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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2015. Vol. 20, no. 6
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- Anatomical characteristics and visibility of mental foramen and accessory mental foramen: panoramic radiography vs. cone beam CT(2015) Muinelo-Lorenzo, Juan; Suárez Quintanilla, Juan; Fernández-Alonso, Ana; Varela Mallou, Jesús; Suárez Cunqueiro, María MercedesBackground: The mental foramen (MF) is a small foramen located in the anterolateral region of the mandible through which the mental nerve and vessels emerge. The knowledge on the anatomic characteristics and variations of MF is very important in surgical procedures involving that area. The aim of this study was two-fold: firstly, to analyze the anatomic characteristics of MF and the presence of accessory mental foramen (AMF) using CBCT and, secondly, to compare the capability of CBCT and PAN in terms of MF and AMF visualization, as well as influencing factors. Material and Methods: A sample of 344 CBCT scans was analyzed for presence and characteristics (i.e. diameter, area, shape, exit angle) of MF and AMF. Subsequently, corresponding PANs were analyzed to ascertain whether MF and AMF were visible. Results: Out of the 344 patients, 344 (100%) MFs and 45 (13%) AMFs were observed on CBCT. Regarding gender, MF diameter and area, MF-MIB and MF-MSB distances, and exit angle were all significantly higher in males. Also, statistically significant differences were found in terms of age and dental status. Statistically significant differences in MF long and short diameters and MF area were found with respect to AMF presence ( p =.021, p =.008, p =.021). Only 83.87% of the MFs and 45.83% of the AMFs identified on CBCT were also visible on PANs. MF diameter, shape, exit angle, and age had a significant influence on MF visualization on PAN (B=.43, p =.005; B=-.55, p =.020; B=.20, p =.008; B=.61, p =.005). Conclusions: PAN is not an adequate technique to properly identify MF and AMF. Diameter, shape, exit angle, and age are all factors influencing MF visualization on PAN images. For surgery involving the MF anatomical region, a preoperative radiological study with CBCT is of crucial importance to avoid complications.
- Use of buccal fat pad to repair post-extraction peri-implant bone defects in the posterior maxilla: a preliminary prospective study(2015) Peñarrocha Diago, María; Alonso González, Rocío; Aloy Prósper, Amparo; Peñarrocha Oltra, David; Camacho Alonso, Fabio; Peñarrocha Diago, MiguelBackground: Extensive literature exists about the use of the BFP in the treatment of oral defects but, to our knowledge, no article refers to the use of the BFP as a substitute of the membrane barriers for treatment of peri- implant bone defects. The aim was to evaluate the use of the buccal fat pad as a coating material for bone grafting in the peri-implant bone defect regeneration of immediate implants placed in the posterior maxilla. Material and Methods: A preliminary prospective study of patients involving immediate implants in which the buccal fat pad was used as a coating material to peri-implant bone defects was carried out. The outcome measures assessed were: postoperative pain and swelling, complications related to buccal fat pad surgery, implant survival and success rates and peri-implant marginal bone loss at 12 months of prosthetic loading. Results: Twenty-seven patients (17 women and 10 men) with a mean age of 55.3 ± 8.9 years, and a total of 43 implants were included. Two-thirds of the patients reported either no pain or only mild intensity pain and moderate inflammation, two days after surgery. Post-operative period was well tolerated by the patients and no serious complications occurred. None wound dehiscence occurred. Implant survival and success rates were 97.6% and the average marginal bone loss 1 year after loading was 0.58 ± 0.27 mm. Conclusions: Within the limits of this preliminary study, the use of the buccal fat pad as a coating material for bone grafting in peri-implant bone defects placed in the upper posterior maxilla was a well-tolerated technique by patients; high implant success rate was achieved with a minimal peri-implant marginal bone loss at 12 months of prosthetic loading.
