCTs) evaluating the effect of root coverage surgery on DH frequency and/or intensity presurgically (baseline) and at least 3 months postsurgically. Two authors independently conducted study screening and data extraction. Subgroup meta-analyses were performed separately for stimulated and unstimulated DH frequency and intensity at different timepoints. The risk of bias and quality of the available evidence were assessed. Results: Nineteen RCTs presenting data from 7 days to 30 months after root coverage surgery with various treatment modalities were included from the 662 identified studies. A total of 486 patients contributed 784 recession defects. Results from the subgroup meta-analyses showed that, overall, root coverage surgery reduced the risk for DH by 67% (RR, 0.33; 95% CI, 0.21 to 0.53) and 53% (RR, 0.47; 95% CI, 0.38 to 0.58) upon unstimulated and stimulated DH assessment, respectively. The DH intensity was also significantly reduced (mean visual analog score difference, 2.37; 95% CI, 2.02 to 2.71) upon stimulated DH assessment. No significant changes in DH intensity were observed upon unstimulated DH assessment. The included studies did not have high risk of bias and the quality of evidence was low to high. Conclusion: Existing evidence suggests that root coverage surgery may effectively reduce the DH frequency and intensity. [ABSTRACT FROM AUTHOR]

Objectives: To provide an overview of the current artificial intelligence (AI) based applications for assisting digital data acquisition and implant planning procedures. Overview: A review of the main AI‐based applications integrated into digital data acquisitions technologies (facial scanners (FS), intraoral scanners (IOSs), cone beam computed tomography (CBCT) devices, and jaw trackers) and computer‐aided static implant planning programs are provided. Conclusions: The main AI‐based application integrated in some FS's programs involves the automatic alignment of facial and intraoral scans for virtual patient integration. The AI‐based applications integrated into IOSs programs include scan cleaning, assist scanning, and automatic alignment between the implant scan body with its corresponding CAD object while scanning. The more frequently AI‐based applications integrated into the programs of CBCT units involve positioning assistant, noise and artifacts reduction, structures identification and segmentation, airway analysis, and alignment of facial, intraoral, and CBCT scans. Some computer‐aided static implant planning programs include patient's digital files, identification, labeling, and segmentation of anatomical structures, mandibular nerve tracing, automatic implant placement, and surgical implant guide design. [ABSTRACT FROM AUTHOR]

Introduction: Multi-modal analgesia is desirable for the management of acute pain since it can provide effective pain relief at lower doses, thereby aiding tolerability. Co-crystal of tramadol-celecoxib (CTC) provides effective analgesia in models of acute pain. Co-crystallization can alter the pharmacokinetics of individual components, potentially improving tolerability. We sought to better understand the safety and tolerability of CTC in patients with acute postoperative pain. Methods: We conducted a pooled analysis of safety data from three phase 3 randomized controlled trials in adults with acute moderate-to-severe pain following oral surgery, bunionectomy, and elective abdominal hysterectomy. We present data for CTC 200 mg twice daily (BID) and its comparators: tramadol 50 mg four times daily (QID) (one trial), tramadol 100 mg QID (two trials), celecoxib 100 mg BID (two trials), and placebo (three trials). Results: In total, n = 551 patients received CTC 200 mg BID, n = 183 received tramadol 50 mg QID, n = 368 received tramadol 100 mg QID, n = 388 received celecoxib 100 mg BID, and n = 274 received placebo. The prevalence of adverse events (AEs) related to study drug up to 48 h was numerically lower with CTC 200 mg BID (35.9%) than with tramadol 50 mg QID (47.5%) and 100 mg QID (44.8%) but greater than with celecoxib 100 mg BID (12.4%) and placebo (20.4%). The most frequent AEs related to study drug up to 48 h were somnolence, nausea, dizziness, and vomiting, which occurred more frequently in patients receiving tramadol 100 mg QID than in those receiving CTC 200 mg BID. Conclusion: CTC 200 mg BID appears to be better tolerated than tramadol 100 mg QID, possibly because of reduced total exposure to tramadol. This may contribute to a more favorable benefit-risk profile for CTC versus individual components, making it a promising treatment for acute pain. Trial Registration: ClinicalTrials.gov identifiers: NCT03108482, NCT02982161 (EudraCT: 2016-000592-24), NCT03062644 (EudraCT: 2016-000593-38). [ABSTRACT FROM AUTHOR]

