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Kazemi T, Nabavizadeh SS, Nadjmi N, Ahmadkhani A, Ghaemmaghami P, Kafaei A, Faramarzi A. The relationship between cleft palate repair technique and audiological outcomes: A retrospective cohort study. Laryngoscope Investig Otolaryngol 2024; 9:e1237. [PMID: 38525123 PMCID: PMC10960244 DOI: 10.1002/lio2.1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Otitis media with effusion is common in children with cleft palates. This study aimed to investigate the link between palatal closure techniques and audiological outcomes. Methods In this retrospective-prospective cohort study, we examined the relationship between palate repair techniques and hearing outcomes in children with cleft palates. From 2017 to 2022, 190 ears of 95 cleft patients were studied at the Cleft Lip and Palate Department of Shiraz University of Medical Sciences. Variables assessed included the surgical technique, cleft severity, auditory brainstem response (ABR) threshold, and tympanometry configuration. Results The mean ABR improved from a prepalatoplasty value of 39.51(11.62) decibels (dB) to a postpalatoplasty mean of 26.61(11.60) dB (Cohen's d: 1.12 [95% CI; 0.90-1.34]). Initially, 87.9% of the studied ears exhibited abnormal tympanometry, but this significantly decreased to 47% postsurgery (risk ratio: 4.43 [95% CI; 1.20-16.43]). When compared with Sommerlad intravelar veloplasty, the Nadjmi modified Furlow palatoplasty was associated with a notably lower mean ABR (β: -6.58 [95% CI: -10.43 to -2.73], p-value = .001) and a reduced frequency of abnormal tympanometry (odds ratio [OR]: -1.10; 95% CI: -1.85 to -0.36, p-value = .004). Factors like prepalatoplasty ABR, cleft palate severity, gender, and syndromic did not confound these findings. Conclusions Although the Nadjmi modified Furlow palatoplasty showed better results, our findings indicate a significant improvement in ABR and tympanometry outcomes for both techniques. Future randomized controlled trials are suggested to confirm the influence of palatal closure techniques on audiological outcomes. Level of Evidence 3b.
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Affiliation(s)
- Tayebeh Kazemi
- Department of Otolaryngology, Otolaryngology Research CenterShiraz University of Medical SciencesShirazIran
| | - Sara S. Nabavizadeh
- Department of Otolaryngology, Otolaryngology Research CenterShiraz University of Medical SciencesShirazIran
| | - Nasser Nadjmi
- Department of Cranio‐Maxillofacial SurgeryAntwerp University HospitalEdegemBelgium
- Department of Maxillofacial SurgeryZMACK, AZ MONICA AntwerpAntwerpBelgium
| | - Alireza Ahmadkhani
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Parvin Ghaemmaghami
- Department of Biostatistics, School of nursing and midwifery, Shiraz University of Medical SciencesShirazIran
| | - Ardavan Kafaei
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Ali Faramarzi
- Department of Otolaryngology, Otolaryngology Research CenterShiraz University of Medical SciencesShirazIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
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Bastami F, Safavi SM, Seifi S, Nadjmi N, Khojasteh A. Addition of Bone-Marrow Mesenchymal Stem Cells to 3D-Printed Alginate/Gelatin Hydrogel Containing Freeze-Dried Bone Nanoparticles Accelerates Regeneration of Critical Size Bone Defects. Macromol Biosci 2024; 24:e2300065. [PMID: 37846197 DOI: 10.1002/mabi.202300065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/20/2023] [Indexed: 10/18/2023]
Abstract
A 3D-printed biodegradable hydrogel, consisting of alginate, gelatin, and freeze-dried bone allograft nanoparticles (npFDBA), is developed as a scaffold for enhancing cell adhesion, proliferation, and osteogenic differentiation when combined with rat bone marrow mesenchymal stem cells (rBMSCs). This composite hydrogel is intended for the regeneration of critical-sized bone defects using a rat calvaria defect model. The behavior of rBMSCs seeded onto the scaffold is evaluated through scanning electron microscope, MTT assays, and quantitative real-time PCR. In a randomized study, thirty rats are assigned to five treatment groups: 1) rBMSCs-loaded hydrogel, 2) rBMSCs-loaded FDBA microparticles, 3) hydrogel alone, 4) FDBA alone, and 5) an empty defect serving as a negative control. After 8 weeks, bone regeneration is assessed using H&E, Masson's trichrome staining, and immunohistochemistry. The 3D-printed hydrogel displays excellent adhesion, proliferation, and differentiation of rBMSCs. The rBMSCs-loaded hydrogel exhibits comparable new bone regeneration to the rBMSCs-loaded FDBA group, outperforming other groups with statistical significance (P-value < 0.05). These findings are corroborated by Masson's trichrome staining and osteocalcin expression. The rBMSCs-loaded 3D-printed hydrogel demonstrates promising potential for significantly enhancing bone regeneration, surpassing the conventional clinical approach (FDBA).
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Affiliation(s)
- Farshid Bastami
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh-Mina Safavi
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Sina Seifi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery, University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cranio-Maxillofacial Surgery, University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Coropciuc R, Moreno-Rabié C, De Vos W, Van de Casteele E, Marks L, Lenaerts V, Coppejans E, Lenssen O, Coopman R, Walschap J, Nadjmi N, Jacobs R, Politis C, Van den Wyngaert T. Navigating the complexities and controversies of medication-related osteonecrosis of the jaw (MRONJ): a critical update and consensus statement. Acta Chir Belg 2024; 124:1-11. [PMID: 38059301 DOI: 10.1080/00015458.2023.2291295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES To provide a critical update identifying the knowledge gaps and controversies in medication-related osteonecrosis of the jaw (MRONJ) within the Belgian healthcare context and outline opportunities for improvement and research in these areas. METHODS A literature review was performed to identify guidelines from international clinical societies in oncology or oral and maxillofacial surgery on diagnosing, preventing, and treating MRONJ. The recommendations were critically assessed in light of recent developments in the field and confronted with the clinical experience of experts. RESULTS Despite progress in the diagnostic criteria of MRONJ, the continued need for an 8-week timeout period should be reconsidered. Furthermore, 3D imaging techniques should be introduced to improve diagnosis and staging. The staging system remains ambiguous regarding Stage 0 MRONJ, and ongoing confusion exists regarding the term non-exposed MRONJ. The prevention of MRONJ should be tailored, considering the individual patient's risk of MRONJ, frailty, and life expectancy. More research seems needed into the efficacy and safety of drug holidays, considering the risks of rebound remodeling on fractures. With renewed interest in surgical and adjunct management techniques, adequately designed clinical studies are needed to help translate trial outcomes into universally applicable treatment guidelines taking into account individual patient characteristics. CONCLUSIONS Important knowledge gaps remain and hamper the development of clinical guidelines. Several controversies were identified where consensus is lacking, and further harmonization between stakeholders is necessary. Finally, the need for randomized controlled comparative clinical trials in MRONJ resonates harder than ever to identify the best treatment for individual patients.
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Affiliation(s)
- Ruxandra Coropciuc
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Catalina Moreno-Rabié
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Wouter De Vos
- Department of Oral and Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Elke Van de Casteele
- Department of Oral and Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luc Marks
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Special Care Dentistry, Antwerp University Hospital, Antwerp, Belgium
| | - Vincent Lenaerts
- Department of Oral and Maxillofacial Surgery, VITAZ, Sint-Niklaas, Belgium
| | - Evy Coppejans
- Department of Oral and Maxillofacial Surgery, VITAZ, Sint-Niklaas, Belgium
| | - Olivier Lenssen
- Department of Oral and Maxillofacial Surgery, ZNA Middelheim, Antwerpen, Belgium
| | - Renaat Coopman
- Department of Oral and Maxillofacial and Plastic Surgery, University Hospital of Ghent, Ghent, Belgium
| | | | - Nasser Nadjmi
- Department of Oral and Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Tim Van den Wyngaert
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
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Nabavizadeh SS, Mootz JJ, Nadjmi N, Massenburg BB, Khoshnood K, Shojaeefard E, Vardanjani HM. Gender inequality and burden of orofacial clefts in the Eastern Mediterranean region: findings from global burden of disease study 1990-2019. BMC Pediatr 2024; 24:76. [PMID: 38262976 PMCID: PMC10804627 DOI: 10.1186/s12887-024-04569-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Gender inequality may be associated with the burden of orofacial clefts (OFCs), particularly in low-and middle-income countries (LMICs). To investigate the OFCs' burden and its association with gender inequality in the Eastern Mediterranean region (EMR). METHODS Country-specific data on the OFCs' prevalence and Disability-Adjusted Life Years (DALYs) from 1990 to 2019 were gathered from the Global Burden of Disease database by age and gender. Estimated annual percentage change (EAPCs) was used to investigate the OFCs' trends. The association of the Gender Inequality Index (GII) with prevalence and DALY rates was determined using multiple linear regression. Human Development Index (HDI), Socio-Demographic Index (SDI), and Gross Domestic Product (GDP) were also considered as potential confounders. RESULTS In 2019, the overall regional OFCs' prevalence and DALYs (per 100,000 person-years) were 93.84 and 9.68, respectively. During the 1990-2019 period, there was a decrease in prevalence (EAPC = -0.05%), demonstrating a consistent trend across genders. Moreover, within the same timeframe, DALYs also declined (EAPC = -2.10%), with a more pronounced reduction observed among females. Gender differences were observed in age-specific prevalence rates (p-value = 0.015). GII was associated with DALYs (βmale= -0.42, p-value = 0.1; βfemale = 0.48, p-value = 0.036) and prevalence (βmale= -1.86, p-value < 0.001, βfemale= -2.07, p-value < 0.001). CONCLUSIONS Despite a declining prevalence, the burden of OFCs remained notably significant in the EMR. Gender inequality is associated with the burden of OFCs in the Eastern Mediterranean region. Countries in the region should establish comprehensive public policies to mitigate gender inequalities in healthcare services available for OFCs.
