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Editorial Board/Reviewing Committee
doi : 10.1016/S0901-5027(21)00255-1
Volume 50, Issue 9, September 2021, Page i
Replacement of lip-split mandibulotomy by pull-through approach for T3–4 oral carcinomas
A.Marhic1J.Guerlain1N.Benmoussa1I.Breuskin1J.-F.Honart2F.Janot1A.Moya-Plana1S.Temam1P.Gorphe1
doi : 10.1016/j.ijom.2020.10.011
Volume 50, Issue 9, September 2021, Pages 1123-1130
At the study hospital, the lip-split mandibulotomy (LSM) has progressively been replaced by a pull-through (PT) approach. This study compared the outcomes of the LSM and PT approaches in a series of 192 patients with T3–T4a oral tongue and floor of the mouth squamous cell carcinoma treated over the two last decades. No difference in margin status (P?=?0.254), rate of early complications (local infections) (P?=?0.867), haematoma/haemorrhage (P?=?0.221), delayed wound healing (P?=?0.438), re-operation (P?=?0.083), or Clavien–Dindo classification (P= 0.5281) was found. The LSM approach was associated with a higher rate of late complications such as pseudarthrosis (14.5% vs 0.9%; OR 17.89, P?=?0.0005) and trismus (35% vs 13.8%; OR 3.32, P?=?0.025), and a trend towards a higher rate of fistulas (24.6% vs 13.1%; OR 2.16, P?=?0.088). The quality of life of long-term survivors (median 132 months) was similar in the two groups, with a mean QLQC30 score of 59.7 (P?=?0.099) and mean MDADI score of 57.4 (P?=?0.213). The 5-year local control rate was 86.4% in the PT group and 86.2% in the LSM group (P?=?0.878), while the 5-year overall survival rates were 50.0% and 48.3%, respectively (P?=?0.68). In our experience, replacement of LSM by a PT approach in oral carcinoma was associated with decreased rates of late complications such as pseudarthrosis, fistula, and trismus, without any difference in oncological outcomes.
Genetic variants in long non-coding RNAs UCA1 and NEAT1 were associated with the prognosis of oral squamous cell carcinoma
L.Zhu1†Y.He12†G.Feng1Y.Yu1R.Wang1N.Chen1H.Yuan123
doi : 10.1016/j.ijom.2020.11.024
Volume 50, Issue 9, September 2021, Pages 1131-1137
Oral squamous cell carcinoma (OSCC) is known for its high incidence, death rate, and relatively low 5-year survival. Long non-coding RNAs (lncRNAs) have been shown to play a significant role in cancerization and cancer progression. However, research on the association of polymorphisms in these lncRNAs with the prognosis of OSCC is lacking. Fifteen functional single-nucleotide polymorphisms (SNPs) in seven lncRNAs were selected to explore the relationship between these lncRNA SNPs and the prognosis among 209 OSCC patients. Kaplan–Meier analysis and Cox proportional hazards regression models were used to examine the associations. Further functional exploration of significant SNPs was done by eQTL analysis. Using multivariate Cox hazards regression analysis, a predictive role of NEAT1 rs3741384 GG and UCA1 rs7255437 TC + TT in a worse prognosis of OSCC was identified. In addition, a marked increased risk of death was observed with an increasing number of unfavourable genotypes (NUG). The NUG was then incorporated with clinical variables in the receiver operating characteristic curve, and the results indicated a potential role of the NUG in predicting OSCC patient risk of death (area under the curve increase from 0.616 to 0.703). In conclusion, the study findings indicate that genetic variants rs3741384 in NEAT and rs7255437 in UCA1 may influence the survival of OSCC patients.
