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Shido R, Ohba S, Moriuchi E, Yasuda G, Hara M, Narahara S, Ogata K, Yoshida N, Yamada T. Comparison of Skeletal Stability after Le Fort I Osteotomy With Bone Fixation Using Biodegradable and Titanium Systems: A Retrospective Study. J Craniofac Surg 2024; 35:1513-1516. [PMID: 38775492 DOI: 10.1097/scs.0000000000010315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/11/2024] [Indexed: 07/24/2024] Open
Abstract
The titanium osteosynthesis system used for fixing bone segments after maxillary osteotomy provides reliable outcomes owing to its biocompatibility and adequate strength. In addition, several studies have evaluated the skeletal stability after maxillary osteotomy with fixation using a biodegradable system. However, the indications for applying a biodegradable system after maxillary osteotomy remain controversial. Therefore, this study aimed to compare the long-term skeletal stability of bone segments after maxillary osteotomy with bone fixation using biodegradable and titanium osteosynthesis systems and to assess the usefulness of a biodegradable osteosynthesis system. Patients who underwent Le Fort I osteotomy of the maxilla to correct jaw deformities between April 2008 and March 2021 were included in this study. A total of 45 patients were included, with 28 in the biodegradable osteosynthesis system group and 17 in the titanium group. Cephalometric and computed tomography analyses were performed to evaluate the skeletal stability of the bone segments after maxillary osteotomy with bone fixation using biodegradable or titanium osteosynthesis systems. The maxillary segment was repositioned anteriorly with a clockwise rotation. Skeletal stability was similar between the biodegradable and titanium osteosynthesis systems. Segmental changes occurred mainly in the first 6 months after surgery, and the segment was completely stable between 6 and 12 months after surgery. This study revealed no significant differences in skeletal stability after maxillary osteotomy between the biodegradable and titanium osteosynthesis systems. However, the findings in this study should be interpreted with caution owing to the small sample size and small amount of maxillary-segment movement.
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Affiliation(s)
- Rena Shido
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima
| | - Seigo Ohba
- Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo
| | - Emi Moriuchi
- Department of Orthjodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Gou Yasuda
- Department of Orthjodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Masahito Hara
- Department of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shun Narahara
- Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo
| | - Kinuko Ogata
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima
| | - Noriaki Yoshida
- Department of Orthjodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Tomohiro Yamada
- Department of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Jaber M, Abouseif N, Hassan M, El-Ameen AM. Risk Factors Contributing to Symptomatic Miniplate Removal following Orthognathic Surgery: Systematic Review and Meta-Analysis. J Clin Med 2024; 13:3335. [PMID: 38893045 PMCID: PMC11172665 DOI: 10.3390/jcm13113335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: The use of miniplates for stabilizing bones post orthognathic surgery has surged in popularity due to their efficacy in ensuring stability and hastening recovery. However, controversy exists regarding what should be done with these miniplates after surgery. Some surgeons advocate for their removal, while others suggest leaving them in place. This study sought to assess the frequency, causes, and potential risk factors linked with miniplate removal in orthognathic procedures. Methods: A thorough meta-analysis was conducted by scrutinizing studies from various databases including PubMed, Google Scholar, Embase, and Scopus, focusing on publications spanning from 1989 to 2023. Results: Ten studies meeting the inclusion criteria, encompassing 1603 patients, were chosen for inclusion in the meta-analysis. The male-to-female ratio varied from 0.7:1 to 4:1. Overall, 5595 miniplates were inserted, with 294 (5.3%) being subsequently removed. Primary reasons for miniplate removal included infection (161 cases, 2.9%), exposure of miniplates (34 cases, 0.6%), and palpable plates (23 cases, 0.4%). Other indications comprised pain, patient preference, and temperature sensitivity. Less frequent causes for miniplate removal included sinusitis, secondary surgery, and dental pathology. The mean duration of miniplate removal was 5.5 months, with the majority (56.1%) being removed from the mandible rather than the maxilla. In conclusion, this meta-analysis underscores the importance of miniplate removal when hardware causes complications and physical discomfort. The primary reasons for removing miniplates were infection and plate exposure, with the mandible being the most common removal site. Conclusions: These findings emphasize the need for continued monitoring to assess the fate of miniplates in orthognathic surgery and provide valuable information for future clinical decision-making.
