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Millogo M, Sanfo M, Idani M, Dargani MF, Coulibaly A, Konsem T. Pertes de substances maxillo-faciales d’origine traumatique au centre hospitalier universitaire Yalgado Ouedraogo. ANN CHIR PLAST ESTH 2022; 68:162-166. [PMID: 36207175 DOI: 10.1016/j.anplas.2022.09.003] [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: 07/17/2022] [Revised: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This work aims to report the modalities of management of maxillofacial substance loss following trauma in our context. METHODS This was a descriptive cross-sectional study with retrospective data collection of 55 cases of maxillofacial substance loss of traumatic origin over a period of 7 years from 2014 to 2020 in the department of stomatology and maxillofacial surgery of Yalgado Ouedraogo University Hospital. RESULTS The annual prevalence was 7.86 cases. The etiology was dominated by road traffic accidents (80% of cases). Loss of labial substance was the most frequent (58.18%). The lesions were severe, Lakmann type IV in 76.36% of cases. Bone loss occurred in 9.10% of the cases and was mainly located in the mandible. The repair of substance losses by locoregional flaps was the main technique for soft tissue reconstruction. Bone defects were repaired with non-vascularized bone grafts. The evolution was satisfactory in the majority of cases (80.3%). Infections were the main complications (5 cases) and the sequelae were dominated by unaesthetic scars (45.45%). CONCLUSION The management of maxillofacial substance loss of traumatic origin must be early and adequate for a better aesthetic and functional result.
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Affiliation(s)
- M Millogo
- Service de stomatologie et chirurgie maxillo-faciale du centre hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso; Service de Stomatologie et Chirurgie Maxillo-faciale du Centre Hospitalier Universitaire de Tengandogo, Burkina Faso.
| | - M Sanfo
- Service de Stomatologie et Chirurgie Maxillo-faciale du Centre Hospitalier Universitaire de Tengandogo, Burkina Faso
| | - M Idani
- Service de stomatologie et chirurgie maxillo-faciale du centre hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | - M F Dargani
- Service de Stomatologie et Chirurgie Maxillo-faciale du Centre Hospitalier Universitaire de Tengandogo, Burkina Faso
| | - A Coulibaly
- Service de Stomatologie et Chirurgie Maxillo-faciale Centre Hospitalier Universitaire de Ouahigouya, Burkina Faso
| | - T Konsem
- Service de stomatologie et chirurgie maxillo-faciale du centre hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso
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Siadat H, Khojasteh A, Beyabanaki E. Reconstruction of a Mandibular Defect with Toronto Bridge Following Tumor Resection and Bone Graft: A Case Report. Front Dent 2019; 16:153-157. [PMID: 31777858 PMCID: PMC6874845 DOI: 10.18502/fid.v16i2.1368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/08/2018] [Indexed: 11/27/2022] Open
Abstract
Dental implants are highly recommended to improve the retention, stability, and support of prostheses in edentulous patients with large surgical defects. Depending on the size of the defect, a bone graft procedure might be necessary. However, due to limitations of bone grafts, some complications might negatively affect the prosthetic rehabilitation of the patient. This case report presents some of these prosthetic problems following surgical resection and autogenous bone graft procedures.
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Affiliation(s)
- Hakimeh Siadat
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Beyabanaki
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Braimah RO, Ibikunle AA, Abubakar U, Taiwo AO, Oboirien M, Adejobi FA, Ndubuisi TG, Abubakar S. Mandibular reconstruction with autogenous non-vascularised bone graft. Afr Health Sci 2019; 19:2768-2777. [PMID: 32127850 PMCID: PMC7040254 DOI: 10.4314/ahs.v19i3.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Reconstruction of mandibular defects can be challenging because an acceptable aesthetic and functional outcome must be achieved simultaneously. Aim To evaluate the pattern of mandibulectomy and reconstruction materials used in the reconstruction of mandibular defects. Materials and methods This was a retrospective study of mandibulectomies with reconstruction in Sokoto, Nigeria between 2012 and 2016. Data such as demographics, type of tumour, type of resection and type of reconstruction materials used were extracted and stored. Results Fifty-two cases of mandibulectomies were done comprising 24 males and 28 females (ratio 1:1.2). Age ranged 5–80 years with mean±SD (37.8±15). Most of the cases 30 (57.7%) were on the right. There are 35 (67.3%) benign and 17 (32.7%) malignant cases. Thirty (57.7%) lateral, 16 (30.8%) condylar, 1 (1.9%) central and 5 (9.6%) combined mandibular defects were seen. Reconstruction plate alone was used in 11 (21.2%) cases, reconstruction plate with rib and tibia grafts in 16 (30.8%) cases, reconstruction plate with Iliac crest and tibia grafts in 15 (28.8%) cases. Graft length ranged from 0–20cm. There was satisfactory outcome altogether in 32 (80.0%). Conclusion This study has shown the types of mandibulectomies and reconstruction materials used in our centre.
