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Telha W, Al-Watary MQ, Sakran K, Chen H, Bi R, Zhu S, Jiang N. The effect of different hybrid rigid internal fixation techniques on the postoperative stability following a mandibular advancement using a bilateral sagittal split ramus osteotomy: A retrospective three-dimensional comparative study. J Stomatol Oral Maxillofac Surg 2024; 125:101667. [PMID: 38738550 DOI: 10.1016/j.jormas.2023.101667] [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] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To three-dimensionally evaluate post-operative mandibular stability following bilateral sagittal split ramus osteotomies between hybrid and non-hybrid rigid internal fixation techniques. MATERIALS AND METHOD Seventy adults with skeletal class II deformity who underwent bilateral split sagittal osteotomy with mandibular advancement were included. Patients were divided into four groups based on their fixation techniques: hybrid technique (HT) groups I, II, and IV received a 4-hole 2 mm miniplate with either a bicortical screw (BS), additional 2 mm 4-hole miniplate, or two-hole miniplate, while non-HT group III received a 4-hole 2 mm miniplate with four mini-screws (MS). Measurements were taken pre-operatively (T0), immediately postoperatively (T1), and ≥1 year after surgery (T2) using 3D Slicer software. RESULTS Age, sex, and follow-up period did not correlate significantly with postoperative relapse or stability. Significant differences were observed in the advancement on the right side between groups II, III, and IV and on the left side between groups I, III, and IV. However, the type of surgical intervention showed no significant effect on postoperative relapse and stability. All groups of fixations showed satisfactory stability with irrelevant relapse (< 2 mm or 2°). CONCLUSION The study demonstrated satisfactory and comparable stability among different fixation groups on patients undergoing mandibular advancement following bilateral split sagittal osteotomy. The results highlighted the importance of considering the degree of advancement when planning orthognathic surgery and managing postoperative outcomes.
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Affiliation(s)
- Wael Telha
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mohammed Qasem Al-Watary
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Karim Sakran
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China; Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Yemen
| | - Haozhe Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Tan P, Telha W, Bi R, Jiang N, Zhu S. Bone Volume Analysis and Associated Influencing Factors in Mandibular Distraction Osteogenesis: A Retrospective Analysis. J Oral Maxillofac Surg 2024:S0278-2391(24)00155-1. [PMID: 38537668 DOI: 10.1016/j.joms.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Distraction osteogenesis is a progressively popular technique for maxillofacial bone reconstruction, but there is a notable gap in the analysis of bone volume within the distraction segment and the exploration of associated influencing factors. PURPOSE The purpose of this study was to quantitatively analyze the new bone volume and the distraction gap volume in the three-dimensional (3D) model and explore the influencing factors associated with the percentage of the new bone volume to the distraction gap volume. STUDY DESIGN, SETTING, SAMPLE This retrospective study included patients who underwent maxillofacial distraction osteogenesis treatment at the West China Hospital of Stomatology between 2014 and 2022, utilizing the mandibular distractor (Cebei, Ningbo, China). Exclusion criteria encompassed individuals with incomplete clinical or radiographical records as well as those who loss to follow-up. PREDICTOR VARIABLE The predictor variables were age, sex, diagnosis, consolidation period duration, distraction modality, osteotomy area, distraction gap volume, and proximal bone segment volume. MAIN OUTCOME VARIABLE(S) The outcome variable was osteogenic effect which defined as the percentage of the new bone volume to the distraction gap volume in the 3D model. COVARIATES Not applicable. ANALYSES T-tests were used to describe categorical variables, and Pearson correlation analysis was used to describe continuous variables. Linear regression was employed to assess the predictiveness of variables for osteogenic effect. Data are described as mean ± standard deviation; statistical significance was established at a P value < .05. RESULTS The study sample contained 35 patients(11 males and 24 females) with a mean age of 21.17 ± 11.82 years (range: 5 to 47 years) were included. The mean osteogenic effect of all samples was 78.89 ± 24.70%. Multiple linear regression models confirmed that the osteogenic effect was significantly influenced by the distraction gap volume (P = .003), proximal bone segment volume (P = .009), osteotomy area (P = .034), diagnosis (P = .004), and distraction modality (P = .021). CONCLUSION AND RELEVANCE The percentage of new bone mass to simulated volume based on 3D model measurement can serve as an effective quantitative indicator for evaluating the osteogenic effect; our study demonstrates that distraction gap volume, proximal bone segment volume, osteotomy area, diagnosis, and distraction modality can statistically significantly influence the osteogenic effect.