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Affiliation(s)
- Mohamed Jaber
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (N.A.); (M.H.)
- Center of Medical and Bio Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Nadin Abouseif
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (N.A.); (M.H.)
| | - Mawada Hassan
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (N.A.); (M.H.)
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Liu J, Liu M, Shi S, Jiang F, Zhang Y, Guo J, Gong X. Evaluation of the effect of intraoperative tropisetron on postoperative rebound pain after brachial plexus block: a randomized controlled trial. Pain Rep 2024; 9:e1163. [PMID: 38756786 PMCID: PMC11098252 DOI: 10.1097/pr9.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Postoperative rebound pain after peripheral nerve block increases patient suffering and delays recovery after surgery. Objectives We tested whether the 5HT-3 receptor antagonist and α7nAChR agonist tropisetron could prevent postoperative rebound pain. Methods A total of 115 patients were randomized to receive 5-mg/5-mL tropisetron or the same volume of normal saline. Pain intensity was measured with the numerical rating scale of pain (NRS). Rebound pain was defined as a change from mild pain (NRS ≤ 3) measured in the postanesthesia care unit to severe pain (NRS ≥ 7) within 24 hours after peripheral nerve blockade. Logistic regression was used to identify relevant factors associated with postoperative rebound pain. Results Tropisetron did not affect the NRS score or the incidence of rebound pain after peripheral nerve block. Logistic regression revealed that preoperative pain, bone surgery, and length of incision were risk factors for postoperative rebound pain, and patient-controlled analgesia was protective against postoperative rebound pain. Conclusion Tropisetron does not affect the incidence of rebound pain after peripheral nerve block. Patients at high risk of postoperative rebound pain should be identified for appropriate management. Registration site: www.chictr.org.cn (ChiCTR2300069994).
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Affiliation(s)
- Junli Liu
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Mingming Liu
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Shengnan Shi
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Fei Jiang
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Ye Zhang
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jing Guo
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xingrui Gong
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Khandelwal G, Alagarsamy R, Roychoudhury A, Bhutia O, Shariff A. Cross-Sectional Study of Serum Metal Ions in Patients With Metal Implants in the Maxillofacial Region. J Maxillofac Oral Surg 2023; 22:1034-1039. [PMID: 38105820 PMCID: PMC10719183 DOI: 10.1007/s12663-023-01988-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/03/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose The purpose of the present study was to measure the serum metal ion levels (titanium, cobalt, chromium) in patients who have metal implants in the maxillofacial region. Methods The investigators implemented a cross sectional study on patients treated with procedures requiring metal implants for management of maxillofacial trauma, fixation for orthognathic surgery, and total temporomandibular joint replacement (TJR). Inductively coupled plasma mass spectrometry was used as an analytical method to detect metal ions in serum samples. Results The study comprised of 50 patients who were divided into 4 groups- group I- total TJR (n = 18), group II- orthognathic (n = 8), group III- trauma (n = 8), and group IV- control (n = 16). The mean values of metal ions level were raised than the control group. Conclusion The present study's results suggest a rise in serum metal ion levels after the metal implantation in maxillofacial region. None of the patients had any abnormal signs and symptoms due to raised metal levels. Further studies are warranted to correlate the serum metal ion levels and their clinical relevance.
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Affiliation(s)
- Garima Khandelwal
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, Safdarjung Hospital, New Delhi, India
| | - Ajoy Roychoudhury
- Department of Oral and Maxillofacial Surgery, Centre of Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A. Shariff
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, 110029 India
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Ding M, Li C, Kang Y, Shan X, Cai Z. Changes of the facial soft tissue after mandibular reconstruction using vascularized iliac flap. Clin Oral Investig 2023; 27:6619-6625. [PMID: 37725170 DOI: 10.1007/s00784-023-05268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES To reveal the change patterns of the facial soft tissue after applying mandibular reconstruction. MATERIALS AND METHODS 16 Patients with mandibular benign tumor were recruited in this retrospective study. For all patients, segmental mandibular osteotomy and concurrent reconstruction using vascularized iliac flap were conducted. The soft tissue thickness of patients' lower face was measured with CT scans before surgery, 1 week, 6 months and 1 year after surgery. The time-dependent changes of tissue thickness were analyzed. RESULTS The most significant tissue swelling was 28.86%, at 1 week after the surgery. The average increase of tissue thickness was 4.78 ± 5.30 mm across patient. After 1 year of the surgery, tissue thickness decreased to the level before operation or the level of the healthy side. The thickness of the low-density tissue fluctuated mildly, while the thickness of the high-density tissue fluctuated significantly. The disuse atrophy of the masseter occurred 1 week after the surgery, and was reversed after 1 year. The removal of the submandibular gland caused depression in submandibular area, which intensified over time. CONCLUSION Across patients, soft tissue thickness in the lower face after mandibular osteotomy and reconstruction increased significantly 1 week after the surgery, and decreased over time. After 1 year, tissue thickness went back to the pre-surgery level, where matched up with the healthy side. CLINICAL RELEVANCE We documented the change patterns of the facial soft tissue after mandibular reconstruction. These results can help improve the planning of virtual surgeries and the timing for aesthetic assessment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ChiCTR2100054103.