Quality of life of Japanese elderly oral cancer patients during the perioperative period
T.Aoki1Y.Ota1M.Sasaki1T.Suzuki1M.Uchibori1Y.Nakanishi1T.Akamatsu2K.Irikura2T.Akiba3T.Arai1
doi : 10.1016/j.ijom.2020.12.011
Volume 50, Issue 9, September 2021, Pages 1138-1146
Japan’s aging society has an increasing incidence of oral cancer. This study investigated perioperative changes in quality of life (QoL) among 172 oral cancer patients (elderly ?75 years vs non-elderly <75 years), pre-treatment, at treatment completion, and at 1, 3, and 6 months post-treatment, using the following Functional Assessment of Cancer Therapy – Head and Neck (FACT-H&N) subscales: physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB), additional head- and neck-specific concerns (H&N). SWB (P = 0.026), H&N (P = 0.024), and total FACT-H&N (P = 0.009) scores were significantly lower in the elderly group than in the non-elderly group at 6 months post-treatment, especially for mastication items (H&N1, P = 0.047; H&N11, P = 0.004), but not for swallowing items (H&N5 and H&N7, both P > 0.05). PWB (P = 0.004), EWB (P < 0.001), and FWB (P = 0.022) scores in the non-elderly group were significantly higher at 6 months post-treatment than before treatment. In the elderly group, no subscale showed a better score at 6 months post-treatment. Post-treatment QoL in elderly oral cancer patients did not improve, unlike in non-elderly patients.
Donor site morbidity of composite free flaps in head and neck surgery: a systematic review of the prospective literature
J.Russell1K.Pateman2M.Batstone3
doi : 10.1016/j.ijom.2020.12.009
Volume 50, Issue 9, September 2021, Pages 1147-1155
Composite free flaps represent the cornerstone for the repair of osseous defects in the head and neck. For many patients, there are often multiple defect-suitable donor sites that may be utilised as part of the reconstructive process. Therefore, to optimise patient outcomes, an evidence-based approach to donor site selection is required to maximise quality of life and long-term functionality. A systematic review of the literature was conducted in accordance with PRISMA guidelines to evaluate the evidence for donor site selection based on minimising the associated donor site morbidity and optimising patient functionality postoperative. The fibula is associated with the greatest potential risk for wound healing complications. Fibula and scapula harvest has the potential to have a significant impact on physical performance. The iliac crest is most favourable in terms of aesthetic scar healing outcomes. Overall, however, the quality and quantity of evidence for all donor sites is limited. Each site is associated with specific complications and morbidity, of which the surgeon and patient must both be aware. Whilst a cross-sectional informed opinion of the likely advantages/disadvantages of one donor site over another can thus be made, there are few head-to-head studies available that directly compare donor sites.
Effect of submental flap reconstruction versus obturator rehabilitation after maxillectomy on quality of life: a randomized clinical trial
O.Q.S.Aladashi1M.I.Shindy1S.A.Noaman2A.Y.Alqutaibi34S.M.Refahee5
doi : 10.1016/j.ijom.2020.12.008
Volume 50, Issue 9, September 2021, Pages 1156-1160
The surgical removal of a maxillary tumour will result in an oronasal communication, which can negatively affect the patient’s life and daily functions. Following maxillectomy, the defect can be treated with a prosthetic obturator or microvascular flap. However, the gold standard technique remains controversial. The aim of this study was to evaluate and compare quality of life (QoL) outcomes of submental island flap versus maxillary obturator reconstruction after partial maxillectomy. Sixty patients indicated for maxillectomy were allocated randomly to two equal-sized groups. Control group patients underwent reconstruction with a surgical obturator, while intervention group patients underwent submental island flap reconstruction. Patient QoL was evaluated at the 6-month follow-up using the University of Washington Quality of Life Questionnaire. Statistically significant differences in QoL were found between the two groups. Chewing (P?=?0.034), swallowing (P?<?0.001), speech (P?=?0.009), taste (P?=?0.04), mood (P?=?0.01), and anxiety (P?=?0.003) domains showed a statistically significant improvement in the submental group compared to the obturator group. However, the obturator group showed a greater improvement in appearance (P?<?0.001). The masticatory function scores in the obturator group were significantly higher after obturator rehabilitation (P?<?0.001). In conclusion, this study found that submental flap reconstruction provided better function and QoL than the obturator. This reconstruction was associated with less pain and better pronouncing of words, chewing, swallowing food, and psychosocial adjustment.