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Affiliation(s)
- Peijie Tan
- Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wael Telha
- Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ruiye Bi
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Songsong Zhu
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Liu Y, Wang P, Telha W, Jiang N, Bi R, Zhu S. Arthroscopic reduction and rigid fixation of the anteriorly displaced temporomandibular joint disc without reduction using titanium screw: a case series. Clin Oral Investig 2024; 28:156. [PMID: 38376600 DOI: 10.1007/s00784-024-05552-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/10/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES To evaluate the effectiveness of arthroscopic reduction and rigid fixation (ARRF) using a suture-free titanium screw as a treatment approach to temporomandibular joint's (TMJ) anterior disc displacement without reduction (ADDwoR) and assess its impact on clinical outcomes, including improvements in symptoms related to TMJ disorders. MATERIALS AND METHODS A series of twenty patients presented to the Department of Orthognathic and Temporomandibular Surgery at West China Hospital of Stomatology between September 2022 and January 2023, complaining of symptoms such as pain, clicking, and limited mouth opening. Standard magnetic resonance image (MRI) imaging T1 and T2 sequences in both sagittal and coronal views study with closed and maximal open mouth positions were taken preoperatively to assess the disc's position, integrity, and shape. Also, cone-beam computed tomography (CBCT) scans images to find any degenerative changes and evaluate the condylar bone's features and volume. Additionally, the clinical examination assesses limited oral opening, mechanical pain, and the presence of any noises such as clicking and crepitus. All cases were treated under general anesthesia using the arthroscopic release, reduction, and rigid fixation of the TMJ's ADDwoR to establish a normal disc-condyle relationship and to restore the functional position. RESULTS Patients' symptoms, such as pain and mouth opening, improved significantly following the arthroscopic treatment. Postoperative MRI and CBCT imaging follow-up conducted at 6 months demonstrated the stable position of the reduced TMJ disc and the fixation screw. Notably, none of the patients exhibited signs of relapse during this follow-up period. CONCLUSION Overall, the ARRF of TMJ's ADDwoR using a suture-free titanium screw proved to be safe and provides satisfactory results, in addition to the several advantages of using suture-free titanium screws, such as biocompatibility, strong fixation, and durability. However, it is a technically demanding procedure requiring extensive, long-term training. CLINICAL RELEVANCE ARRF using a cost-effective fixation titanium screw to treat ADDwoR emerges as a clinically effective minimally invasive approach.
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Affiliation(s)
- Yao Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Peng Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
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Ren R, Li Y, Telha W, Zhu S, Jiang N. Effect of the magnitude of condylar head displacement on the TMJ function in skeletal class II patients undergoing different degrees of mandibular advancement: A retrospective comparative study. J Plast Reconstr Aesthet Surg 2023; 84:241-249. [PMID: 37352620 DOI: 10.1016/j.bjps.2023.06.001] [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: 12/14/2022] [Accepted: 06/05/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE This study aimed to compare the condylar head displacement (CHD) after bilateral sagittal split ramus osteotomy (BSSO) between different degrees of mandibular advancement in skeletal class II patients and to evaluate whether the temporomandibular joint (TMJ) function would be affected. PATIENTS AND METHODS Fifty-nine patients (118 condyles) were included in this retrospective study and were divided into three groups based on the distance of mandibular advancement. The CHD in three directions, x (sagittal direction), y (coronal direction), and z (axial direction), was measured before operation (T0), immediately after operation (T1), and at least 6 months after operation (T2), and the TMJ function of patients was followed up and scored using the Helkimo index system. All the abovementioned data were statistically analyzed, and p < 0.05 was considered the statistical difference standard. RESULT During the BSSO surgery, the condyle was predominantly displaced in a lateral, posterior, and superior direction whenever in T1 and T2, even though the degree of CHD was different. Regarding the amount of CHD, the large advancement group was higher than the other two groups in T1 and T2 (p<0.01). The Helkimo index scores of the three groups were evaluated, and there was no significant statistical difference between the Ai and Di index of the three groups. CONCLUSION In our center, CHD occurred in lateral, posterior, and superior directions following mandibular advancement in skeletal class II patients, with a positive correlation between the CHD and the mandibular advancement; however, the TMJ function of the three groups did not show significant differences.
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Affiliation(s)
- Rong Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu 610041, Sichuan, China
| | - Yibo Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu 610041, Sichuan, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu 610041, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu 610041, Sichuan, China.
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu 610041, Sichuan, China.