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Affiliation(s)
- Sara Sadat Nabavizadeh
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jennifer J Mootz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Kolb 171, New York, NY, 10032, USA
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Antwerp, Belgium
| | - Benjamin B Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Kaveh Khoshnood
- School of Public Health, Yale University, 60 College St, New Haven, CT, 06510, USA
| | - Ehsan Shojaeefard
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Heydari MH, Sadeghian A, Khadivi G, Mustafa HJ, Javinani A, Nadjmi N, Khojasteh A. Prevalence, trend, and associated risk factors for cleft lip with/without cleft palate: a national study on live births from 2016 to 2021. BMC Oral Health 2024; 24:36. [PMID: 38185687 PMCID: PMC10771673 DOI: 10.1186/s12903-023-03797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUNDS Cleft lip with or without cleft palate (CL/P) is the most common congenital craniofacial anomaly, including non-syndromic cleft lip with or without cleft palate and cleft palate only. Failure in the fusion of median and lateral nasal processes, the maxillary prominence, and soft tissues around the oral cavity can cause CL/P. Previously, the prevalence has been estimated to be 1 among every 1000 births in 2014 among American neonates and no other reports have been available since. Thus, this study aimed to calculate the prevalence and trend of isolated CL/P among American live births from 2016 to 2021 with its associated risk factors. METHODS AND MATERIALS In this cross-sectional population-based retrospective study, we used live birth data provided by the National Center for Health Statistics (NCHS) from the Center for Disease Control and Prevention (CDC). We calculated the prevalence per 10,000 live births of isolated (non-syndromic) CL/P from 2016 to 2021. To examine risk factors for developing isolated CL/P, we used logistic regression modelling. RESULTS The total prevalence per 10,000 births from 2016 to 2021 was 4.88 (4.79-4.97), for both sexes, and 5.96 (5.82-6.10) for males, and 3.75 (3.64-3.87) for females. The prevalence did not show any consistent linear decreasing or increasing pattern. We found significant association between increased odds of developing isolated CL/P among cases with 20 to 24 year-old mothers (OR = 1.07, 1.01-1.13, p = 0.013), mothers who smoked 11 to 20 cigarettes per day (OR = 1.46, 1.33-1.60, p < 0.001), mothers with extreme obesity (OR = 1.32, 1.21-1.43, p < 0.001), mothers with grade II obesity (OR = 1.32, 1.23-1.42, p < 0.001), mothers with pre-pregnancy hypertension (OR = 1.17, 1.04-1.31, p = 0.009), mothers with pre-pregnancy diabetes mellitus (OR = 1.96, 1.71-2.25, p < 0.001), and mothers who used assisted reproductive technology (OR = 1.40, 1.18-1.66, p < 0.001). CONCLUSIONS Our findings suggest a minuscule increase, albeit insignificant, in the trend of CL/P prevalence from 2016 to 2021. Developing CL/P had greater odds among mothers with pre-pregnancy diabetes, smoking, obesity, and pre-pregnancy hypertension mothers along with mothers who used assisted reproductive technology. Isolated CL/P had the highest prevalence in non-Hispanic Whites, American Indian or Alaskan Native and Native Hawaiian and Other Pacific Islanders.
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Affiliation(s)
- Mohammad-Hossein Heydari
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sadeghian
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
| | - Gita Khadivi
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
| | - Hiba J Mustafa
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Riley Children's and Indiana University Health Fetal Center, Indianapolis, IN, USA
| | - Ali Javinani
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran.
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Collier E, Nadjmi N, Verbraecken J, Van de Casteele E. Anthropometric 3D evaluation of the face in patients with sleep related breathing disorders. Sleep Breath 2023; 27:2209-2221. [PMID: 37067632 DOI: 10.1007/s11325-023-02827-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE To evaluate craniofacial measurements on 3D-stereophotogrammetry and see if particular measurements are more typical in obstructive sleep apnea (OSA) and have a correlation with its severity. METHODS Subjects included were adults undergoing a diagnostic polysomnography. Age, BMI, neck, abdominal and hip circumference (cm) were recorded. 3D-stereophotogrammetry was performed and landmarks were placed on the 3D-image. Different linear, angular and volume measurements were performed to gauge facial and neck anatomy. The relationship between these measurements and the severity of OSA, based on the obstructive apnea/hypopnea index (OAHI, events/h), was assessed by multiple linear regression, and adjusted for BMI and sex. RESULTS Of 91 subjects included (61 male), mean age was 46 ± 12 years, BMI 30.1 ± 6.5 kg/m2, OAHI 19.3 ± 18.8/h. BMI was higher (p = 0.0145) in females (32.9 ± 7.7) than in males (28.6 ± 5.3). This was also true for hip circumference (118 ± 15 vs 107 ± 10, p = 0.0006), while the neck circumference was higher (p < 0.0001) in males (41 ± 4 vs 37 ± 4). The following parameters could predict the logOAHI (r2-adjusted = 0.51): sex (p < 0.0001), BMI (p = 0.0116), neck-depth/mandibular-length (p = 0.0002), mandibular-width angle (p = 0.0118), neck-depth euclidean distance/surface distance (E/S) (p = 0.0001) and the interaction terms between sex and neck-depth/mandibular-length (p = 0.0034), sex and neck-depth E/S (p = 0.0276) and BMI and neck-depth E/S (p = 0.0118). The interaction between sex and neck-depth/mandibular-length showed a steeper linear course in females. This is also true for the interaction term BMI with neck-depth E/S in patients with a higher BMI. With a same neck-depth ratio, the OAHI is larger in men. CONCLUSION Measurements involving the width of the face and addressing the soft tissue in the upper neck were found to have a significant relation with OSA severity. We found remarkable differences between non-obese/obese subjects and between males and females.
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Affiliation(s)
- Ellen Collier
- Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium.
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium.
- ZMACK/Associatie MKA, AZ Monica, Antwerp, Belgium.
| | - Nasser Nadjmi
- Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- ZMACK/Associatie MKA, AZ Monica, Antwerp, Belgium
- All for Research vzw, Antwerp, Belgium
| | - Johan Verbraecken
- Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Elke Van de Casteele
- Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium
- ZMACK/Associatie MKA, AZ Monica, Antwerp, Belgium
- All for Research vzw, Antwerp, Belgium
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Téblick S, Ruymaekers M, Van de Casteele E, Boudewyns A, Nadjmi N. The effect of soft palate reconstruction with the da Vinci robot on middle ear function in children: an observational study. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00045-0. [PMID: 36914451 DOI: 10.1016/j.ijom.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/11/2023] [Accepted: 02/24/2023] [Indexed: 03/13/2023]
Abstract
Cleft palate is associated with a high prevalence of middle ear dysfunction, even after palatal repair. The aim of this study was to evaluate the effects of robot-enhanced soft palate closure on middle ear functioning. This retrospective study compared two patient groups after soft palate closure with a modified Furlow double-opposing Z-palatoplasty technique. Dissection of the palatal musculature was performed using a da Vinci robot in one group and manually in the other. Outcome parameters were otitis media with effusion (OME), tympanostomy tube use, and hearing loss during 2 years of follow-up. At 2 years post-surgery, the percentage of children with OME had reduced significantly to 30% in the manual group and 10% in the robot group. The need for ventilation tubes (VTs) decreased significantly over time, with fewer children in the robot group (41%) than those in the manual group (91%) needing new VTs during postoperative follow-up (P = 0.026). The number of children presenting without OME and VTs increased significantly over time, with a faster increase in the robot group at 1 year post-surgery (P = 0.009). Regarding hearing loss, significantly lower hearing thresholds were recorded in the robot group from 7 to 18 months postoperatively. To conclude, beneficial effects of robot-enhanced surgery were recorded, suggesting a faster recovery when the soft palate was reconstructed using the da Vinci robot.
