1
|
Watanabe C, Zhong J, Yamashita S, Kondo Y, Masaki C, Hosokawa R, Shibata Y. Mechanical insights into jawbone characteristics under chronic kidney disease: A comprehensive nanoindentation approach. J Mech Behav Biomed Mater 2024; 154:106506. [PMID: 38518511 DOI: 10.1016/j.jmbbm.2024.106506] [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: 12/21/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 03/24/2024]
Abstract
The mechanical properties of the jawbone play a critical role in determining the successful integration of dental prostheses. Chronic kidney disease (CKD) has been identified to abnormally accelerate bone turnover rates. However, the impact of CKD on the mechanical characteristics of the jawbone has not been extensively studied. This study sought to evaluate the time-dependent viscoelastic behaviors of rat jawbones, particularly in the scenarios both with and without CKD. We hypothesized that CKD might compromise the bone's innate toughening mechanisms, potentially owing to the time-dependent viscoelasticity of the bone matrix proteins. The maxillary and mandibular bones of Wistar rats were subjected to nanoindentation and Raman micro-spectroscopy. Load-hold-displacement curves from the cortical regions were obtained via nanoindentation and were mathematically characterized using a suitable viscoelastic constitutive model. Raman micro-spectroscopy was employed to identify nuanced vibrational changes in local molecular structures induced by CKD. The time course of indenter penetration onto cortical bones during the holding stage (creep behavior) can be mathematically represented by a series arrangement of the Kelvin-Voigt bodies. This configuration dictates the overall viscoelastic response observed during nanoindentation tests. The CKD model exhibited a reduced extent of viscoelastic contributions, especially during the initial ramp loading phase in both the maxillary and mandibular cortical bones. The generalized Kelvin-Voigt model comprises 2 K-Voigt elements that signify an immediate short retardation time (τ1) and a subsequent prolonged retardation time (τ2), respectively. Notably, the mandibular CKD model led to an increase in the delayed τ2 alongside an increase in non-enzymatic collagen cross-linking. These suggest that, over time, CKD diminishes the bone's capability for supplementary energy absorption and dimensional recovery, thus heightening their susceptibility to fractures.
Collapse
Affiliation(s)
- Chie Watanabe
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan.
| | - Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, Australia
| | - Sotaro Yamashita
- Division of Oral Reconstruction and Rehabilitation, Kyusyu Dental University, Kitakyushu, Japan
| | - Yusuke Kondo
- Division of Oral Reconstruction and Rehabilitation, Kyusyu Dental University, Kitakyushu, Japan
| | - Chihiro Masaki
- Division of Oral Reconstruction and Rehabilitation, Kyusyu Dental University, Kitakyushu, Japan
| | - Ryuji Hosokawa
- Division of Oral Reconstruction and Rehabilitation, Kyusyu Dental University, Kitakyushu, Japan
| | - Yo Shibata
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| |
Collapse
|
2
|
Raghoebar GM, Meijer HJA, Vissink A. Immediate repair of bony defects in the posterior mandibular region following removal of a fractured implant: a feasible treatment? Int J Oral Maxillofac Surg 2024; 53:430-435. [PMID: 38061953 DOI: 10.1016/j.ijom.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 04/16/2024]
Abstract
The aim of this study was to assess whether immediate bone reconstruction after removal of a fractured dental implant in the posterior mandible provides a sound base for implant replacement, with a favourable treatment outcome and high patient satisfaction. Eight consecutive patients with a fractured implant neck were included. The implant was removed via osteotomy, following which the site was immediately repaired with a mixture of autogenous bone and bone substitute. After a 4-month healing period, sufficient bone and favourable soft tissue conditions were present, allowing implant placement with adequate primary stability. After a further 3 months, the implants were restored with an all-ceramic restoration. Patient satisfaction, the aesthetic outcome, complications, and postoperative morbidity were assessed using standardized clinical and radiographic examinations up to 5 years after crown placement. No implant failures were observed during the follow-up. Plaque accumulation, the presence of calculus, bleeding tendency, and peri-implant inflammation indices were low, indicating healthy peri-implant conditions. The mean marginal bone level change at the 5-year follow-up was - 0.17 ± 0.46 mm. All patients reported a high level of satisfaction (mean overall score 9.3 ± 0.5). In conclusion, immediate reconstruction of the hard tissue after removal of a fractured dental implant is a viable treatment option. This approach facilitates rehabilitation, reduces morbidity, and leads to favourable aesthetic outcomes.
Collapse
Affiliation(s)
- G M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - H J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Implant Dentistry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
3
|
Decaup PH, Garot E, Vanderesse N, Couture C. How geographical origin and dietary habits interact with the shape of cortical mandibular sections? A geometric morphometrics study in an archaeological context. Arch Oral Biol 2024; 161:105938. [PMID: 38430644 DOI: 10.1016/j.archoralbio.2024.105938] [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: 11/08/2023] [Revised: 02/14/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Mandibular shape is strongly influenced by biomechanics, particularly during dietary shifts that often occurred in past populations. The relationship is considered extremely complex as development of the mandible is a multifactorial process. Since cortical bone distribution is purportedly more biomechanically sensitive than external shape, comparison of its distribution in past populations can provide new input to understand this complex relationship. The present study examined the effects of geographical origin and dietary habits on the internal anatomy of the mandibular corpus and symphysis. DESIGN A morphometric analysis was conducted on 72 mandibles from different populations, sampled by their geographical origin and subsistence strategies. Procrustes ANOVAs were performed to test the impact of section-plane location, geographical origin, and dietary habits on the groups' shapes. RESULTS The specimens' geographical origin and dietary habits had a significant effect on the shapes of the sections (Generalized Goodall F-test, F = 3.2745, df = 6, 304: p < 0.001 and F = 3.7007, df = 4, 306: p < 0.001). CONCLUSION Geographical origin and dietary habits influenced the shape of the mandibular sections in our sample. These relationships become more complex when analysed in isolated sections. Indeed, this study revealed that symphysis sections could be predominantly influenced by individual variables, whereas intermediate sections of the corpus could be predominantly influenced by populational variables. Future studies could focus on specific sections to better identify the specific "rules of dependence" in each cross-section.
Collapse
Affiliation(s)
- Pierre-Hadrien Decaup
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France; Université de Bordeaux, UFR des sciences odontologiques, Bordeaux, France.
| | - Elsa Garot
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France; Université de Bordeaux, UFR des sciences odontologiques, Bordeaux, France
| | - Nicolas Vanderesse
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France
| | - Christine Couture
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France
| |
Collapse
|
4
|
Noviyanti D, Kuntara A, Oli'i EM, Agustina H. Giant cementoblastoma involving multiple teeth: A rare case report and review of differential diagnoses. Radiol Case Rep 2024; 19:2085-2092. [PMID: 38523691 PMCID: PMC10958121 DOI: 10.1016/j.radcr.2024.02.026] [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: 10/31/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 03/26/2024] Open
Abstract
Cementoblastoma, a rare odontogenic benign tumor characterized by calcified cementum-like deposits produced by cementoblasts fused with the tooth root, represents a minute proportion of all odontogenic tumors, with a prevalence ranging from less than 1% to 6.2%. We present a case of a 19-year-old female experiencing pain, progressive swelling, and facial asymmetry in the left lower region over the 1 year ago. Physical examination revealed diffuse swelling in the left mandibular area, demonstrating tenderness and bony hardness on palpation. Radiographic findings displayed a giant, well-defined, relatively round, radiopaque mass, partially delineated by a thin radiolucent halo, and adhered to the roots of the teeth. Computed Tomography imaging revealed an osteoblastic hyperdense mass with extensive buccal and lingual extension. Sagittal images illustrated the mass's continuity with the root apex of the first molar, accompanied by a well-defined hypodense border. A biopsy confirmed the diagnosis of cementoblastoma, leading to the patient undergoing a left hemimandibulectomy. Given the various periapical radiopaque lesions that serve as potential differential diagnoses for cementoblastoma, the ability of the radiologist to distinguish their imaging characteristics plays a crucial role in determining an accurate diagnosis.
Collapse
Affiliation(s)
- Dwi Noviyanti
- Department of Radiology, Faculty of Medicine, University of Padjadjaran, Bandung City, West Java 40161, Indonesia
| | - Atta Kuntara
- Department of Radiology, Faculty of Medicine, University of Padjadjaran, Bandung City, West Java 40161, Indonesia
| | - Eka Marwansyah Oli'i
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, University of Padjadjaran, Bandung City, West Java 40161, Indonesia
| | - Hasrayati Agustina
- Department of Pathological Anatomy, Faculty of Medicine, University of Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung City, West Java 40161, Indonesia
| |
Collapse
|
5
|
Gebeyehu T, Abaynew Y. Prevalence and patterns of third molar impaction among Ethiopians in Addis Ababa: a retrospective pilot study. Sci Rep 2024; 14:8952. [PMID: 38637677 PMCID: PMC11026538 DOI: 10.1038/s41598-024-59821-x] [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: 11/08/2023] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
Tooth impaction is a condition in which a tooth does not reach its normal position and is often observed in the third mandibular molar due to inadequate space. This study aimed to investigate the prevalence and configuration of the impacted third molars with an emphasis on angular orientations in a sample of the Ethiopian population. This cross-sectional study included a retrospective analysis of 291 patient records and orthopantomography data from the archives of a private dental clinic in Addis Ababa, during the study period from December 2020 to November 2022. Demographic details and data on the position and level of the impacted third molars were evaluated using the Winter classification. Data were analyzed for frequency distribution. The prevalence of impacted third molars was 22% (n = 64), with a greater incidence on the right side (60.9%) and a higher frequency in the mandible (67.2%). Vertical angulation (32.8%), followed by mesioangular angulation (31.2%), was the most common impaction pattern. The results highlight the need for improved treatment protocols for third molar impaction, emphasizing the prevalence in the mandible and the importance of addressing vertical impaction. Regular dental check-ups are essential for assessing third molar impaction and planning appropriate management. These data can inform policymaking and treatment considerations for impacted third molars in the Ethiopian population.
Collapse
Affiliation(s)
| | - Yeshewas Abaynew
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| |
Collapse
|
6
|
Schulz KL, Matta R, Nobis CP, Möst T, Kesting M, Lutz R. Three-dimensional assessment of upper airway changes associated with mandibular positional deviations following fibula free flap reconstruction. Clin Oral Investig 2024; 28:248. [PMID: 38602619 PMCID: PMC11008060 DOI: 10.1007/s00784-024-05646-x] [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: 12/21/2023] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Fibula free flaps (FFF) are the standard approach to mandibular reconstruction after partial resection, with the goal of restoring aesthetics and masticatory function. The graft position affects both and must be carefully selected. Correlations between sagittal positioning and upper airway anatomy are known from orthognathic surgery. This study aims to evaluate changes in mandibular position and upper airway anatomy after reconstructive surgery with FFF and corresponding correlations. MATERIALS AND METHODS Mandibular position after reconstruction was evaluated using three-dimensional datasets of pre- and postoperative computed tomography scans of patients treated between 2020 and 2022. Three-dimensional measurements were performed on both condyles and the symphyseal region. Changes in upper airway volume and minimum cross-sectional area (minCSA) were analysed. Intra-rater reliability was assessed. Correlations between changes in upper airway anatomy and sagittal mandibular position were tested. RESULTS The analysis included 35 patients. Intra-rater reliability was good to excellent. Condylar deviations and rotations were mostly rated as small. Changes in symphyseal position were considerably greater. Median airway volume decreased in the oropharynx and hypopharynx. Posterior deviation of the symphysis was associated with a decreasing minCSA in the hypopharynx and vice versa. CONCLUSIONS The overall accuracy of mandibular reconstructions with FFF is high, but there is room for optimization. The focus of research should be extended from masticatory to respiratory rehabilitation. CLINICAL RELEVANCE Effects on respiratory function should be considered prior to graft positioning. The clinical relevance of upper airway changes within the complex rehabilitation of reconstructive surgery patients needs to be further investigated.