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Affiliation(s)
- Ramat Oyebunmi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodio University Teaching Hospital, Sokoto, Nigeria. ., Phone number +234 803 583 9900
| | - Adebayo Aremu Ibikunle
- Consultant Oral and Maxillofacial Surgeon, Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. , Phone number: +234 8029190888
| | - Umar Abubakar
- Lecturer/Honourary Consultant Cardio-thoracic surgeon, Cardio-thoracic Surgery unit, Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University/ Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. , Phone number: +234 8036012733
| | - Abdurrazaq Olanrewaju Taiwo
- Senior Lecturer/Honorary Consultant, Department of Surgery/Dental & Maxillofacial Surgery, College of Health Sciences, Usmanu Danfodiyo University/ Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. , Phone number: +234 8078061517
| | - Muhammed Oboirien
- Muhammed Oboirien: MBBS, FWACS, Senior lecturer/Consultant Orthopaedic and Traumatology Surgeon, Orthopaedic and Traumatology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. , Phone number: +234 8067893799
| | - Francis Adewale Adejobi
- Adejobi Adewale Francis (B.Ch.D), Senior Registrar, Department of Oral & Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife Osun State, Nigeria. Phone number +234 08148668418
| | - Terry Godwin Ndubuisi
- Ndubuisi Godwin .T (BDS, MSc), Junior Registrar, Department of Dental & Maxillofacial Surgery Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria Phone number +234 8030920154
| | - Siddiq Abubakar
- Abubakar Siddiq (BDS), Junior Registrar, Department of Dental & Maxillofacial Surgery Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria , Phone number +234 8069457770
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Xiao N, Zhang L, Peng X, Mao C, Zhang J, Cai ZG. Non-vascularised fibular bone graft after vascular crisis: compensation for the failure of vascularised fibular free flaps. Br J Oral Maxillofac Surg 2018; 56:667-670. [PMID: 30055855 DOI: 10.1016/j.bjoms.2018.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 06/27/2018] [Indexed: 11/17/2022]
Abstract
After reconstruction of a segmental mandibular defect with a fibular free flap, a vascular crisis can be detected clinically and a "no-flow" phenomenon found during re-exploration. Traditional methods used to solve this include removal of the failed flap and delayed mandibular reconstruction, or restoration of the defect with a functional reconstruction plate or contralateral fibular free flap. Our aim therefore was to investigate under what circumstances it is feasible to use a non-vascularised fibular bone graft (NVFB) as a free bone graft after the failure of a vascularised fibular free flap. From 1 January 2010-31 December 2014, 10 patients who had NVFB after failure of a fibular free flap were included in the study. All patients were treated at the Peking University School and Hospital of Stomatology. NVFB were preserved successfully without infection in all 10 cases, and follow-up imaging showed that it had incorporated well with the residual mandible, the basic function and facial aesthetics of which were maintained. In conclusion we have identified that by precise selection of patients, detailed preoperative planning, and meticulous postoperative care, NVFB can be used as a "rescue" technique after failure of a fibular free flap, and can successfully restore the segmental mandibular defect and facial contour.
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Affiliation(s)
- N Xiao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - L Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
| | - X Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - C Mao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - J Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Z G Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Lee YW, You HJ, Jung JA, Kim DW. Mandibular reconstruction using customized three-dimensional titanium implant. Arch Craniofac Surg 2018; 19:152-156. [PMID: 29921117 PMCID: PMC6057131 DOI: 10.7181/acfs.2018.01830] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/08/2018] [Indexed: 11/25/2022] Open
Abstract
Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.
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Affiliation(s)
- Yun-Whan Lee
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hi-Jin You
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jae-A Jung
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea
| | - Deok-Woo Kim
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea
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Ibikunle AA, Taiwo AO, Braimah RO. A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria. BMC Health Serv Res 2018; 18:416. [PMID: 29879975 PMCID: PMC5992770 DOI: 10.1186/s12913-018-3236-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery. Methods A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software. Results One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)]. Conclusion Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted.
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Affiliation(s)
- Adebayo Aremu Ibikunle
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria.
| | - Abdurrazaq Olanrewaju Taiwo
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
| | - Ramat Oyebunmi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
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Ahmed FT, Aljeuary MT. The Strategy of Delayed Reconstruction of the Mandible in War Injuries. J Craniofac Surg 2018; 28:826-830. [PMID: 28468174 DOI: 10.1097/scs.0000000000003447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The most common causes of mandibular defects are ablative surgery of benign or malignant tumors, severe trauma, inflammatory diseases, and osteoradionecrosis. War injuries are another cause for mandibular defect. Reconstruction of the mandible is considered a challenge to the maxillofacial surgeon due to the accompanying functional and cosmetic importance. The object of this article was to show the role of nonvascularized bone graft in the reconstruction of segmental defect of the mandible resulted from projectiles and its snags. Seventeen patients underwent reconstruction of defect in the body of the mandible using non-vascularized iliac bone graft,in sixteen patients the grafts were fixed by reconstruction plate and in one by stainless-steel wire. In the emergency phase in which life-saving measures were done, in the immediate phase, treatments of associated facial and systemic injuries were carried out. The delayed phase includes the reconstruction of the residual defects and rehabilitation. A total of 17 male patients with a mean age of 34.5 years underwent reconstructive surgery, the time lapse between the injury and the delayed phase of treatment ranged from 20 days to 3 months. The size of the defects ranged from 4 to 7 cm. Treatment was considered successful in 15 patients (88.2%) in whom the grafts were incorporated to mandible with improvement of facial contour and symmetry and satisfactory occlusion of the remaining teeth. Nonvascularized bone graft is considered a feasible option for the reconstruction of a relatively small mandibular defect, especially in ascetic conditions for its role in improving facial appearance and to less extent functional benefit and more advanced method for the reconstruction needed to be introduced especially in war injuries.