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Affiliation(s)
- S Téblick
- Faculty of Medicine and Translational Neurosciences, University of Antwerp, Antwerp, Belgium; Department of Craniomaxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium.
| | - M Ruymaekers
- Faculty of Medicine and Translational Neurosciences, University of Antwerp, Antwerp, Belgium
| | - E Van de Casteele
- Faculty of Medicine and Translational Neurosciences, University of Antwerp, Antwerp, Belgium; Department of Craniomaxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium
| | - A Boudewyns
- Faculty of Medicine and Translational Neurosciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - N Nadjmi
- Faculty of Medicine and Translational Neurosciences, University of Antwerp, Antwerp, Belgium; Department of Craniomaxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Antwerp, Belgium; OMFS Program, University of Antwerp, Antwerp, Belgium
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8
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Van Opstal E, Van de Casteele E, Carlier A, Vercruysse H, Nadjmi N. The influence of tissue redraping after Le Fort I type osteotomy. Br J Oral Maxillofac Surg 2023; 61:141-146. [PMID: 36707311 DOI: 10.1016/j.bjoms.2022.11.283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
Elongation of the upper lip, in particular the philtrum, and nose widening are common postoperative changes after a Le Fort I osteotomy. These changes can be induced by the transection of soft tissue and loosening of the underlying musculature. A methodology for soft tissue redraping was developed to limit these undesirable nasolabial changes. This study evaluates the effectiveness of the technique and influence of maxillary translocation on the nasolabial form. Anthropometric measurements, lip, philtrum length, and nose width, were taken two weeks prior to, and one year after, surgery. The mean postoperative changes were minimised to less than 1mm except for lip length in the extrusion groups, which was less than 1.5mm. Statistical analysis showed a stable result for lip length after maxillary advancement and/or intrusion as limited lengthening mainly occurred at the vermilion. Conversely, lip lengthening after extrusion mainly occurred at the philtrum. The mean nose width was maintained after maxillary advancement, decreased after extrusion, and increased after intrusion. The type of maxillary translocation only influenced the nasolabial soft tissue in case of intrusion and extrusion, not after advancement.
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Affiliation(s)
- Ellen Van Opstal
- Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium
| | - Elke Van de Casteele
- Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium; All for Research vzw, Harmoniestraat 68, 2018 Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Adélaide Carlier
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, Chemin du grand Revoyet, 69495 Pierre Benite Cedex, France
| | - Herman Vercruysse
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium
| | - Nasser Nadjmi
- Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium; All for Research vzw, Harmoniestraat 68, 2018 Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium.
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9
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Wallner J, Denoiseux B, Van de Casteele E, Bila M, Van Hemelen G, Nadjmi N, Vercruysse H. Do sex and age influence nasal soft tissue widening after bone-borne transpalatal distraction ? J Oral Maxillofac Surg 2022; 80:1613-1627. [DOI: 10.1016/j.joms.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 06/03/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
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10
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Kustermans L, Van de Casteele E, Asscherickx K, Van Hemelen G, Nadjmi N. Impact of surgically assisted rapid mandibular expansion on the temporomandibular joint. J Craniomaxillofac Surg 2022; 50:590-598. [DOI: 10.1016/j.jcms.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/18/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022] Open
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11
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Nokhbatolfoghahaei H, Bastami F, Farzad-Mohajeri S, Rezai Rad M, Dehghan MM, Bohlouli M, Farajpour H, Nadjmi N, Khojasteh A. Prefabrication technique by preserving a muscular pedicle from masseter muscle as an in vivo bioreactor for reconstruction of mandibular critical-sized bone defects in canine models. J Biomed Mater Res B Appl Biomater 2022; 110:1675-1686. [PMID: 35167181 DOI: 10.1002/jbm.b.35028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 11/08/2022]
Abstract
In vivo bioreactors serve as regenerative niches that improve vascularization and regeneration of bone grafts. This study has evaluated the masseter muscle as a natural bioreactor for βTCP or PCL/βTCP scaffolds, in terms of bone regeneration. The effect of pedicle preservation, along with sole, or MSC- or rhBMP2-combined application of scaffolds, has also been studied. Twenty-four mongrel dogs were randomly placed in six groups, including βTCP, βTCP/rhBMP2, βTCP/MSCs, PCL/βTCP, PCL/βTCP/rhBMP2, and PCL/βTCP/MSCs. During the first surgery, the scaffolds were implanted into the masseter muscle for being prefabricated. After 2 months, each group was divided into two subgroups prior to mandibular bone defect reconstruction; one with a preserved vascularized pedicle and one without. After 12 weeks, animals were euthanized, and new bone formation was evaluated using histological analysis. Histological analysis showed that all β-TCP scaffold groups had resulted in significantly greater rates of new bone formation, either with a pedicle surgical approach or non-pedicle surgical approach, comparing to their parallel groups of βTCP/PCL scaffolds (p ≤ .05). Pedicled β-TCP scaffold groups that were treated with either rhBMP2 (48.443% ± 0.250%) or MSCs (46.577% ± 0.601%) demonstrated the highest rates of new bone formation (p ≤ .05). Therefore, masseter muscle can be used as a local in vivo bioreactor with potential clinical advantages in reconstruction of human mandibular defects. In addition, scaffold composition, pedicle preservation, and treatment with MSCs or rhBMP2, influence new bone formation and scaffold degradation rates in the prefabrication technique.
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Affiliation(s)
- Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshid Bastami
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Farzad-Mohajeri
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.,Institute of Biomedical Research, University of Tehran, Tehran, Iran
| | - Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Dehghan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.,Institute of Biomedical Research, University of Tehran, Tehran, Iran
| | - Mahboubeh Bohlouli
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hekmat Farajpour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasser Nadjmi
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Arash Khojasteh
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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12
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Michaux D, Van de Casteele E, Dielen D, Van Hemelen G, Nadjmi N. The effect of subspinal Le Fort 1 corticotomy on nasal morphology in surgically assisted rapid palatal expansion. Int J Oral Maxillofac Surg 2021; 51:518-525. [PMID: 34456080 DOI: 10.1016/j.ijom.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/07/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022]
Abstract
The purpose of this retrospective study was to evaluate the influence of subspinal Le Fort 1 corticotomy (SLF1C) on nasal morphology in patients treated with surgically assisted rapid palatal expansion (SARPE) using three-dimensional (3D) stereophotogrammetry images. A total of 64 patients were enrolled in the study and divided into two groups according to the surgical approach that was used: in group 1 (n = 32) SARPE was performed using a conventional Le Fort 1 corticotomy (CLF1C), and in group 2 (n = 32) SARPE was performed using a subspinal Le Fort 1 corticotomy (SLF1C). Measurements of alar and columellar width, and nasolabial angle were taken on 3D stereophotogrammetry images before and after SARPE using Vectra 3D camera system. Both surgical groups showed a statistically significant increase in alar and columellar width, and nasolabial angle postoperatively (p<0.05). SLF1C resulted in significantly smaller changes of the columellar base postoperatively (p=0.0456). The datasuggests that SARPE with an osteotomy of the anterior nasal spine as an additional step to the conventional Le Fort 1 corticotomy results in a smaller increase of the columellar base.
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Affiliation(s)
- D Michaux
- ZMACK association Cranio-Maxillofacial Surgery, AZ Monica Hospital Antwerp, Antwerp, Belgium
| | - E Van de Casteele
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium
| | - D Dielen
- ZMACK association Cranio-Maxillofacial Surgery, AZ Monica Hospital Antwerp, Antwerp, Belgium
| | - G Van Hemelen
- ZMACK association Cranio-Maxillofacial Surgery, AZ Monica Hospital Antwerp, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium
| | - N Nadjmi
- ZMACK association Cranio-Maxillofacial Surgery, AZ Monica Hospital Antwerp, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium.
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13
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Van den Borre C, Van de Casteele E, Boeckx P, Nadjmi N. A novel instrument for the prevention of condylar torque in bilateral sagittal ramus osteotomy when using bicortical screw fixation. Int J Oral Maxillofac Surg 2021; 51:376-379. [PMID: 34325976 DOI: 10.1016/j.ijom.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/10/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
When using the bilateral sagittal split osteotomy (BSSO) technique, rigid internal fixation (RIF) remains the standard method to accurately fix the distal and proximal osteotomy fragments. A concern with the use of RIF, especially with bicortical screws, is the increased risk of condylar torque and its functional consequences. This technical note introduces a new method for preventing torque of the mandibular condyles after BSSO, using a sagittal split space maintainer.
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Affiliation(s)
- C Van den Borre
- Department of Cranio-Maxillofacial Surgery, ZMACK, AZ Monica Antwerpen, Antwerp, Belgium
| | - E Van de Casteele
- All for Research vzw, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - P Boeckx
- Department of Cranio-Maxillofacial Surgery, ZMACK, AZ Monica Antwerpen, Antwerp, Belgium
| | - N Nadjmi
- Department of Cranio-Maxillofacial Surgery, ZMACK, AZ Monica Antwerpen, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium.
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14
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Vercruysse H, Rubio-Palau J, Van de Casteele E, Nadjmi N, De Praeter M, Dunaway D. Virtual planning in Le Fort III distraction osteogenesis: A case series. J Craniomaxillofac Surg 2021; 49:341-346. [PMID: 33589332 DOI: 10.1016/j.jcms.2021.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/27/2020] [Accepted: 01/31/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of this study is to determine the value of using 3D planning tools and 3D printed cutting guides in Le Fort III osteotomies with external frame distraction osteogenesis. The process of planning and transfer of the virtual planning to the operating room is illustrated with 5 case. The virtual planning is transferred to the operating room using a 3D-printed supra-orbital reference bar with puzzle connections for the planned osteotomy guides. Different systems are presented to transfer the vector of distraction and the position of the external midface distractor. Three-dimensional planning tools and cutting guides help to design the Le Fort III osteotomy and the distraction vector, to anticipate possible difficulties, and to avoid adverse events.