Intraoral anastomosis in maxillary microvascular reconstruction after oncological excision
A.Bueno de VicenteF.AlmeidaJ.A.NuñezM.PiconJ.Acero
doi : 10.1016/j.ijom.2021.01.008
Volume 50, Issue 9, September 2021, Pages 1161-1167
Microvascular anastomosis using an intraoral approach can avoid unnecessary external incisions thus improving patient satisfaction. Furthermore, in case of short pedicle flaps, the lack of proximity of the recipient vessels can be a problem in microvascular reconstruction of the midface. We present our experience in six patients treated for tumours affecting the midface and reconstructed with microvascular flaps through anastomosis to the intraoral aspect of the facial vessels, with the aim of reviewing the use of this technique. Our results showed that intraoral anastomosis is a feasible technique that can be used in the reconstruction after tumours resection, avoiding additional external incisions in patients with no previous cervicotomy incisions. In two cases, a vein graft was interposed to perform the intraoral arterial anastomosis in a tension-free situation without increasing morbidity. The technical features and advantages of intraoral anastomosis were reviewed.
Surgical management of the odontogenic keratocyst: A 20-year experience
S.MohantyaJ.DabasbA.VermaaS.GuptacA.B.UrsdS.Hemavathya
doi : 10.1016/j.ijom.2021.02.015
Volume 50, Issue 9, September 2021, Pages 1168-1176
The objective of this study was to describe the authors’ long-term experience with the management of odontogenic keratocysts (OKCs). All OKC cases treated at the study centre between 1999 and 2015, with a minimum of 5 years of follow-up by December 2019, were reviewed retrospectively. Operative procedures including decompression/marsupialization, enucleation (E), E + Carnoy’s solution (CS), E + CS + peripheral ostectomy (PO), and resection were assessed for complete resolution, partial resolution, and recurrence rates. In the parakeratinized non-syndromic group, E + CS + PO resulted in the lowest recurrence rate among the minimally invasive procedures (4.3%), while enucleation resulted in the highest rate (60%). Regarding the other modalities, recurrence was 12.5% for decompression, 11.5% for marsupialization, 16.7% for E + CS, 26.7% for E + PO, and 0% for resection. In the syndromic group, marsupialization resulted in a significantly higher recurrence (23.1%), while E + CS + PO cases showed no recurrence. No recurrence was observed in the orthokeratinized group patients treated with marsupialization or with E + CS. Based on clinico-radiographic features and observed results, it is concluded that OKC, although having a high recurrence rate, is a benign lesion and responds well to conservative procedures in most cases. Radical procedures should be reserved for unresponsive lesions and those with extensive tissue destruction.
Mirror-image unilateral condylar hyperplasia in monozygotic twins
A.Q.J.Toh1A.G.Becking2Y.Y.Leung1
doi : 10.1016/j.ijom.2020.12.004
Volume 50, Issue 9, September 2021, Pages 1177-1181
Unilateral condylar hyperplasia (UCH) is an abnormal growth process that results in the development of mandibular asymmetry. The aetiopathogenesis of this entity is still unclear. Various factors including hormonal influences, intrauterine factors, trauma, infection, and genetics have been speculated to lead to the development of UCH. In genetic epidemiology, twins have been a valuable resource for investigating the genetic basis of complex traits and diseases. We present a case of mirror-image UCH in a pair of monozygotic twins, providing evidence of a possible genetic link for this mandibular growth disorder. The concordance in the monozygotic twins appears to be reflected by the precise mirror-image presentation of the congenital dentofacial anomalies. Further twin studies would be useful in clarifying the contributions of genetic and environmental factors to the presence and development of UCH.
Odontogenic gingival epithelial hamartoma with a pleomorphic histological appearance: a case report and review of the literature
H.Sakamoto1S.Fujita2M.Umeda3S.Rokutanda45
doi : 10.1016/j.ijom.2021.01.007
Volume 50, Issue 9, September 2021, Pages 1182-1186
Odontogenic gingival epithelial hamartoma (OGEH) is a rare odontogenic epitheliallesion. Distinguishing OGEH from peripheral ameloblastoma can pose a differential diagnostic challenge. We report a case of OGEH affecting the lower gingiva in a 78-year-old male patient. The lesion presented as a large, painless, pedunculated mass with a pleomorphic histological appearance. A diagnosis of OGEH was made after the exclusion of peripheral ameloblastoma and peripheral adenomatoid odontogenic tumour. Previous studies have reported differences in sex and age between patients with OGEH and peripheral ameloblastoma; this suggests that peripheral ameloblastoma is not derived from OGEH. Histological findings suggest that the lesions are independent entities.