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Affiliation(s)
- Mengkun Ding
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Chengqian Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yifan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaofeng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zhigang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Roman R, Almășan O, Hedeșiu M, Băciuț M, Bran S, Popa D, Ban A, Dinu C. Evaluation of the Mandibular Condyle Morphologic Relation before and after Orthognathic Surgery in Class II and III Malocclusion Patients Using Cone Beam Computed Tomography. BIOLOGY 2022; 11:biology11091353. [PMID: 36138832 PMCID: PMC9495726 DOI: 10.3390/biology11091353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022]
Abstract
Simple Summary In individuals with severe malocclusions, orthognathic surgery seeks to rebalance the relationships between the jaws by providing a stable occlusion, a healthy muscle balance, and the functioning of the temporomandibular joint. Cone beam computed tomography may be used to determine the position of the mandibular condyle in the glenoid fossa. This study aimed to assess how the position of the mandibular condyle varies in class II and III malocclusions before and after bimaxillary orthognathic surgery. Before and after orthognathic surgery, 56 TMJs from 28 patients were studied. Following surgery, both class II and class III patients experienced changes in the anterior joint space, posterior joint space, condyle position, and condyle angle. The preliminary findings are promising for determining changes in condyle position and joint spaces that might guide oral and maxillofacial surgeons to address a debilitating clinical affliction. Abstract This study aimed at evaluating the mandibular condyle position changes before and after bimaxillary orthognathic surgery in class II and III malocclusion patients. CBCT scans from patients who underwent bimaxillary orthognathic surgery were analyzed: Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). Both condyles were independently assessed for their largest anterior and posterior joint spaces, smallest medial joint spaces, and condyle angles concerning the transverse line. In the sagittal plane, the minimum size of the anterior and posterior joint spaces was measured. In the coronal plane, the smallest medial joint space was measured. The position of the condyle within the glenoid fossa was determined before and after surgery. A total of 56 TMJs from 28 patients were studied. Following orthognathic surgery, the anterior and posterior space in class II increased. Postoperatively, the anterior joint space in class III decreased. In 42.85% of malocclusion class II patients and 57.14% of malocclusion class III patients, the pre-and post-surgical position of the condyle changed, the condyle was anteriorly positioned (42.85%) in class II patients and centrically positioned (71.4%) in class III patients. Significant changes in the joint space, condylar position, and condyle angle were found in the class II and class III subjects.