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Affiliation(s)
- Herman Vercruysse
- Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium; Division of Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain.
| | - Josep Rubio-Palau
- Division of Paediatric Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Barcelona Children's Hospital, Esplugues de Llobregat, Barcelona, Spain.
| | - Elke Van de Casteele
- Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium; Department of Maxillofacial Surgery, All for Research VZW, ZMACK Association, AZ MONICA Antwerp, Antwerp, Belgium; Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteits-plein 1, 2610 Antwerp, Belgium.
| | - Nasser Nadjmi
- Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium; Department of Maxillofacial Surgery, All for Research VZW, ZMACK Association, AZ MONICA Antwerp, Antwerp, Belgium; Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteits-plein 1, 2610 Antwerp, Belgium.
| | - Mania De Praeter
- Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium.
| | - David Dunaway
- Department of Plastic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, United Kingdom.
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15
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Nokhbatolfoghahaei H, Paknejad Z, Bohlouli M, Rezai Rad M, Aminishakib P, Derakhshan S, Mohammadi Amirabad L, Nadjmi N, Khojasteh A. Fabrication of Decellularized Engineered Extracellular Matrix through Bioreactor-Based Environment for Bone Tissue Engineering. ACS Omega 2020; 5:31943-31956. [PMID: 33344849 PMCID: PMC7745398 DOI: 10.1021/acsomega.0c04861] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/17/2020] [Indexed: 05/31/2023]
Abstract
Extracellular matrix (ECM)-contained grafts can be achieved by decellularization of native bones or synthetic scaffolds. Limitations associated with harvesting the native bone has raised interest in preparing in vitro ECM bioscaffold for bone tissue engineering. Here, we intend to develop an ECM-contained construct via decellularizing an engineered gelatin-coated β-tricalcium phosphate (gTCP) scaffold. In order to find an optimal protocol for decellularization of cell-loaded gTCP scaffolds, they were seeded with buccal fat pad-derived stem cells. Then, four decellularization protocols including sodium dodecyl sulfate, trypsin, Triton X-100, and combined solution methods were compared for the amounts of residual cells and remnant collagen and alteration of scaffold structure. Then, the efficacy of the selected protocol in removing cells from gTCP scaffolds incubated in a rotating and perfusion bioreactor for 24 days was evaluated and compared with static condition using histological analysis. Finally, decellularized scaffolds, reloaded with cells, and their cytotoxicity and osteoinductive capability were evaluated. Complete removal of cells from gTCP scaffolds was achieved from all protocols. However, treatment with Triton X-100 showed significantly higher amount of remnant ECM. Bioreactor-incubated scaffolds possessed greater magnitude of ECM proteins including collagen and glycosaminoglycans. Reseeding the decellularized scaffolds also represented higher osteoinductivity of bioreactor-based scaffolds. Application of Triton X-100 as decellularization protocol and usage of bioreactors are suggested as a suitable technique for designing ECM-contained grafts for bone tissue engineering.
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Affiliation(s)
- Hanieh Nokhbatolfoghahaei
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
- Student
Research Committee, Department of Tissue Engineering and Applied Cell
Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Zahrasadat Paknejad
- Department
of Tissue Engineering and Applied Cell Sciences, School of Advanced
Technologies in Medicine, Shahid Beheshti
University of Medical Sciences, Tehran 1985717443, Iran
- Medical
Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Mahboubeh Bohlouli
- Student
Research Committee, Department of Tissue Engineering and Applied Cell
Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Maryam Rezai Rad
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
| | - Pouyan Aminishakib
- Department
of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran
| | - Samira Derakhshan
- Department
of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran
| | | | - Nasser Nadjmi
- Department
of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine
& Health Sciences, University of Antwerp, Antwerp 2100, Belgium
- All
for Research vzw, Harmoniestraat
68, Antwerp 2018, Belgium
| | - Arash Khojasteh
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
- Department
of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran
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16
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Nokhbatolfoghahaei H, Bohlouli M, Paknejad Z, R Rad M, M Amirabad L, Salehi-Nik N, Khani MM, Shahriari S, Nadjmi N, Ebrahimpour A, Khojasteh A. Bioreactor cultivation condition for engineered bone tissue: Effect of various bioreactor designs on extra cellular matrix synthesis. J Biomed Mater Res A 2020; 108:1662-1672. [PMID: 32191385 DOI: 10.1002/jbm.a.36932] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 01/18/2023]
Abstract
Dynamic-based systems are bio-designed in order to mimic the micro-environments of the bone tissue. There is limited direct comparison between perfusion and perfusion-rotation forces in designing a bioreactor. Hence, in current study, we aimed to compare given bioreactors for bone regeneration. Two types of bioreactors including rotating & perfusion and perfusion bioreactors were designed. Mesenchymal stem cells derived from buccal fat pad were loaded on a gelatin/β-Tricalcium phosphate scaffold. Cell-scaffold constructs were subjected to different treatment condition and place in either of the bioreactors. Effect of different dynamic conditions on cellular behavior including cell proliferation, cell adhesion, and osteogenic differentiation were assessed. Osteogenic assessment of scaffolds after 24 days revealed that rotating & perfusion bioreactor led to significantly higher expression of OCN and RUNX2 genes and also greater amount of ALP and collagen I protein production compared to static groups and perfusion bioreactor. Observation of cellular sheets which filled the scaffold porosities in SEM images, approved the better cell responses to rotating & perfusion forces of the bioreactor. The outcomes demonstrated that rotating & perfusion bioreactor action on bone regeneration is much preferable than perfusion bioreactor. Therefore, it seems that exertion of multi-stimuli is more effective for bone engineering.
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Affiliation(s)
- Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Bohlouli
- Student Research Committee, Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahrasadat Paknejad
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam R Rad
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila M Amirabad
- School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Nasim Salehi-Nik
- Department of Biomechanical Engineering, Faulty of Engineering Technology, University of Twente, Enschede, The Netherlands
| | - Mohammad M Khani
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Shahriari
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nasser Nadjmi
- The Team for Cleft and Craniofacial Anomalies, Oral and Maxillofacial Surgery, University of Antwerp, Antwerp, Belgium
| | - Adel Ebrahimpour
- Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Kastoer C, Op de Beeck S, Dom M, Neirinckx T, Verbraecken J, Braem MJ, Van de Heyning PH, Nadjmi N, Vanderveken OM. Drug‐Induced Sleep Endoscopy Upper Airway Collapse Patterns and Maxillomandibular Advancement. Laryngoscope 2020; 130:E268-E274. [DOI: 10.1002/lary.28022] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Chloé Kastoer
- Department of Otorhinolaryngology–Head and Neck SurgeryAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
| | - Sara Op de Beeck
- Department of Otorhinolaryngology–Head and Neck SurgeryAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
| | - Marc Dom
- Department of Special Care DentistryAntwerp University Hospital Edegem, Antwerp Belgium
| | - Thérèse Neirinckx
- Department of Special Care DentistryAntwerp University Hospital Edegem, Antwerp Belgium
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders CentreAntwerp University Hospital Edegem, Antwerp Belgium
- Department of PulmonologyAntwerp University Hospital Edegem, Antwerp Belgium
| | - Marc J. Braem
- Department of Special Care DentistryAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
| | - Paul H. Van de Heyning
- Department of Otorhinolaryngology–Head and Neck SurgeryAntwerp University Hospital Edegem, Antwerp Belgium
- Multidisciplinary Sleep Disorders CentreAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
| | - Nasser Nadjmi
- Department of Oral and Cranio‐Maxillofacial SurgeryAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
| | - Olivier M. Vanderveken
- Department of Otorhinolaryngology–Head and Neck SurgeryAntwerp University Hospital Edegem, Antwerp Belgium
- Multidisciplinary Sleep Disorders CentreAntwerp University Hospital Edegem, Antwerp Belgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp Wilrijk, Antwerp Belgium
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18
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Mauriën K, Van de Casteele E, Nadjmi N. Psychological Well-being and Medical Guidance of Parents of Children With Cleft in Belgium During Feeding Problems of the Child: A Mixed Method Study. J Pediatr Nurs 2019; 48:e56-e66. [PMID: 31326278 DOI: 10.1016/j.pedn.2019.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Cleft is one of the most common anomalies affecting 1 in every 500-750 newborns. Depending on the type of cleft and its size, these children may experience feeding problems immediately after birth. Cleft has consequences for the child, as well as for the parents. The aim of this study was to gain a better understanding on the factors influencing the psychological well-being of the parents. Also, the experiences of parents of children with feeding problems and the received medical guidance were studied. DESIGN AND METHODS A mixed method convergent parallel design was used. In the quantitative study, a cross-sectional design was applied, in which parents completed 3 validated questionnaires about their psychological well-being. For the qualitative research a phenomenological design was used to conduct semi-structured interviews. Ninety parents agreed to join the quantitative study, of which 15 participated in the qualitative study as well. RESULTS The timing of the diagnosis revealed a significant difference in the depression and stress scores, while the number of children was significant for depression, anxiety, and stress. Other parental- and child-related factors did not cause a significant difference in psychological well-being. Different opinions about medical guidance and feeding problems came up during the interviews. CONCLUSION With these results, a recommendation toward future medical guidance can be given. The number of children and the timing of diagnosis were found to be significant variables determining the psychological well-being of the parents. All parents agreed on the need for a point of contact and an umbrella framework for a clearer guidance. Moreover, caregivers should have more knowledge about cleft and associated feeding problems.
