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Bohner L, Lustosa RM, Stamm T, Hanisch M, Kleinheinz J, Jung S. Influence of marginal incision and Le Fort I osteotomy on periodontal tissues: a prospective longitudinal study. Odontology 2023; 111:201-206. [PMID: 35737145 PMCID: PMC9810686 DOI: 10.1007/s10266-022-00721-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 01/12/2023]
Abstract
The purpose of this prospective study was to evaluate whether the surgical protocol involving marginal incision and Le Fort I osteotomy affects the periodontal outcome. Twenty-nine patients requiring surgical correction of maxillary dysgnathia were selected for this study. Periodontal conditions of maxillary anterior teeth were assessed prior to the surgery (T0), one month (T1), and 6 months (T2) after the surgical procedure. Interdental papillae loss, periodontal parameters and aesthetic outcomes in the anterior zone were assessed. Statistical analysis was performed with Friedman´s test and within ANOVA (p ≤ 0.05) followed by post-hoc tests. Papilla height decreased from T0 to T1 (p = 0.003), followed by an increase from T1 to T2 (p = 0.040). PPD (T0 = 1.72 ± 0.46; T2 = 2.13 ± 0.43) and CAL (T0 = 1.24 ± 0.55; T2 = 1.99 ± 0.70) increased after 6 months. There were statistically significant differences in aesthetic score among T0, T1 and T2. Periodontal changes after orthognathic surgery were within acceptable biological levels. Although a change in papillae height was reported after the surgery, initial values were recovered after 6 months. Surgical incision design might improve the outcome of Le-Fort I osteotomy. Anterior aesthetic zone may benefit from a marginal incision design, as it respects vascularization principle and may ensure a wound healing without complications.
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Affiliation(s)
- Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany
| | - Rômulo Maciel Lustosa
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany ,Department of Periodontology, State University of Maringá, Maringá, A. Colombo 5790, 87020-900 Brazil
| | - Thomas Stamm
- Department of Orthodontics, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany
| | - Marcel Hanisch
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany
| | - Susanne Jung
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149 Muenster, Germany
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Friedrich RE, Quade M, Jowett N, Kroetz P, Amling M, Kohlrusch FK, Zustin J, Gosau M, SchlÜter H, Miller RJD. Ablation Precision and Thermal Effects of a Picosecond Infrared Laser (PIRL) on Roots of Human Teeth: A Pilot Study Ex Vivo. In Vivo 2021; 34:2325-2336. [PMID: 32871757 DOI: 10.21873/invivo.12045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND/AIM Picosecond infrared laser (PIRL) was investigated regarding its possible therapeutic application in cutting dental roots. MATERIALS AND METHODS Extracted human teeth were processed in the root area by laser ablations followed by histological evaluation. Dentin adjacent to the cutting surface was evaluated morphometrically. RESULTS PIRL produced clearly defined cutting boundaries in dental roots. At the bottom of the cavity, the ablation surface became slightly concave. Heat development in this scantly hydrated tissue was considerable. We attributed the excess heating effects to heat accumulation due to multiple pulse overlap across a limited scan range imposed by tooth geometries. CONCLUSION Defined areas of the tooth root may be treated using the PIRL. For clinical translation, it would be necessary to improve beam delivery to facilitate beam steering for the intended oral application (e.g. by using a fiber) and identify optimal repetition rates/scan speeds combined with cooling techniques to minimize accumulated heat within ablation cavities.
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Affiliation(s)
- Reinhard E Friedrich
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Maria Quade
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Nate Jowett
- Otorhinolaryngology, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.,Otolaryngology - Head and Neck Surgery, Mass Eye & Ear and Harvard Medical School, Boston, MA, U.S.A.,Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany
| | - Peter Kroetz
- Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany
| | - Michael Amling
- Institute of Osteology and Biomechanics, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Felix K Kohlrusch
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Jozef Zustin
- Institute of Osteology and Biomechanics, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.,Institute of Pathology, Gemeinschaftspraxis Pathologie-Regensburg, Regensburg, Germany
| | - Martin Gosau
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Hartmut SchlÜter
- Institute of Clinical Chemistry and Laboratory Medicine, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - R J Dwayne Miller
- Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany.,Departments of Chemistry and Physics, University of Toronto, Toronto, Canada.,PIRL Laboratory, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
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Effects of Water-Circulating Cooling Mask on Postoperative Outcomes in Orthognathic Surgery and Facial Trauma. J Craniofac Surg 2021; 31:1981-1985. [PMID: 32604311 DOI: 10.1097/scs.0000000000006624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy of hilotherapy on postoperative pain, swelling, neurosensory impairment and patient satisfaction. The authors analyzed RCTs comparing the use of hilotherapy versus conventional cryotherapy or no cold treatment for orthognathic surgery and repair of facial trauma. The authors assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. Treatment effects were defined as weighted or standardized mean difference using the inverse variance method. Five RCTs were included. Postoperative pain and swelling in patients using hilotherapy were lower comparing to the control group in the postoperative day 2 (Pain: MD -1.75, CI 95% -2.69 to -0.81; Swelling: MD -21.16 mL, CI 95% -38.91 to -3.41) and in the final evaluation (Pain: MD -0.31, CI 95% -0.44 to -0.18; MD -4.45 mL, CI 95% -7.87 to -1.03). Patients reported higher satisfaction with hilotherapy, but no differences were found for neurosensory impairment. Current evidence suggests that hilotherapy is effective in reducing postoperative pain and swelling in orthognathic surgery and repair of facial fractures and may lead to improvements in patient satisfaction in the recovery phase.
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Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial. Lasers Med Sci 2019; 35:395-402. [PMID: 31273569 DOI: 10.1007/s10103-019-02832-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.
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