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Telha W, Bi R, Abotaleb B, Al-Watary M, Sakran K, Zhu S, Jiang N. Condylar positional changes and remodeling following bimaxillary anterior segment osteotomy with and without Le Fort I osteotomy: a three-dimensional comparative analysis. Clin Oral Investig 2023; 27:5121-5130. [PMID: 37474831 DOI: 10.1007/s00784-023-05132-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To evaluate 3D condylar displacement and long-term remodeling following the correction of bimaxillary protrusion by anterior segment osteotomy (ASO) with and without Le Fort I surgery. MATERIALS AND METHOD This retrospective study included 32 adults with bimaxillary protrusion who underwent ASO alone (group 1) or with concomitant Le Fort I osteotomy (group 2). Subject's computed tomography scans at basic (T0), immediate postoperatively (T1), and at 1 year or more follow-up (T2) were collected. The condyle displacement was measured at superior-inferior, lateromedially, and anteroposterior surfaces, while condyle remodeling was measured at the superior, lateral, anterior, medial, and posterior surfaces. All 3D analyses were performed using 3D Slicer software (4.11.2). RESULTS At T1, 52.7%, 86.7%, and 94.4% of condyles in group 1 were displaced inferiorly, laterally, and posteriorly, respectively, as well as 75%, 89.2%, and 53.5% of condyles in group 2, which had not fully returned to the original preoperative positions at T2. Condylar remodeling was observed in both groups at T2, and no significant difference was found in the overall condylar volume between T1 and T2 in both groups. Patients in group 2 exhibited significant bone resorption at both lateral and anterior surfaces compared to group 1 (P = 0.000 and 0.01, respectively). CONCLUSION This study's results demonstrated that ASO is associated with a degree of condylar changes even if the posterior mandible is not osteomized. The positional changes vary between bimaxillary ASO alone and those with simultaneous Le Fort I osteotomy. However, both groups' condyle volume remained stable at the long-term follow-up.
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Affiliation(s)
- Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Rui Bi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Bassam Abotaleb
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Mohammed Al-Watary
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Karim Sakran
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
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Ren R, Zhou J, Sun Y, Telha W, Song N, Zhan Y, Zhu S, Jiang N. Interspecies comparison of temporomandibular joint condylar cartilage extracellular matrix from macro to microscopy. J Mech Behav Biomed Mater 2023; 145:106007. [PMID: 37451050 DOI: 10.1016/j.jmbbm.2023.106007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
Interspecies comparisons of the extracellular matrix of temporomandibular joint (TMJ) condylar cartilage are necessary to elucidate the mechanisms underlying its superior mechanical properties, to guide the construction of animal models of TMJ-related diseases, and to establish standards for the engineering of TMJ condylar cartilage. Here we characterize and compare TMJ condylar cartilage from six different species from a materials science perspective, including structure, composition and mechanical properties from the macroscopic to the microscopic level. The gross morphology showed obvious interspecies differences in size and shape, which may be related to the different joint motion patterns. Although the condylar cartilage of all species can be divided histologically into a superficial fibrous layer and a deep hyaline layer, there are significant interspecies differences in the microstructure of the fibrils in the two layers, mainly in the diameter of the fibrils. Compositionally, there were no significant differences in collagen composition between species, but the content of glycosaminoglycans (GAGs) decreased progressively with increasing body size, with the same results obtained by Safranin O staining and biochemical analysis. Mechanically, the elastic modulus of mouse condylar cartilage was significantly higher than that of the other species and tended to decrease with increasing body size. This study shows that the TMJ condylar cartilage of different species has its own specific structure-composition-mechanics matching characteristics for their unique masticatory stress dissipation, and differences in fibril diameter and GAGs content may be the two ultimate factors influencing the differences in cartilage mechanical properties between species, while the condylar cartilage of pigs is most similar to that of humans, suggesting that pigs may be a suitable animal model for TMJ studies.
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Affiliation(s)
- Rong Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Jiahao Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Yixin Sun
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Ning Song
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Yanjing Zhan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China.
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China.
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Wang P, Liu Y, Bi R, Jiang N, Telha W, Cao P, Zhu S. TMJ anterior disc displacement anchorage surgery: a retrospective study based on a suture-free titanium screw strategy. Clin Oral Investig 2023; 27:4579-4584. [PMID: 37468599 DOI: 10.1007/s00784-023-05083-2] [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: 02/25/2023] [Accepted: 05/21/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To evaluate the feasibility and effectiveness of using a suture-free titanium screw in repositioning anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ). METHODS A consecutive sample of twelve patients (fifteen joints) was included in this study. All patients were diagnosed with ADDwoR and showed limited mouth opening or temporomandibular joint pain symptoms. Suture-free titanium screw was placed in the condyle directly following the disc repositioning. Pre- and postoperative evaluation parameters include operation time, the visual analogue scale for pain (VAS), lateral excursion movements (LEM), maximum interincisal opening (MIO), and disc length and position on MRI. In addition, the mandibular condyle height was also measured. Statistical significance was considered when p < 0.05. RESULTS The unilateral operation time was 58.54 ± 5.43 min; during the 6-month period after the operation, the VAS values decreased from 87 ± 6.34 to 14.08 ± 6.65. The MIO increased from 30.07 ± 4.73 to 39.89 ± 1.69 mm (p = 0.01). The TMJ disc length was prolonged from 8.23 ± 1.12 to 11.51 ± 1.29 mm. The condyles showed significant remodeling, and the height of the condyle increased from 18.24 ± 4.12 increase to 19.6 ± 4.31 mm. The LEM was increased from 5.27 ± 0.51 to 6.36 ± 0.62 mm. The MRI images showed the stability of the disc in position during the opening and closing of the mouth. The TMJ disc position was stable during the follow-up period. CONCLUSION Anteriorly displaced articular disc can be repositioned by a suture-free titanium screw strategy. This technique is an alternative method to address ADDwoR.
