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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2023. Vol. 28, no. 3
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- Pattern and management of maxillofacial fractures in Jordanian children and adolescents(2023) Bataineh, Anwar B.The aim of this study was to analyze the characteristics, etiology and treatment of maxillofacial fractures among children and adolescents in northern part of Jordan. A retrospective cohort study which included 91 children and adolescents patients who were treated for maxillofacial fractures during a period of three years between January 2019 and December 2021 at a tertiary hospital in Jordan. Over a period of three years, a total of 91 children between the age of 0 and 19 years were treated with 156 total maxillofacial fractures. Of these, 68 (74.73%) were males and 23 (25.27%) were females. One tenth of patients (10 (10.99%) were children of the preschool group and 55 patients (60.44%) were adolescents. Road traffic accident (RTA) was the most common cause of maxillofacial fractures, accounting for 57 (62.64%) of cases. Mandibular fractures were the most common and accounted for 82 (90.2%) of all fractures, followed by the zygomatic bone fractures 40 (44%). The most common treatment was intermaxillary fixation (IMF) with 53 (33.97%) fractures. Maxillofacial fractures are predominant among adolescents in comparison to children. RTA was the most common cause of maxillofacial fractures, mandibular fractures were the most common fractures, and intermaxillary fixation (IMF) was the most common treatment modality.
- Stafne's bone defect:a systematic review(2023) Soares, Alini; Ferreira, Luíse; Calderipe, Camila; Bologna Molina, Ronell; Damian, Melissa; Martins, Manoela D.; Silveira Esses, Diego Felipe; Uchoa Vasconcelos, Ana CarolinaThis systematic review integrated the available data published in the literature on Stafne?s bone defect (SBD), considering the clinical, imaging and histopathological results. An electronic search was undertaken in six databases. Eligibility criteria were: articles in English, Spanish, and Portuguese describing case reports or case series of SBD, reported up to September/2021. Risk of bias was assessed using the Joanna Briggs Institute tool. A total of 98 articles were retrieved, involving 465 individuals with SBD and were included for quantitative analysis. Mean age was 52.78 years (range: 11-89 years), with male predilection (n=374/80.85%). Radiographs were the most frequent imagiological exams (n=298/64.09%), followed by computed tomography (n=98/21.08%). SBD was more prevalent in the posterior mandible (n=361/93.77%) as a hypodense radiolucent lesion (n=250/77.40%). Mean size was 1.58 cm (range: 0.3-.8.0 cm). Two-hundred-and-two lesions (97.37%) were unilocular and 126 (91.97%) were classified as well-defined. Clinical symptoms were reported in 73 cases, while 68 cases (93.15%) were asymptomatic. Only 34 cases (12.32%) were submitted to histopathological examination. Mean follow-up time was 26.42 ±25.39 months. SBD is more frequent in male patients in the fifth and sixth decade of life. Classic SBD is radiographically characterized as a single, unilocular and well-defined lesion in the posterior region of the jaw with a radiolucent/hypodense appearance.
- Histopathological parameters reported in microinvasive oral squamous cell carcinoma:a systematic review(2023) Saldivia-Siracusa, Cristina; Araújo, Anna Luiza Damaceno; González-Arriagada, Wilfredo; Nava, Francisco Javier Tejeda; Hunter, Keith; Lopes, Márcio Ajudarte; Vargas, Pablo Agustín; Santos Silva, Alan RogerMicroinvasive oral squamous cell carcinoma (OSCCmi) is an incipient stage of oral cancer. Through this systematic review, we aim to assess patterns of histopathological outcomes reported in OSCCmi cases. An online search in major databases was performed without period restriction, and 2,024 publications in English, Spanish and Portuguese were obtained. After screening and eligibility, 4 studies were selected. The risk of bias was assessed using Joanna Briggs Institute Critical Appraisal Checklist. A descriptive synthesis was conducted. All 4 publications included were retrospective, reporting a total of 116 OSCCmi patients, with a male predominance (1.6:1) and a mean age of 55.9 years. The main parameters considered for microinvasion were tumor thickness (TT) (range 4-10mm) and depth of invasion (DOI) (range 0,02-5mm). Definition, cut-off values, and assessment of microscopic features were not standardized. Other relevant measures such as perineural or lymphovascular invasion and pattern of invasive front were barely described, and cytological/architectural characteristics were not discussed. TT and DOI are currently the primary histopathological criteria used to define OSCCmi. Nonetheless, the outcomes of this systematic review showed the absence of standardized quantitative parameters to render the diagnosis of microinvasive OSCC. Therefore, additional studies aiming to standardize histopathological features to diagnose OSCCmi are paramount.
