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Objectives: After resection of an oral carcinoma, patients are faced with physical, psychological, and socioeconomic challenges. Rehabilitation plays an essential role in patients’ reintegration into their social and professional environment. This study evaluated whether socioeconomic aspects affect oral cancer patients’ participation in rehabilitation treatment. Materials and methods: A retrospective analysis was conducted with 1,532 patients following surgical treatment of oral cancer during an international multicenter rehabilitation study of the German-Swiss-Austrian Cooperative Working Group on Maxillofacial Tumors using a questionnaire comprising disease-related and psychosocial items postoperatively and at least 6 months after surgery.Results: Only 35.4% of patients participated in rehabilitation. Age (p

Computer assistance has become indispensable in the reconstruction of the orbit and midface. Although these are key areas of an individual’s esthetic appearance, defects or deformities of the midface, especially those of the orbit, are treated diversely.

Study Design: This study presents a review of the evolutionary development in reconstructive orbital surgery over the past 3 decades. Additionally, it proposes the Orbital Assessment Algorithm (OA2) to enhance decision-making for intraorbital reconstruction of post-traumatic orbital deformities. Objective: The objective of this paper is to provide insights into modern post-traumatic orbital reconstruction from a surgeon's perspective, with a specific focus on adult patients. It aims to highlight the advancements in computer-aided design and manufacturing techniques, particularly in the field of reconstructive orbital surgery, and to introduce the OA2 as a tool for improved decision-making in this context. Methods: The study conducts a comprehensive review of the evolution of reconstructive orbital surgery, focusing on the integration of 3D technology into surgical practices. It also outlines the development and rationale behind the proposed OA2, emphasizing its potential to enhance the accuracy and efficacy of intraorbital reconstruction procedures for post-traumatic deformities. Results: The review demonstrates the significant progress made in reconstructive orbital surgery, particularly in leveraging 3D technology for virtual modeling, navigation, and the design and manufacturing of patient-specific implants. The introduction of the OA2 provides a structured approach to assessing and addressing post-traumatic orbital deformities, offering potential benefits in decision-making and surgical outcomes. Conclusions: In conclusion, this paper underscores the pivotal role of computer-aided design and manufacturing in advancing reconstructive orbital surgery. It highlights the importance of integrating innovative design concepts into implant manufacturing processes and emphasizes the potential of the OA2 to guide surgeons in the management of post-traumatic orbital deformities, ultimately contributing to improved patient outcomes. [ABSTRACT FROM AUTHOR]

Defects and bone loss in the maxilla and mandible pose significant challenges for dental rehabilitation. This paper focuses on complex cases of bimaxillary dental rehabilitation, where traditional dental implant protocols were not feasible in at least one jaw. Four patients were examined conceptually, where conventional dental implant placement (n = 20) was combined in either the same or opposite jaw with a patient-specific subperiosteal implant (n = 5). This study evaluates aspects such as primary stability, prosthodontic restoration, complications, and soft tissue management over the observation period. None of the five patient-specific subperiosteal implants (IPS Implants® Preprosthetic; KLS-Martin Group, Tuttlingen, Germany) experienced failure or showed any loosening of screws, with the longest observation period extending to 68 months. These implants were securely fixated away from the posts, without any biomechanical restrictions on loading from the time of insertion. Planning and manufacturing, including the initial suprastructure, followed a fully digital workflow. The number of screws required for multivector fixation ranged from 13 to 22. All dental implants placed remain functional, definitive prosthodontic restoration has been performed, and no stability loss or peri-implantitis has been observed. The IPS Implants® Preprosthetic emerges as a valuable consideration when conventional implant dentistry protocols encounter limitations. [ABSTRACT FROM AUTHOR]

Traumatic optic neuropathy (TON) is a rare but serious consequence of head injuries. The optimal therapy for TON remains controversial, and standardized recommendations are lacking. The most common therapies used are steroid administration and surgical decompression procedures. The aim of the present study was to compare two common conservative and surgical therapies in a rodent model with a standardized traumatic optic nerve lesion. This study employed 59 male Wistar rats. After exposing the optic nerve, defined trauma was exerted on the optic nerve using a micromanipulator to trigger TON. Rats received either "megadose" methylprednisolone applied perioperatively or decompression via nerve sheath fenestration. The number of neurons was histologically evaluated in retinae explanted as whole mounts. Neuronal size was determined histomorphometrically. Neuronal loss was significantly lower following perioperative "megadose" steroid therapy (p =.017), especially in the central retinal area (p =.025). Compared to the control group without therapy, on average more than 400 neurons/mm2 were saved. In the central retinal area, more than 600 neurons/mm2 were rescued. In contrast, neuronal loss was not significantly affected by surgical decompression; however, this procedure was associated with a reduction in neuron size (p =.003). The present model revealed significant neuroprotective effects following administration of methylprednisolone for TON treatment. Mitigation of neuronal loss may result in functional benefits. Neuroprotective effects were not observed following surgical therapy, suggesting that this approach should be reserved for individual cases such as hematomas in the area of nerve envelopes. [ABSTRACT FROM AUTHOR]