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Affiliation(s)
- Peng Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Pinyin Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
- Department of Orthognathic and TMJ Surgery, No. 14, 3Rd Section of Ren Min Nan Rd, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Al-Shujaa EA, Al-Awdi HH, Al-Wesabi SN, Lubamba GP, Altayar BA, Sakran KA, Telha W, Xia X, Liu B, Xie F. Maxillary sinus volume and facial asymmetry after unilateral zygomaticomaxillary complex fracture reduction with 2, 3, and 4 fixation points: CBCT-based investigation. J Stomatol Oral Maxillofac Surg 2023:101537. [PMID: 37336318 DOI: 10.1016/j.jormas.2023.101537] [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] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aimed to assess the maxillary sinus volume (MSV), Chronic Sinusitis incidence, and asymmetry of the zygomaticomaxillary complex (ZMC) following ZMC fracture surgery with various numbers of fixation points. MATERIALS AND METHODS In a prospective non-randomized cohort, 50 adults with unilateral ZMC fractures who treated by open reduction and internal fixation (ORIF) between November 2019 and October 2021 were assigned to accomplish this study. They distributed into three groups as per fixation points (2, 3, or 4 Points). Preoperative (T1), Immediate postoperative (T2), and follow-up (T3) cone beam computed topography were analyzed using the Mimics software. The main measures were MSV and asymmetry indexes (ASI) of six paired bilateral anatomical landmarks (Orbital, Suprajugal, Jugale, Zygon, Maxillozygion 1, and Maxillozygion 2). RESULTS MSV decreased significantly on the affected sides postoperatively in 2P and 3P groups, both in T2 and T3. Further, the T2-T3 comparisons showed a significant MSV change (p = 0.001). ASI reduced considerably to clinically tolerated levels (<3 mm) on landmarks near the fixation sites postoperatively. The ASI on the Zygon and Maxillozygion 1 landmarks showed significant changes among the three groups in both T2 and T3. Interestingly, only five cases had reported postoperative sinusitis symptoms. CONCLUSIONS Although the MSV was changed among the different fixation point groups, the incidence of chronic sinusitis was uncommon. Bilateral asymmetry affected by number and position of the fixation points, fixation with 4 points provide more symmetry.
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Affiliation(s)
- Eissa Abdo Al-Shujaa
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China; State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Hebah Hasan Al-Awdi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen; Department of Orthodontics, Xiangya Stomatological Hospital, School of Stomatology, Central South University, Changsha, China
| | - Saddam Noman Al-Wesabi
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China; State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Grace Paka Lubamba
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Bassam A Altayar
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Karim Ahmed Sakran
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Xia
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
| | - Bin Liu
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
| | - Fuqiang Xie
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China.
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Sakran KA, Zhang S, Chen N, Yin J, Alkebsi K, Elayah SA, Al-Rokhami RK, Al-Watary MQ, Telha W, Al-Aroomi M, Shi B, Yin H, Huang H. Development of postoperative velopharyngeal function in patients with cleft palate. Int J Pediatr Otorhinolaryngol 2023; 171:111607. [PMID: 37329703 DOI: 10.1016/j.ijporl.2023.111607] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Patients with a cleft palate often experience a velopharyngeal dysfunction known as velopharyngeal insufficiency (VPI). The purpose of this study was to examine the development of velopharyngeal function (VPF) following primary palatoplasty and the factors that are linked to it. METHODS A retrospective study was conducted to examine the medical records of patients who had cleft palate, with or without cleft lip (CP ± L) and underwent palatoplasty at a Tertiary Affiliated Hospital between 2004 and 2017. Postoperative evaluation of VPF was conducted at two follow-up times (T1, T2) and was classified as either normal VPF, mild VPI, or moderate/severe VPI. The consistency of VPF evaluations between the two time points was then assessed, and patients were categorized into either the consistent or inconsistent group. The study collected and analyzed data on gender, cleft type, age at operation, follow-up duration, and speech records. RESULTS The study included 188 patients with CP ± L. Out of these, 138 patients (73.4%) showed consistent VPF evaluations, while 50 patients (26.6%) showed inconsistent VPF evaluations. Among those with VPI at T1 (91 patients), 36 patients (39.6%) had normal VPF at T2. The rate of VPI decreased from 48.40% at T1 to 27.13% at T2, whereas the rate of normal VPF increased from 44.68% at T1 to 68.09% at T2. The consistent group had a significantly younger age at operation (2.90 ± 3.82 vs 3.68 ± 4.02), a longer duration of T1 (1.67 ± 0.97 vs 1.04 ± 0.59), and a lower comprehensive score of speech performance (1.86 ± 1.27 vs 2.60 ± 1.07) than the inconsistent group. CONCLUSIONS It has been verified that there are changes in the development of VPF over time. Patients who underwent palatoplasty at a younger age were more likely to have confirmed VPF diagnosis at the first evaluation. The duration of follow-up was identified as a critical factor that affects the confirmation of VPF diagnosis.