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Affiliation(s)
- Raluca Roman
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
- Correspondence:
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Daiana Popa
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Alina Ban
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
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Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances. Polymers (Basel) 2022; 14:polym14142782. [PMID: 35890557 PMCID: PMC9316877 DOI: 10.3390/polym14142782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 02/06/2023] Open
Abstract
Osteosynthesis systems are used to fixate bone segments in maxillofacial surgery. Titanium osteosynthesis systems are currently the gold standard. However, the disadvantages result in symptomatic removal in up to 40% of cases. Biodegradable osteosynthesis systems, composed of degradable polymers, could reduce the need for removal of osteosynthesis systems while avoiding the aforementioned disadvantages of titanium osteosyntheses. However, disadvantages of biodegradable systems include decreased mechanical properties and possible foreign body reactions. In this review, the literature that focused on the in vitro and in vivo performances of biodegradable and titanium osteosyntheses is discussed. The focus was on factors underlying the favorable clinical outcome of osteosyntheses, including the degradation characteristics of biodegradable osteosyntheses and the host response they elicit. Furthermore, recommendations for clinical usage and future research are given. Based on the available (clinical) evidence, biodegradable copolymeric osteosyntheses are a viable alternative to titanium osteosyntheses when applied to treat maxillofacial trauma, with similar efficacy and significantly lower symptomatic osteosynthesis removal. For orthognathic surgery, biodegradable copolymeric osteosyntheses are a valid alternative to titanium osteosyntheses, but a longer operation time is needed. An osteosynthesis system composed of an amorphous copolymer, preferably using ultrasound welding with well-contoured shapes and sufficient mechanical properties, has the greatest potential as a biocompatible biodegradable copolymeric osteosynthesis system. Future research should focus on surface modifications (e.g., nanogel coatings) and novel biodegradable materials (e.g., magnesium alloys and silk) to address the disadvantages of current osteosynthesis systems.
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Orassi V, Fischer H, Duda GN, Heiland M, Checa S, Rendenbach C. In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation. Front Bioeng Biotechnol 2022; 9:803103. [PMID: 35223813 PMCID: PMC8866862 DOI: 10.3389/fbioe.2021.803103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Titanium fixation devices are the gold standard for the treatment of mandibular fractures; however, they present serious limitations, such as non-degradability and generation of imaging artifacts. As an alternative, biodegradable magnesium alloys have lately drawn attention due to their biodegradability and biocompatibility. In addition, magnesium alloys offer a relatively high modulus of elasticity in comparison to biodegradable polymers, being a potential option to substitute titanium in highly loaded anatomical areas, such as the mandible. This study aimed to evaluate the biomechanical competence of magnesium alloy WE43 plates for mandibular fracture fixation in comparison to the clinical standard or even softer polymer solutions. A 3D finite element model of the human mandible was developed, and four different fracture scenarios were simulated, together with physiological post-operative loading and boundary conditions. In a systematic comparison, the material properties of titanium alloy Ti-6Al-4V, magnesium alloy WE43, and polylactic acid (PLA) were assigned to the fixation devices, and two different plate thicknesses were tested. No failure was predicted in the fixation devices for any of the tested materials. Moreover, the magnesium and titanium fixation devices induced a similar amount of strain within the healing regions. On the other hand, the PLA devices led to higher mechanical strains within the healing region. Plate thickness only slightly influenced the primary fixation stability. Therefore, magnesium alloy WE43 fixation devices seem to provide a suitable biomechanical environment to support mandibular fracture healing in the early stages of bone healing. Magnesium WE43 showed a biomechanical performance similar to clinically used titanium devices with the added advantages of biodegradability and radiopacity, and at the same time it showed a remarkably higher primary stability compared to PLA fixation devices, which appear to be too unstable, especially in the posterior and more loaded mandibular fracture cases.
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Affiliation(s)
- Vincenzo Orassi
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Berlin, Germany
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Georg N. Duda
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sara Checa
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- *Correspondence: Sara Checa,
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Di Spirito F, Pisano M, Caggiano M, Bhasin P, Lo Giudice R, Abdellatif D. Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis. Medicina (B Aires) 2022; 58:medicina58020193. [PMID: 35208517 PMCID: PMC8874436 DOI: 10.3390/medicina58020193] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 01/17/2023] Open
Abstract
Background and Objectives: The endodontic space is a complex area on both micro and macro levels; therefore, traditional irrigation techniques may not guarantee a complete cleaning of such a complicated tridimensional system. The presented ex vivo study aimed to evaluate root canal cleanliness, obtained through an equal volume of traditionally applied sodium hypochlorite (NaOCl), compared to ultrasonically activated NaOCl and ultrasonically activated NaOCl that had undergone intracanal heating NaOCl. Materials and Methods: A total of 60 freshly extracted human mandibular premolars underwent root sample length standardization (18 mm), root canal preparation and, based on the irrigation method employed, were randomly and equally assigned to three study groups, composed of root samples treated with ultrasonically activated NaOCl, ultrasonically activated NaOCl that had undergone intracanal heating and traditionally applied NaOCl. The root specimens were subsequently fixated with 4% buffered formalin solution and decalcified in Morse liquid. A total often 6-micron-thick serial cross-sections were obtained, dyed using hematoxylin and eosin and examined through an optical microscope at 40×, 100×, and 200×. Results: Ultrasonically activated NaOCl that had undergone intracanal heating showed a significantly smaller amount of debris compared to ultrasonically activated and traditionally applied NaOCl groups (p value < 0.05). Conclusions: Root canal cleanliness saw significant enhancements by ultrasonically activated NaOCl that had undergone intracanal heating.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; (M.P.); (M.C.)