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Affiliation(s)
- Firas Taha Ahmed
- Ghazi Al-Hariri Specialized Surgeries Hospital, Medical City, Baghdad, Iraq
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Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review. Int J Oral Maxillofac Surg 2016; 45:1388-1394. [PMID: 27237079 DOI: 10.1016/j.ijom.2016.05.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 04/19/2016] [Accepted: 05/05/2016] [Indexed: 11/20/2022]
Abstract
The restoration of mandibular bone defects with non-vascularized bone grafts depends on the diagnosis, anatomical site, extent of the defect, and the patient's age, as well as the surgeon's experience. The aim of this study was to perform a systematic literature review on mandibular reconstruction for segmental mandibular bone defects using non-vascularized bone grafts to answer the following question: Is there scientific evidence to support the use of this technique? The initial literature search in PubMed, Scopus, and Cochrane databases identified 862 articles. Of these, 25 were included in the final review. These articles encompassed 926 procedures with non-vascularized bone grafts; 76.1% were from the iliac crest. Benign tumours were the major cause of these defects (56.8%), and 44.7% of defects were located in the lateral mandibular area. Although this technique showed a high occurrence of complications (290 in 873 patients, some with more than one complication), these did not account for treatment failure. The restoration of bone defects due to malignant tumours treated with radiation therapy had lower success rates, and these appear to be a contraindication for the technique. Although standardized randomized controlled clinical studies are needed to obtain better clinical evidence for treatment choices in general, the use of non-vascularized bone grafts for mandibular reconstruction showed an 87.6% success rate in this review.
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Akinbami BO. Reconstruction of Continuity Defects of the Mandible with Non-vascularized Bone Grafts. Systematic Literature Review. Craniomaxillofac Trauma Reconstr 2016; 9:195-205. [PMID: 27516833 DOI: 10.1055/s-0036-1572494] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND The use of NVBG for mandibular defects seems to be gradually giving way for more advanced reconstructive techniques but it has the advantages of shorter operating time and lesser amount of blood loss. The aim of this study was to review the available data on the success and failure rates of use of NVBG and factors associated with failure. METHOD Studies published from 1978 to 2014 regarding the use of NVBG were searched. Most important information was graft success and failure outcomes. Information on graft success with particular focus on large defects was extracted and the quality of papers was rated. Defects > 6cm were considered long defects. RESULTS Twenty publications were included in this review. The quality of the studies was low and there was high heterogeneity. All articles reported high graft success rates ranging from 67 to 100%. Success in defects > 6cm was considerable, the range was 72-100%. Three main factors were associated with failure; these were defect length, fixation method and infection. Infection contributed the highest complication rate which was 48.2%. CONCLUSION NVBG seems to be appropriate for mandible reconstruction when there is vascular recipient bed and sufficient soft tissue cover and mucosal lining are achievable.
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Affiliation(s)
- Babatunde Olayemi Akinbami
- Department of Oral and Maxillofacial Surgery, Dental Center, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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Moldovan I, Juncar M, Dinu C, Onisor-Gligor F, Rotar H, Bran S, Baciut G. Mandibular reconstruction using free vascularized iliac crest grafts and dental implants. ACTA ACUST UNITED AC 2015; 88:391-4. [PMID: 26609275 PMCID: PMC4632901 DOI: 10.15386/cjmed-446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/07/2015] [Accepted: 05/13/2015] [Indexed: 11/23/2022]
Abstract
Background and aim The mandible is frequently affected by tumor masses present in the oral cavity and is included in the tumor ablation procedure, with major functional and esthetic consequences for the patient. A method of high current interest in mandibular reconstruction is based on the use of free vascularized iliac crest grafts, followed by reconstruction using dental implants. Methods This study presents the case of four patients benefiting from this treatment method, and monitors the treatment stages and their clinical evolution after mandibular reconstruction and dental implant placement. Results The postoperative evolution of the patients was favorable, with the integration of the iliac crest grafts and dental implants. After prosthetic loading, the masticatory as well as the esthetic function of the patients was restored to a standard close to the initial one. Conclusions This mandibular reconstruction method proved to be effective, with a high degree of reliability and a significant improvement of the patients’ quality of life.
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Affiliation(s)
- Iuliu Moldovan
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihai Juncar
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor-Gligor
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotar
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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