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Affiliation(s)
- Kim Mauriën
- Faculty of Medicine & Health Sciences, University of Antwerp, Belgium
| | - Elke Van de Casteele
- Faculty of Medicine & Health Sciences, University of Antwerp, Belgium; All for Research vzw, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Belgium
| | - Nasser Nadjmi
- Faculty of Medicine & Health Sciences, University of Antwerp, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerpen, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Belgium.
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19
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Téblick S, Ruymaekers M, Van de Casteele E, Nadjmi N. Effect of Cleft Palate Closure Technique on Speech and Middle Ear Outcome: A Systematic Review. J Oral Maxillofac Surg 2019; 77:405.e1-405.e15. [DOI: 10.1016/j.joms.2018.09.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/21/2018] [Accepted: 09/21/2018] [Indexed: 12/01/2022]
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20
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Zeraatkar M, Ajami S, Nadjmi N, Faghihi SA, Golkari A. A qualitative study of children's quality of life in the context of living with cleft lip and palate. Pediatric Health Med Ther 2019; 10:13-20. [PMID: 30697094 PMCID: PMC6342148 DOI: 10.2147/phmt.s173070] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background and objective Quality-of-life measures have been expanded to help in assessing the physical and psychosocial effects of oral health. Although, in the case of children undergoing oral surgery, the oro-facial status is generally measured by studies, it is essential to carry out investigations into the level of quality of life (QoL) after surgery to assess the actual effect of these surgeries on children’s lives. Hence, our study is aimed at evaluating the QoL in these children. Methods The study was performed using qualitative content analysis method. Eighteen caregivers of 4–6 year old children with a history of unilateral cleft lip and palate participated in in-depth interviews about the children’s experiences with different problems affecting their daily lives. The results were divided into codes, sub-categories and categories through an inductive process in which the researchers moved from the specific to the general. Result A number of problems were identified, particularly insufficient functional and socio-emotional well-being including, difficulty in eating and speaking, dento-facial problems, shame, anxiety, insufficient peer interaction and dissatisfaction with their own appearance. Conclusion The most critical problems derived from the participants’ experiences were insufficient functional and socio-emotional well-being that contributed to the reduced QoL among these children. Long term multidisciplinary interventional strategies such as psycho-social supportive programs are required to improve the QoL of these children. These interventions should be considered from the early stages of treatment, or even early stages of diagnosis.
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Affiliation(s)
- Maryam Zeraatkar
- Oral and Dental Disease Research Center, Department of Dental Public Health, Shiraz University of Medical Sciences, Shiraz, Iran,
| | - Shabnam Ajami
- Orthodontic Research Center, Department of Orthodontics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerpen, Belgium
| | - Seyad Aliakbar Faghihi
- Clinical Educational Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Golkari
- Oral and Dental Disease Research Center, Department of Dental Public Health, Shiraz University of Medical Sciences, Shiraz, Iran,
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Scheuermann M, Vanreusel I, Van de Casteele E, Nadjmi N. Spontaneous Bone Regeneration After Closure of the Hard Palate Cleft: A Literature Review. J Oral Maxillofac Surg 2018; 77:1074.e1-1074.e7. [PMID: 30689964 DOI: 10.1016/j.joms.2018.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/30/2018] [Accepted: 12/20/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE A wide range of surgical techniques have been described for the treatment of palatal clefts. Some of these surgical procedures result in postoperative osteogenesis at the palatal fissure. The aims of this review were to discuss the current approaches to cleft palate surgery leading to spontaneous bone regeneration and to compare these different procedures. Moreover, the causes of bone regeneration, effects on maxillary growth, and factors affecting bone regeneration on the hard palate are discussed. MATERIALS AND METHODS The selected articles were found via MEDLINE and Web of Science. The keywords for the search were "cleft palate," "bone regeneration," "palatoplasty," "reconstructive surgical procedures," and "cleft palate surgery." Studies that examined the effect of primary palatoplasty on spontaneous bone regeneration in the hard palate in children were included in this review. Four articles were analyzed in the qualitative synthesis. RESULTS Because of differences in patient characteristics and evaluation methods, it was difficult to compare different surgical procedures. The use of a mucoperiosteal flap in combination with adequate closure of the mucosa is needed to obtain bone formation. The area with the largest amount of regenerated bone was located in the middle of the hard palate. In the literature, it was found that complete closure was considered unfavorable because of the negative effects on maxillary growth, but more studies are needed to confirm this. Of the factors that have been studied, only age turned out to be borderline relevant. CONCLUSIONS Only a few studies with small sample sizes have been published on bone regeneration in the hard palate. More research is needed to validate these findings.
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Affiliation(s)
- Maria Scheuermann
- Medical Master Student, Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Inne Vanreusel
- Medical Master Student, Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Elke Van de Casteele
- Postdoctoral Researcher, Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium; All for Research vzw, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Nasser Nadjmi
- Professor, Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium; Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Antwerp, Belgium; Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium.
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Zeraatkar M, Ajami S, Nadjmi N, Golkari A. Impact of oral clefts on the oral health-related quality of life of preschool children and their parents. Niger J Clin Pract 2018; 21:1158-1163. [PMID: 30156201 DOI: 10.4103/njcp.njcp_426_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective To assess the oral health-related quality of life (OHRQoL) of preschool children with cleft lip and palate (CLP) and their relatives. Materials and Methods In this cross-sectional study, 55 2-5-year-old children with the history of CLP were randomly selected from those referred to Shiraz Lip and Palate Cleft Research Center and treated with single-stage closure (Push back palatoplasty). Furthermore, same number of children with the same age who attended the Shiraz School of Dentistry for routine dental care were selected as control group using randomized sampling. Children's demographic data were obtained from their parents. Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS) was used for evaluating these children's QoL. Results We found a significant difference in OHRQoL between children with CLP and children without CLP in the overall score of F-ECOHIS and all of subscales. In the impact on children subscale, the difference between these groups was remarkable in limitations' domain. As for difficulties faced by children, question on "difficulty in pronouncing words" had the highest average score. Furthermore, in impact on family, in parental distress domain, the difference between these groups was remarkable. For difficulties faced by family, financial impact got the highest average score. No significant difference was found between boys and girls with CLP in all subscales. While according to the score of total F-ECOHIS in unilateral and bilateral CLP children, there was statistically significant difference in these groups. Conclusion Since oral clefts affect the QoL of children and their families even after the usual treatments, the implementation and maintenance of multidisciplinary interventional strategies are required for establishment of facial esthetics, oral function, and psychological support for such individuals.
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Affiliation(s)
- M Zeraatkar
- Department of Dental Public Health, Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Ajami
- Department of Orthodontics, Orthodontic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - N Nadjmi
- Department of Cranio-Maxillofacial Surgery, University Hospital Antwerp, Edegem, Belgium
| | - A Golkari
- Department of Dental Public Health, Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kalantary S, Van de Casteele E, Nadjmi N. Congenital Infiltrating Lipomatosis of the Face: Case Report With Presentation of a New Multistep Surgical Approach. J Oral Maxillofac Surg 2018; 76:1334-1343. [DOI: 10.1016/j.joms.2017.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 10/18/2022]
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Nokhbatolfoghahaei H, Rad MR, Khani MM, Shahriari S, Nadjmi N, Khojasteh A. Application of Bioreactors to Improve Functionality of Bone Tissue Engineering Constructs: A Systematic Review. Curr Stem Cell Res Ther 2017; 12:564-599. [DOI: 10.2174/1574888x12666170822100105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/28/2017] [Accepted: 08/15/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mehdi Khani
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Shahriari
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nasser Nadjmi
- The Team for Cleft and Craniofacial Anomalies, Oral and Maxillofacial Surgery, University of Antwerp, Antwerp, Belgium
| | - Arash Khojasteh
- Department of Tissue Engineering, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tehranchi A, Behnia H, Nadjmi N, Yassaee VR, Ravesh Z, Mina M. Multidisciplinary management of a patient with van der Woude syndrome: A case report. Int J Surg Case Rep 2016; 30:142-147. [PMID: 28012331 PMCID: PMC5192017 DOI: 10.1016/j.ijscr.2016.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 11/11/2022] Open
Abstract
We described the orthodontic treatment of a girl diagnosed with VWS. Multidisciplinary techniques resulted in satisfactory outcomes. Genetic testing determined a known putative splice site mutation.
Introduction Van der Woude syndrome (VWS) is the most frequent form of syndromic cleft lip and palate (SCLP) accounting for 2% of all patients with CLP. Case presentation We describe the orthodontic treatment of a girl diagnosed with VWS referred by her family dentist for her cosmetic concerns. Discussion Comprehensive orthodontic treatment, secondary bone graft, distraction osteogenesis (for a deficient maxilla), secondary palatoplasty and excision of lower lip pits, as well as orthodontic and prosthetic procedures may provide a satisfactory outcome. Genetic testing showed a known putative splice site mutation (c.174 + 1 G/A) as the prime cause of VWS in our patient and her family. Conclusion SCLP has significant effects on facial aesthetics and the psychosocial status. Parents should be assessed and counseled appropriately. This condition is treatable in the absence of life threatening systemic anomalies. An interdisciplinary team approach is advocated.