Collapse
Affiliation(s)
- Katja Leonie Schulz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Ragai Matta
- Department of Prosthodontics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christopher-Philipp Nobis
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobias Möst
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
7
|
Yamashita S, Kondo Y, Watanabe C, Nodai T, Munemasa T, Mukaibo T, Masaki C, Shibata Y, Hosokawa R. Chronic kidney disease compromises structural and mechanical properties of maxillary cortical bone in a rat model. J Prosthodont Res 2024; 68:264-272. [PMID: 37211410 DOI: 10.2186/jpr.jpr_d_23_00016] [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] [Indexed: 05/23/2023]
Abstract
PURPOSE This study aimed to investigate the effects of chronic kidney disease (CKD) on the structural and mechanical properties of the maxillary and mandibular cortical bone. METHODS The maxillary and mandibular cortical bones from CKD model rats were used in this study. CKD-induced histological, structural, and micro-mechanical alterations were assessed using histological analyses, micro-computed tomography (CT), bone mineral density (BMD) measurements, and nanoindentation tests. RESULTS Histological analyses indicated that CKD caused an increase in the number of osteoclasts and a decrease in the number of osteocytes in the maxilla. Micro-CT analysis revealed that CKD induced a void volume/cortical volume (%) increase, which was more remarkable in the maxilla than in the mandible. CKD also significantly decreased the BMD in the maxilla. In the nanoindentation stress-strain curve, the elastic-plastic transition point and loss modulus were lower in the CKD group than that in the control group in the maxilla, suggesting that CKD increased micro fragility of the maxillary bone. CONCLUSIONS CKD affected bone turnover in the maxillary cortical bone. Furthermore, the maxillary histological and structural properties were compromised, and micro-mechanical properties, including the elastic-plastic transition point and loss modulus, were altered by CKD.
Collapse
Affiliation(s)
- Sotaro Yamashita
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Yusuke Kondo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Chie Watanabe
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Tomotaka Nodai
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Takashi Munemasa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Taro Mukaibo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Chihiro Masaki
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Yo Shibata
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Ryuji Hosokawa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| |
Collapse
|
8
|
Chen Y, Liao Q, Wu Y, He R, Zhang N, Liao Y, Lian K. Study of the mandibular canal and its surrounding canals by multi-view cone-beam computed tomography. Insights Imaging 2024; 15:103. [PMID: 38589638 PMCID: PMC11001830 DOI: 10.1186/s13244-024-01676-x] [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: 10/11/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES To determine the mandibular anatomical structures by observing cone-beam computed tomography (CBCT) from multiple angles. MATERIALS AND METHODS This retrospective study analyzed 1593 consecutive CBCT images. Ultimately, 95 CBCTs met the inclusion criteria. The mandibular, inferior lingual, and bony canals at the tooth apex were studied by multi-angle observation CBCT. Descriptive statistics were used for statistical analysis. RESULTS It is beneficial to further observe the anastomosis of the mandibular, lingual, and mandibular canals when the course of the mandibular lingual canal is observed on CBCT cross-section. The frequency of the inferior lingual canal anastomosis with the mandibular canal was 43.2% (95% confidence interval (CI) 33, 53.3) in the sample. The mental foramen was located below the long axis of the tooth in a few samples, with an occurrence rate of 29.5% (95% CI 20.1, 38.8). The occurrence rate of various types of the bony canal at the apex of the tooth in canines, first premolars, second premolars, first molars, and second molars under the root apex was recorded through the multi-angle observation of the dental volume reformat (DVR) and three-dimensional (3D) levels in CBCT. CONCLUSION This study demonstrates the utility of CBCT imaging in examining mandibular anatomy from multiple angles, providing valuable insights into anatomical variations, and enhancing our understanding of mandibular structures. This research emphasizes the crucial role of meticulous CBCT examination in precisely identifying and understanding key anatomical structures, ultimately reducing the risk of surgical complications. CRITICAL RELEVANCE STATEMENT By examining cone-beam computed tomography scans from various perspectives, it is possible to determine the precise position of anatomical structures within the jaw. This allows for a more accurate assessment, reducing the risk of harm to these structures during treatment. KEY POINTS • It is crucial to utilize image data effectively to enhance the comprehension of human anatomy. • We captured detailed images of the mandible from different angles and orientations utilizing cone-beam computed tomography (CBCT). • This study provides essential anatomical information for procedural planning to ensure optimal outcomes and patient safety.
Collapse
Affiliation(s)
- Yingqi Chen
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qianting Liao
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yuexia Wu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China
| | - Rui He
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Nanxiang Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 511400, China
| | - Yanfen Liao
- Department of Stomatology, The Second People's Hospital of Panyu Guangzhou, Guangzhou, 511400, China.
| | - Keqian Lian
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
| |
Collapse
|
9
|
Dudde F, Henkel KO, Barbarewicz F. The "Lumpy Jaw" Disease-Treatment and Diagnostical Challenge of Actinomycotic Osteomyelitis. J Maxillofac Oral Surg 2024; 23:328-329. [PMID: 38601245 PMCID: PMC11001794 DOI: 10.1007/s12663-023-02069-1] [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: 10/06/2023] [Accepted: 11/04/2023] [Indexed: 04/12/2024] Open
Abstract
Background Osteomyelitis is a serious entity that can occur in many different locations. Especially in the mandible, osteomyelitis can show different clinical courses, which differ clearly from other anatomical regions in terms of severity and treatment. Osteomyelitis in the mandible is often caused by mixed species of the oral cavity. A species causing subacute/chronic osteomyelitis can be actinomyces. Actinomycotic osteomyelitis of the jaw represents a diagnostic and treatment challenging disease. Conclusion This article describes our perspective on the therapy pillars treating actinomycotic osteomyelitis. The rapid introduction of the two therapeutic elements (antibiosis/surgical therapy) is crucial regarding the outcome of this entity.
Collapse
Affiliation(s)
- Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstraße 180, 22049 Hamburg, Germany
| | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstraße 180, 22049 Hamburg, Germany
| | - Filip Barbarewicz
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstraße 180, 22049 Hamburg, Germany
| |
Collapse
|
10
|
Agarwal SK, Agarwal J, Gupta A, Dutta VB. Giant Cell Tumor of Mandible : A Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:2113-2116. [PMID: 38566730 PMCID: PMC10982140 DOI: 10.1007/s12070-023-04431-8] [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: 10/06/2023] [Accepted: 12/03/2023] [Indexed: 04/04/2024] Open
Abstract
Giant cell tumor is locally aggressive primary benign neoplasm of bone with tendency of frequent recurrence, metastasis and malignant transformation. Because of the rarity of the disease involving mandible, no definite treatment guideline is established. Surgical treatment is the treatment of choice for giant cell tumor. Due to its proximity to vital structures including skull base, the recurrent disease associated with less invasive procedure could be difficult to manage while more invasive procedure will result in higher morbidity and complex reconstruction. Medical management with denosumab or zoledronic acid has been advocated in surgically unresectable disease. We present a rare case of giant cell tumor of mandible. Patient was a 33 years old lady who presented with gradually progressive painful swelling in chin. After exclusion of distant metastasis by F-18 FDG PET scan, she underwent en-bloc resection of the tumor with free fibula flap reconstruction. During 6 months of follow up visit patient had no recurrence.
Collapse
Affiliation(s)
| | - Jyoti Agarwal
- Department of Otorhinolaryngology, Sir Ganga Ram Hospital, New Delhi, India
| | - Arushi Gupta
- Department of Otorhinolaryngology, Sir Ganga Ram Hospital, New Delhi, India
| | - Vijay Bhushan Dutta
- Department of Head and Neck Oncosurgery, Sir Ganga Ram Hospital, New Delhi, India
| |
Collapse
|
11
|
de Boutray M, Cuau L, Ohayon M, Garrel R, Poignet P, Zemiti N. Robot-guided osteotomy in fibula free flap mandibular reconstruction: a preclinical study. Int J Oral Maxillofac Surg 2024; 53:343-346. [PMID: 37604757 DOI: 10.1016/j.ijom.2023.07.010] [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: 02/22/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023]
Abstract
Various methods currently exist to guide fibular osteotomy positioning in fibula free flap mandibular reconstruction, but patient-specific navigation methods and cutting guides require experience, and may be time-consuming and/or expensive. This study describes a robot-guided osteotomy technique for mandible reconstruction using a fibula free flap according to virtual preoperative planning. The method was assessed on five 3D-printed models and a cadaveric model. The precision of the robot-guided osteotomy was evaluated by measuring the deviations between the lengths and angles of the fragments obtained and those of the virtual planning. The average deviation of the anterior and posterior crest lengths was 0.42 ± 0.29 mm for the 3D-printed models and 1.00 ± 0.53 mm for the cadaveric model. The average angle deviation was 1.90 ± 1.22° and 1.94 ± 0.69° for the 3D-printed and cadaveric models, respectively. The results of this preclinical study revealed that fibular osteotomy positioning guidance using a robot-positioned cutting guide may be a precise, easy-to-use technique that could be tailored for fibula free flap mandibular reconstruction.
Collapse
Affiliation(s)
- M de Boutray
- ENT Department, Neck Surgery and Maxillofacial Surgery, Gui de Chauliac University Hospital, Montpellier University School of Medicine, Montpellier, France; LIRMM, University of Montpellier, CNRS, Montpellier, France.
| | - L Cuau
- LIRMM, University of Montpellier, CNRS, Montpellier, France
| | - M Ohayon
- LIRMM, University of Montpellier, CNRS, Montpellier, France
| | - R Garrel
- ENT Department, Neck Surgery and Maxillofacial Surgery, Gui de Chauliac University Hospital, Montpellier University School of Medicine, Montpellier, France
| | - P Poignet
- LIRMM, University of Montpellier, CNRS, Montpellier, France
| | - N Zemiti
- LIRMM, University of Montpellier, CNRS, Montpellier, France
| |
Collapse
|
12
|
Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
Collapse
Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
| |
Collapse
|
13
|
Ye Z, Ye H, Wu Y, Jiang Z, Yao H, Xu X, Zhang Y, Du W, Li W, Zheng Y, Ye P, Ding X, Wu L. Effect of bone mass density and alveolar bone resorption on stress in implant restoration of free-end edentulous posterior mandible: Finite element analysis of double-factor sensitivity. Ann Anat 2024; 253:152210. [PMID: 38244942 DOI: 10.1016/j.aanat.2024.152210] [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: 10/18/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Osseous condition of the mandible was regarded as a key factor influencing stability of implants in the early stage. Finite element analysis was used to assess the effect of bone mass density and alveolar bone resorption (double factors) on stress in a four-unit implant restoration of a free-end edentulous posterior mandible. METHODS A 3D finite element model was constructed for a single-sided free-end edentulous mandible (from mandibular first premolar to mandibular second molar) containing threaded dental implants. Mandible sensitivity modes were constructed with different alveolar bone resorption levels for normal conditions as well as mild, moderate and severe periodontitis, respectively. Based on the mass density of cancellous bone for four types of bones as the sensitivity parameter, two implant design modes were constructed: Model A (four-unit fixed bridge supported by three implants, implant positions were 34, 36 and 37) and model B: 34 × 36, 37 (37: a single implant crown) (34 × 36: three-unit fixed bridge supported by two implants, implant positions were 34 and 36). A total of 32 sensitivity-based finite element models, grouped in two groups, were constructed. Stress distribution and maximum von Mises stress on cortical bone and cancellous bone around the implant, as well as the surface of implant were investigated by using ABAQUS when vertical loading and 45° oblique loading were applied, respectively. RESULTS When vertical loading was applied on the implant, maximum von Mises stress on the cortical bone around the implant was assessed to be 4.726 MPa - 13.15 MPa and 6.254 MPa - 13.79 MPa for groups A and B, respectively; maximum stress on the cancellous bone around the implant was 2.641 MPa - 3.773 MPa and 2.864 MPa - 4.605 MPa, respectively; maximum stress on the surface of implant was 14.7 MPa - 21.17 MPa and 21.64 MPa - 30.70 MPa, respectively. When 45° oblique loading was applied on the implant restoration, maximum von Mises stress on the cortical bone around the implant was assessed to be 42.08 MPa - 92.71 MPa and 50.84 MPa - 102.5 MPa for groups A and B, respectively; maximum stress on the cancellous bone around the implant was 4.88 MPa - 25.95 MPa and 5.227 MPa - 28.43 MPa, respectively; maximum stress on the surface of implant was 77.91 MPa - 124.8 MPa and 109.2 MPa - 150.7 MPa, respectively. Stress peak on the cortical bone and that on cancellous bone around the implant increased and decreased with the decrease in bone mass density, respectively. Stress peak on alveolar bone increased with alveolar bone resorption when oblique loading was applied. CONCLUSION 1. Both alveolar bone resorption and bone mass density (double factors) are critical to implant restoration. Bone mass density may exhibit a more pronounced impact than alveolar bone resorption. 2. From the biomechanical perspective, types I and II bones are preferred for implant restoration, while implantation should be considered carefully in the case of type III bones, or those with less bone mass density accompanied by moderate to severe alveolar bone loss. 3. Splinting crowns restoration is biomechanically superior to single crown restoration.
