1
|
Babu VR, Selvakumar T, Panneerselvam E, Balasubramanian S, Menon R, Raja VBKK. Open reduction and internal fixation of zygomatic arch fracture by transbuccal instrumentation - A prospective clinical trial. Natl J Maxillofac Surg 2024; 15:239-245. [PMID: 39234134 PMCID: PMC11371279 DOI: 10.4103/njms.njms_116_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 09/06/2024] Open
Abstract
Background and Purpose The zygomatic arch is important to maintain facial projection as well as width. Hence, restitution of its form by open reduction and internal fixation (ORIF) is indicated following its fracture, in certain clinical scenarios. The contemporary surgical approaches are cutaneous with associated complications. This observational clinical trial was designed to evaluate intraoral reduction and transbuccal fixation of zygomatic arch fractures. Materials and Method Six patients requiring ORIF of the zygomatic arch were recruited for the study. The clinical parameters such as pain, swelling, mouth opening, facial nerve function, and scar were assessed in the pre-operative as well as post-operative period. Radiographic assessment of displacement and inter-fragmentary separation were studied on computed tomography (CT) images. Results Mean pre-operative mouth opening was increased from 28.33 ± 6.80 to 36.83 ± 1.94 (P value 0.03). Mean pre-operative swelling was decreased from 34.63 ± 5.41 to 29.71 ± 2.73 (P value 0.02). The pain decreased by day 7 in all the patients (P value 0.01). No facial nerve injury (P value 1) or scar formation (P value 0.002) was encountered in our study. The inter-fragmentary separation as assessed by CT analysis revealed satisfactory outcome. Conclusion Intraoral open reduction and transbuccal fixation is a simple, effective, and less invasive method to address zygomatic arch fractures with no complications.
Collapse
Affiliation(s)
- Vijitha Ravindira Babu
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Thulasiraman Selvakumar
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Elavenil Panneerselvam
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Sasikala Balasubramanian
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Radhika Menon
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - V. B. Krishna Kumar Raja
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| |
Collapse
|
2
|
Unexpected Total Zygomatic Arch Bone Resorption Induced by Reduction Malarplasty. J Craniofac Surg 2019; 30:2211-2213. [PMID: 31369506 DOI: 10.1097/scs.0000000000005799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In this report, the authors introduce a rare complication after reduction malarplasty in 2 patients. One patient underwent temporal rhytidectomy and malar osteotomy. The other patient underwent zygoma grinding without osteotomy. Both patients presented malar depression and cheek ptosis after surgery and visited the clinic. Physical examination, cephalometric radiographs, and facial 3-dimensional computed tomography were conducted, which indicated total zygomatic arch bone resorption. After examining the possible causes of the complication, the authors concluded that preserving enough blood supply and performing adequate rigid fixation of the separated zygoma bone are key prevention for bone resorption. This is the first report of total zygomatic arch bone resorption after reduction malarplasty.
Collapse
|
3
|
Schuh A, Kupczik K, Gunz P, Hublin J, Freidline SE. Ontogeny of the human maxilla: a study of intra-population variability combining surface bone histology and geometric morphometrics. J Anat 2019; 235:233-245. [PMID: 31070788 PMCID: PMC6637443 DOI: 10.1111/joa.13002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2019] [Indexed: 01/21/2023] Open
Abstract
Bone modeling is the process by which bone grows in size and models its shape via the cellular activities of the osteoblasts and osteoclasts that respectively form and remove bone. The patterns of expression of these two activities, visible on bone surfaces, are poorly understood during facial ontogeny in Homo sapiens; this is due mainly to small sample sizes and a lack of quantitative data. Furthermore, how microscopic activities are related to the development of morphological features, like the uniquely human-canine fossa, has been rarely explored. We developed novel techniques for quantifying and visualizing variability in bone modeling patterns and applied these methods to the human maxilla to better understand its development at the micro- and macroscopic levels. We used a cross-sectional ontogenetic series of 47 skulls of known calendar age, ranging from birth to 12 years, from a population of European ancestry. Surface histology was employed to record and quantify formation and resorption on the maxilla, and digital maps representing each individual's bone modeling patterns were created. Semilandmark geometric morphometric (GM) methods and multivariate statistics were used to analyze facial growth. Our results demonstrate that surface histology and GM methods give complementary results, and can be used as an integrative approach in ontogenetic studies. The bone modeling patterns specific to our sample are expressed early in ontogeny, and fairly constant through time. Bone resorption varies in the size of its fields, but not in location. Consequently, absence of bone resorption in extinct species with small sample sizes should be interpreted with caution. At the macroscopic level, maxillary growth is predominant in the top half of the bone where bone formation is mostly present. Our results suggest that maxillary growth in humans is highly constrained from early stages in ontogeny, and morphological changes are likely driven by changes in osteoblastic and osteoclastic rates of expression rather than differences in the bone modeling patterns (i.e. changes in location of formation and resorption). Finally, the results of the micro- and macroscopic analyses suggest that the development of the canine fossa results from a combination of bone resorption and bone growth in the surrounding region.