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Affiliation(s)
- Karim Ahmed Sakran
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Yemen
| | - Shiming Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Nan Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayi Yin
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Khaled Alkebsi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Yemen
| | - Sadam Ahmed Elayah
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Yemen
| | - Remsh Khaled Al-Rokhami
- Department of Orthodontics, School of Stomatology, Nanchang University, Nanchang, Jiangxi, China
| | - Mohammed Qasem Al-Watary
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Maged Al-Aroomi
- Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Heng Yin
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Hanyao Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
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Elayah SA, Liang X, Sakran KA, Telha W, Al-Aroomi MA, Younis H, Alqurmoti SA, Ghaleb O, Cui H, Wang W, Na S. An early microvascular training program of dental intern students and junior residents: a comparative prospective study. Head Face Med 2023; 19:17. [PMID: 37194048 DOI: 10.1186/s13005-023-00360-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/24/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Clinical instructional strategies and the climate in which teaching and learning take place have a significant impact on the quality of dental education. Therefore, this study aimed to evaluate the impact of early microsurgery training on the skills of dental intern students who are planning to join an oral and maxillofacial surgical field (DIS) as compared with junior residents within an oral and maxillofacial surgery department who had no microsurgery experience (JR). METHODS A total of 100 trainees, 70 were DIS, while the other 30 were JR. The average age was 23.87 ± 2.05 years for DIS group and 31.05 ± 3.06 for JR group. All trainees attended a microsurgical course (theoretical and practical parts) for seven days within a Microvascular Laboratory for Research and Education of a university-affiliated tertiary hospital. Two blinded examiners had assessed the performance of trainees independently using a specific scoring system. The independent sample t-test was used to compare the effect of microsurgery training between DIS and JR groups. The significance level was set at 0.05. RESULTS The DIS group had showed higher attendance rate than JR group (p < 0.01), with a lower absence score in DIS than JR groups (0.33 ± 0.58 vs. 2.47 ± 1.36). The total score of the theoretical test was significantly different between both groups (p < 0.01). In this context, the DIS group had revealed higher total score than JR group (15.06 ± 1.92 vs. 12.73 ± 2.49). In term of tissue preservation, there was a significant difference between both groups, with the DIS had better performance score than JR (1.49 ± 0.51 vs. 0.93 ± 0.59). Further, the practical exam score was significantly higher in DIS group than JR group (p < 0.01). CONCLUSION Overall, the performance of dental intern students was favourably compared with junior residents in most aspects. Therefore, it is promising and essential for dental colleges to add a microsurgery course to the curriculum of dental intern students who plan to specialize in oral and maxillofacial surgery.
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Affiliation(s)
- Sadam Ahmed Elayah
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, Ibb University, Ibb, Yemen
| | - Xiang Liang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Karim Ahmed Sakran
- Department of Oral and Maxillofacial Surgery, Ibb University, Ibb, Yemen
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | | | - Hamza Younis
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Sarah A Alqurmoti
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Omar Ghaleb
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hao Cui
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Weiqi Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Disease, Department of Oral and Maxillofacial Surgery, School of Stomatology, Air Force Military Medical University, Xi'an, Shaanxi, China.