Collapse
Affiliation(s)
- Zhangyan Ye
- Department of Stomatology, The People's Hospital of Pingyang (Pingyang Hospital of Wenzhou Medical University), Wenzhou, Zhejiang 325400, PR China; Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Hao Ye
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Yue Wu
- City Institute, Dalian University of Technology, Dalian, Liaoning 116600, PR China
| | - Zhengting Jiang
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Huiyu Yao
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Xiaomin Xu
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Yitian Zhang
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Weifeng Du
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Wenshan Li
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Yuwei Zheng
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Pengcheng Ye
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China
| | - Xi Ding
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China.
| | - Lijun Wu
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325015, PR China.
| |
Collapse
|
14
|
Champagne R, Vutukuri R, Kim CY, Tubbs RS, Iwanaga J. A comprehensive review of the mental spine. Anat Cell Biol 2024; 57:1-6. [PMID: 38098242 DOI: 10.5115/acb.23.220] [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: 08/27/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 03/23/2024] Open
Abstract
Clinical case reports and research regarding the mental spines and their associated structures create a detailed picture of the floor of the mouth for assessment during clinical treatment. This compilation of information covers the mental spines, the attached geniohyoid and genioglossus muscles, the lingual foramina, and the veins and arteries of the jaw and floor of the mouth. It is important to consider the variations in the mental spines for oral and maxillofacial treatment involving the mandible. Differences in anatomy of the mental spine, including their number, location, and size, can impact diagnosis and treatment approaches.
Collapse
Affiliation(s)
- Ross Champagne
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
| | | | - Chung Yoh Kim
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, US
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- University of Queensland, Brisbane, Australia
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, US
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, US
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| |
Collapse
|
15
|
Son J, Lee DJ, Ahn KM. Radiological features of Stafne mandibular bone cavity in panoramic image and cone beam computed tomography. Maxillofac Plast Reconstr Surg 2024; 46:9. [PMID: 38502345 PMCID: PMC10951144 DOI: 10.1186/s40902-024-00415-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/22/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Stafne mandibular bone cavity (SMBC) is an asymptomatic radiolucent lesion observed in the mandible on X-ray images, with well-defined borders. This lesion does not require treatment, and size changes are very rare. The purpose of this article is to summarize the radiological and clinical features of SMBC, aiming to prevent misinterpretation of this benign lesion as other pathologies and aid in differential diagnosis within the field of dental practice. METHODS A total of 32 patients who visited our hospital and were radiologically diagnosed with SMBC based on cone-beam computed tomography (CBCT) and panoramic images between 2005 and 2021 were included in this study. Among them, surgical intervention was performed in one case. Gender and age distribution of the patients, radiographic location and size of the lesion, relationship with the mandibular canal in CBCT, presence of cortical bone erosion in the mandibular lingual area in panoramic images, and the amount of residual cortical bone on the affected side in CBCT were investigated. RESULT Patients were 26 men (81.3%) and 6 women, with a mean age of 54.3 years. The average horizontal and vertical length was 16.6 mm and 10.6 mm. Out of a total of 32 cases, 29 cases were found in the posterior region of the mandibular body, while 3 cases were in the angle of the mandible. Lesions located below the mandibular canal were observed in 29 cases, while lesions involving the mandibular canal were present in 3 cases. Erosion of the mandibular lingual cortical bone was observed in 11 cases (34.4%), while 21 cases (65.6%) showed no erosion on panoramic images. Among the total of 14 cases (43.8%) where the cortical bone on the affected side was invaded, the average residual cortical bone thickness was 1.1 mm. CONCLUSION SMBC is a benign lesion primarily found in the mandibular angle and posterior body of the mandible. In most cases, treatment is not necessary, and differentiation from other lesions can be achieved by understanding its clinical characteristics and features on panoramic radiographs and CBCT.
Collapse
Affiliation(s)
- Jangwoo Son
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Dong-Jae Lee
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Kang-Min Ahn
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea.
| |
Collapse
|
16
|
Svanholt P, Svanholt M, Thomsen J, Kjær I. The ectopic mandibular canines can start tooth formation in three different locations: a case series study based on single orthopantomograms from 47 individuals. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00865-y. [PMID: 38502521 DOI: 10.1007/s40368-024-00865-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/15/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION A former study on orthopantomograms from young children with abnormal dental development (not canine ectopia) demonstrated that the tooth bud of the mandibular canine, compared to a stable longitudinal canine axis, could be located normally, anteriorly or posteriorly, with close relation to the first premolar. AIM The aim of the present study is to analyse on orthopantomograms if the canine axis can demonstrate where the ectopic mandibular canine started tooth formation. MATERIALS The material consists of orthopantomograms with ectopic mandibular canines and presence of primary mandibular canines from 47 cases (29 cases 9-21 years old and 18 cases with unknown ages). The primary canines demonstrated from minor apical resorption to more severe apical resorption. METHODS Based on canine maturity, location of the canine axes and the interrelationships between the roots of the permanent canine and first premolar, the location from where the canine started tooth formation was determined. Canine maturity. Maturity stage below half root length and maturity stage above half root length revealed that 11 ectopic canines had less than half root length and 36 cases more than half root length. Canine axes. The canine axis, through the length of the primary canines Ax, is inserted on drawings of the orthopantomograms using the tracing programme Inkscape®. Interrelationship between roots. By visual inspection, the distance between the canine and first premolar was designated close distance, normal distance and extended distance. RESULTS The results are divided into 3 groups. Group 1: The initial site of the permanent ectopic canine is located within the canine axis (6 cases). Group 2: The initial site of the permanent ectopic canine is located posterior to the canine axis (36 cases). Group 3: The initial site of the permanent ectopic canine is located anterior to the canine axis (5 cases). CONCLUSION The study explained that the canine axis could divide cases of ectopic canines into three groups according to the location from where tooth formation starts. For getting closer to the pattern of the ectopic canine eruption, it is necessary to analyse series of orthopantomograms taken from the same individual over several years.
Collapse
Affiliation(s)
- P Svanholt
- Section of Orthodontics, Department of Odontology. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Guldborgsund Municipal Clinic of Orthodontics, Nykøbing Falster, Denmark
| | - M Svanholt
- Section of Orthodontics, Department of Odontology. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Municipal Clinic of Orthodontics, Copenhagen, Denmark
| | - J Thomsen
- Section of Orthodontics, Department of Odontology. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Odense Municipal Clinic of Orthodontics Odense, Odense, Denmark
| | - I Kjær
- Department of Odontology. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
17
|
Moles SL, Magraw CBL. Pediatric Odontogenic Cysts and Tumors. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00006-2. [PMID: 38462396 DOI: 10.1016/j.coms.2024.01.006] [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] [Indexed: 03/12/2024]
Abstract
Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified histologically as epithelial, mesenchymal, or mixed tumors. This article will discuss the presentation, diagnosis, and treatment of odontogenic cysts and tumors in the pediatric population.
Collapse
Affiliation(s)
- Sarah Loren Moles
- Head and Neck Surgical Oncology and Microvascular Reconstruction, Providence Cancer Institute, Portland, OR, USA
| | - Caitlin B L Magraw
- The Head and Neck Institute, Head and Neck Surgical Associates, Portland, OR, USA; Department of Oral and Maxillofacial Surgery, Oregon Health and Sciences University, Portland, OR, USA.
| |
Collapse
|
18
|
Yoon Y, Kang I, Noh G, Kwon YD. Biomechanical analysis of alveolar bones with compromised quality supporting a 4-unit implant bridge; a possible association with implant-related sequestration (IRS). Clin Oral Investig 2024; 28:197. [PMID: 38448748 DOI: 10.1007/s00784-024-05589-3] [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: 12/21/2023] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES This study aimed to investigate the strain in the bone surrounding dental implants supporting a 4-unit bridge and assess the role of excessive strain as a possible risk factor for implant related sequestration (IRS) or peri-implant medication-related osteonecrosis of the jaw (PI-MRONJ). MATERIALS AND METHODS A 3D-mandibular model was constructed using computed tomography and segmented it into cortical and cancellous bones. The 4-unit implant-supported bridges replacing the mandibular posteriors were constructed, and each featuring two, three, and four implants, respectively. The Young's modulus was assigned based on the quality of the bone. A maximum occlusal force of 200 N was applied to each implant in the axial and in a 30-degree oblique direction. RESULTS The maximum principal strain of the fatigue failure range (> 3000 µε) in the bone was analyzed. The volume fraction of fatigue failure was higher in poor-quality bone compared to normal bone and oblique load than in axial load. An increasing number of implants may dissipate excessive strain in poor-quality bones. CONCLUSIONS Occlusal force applied to poor-quality bone can result in microdamage. Given that unrepaired microdamage may initiate medication-related osteonecrosis of the jaw, long-term occlusal force on fragile bones might be a risk factor. CLINICAL RELEVANCE When planning implant treatment for patients with compromised bone status, clinical modifications such as strategic placement of implants and optimization of restoration morphology should be considered to reduce excessive strain which might be associated with IRS or PI-MRONJ.
Collapse
Affiliation(s)
- Youngjae Yoon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Inyeong Kang
- School of Mechanical Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Gunwoo Noh
- School of Mechanical Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| |
Collapse
|
19
|
Olbrisch C, Santander P, Moser N, Klenke D, Meyer-Marcotty P, Quast A. Three-dimensional mandibular characteristics in skeletal malocclusion : A cross-sectional study. J Orofac Orthop 2024; 85:134-145. [PMID: 36018344 PMCID: PMC10879264 DOI: 10.1007/s00056-022-00419-1] [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: 11/06/2021] [Accepted: 07/12/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to comprehensively analyse a possible correlation between skeletal malocclusions, gender and mandibular characteristics in all three dimensions in adults and to identify mandibular characteristics that are typical for extreme skeletal patterns. METHODS A 3D model of the skull was calculated in 111 adult patients (mean age = 27.0 ± 10.2 years; 49 women, 62 men) from available computed tomography or cone beam computed tomography scans of their heads. Based on the 3D models, the skeletal patterns were examined in (a) the transversal dimension regarding asymmetry according to menton deviation, (b) the sagittal dimension according to the Wits appraisal and (c) the vertical dimension according to the maxillomandibular plane angle. The mandibular characteristics assessed were linear (ramus height and width, body length), angular (ramus, gonial and body angle) and volumetric (ramus/mandibular volume, body/mandibular volume) parameters. RESULTS No correlation between transversal skeletal asymmetry and mandibular characteristics were found, while sagittal (F(16, 174) = 3.32, p < 0.001, η2 = 0.23) and vertical (F(16, 174) = 3.18, p < 0.001, η2 = 0.23) skeletal patterns were shown to have a significant effect on the mandible. Gender correlated with mandibular characteristics independently from the skeletal pattern. Discriminant analysis revealed that class II and III patients differed in ramus and body angle with class II patients showing higher angles (ramus angle: class II = 89.8 ± 3.9° vs. class III = 84.4 ± 4.8°; body angle: class II = 87.7 ± 4.8° vs. class III = 82.1 ± 5.2°). Hypo- and hyperdivergent patients were discriminated by gonial angle, body angle and body/mandibular volume with hyperdivergent patients having a greater gonial and body angle and body/mandibular volume (gonial angle: hypodivergent = 114 ± 9.3° vs. hyperdivergent = 126.4 ± 8.6°; body angle: hypodivergent = 82.9 ± 4.4° vs. hyperdivergent = 87.7 ± 6.5°; body/mandibular volume: hypodivergent = 72.4 ± 2.7% vs. hyperdivergent = 76.2 ± 2.6%). CONCLUSION When analysing 3D data for treatment planning of adult patients, the orthodontist should pay attention to angular and volumetric characteristics of the mandible to identify extreme skeletal sagittal or vertical malocclusions.
Collapse
Affiliation(s)
- Carolin Olbrisch
- Department of Orthodontics, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.
- Department of Orthodontics, University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
| | - Petra Santander
- Department of Orthodontics, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Norman Moser
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Daniela Klenke
- Department of Orthodontics, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Philipp Meyer-Marcotty
- Department of Orthodontics, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Anja Quast
- Department of Orthodontics, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| |
Collapse
|
20
|
Rahbani D, Fliss B, Ebert LC, Bjelopavlovic M. Detecting missing teeth on PMCT using statistical shape modeling. Forensic Sci Med Pathol 2024; 20:23-31. [PMID: 36892806 PMCID: PMC10944413 DOI: 10.1007/s12024-023-00590-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] [Accepted: 01/31/2023] [Indexed: 03/10/2023]
Abstract
The identification of teeth in 3D medical images can be a first step for victim identification from scant remains, for comparison of ante- and postmortem images or for other forensic investigations. We evaluate the performance of a tooth detection approach on mandibles with missing parts or pathologies based on statistical shape models. The proposed approach relies on a shape model that has been built from the full lower jaw, including the mandible and teeth. The model is fitted to the target, resulting in a reconstruction, in addition to a label map that indicates the presence or absence of teeth. We evaluate the accuracy of the proposed solution on a dataset consisting of 76 target mandibles, all extracted from CT images and exhibiting various cases of missing teeth or other cases, such as roots, implants, first dentition, and gap closure. We show an accuracy of approximately 90% on the front teeth (including incisors and canines in our study) that decreases for the molars due to high false-positive rates at the wisdom teeth level. Despite the drop in performance, the proposed approach can be used to obtain an estimate of the tooth count without wisdom teeth, tooth identification, reconstruction of the existing teeth to automate measurements taken as part of routine forensic procedures, or prediction of the missing teeth shape. In comparison to other approaches, our solution relies solely on shape information. This means it can be applied to cases obtained from either medical images or 3D scans because it does not depend on the imaging modality intensities. Another novelty is that the proposed solution avoids heuristics for the separation of teeth or for fitting individual tooth models. The solution is therefore not target-specific and can be directly applied to detect missing parts in other target organs using a shape model of the new target.