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Affiliation(s)
- Azita Tehranchi
- Preventive Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Orthodontic Department, Dental School, Tehran, Iran.
| | - Hossein Behnia
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Dental School, Tehran, Iran.
| | - Nasser Nadjmi
- University of Antwerp (UA), Belgium; The Team for Cleft and Craniofacial Anomalies, Oral and Maxillofacial Surgery, University of Antwerp, Prinsstraat 13, 2000 Antwerp, Belgium.
| | - Vahid Reza Yassaee
- Genomic Research Center, Aarabi St., Yaman Ave., Evin, Velenjak, Shahid Beheshti University of Medical Sciences, Tehran, 1966645643, Iran; Dept. of Medical Genetic, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1966645643, Iran.
| | - Zeinab Ravesh
- Genomic Research Center, Aarabi St., Yaman Ave., Evin, Velenjak, Shahid Beheshti University of Medical Sciences, Tehran, 1966645643, Iran.
| | - Morteza Mina
- North Khorasan University of Medical Sciences, Bojnurd, Iran.
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Marangoni S, Van de Casteele E, Frigo AC, Fusetti S, Nadjmi N. Surgical treatment of class II dento-facial deformity during adolescence: Long-term follow-up. J Craniomaxillofac Surg 2016; 44:979-84. [PMID: 27269412 DOI: 10.1016/j.jcms.2016.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/13/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the long-term stability of patients operated during adolescence on the base of clinical measurements and cephalometric analysis. Although, the potential benefits of early orthognathic surgery are known to be a reduction in treatment times and a greater healing potential leading to a better adaptation and stability of the occlusion, muscles, bones and joints, no consensus can be found in literature on the minimum age for surgical correction. MATERIALS AND METHODS In this study, thirty patients (age ≤ 15) with a class II dento-skeletal malocclusion were selected, of which 11 having a hyperdivergent (II,1) and 19 a hypodivergent (II,2) growth pattern, representing 2 distinct groups with a different treatment plan and long-term behavior. RESULTS AND CONCLUSION Observing the performance of all parameters over-time, it is seen that subjects belonging to division II,2 have a modification of the growth vectors maintaining the harmonious development between the jaws and the facial aesthetics. Less predictable is the trend in hyperdivergent patients, which are more prone to relapse in the long-term. Early surgery in these patients should be considered in the light of the degree of deformity and its influence felt by the patient on his development of self-image and interpersonal relationship.
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Affiliation(s)
- Sara Marangoni
- Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium; Department of Maxillofacial Surgery, Ospedale dell' Angelo di Mestre, via Paccagnella 11, 30174 Venezia, Italy
| | - Elke Van de Casteele
- Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium; All for Research vzw, Harmoniestraat 68, 2018 Antwerp, Belgium
| | - Anna Chiara Frigo
- Department of Cardiac, Thoracic and Vascular Sciences, Medical Statistics, University of Padova, Italy
| | - Stefano Fusetti
- Department of Maxillofacial Surgery, University of Padova, Policlinico Universitario di Padova, via Giustiani 2, 35100 Padova, Italy
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium.
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Khojasteh A, Motamedian SR, Rad MR, Shahriari MH, Nadjmi N. Polymeric vs hydroxyapatite-based scaffolds on dental pulp stem cell proliferation and differentiation. World J Stem Cells 2015; 7:1215-1221. [PMID: 26640621 PMCID: PMC4663374 DOI: 10.4252/wjsc.v7.i10.1215] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/04/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate adhesion, proliferation and differentiation of human dental pulp stem cells (hDPSCs) on four commercially available scaffold biomaterials.
METHODS: hDPSCs were isolated from human dental pulp tissues of extracted wisdom teeth and established in stem cell growth medium. hDPSCs at passage 3-5 were seeded on four commercially available scaffold biomaterials, SureOss (Allograft), Cerabone (Xenograft), PLLA (Synthetic), and OSTEON II Collagen (Composite), for 7 and 14 d in osteogenic medium. Cell adhesion and morphology to the scaffolds were evaluated by scanning electron microscopy (SEM). Cell proliferation and differentiation into osteogenic lineage were evaluated using DNA counting and alkaline phosphatase (ALP) activity assay, respectively.
RESULTS: All scaffold biomaterials except SureOss (Allograft) supported hDPSC adhesion, proliferation and differentiation. hDPSCs seeded on PLLA (Synthetic) scaffold showed the highest cell proliferation and attachment as indicated with both SEM and DNA counting assay. Evaluating the osteogenic differentiation capability of hDPSCs on different scaffold biomaterials with ALP activity assay showed high level of ALP activity on cells cultured on PLLA (Synthetic) and OSTEON II Collagen (Composite) scaffolds. SEM micrographs also showed that in the presence of Cerabone (Xenograft) and OSTEON II Collagen (Composite) scaffolds, the hDPSCs demonstrated the fibroblastic phenotype with several cytoplasmic extension, while the cells on PLLA scaffold showed the osteoblastic-like morphology, round-like shape.
CONCLUSION: PLLA scaffold supports adhesion, proliferation and osteogenic differentiation of hDPSCs. Hence, it may be useful in combination with hDPSCs for cell-based reconstructive therapy.
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Jafari M, Paknejad Z, Rad MR, Motamedian SR, Eghbal MJ, Nadjmi N, Khojasteh A. Polymeric scaffolds in tissue engineering: a literature review. J Biomed Mater Res B Appl Biomater 2015; 105:431-459. [PMID: 26496456 DOI: 10.1002/jbm.b.33547] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 09/06/2015] [Accepted: 09/27/2015] [Indexed: 12/16/2022]
Abstract
The tissue engineering scaffold acts as an extracellular matrix that interacts to the cells prior to forming new tissues. The chemical and structural characteristics of scaffolds are major concerns in fabricating of ideal three-dimensional structure for tissue engineering applications. The polymer scaffolds used for tissue engineering should possess proper architecture and mechanical properties in addition to supporting cell adhesion, proliferation, and differentiation. Much research has been done on the topic of polymeric scaffold properties such as surface topographic features (roughness and hydrophilicity) and scaffold microstructures (pore size, porosity, pore interconnectivity, and pore and fiber architectures) that influence the cell-scaffold interactions. In this review, efforts were given to evaluate the effect of both chemical and structural characteristics of scaffolds on cell behaviors such as adhesion, proliferation, migration, and differentiation. This review would provide the fundamental information which would be beneficial for scaffold design in future. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 431-459, 2017.
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Affiliation(s)
- Maissa Jafari
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahrasadat Paknejad
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Oral and Maxillofacial Surgery, University of Antwerp, Belgium, Antwerp, Belgium
| | - Saeed Reza Motamedian
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Eghbal
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasser Nadjmi
- Department of Oral and Maxillofacial Surgery, University of Antwerp, Belgium, Antwerp, Belgium
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nadjmi N. Transoral robotic cleft palate surgery (TORCS). Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bila M, Defrancq J, Nadjmi N, Renier L, Stevens S, Vanassche B, Van de Perre J, Van Hemelen G, Vercruysse H. CBCT analysis of skeletal, dental and nasal changes after transpalatal distraction. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
UNLABELLED Objective This study aimed to assess the safety and feasibility of transoral robotic surgery for the reconstruction of soft palatal clefts. Design The application of transoral robotic surgery for soft palate muscle reconstruction was investigated. The da Vinci Surgical Robot was first used on a cadaver to assess the optimal positioning of the patient and the robot. The robot was then used for the dissection and reconstruction of palatal muscles in 10 consecutive patients with palatal clefts. The procedures were documented using video and still photography. A group of 30 control patients were subjected to surgery with manual instruments. Surgical and clinical outcomes were evaluated with at least 6 months of follow-up (8 ± 1 months). Results The use of the surgical robot on a cadaver provided great dexterity and excellent 3D depth perception. The transoral access was efficient and safe for the precise dissection, reorientation, and suturing of palatal muscles. In our series, the surgical duration was longer for the robotic approach than for the manual approach (87 ± 6 minutes versus 122 ± 8 minutes, P < .0001). No intraoperative or postoperative complications occurred in either group. CONCLUSIONS A robotic surgical approach can be used safely for palatal surgery. We believe that the precise dissection of the palatal muscles provided by the robotic system might reduce damage to the vascularization and innervation of these muscles, as well as damage to the mucosal surfaces that could cause fistula formation. In addition, this technique might improve palatal function and Eustachian tube function in cleft palate patients.