Purpose: High-dose denosumab (Xgeva®) is increasingly used for treating bone metastasis and various malignant diseases but carries the risk of medication-related osteonecrosis of the jaw (MRONJ). This study aimed to evaluate the incidence, risk factors, and clinical outcomes of MRONJ in patients treated with high-dose denosumab. Methods: A retrospective review was performed on 1278 patients who received high-dose denosumab at Severance Hospital, Seoul, South Korea, from September 2014 to February 2023. Data on the incidence of MRONJ, patient demographics, primary diseases, and treatment outcomes were analyzed. Results: Among the 1278 patients (average age 64.72 years; 728 males and 550 females) treated, 34 developed MRONJ, with a 2.66% incidence rate. The average age of those with MRONJ was 68.32 years, and they received more Xgeva® injections on average (13.62) compared to the overall cohort. Factors such as age and the frequency of injections were significantly associated with the risk of MRONJ. Notably, the incidence of MRONJ did not significantly differ between those who underwent oral surgery and those with spontaneous MRONJ, especially if oral surgery occurred within 1 month of injection. Surgical interventions have shown higher recovery rates in advanced MRONJ stages. Conclusion: This study confirmed a significant MRONJ incidence of 2.66% among high-dose denosumab recipients, highlighting the importance of careful patient selection, monitoring, and education, particularly in older and long-term treatment patients, to mitigate the risk of MRONJ. [ABSTRACT FROM AUTHOR]

Introduction: Vomer flap is a technique to close cleft lip and palate. This technique is a simple procedure that has many benefits. However, the vomer flap's application together with primary lip closure is still questionable. Objective: To find out whether the vomer flap's application in primary cleft lip repair can provide significant benefits Design: A systematic review was conducted using the PRISMA methodology has been licensed in PROSPERO databases (CRD42023399487). Setting: A comprehensive search was set out, utilizing eight data sources up to March 2023. Participants: Both cohort studies and randomized control trials regarding the use of vomer flaps performed concurrently with cleft lip repair in children up to six months old. Results: This article involved 8 studies involving 542 patients who met the inclusion criteria, consisting of 6 retrospective cohort studies, 1 RCT study, and 1 prospective cohort study. Vomer flaps provide a reduction in palatal cleft distance of 3–5 mm, a relatively small number of fistulas (0–4%), improvement of velopharyngeal function (nasal tone and nasal emission), maximal development of the maxilla although it is still controversial. Conclusion: The vomer flap's application in primary cleft lip repair provides many advantages, such as reduced palatal and alveolar clefts, decreased risk of oronasal fistula, increased velopharyngeal function, and increased maxillary growth. It is reliable for the management of cleft lip and palate. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. Materials and methods: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5–7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Results: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Conclusions: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable. [ABSTRACT FROM AUTHOR]

Objectives: Peripherally induced movement disorders (PIMD) are hyperkinetic movement disorders that can occur after injury to a part of the body. This study aimed to identify PIMD in the stomatognathic system following dental or oral surgical procedures. Materials and methods: A total of 229 patients with PIMD (144 women and 85 men; mean age: 53.4 years) triggered by oral surgical or dental interventions were evaluated retrospectively. Results: The average latency between the procedures and onset of PIMD was 14.3 days. Oral surgery (40.2%), including tooth extraction, trauma treatment, and other surgical procedures, was the most frequent trigger of PIMD. This was followed by general dental treatment, including periodontal, endodontic, and restorative procedures (36.7%), prosthetic treatment (19.7%), and orthodontic treatment (3.5%). PIMD consisted of oromandibular dystonia (73.8%), functional (psychogenic) movement disorders (11.4%), orolingual dyskinesia (7.9%), and hemimasticatory spasms (5.7%). Conclusions: These results suggest that even minor alterations in normal anatomy or physiology after dental procedures may result in PIMD in predisposing patients. Clinical relevance: Dental professionals should be aware that although infrequently, PIMD can develop after various dental treatments. If such symptoms precipitate, the attending physician should properly explain them to the patient and provide appropriate treatment or consultation with a movement disorder specialist. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of maxillary sinus anatomy on sinus floor elevation (SFE) operations performed with the lateral window approach. Materials and Methods: CBCT and digital panoramic radiographs were evaluated before and at least 6 months after maxillary sinus floor elevation (SFE) operations performed in 33 maxillary sinus regions in 26 patients. Maxillary sinus volume, grafted volume (GV), sinus width (SW), residual bone height (RBH), and vertical graft resorption (VGR) were calculated. The effects of RBH and SW on GV and VGR were evaluated statistically. Results: The mean GV values in the maxillary sinuses classified as narrow, average, and wide were 2.60 ± 0.57, 3.44 ± 0.65, and 3.70 ± 0.64 cm3, respectively. The mean VGR was 2.12 ± 1.67 mm, and in the sites classified as narrow, average, and wide, the mean VGR values were 1.50 ± 0.79, 1.58 ± 1.28, and 3.46 ± 2.06 mm, respectively. A statistically significant difference in GV and VGR was found between the SW groups. The mean posterior maxillary RBH was 2.30 ± 1.05 mm, and 17 and 16 sinuses were classified as = 2 and > 2 mm, respectively. There was no statistically significant difference in the effect of RBH on GV or VGR. Conclusion: Although posterior maxillary RBH did not affect new bone formation in the sinuses grafted only with hydroxyapatite-derived inorganic bovine bone, with increasing SW, the GV decreased and the VGR increased. [ABSTRACT FROM AUTHOR]