Collapse
Affiliation(s)
- Dana Rahbani
- Graphics and Vision Research Group (GraVis), University of Basel, Basel, Switzerland
| | - Barbara Fliss
- Institute of Forensic Medicine, University Hospital of Mainz, Mainz, Germany
| | - Lars Christian Ebert
- 3D Center Zurich, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Bjelopavlovic
- Department of Prosthodontics and Materials Science, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| |
Collapse
|
21
|
Guo W, Lu B, Liu F, Jin D, Wu S, Zhou S, Li Z, Lv Y, Zhao Z, Zhang J, Li Y. Comprehensive repair of the alveolar cleft using cortical and cancellous bone layers: A retrospective study. J Craniomaxillofac Surg 2024; 52:310-315. [PMID: 38212164 DOI: 10.1016/j.jcms.2024.01.004] [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: 12/30/2022] [Revised: 10/11/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
To retrospectively review the clinical effect of comprehensive treatment of alveolar cleft (CTAC) using the mandible as the bone source. Patients with alveolar clefts who met the inclusion criteria were subjected to a CTAC protocol that included the following: (1) preoperative orthodontic treatment for creating good soft-tissue conditions; (2) 'area-like grafting' with subperiosteal osteogenic chin bone instead of cartilaginous osteogenic iliac bone; (3) simulation of normal bone anatomy via a sandwich-like bone graft consisting of 'cortical bone + cancellous bone + cortical bone'; and (4) strong internal fixation to ensure initial bone block stability. At 6 months postoperatively, the titanium plate was removed and cone-beam computed tomography was performed to evaluate the surgical results. A total of 54 patients underwent treatment with the CTAC protocol. The average age at the initial operation was 10.3 ± 2.1 years, and the average hospital stay was 2.8 ± 0.6 days. At 6 months postoperatively, 49 patients (90.7%) showed good clinical results. The transplanted bone block formed a 'cortical bone + cancellous bone + cortical bone' structure similar to that of the normal jawbone. A mature bone bridge formed, and the impacted permanent teeth continued to erupt and enter the bone graft area. CTAC is a comprehensive restorative solution for alveolar cleft repair that integrates multiple concepts, including orthodontics, embryology, anatomy, and improvements to surgical methods. The method is easy to perform, causes little surgical trauma, and shows a stable success rate, and is thus worth promoting.
Collapse
Affiliation(s)
- Weiwei Guo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Bin Lu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Fuwei Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Dan Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Simo Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Shanluo Zhou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Zhiye Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Yaoguang Lv
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Zhihe Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Junrui Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China.
| | - Yunpeng Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China.
| |
Collapse
|
22
|
Ibald LC, Witte V, Klawonn F, Conrad R, Mücke M, Sellin J, Teschke M. Suggestion of a new standard in measuring the mandible via MRI and an overview of reference values in young women. Oral Maxillofac Surg 2024; 28:373-383. [PMID: 37099046 PMCID: PMC10914874 DOI: 10.1007/s10006-023-01153-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/07/2023] [Indexed: 04/27/2023]
Abstract
PURPOSE Adult idiopathic condylar resorption (AICR) mainly affects young women, but generally accepted diagnostic standards are lacking. Patients often need temporomandibular joint (TMJ) surgery, and often jaw anatomy is assessed by CT as well as MRI to observe both bone and soft tissue. This study aims to establish reference values for mandible dimensions in women from MRI only and correlate them to, e.g., laboratory parameters and lifestyle, to explore new putative parameters relevant in AICR. MRI-derived reference values could reduce preoperative effort by allowing physicians to rely on only the MRI without additional CT scan. METHODS We analyzed MRI data from a previous study (LIFE-Adult-Study, Leipzig, Germany) of 158 female participants aged 15-40 years (as AICR typically affects young women). The MR images were segmented, and standardized measuring of the mandibles was established. We correlated morphological features of the mandible with a large variety of other parameters documented in the LIFE-Adult study. RESULTS We established new reference values for mandible morphology in MRI, which are consistent with previous CT-based studies. Our results allow assessment of both mandible and soft tissue without radiation exposure. Correlations with BMI, lifestyle, or laboratory parameters could not be observed. Of note, correlation between SNB angle, a parameter often used for AICR assessment, and condylar volume, was also not observed, opening up the question if these parameters behave differently in AICR patients. CONCLUSION These efforts constitute a first step towards establishing MRI as a viable method for condylar resorption assessment.
Collapse
Affiliation(s)
- Leonie Carina Ibald
- Centre for Rare Diseases Bonn (ZSEB), University Hospital Bonn, Bonn, Germany
| | - Veronica Witte
- Cognitive Neurology, University Medical Center Leipzig, Leipzig, Germany
- Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| | - Fank Klawonn
- Biostatistics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Department of Computer Science, Ostfalia University, Wolfenbüttel, Germany
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Muenster, Muenster, Germany
| | - Martin Mücke
- Institute for Digitalization and General Medicine, University Hospital RWTH Aachen, Aachen, Germany
- Centre for Rare Diseases Aachen (ZSEA), University Hospital RWTH Aachen, Aachen, Germany
| | - Julia Sellin
- Institute for Digitalization and General Medicine, University Hospital RWTH Aachen, Aachen, Germany.
- Centre for Rare Diseases Aachen (ZSEA), University Hospital RWTH Aachen, Aachen, Germany.
| | - Marcus Teschke
- Dept. of Maxillofacial Surgery, Parkklinik Manhagen, Großhansdorf, Germany
| |
Collapse
|
23
|
Girdhar A, Keerthika R, Narwal A, Kamboj M, Devi A, Sharma R. Comparative manual and digital analysis of gonial angle in lateral cephalograms for gender determination. Forensic Sci Med Pathol 2024; 20:73-78. [PMID: 37060537 DOI: 10.1007/s12024-023-00625-2] [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] [Accepted: 03/29/2023] [Indexed: 04/16/2023]
Abstract
Human skull has always been used for victim identification in forensic odontology. The gender-dimorphic bone of the skull is the mandible. The gonial angle has frequently been investigated for gender estimation with variable results and requires further exploration. We aim to compare the efficacy of gonial angle estimation by ancient methods of lateral cephalometric tracing compared with more recent digital analysis methods for gender estimation in the Indian population. Lateral cephalograms of 191 (96 M and 95F) cases above the age of 17 years were retrieved. Cephalometric analysis of gonial angle on radiographs was done using both manual cephalometric tracing method and digitally using Adobe Photoshop software. The results were subjected to statistical analysis for evaluation. The mean gonial angle was higher in females (125.05; 123.77 and 125.28) than in males (122.583; 121.715 and 122.008) using both manual and digital methods. On applying the logistical regression analysis (LRA), the digital method showed the highest gender estimation accuracy of 60.7% followed by Burstone's analysis (57.1%) and manual conventional analysis (56.5%). Burstone's analysis (57.9%) correctly identified increased females, whereas digital analysis (62.5%) and manual conventional analysis (59.4%) accurately recognised increased males. The present study showed a higher gender estimation accuracy using digital methods as compared to manual methods, but it still lacks the credibility to be used as a sole factor for predicting the gender of an individual. Hence, a cumulative factor must be taken into consideration for gender identification which would provide more promising results.
Collapse
Affiliation(s)
- Akhil Girdhar
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - R Keerthika
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India.
| | - Anjali Narwal
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Anju Devi
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Rekha Sharma
- Department of Orthodontics, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| |
Collapse
|
24
|
Braga J, Grine FE. New craniodental fossils of Paranthropus robustus from Kromdraai, South Africa (2014-2017 excavations). J Hum Evol 2024; 188:103481. [PMID: 38382132 DOI: 10.1016/j.jhevol.2023.103481] [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: 06/19/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 02/23/2024]
Abstract
Since the initial discovery of Paranthropus robustus at the site of Kromdraai in 1938, the hypodigm of this species has been expanded by subsequent work at the localities of Swartkrans and Drimolen, with a few fossils also known from Cooper's D, Gondolin and Sterkfontein Member 5. Beginning in 2014, systematic excavations at Kromdraai uncovered a large and previously unknown fossiliferous area, shedding light on Units O and P in the earliest part of the site's stratigraphic sequence. The aim of this paper is to provide detailed descriptions and illustrations of 30 P. robustus craniodental specimens recovered between 2014 and 2017 within the Unit P deposits at Kromdraai. This new sample predates all prior conspecific specimens found at this site (including the holotype of P. robustus from Kromdraai, TM 1517). Its basic dental morphology dimensions and cranial features are compared in a preliminary analysis with other P. robustus samples. The P. robustus sample from Kromdraai Unit P documents previously unknown portions of the P. robustus juvenile cranium. The new dental and cranial remains aid in the exploration of potential morphological distinctions between site-specific P. robustus samples and are compared favorably in size and morphology with the small P. robustus specimens from Drimolen (e.g., DNH 7). These findings do not support the hypothesis that the specimens from Drimolen belong to a different taxonomic group. Instead, they reinforce the presence of a significant degree of sexual dimorphism within P. robustus. The Kromdraai Unit P specimens also contribute to the biodemographic profile of P. robustus. The notable prevalence of infants (i.e., juvenile individuals before the emergence of their first permanent molars) mirrors the natural mortality profiles observed in wild chimpanzees. This suggests a closer resemblance in the processes of accumulation in Kromdraai Unit P and Drimolen than at Swartkrans.
Collapse
Affiliation(s)
- José Braga
- Centre for Anthropobiology & Genomics of Toulouse, CNRS UMR 5288, Université de Toulouse, Université Paul Sabatier, 37 allées Jules Guesde, Toulouse, France; Evolutionary Studies Institute, University of the Witwatersrand, Johannesburg, South Africa.
| | - Frederick E Grine
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA; Department of Anatomical Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| |
Collapse
|
25
|
Sexton P, ElMinshawi A, O'Higgins C, Barry T, McCann PJ. The necessity of removal of third molars involved in mandibular fractures: A retrospective study. J Craniomaxillofac Surg 2024; 52:279-282. [PMID: 38320919 DOI: 10.1016/j.jcms.2023.11.012] [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: 01/10/2023] [Revised: 06/01/2023] [Accepted: 11/23/2023] [Indexed: 02/08/2024] Open
Abstract
This retrospective analysis aimed to investigate the necessity of removing the wisdom tooth in cases of angle fractures of the mandible. The study retrieved 595 mandible fractures from January 2006 to December 2021 through the Hospital Inpatient Enquiry System, of which 303 involved a fracture through the angle of the mandible, including the wisdom tooth socket. Of these, 203 (66.9%) underwent open reduction and internal fixation with retention of the third molar. The authors found that only four (2%) patients returned for the removal of plates and the retained third molar during the follow-up period. Therefore, the authors concluded that wisdom teeth removal should remain an exception during open reduction and internal fixation of mandibular angle fractures unless they hinder fracture reduction, pose a potential infection risk, or interfere with occlusal stability.
Collapse
Affiliation(s)
- P Sexton
- Department of Oral and Maxillofacial Surgery, Galway University Hospital, Galway, Ireland.
| | - A ElMinshawi
- Department of Oral and Maxillofacial Surgery, Galway University Hospital, Galway, Ireland
| | - C O'Higgins
- Department of Oral and Maxillofacial Surgery, Galway University Hospital, Galway, Ireland
| | - T Barry
- Department of Oral and Maxillofacial Surgery, Galway University Hospital, Galway, Ireland
| | - P J McCann
- Department of Oral and Maxillofacial Surgery, Galway University Hospital, Galway, Ireland
| |
Collapse
|
26
|
Mattavelli D, Verzeletti V, Deganello A, Fiorentino A, Gualtieri T, Ferrari M, Taboni S, Anfuso W, Ravanelli M, Rampinelli V, Grammatica A, Buffoli B, Maroldi R, Elisabetta C, Rezzani R, Nicolai P, Piazza C. Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study. Eur Arch Otorhinolaryngol 2024; 281:1493-1503. [PMID: 38170208 PMCID: PMC10857968 DOI: 10.1007/s00405-023-08392-0] [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: 11/01/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To investigate the potential reconstruction of complex maxillofacial defects using computer-aided design 3D-printed polymeric scaffolds by defining the production process, simulating the surgical procedure, and explore the feasibility and reproducibility of the whole algorithm. METHODS This a preclinical study to investigate feasibility, reproducibility and efficacy of the reconstruction algorithm proposed. It encompassed 3 phases: (1) scaffold production (CAD and 3D-printing in polylactic acid); (2) surgical simulation on cadaver heads (navigation-guided osteotomies and scaffold fixation); (3) assessment of reconstruction (bone and occlusal morphological conformance, symmetry, and mechanical stress tests). RESULTS Six cadaver heads were dissected. Six types of defects (3 mandibular and 3 maxillary) with different degree of complexity were tested. In all case the reconstruction algorithm could be successfully completed. Bone morphological conformance was optimal while the occlusal one was slightly higher. Mechanical stress tests were good (mean value, 318.6 and 286.4 N for maxillary and mandibular defects, respectively). CONCLUSIONS Our reconstructive algorithm was feasible and reproducible in a preclinical setting. Functional and aesthetic outcomes were satisfactory independently of the complexity of the defect.