Saliva flow rates and clinical characteristics of patients with burning mouth syndrome: A case–control study
S.WerfalliM.DrangsholtJ.M.JohnsenS.K.JeffreyS.DakhilR.B.PreslandL.LeResche
doi : 10.1016/j.ijom.2021.01.018
Volume 50, Issue 9, September 2021, Pages 1187-1194
Burning mouth syndrome (BMS) is a chronic pain condition that most commonly affects postmenopausal women older than 50 years of age. Xerostomia is a common complaint among BMS patients. However, previous studies showed inconsistent findings regarding saliva flow rate reduction. This study examined saliva flow rates, degree of mucosal hydration, xerostomia, and clinical characteristics in BMS patients compared with healthy controls. Unstimulated whole saliva (USWS) was collected through passive drooling; residual mucosal saliva (RMS) was collected using filter paper strips. Stimulated whole saliva (SWS) was collected while chewing on gum base. Oral exam and self-report data were collected. A total of 50 women (22 BMS cases and 28 healthy controls) aged 50 years or older were included in the analysis of this study. Mean age was 62 years for cases and 56 years for controls (P = 0.05). Compared with controls, cases had significantly lower USWS flow rates (P < 0.001) and had a higher prevalence of xerostomia (P = 0.001), gastrointestinal disease (P < 0.001), and vaginal dryness (P = 0.01). These data show that oral and vaginal dryness are common among BMS patients. Further studies are needed to investigate potential pathophysiological mechanisms related to the quality of saliva and mucosal barrier status among these patients.
Impact of muscle volume loss on acute oral mucositis in patients undergoing concurrent chemoradiotherapy after oral cancer resection
T.Yamaguchi1aT.Makiguchi1aH.Nakamura1Y.Yamatsu1Y.Hirai1K.Shoda1K.Suzuki1M.Kim1S.Kurozumi2S.I.Motegi3K.Shirabe2S.Yokoo1
doi : 10.1016/j.ijom.2020.12.005
Volume 50, Issue 9, September 2021, Pages 1195-1202
This study evaluated the association between skeletal muscle mass depletion and severe oral mucositis in patients undergoing concurrent chemoradiotherapy after oral cancer resection. Skeletal muscle mass was evaluated in 60 patients using the skeletal muscle index, which was based on skeletal muscle cross-sectional area (on computed tomography) at the level of the third lumbar vertebra. In accordance with the grading criteria of the Radiation Therapy Oncology Group, patients with a grade ?3 were defined as having severe oral mucositis. Multivariate logistic regression analysis was used to evaluate independent risk factors for severe oral mucositis. Eleven patients (18.3%) were diagnosed with low skeletal muscle mass. Severe oral mucositis occurred in 17 (28.3%) patients, and the mean skeletal muscle index was 42.8 cm2/m2. A low skeletal muscle mass (hazard ratio 18.1; P = 0.001) and a chemotherapy regimen consisting of 5-fluorouracil and cisplatin (versus cisplatin only) (hazard ratio 5.5; P = 0.015) were independent risk factors for severe oral mucositis. Future prospective studies are warranted to identify effective pre- and perioperative exercises and nutrition programmes to increase low skeletal muscle mass and reduce the incidence of severe oral mucositis in patients undergoing concurrent chemoradiotherapy after oral cancer resection.
Variables associated with stability after Le Fort I osteotomy for skeletal class III malocclusion
C.C.Lee1O.Xhori2R.J.Tannyhill1L.B.Kaban1Z.S.Peacock1
doi : 10.1016/j.ijom.2021.02.004
Volume 50, Issue 9, September 2021, Pages 1203-1209
The purpose of this study was to assess skeletal stability and predictors of relapse in patients undergoing an isolated Le Fort I osteotomy. A retrospective cohort study of 92 subjects undergoing Le Fort I osteotomy for Class III malocclusion was implemented. Predictor variables were demographic and perioperative factors. The primary outcome variable was postoperative skeletal position with relapse defined as >2 mm sagittal and/or vertical change at A-point on serial lateral cephalograms at immediate postoperative, 1 year, and latest follow-up time points. Mean advancement at A-point was 6.28 ± 2.63 mm and mean lengthening was 0.92 ± 1.76 mm. Eight subjects (8.70%) had relapse (>2 mm) in the sagittal plane, and two subjects (2.17%) in the vertical plane. No subjects required reoperation for relapse as overbite and overjet remained in an acceptable range due to dental compensation. In regression analysis, magnitude of maxillary advancement was an independent predictor of relapse in the sagittal plane (P = 0.008). There were no significant predictors of relapse in the vertical plane. This study suggests that isolated Le Fort I osteotomy for correction of skeletal Class III malocclusion is a stable procedure and that greater advancement is an independent risk factor for sagittal relapse.
Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy
J.CedeA.GrafJ.ZeitlingerF.WagnerK.WillingerC.Klug
doi : 10.1016/j.ijom.2021.01.013
Volume 50, Issue 9, September 2021, Pages 1210-1218
In this study we compared the aesthetic outcome of (1) Le Fort I (LFI) osteotomy and (2) intraoral quadrangular Le Fort II (IQLFII) osteotomy for surgical correction of skeletal class III dysgnathia involving midfacial deficiency. The aim was to investigate whether laypersons see differences in facial changes that occur due to variations of the osteotomy cuts. The patient collectives consisted of 23 patients in each group. Pre- and postoperative photographs were presented in a random sequence to 40 layperson raters. The rating procedure was conducted with a four-point Likert scale. Assessed characteristics were ‘attractiveness’ (‘Attraktivität’), ‘likeability’ (‘Sympathie’), ‘intelligence’ (‘Intelligenz’), ‘aggressiveness’ (‘Aggressivität’) and ‘dominance’ (‘Dominanz’). For preoperative photographs we found a significant difference for ‘likeability’ with lower ratings for the IQLFII group; all other criteria were rated similarly. For the IQLFII group we found a significantly larger shift from lower to higher ratings for ‘attractiveness’ and ‘likeability’ and a significantly larger shift from higher to lower ratings for ‘aggressiveness’ and ‘dominance’ than for the LF I group. Our study shows that lay raters detect significant differences between the two surgical groups. Thus, IQLFII osteotomy, when indicated, represents a favourable alternative to conventional LFI osteotomy, if patients desire the expectable change in recognition by their social circle.
Virtual occlusion in orthognathic surgery
F.Baan12E.M.van Meggelen2A.C.Verhulst12R.Bruggink12T.Xi2T.J.J.Maal12
doi : 10.1016/j.ijom.2020.12.006
Volume 50, Issue 9, September 2021, Pages 1219-1225
The aim of this retrospective study was to determine whether a virtually created occlusion is as accurate as a conventionally created occlusion. Seventeen orthognathic patients were included in the study, which was conducted in a university clinic. Plaster cast models were obtained and digitized. Two experienced observers created the conventional (gold standard) and virtual occlusion to assess inter-observer variability. One observer created the conventional and virtual occlusion a second time to assess the intra-observer variability. The criterion for accepting the virtual occlusion was that the difference between the gold standard and the virtual occlusion was not larger than the intra-observer variability for the gold standard. A non-parametric Kruskal–Wallis H test was performed to detect statistically significant differences between the intra- and inter-observer groups for both the conventional and virtual occlusion. No statistically significant differences were found between the different groups. The difference between the conventional and virtual occlusion group was 0.20 mm larger than the intra-observer variability of the gold standard. The virtual occlusion tool presented here can be utilized in daily clinical practice and makes the use of physical dental models redundant.