- Adverse reactions to the injection of face and neck aesthetic filling materials:a systematic review(2023) Machado, Renato Assis; de Oliveira, Lilianny Querino Rocha; Martelli Júnior, Hercílio; Pires, Fábio-Ramôa; Carvas, Janaína Badin; Rogerio, Victor Edson; Rabelo, Viviane de Azevedo; Della Coletta, RicardoAdverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts. A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications. There is evidence that adverse reaction can be caused by different fillers in specific sites on the face. Although foreign body granuloma was the most common, other adverse lesions were diagnosed, exacerbating systemic diseases. In this way, we reinforce the importance of previous systemic evaluations and histopathological analyses for the correct diagnosis of lesions.
- Evaluation of jaw bone changes in patients with asthma using inhaled corticosteroids with mandibular radiomorphometric indices on dental panoramic radiographs(2023) Günen-Yilmaz, Sevcihan; Aytekin, ZelihaInhaled corticosteroids (ICSs) are an effective drug commonly used in asthma treatment. It is known that osteoporotic changes can occur secondary to steroid usage, depending on dosage and duration. The aim of this study was to compare radiomorphometric indices and fractal dimension on panoramic images of patients with asthma using ICSs and healthy controls. A total of 66 dental panoramic radiographs (DPRs) taken from 32 patients with asthma using ICSs and 34 healthy individuals were evaluated in this retrospective study. Panoramic mandibular index inferior and superior (PMI-i,PMI-s), mandibular cortical width (MCW), gonial index (GI), antegonial index (AI), mandibular cortical index (MCI), and fractal dimension analysis (FDA) were measured on DPRs. PMI-s (p=0.02), MCW (p<0.001), GI (p<0.001) and AI (p<0.001) values were significantly lower in the group of the asthma using ICSs than control group. However, the PMI-i (p ?0.05) measurement, the MCI (p ?0.05) and FDA values distribution were similar in both groups. The use of ICSs in asthma patients can affect bone quality. The evaluation of PMI-s, MCW, GI, and AI on DPR can help determine the effect of this drug on the jawbones in the early period and select dental and surgical treatment plans appropriately.
- Pentoxifylline and tocopherol for the treatment of osteoradionecrosis of the jaws. A systematic review(2023) Arqueros-Lemus, Marcelo; Mariño, Dylan; Niklander, Sven; Martínez, René; Moraga, VíctorOsteoradionecrosis of the jaws (ORNJ) is a severe and challenging complication of head and neck radiation therapy. Despite its aggressiveness and controversy respect to its efficacy, surgical intervention remains the main treatment modality. Nevertheless, due to advances in the understanding of ORNJ physiopathology, new treatment alternatives such as the combination of pentoxifylline with tocopherol (PENTO) have emerged. The aim of this systematic review was to assess the reported efficacy of PENTO for the treatment of ORNJ. Studies were search using Pubmed, The Cochrane Library, Scopus, and Web of Science data bases following the PRISMA guidelines. Inclusion criteria were cohort, case series, randomized or non-randomized clinical studies published in English including human subjects who received PENTO as treatment for ORN of the jaws. Eleven articles met the inclusion criteria and were included for data analysis. All studies reported patients with complete mucosal coverage with no exposed bone (considered healthy) after PENTO treatment, ranging from 16.6% to 100% of the patients, depending on the study. Clinical improvement or disease stabilization was reported between 7.6% and 66.6% of studied individuals, while disease progression was seen in only 5 studies involving 7.6 - 32% of patients. PENTO treatment achieved a complete disease control in a significant number of patients in all studies. However, there is no standardized protocol for administering the therapy. It is necessary to determine the pharmacological doses and to evaluate the benefits of adding antibiotics and clodronate. Good quality clinical trials are needed to develop a successful algorithm for the management of ORN of the jaws.
- Efficacy of stem cells in bone rehabilitation in patients with alveolar bone atrophy:a systematic review(2023) Pérez Leal, Martín; Scanferla, Marta; Carceller, María Carmen; Flacco, NiclaBiomedical engineering proposes the use of stem cells as a bone rehabilitation treatment in patients with alveolar bone defects. Many authors suggest that this innovative technique could represent the future of bone regeneration in dentistry. The present study systematically reviewed the efficacy of stem cells in bone regeneration in patients with alveolar bone atrophy. Seven clinical trials in humans were included in this systematic review. In all the studies, the proposed objective of bone regeneration by using stem cells was achieved, although in a different way with different results. Although the authors of the analysed clinical trials achieved favourable results, they highlighted the presence of multiple limitations throughout bone regeneration treatments, such as scarce scientific literature on stem cells, a reduced number of follow-up studies, and a lack of a standardized international protocol. Based on the analysed studies, it is concluded that the therapy proposed by tissue engineering through the use of stem cells to rehabilitate patients with bone atrophies can be considered effective. In addition, the need for further studies and standardization of protocols is highlighted.