- Characterization of muscle alteration in oral submucous fibrosis-seeking new evidence(2015) Chawla, Himanshi; Urs, Aadithya-Basavaraj; Augustine, Jeyaseelan; Kumar, PriyaBackground: The aim of the study was to assess the progression of Oral Submucous Fibrosis (OSF) by investigating the correlation between clinical mouth opening and muscle-epithelial distance in tissue sections. Characterization of changes involving muscle was ascertained. Material and Methods: 50 cases and 10 controls were included in this case-control study. Inter-incisal mouth opening was measured and classified according to Lai et al . as Group A (more than 35mm), Group B (30 to 35mm), Group C (20 to 30mm), Group D (less than 20mm). Histopathological sections were graded as very early, early, moderately advanced, advanced OSF. Muscle-epithelial distance was calculated using image analysis software. The four most common degenerative changes observed in muscles, namely fragmentation, highly eosinophilic areas with loss of striations, nucleus internalization and multiple pyknotic nuclei were also assessed. Results: Comparisons of muscle-epithelial distance were made between the clinical and histopathological groups to those of controls. The mean muscle-epithelial distance was: Group A-626.8±309.36 μm, B-827.5±549.72 μm, C-673.2±321.93 μm, D-439.9±173.84μm, Controls-1222.19 ±441.7μm. Post-hoc Bonferroni Test revealed a statistically significant reduction in the muscle-epithelial distance in Group C ( p -value = 0.001) and D ( p -value = 0.001) as compared to controls. The mean muscle-epithelial distance in very early, early, moderately advanced and advanced OSF was 732.73±232.81μm, 726.54±361.63 μm, 548.36±273.13 and 172.40±58.41 μm respectively. Highly significant difference in muscle-epithelial distance was seen between controls as compared to early ( p - value =0.002), moderately advanced ( p -value = 0.001) and advanced OSF ( p -value = 0.001. Fragmentation and highly eosinophilic areas were invariably noticed in advanced OSF. Multiple pyknotic nuclei were variable with no specificity. Conclusions: Reduction in muscle-epithelial distance may prove to be a significant predictor of OSF progression. Degenerative changes must be noted while observing OSF cases, irrespective of the histopathological grade.
- Association between general and oral health-related quality of life in patients treated for oral cancer(2015) Barrios, Rocío; Tsakos, Georgios; Gil Montoya, José Antonio; Montero Martín, Javier; Bravo Pérez, ManuelBackground: Less is known about the association between general health-related quality of life (HRQoL) and oral HRQoL (OHRQoL) among patients with specific diseases. The aim of this study was to assess the association between patient-centered outcome measurements (HRQoL and OHRQoL) of oral cancer patients at least 6 months after treatment. Material and Methods: HRQoL was measured with the 12-Item Short Form Health Survey (SF-12); OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) and the Oral Impacts on Daily Performances (OIDP). Results: Higher OHRQoL scores were associated with lower SF-12 domains scores. The OHIP-14 explained 16.5 % of the total variance of SF-12 Physical Component Summary (PCS) and the OIDP explained 16.1 %. In the SF- 12 Mental Component Summary (MCS), the total variance explained was 23.9 % by the OHIP-14 and 21.8 % by the OIDP. Conclusions: There was a significant association between long-term OHRQoL and HRQoL in oral and oropharyngeal cancer patients. These results may help to carry out new interventions aiming to improve patient ́s life overall.
- Nested PCR for detection of HSV-1 in oral mucosa(2015) Jalouli, Miranda-Masoumeh; Jalouli, Jamshid; Hasséus, Bengt; Öhman, Jenny; Hirsch, Jan-Michaél; Sand, LarsBackground: It has been estimated that 15%-20% of human tumours are driven by infection and inflammation, and viral infections play an important role in malignant transformation. The evidence that herpes simplex virus type 1 (HSV-1) could be involved in the aetiology of oral cancer varies from weak to persuasive. This study aimed to investigate by nested PCR (NPCR) the prevalence of HSV-1 in samples from normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma (OSCC). Material and Methods: We investigated the prevalence of HSV-1 in biopsies obtained from 26 fresh, normal oral mucosa from healthy volunteers as well as 53 oral leukoplakia and 27 OSCC paraffin-embedded samples. DNA was extracted from the specimens and investigated for the presence of HSV-1 by nested polymerase chain reaction (NPCR) and DNA sequencing. Results: HSV-1 was detected in 14 (54%) of the healthy samples, in 19 (36%) of the oral leukoplakia samples, and in 14 (52%) of the OSCC samples. The differences were not statistically significant. Conclusions: We observed a high incidence of HSV-1 in healthy oral mucosa, oral leukoplakia, and OSCC tissues. Thus, no connection between OSCC development and presence of HSV-1 was detected.