Variation between natural head orientation and Frankfort horizontal planes in orthognathic surgery patients: 187 consecutive cases
F.Hernández-AlfaroabM.Giralt-HernandoabP.J.BrabynbO.L.HaasJr.cA.Valls-Ontañónab
doi : 10.1016/j.ijom.2021.02.011
Volume 50, Issue 9, September 2021, Pages 1226-1232
The purpose of this study was to assess the relationship between the Frankfort horizontal (FH) and natural head orientation (NHO), their correlation between patients’ malocclusion, and the impact of counterclockwise rotation (CCW) on the FH-NHO angle variation after orthognathic surgery. An evaluation of 187 consecutive patients was performed at the Maxillofacial Institute (Teknon Medical Center, Barcelona). FH-NHO° was measured pre- and postoperatively at 1 and 12 months, after three-dimensional (3D) superimposition using a software (Dolphin®). Patients were classified as follows: 3.2%, 48.7% and 48.1%, class I, II and III, respectively. Baseline FH-NHO° was significantly positive for patients with dentofacial deformities (2.73° ± 4.19 (2.12–3.33°, P < 0.001). The impact of orthognathic surgery in FH-NHO° was greater in class II when compared with class III patients, with a variation of 2.04° ± 4.79 (P < 0.001) and ?1.20° ± 3.03 (P < 0.001), respectively. FH-NHO° increased when CCW rotational movements were performed (P = 0.006). The results of this study suggest that pre- and postoperative NHO differs from FH in orthognathic patients. The angle between FH and NHO is significantly larger in class III than in class II patients at baseline, which converges after orthognathic surgery when CCW rotation is performed. Therefore, NHO should be used as the real horizontal plane when planning for orthognathic surgery.
Is there a difference in treatment effect of different intra-articular drugs for temporomandibular joint osteoarthritis? A systematic review of randomized controlled trials
A.LiapakiaJ.R.ThammaS.HaJ.L.G.C.MonteiroJ.P.McCainM.J.TroulisF.P.S.Guastaldi
doi : 10.1016/j.ijom.2021.01.019
Volume 50, Issue 9, September 2021, Pages 1233-1243
A systematic review based on the PRISMA guidelines was conducted to investigate and compare treatment with hyaluronic acid (HA), corticosteroids, and blood products in patients with temporomandibular joint osteoarthritis (TMJOA). The MEDLINE/PubMed, Embase, and Cochrane Library databases were searched for articles published until September 25, 2019. Articles met the inclusion criteria if they reported patients with TMJOA, a comparison group, and a follow-up period of at least 6 months. The mean and standard deviation for TMJ pain and maximum mouth opening (MMO) were reported. Nine studies involving 443 patients were included. Injectables and Ringer’s lactate solution or normal saline were reported to significantly improve TMJ pain and MMO. Regarding TMJ pain, two studies showed a significant superiority of plasma rich in growth factors (PRGF)/platelet-rich plasma (PRP) injections with or without arthrocentesis over HA, but HA showed a significant improvement compared to corticosteroids. For MMO, no injectable was found to be superior to Ringer’s lactate or a normal saline control, but arthrocentesis + PRP resulted in MMO improvement compared to arthrocentesis + HA. Overall, all injectables in conjunction with arthrocentesis were efficient in alleviating pain and improving MMO in TMJOA patients; however, a meta-analysis was not possible due to heterogeneity across studies.
Do sex hormone imbalances contribute to idiopathic condylar resorption?
M.YuanQ.XieP.ShenC.Yang
doi : 10.1016/j.ijom.2021.01.017
Volume 50, Issue 9, September 2021, Pages 1244-1248
Idiopathic condylar resorption (ICR) is an aggressive form of temporomandibular joint disease that most frequently presents in adolescent girls during the pubertal growth spurt. Although numerous studies have indicated that the etiopathogenesis of ICR may be related to estrogen deficiency, the decisive role of estrogens remains controversial, and other sex hormone disturbances have not yet been investigated in this regard. Therefore, the aim of this study was to ascertain the role of serum estrogen levels and also the roles of other sex hormones in the pathogenesis of ICR. Ninety-four ICR patients and 324 disc displacement (DD) patients, of both sexes, were enrolled. Information on menstruation and serum levels of follicle-stimulating hormone, luteinizing hormone, prolactin, 17?-estradiol (E2), testosterone, and progesterone were recorded and analyzed. The results showed that female ICR patients had normal puberty onset, within the average age range. Use of oral contraceptives and other menstruation-regulating pharmaceuticals was similar in the two groups. Of note, neither serum E2 levels nor those of the other sex hormones differed significantly between female ICR and DD patients. However, male ICR patients had significantly increased serum testosterone levels (P = 0.002) and relatively higher E2 levels (P = 0.095) compared to DD patients. This study found that reduced serum E2 did not contribute to ICR; instead, systemic testosterone disturbances were found to be related to ICR.