- Association of oral lichen planus with hepatic disorders and hepatocellular carcinoma:systematic review and meta-analysis(2023) González Moles, M.A.; de Porras Carrique, Teresa; Ramos-García, PabloOral lichen planus (OLP) is a prevalent autoimmune chronic inflammatory disease of unknown etiology. The importance of the association between hepatic disease and OLP lies in the fact that many of these disorders (HC, HB, cirrhosis, hepatic steatosis) behave as risk factors for hepatocellular carcinoma. We searched PubMed, Embase, Web of Science, and Scopus for studies published before January 2022. We evaluated the quality of studies (Joanna Briggs Institute tool). We performed meta-analyses, investigated the heterogeneity between studies, and we also carried out subgroups, meta-regression, and small-study effects analyses. 146 studies (21,187 patients) were included in this study. Our study aims to evaluate current evidence on the prevalence and magnitude of association between hepatic diseases (especially those with risk of malignancy), hepatocellular carcinoma and OLP. Our results suggest that patients with OLP present a significant tendency to the development of hepatitis B (OR=1.62, 95%CI=1.01-2.40, p=0.02), hepatitis C (OR=4.09, 95%CI=2.77-6.03, p<0.001), cirrhosis (OR=5.58, 95%CI=1.83-16.96, p=0.002), hepatic steatosis (OR=5.71, 95%CI=0.97-33.60, p=0.05) and hepatocellular carcinoma (OR=3.10,95%CI=1.14-8.43, p=0.03). Patients with OLP should be investigated to rule out the presence of hepatic disease, which can lead to hepatocellular carcinoma, allowing an early diagnosis that would help to a better approach to liver disease and a noTable improvement in prognosis in terms of both progression and severity.
- Urban drinking and driving:comparison of electric scooter and bicycle related accidents in facial fracture patients(2023) Murros, Olli-Jussi; Puolakkainen, Tero; Abio, Anne; Thorén, Hanna; Snäll, JohannaIn recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention. This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries. Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients. Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.
- Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances:a randomized controlled trial(2023) Leyva, Patricia de; Eslava, Jose Miguel; Hernández-Alfaro, Federico; Acero Sanz, Julio JesúsRemovable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery (OS). The objective of this study was to compare periodontal health and quality of life (QoL) associated to postsurgical orthodontic treatment. Patients with dentofacial deformities undergoing OS were randomly allocated to receive postsurgical orthodontic treatment with either fixed orthodontic appliances or Invisalign. The main outcomes were periodontal health and QoL. Plaque index, probing depth and bleeding on probing were assessed as periodontal health indicators. QoL was assessed through the Orthognathic Quality of Life Questionnaire (OQLQ-22) and the Oral Health Impact Profile (OHIP-14). Data were analyzed before surgery and end of treatment. Total duration of treatment was also recorded. Twenty-eight patients were randomized, (16 women, 12 men). Periodontal assessment showed better outcomes for the Invisalign group: bleeding on probing (p=0.013), plaque index (p=0.001) and probing depth (p<0.001). The QoL questionnaires showed significant differences in favor of the Invisalign group: OHIP-14 (p=0.004) and OQLQ-22 (p=0.002). Total duration of treatment was similar in both groups (p=0.575). Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after OS (surgery-first approach) had better periodontal health and QoL outcomes.
- Preoperative oral practices and incidence of postoperative complications in hospital medical-surgical procedures:a meta-analysis(2023) Camus-Jansson, Fabián; Longueira-Diaz, Natalia; Salinas-Diaz, Barbara; Granic-Chinchón, Abril; Cueto-Urbina, Waldo; Parra-Parra, Miguel; López de Blanc, Silvia AdrianaOral decay prior to a hospital medical-surgical procedure is a risk factor for the development of postoperative complications. However, perioperative oral practices as a protective factor have not been studied. This review aims to evaluate the effectiveness of perioperative oral practices in the reduction of risk of developing postoperative complications in in-hospital medical surgical procedures. This review and meta-analysis was conducted according to Cochrane guidelines. Medline, Scopus, Scielo, and Cochrane were consulted. Articles of the previous 10 years concerning adult patients undergoing perioperative oral practices prior to hospital medical-surgical procedures, were included. Data of the type of perioperative oral practice, type of postoperative complication and measures of effect on the development of complications were extracted. Of a pool of 1470 articles, 13 were included for systematic review and 10 for meta-analysis. The most common perioperative oral procedures were focalized approach (FA), referred to only the elimination of infectious foci in the oral cavity and comprehensive approach (CA), referred to a integral approach of the patient's oral health, both of which were mainly performed in oncologic surgeries, both were effective in the reduction of postoperative complications (RR=0.48, [95% CI 0.36 - 0.63]). The most reported postoperative complication was postoperative pneumonia. Perioperative oral management proved to be a protective factor against the development of postoperative complications.
- Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial(2023) Kaba, Yusuf Nuri; Demirbas, Ahmet E; Kütük, Nükhet; Gunay Canpolat, Dilek; Alkan, AlperThe purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery. The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test. The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05). Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.