Collapse
Affiliation(s)
- Davide Mattavelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy.
| | - Vincenzo Verzeletti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedale Università di Padova, Padua, Italy
| | - Alberto Deganello
- Otolaryngology Head and Neck Surgery Department of IRCCS, National Cancer Institute (INT), Milan, Italy
| | - Antonio Fiorentino
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Tommaso Gualtieri
- Department of Otorhinolaryngology, Head and Neck Surgery, "Nuovo Santo Stefano" Civil Hospital, Prato, Italy
| | - Marco Ferrari
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-Azienda Ospedale Università di Padova, Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON, Canada
| | - Stefano Taboni
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-Azienda Ospedale Università di Padova, Padua, Italy
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - William Anfuso
- Otolaryngology Head and Neck Surgery Department of IRCCS, National Cancer Institute (INT), Milan, Italy
| | - Marco Ravanelli
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
- Unit of Radiology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alberto Grammatica
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Barbara Buffoli
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, School of Medicine, Brescia, Italy
| | - Roberto Maroldi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
- Unit of Radiology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Ceretti Elisabetta
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Rita Rezzani
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, School of Medicine, Brescia, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-Azienda Ospedale Università di Padova, Padua, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| |
Collapse
|
27
|
Janeczek M, Makowiecki D, Pasicka E, Rozwadowska A, Ciaputa R. A probable case of "lumpy jaw" in early medieval (11th - 12th c.) cattle from a stronghold in Kruszwica, Poland. Int J Paleopathol 2024; 44:46-50. [PMID: 38134631 DOI: 10.1016/j.ijpp.2023.11.006] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered. MATERIALS The skeletal material included a caudal fragment of a cattle mandible. The specimen, exhibiting chronic disease was separated from approximately 10,000 early medieval cattle remains discovered during excavations of the former Kruszwica stronghold. METHODS The bone was underwent macroscopic, radiological and histopathological examination. RESULTS Location, macroscopic, microscopic and X-ray images of the lesions within the examined mandible indicate it could have been caused by the actinomycosis. CONCLUSIONS In the face of infection, no effective therapies were undertaken in the Middle Ages. SIGNIFICANCE Descriptions of lumpy jaw in the paleopathological literature are rare. This disease, due to its background and course, eliminated animals from breeding for centuries until the era of antibiotics. The case described in our paper is in an advanced stage, but its adult age suggests that efforts were possibly made to keep the cow alive as long as possible, indicating the significant economic importance of the animal. LIMITATIONS This analysis is limited by the absence of other anatomical elements of the affected animal, which impacts the interpretation of the palaeopathological bone. SUGGESTIONS FOR FURTHER RESEARCH It is recommended that similar studies are conducted on better preserved and more numerous cattle assemblages.
Collapse
Affiliation(s)
- Maciej Janeczek
- Wrocław University of Environmental and Life Sciences, ul. Norwida 25, 50-375 Wrocław, Poland
| | - Daniel Makowiecki
- Nicolaus Copernicus University in Toruń ul. Gagarina 11, 87-100 Toruń, Poland
| | - Edyta Pasicka
- Wrocław University of Environmental and Life Sciences, ul. Norwida 25, 50-375 Wrocław, Poland.
| | - Aleksandra Rozwadowska
- Wrocław University of Environmental and Life Sciences, ul. Norwida 25, 50-375 Wrocław, Poland
| | - Rafał Ciaputa
- Wrocław University of Environmental and Life Sciences, ul. Norwida 25, 50-375 Wrocław, Poland
| |
Collapse
|
28
|
Abualhija D, Gómez García-Donas J, Shepherd S, McGregor S, Franco A, Manica S. Biological profiling using the human mandible. J Oral Biosci 2024; 66:5-12. [PMID: 38036053 DOI: 10.1016/j.job.2023.11.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND In the absence of soft tissue, skeletal remains are analyzed to identify the deceased. This assessment involves establishing the biological profile that aids medicolegal investigations and fulfils the right of the dead to be identified. Since the mandible is the strongest bone in the skull and easily identifiable, even when fragmented, this study aimed to systematically review its value in constructing the biological profile in the published literature. We searched PubMed, ScienceDirect, Scopus, and Latin American and Caribbean Health Sciences Literature and collected cross-sectional studies published in English before 2021. A risk of bias assessment was completed based on Joanna Briggs Institute's critical appraisal tools. The data are presented descriptively and were analyzed using Microsoft Office Excel 365. HIGHLIGHT Of the 104 eligible articles, 94 examined the sexual dimorphism of the mandible, while 25 attempted to estimate age. Ancestry and stature were the least explored biological characteristics (five and one articles, respectively). A metric analysis was the most common approach (n = 80), followed by morphological analysis and combined morphologic and metric techniques (n = 18 and n = 6, respectively). The results showed no statistically significant correlation between an individual's mandible and stature. Orthopantomogram radiography continues to be the most common radiographic technique for assessing the mandible. CONCLUSION The mandible is reliable when used for sex estimation; however, caution should be exercised in relying solely on it for morphological assessments. This review provides guidance on estimating age, sex, and ancestry directly from mandibular specimens or radiographs.
Collapse
Affiliation(s)
- Doha Abualhija
- Centre for Forensic and Legal Medicine and Dentistry, DD1 4HN, University of Dundee, UK.
| | | | - Simon Shepherd
- Department of Oral Surgery and Medicine, DD1 4HN, University of Dundee, UK
| | | | - Ademir Franco
- Centre for Forensic and Legal Medicine and Dentistry, DD1 4HN, University of Dundee, UK
| | - Scheila Manica
- Centre for Forensic and Legal Medicine and Dentistry, DD1 4HN, University of Dundee, UK
| |
Collapse
|
29
|
de Oliveira E Silva G, Mendes TS, Carneiro DPA, Menezes CCD, Vedovello SAS, Terossi de Godoi AP. Three-dimensional analysis of posterior tooth inclinations in transverse and sagittal relationships: A cross-sectional study. Int Orthod 2024; 22:100824. [PMID: 37992474 DOI: 10.1016/j.ortho.2023.100824] [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: 08/16/2023] [Revised: 10/09/2023] [Accepted: 10/14/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To compare tooth inclinations in different sagittal skeletal patterns and transverse maxillary relationships three-dimensionally. METHODS A cross-sectional study carried out with 132 three-dimensional digital models in the complete permanent dentition divided into six groups (n=22); three groups with maxillary atresia: G1- skeletal class I, G2- skeletal class II and G3-skeletal class III; three groups without maxillary atresia: G4- skeletal class I; G5- skeletal class II and G6- skeletal class III. The comparison between the skeletal pattern was performed by the non-parametric tests of Kruskal Wallis and Dunn and between the groups by the non-parametric test of Mann Whitney. RESULTS Subjects with skeletal class II and maxillary atresia had a greater lingual inclination of the maxillary teeth than those with class I and III; Subjects with skeletal class II without atresia had a less lingual inclination of the mandibular molars than the other classes (p<0.05). The maxillary premolars showed no variation in dental inclination with atresia, independent of the skeletal class in G1, G2, and G3 (p>0.05). The mandibular premolars showed that the groups without atresia G4, G5, and G6 presented no significant difference (p>0.05). Lower premolars in skeletal class III malocclusion individuals with atresia had a more negative inclination than the others. CONCLUSION There is a difference in the inclination of posterior teeth between individuals with and without maxillary atresia and skeletal classes I, II, and III.
Collapse
Affiliation(s)
- Guto de Oliveira E Silva
- University Center of Hermínio Ometto Foudantion - FHOAraras Dental School, Department of Orthodontics, Araras, São Paulo, Brazil
| | - Thiago Santos Mendes
- University Center of Hermínio Ometto Foudantion - FHOAraras Dental School, Department of Orthodontics, Araras, São Paulo, Brazil
| | - Diego Patrik Alves Carneiro
- University of Campinas, Piracicaba Dental School, Department of Community Dentistry, Piracicaba, São Paulo, Brazil
| | - Carolina Carmo de Menezes
- University Center of Hermínio Ometto Foudantion - FHOAraras Dental School, Department of Orthodontics, Araras, São Paulo, Brazil
| | - Silvia Amélia Scudeler Vedovello
- University Center of Hermínio Ometto Foudantion - FHOAraras Dental School, Department of Orthodontics, Araras, São Paulo, Brazil.
| | - Ana Paula Terossi de Godoi
- University Center of Hermínio Ometto Foudantion - FHOAraras Dental School, Department of Orthodontics, Araras, São Paulo, Brazil
| |
Collapse
|
30
|
Choi S, Kim MJ, Kang SH, Park IW. Pediatric mandibular chronic nonbacterial osteomyelitis: A case report with 12 years of radiologic follow-up. Imaging Sci Dent 2024; 54:93-104. [PMID: 38571777 PMCID: PMC10985518 DOI: 10.5624/isd.20230189] [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: 08/31/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 04/05/2024] Open
Abstract
Chronic nonbacterial osteomyelitis (CNO) is histologically characterized by nonspecific osteitis. This inflammatory disorder, which lacks an infectious origin, typically presents with chronic pain and swelling at the affected site that can persist for months or even years. However, it is rare for CNO to affect the mandible. A 10-year-old girl presented with a primary complaint of pain in her left mandible. She had no significant medical or dental history. On examination, swelling was visible on the left buccal side, and imaging revealed radiolucent bone deterioration within the left mandible. This case report presents the radiological changes observed over a 12-year follow-up period. Variations in radiopacity, radiolucency, and periosteal reactions were noted periodically. This case highlights the radiological characteristics and findings that are crucial for the diagnosis of CNO, a condition for which no clear diagnostic criteria are currently available.
Collapse
Affiliation(s)
- Sehyun Choi
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Min-Ji Kim
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sang-Hoon Kang
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - In-Woo Park
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| |
Collapse
|
31
|
Marchand T, Pey B, Pautot C, Lecerf A. Mechanical traits as drivers of trophic interaction between macrodetritivores and leaf litter. Oecologia 2024; 204:641-651. [PMID: 38472472 DOI: 10.1007/s00442-024-05515-0] [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: 09/04/2023] [Accepted: 01/16/2024] [Indexed: 03/14/2024]
Abstract
In ecosystems, the rates of resource consumption by animals drive the flows of matter and energy. Consumption rates are known to vary according to consumer energy requirements, resource nutrient content and mechanical properties. The aim of our study is to determine how mechanical constraints, compared to energetic and nutritional constraints, explain the variation in leaf litter consumption rates by macrodetritivores. In particular, we focus on the impact of litter toughness. To this end, we propose a non-linear model describing leaf litter consumption rates of detritivore as a function of litter toughness. We also investigate a possible match between bite force and litter toughness, since consumer-resource co-occurrence is thought to be driven by the match between invertebrate mandibular traits and resource toughness. Our study was designed as follows: leaf litter from oak and hornbeam was exposed to field physical and microbial decomposition in aquatic and terrestrial ecosystems for selected time periods before it was offered to eight macrodetritivore taxa (three forest stream taxa and five forest soil taxa) in no-choice laboratory feeding experiments. Our findings show that, compared to energetic and nutritional constraints, mechanical traits have a greater impact on litter consumption rate by detritivores. After subtracting the contribution of the detritivore body mass, we report that litter consumption rates depend primarily on litter toughness. A sigmoid function is best suited to characterize the relationship between mass-independent consumption rate and litter toughness. We note that the parameters of our sigmoid model are taxon-specific, suggesting biomechanical thresholds and biological differences among taxa. Interestingly, we found no correlation with detritivore bite force, suggesting that food processing by detritivores does not only depend on mandibles strength.