Subperiosteal implants have experienced fluctuating popularity since their inception. Initially introduced in the mid-20th century, they were overshadowed by the development and success of endosteal implants, which are now the standard in dental implantology. Modern subperiosteal implants are typically custom-made using computer-aided design and computer-aided manufacturing technologies, which ensure a precise fit to the patient's bone anatomy. A meta-analysis was conducted to evaluate the success rates, complications, and patient satisfaction associated with subperiosteal implants. Studies were selected based on predefined inclusion criteria, focusing on clinical trials and observational studies that reported on the long-term outcomes of subperiosteal implants., Competing Interests: Disclosure The authors received speaker’s honoraria from DePuys Synthes, West Chester, PA, USA, Brainlab AG, Munich, Germany, and KLS Martin Group, Tuttlingen, Germany., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Often, midfacial defects are not only relevant regarding functional aspects but also esthetics of such congenital or acquired deformities impair significantly the patients' quality of life. Reconstructions of the midface do not only include replacing lost or non-developed tissue but moreover to achieve predictable results with regard to esthetics as well as function for the individual patient. Digital planning modalities including different surface and volume data in combination with modern additive manufacturing techniques for biomodel and implant production and intraoperative support by using real and virtual 3D volume data for navigation and intraoperative imaging, but also securing the outcome based on postoperative analysis have been implemented in modern midface reconstruction and represent new standards for medical care. The objective of this paper is to describe modern options of patient-specific midfacial reconstruction with integration of computer-assisted planning and production techniques., Competing Interests: Prof. Gellrich und Dr. Rahlf haben Vortragstätigkeiten für Gebrüder Martin GmbH mit Honorarvergütung., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Posttraumatic reconstruction of the neurocranium and viscerocranium is an essential part of modern oral and maxillofacial surgery, in addition to oncological surgery, surgery of congenital craniofacial deformities and dental surgery. Due to the complex anatomy of the facial skull and significant esthetic and functional demands on its reconstruction, reconstructive trauma surgery in this area places the highest demands on the surgeon. This is all the more true if definitive craniomaxillofacial surgical treatment can sometimes only be performed with considerable delays for the benefit of other life-threatening injuries. In order to take these prerequisites into account, achievements of modern biomedical technology, such as intraoperative real-time navigation, computer-assisted planning and computer-assisted manufacturing (CAD/CAM) of patient-specific biomodels and implants, came up early for use in oral and maxillofacial surgery. In combination with intraoperative three-dimensional imaging, these methods result in a treatment pathway tailored to the individual patient, which is directly checked for quality at every step and thus ensures the best possible result for the patient. The use of these technologies extends far beyond the original indications in the area of orbital reconstruction and restoration of bony defects with simple geometry, such as skull defects. Nowadays, even the most complex pan-facial fractures can be restored esthetically and functionally by means of digitalized preliminary planning and individualized skull, orbital and zygomatic implants as well as total temporomandibular joint prostheses., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Osseous reconstruction of large bone defects remains a challenge in oral and maxillofacial surgery. In addition to autogenous bone grafts, which despite potential donor-site mobility still represent the gold standard in reconstructive surgery, many studies have investigated less invasive alternatives such as in vitro cultivation techniques. This study compared different types of seeding techniques on pure β-tricalcium phosphate scaffolds in terms of bone formation and ceramic resorption in vivo . Cylindrical scaffolds loaded with autologous cancellous bone, venous blood, bone marrow aspirate concentrate or extracorporeal in vitro cultivated bone marrow stromal cells were cultured in sheep on a perforator vessel of the musculus latissimus dorsi over a 6-month period. Histological and histomorphometric analyses revealed that scaffolds loaded with cancellous bone were superior at promoting heterotopic bone formation and ceramic degradation, with autogenous bone and bone marrow aspirate concentrate inducing in vivo formation of vital bone tissue. These results confirm that autologous bone constitutes the preferred source of osteoinductive and osteogenic material that can reliably induce heterotopic bone formation in vivo .