| | - Sijia Na
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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11
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Al-Aroomi MA, Al-Worafi NA, Zhou W, Telha W, Elayah SA, Al-Sharani HM, Sun C, Qi Z. Lower lip reconstruction using McGregor fan technique with or without depressor anguli oris chimeric flap. Is there a difference in function and aesthetic outcomes? Head Neck 2023; 45:1511-1518. [PMID: 37015892 DOI: 10.1002/hed.27364] [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: 11/11/2022] [Revised: 03/06/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Lower lip reconstruction aims to maintain facial subunit function and aesthetics. We present a minor modification of the McGregor flap technique, in which depressor anguli oris (DAO) muscle is separately elevated as a chimeric flap together to investigate the outcomes for reconstructing lower lip defects using various functional parameters. METHODS The study included patients who underwent surgical repair of lower lip defects using a McGregor fan flap with or without DAO muscle chimeric flap between January 2018 and May 2021. The patients were divided into our modified technique with DAO chimeric flap (study group) and conventional McGregor (control group). The primary outcomes were functional evaluation of oral competency, speech intelligibility, and tactile sensation of reconstructed lip outcomes. The functional satisfaction and Patient and Observer Scar Assessment Scale (POSAS) were analyzed. RESULTS A total of 20 patients were enrolled (10 patients for each group). Excellent oral competence was present in 12 patients, favorably significant in patients with DAO chimeric flap (n = 8/10, p = 0.018). All patients had intelligible speech with insignificant differences between the two groups. No patients demonstrated differences to light touch from baseline sensation at 1 year. Patients in the study group reported more lip function satisfaction (p = 0.049). The POSAS score indicates satisfaction with the appearance of all patients. CONCLUSION McGregor fan technique combined with DAO muscle chimeric flap offers a good choice by maintaining sensory and motor functions. Our minor modification can ensure the integrity of the oral sphincter, leading to improved lower lip function.
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Affiliation(s)
- Maged Ali Al-Aroomi
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, Oral Diseases Laboratory of Liaoning, China Medical University, Shenyang, Liaoning, China
| | - Naseem Ali Al-Worafi
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Wanhang Zhou
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, Oral Diseases Laboratory of Liaoning, China Medical University, Shenyang, Liaoning, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sadam Ahmed Elayah
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hesham Mohamed Al-Sharani
- National Center for Epidemiology and Population Health, ANU College of Health and Medicine, Canberra, Australia
| | - Changfu Sun
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, Oral Diseases Laboratory of Liaoning, China Medical University, Shenyang, Liaoning, China
| | - Zhongzheng Qi
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, Oral Diseases Laboratory of Liaoning, China Medical University, Shenyang, Liaoning, China
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12
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Al-Wesabi SN, Abotaleb B, Al-Shujaa EA, Mohamed AA, Alkebsi K, Telha W, Jian S, Fuqiang X. Three dimensional condylar positional and morphological changes following mandibular reconstruction based on CBCT analysis: a prospective study. Head Face Med 2023; 19:3. [PMID: 36747208 PMCID: PMC9903492 DOI: 10.1186/s13005-023-00347-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/06/2023] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the condylar positional changes following mandibular reconstruction with preservation of the condylar head using Cone-Beam Computed Tomography (CBCT). Also, to assess joint space changes and the overall volumetric space compared to the preoperative status. METHODOLOGY This prospective study included 30 patients (60 joints) subjected to unilateral mandibular resection and reconstruction with preservation of the condylar head. The Helkimo index and preoperative (T1), two weeks postoperative (T2), and follow-up CBCTs (T3) after at least six months were gathered and processed to evaluate the condylar position and TMJ joint space using Anatomage Invivo 6. A student's t-test and repeated-measures ANOVA statistics were used. A P value of less than 0.05 was considered statistically significant. RESULTS Thirty patients (14 males, 16 females) with a mean age of 40.01 ± 12.7 years (a range of 18.1-62.9 years) were included. On the tumor side, there were significant variances in the vertical and mediolateral condylar positions between the three-time points (T1, T2, T3). Immediately after the operation, the condyles were significantly displaced in a downward direction at T2, which became larger after the last follow-up period (T3) (p = 0.007). The condylar positions at the anteroposterior direction were relatively stable without significant differences between the three times points (p = 0.915). On the non-tumor side, the condylar positions were relatively stable in the mediolateral and anteroposterior positions. In the tumor side, all of the TMJ spaces were significantly increased in size following the mandibular reconstructions (T2 and T3). However, on the non-tumor side, the anterior, posterior, and medial joint spaces were significantly changed postoperatively. CONCLUSION After mandibular reconstruction with condylar preservation, the condylar position and volumetric measurement immediately changed noticeably and continued to be a permanent change over time compared to relatively stable condyles on the non-tumor side. According to Helkimo index, patients become adapted to the postoperative changes without significant differences between the two sides.
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Affiliation(s)
- Saddam Noman Al-Wesabi
- Lanzhou University, Second Hospital, Oral and Maxillofacial Surgery Department, Lanzhou, Gansu Province, China. .,State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China. .,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Bassam Abotaleb
- grid.444909.4Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Eissa Abdo Al-Shujaa
- grid.32566.340000 0000 8571 0482Lanzhou University, Second Hospital, Oral and Maxillofacial Surgery Department, Lanzhou, Gansu Province China ,grid.444909.4Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Abdo Ahmed Mohamed
- grid.412536.70000 0004 1791 7851Department of Oral & Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Khaled Alkebsi
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan China
| | - Wael Telha
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan China
| | - Sun Jian
- grid.32566.340000 0000 8571 0482Lanzhou University, Second Hospital, Oral and Maxillofacial Surgery Department, Lanzhou, Gansu Province China
| | - Xie Fuqiang
- Lanzhou University, Second Hospital, Oral and Maxillofacial Surgery Department, Lanzhou, Gansu Province, China.