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Nadjmi N, Stevens S, Van Erum R. Mandibular midline distraction using a tooth-borne device and a minimally invasive surgical procedure. Int J Oral Maxillofac Surg 2015; 44:452-4. [DOI: 10.1016/j.ijom.2014.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 08/31/2014] [Accepted: 11/05/2014] [Indexed: 11/25/2022]
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Nadjmi N, Defrancq E, Mollemans W, Hemelen GV, Bergé S. Quantitative validation of a computer-aided maxillofacial planning system, focusing on soft tissue deformations. Ann Maxillofac Surg 2015; 4:171-5. [PMID: 25593866 PMCID: PMC4293837 DOI: 10.4103/2231-0746.147112] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to evaluate the accuracy of 3D soft tissue predictions generated by a computer-aided maxillofacial planning system in patients undergoing orthognathic surgery. METHODS AND MATERIALS Twenty patients with dentofacial dysmorphosis were treated with orthognathic surgery after a preoperative orthodontic treatment. Fourteen patients had an Angle Class II malocclusion; three patients had an Angle class III malocclusion, and three patients had an Angle Class I malocclusion. Skeletal asymmetry was observed in six patient. The surgeries were planned using the Maxilim software. Computer assisted surgical planning was transferred to the patient by digitally generated splints. The validation procedures were performed in the following steps: (1) Standardized registration of the pre- and postoperative Cone Beam CT volumes; (2) Automated adjustment of the bone-related planning to the actual operative bony displacement; (3) Simulation of soft tissue changes; (4) Calculation of the soft tissue differences between the predicted and the postoperative results by distance mapping. STATISTICAL ANALYSIS AND RESULTS Eighty four percent of the mapped distances between the predicted and actual postoperative results measured between -2 mm and +2 mm. The mean absolute linear measurements between the predicted and actual postoperative surface was 1.18. Our study shows the overall prediction was dependent on neither the surgical procedures nor the dentofacial deformity type. CONCLUSION Despite some shortcomings in the prediction of the final position of the lower lip and cheek area, this software promises a clinically acceptable soft tissue prediction for orthognathic surgical procedures.
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Affiliation(s)
- Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery, AZ MONICA, Harmoniestraat 68, B-2018 Antwerp, Belgium University Hospital Antwerp, Belgium
| | - Ellen Defrancq
- Department of Cranio-Maxillofacial Surgery, AZ MONICA, Harmoniestraat 68, B-2018 Antwerp, Belgium University Hospital Antwerp, Belgium
| | - Wouter Mollemans
- Medical Image Computing (Radiology - ESAT/PSI), Faculties of Medicine and Engineering University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
| | - Geert Van Hemelen
- Department of Cranio-Maxillofacial Surgery, AZ MONICA, Harmoniestraat 68, B-2018 Antwerp, Belgium University Hospital Antwerp, Belgium
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
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Van Holsbeke CS, Verhulst SL, Vos WG, De Backer JW, Vinchurkar SC, Verdonck PR, van Doorn JWD, Nadjmi N, De Backer WA. Change in upper airway geometry between upright and supine position during tidal nasal breathing. J Aerosol Med Pulm Drug Deliv 2013; 27:51-7. [PMID: 23509935 DOI: 10.1089/jamp.2012.1010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As the upper airway is the most important limiting factor for the deposition of inhalation medication in the lower airways, it is interesting to assess how its morphology varies between different postures. The goal of this study is to compare the upper airway morphology and functionality of healthy volunteers in the upright and supine positions during tidal nasal breathing and to search for baseline indicators for these changes. This is done by performing three-dimensional measurements on computed tomography (CT) and cone beam computed tomography (CBCT) scans. METHODS This prospective study was approved by all relevant institutional review boards. All patients gave their signed informed consent. In this study, 20 healthy volunteers (mean age, 62 years; age range, 37-78 years; mean body mass index, 29.26; body mass index range, 21.63-42.17; 16 men, 4 women) underwent a supine low-dose CT scan and an upright CBCT scan of the upper airway. The (local) average (Savg) and minimal (Smin) cross-sectional area, the position of the latter, the concavity, and the airway resistance were examined to determine if they changed from the upright to the supine position. If changes were found, baseline parameters were sought that were indicators for these differences. RESULTS There were five dropouts due to movement artifacts in the CBCT scans. Savg and Smin were 9.76% and 26.90% larger, respectively, in the CBCT scan than in the CT scan, whereas the resistance decreased by 26.15% in the upright position. The Savg of the region between the hard palate and the bottom of the uvula increased the most (49.85%). In people with a high body mass index, this value changed the least. The airway resistance in men decreased more than in women. CONCLUSIONS This study demonstrated that there are differences in upper airway morphology and functionality between the supine and upright positions and that there are baseline indicators for these differences.
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Nadjmi N, Van Erum R, De Bodt M, Bronkhorst EM. Two-stage palatoplasty using a modified Furlow procedure. Int J Oral Maxillofac Surg 2013; 42:551-8. [PMID: 23433472 DOI: 10.1016/j.ijom.2012.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 11/16/2012] [Accepted: 12/05/2012] [Indexed: 10/27/2022]
Abstract
A two-stage palatal repair using a modification of Furlow palatoplasty is presented. The authors investigate the speech outcome, fistula formation and maxillary growth. In a prospective, successive cohort study, 40 nonsyndromic patients with wide cleft palate were operated on between March 2001 and June 2006 by a single surgeon. 10 patients in the first cohort underwent a Furlow palatoplasty (control group). In 30 patients in the second cohort a unilateral myomucosal cheek flap was used in combination with a modified Furlow palatoplasty (study group). The hard palate was closed in both groups 9-12 months later. The Bzoch speech quality score was superior in the study group, and the hypernasality was significantly reduced in the study group. Overall fistula formation was 0%. At the time of hard palate reconstruction palatal cleft width was significantly reduced. Relative short-term follow up of maxillary growth was excellent. There were no postoperative haematomas, infections, or episodes of airway obstruction. This technique is particularly encouraging, because of better speech outcome, absence of raw surfaces on the soft palate, no fistula formation, and good maxillary growth. Further follow-up is necessary to determine the long-term effects on facial development.
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Affiliation(s)
- N Nadjmi
- OMFS, University Hospital Antwerp (UA), Belgium.
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Nadjmi N, Mollemans W, Daelemans A, Van Hemelen G, Schutyser F. O.104 Virtual occlusion planning for orthognathic surgery. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71228-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mollemans W, Schutyser F, Nadjmi N, Maes F, Suetens P. Predicting soft tissue deformations for a maxillofacial surgery planning system: From computational strategies to a complete clinical validation. Med Image Anal 2007; 11:282-301. [PMID: 17493864 DOI: 10.1016/j.media.2007.02.003] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 08/03/2006] [Accepted: 02/15/2007] [Indexed: 11/24/2022]
Abstract
In the field of maxillofacial surgery, there is a huge demand from surgeons to be able to pre-operatively predict the new facial outlook after surgery. Besides the big interest for the surgeon during the planning, it is also an essential tool to improve the communication between the surgeon and his patient. In this work, we compare the usage of four different computational strategies to predict this new facial outlook. These four strategies are: a linear Finite Element Model (FEM), a non-linear Finite Element Model (NFEM), a Mass Spring Model (MSM) and a novel Mass Tensor Model (MTM). For true validation of these four models we acquired a data set of 10 patients who underwent maxillofacial surgery, including pre-operative and post-operative CT data. For all patient data we compared in a quantitative validation the predicted facial outlook, obtained with one of the four computational models, with post-operative image data. During this quantitative validation distance measurements between corresponding points of the predicted and the actual post-operative facial skin surface, are quantified and visualised in 3D. Our results show that the MTM and linear FEM predictions achieve the highest accuracy. For these models the average median distance measures only 0.60 mm and even the average 90% percentile stays below 1.5 mm. Furthermore, the MTM turned out to be the fastest model, with an average simulation time of only 10 s. Besides this quantitative validation, a qualitative validation study was carried out by eight maxillofacial surgeons, who scored the visualised predicted facial appearance by means of pre-defined statements. This study confirmed the positive results of the quantitative study, so we can conclude that fast and accurate predictions of the post-operative facial outcome are possible. Therefore, the usage of a maxillofacial soft tissue prediction system is relevant and suitable for daily clinical practice.
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Affiliation(s)
- W Mollemans
- Medical Image Computing (Radiology - ESAT/PSI), Faculties of Medicine and Engineering, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
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Wenghoefer M, Martini M, Nadjmi N, Schutyser F, Jagtman AK, Bergé S. Trans-sinusoidal maxillary distraction in three cleft patients. Int J Oral Maxillofac Surg 2006; 35:954-60. [PMID: 17014993 DOI: 10.1016/j.ijom.2006.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 02/08/2006] [Accepted: 07/13/2006] [Indexed: 10/24/2022]
Abstract
The trans-sinusoidal maxillary distractor (TS-MD) was used to achieve maxillary advancement in three patients with repaired cleft lip and palate. After preoperative computer-aided planning of the distraction vectors, each TS-MD was bent on a stereolithographic model of the maxilla of the patient. The devices were intraoperatively positioned using a methyl-methacrylate template. After standard Le Fort I osteotomy the devices were intraorally activated. After distraction the devices remained in situ for 3 months as rigid internal fixation of the maxilla. All patients were successfully distracted according to protocol. Maxillary advancement was 12, 8 and 11 mm. In two patients, additional maxillary widening of 6 and 8 mm was achieved by choosing divergent distraction vectors. After distraction a clockwise rotation of the maxilla was observed in two patients. There was no relapse during the 3 months of consolidation and 12-month follow-up. The TS-MD allows not only distraction but also rigid internal fixation after distraction. It was easy to apply but difficult to remove. Owing to preoperative 3D planning of the distraction vectors, the results were predictable, but clockwise rotation of the maxilla during distraction should be considered in planning. The distractor did not interfere with function or social activities during distraction and retention periods. After removal it left no extraoral scars.