Collapse
Affiliation(s)
- Théo Marchand
- Laboratoire Écologie Fonctionnelle et Environnement, Université de Toulouse, CNRS, Toulouse, France.
| | - Benjamin Pey
- Laboratoire Écologie Fonctionnelle et Environnement, Université de Toulouse, CNRS, Toulouse, France
| | - Corinne Pautot
- Laboratoire Écologie Fonctionnelle et Environnement, Université de Toulouse, CNRS, Toulouse, France
| | - Antoine Lecerf
- Laboratoire Écologie Fonctionnelle et Environnement, Université de Toulouse, CNRS, Toulouse, France
| |
Collapse
|
32
|
Yamada K, Akita S, Ando N, Tamura T, Hayashi M, Isono S, Mitsukawa N. Changes in mandibular position during midface distraction in patients with syndromic craniosynostosis. J Craniomaxillofac Surg 2024; 52:340-346. [PMID: 38326126 DOI: 10.1016/j.jcms.2024.01.011] [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] [Revised: 10/20/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
The purpose of this study was to evaluate changes in mandibular position during midface distraction. Midface distraction was performed in patients with syndromic craniosynostosis to increase upper airway volume. Although this treatment resulted in changes in occlusion, the concomitant changes in mandibular position were poorly understood. In this retrospective study, three-dimensional (3D) cephalograms were obtained before and after midface distraction in 15 patients with syndromic craniosynostosis. Perioperative polysomnography scores and changes in maxillary and mandibular position, mandibular volume, and upper airway volume were analyzed. Results showed a significant improvement in apnea-hypopnea index (AHI) (from 20.6 ± 21.3 to 6.9 ± 5.1, p < 0.05) and upper airway volume (from 2951.65 ± 2286.38 to 5218.04 ± 3150.05 mm3, p < 0.001). When the lowest point of the sella turcica was set as the reference point, the mandible moved significantly in an anterior direction (from 47.9 ± 11.5 to 51.9 ± 9.8 mm, p < 0.05). Mandibular volume did not change significantly perioperatively (from 32530.19 ± 10726.01 to 35590.50 ± 14879.21 mm3, p = 0.10). There were positive correlations between the rates of improvement in AHI and the amount of mandibular movement in the anterior and inferior directions (both p < 0.05). Within the limitations of the study, it seems that the mandible moved in the anterior-inferior direction after midface distraction, and the amount of movement correlated with improvement in respiratory function. Therefore, it is important to consider the position of the mandible when determining the direction of midface distraction, as it may influence the therapeutic effect.
Collapse
Affiliation(s)
- Kahoko Yamada
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinsuke Akita
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuhiro Ando
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeshi Tamura
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Minoru Hayashi
- Department of Plastic and Reconstructive Surgery, St. Mary's Hospital, Fukuoka, Japan
| | - Shiroh Isono
- Department of Anesthesiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| |
Collapse
|
33
|
Soares FO, Rosado IR, Sousa MVC, Dumont CF, Bittar JFF, Martin I, Beletti ME, Melo RT, Alves EGL. Osteomyelitis by Microsporum canis and Staphylococcus spp. in cat (Felis catus) - case report. BMC Vet Res 2024; 20:58. [PMID: 38374006 PMCID: PMC10875912 DOI: 10.1186/s12917-024-03904-4] [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: 07/05/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Staphylococcus spp and Microsporum canis are zoonotic microorganisms which can cause infections and systemic diseases. The bone infection is usually caused by invasion of pathogen through the hematologic route. Mixed osteomyelitis caused by bacteria and fungi is rare, and to date, there have been no reports of mixed osteomyelitis with Staphylococcus spp. and Microsporum canis. CASE PRESENTATION This essay reports an atypical presentation of mixed osteomyelitis (Staphylococcus spp. and Microsporum canis) in a domestic cat. A 15-month-old female Persian cat was presented to a veterinary service; the main complaint was the appearance of a nodule in the mandibular ventral rostral region. A radiographic exam performed on the animal showed proliferative and osteolytic bone lesions. The patient was submitted to a biopsy for histopathological evaluation, along with bacterial and fungal cultures. Results showed mixed osteomyelitis by Staphylococcus spp. and Microsporum canis. Microbial Sensitivity Test was performed to choose a more suitable treatment. Two surgical procedures were executed to resect and curette the lesion, and treatments with anti-inflammatory, antibiotic, and antifungal drugs were established, showing a positive clinical evolution. After 8 months of treatment, the patient's owner moved to a different city, and the animal was seen by other veterinarians, who followed along with the same treatment. However, due to complications and a diminishing quality of life over 4 years of diagnosis, the patient was euthanized. CONCLUSION Given the above, mixed osteomyelitis is difficult to treat and can cause losses of life quality resulting death, especially in infections where M. canis is the agent causing the disease. Bacterial osteomyelitis is more frequently reported. But the lack of investigation of microorganisms other than bacteria, such as fungal cases, may imply in underdiagnosed cases. Treatment of osteomyelitis can be difficult considering the difficulties in isolating the pathological agent, resistance to the drug used, prolonged treatment time, and cost.
Collapse
Affiliation(s)
- Fernanda O Soares
- Hospital Veterinário Uniube, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| | - Isabel R Rosado
- Hospital Veterinário Uniube, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| | - Marcus V C Sousa
- Laboratório de Patologia Animal - PAVET, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| | - Carolyne F Dumont
- Laboratório de Epidemiologia Molecular - LEPIMOL, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal de Uberlândia, Av. Ceará, s/n, Bloco 2D43, Uberlândia, CC 38402-018, Brazil.
| | - Joely F F Bittar
- Hospital Veterinário Uniube, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| | - Ian Martin
- Hospital Veterinário Uniube, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| | - Marcelo E Beletti
- Laboratório de Epidemiologia Molecular - LEPIMOL, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Roberta T Melo
- Laboratório de Epidemiologia Molecular - LEPIMOL, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Endrigo G L Alves
- Hospital Veterinário Uniube, Universidade de Uberaba, Uberaba, Minas Gerais, Brazil
| |
Collapse
|
34
|
Marc KK, Bakary O, Alexandre De Misères OO, Laurent BK, Annick BZ, Lucien Jonathan YA, Linda Marie Pièrre KA, Ahi Morel C. Children mandibular fractures: Epidemiological and anatomo-clinical aspects. Heliyon 2024; 10:e24947. [PMID: 38314295 PMCID: PMC10837532 DOI: 10.1016/j.heliyon.2024.e24947] [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: 07/30/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/06/2024] Open
Abstract
Introduction Maxillofacial trauma in children is uncommon, accounting for between 1 % and 14 % of all facial trauma in the general population. Objective To describe the epidemiological and anatomical-clinical aspects of mandibular fractures in children. Material and method This was a retrospective descriptive cross-sectional study with non-probabilistic accidental sampling. It took place in the maxillofacial surgery and stomatology department of Cocody University Hospital in the Republic of Côte d'Ivoire, over a 20-year period (2000-2019). The study population consisted of patients aged 0-16 years admitted to our department for a mandibular fracture. At the end of this study, we identified 58 patients. Data was entered using Excel 2016. Tables and graphs were processed using Excel version 2016. Results we have identified 58 patients. The mean age of patients was 9.35 ± 2.1 years, with extremes of 1 and 16 years, and a sex ratio of 2,22 in favouring men. The 6-12 age group was the most affected (n: 34 cases or 60.35 %). Soft tissue wounds were present in all our patients, followed by peri-mandibular swelling (n: 37 cases or 63.79 %) and disorders of the dental articulation (n: 28 cases or 48.2 %). Condylar fractures were the most frequent (46.87 %).Mandibular fracture lines were uni-focal in 75 % of cases. These fractures were associated with other facial lesions in 48.28 % of cases and with extra-facial lesions in 34.48 % of cases. Conclusion Mandibular fractures are common in maxillofacial trauma in children. Condylar fractures are the most common, almost always associated with chin injuries. Hence the importance of a systematic examination of the mandibular condyles.
Collapse
Affiliation(s)
- Koffi Konan Marc
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| | - Ouattara Bakary
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| | | | - Boka Koffi Laurent
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| | - Brou-Zoglo Annick
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| | - Yapo Aké Lucien Jonathan
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| | | | - Chapo Ahi Morel
- Department of Stomatology, Maxillofacial and Plastic Surgery of the Face University Hospital of Cocody, Cote d'Ivoire
| |
Collapse
|
35
|
Benedict KC, Martinez IV, McIntyre B. Virtual Surgical Planning in Condyle Reconstruction of Posterior Mandibulectomy Defects. Eplasty 2024; 24:e8. [PMID: 38476514 PMCID: PMC10929072] [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] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Background Ameloblastoma is a rare odontogenic tumor most commonly located within the mandible. These tumors can grow to massive proportions and result in malocclusion. Segmental mandibulectomy and reconstruction with an osteocutaneous free flap are frequently required. Virtual surgical planning (VSP) aids the surgeon in creating precise anatomic reconstruction when there is preoperative malocclusion due to tumor size. In this study we seek to further examine reconstruction of posterior mandibulectomy defects inclusive of condylar resection. Methods Retrospective review of patients treated for giant ameloblastoma (tumor >4 cm) was examined; 3 patients with posterior tumors requiring ramus and condylar resection were included. Reconstruction in all patients was performed using fibula free flaps and VSP custom-made mandibular reconstruction plates. In these patients the reconstructed ramus was shortened and precise contouring done with a burr to recreate the native condylar surface. Intermaxillary fixation was used to maintain occlusion for 1 month postoperatively. Inferior alveolar nerve repair with allograft and nerve connectors was performed for all 3 patients. Results All patients underwent successful mandibular reconstruction with preservation of mandibular function and improved occlusion postoperatively. Inferior alveolar nerve repair using nerve allograft allowed for neurosensory recovery in the mandibular division of trigeminal nerve distribution in 2 of the 3 patients. Conclusions Giant ameloblastoma involving the mandibular condyle can be successfully treated with the fibula free flap utilizing mandible reconstruction plates and VSP. This technique allows for excellent restoration of occlusion and neurosensory recovery when paired with reconstruction of the inferior alveolar nerve at time of reconstruction.
Collapse
Affiliation(s)
- Katherine C. Benedict
- University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, Jackson, Mississippi
| | - Ignacio Velasco Martinez
- University of Mississippi Medical Center, Department of Oral-Maxillofacial Surgery and Pathology, Jackson, Mississippi
| | - Benjamin McIntyre
- University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, Jackson, Mississippi
| |
Collapse
|
36
|
Simonek M, Türp JC, Bornstein MM, Dagassan-Berndt D. Prevalence and correlation with sex, age, and dental status of bone apposition at the mandibular angle and radiographic alterations of the temporomandibular joints: a retrospective observational study in an adult Swiss population. BMC Oral Health 2024; 24:193. [PMID: 38321445 PMCID: PMC10845652 DOI: 10.1186/s12903-024-03855-0] [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: 09/13/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The purpose of this study was to determine the prevalence of radiographic changes in the mandibular angle (bone apposition) and osseous alterations in the temporomandibular joints (TMJs) in the adult population of Switzerland. In addition, the study intended to investigate possible correlations between the two sites of contour bone changes (mandibular angle and TMJ) and to analyze various patient-related factors, including sex, age, dental status, and medical history. METHODS Panoramic radiographs of 600 patients distributed into six age groups (283 females, 317 males, aged 20 to 79 years) were included to evaluate radiographic changes. The bone in the mandibular angle region and the shape of the condylar heads were examined for contour changes (bone apposition at the jaw angles and osseous changes of the TMJs). General estimating equations, binormal tests, and chi-squared tests were used for statistical analysis. RESULTS Approximately half of the mandibular angles (47.8%) showed bone apposition, mostly bilateral. TMJ alterations were less common (27%), often unilateral, with flattening being the most frequent finding. No significant correlation was found between the two sites. Bone apposition at the mandibular angle showed a significant male predominance, whereas TMJ changes did not differ by sex. Alterations in both sites increased with age, and were not related to dental status or analgesic use. CONCLUSIONS Bone apposition at the mandibular angle should be interpreted as part of the natural functional adaptation of the bone associated with aging. Assuming that parafunctional habits may influence the development and progression of alterations in the mandibular angle or TMJs, the presence of radiographic changes in these areas should prompt dental clinicians to investigate further in this direction. TRIAL REGISTRATION The study was approved by the Swiss Association of Research Ethics Committees (swissethics), BASEC reference number: 2020-00963 (25.05.2020).