Collapse
Affiliation(s)
- Alexandra Schuh
- Department of Human EvolutionMax Planck Institute for Evolutionary AnthropologyLeipzigGermany
| | - Kornelius Kupczik
- Max Planck Weizmann Center for Integrative Archaeology and AnthropologyMax Planck Institute for Evolutionary AnthropologyLeipzigGermany
| | - Philipp Gunz
- Department of Human EvolutionMax Planck Institute for Evolutionary AnthropologyLeipzigGermany
| | - Jean‐Jacques Hublin
- Department of Human EvolutionMax Planck Institute for Evolutionary AnthropologyLeipzigGermany
| | - Sarah E. Freidline
- Department of Human EvolutionMax Planck Institute for Evolutionary AnthropologyLeipzigGermany
| |
Collapse
|
4
|
Walters M, Crew M, Fyfe G. Bone Surface Micro‐Topography at Craniofacial Entheses: Insights on Osteogenic Adaptation at Muscle Insertions. Anat Rec (Hoboken) 2019; 302:2140-2155. [DOI: 10.1002/ar.24215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 02/04/2019] [Accepted: 03/06/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Mark Walters
- School of Human SciencesThe University of Western Australia Crawley Perth Western Australia
- Department of Plastic and Reconstructive SurgeryPerth Children's Hospital Nedlands Perth Western Australia
| | - Michael Crew
- Health Department of Western Australia and Faculty of Health SciencesCurtin University Western Australia
| | - Georgina Fyfe
- Faculty of Health SciencesCurtin University Perth Western Australia
| |
Collapse
|
5
|
Abstract
Adequate bone remodeling may be a primary parameter for long-term successful complication-free dental implant treatment. A 1.8-mm osseous thickness around dental implants is thought to be the minimum thickness for adequate vasculature for osteocyte nutrition and function. A dental implant does not provide progenitor cells or angiogenic or osteogenic factors. Thus, the surrounding bone may need to have a 1.8-mm thickness to accommodate the vasculature necessary for nutrients for appropriate remodeling. Additionally, the 1.8-mm dimension may provide for mechanical load resistance. There is no evidence to illustrate the physiologic need for the 1.8-mm dimension. This dimension requirement is based on clinical outcome observations. Basic science research for bone survival around dental implants is needed.