- Cyclin D1 and Ki-67 expression correlates to tumor staging in tongue squamous cell carcinoma(2015) Guimarães, Eduardo-Pereira; de Carli, Marina-Lara; Sperandio, Felipe-Fornias; Hanemann, João-Adolfo-Costa; Pereira, Alessandro-Antônio-CostaBackground: The immunohistochemical expression of Cyclin D1 and Ki-67 were analyzed in tongue squamous cell carcinomas (SCC), relating them to the clinical and morphological exhibition of these tumors. Material and Methods: Twenty-nine patients fulfilled the inclusion criteria; clinical data included gender, age, ethnicity and use of licit drugs such as alcohol and tobacco. The TNM staging and histopathological differentiation grading was assessed for each case. In addition, T1 patients were gathered with T2 patients; and T3 patients were gathered with T4 patients to assemble two distinct groups: (T1/T2) and (T3/T4). Results: The mean follow-up time was 24 months and 30% of the patients died as a consequence of the disease, while 23.3% lived with the disease and 46.7% lived lesion-free. T1 and T2 tumors showed statistically lesser Ki-67 and Cyclin D1 staining when compared to T3 and T4 tumors. Conclusions: Ki-67 and Cyclin D1 pose as auxiliary tools when determining the progression of tongue SCC at the time of diagnosis.
- Effect of Royal Jelly on new bone formation in rapid maxillary expansion in rats(2015) Özan, Fatih; Çörekçi, Bayram; Toptaş, Orçun; Halicioğlu, Koray; Irgin, Celal; Yilmaz, Fahri; Hezenci, YasinBackground: The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model. Material and Methods: Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation. Results: New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group. Conclusions: The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone.
- A 3 dimensional assessment of the depth of tumor invasion in microinvasive tongue squamous cell carcinoma: a case series analysis(2015) Amit-Byatnal, Aditi; Natarajan, Jayalakshmi; Shenoy, Satish; Kamath, Asha; Hunter, Keith; Rad-hakrishnan, RaghuBackground: Accurate assessment of the depth of tumor invasion (DI) in microinvasive squamous cell carcinoma (MISCC) of the tongue is critical to prognosis. An arithmetic model is generated to determine a reliable method of measurement of DI and correlate this with the local recurrence. Material and Methods: Tumor thickness (TT) and DI were measured in tissue sections of 14 cases of MISCC of the tongue, by manual ocular micrometer and digital image analysis at four reference points (A, B, C, and D). The comparison of TT and DI with relevant clinicopathologic parameters was assessed using Mann Whitney U test. Reliability of these methods and the values obtained were compared and correlated with the recurrence of tumors by Wilcoxon Signed Ranks Test. 3D reconstruction of the lesion was done on a Cartesian coordinate system. X face was on the YZ plane and Z face was on the XY plane of the coordinate system. Results: Computer generated 3D model of oral mucosa in four cases that recurred showed increased DI in the Z coordinate compared to the XY coordinate. The median DI measurements between XY and Z coordinates in these cases showed no significant difference (Wilcoxon Signed Ranks Test, p = 0.068). Conclusions: The assessment of DI in 3 dimensions is critical for accurate assessment of MISCC and precise DI allows complete removal of tumor.