Collapse
Affiliation(s)
- Michelle Simonek
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland.
| | - Jens Christoph Türp
- Division of Temporomandibular Disorders and Orofacial Pain, Department of Oral Health & Medicine, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| |
Collapse
|
37
|
Ye Y, Zheng X, Chen T, Zheng K, Pan J, Lin L. Computed tomography/magnetic resonance imaging for mandibular boundary invasion of oral squamous cell carcinoma assessment. BMC Oral Health 2024; 24:172. [PMID: 38308269 PMCID: PMC10837888 DOI: 10.1186/s12903-024-03920-8] [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: 11/03/2023] [Accepted: 01/20/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND The range of mandibular invasion by a tumour needs to be determined accurately to minimize unnecessary damage to the mandible. This study aimed to compare tumour boundary lines on computed tomography/magnetic resonance (CT/MR) images with those from pathological findings during the preoperative assessment of mandibular invasion by oral squamous cell carcinoma (OSCC). By comparing the methods, the potential of CT/MR for this application could be further elucidated. METHODS Eight patients with OSCC were imaged with CT/MR, mandibular specimens were collected, and the material site was measured. Haematoxylin-eosin staining was used for histopathological assessment. The presence and boundaries of bone invasion were evaluated. The CT/MR and histopathological boundaries of bone invasion were delineated and merged to compare and calculate the deviation of CT/MR and histopathological boundaries using the Fréchet distance. RESULTS The mean Fréchet distance between the CT and pathological tumour boundaries was 2.69 mm (standard error 0.46 mm), with a minimum of 1.18 mm, maximum of 3.64 mm, median of 3.10 mm, and 95% confidence interval of 1.40-3.97 mm. The mean Fréchet distance between the tumour boundaries on the MR and pathological images was 3.07 mm (standard error 0.56 mm), with a minimum of 1.53 mm, maximum of 4.74 mm, median of 2.90 mm, and 95% confidence interval of 1.53-4.61 mm. CONCLUSIONS CT/MR imaging can provide an effective preoperative assessment of mandibular invasion of OSCC. Pathology images can be positioned on CT/MR scans with the help of computer software to improve the accuracy of the findings. The introduction of the Fréchet distance to compare tumour boundary lines is conducive to computer image diagnosis of tumour invasion of jaw boundaries.
Collapse
Affiliation(s)
- Yingding Ye
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Xianglong Zheng
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Tanhui Chen
- Department of Radiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Ke Zheng
- Department of Pathology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Jie Pan
- Fujian Medical University, Fuzhou, China
| | - Lisong Lin
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
- National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
| |
Collapse
|
38
|
Grillo R, Reis BAQ, Brozoski MA, Traina AA, Melhem-Elias F. Optimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide. J Stomatol Oral Maxillofac Surg 2024; 125:101639. [PMID: 37729964 DOI: 10.1016/j.jormas.2023.101639] [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: 07/31/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE This study aimed to comprehensively review the literature and provide a practical guide for optimizing drug regimens and supplementation related to orthognathic surgery. METHODS The authors conducted a thorough review of the existing literature, following the PRISMA-ScR guidelines. Various types of studies except case reports and reviews were included. The study applied specific inclusion criteria, focusing on perioperative and/or postoperative drugs, medications, or supplementation related to orthognathic surgery. RESULTS This guide included 78 studies on various medications in orthognathic surgery. It encompasses clinical trials, cohort studies, cross-sectional studies, prospective and retrospective studies. The topics covered include antibiotics, analgesics, corticosteroids, antiemetics, hemostatic agents, local anesthetics, herbal medicine, and botulinum toxin. Pain and edema control involved specific medications, while local anesthesia utilized ropivacaine and bupivacaine. The guide also discusses mineral and vitamin supplementation. The effectiveness of hemostatic agents and antiemetics was highlighted. CONCLUSION Pain management, reduced swelling, enhanced wound healing, and faster recovery are among the advantages. In addition to the standard drugs and medications, the inclusion of vitamin and mineral supplements, tranexamic acid, postoperative anesthetic blocks, and preemptive antiemetics is anticipated to offer various benefits in orthognathic surgery, despite the limited available evidence.
Collapse
Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília-DF, Brazil.
| | | | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil
| | - Andreia Aparecida Traina
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil
| | - Fernando Melhem-Elias
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, São Paulo-SP, Brazil; Private Practice in São Paulo-SP, Brazil
| |
Collapse
|
39
|
Tekin G, Kose NS, Ugurlu M, Dereci O, Kosar YC, Gojayeva G, Caliskan G. Determining the safety margin of mandibular lingula in sagittal split ramus osteotomy. Surg Radiol Anat 2024; 46:159-166. [PMID: 38244088 DOI: 10.1007/s00276-023-03291-9] [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: 08/22/2023] [Accepted: 12/20/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE The anatomical position of the lingula is clinically very important to prevent injuries during sagittal split ramus osteotomy. Our study aims to evaluate the localisation of the lingula by cone beam computed tomography (CBCT) and to compare the localisation of the lingula between malocclusion, gender, and lingula types. METHODS A retrospective study was conducted to evaluate the shape and location of the lingula using CBCT. A total of 250 CBCT images were included in this study. The lingula was classified as nodular, assimilated, truncated, or triangular type. Six defined distances from the top of the lingula were measured: anterior border of the ramus (L-A), posterior border of the ramus (L-P), internal oblique ridge (L-IOR), mandibular notch (L-N), and distal surface of the mandibular second molar (L-M2) and occlusal plane (L-OP). The measured distances were compared between gender, malocclusion, and lingula types. RESULTS The most common type of lingula was nodular (32.4%). The L-N, L-P, L-M2, and L-OP distances between genders were statistically higher in male patients than in female patients. The L-IOR, L-M2, and L-OP distances exhibited statistically significant differences found between malocclusions. No statistically significant difference was found when the distances of the lingula to the anatomical points were compared between the lingula types. CONCLUSION These variations in positioning of the lingula depending on the dysmorphoses are developing towards a systematic 3D examination before any mandibular osteotomy to precisely visualize the position and shape of the lingula.
Collapse
Affiliation(s)
- Gorkem Tekin
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey.
| | - Nesrin Saruhan Kose
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Mehmet Ugurlu
- Department of Orthodontics, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Omur Dereci
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Yasin Caglar Kosar
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Gunay Gojayeva
- Specialist in Oral and Maxillofacial Surgeon, Private Practice, Eskişehir, Turkey
| | - Gizem Caliskan
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| |
Collapse
|
40
|
Hamza NC, Gupta C, Palimar V. Morphometric measurements of mandible to determine stature and sex: A postmortem study. J Taibah Univ Med Sci 2024; 19:106-113. [PMID: 37868104 PMCID: PMC10585390 DOI: 10.1016/j.jtumed.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/05/2023] [Accepted: 09/29/2023] [Indexed: 10/24/2023] Open
Abstract
Objectives Identification of humans has medicolegal relevance in civil issues involving property inheritance, marriage, contested sex, admission to educational institutions, and the disappearance of individuals. To determine the sex of human remains, forensic anthropologists usually use morphologic and metric approaches. This study was conducted to determine stature and sex according to mandibular dimensions in postmortem autopsy samples. Methods A total of 150 mandibles from people 18-65 years of age were studied. Stature and sex were noted, and six mandibular measurements were taken with Vernier calipers, flexible measuring tape, a protractor, and a graduated autopsy table. Statistical analysis of the measured parameters was conducted in SPSS software. Statistical parameters, such as mean, standard deviation, Spearman's correlation coefficient, multiple linear regression, stepwise regression, and Mann-Whitney U test were analyzed. Results Bicondylar width was the stature estimation predictor with the strongest correlation (r = 0.439). The other parameters significantly associated with stature were bigonial width (p = 0.000), mandibular angle (p = 0.004), and mandibular arch length (p = 0.000), according to Spearman's correlation coefficient. The mandibular angle had the greatest dimorphic statistical significance (p = 0.004) according to the Mann-Whitney U test. Conclusion Bicondylar width may serve as a valuable tool for estimating stature, and mandibular angle can be used to identify sex. Our findings may help forensic anthropologists estimate stature and identify human remains.
Collapse
Affiliation(s)
- Nehala C Hamza
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Chandni Gupta
- Department of Anatomy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vikram Palimar
- Department of Forensic Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
41
|
Goudarzi F, Anbiaee N, Shakeri MT. Comprehensive view of the posterior mandibular ridge morphology. Int J Oral Maxillofac Surg 2024; 53:170-177. [PMID: 37055261 DOI: 10.1016/j.ijom.2023.03.012] [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: 06/25/2022] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/15/2023]
Abstract
The anatomy of the posterior mandibular ridge and the anatomical structures present in this region are important in the planning and execution of dental treatments. The aim of this study was to examine all forms of alveolar ridge in detail to provide a comprehensive description of the posterior mandibular ridge. This study included 1865 cross-sectional sections of cone beam computed tomography scans obtained from 511 Iranian patients with a mean age of 48.14 years (280 female, 231 male). The alveolar ridge was described based on the ridge shape, including the existence and location of convexity and concavity. The morphology of the posterior mandibular ridge was categorized into 14 types: straight, pen shape, oblique, D type, B type, kidney, hourglass, sickle, golf club, toucan beak, tear, cudgel, basal, and saddle. Among the alveolar ridge types, the straight type in the premolar region and toucan beak type in the molar region were most frequent in the female, male, dentulous, and edentulous ridges. This study found significant differences in alveolar ridge morphology according to sex, dental status, and region of the ridge (all P < 0.001). In conclusion, the morphology of the alveolar ridge varies significantly between the sexes and between dentulous and edentulous locations.
Collapse
Affiliation(s)
- F Goudarzi
- Oral and Maxillofacial Radiology Department, School of Dentistry, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - N Anbiaee
- Oral and Maxillofacial Radiology Department, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - M T Shakeri
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
42
|
Pandiar D, Anbumani P, Krishnan RP. Literature Review, Case Presentation and Management of Non-ossifying Fibroma of Right Angle of Mandible: More Than just a Cortical Defect! Indian J Otolaryngol Head Neck Surg 2024; 76:1054-1061. [PMID: 38440574 PMCID: PMC10908682 DOI: 10.1007/s12070-023-04110-8] [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: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 03/06/2024] Open
Abstract
Non-ossifying fibroma (NOF) of jaw bones are rare. While NOF is the most common benign bone tumor of long bones with pathognomonic radiological features and bear a tendency for self-regression, gnathic NOF appears to be comparatively larger in size and behave more aggressively. A 16 years old female patient reported with painless swelling of the right side of the face of 4 months duration. Radiographic analysis showed a unilocular radiolucent lesion of right angle of the mandible with ill-defined margins, cortical perforation and thinning of inferior border. The lesion was provisionally diagnosed as odontogenic keratocyst/unicystic ameloblastoma and incisional biopsy was performed. The histopathological features and immunohistochemical characteristics favored a diagnosis of NOF. The lesion was excised and reconstructed. The excised specimen confirmed the diagnosis. There are no signs of recurrence at 18 months follow-up. NOF should be considered in the differential diagnosis of uni-/multilocular radiolucencies of jaws particularly the posterior mandible.
Collapse
Affiliation(s)
- Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu India
| | - P. Anbumani
- Oral and Maxillofacial Surgeon, 115, Vellam Thangiya Pillayar Kovil street, Tirunelveli town, Tirunelveli, Tamil Nadu India
| | - Reshma Poothakulath Krishnan
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu India
| |
Collapse
|
43
|
Akashi M. Second paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol 2024; 149:106662. [PMID: 38118250 DOI: 10.1016/j.oraloncology.2023.106662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 12/22/2023]
Affiliation(s)
- Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| |
Collapse
|
44
|
Choi Y, Ji JM, Kim CH, Sung KP. Surgical management of severe cherubism persisting into early adulthood: a case report and literature review. Arch Craniofac Surg 2024; 25:38-43. [PMID: 38461827 PMCID: PMC10924791 DOI: 10.7181/acfs.2023.00577] [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: 11/03/2023] [Revised: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 03/12/2024] Open
Abstract
Cherubism is a rare fibro-osseous condition characterized by bilateral expansion of the mandible and maxilla. Due to its rarity, treatment guidelines for cherubism have not been clearly established. Observation without surgical intervention is typically recommended, as cherubism often regresses spontaneously after puberty. However, a surgical intervention may be necessary if aggressive lesions lead to severe complications. In this report, we present a case involving surgical management of cherubism that did not spontaneously regress until early adulthood. An 18-year-old man was diagnosed with cherubism, presenting characteristic upward-looking eyes and a swollen face. He strongly desired surgical management. Gross contouring of the mandible was performed using an osteotome. Subsequently, delicate contouring was performed by bone burring and curettage. The remaining multiple locular bony defects were filled with demineralized bone matrix. No major complications, including infection and hematoma, occurred during the 8-month follow-up period. The facial contour remained stable without the aggravation of cherubism. The patient was satisfied with the cosmetic results. Considering that cherubism is a rare disease globally, with few reported cases in Korea, and that treatment guidelines are not clearly established, we anticipate that the results of this case will contribute to the development of future protocols for treating cherubism.