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Wang Q, Telha W, Wu Y, Abotaleb B, Jiang N, Zhu S. Evaluation of the Properties of 3D-Printed Ti Alloy Plates: In Vivo and In Vitro Comparative Experimental Study. J Clin Med 2023; 12:jcm12020444. [PMID: 36675373 PMCID: PMC9860900 DOI: 10.3390/jcm12020444] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 01/09/2023] Open
Abstract
Titanium (Ti)-based implants play a significant role in rigid internal fixation in maxillofacial surgery. No study has reported that three-dimensional-printed Ti alloy plates (3D-Ti plates) have comprehensively excellent properties similar to standard plates (Matrix-MANDIBLE, SYNTHES, Switzerland) (Synthes-Ti plates). In this work, we manufactured 3D-Ti plates by selective laser melting with Ti6Al4V powder. The surface morphology, mechanical properties, and bone-plate contact rate of the 3D-Ti plates and the Synthes-Ti plates were characterized and compared via electron microscopy, atomic force microscopy, Vickers hardness test, three-point bending test, and software calculation. Human bone marrow stromal cells (HBMSCs) were cultured on the plates to test their biocompatibility. Importantly, the 3D-Ti plates were placed into a mandibular fracture model to assess the effect of medical application for 4 and 24 weeks. The 3D-Ti plates were demonstrated to have similar biocompatibility and stability for rigid internal fixation with the Synthes-Ti plates, lower roughness (106.44 ± 78.35 nm), better mechanical strength (370.78 ± 1.25 HV10), and a higher bone-plate contact rate (96.9%). These promising results indicate the feasibility of using 3D-Ti plates for irregular shapes and complex anatomical structures in a clinical context.
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Affiliation(s)
- Qi Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wael Telha
- Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yange Wu
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bassam Abotaleb
- Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (N.J.); (S.Z.)
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (N.J.); (S.Z.)
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14
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Abotaleb BM, Alkebsi K, Jiang N, Bi R, Liu Y, Telha W, Zhu S. Influence of Inferior Alveolar Nerve Exposure During Sagittal Split Osteotomy on the Rate and Timing of Baseline Sensory Recovery. J Oral Maxillofac Surg 2022; 80:1893-1901. [PMID: 36174664 DOI: 10.1016/j.joms.2022.08.022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE Neurosensory disturbance is the most common consequence of sagittal split osteotomy (SSO). The purpose of this study is to quantitatively assess neurosensory deficiency and recovery to the preoperative status when the inferior alveolar nerve (IAN) was exposed versus unexposed during SSO. METHODS This is a single-center, prospective, cohort study of all patients undergoing bilateral SSO between August 2018 and July 2019. Patients were included in the study sample if they underwent bilateral SSO with an intact intraoperative IAN and were received follow-up assessment for at least a year. The predictor variable was the intraoperative IAN status (exposed vs unexposed). The outcomes of interest were the rate and timing of recovery to the preoperative status. The covariates were age, sex, and the magnitude and direction of surgical movements. Neurosensory function was quantitatively evaluated using the Semmes-Weinstein monofilament test at follow-up intervals of 1, 3, 6, and 12 months. Descriptive statistics, bivariate statistics, Cox proportional hazards regression, and Kaplan-Meier analyses were performed. P value <.05 was considered statistically significant. RESULTS Of 90 patients, 86 patients who underwent 172 SSOs were included in this study. The mean age was 22.95 ± 3.34 years (range, 17 to 30), 65 were women, and the range of surgical movements was 3 to 8.3 mm of advancement and 2 to 12 mm of setback. Eighty-five nerves (49.4%) were allocated to the unexposed group, and 87 (50.6%) to the exposed group, with statistically significant differences in the rate and timing of recovery (hazard ratio = 2.368; 95% confidence interval, 1.662 to 3.376; P < .001). Among those with recovered nerves, the median time to recovery was 90 days in the unexposed group and 364 days in the exposed group (P < .0001). CONCLUSIONS IAN exposure during SSO is associated with an increased risk of neurosensory deficiency and an increased time of sensory recovery to the baseline threshold in patients aged 17 to 30 years. When the IAN remained fully enclosed in the canal of the distal segment, only 11% of patients had a measurable sensory deficit 1 year after surgery. In those patients with any degree of IAN exposure, 36% had a residual sensory deficit 1 year after surgery.