- Prognostic factors on periapical surgery: a systematic review(2015) Serrano Giménez, Mireia; Sánchez Torres, Alba; Gay Escoda, CosmeBackground: Analyze the most important prognostic factors when performing periapical surgery and compare the success rates of distinct authors. Introduction: Periapical surgery is an approach to treat non-healing periapical lesions and it should be viewed as an extension of endodontic treatment and not as a separate entity. Material and Methods: A search of articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted with the key words “prognostic factors”, “prognosis”, “periapical surgery”, “endodontic surgery” and “surgical endodontic treatment”. The inclusion criteria were articles including at least 10 patients, published in English, for the last 10 years. The exclusion criteria were nonhuman studies and case reports. Results: 33 articles were selected from 321 initially found. Ten articles from 33 were excluded and finally the systematic review included 23 articles: 1 metaanalysis, 1 systematic review, 2 randomized clinical trials, 6 reviews, 12 prospective studies and 1 retrospective study. They were stratified according to their level of scientific evidence using the SORT criteria. Conclusions: Factors associated with a better outcome of periapical surgery are patients ≤45 years old, upper anterior or premolar teeth, ≤10 sized lesions, non cystic lesions, absence of preoperative signs and symptoms, lesions without periodontal involvement, teeth with an adequate root-filling length, MTA as root-end filling material, uniradicular teeth, absence of perforating lesions, apical resection < 3 mm, teeth not associated to an oroantral fistula and teeth with only one periapical surgery.
- Oral leukoplakia, the ongoing discussion on definition and terminology(2015) Van der Waal, IsaäcIn the past decades several definitions of oral leukoplakia have been proposed, the last one, being authorized by the World Health Organization (WHO), dating from 2005. In the present treatise an adjustment of that definition and the 1978 WHO definition is suggested, being : “A predominantly white patch or plaque that cannot be characterized clinically or pathologically as any other disorder; oral leukoplakia carries an increased risk of cancer development either in or close to the area of the leukoplakia or elsewhere in the oral cavity or the head-and-neck region”. Furthermore, the use of strict diagnostic criteria is recommended for predominantly white lesions for which a causative factor has been identified, e.g. smokers’ lesion, frictional lesion and dental restoration associated lesion. A final diagnosis of such leukoplakic lesions can only be made in retrospect after successful elimination of the causative factor within a somewhat arbitrarily chosen period of 4-8 weeks. It seems questionable to exclude “frictional keratosis” and “alveolar ridge keratosis” from the category of leukoplakia as has been suggested in the literature. Finally, brief attention has been paid to some histopathological issues that may cause confusion in establishing a final diagnosis of leukoplakia.
- Identification of susceptibility genes in non-syndromic cleft lip with or without cleft palate using whole-exome sequencing(2015) Liu, Ya-Peng; Xu, Li-Fang; Wang, Qi; Zhou, Xiao-Long; Zhou, Ji-Long; Pan, Chen; Zhang, Jin-Peng; Wu, Qin-Rong; Li, Yi-Qun; Xia, Yu-Juan; Peng, Xiu; Zhang, Mei-Rong; Yu, Hong-Min; Xu, Li-ChunBackground: Non-syndromic cleft lip with or without cleft palate (NSCL/P) is among the most common congenital malformations. The etiology of NSCL/P remains poorly characterized owing to its complex genetic heterogeneity. The objective of this study was to identify genetic variants that increase susceptibility to NSCL/P. Material and Methods: Whole-exome sequencing (WES) was performed in 8 fetuses with NSCL/P in China. Bioinformatics analysis was performed using commercially available software. Variants detected by WES were validated by Sanger sequencing. Results: By filtering out synonymous variants in exons, we identified average 8575 nonsynonymous single nucleotide variants (SNVs). We subsequently compared the SNVs against public databases including NCBI dbSNP build 135 and 1000 Genomes Project and obtained an average of 203 SNVs. Total 12 reported candidate genes were verified by Sanger sequencing. Sanger sequencing also confirmed 16 novel SNVs shared by two or more samples. Conclusions: We have found and confirmed 16 susceptibility genes responsible for NSCL/P, which may play important role in the etiology of NSCL/P. The susceptibility genes identified in this study will not only be useful in revealing the etiology of NSCL/P but also in diagnosis and treatment of the patients with NSCL/P.