Collapse
Affiliation(s)
- Youngwoong Choi
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jeong Min Ji
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Choong Hyeon Kim
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Ki Pyo Sung
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| |
Collapse
|
45
|
Jafari-Pozve N, EmamJome SH, Saei M. Relation between maxillary sinus pneumatization and the thickness of the mandibular inferior border in panoramic radiographs. Saudi Dent J 2024; 36:286-290. [PMID: 38419991 PMCID: PMC10897602 DOI: 10.1016/j.sdentj.2023.10.026] [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: 04/13/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 03/02/2024] Open
Abstract
Background Maxillary sinus pneumatization is a physiological process that can adversely affect bone availability for further dental rehabilitation. If a relation between the thickness of the mandibular cortex and maxillary sinus pneumatization is proven, future bone availability can be deducted. Material and methods In this cross-sectional study, 85 panoramic radiographs were evaluated. All patients were between 19 and 70, had at least lost a second premolar, first molar, or second molar on one side of the maxilla, and had these teeth on the other side. Four lines were digitally drawn on the radiographs to determine the superior and inferior borders of the sinus on both sides. The amount of inferior sinus border progression was deducted using the digitally-measured lines' ratios. The following tests were done using IBM SPSS ver. 24: Pearson's correlation coefficient test, Tukey's dual comparison posthoc test, One-way ANOVA test, and the independent T-test (p = 0.05). Results There was a negative correlation between the inferior mandibular cortex's thickness and the maxillary sinus's pneumatization (p < 0.001). Also, there was a significant difference between maxilla sinus pneumatization in the second premolar, first, and second molar areas based on the inferior mandibular cortex's thickness (p = 0.009). Conclusions Based on the present study, there is a significant relationship between the thickness of the inferior mandibular cortex and maxillary sinus pneumatization, especially for women and patients above 40 years old.
Collapse
Affiliation(s)
- Nasim Jafari-Pozve
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Dental Implants Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Hanif EmamJome
- School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Mahshad Saei
- School of Dentistry, Student Research Committee, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| |
Collapse
|
46
|
Paddenberg-Schubert E, Küchler E, Bitencourt Reis CL, Silva-Sousa AC, Kirschneck C. New insights into the genetics of mandibular retrognathism: novel candidate genes. J Orofac Orthop 2024:10.1007/s00056-023-00512-z. [PMID: 38296908 DOI: 10.1007/s00056-023-00512-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE Mandibular retrognathism (MR) is a common skeletal malocclusion in humans with a strong genetic component. Single nucleotide polymorphisms (SNPs) in genes encoding epidermal growth factor (EGF) and EGF receptor (EGFR) could be involved in the etiology of mandibular retrognathism. Therefore, in this study, we investigated whether SNPs in the genes encoding for EGF and EGFR are associated with MR in German teenagers. METHODS This nested case-control study evaluated German orthodontic patients, aged 10-18 years. DNA, which was isolated from buccal epithelial cells using two cytobrushes, was used for genotyping analysis and digital pretreatment lateral cephalograms were examined to calculate SNB and ANB. Patients with a retrognathic mandible (SNB < 78°) were included as cases, while patients with an orthognathic mandible (SNB = 78-82°) were included as controls. Four SNPs in the genes encoding for EGF and EGFR were chosen and genotyped using real-time PCR. Allele, genotype, and haplotype frequency were compared across groups (α = 5%). RESULTS Finally, 119 patients were included in this study (45 orthognathic mandible, 74 retrognathic mandible). The minor allele G in rs4444903 (EGF) was statistically more frequent in individuals with an orthognathic mandible (p = 0.008). The haplotype formed by the mutant alleles for rs4444903|rs2237051 (EGF; G|A) was statistically more frequent in the orthognathic mandible group (p = 0.007). The SNPs rs4444903 and rs2237051 in EGF, and rs2227983 in EGFR were statistically associated with a decreasing risk of developing a retrognathic mandible according to univariate and multivariate statistical analysis (p < 0.05). CONCLUSION SNPs in EGF (rs4444903 and rs2237051) and EGFR (rs2227983) were associated with MR in our German sample and could be genetic biomarkers for early and individualized diagnostic identification of retrognathic mandibular development by means of genetic screening tests.
Collapse
Affiliation(s)
- Eva Paddenberg-Schubert
- Department of Orthodontics, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Erika Küchler
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Caio Luiz Bitencourt Reis
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Alice Corrêa Silva-Sousa
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| |
Collapse
|
47
|
Oksa M, Haapanen A, Kannari L, Furuholm J, Snäll J. Surgical treatment of clinically infected mandibular fractures. Oral Maxillofac Surg 2024:10.1007/s10006-024-01213-6. [PMID: 38286958 DOI: 10.1007/s10006-024-01213-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
PURPOSE To clarify reasons for infections, surgical techniques, and occurrence of postoperative surgical site complications in infected mandibular fractures. METHODS Patients with clinically infected mandibular fracture of the dentate part without preceding surgery were studied retrospectively. Clinical infection was defined to occur if pus, abscess, or a fistula in the fracture area was present. Patient-, fracture-, and surgery-related variables were evaluated, and predictors for postoperative complications were analysed. RESULTS Of 908 patients with surgically treated fracture in the dentate part of the mandible, 41 had infected fracture at the time of surgery (4.5%). Of these patients, 46.3% were alcohol or drug abusers. Median delay from injury to surgery was 9 days. Patient-related factors were the most common cause for delayed surgery (n = 30, 73.2%), followed by missed diagnosis by a health care professional (n = 8, 19.5%). Twenty-two fractures were treated via extraoral approach (53.7%) and the remaining 19 intraorally (46.3%). Postoperative surgical site complications were found in 13 patients (31.7%), with recurrent surgical site infections predominating. Notable differences between total complication rates between intraoral and extraoral approaches were not detected. Secondary osteosynthesis for non-union was conducted for one patient treated intraorally. CONCLUSIONS Postoperative surgical site complications are common after treatment of infected mandibular fractures, and these occur despite the chosen surgical approach. Infected mandibular fractures heal mainly without bone grafting, and non-union is a rare complication. Due to the high complication rate, careful perioperative and postoperative care is required for these patients.
Collapse
Affiliation(s)
- Marko Oksa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, FI-00290, Helsinki, Finland.
- Helsinki University Hospital, Haartmaninkatu 1A, FI-00029, Helsinki, Finland.
| | - Aleksi Haapanen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, FI-00290, Helsinki, Finland
- Helsinki University Hospital, Haartmaninkatu 1A, FI-00029, Helsinki, Finland
| | - Leena Kannari
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, FI-00290, Helsinki, Finland
- Helsinki University Hospital, Haartmaninkatu 1A, FI-00029, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, FI-00290, Helsinki, Finland
- Helsinki University Hospital, Haartmaninkatu 1A, FI-00029, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, FI-00290, Helsinki, Finland
- Helsinki University Hospital, Haartmaninkatu 1A, FI-00029, Helsinki, Finland
| |
Collapse
|
48
|
Farhad A, Hasheminia M, Hekmatian E, Mojiri V. Prevalence of middle mesial root canal in mandibular molars in an Iranian population: A micro-computed tomography study. Dent Res J (Isfahan) 2024; 21:9. [PMID: 38425321 PMCID: PMC10899162] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 03/02/2024] Open
Abstract
Background Knowledge about the anatomic variations of the root canal system and their prevalence is necessary for clinicians to ideally clean the root canal system. The anatomic complexity of the root canal system is one of the reasons for its inadequate debridement, resulting in residual microorganisms and root canal treatment failure. The present study aimed to evaluate the prevalence of middle mesial root canals in mandibular molars in an Iranian population. Materials and Methods The samples in the present descriptive/cross-sectional study consisted of mandibular first and second molars (n = 100, with 50 first and 50 s molars). A convenient sampling method was used to collect samples. The teeth were mounted in gypsum and scanned using a micro-computed tomography unit. The images were reconstructed with software, and the relevant checklist was completed by the observers. The data were analyzed with SPSS v26 using the Chi-squared test at a significance level of P < 0.05. Results The prevalence of the middle mesial root canal in the present study was 36% for mandibular first molars and 22% for mandibular second molars, with an overall prevalence of 29%. The prevalence of the middle mesial root canal was not significantly different between the first and second mandibular molars (P = 0.12). The mean distance between the mesiobuccal and mesiolingual root canal orifices in the teeth with a middle mesial root canal was significantly higher than in those without the middle mesial root canal (P < 0.001). In addition, there was no significant difference in the prevalence of the middle mesial root canal between the teeth with and without the second distal root canal (P = 0.89). Conclusion The prevalence of the middle mesial root canal in the studied population was 29%, which is significant clinically. In addition, the mean distance between the mesiobuccal and mesiolingual root canal orifices in teeth with a middle mesial root canal was higher than that in teeth without this root canal.
Collapse
Affiliation(s)
- Alireza Farhad
- Department of Endodontics, Dental Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Hasheminia
- Department of Endodontics, Dental Material Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Hekmatian
- Department of Radiology, Dental Implant Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Mojiri
- Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
49
|
Marghalani HYA. Volumetric comparison of mandibular condyles and mandibles in the different skeletal classes in the Saudi population. PeerJ 2024; 12:e16750. [PMID: 38188155 PMCID: PMC10771761 DOI: 10.7717/peerj.16750] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
Background Assessing the relationship between the condyle and mandible volume and the various skeletal classes is essential in orthodontic diagnosis. The current study evaluated this relationship using volumetric cone-beam computed tomography (CBCT), cephalometric methods, and the correlations between them. Materials and Methods The study examined 37 full-head CBCTs (74 condyles) from adults in the Saudi population. The condyle and mandible were separated from within the CBCT images. The volume of each segment was compared to measurements from multiple cephalometric analyses. Results The combined total condylar volume has a moderate correlation with the maxillomandibular differential in each of the genders and in the total sample. Mandibular volume has a significant correlation with the Wits appraisal (sagittal classification) in males. It was also significantly correlated with the vertical classification using gonial angles in females and in the total sample. Conclusion The relationship between mandible and condyle volume and cephalometric measurements is both dimensional and within the maxillomandibular complex rather than positional or related to the cranial base. Also, the correlation between the condylar and mandibular volumes and the sagittal and vertical dimensions in the orthodontic skeletal classes provides better insight into the mandibular complex.
Collapse
Affiliation(s)
- Hussain Y. A. Marghalani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
50
|
Gateno J, Kim D, Bartlett S, Deng HH, Xu JS, Xia JJ. Helical distraction is superior to linear and circular distraction in mandibular distraction osteogenesis: an in silico study. Int J Oral Maxillofac Surg 2024; 53:89-99. [PMID: 37277242 DOI: 10.1016/j.ijom.2023.04.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/04/2023] [Accepted: 04/18/2023] [Indexed: 06/07/2023]
Abstract
Helical mandibular distraction is theoretically better than linear or circular distraction. However, it is not known whether this more complex treatment will result in unquestionably better outcomes. Therefore, the best attainable outcomes of mandibular distraction osteogenesis were evaluated in silico, given the constraints of linear, circular, and helical motion. This cross-sectional kinematic study included 30 patients with mandibular hypoplasia who had been treated with distraction, or to whom this treatment had been recommended. Demographic information and the computed tomography (CT) scans showing the baseline deformity were collected. The CT scans of each patient were segmented and three-dimensional models of the face created. Then, the ideal distraction outcomes were simulated. Next, the most favorable helical, circular, and linear distraction movements were calculated. Finally, errors were measured: misalignment of key mandibular landmarks, misalignment of the occlusion, and changes in intercondylar distance. Helical distraction produced trivial errors. In contrast, circular and linear distractions resulted in errors that were statistically and clinically significant. Helical distraction also preserved the planned intercondylar distance, while circular and linear distractions led to unwanted changes in the intercondylar distance. It is now evident that helical distraction offers a new strategy to improve the outcomes of mandibular distraction osteogenesis.
Collapse
Affiliation(s)
- J Gateno
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital and Research Institute, Houston, TX, USA; Houston Methodist Research Institute and Academic Institute, Houston, TX, USA; Weill-Cornell Medical College, New York City, NY, USA
| | - D Kim
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital and Research Institute, Houston, TX, USA; Houston Methodist Research Institute and Academic Institute, Houston, TX, USA.
| | - S Bartlett
- Craniofacial Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - H H Deng
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital and Research Institute, Houston, TX, USA; Houston Methodist Research Institute and Academic Institute, Houston, TX, USA
| | - J S Xu
- Houston Methodist Research Institute and Academic Institute, Houston, TX, USA; Weill-Cornell Medical College, New York City, NY, USA; Division of Statistics and Research Design, Center for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, TX, USA
| | - J J Xia
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital and Research Institute, Houston, TX, USA; Houston Methodist Research Institute and Academic Institute, Houston, TX, USA; Weill-Cornell Medical College, New York City, NY, USA
| |
Collapse
|