Collapse
|
6
|
Dechow PC, Wang Q. Evolution of the Jugal/Zygomatic Bones. Anat Rec (Hoboken) 2017; 300:12-15. [PMID: 28000397 DOI: 10.1002/ar.23519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 11/11/2022]
Abstract
This issue of the Anatomical Record is the second of a two-volume set on the zygoma (also called the cheek bone, the zygomatic bone, the malar, or the jugal, the latter term being used in vertebrates other than mammals). The zygoma is an important component of the craniofacial skeleton, in which the zygoma is a connection between the midfacial and the cranial skeletons; has a functional role as the origin of one of the masticatory muscles, the masseter muscle, and several facial muscles; has been considered as an essential buttress of the facial skeleton for resisting masticatory forces; and has importance for determining phylogenetic relationships. In humans, the zygoma is also of aesthetic significance for facial appearance, and its restoration following trauma has resulted in a large clinical literature. In this second half of the special issue on the zygoma, a series of papers discuss studies related to evolution of the zygoma and related parts of the craniofacial skeleton throughout the vertebrates, and in particular in human evolution. There are also a series of articles discussing variation of the zygoma in modern humans. This article is an overview in which we discuss the primary findings of these studies and some of their implications. Anat Rec, 300:12-15, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Paul C Dechow
- Department of Biomedical Sciences, Texas A & M University College of Dentistry, Dallas, Texas
| | - Qian Wang
- Department of Biomedical Sciences, Texas A & M University College of Dentistry, Dallas, Texas
| |
Collapse
|
7
|
Dechow PC, Wang Q. Development, Structure, and Function of the Zygomatic Bones: What is New and Why Do We Care? Anat Rec (Hoboken) 2017; 299:1611-1615. [PMID: 27870341 DOI: 10.1002/ar.23480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 11/07/2022]
Abstract
This issue of The Anatomical Record is the first of a two-volume set on the zygoma (also called the cheek bone, the zygomatic bone, the malar, or the jugal, the latter term being used in vertebrates other than mammals). The zygoma is an important component of the craniofacial skeleton, in which the zygoma is a connection between the midfacial and the cranial skeletons; has a functional role as the origin of one of the masticatory muscles, the masseter muscle, and several facial muscles; has been considered as an essential buttress of the facial skeleton for resisting masticatory forces; and has importance for determining phylogenetic relationships. In humans, the zygoma is also of aesthetic significance for facial appearance, and its restoration following trauma has resulted in a large clinical literature. In this first volume of this Special Issue, a wide ranging series of papers discuss studies related to issues of development, structure, and function of the zygoma and closely related parts of the craniofacial skeleton in mammals, and in particular primates. This Introductory article provides an overview in which we discuss the primary findings of these studies and some of their implications. The second volume, which will be published as the January 2017 issue of The Anatomical Record, will focus on variation and evolution of the zygoma throughout the vertebrates. Anat Rec, 299:1611-1615, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Paul C Dechow
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas
| | - Qian Wang
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas
| |
Collapse
|
8
|
Lutz R, Sendlbeck C, Wahabzada H, Tudor C, Prechtl C, Schlegel KA. Periosteal elevation induces supracortical peri-implant bone formation. J Craniomaxillofac Surg 2017; 45:1170-1178. [PMID: 28606438 DOI: 10.1016/j.jcms.2017.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/12/2017] [Accepted: 05/11/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE The aim of the study was to evaluate the possibility of supracortical peri-implant bone formation after periosteal elevation. MATERIALS AND METHODS Periosteal elevation with an elevation height of 5 or 10 mm was performed in an animal experiment with 24 female domestic pigs. For this purpose, four implants were inserted in the frontal bone of each animal. The implants protruded from the local bone by 5 or 10 mm. In the test groups, the periosteum was attached to the protruding implants. In the control groups, the implants were covered with biocompatible degradable periosteal-shielding devices. Each 8 animals were sacrificed after 20, 40 and 60 days. De novo bone formation was evaluated radiographically and histologically. RESULTS Bone formation rate was higher in the test groups compared to the control groups after 20, 40 and 60 days. After 40 and 60 days, a statistically significant higher (P < 0.01) bone formation rate was found for both elevation heights. The maximum height of the generated bone was statistically significantly higher (P < 0.01) in the test groups for both elevation heights, compared to the control groups for all time points investigated. CONCLUSION Periosteal elevation by dental implants is a treatment option for supracortical peri-implant bone formation.
Collapse
Affiliation(s)
- Rainer Lutz
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany.
| | - Christina Sendlbeck
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Hommeira Wahabzada
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christian Tudor
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christopher Prechtl
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| |
Collapse
|