- Satisfaction and quality of life with palatal positioned implants in severely atrophic maxillae versus conventional implants supporting fixed full-arch prostheses(2015) Candel Martí, Eugenia; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, MiguelBackground: To evaluate satisfaction and quality of life in patients with palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic supporting fixed full-arch prostheses. Material and Methods: A clinical retrospective study was performed of patients that were rehabilitated with full- arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) and with class III maxilla and treated with implants well-centered in the alveolar ridge and completely surrounded by bone (control). Ten-cm visual analogue scales (VAS) (range 1-10) and the OHIP-14 (Oral Health Impact Profile) questionnaire were used respectively to estimate patient satisfaction and quality of life after implant therapy. Statistical analysis was performed applying Mann-Whitney Test using alpha set at 0.05. Results: Mean global and specific satisfaction – except for self-esteem – were superior for the test group than the control group, although differences were not statistically significant. Regarding quality of life, the reported incidence of problems was lower in the test group for all the studied ítems except for ‘problems at work’. However, differences were not statistically significant in any case. Conclusions: Despite the limitations of the study (retrospective and nonrandomized design) the results suggest that the prosthesis design needed to rehabilitate palatally positioned implants (more coverage of palate) does not lead to lower satisfaction and quality of life of patients, compared to patients treated with implants placed centered and conventional design prostheses that do not cover the palate
- Functional assessment: free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects(2015) Lu, Mingxing; Sun, Guowen; Hu, Qingang; Tang, Enyi; Wang, YujiaBackground: To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap. Material and Methods: The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for the articulation and the swallowing function 3 months after the surgery. Results: Among these 46 patients, 12 patients underwent tongue reconstruction after hemiglossectomy with ALT flap; 34 patients underwent tongue reconstruction with FRF flap. The differences in the incidence of vascular crisis, the speech and the swallowing function between two groups were not significant ( P ﹥0.05). Conclusions: Thin ALT flap could be one of the ideal flaps for hemiglossectomy defect reconstruction with its versatility in design, long pedicle with a suitable vessel diameter, and the neglectable donor site morbidity.
- Clinical significance of interleukin-1 genotype in smoking patients as a predictor of peri-implantitis: a case-control study(2015) García Delaney, Cristina; Sánchez Garcés, María Angeles; Figueiredo, Rui; Sánchez Torres, Alba; Gay Escoda, CosmeBackground: Interleukin-1 (IL-1) is a proinflammatory cytokine that plays an important role in the pathogenesis of periodontitis, and so it might be useful to detect high-risk cases of peri-implantitis. It has been reported that IL-1 polymorphisms and smoking habit have a synergic effect, increasing the incidence of peri-implantitis. The aim of the present study was to evaluate the relationship between IL-1 gene polymorphisms and peri-implantitis in smoking patients. Material and Methods: A case-control study was performed in 27 patients with peri-implantitis and 27 patients with healthy implants. All patients included were smokers. IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C were identified by polymerase chain reaction (PCR) amplification in order to establish a relation between these variables and the presence of peri-implantitis. A bivariate analysis was performed and odds-ratio (OR) were calculated. Results: The incidence of peri-implantitis was significantly higher in patients with previous history of periodontitis ( p =0.024; OR=10.9). Both groups were similar regarding IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C genotypes. No increased risk in heavy smokers with IL-1 polymorphism was found. Conclusions: IL-1 genotypes do not seem to be good predictors of peri-implantitis in the great majority of smoking patients. Furthermore, no synergic effect was found between IL-1 genotypes and heavy smokers. Patients with a previous history of periodontitis were more prone to peri-implantitis.
- Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction(2015) Lodders, Johannes N.; Parmar, Satyesh; Stienen, Niki L.M.; Martin, Timothy J.; Karagozoglu, Kemal H.; Heymans, Martijn W; Nandra, Baljeet; Forouzanfar, TymourBackground: The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Material and Methods: Desired data was retrieved from a computer database at the department of Oral and Maxillofacial Department, Queen Elisabeth hospital Birmingham, United Kingdom, between June 2007 and October 2012. Logistic regression was used to study relationships between preoperative variables and postoperative outcomes. Results: The study population consisted 184 patients, comprising 189 composite resections with reconstruction. Complications developed in 40.2% of the patients. Three patients (1.6%) died, 11.1% returned to the operating room, 5.3% developed donor site complications and 6.9% flap complications of which 3.2% total flap failure. In the multivariable analysis systemic complications were associated with anaesthesia time and hospital stay with red cell transfusion. Conclusions: A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations.
- The mandibular incisive canal and its anatomical relationships: a cone beam computed tomography study(2015) Pereira-Maciel, Patrícia; Tavares-de-Sousa, Emerson; Oliveira-Sales, Marcelo-AugustoBackground: To avoid postoperative injuries in the interforaminal region, presence of the Mandibular Incisive Canal (MIC), its extension and canal positioning in relation to the cortical bone and alveolar process were investigated by cone beam computed tomography (CBCT). Material and Methods: One hundred CBCT examinations obtained by means of the i-CAT CBCT imaging system were analyzed in multiple-plane views (axial, panoramic and cross-sectional) and three-dimensional representations were performed using iCAT CBCT software. The MIC was evaluated for its presence, measurement and proximity to the buccal and lingual plates, alveolar process and inferior border of the mandible. Results: The MIC was visible in all (100%) CBCT images. The mean length of MIC was 9.8 ± 3.8 mm. The distances between the canal and buccal plate, as well as between the canal and lingual plate of the alveolar bone were 4.62 ± 1.41 mm and 6.25 ± 2.03 mm, respectively. The distances from the canal to the alveolar process, and to the inferior border of the mandible were 10.25 ± 2.27 mm and 7.06 ± 2.95 mm, respectively. Conclusions: Due to the high prevalence of MIC, its variation in length and distance up to the cortical bone, suggested that preoperative radiographic evaluation of the MIC must be carried out case-by-case using CBCT, which could clearly show the three-dimensional structure and adjacent structure of the MIC.
- Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran(2015) Samieirad, Sahand; Tohidi, Elahe; Shahidi-Payam, Akbar; Hashemipour, Maryam Alsadat; Abedini, AliBackground: The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods: In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results: The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups ( P =0.02). Also, a significant association was observed between gender and the occurrence of fractures ( P =0.01). Conclusions: Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans.
- Jaw mobility changes in patients with upper aerodigestive tract cancer undergoing radiation therapy(2015) Bragante, Karoline; Wienandts, Patrícia; Mozzini, Carolina; Pinto, Rosélie; da Motta, Neiro; Jotz, GeraldoBackground: Radiation therapy is a therapeutic modality widely used for treatment of upper aerodigestive tract (UADT) neoplasms. However, its action is not restricted to tumor cells, and it may cause a variety of adverse reactions, including reduced jaw mobility. Material and Methods: A prospective cohort study was conducted to assess changes in jaw mobility in patients with UADT cancer undergoing radiation therapy. Results: Fifty-six patients completed the study. The results showed a significant reduction in mouth opening ( p <0.001), right lateral excursion ( p =0.038) and left lateral excursion ( p =0.035) of the jaw, a significant increase in the presence ( p <0.001) and severity of oral mucositis ( p <0.001), and a significant decrease in performance status ( p <0.001) after radiation therapy. Thirty-six patients (64.3%) exhibited reduction in mouth opening after treatment. The variables significantly associated with mouth opening reduction on bivariate analysis were: modification of diet ( p =0.037), radiation field ( p =0.024), presence of mucositis ( p =0.003), and reduction in performance status ( p =0.007). After adjustment by the multivariate model, the only variables that remained significantly associated with reduction in mouth opening were presence of mucositis ( p =0.018) and reduction in performance status ( p =0.47). Conclusions: These findings indicate that patients with upper aerodigestive tract cancer experience reduced jaw mobility after radiation therapy, which is strongly correlated with mucositis and reduced functional ability.