- Correspondence:
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; (M.P.); (M.C.)
| | - Mario Caggiano
- Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; (M.P.); (M.C.)
| | - Prashant Bhasin
- Department of Conservative Dentistry & Endodontics, Sudha Rustagi College of Dental Sciences and Research Faridabad, Faridabad 121002, India;
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ME, Italy;
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21545, Egypt;
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Balaji SM, Balaji P. Rigid versus resorbable plate fixation in fronto-orbital advancement in unicoronal stenosis - A retrospective study. Ann Maxillofac Surg 2022; 12:22-26. [PMID: 36199468 PMCID: PMC9527842 DOI: 10.4103/ams.ams_35_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/28/2022] [Accepted: 07/03/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction: Rigid plating fixation (RPF) and resorbable plating systems (RPS) advanced the field of reconstruction in craniomaxillofacial region. However, their performance in patients, particularly the effect on bone remodeling at site of hardware placement is not much documented. This manuscript aims to compare the performance of RPF and RPS in a cohort using a retrospective audit of case records. Methods: Archival records were searched for patients who had undergone cranial metal-RPF or RPS or combination for the correction of craniofacial deformities following inclusion-exclusion criteria. From records, data of the quality and quantity of bone formed along the site of plate fixation as compared with the adjacent site, accommodating or facilitating brain growth, and persistence of bone deformity at the site of hardware placement were collected at the end of the follow-up period. A total of 128 sites from 18 individuals (6 with exclusive metal-RPF and 12 with RPS) mean age of 7.45 ± 7.28 (Median 4; IQR of 8.88;2.6–11.5) who underwent cranial bone remodeling surgery formed the study group. Results: There was a statistically significant difference between the RPF and PRS system at the fronto-orbital suture (P = 0.002) and coronal suture (P = 0.036) with bone quality and quantity. Discussion: The RPF system was rigid but had a set of issues, while RPS has advantages and limitations. The qualitative difference in between the two systems is different. Due to inherent dissimilarity, the two systems cannot be interchanged and due diligence has to be exercised while deciding on the system. More prospective studies are needed to validate the findings.
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Zou L, Zhong Y, Xiong Y, He D, Li X, Lu C, Zhu H. A Novel Design of Temporomandibular Joint Prosthesis for Lateral Pterygoid Muscle Attachment: A Preliminary Study. Front Bioeng Biotechnol 2021; 8:630983. [PMID: 33585426 PMCID: PMC7873886 DOI: 10.3389/fbioe.2020.630983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction: In temporomandibular joint (TMJ) replacement operation, due to the condylectomy, the lateral pterygoid muscle (LPM) lost attachment and had impact on the mandible kinematic function. This study aimed to design a novel TMJ replacement prosthesis for LPM attachment and to verify its feasibility by preliminary in vitro and in vivo experiments. Materials and Methods: An artificial TMJ prosthesis designed with a porous structure on the condylar neck region for LPM attachment was fabricated by a 3D printed titanium (Ti) alloy. A rat myoblast cell line (L6) was tested for adhesion and biocompatibility with porous titanium scaffolds in vitro by cell counting Kit-8 (CCK-8), scanning electron microscope (SEM), flow cytometry (FCM), real-time quantitative polymerase chain reaction (RT-qPCR), immunocytofluorescense, western blotting, etc. The porous titanium scaffolds were further embedded in the rat intervertebral muscle to analyze muscle growth and biomechanical strength in vivo. The novel artificial TMJ prosthesis was implanted to reconstruct the goat's condyle and LPM reattachment was analyzed by hard tissue section and avulsion force test. Results: L6 muscle cells showed good proliferation potential on the porous Ti scaffold under SEM scanning and FCM test. In RT-qPCR, immunocytofluorescense and western blotting tests, the L6 cell lines had good myogenic capacity when cultured on the scaffold with high expression of factors such as Myod1 and myoglobin, etc. In the in vivo experiment, muscles penetrated into the porous scaffold in both rats and goats. In rat's intervertebral muscle implantation, the avulsion force was 0.716 N/mm2 in 4 weeks after operation and was significantly increased to 0.801 N/mm2 at 8 weeks (p < 0.05). In goat condylar reconstruction with the porous scaffold prosthesis, muscles attached to the prosthesis with the avulsion force of 0.436 N/mm2 at 8 weeks, but was smaller than the biological muscle-bone attachment force. Conclusion: The novel designed TMJ prosthesis can help LPM attach to its porous titanium scaffold structure area for future function.