Vertical bone augmentation and regular implants versus short implants in the vertically deficient posterior mandible: a systematic review and meta-analysis of randomized studies
H.Terheyden1G.J.Meijer2G.M.Raghoebar3
doi : 10.1016/j.ijom.2021.01.005
Volume 50, Issue 9, September 2021, Pages 1249-1258
The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the outcomes of short dental implants (?7 mm) versus vertical bone augmentation followed by regular dental implants (>7 mm) in the deficient posterior mandible. In total, eight RCTs (six using interpositional sandwich grafting and two using a guided bone regeneration technique) were reported in 17 articles at different time points. In the meta-analysis of the sandwich group, the relative risk (RR) for implant loss at 1 year was in favour of short implants (RR 0.41, P = 0.02), while no significant difference was found at 3 years (RR 0.65, P = 0.43), 5 years (RR 1.08, P = 0.86), or 8 years (RR 1.53, P = 0.52). The risk of complications was in favour of short implants (RR 0.34, P = 0.0002), as was the mean difference in marginal bone resorption after 1 year (?0.09 mm, P = 0.17), 3 years (?0.32 mm, P < 0.00001), 5 years (?0.65 mm, P < 0.00001), and 8 years (?0.88, P < 0.00001). The mean residual osseointegration length of the implants was between 2.94 mm and 4.44 mm in the short implants group and between 7.97 mm and 8.62 mm in the regular implants group after 5 years. In conclusion, in the deficient atrophic posterior mandible, short implants and regular implants demonstrate comparable outcomes within the first 5 years. Patients who are fit for surgery should be informed about the risks and benefits of both options.
Short-term use of an exposed polypropylene barrier in the preservation of alveolar bone after extraction: randomized clinical trial
C.C.V.dos Santos1K.R.Tonini1M.A.A.Silva1P.S.P.de Carvalho2D.Ponzoni3
doi : 10.1016/j.ijom.2021.02.005
Volume 50, Issue 9, September 2021, Pages 1259-1266
This study was performed to evaluate the short-term preservation of alveolar bone volume with or without a polypropylene barrier and exposure of the area after extractions. Thirty posterior tooth extraction sockets were distributed randomly to a control group (n = 15; extraction and suture) and a barrier group (n = 15; extraction, barrier, and suture). All sutures and barriers were removed 10 days postoperatively. Cone beam computed tomography scans taken with the aid of a tomographic guide were obtained preoperatively, immediately postoperative, and at 120 days postoperative. A visual analysis of the coronal sections of the alveolus was performed, and vertical loss in the mesial, distal, buccal, and lingual bone ridges and horizontal thickness were evaluated. The mean vertical loss after extraction did not differ significantly between the control and barrier groups (Student t-test: mesial P = 0.989, buccal P = 0.997, lingual/palatal P = 0.070, distal P = 0.107). The mean vertical loss at 120 days postoperative did not differ significantly between the control (0.65 mm) and barrier (0.52 mm) groups (P > 0.05), with an effect size of 0.13 mm. At 120 days, the barrier group presented a mean resorption in thickness (0.45 mm) that was significantly lower than that in the control group (0.76 mm) (P = 0.021), with an effect size of 0.31 mm. The polypropylene barrier reduced the horizontal resorption in sockets of posterior teeth after extraction.
Measurement of hydraulic pressure on the sinus membrane for safer control during transcrestal sinus lifting
J.H.Ro1J.H.Moon1M.C.Cheon1C.J.Park2
doi : 10.1016/j.ijom.2021.02.003
Volume 50, Issue 9, September 2021, Pages 1267-1270
The aim of this study was to determine the hydraulic pressures necessary to separate and lift the sinus membrane from the sinus floor in order to ensure a more controlled and safer hydraulic transcrestal sinus lifting surgery and prevent sinus membrane perforation. A flow-regulating hydrodynamic device with a pressure sensor was used in nine patients. The hydraulic pressure was found to increase steadily up to a mean peak of 25.0 ± 13.0 kPa, which is comparable to the medium suction power of ordinary vacuum cleaners. Subsequently, there was a short plateau followed by a sharp decrease in the hydraulic pressure.