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Affiliation(s)
- Bassam M Abotaleb
- Assistant Professor, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Khaled Alkebsi
- Resident, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Nan Jiang
- Assistant Professor, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ruiye Bi
- Assistant Professor, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yao Liu
- Assistant Professor, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wael Telha
- Resident, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Songsong Zhu
- Professor, Vice-dean, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Abotaleb BM, Bi R, Liu Y, Jiang N, Telha W, Zhu S. Three-dimensional condylar displacement and remodelling in patients with asymmetrical mandibular prognathism following bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 2021; 51:509-517. [PMID: 34446294 DOI: 10.1016/j.ijom.2021.08.008] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/25/2021] [Accepted: 08/10/2021] [Indexed: 02/08/2023]
Abstract
This study aims to assess the postoperative condylar displacement and the long-term condylar remodelling in patients with mandibular prognathism with transverse asymmetry after bilateral sagittal split ramus osteotomy (BSSRO). Forty-one consecutive patients (82 condyles) with a transverse mandibular asymmetry of more than 4 mm without occlusal canting treated by BSSRO were included. The preoperative (T1), immediate postoperative (T2) and long-term follow-up of an average of 16.2 months (T3) spiral computed tomography scans were gathered and processed to measure the condylar displacement and remodelling based on cranial base voxel-based and rigid regional registrations. The statistical analysis revealed that the majority of condyles (T1-T2) were transitionally displaced forwards, downwards and laterally, and were not fully returned to the preoperative position at T3. Condylar lateral displacement was significantly higher on the deviated side (DS) (P = 0.035). Non-deviated side (NDS) condyles were mainly subjected to upward pitch, medial yaw and medial roll compared with downward pitch, lateral yaw and lateral roll on DS. Condylar remodelling at T3 was observed, with the superior and posterior surfaces commonly subjected to bone resorption, whereas the anterior and medial surfaces were commonly subjected to bone apposition. Condylar volumetric changes were relatively comparable on NDS (3 ± 85.2 mm3) and DS (8.3 ± 111.7 mm3) condyles. Age, amount of preoperative asymmetry and follow-up period were not correlated with the condylar remodelling. Transitional and rotational displacements were to some extent significantly correlated with the condylar remodelling on both sides. Consequently, passive condylar seating without torque might prevent the long-term unfavourable condylar remodelling.
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Affiliation(s)
- B M Abotaleb
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - R Bi
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - N Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - W Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - S Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Abotaleb B, Bi R, Telha W, Zhao W, Li Y, Zhu S. Treatment measures of hemimandibular hyperplasia and associated facial deformities. J Craniomaxillofac Surg 2020; 49:126-134. [PMID: 33451941 DOI: 10.1016/j.jcms.2020.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/27/2020] [Revised: 09/17/2020] [Accepted: 12/25/2020] [Indexed: 02/05/2023] Open
Abstract
This study aims to show our institute's experience in the treatment of HH and its associated facial deformities in adults and growing adolescents and to investigate condylar remodeling and volumetric changes and long-term stability of orthognathic surgery in adults. The study included consecutive patients with clinical and radiological features of HH who underwent high condylectomy with or without simultaneous orthognathic surgery from 2013 to 2018. The clinical outcomes were assessed based on functional activities, TMJ pain, and recurrence. Postoperative 3D condylar remodeling and orthognathic stability were evaluated with the use of ITK-Snap and 3D Slicer. Thirteen patients (8 females and 5 males) with a mean age of 26.3 ± 5.79 years (range; 13-34 years) were included with facial asymmetry as the chief complaint. The patients were followed up for a minimum of 12 months and a maximum of 4 years (mean; 16.85 ± 10.04). There were no postoperative complications, and all patients achieved a satisfactory functional and aesthetic outcome using a one-stage surgical procedure. There was no incidence of recurrence or further asymmetries, with long-term stability at the selected points showing a mean difference of less than ±1 mm. The affected condylar volume was significantly reduced following high condylectomy, with mean changes between T1 and T2 of -144. 80 mm3 (p = .012). However, the contralateral condylar volume remained stable, with a mean change of 2.54 mm3 (p = .881). One-stage high condylectomy and orthognathic surgery is a viable measure for the treatment of HH and associated deformities in adults. High condylectomy in early adolescence could result in termination of the disease, and aesthetic improvement with further constant orthodontist-surgeon follow-up is required.
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Affiliation(s)
- Bassam Abotaleb
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wael Telha
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wenli Zhao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunfeng Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Head of the Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Gharaibeh T, Telha W, Al Khateeb T. 70 Neurosensory status of the anterior palatal mucosae after separation of the nasopalatine nerve. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60071-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: 10/19/2022]
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