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Affiliation(s)
- Luxiang Zou
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,National Clinical Research Center of Stomatolog, Shanghai, China
| | - Yingqian Zhong
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,National Clinical Research Center of Stomatolog, Shanghai, China
| | - Yinze Xiong
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Dongmei He
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,National Clinical Research Center of Stomatolog, Shanghai, China
| | - Xiang Li
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chuan Lu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,National Clinical Research Center of Stomatolog, Shanghai, China
| | - Huimin Zhu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,National Clinical Research Center of Stomatolog, Shanghai, China
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Sikora M, Baranowska-Bosiacka I, Goschorska M, Chlubek D. In vitro effect of three-dimensional (3D) titanium mini-plate systems used for surgical treatment of condylar fractures on interleukin 1 (IL-1) and interleukin 6 (IL-6) concentration in THP-1 macrophages. Tissue Cell 2020; 67:101404. [PMID: 32835937 DOI: 10.1016/j.tice.2020.101404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 01/03/2023]
Abstract
About 20 %-35 % of mandibular fractures occur in the condylar process, a complication frequently associated with craniofacial traumas. Compared to other craniofacial fractures, some controversy remains around the effectiveness of the various treatment methods. It has been suggested that condylar osteosynthesis using mini-plates - a technique widely used by maxillofacial surgeons - may activate a pro-inflammatory response which is mediated by interleukins, later involved in bone remodelling and tissue regeneration. This study aimed at examining the influence of three-dimensional (3D) titanium mini-plate systems and the dedicated screws used in the surgical treatment of condylar fractions on the concentrations of interleukin 1(IL-1) and interleukin 6 (IL-6) in macrophages obtained from THP-1 monocytes. The cells were cultured for 24 h and 48 h with the 3D titanium condylar plates and dedicated screws (Synthes, Martin, Medartis manufacturer). The concentrations of IL-1 and IL-6 were measured using the ELISA method. Incubation of macrophages with plates did not cause a significant increase in IL-1 (for: Synthes 0.89-0.86 pg/mg protein; Martin 1.10-0.80 pg/mg protein; Medartis 1.20-0.84 pg/mg protein) and IL-6 (for Synthes 16.00-14.00 pg/mg protein, Martin 13.0-10.0 pg/mg protein; Medartis 9.0-12.0 pg/mg protein) expression for any of the plates used, compared to THP-1 macrophages incubated for 48 h under control conditions. Neither three-dimensional titanium mini-plates nor dedicated screws caused any changes in IL-1 and IL-6 expression in THP-1 macrophages, which is an important observation for clinicians treating condylar fractures. It confirms that titanium plates can be a safe/neutral material for humans, especially considering their significant influence on the osteoclast functions and bone remodelling processes after implantation.
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Affiliation(s)
- Maciej Sikora
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Kielce, Wojska Polskiego 51, 25-375, Kielce, Poland; Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
| | - Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
| | - Marta Goschorska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
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The Implications of Titanium Alloys Applied in Maxillofacial Osteosynthesis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Titanium alloys are known for their biological, mechanical and chemical properties, which have successfully expanded their use in the maxillofacial field. The internal fixation using titanium miniplates and screws offer a new perspective for the treatment of trauma and in orthognathic surgery and maxillofacial oncology. Although, titanium is highly recommended for its excellent biocompatibility, recent research has focused on identifying the potential local and general implications of the interactions between the human tissue and the metallic particles. This present review aims to outline the existing tissue changes, cellular alterations and future perspectives regarding the use of titanium-based alloys as osteosynthesis materials, taking into consideration the existing present debate whether the routinely removal of these materials should be an indication.
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