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Affiliation(s)
- M Wenghoefer
- Department of Oral & Maxillofacial Surgery, University of Bonn, Sigmund-Freud-Str. 25, Bonn 53105, Germany
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Nadjmi N, Schutyser F, Van Erum R. Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results. Int J Oral Maxillofac Surg 2006; 35:885-96. [PMID: 16965902 DOI: 10.1016/j.ijom.2006.06.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2006] [Revised: 03/20/2006] [Accepted: 06/05/2006] [Indexed: 11/25/2022]
Abstract
Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.
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Affiliation(s)
- N Nadjmi
- Department of Cranio-Maxillofacial Surgery, Eeuwfeestkliniek, Harmoniestraat 68, B-2018 Antwerpen, Belgium.
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Nadjmi N, Mollemans W, Schutyser F, Suetens P. P.162 3D soft tissue predictions for a computer-aided maxillofacial surgery planning system. J Craniomaxillofac Surg 2006. [DOI: 10.1016/s1010-5182(06)60670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Van Hemelen G, Simon D, Defrancq J, Nadjmi N. O.092 Preliminary report of a new bone born transversal distractor of the maxilla (Smile®). J Craniomaxillofac Surg 2006. [DOI: 10.1016/s1010-5182(06)60121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nadjmi N, Defranq J, Van Hemelen G, Vercruysse H. P.007 Recontouring of the aged face. J Craniomaxillofac Surg 2006. [DOI: 10.1016/s1010-5182(06)60516-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mollemans W, Schutyser F, Nadjmi N, Maes F, Suetens P. Parameter Optimisation of a Linear Tetrahedral Mass Tensor Model for a Maxillofacial Soft Tissue Simulator. Biomedical Simulation 2006. [DOI: 10.1007/11790273_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Abstract
INTRODUCTION This work was conducted to evaluate a new maxillary distractor with an activating system introduced into the maxilary sinus. PATIENTS AND METHOD Fourteen patients age 8 to 55 Years with severe maxillary and midfacial hypoplasia were treated in our center. A trans-sinusoidal maxillary distractor (TS-MD, developed by Dr. N. Nadjmi in cooperation with Martin, Tuttlingen, Germany) was placed intra-orally at each side of the maxilla. The distraction vector was predicted with devoted software (Medicim N.V Belgium), and was transferred to the patients using stereolithographic models and individual templates. A high Lefort I type osteotomy was performed. RESULTS Forward maxillary movement at distractor level varied from 7 to 22 mm. Soft and hard tIssue formation resulted in complete healing across the distraction gaps. The maxillary movements and new bone formation in the sagittal, horizontal, and vertical planes could be predicted and achieved. Distractors were designed to allow clockwise rotation of the maxilla during the distraction phase allowing the correction of the anterior open-bite in all patients with this skeletal deformity. The distractors were almost completely submerged, and could be left in place as long as necessary to avoid relapse. DISCUSSION The TS-MD distractor has the advantage of good tolerance since the most voluminous part is placed within the maxilary sinus. Implantation via an exclusively oral approach is a further advantage. The devise does not interfere with the patient's social life and does not require alveolodental fixation. The TS-MD distractor can also aleviate the need for bone grafting in cases with major advancement. Correct position of the vector is crucial but one-sided catch-up distraction is possible.
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Affiliation(s)
- N Nadjmi
- Groupe Cranio-Maxillo-Facial, EeuRwfeestkliniek, 2018 Anvers, Belgique
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Stalmans K, Van Erum R, Verdonck A, Nadjmi N, Schepers E, Schoenaers J, Carels C. Cephalometric evaluation of maxillary advancement with an internal distractor in an adult boxer dog. Orthod Craniofac Res 2003; 6:104-11. [PMID: 12809273 DOI: 10.1034/j.1600-0854.2003.c250.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate cephalometrically the effects of distraction of the maxilla over a 1-year period by means of an internal distractor applied in a boxer dog. DESIGN Internal distractors were placed bilaterally in the internal cavity of the maxillary sinus of a 2-year-old boxer dog after a Le Fort I osteotomy. Distraction was started 5 days after surgery and activations were continued for 14 days at a rate of 1 mm/day. Standardized lateral cephalograms were taken with an extemal source of 90 kV, 60 mS immediately pre-surgery, at day 1 after the start of the distraction (dp) and at day 5 dp, day 7 dp, day 10 dp, day 14 dp (end of distraction), at 14 days of consolidation period (cp), at 28 days cp and at 56 days cp (removal of the distractors). One year after the removal of the distractor, a final lateral cephalogram was taken. Cephalometric analysis was performed and superimpositions were used for the evaluation of the sagittal position of the maxilla. RESULTS The linear measurements, as well as the superimposition showed evidence for a significantly advanced position of the maxilla, which was stable 1 year after removal of the distractor. CONCLUSION The application of the internal maxillary distractor in a boxer dog resulted in a sagittal advancement of the midface that was still present after 1 year.
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Affiliation(s)
- K Stalmans
- Department of Orthodontics, Katholieke Universiteit Leuven, Belgium
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Nadjmi N, Jackson IT. Full-thickness skin graft in the secondary repair of bilateral cleft lip. A case report. Int J Oral Maxillofac Surg 1999; 28:176-8. [PMID: 10355936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
A 13-week-old boy with bilateral complete cleft lip and palate is presented. He had three attempted repairs of his lip elsewhere over a period of four weeks, and all of these broke down. Consequently, a substantial amount of his prolabium became necrotic. After a preoperative orthodontic realignment of the cleft segments, a secondary lip/nose repair was performed. The mucosa was reconstructed by advancement flaps. The orbicularis muscle was dissected out from its abnormal insertion and reconstructed in the midline. The philtrum was reconstructed with a full-thickness skin graft from the right postauricular area. The six-month postoperative result was satisfactory. This technique could be considered as an alternative to primary Abbé flap in secondary reconstruction of the cleft lip, although long-term follow-up must be obtained.
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Affiliation(s)
- N Nadjmi
- Institute for Craniofacial and Reconstructive Surgery, affiliated with Providence Hospital, Southfield, Michigan 48075, USA
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Nadjmi N, Jackson IT. Full-thickness skin graft in the secondary repair of bilateral cleft lip. A case report. Int J Oral Maxillofac Surg 1999. [DOI: 10.1034/j.1399-0020.1999.283280304.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mommaerts MY, Nadjmi N, Abeloos JV, Neyt LF. Six year's experience with the zygomatic "sandwich" osteotomy for correction of malar deficiency. J Oral Maxillofac Surg 1999; 57:8-13; discussion 14-5. [PMID: 9915389 DOI: 10.1016/s0278-2391(99)90621-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study discusses the rationale, modifications, and complications of an osteotomy technique used to increase malar projection. PATIENTS AND METHODS Seventy "sandwich" zygomatic osteotomies were performed in a 6-year period. Hydroxyapatite (HA) blocks were used to stabilize the anterolateral rotation of the zygomatic body in 44 osteotomies, calcium carbonate blocks were used in 23, calvarial bone grafts in three, a piece of bovine cartilage in one, and a bone graft from a chin ostectomy procedure combined with mesh osteosynthesis in one procedure. Fifty-six zygomatic osteotomies were combined with Le Fort I-type osteotomies (eight with a midline split). Nineteen zygomatic osteotomies were performed simultaneously with a Le Fort I-type osteotomy and a rhinoplasty with lateral osteotomies. RESULTS The increase of malar projection and the stability of the procedure could not be measured on conventional three-plane cephalograms. However, patient's and surgeon's satisfaction were high and remained so during the follow-up period (maximum, 6.5 years; minimum, 6 months). Three patients developed maxillary sinusitis. In two of them, this was clearly related to fragmentation of an HA block. A Treacher-Collins patient developed a chronic fistula in the upper vestibule, caused by leakage of infraorbitally placed HA granules. In two cases, a fracture of the zygomatic arch occurred. Osteosynthesis was performed in one of them. CONCLUSION With proper technique and care not to fracture the interpositional HA block, complications are rare. The procedure is expedient and provides predictable and stable correction of malar deficiency.
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Affiliation(s)
- M Y Mommaerts
- Department of Surgery, General Hospital St John, Bruges, Belgium
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Abstract
PURPOSE The purpose of this investigation was to test the hypothesis that the mandible rotates around the same point during maxillary impaction surgery as during initial jaw opening. This point, called the center of mandibular autorotation (CAR), could then be used to predict mandibular position and to decide whether only maxillary impaction would be needed to correct the occlusion and the facial profile. PATIENTS AND METHODS Preoperatively, two lateral cephalograms were obtained from a consecutive series of 20 patients who underwent maxillary impaction without concomitant mandibular ramus osteotomy. One cephalogram was taken with the mandible in centric relation using a wax bite wafer and another with a jaw opening of 10 mm using a fabricated acrylic bite block with the mandible manipulated to its most retruded position. The CAR was calculated before and after jaw opening using the Rouleaux method on the lower incisor and gonion point. A third lateral cephalogram was taken within 2 days postoperatively. The postoperative lower incisal point was then transferred to the first cephalogram using cranial base superimposition. RESULTS When the preoperative and postoperative distances between CAR and incisal point were compared, there was no significant difference between these distances, proving the hypothesis. CONCLUSIONS The method used is a practical and precise way to determine the center of mandibular autorotation on an individual basis. The center of rotation during initial jaw opening is the same as during impaction surgery.
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Affiliation(s)
- N Nadjmi
- Department of Surgery, General Hospital St John, Bruges, Belgium
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