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Editorial Board/Reviewing Committee
doi : 10.1016/S0901-5027(21)00306-4
Volume 50, Issue 10, October 2021, Page i
Diagnostic yield of sentinel lymph node biopsy in oral squamous cell carcinoma T1/T2-N0: systematic review and meta-analysis
M.Mallo Magariños1aM.Suárez Ajuria2aX.Marichalar Mendía3Ó.Álvarez-Calderón Iglesias45C.M.Chamorro Petronacci16A.García García16M.Pérez Sayáns16
doi : 10.1016/j.ijom.2021.01.020
Volume 50, Issue 10, October 2021, Pages 1271-1279
The objective of this study was to conduct a systematic review and meta-analysis on the efficacy of sentinel lymph node biopsy (SLNB) in T1/T2-N0 oral squamous cell carcinoma (OSCC). A systematic review of the literature on SLNB until March 2019 was conducted. The review was organized according to the PRISMA protocol, considering the following PICO (population, intervention, comparison, outcome) question: What is the sensitivity of sentinel lymph node biopsy in OSCC? ‘P’ was patients with head and neck squamous cell carcinoma T1/2-N0; ‘I’ was SLNB; ‘C’ was neck treated with elective neck dissection and haematoxylin–eosin histopathology; ‘O’ was sensitivity and specificity. A meta-analysis and meta-regression were performed on the selected studies. The sensitivity of SLNB was up to 88% (95% confidence interval (CI) 72–96%) and specificity was up to 99% (95% CI 96–100%). The area under the summary receiver operating characteristic curve was 0.99 (95% CI 0.98–1.00). In the four studies where immunohistochemistry was performed, both the sensitivity and specificity were higher than in the studies without immunohistochemistry: 93% (95% CI 88–97%) and 98% (95% CI 96–100%), respectively. In conclusion, SLNB is an effective technique for treating patients with some types of stage T1/2-N0 OSCC. Some parameters such as immunohistochemistry could determine the level of diagnostic accuracy.
Analysis of local invasion and regional spread in malignant sublingual gland tumour: Implications for surgical planning
W.Park1aM.Park1aK.Choi2Y.Heo1S.Y.Choi1J.Cho2Y.-H.Ko2H.-S.Jeong1
doi : 10.1016/j.ijom.2021.01.016
Volume 50, Issue 10, October 2021, Pages 1280-1288
Malignant tumours arising from the sublingual glands are very rare, and the extent and frequency of local invasion or regional spread in malignant sublingual gland tumour (MSLT) has not been fully studied due to the disease rarity. To provide comprehensive features of local and regional spread of MSLT, we reviewed 20 surgical cases for detailed pathological analyses among 26 cases diagnosed as having primary MSLT. Adenoid cystic carcinoma (ACC) was the most common pathological subtype, followed by mucoepidermoid carcinoma. Disease-free and overall survivals at 5 years were 76.1 % and 77.7 %, respectively. High-grade malignant tumours and grade 2–3 ACC accounted for 41.7 % and 85.7 %. Clinical and pathological extraparenchymal extensions were found in 34.6 % and 80.0 %, respectively. Tumour invasion to the lingual nerve and submandibular gland/ductal system were also detected in 40.0 % and 28.6 %. The incidences of lingual nerve invasion in ACC and ACC ?4 cm were 30.8 % and 42.9 %. Regional nodal involvement occurred in seven of 26 cases, and all metastatic lymph nodes were found in neck levels Ib and IIa. In summary, a significant portion of MSLT cases consisted of high-grade tumours and grade 2–3 ACC; therefore local invasion into adjacent structures should be cautiously evaluated in cases of MSLT.
Trichilemmal carcinoma of the scalp
J.Usseglio1E.Pagès1A.Guyot2J.Laloze1J.Ferri3
doi : 10.1016/j.ijom.2021.02.008
Volume 50, Issue 10, October 2021, Pages 1289-1292
This report describes the case of an 86-year-old male who presented with a large scalp tumour. Imaging revealed a large vertex mass, without intracranial extension, and multiple nodular subcapsular hepatic lesions suspected to be secondary in nature. Surgical resection was performed. Pathological examination revealed an adnexal carcinoma of follicular origin, thus a trichilemmal carcinoma. Controlled wound healing (budding of the diploë) was completely successful within 12 months. The patient refused the assessment and treatment of his metastases.
First bite syndrome after parotidectomy: a single-centre experience
K.LammekD.TretiakowA.Skorek
doi : 10.1016/j.ijom.2021.02.029
Volume 50, Issue 10, October 2021, Pages 1293-1297
The aim of this study was to investigate the prevalence of first bite syndrome (FBS) among post-parotidectomy patients and to analyse the risk factors for its occurrence. The study involved 111 adult patients operated for benign parotid tumours. After surgery, the participants were asked to assess the presence of food-related pain and the nature of the pain. Participants also answered questions on complications after parotidectomy. FBS was found in seven patients (6.3%). Sex (P = 0.036) and age (P = 0.002) differed significantly between patients with and without FBS. Female patients were found to be at higher risk of FBS, and the lower the patient’s age, the more likely FBS was to occur after surgery. Tumour location (P = 0.002) and the occurrence of disturbing symptoms before surgery (P = 0.009) had a statistically significant effect on the occurrence of FBS. A tendency towards significance for paresis of cranial nerve VII after surgery (P = 0.051) was found; this complication was more frequent in the FBS patients. FBS is a rare pain syndrome that can occur after parotidectomy and should be distinguished from postoperative pain. Proper diagnosis and implementation of the appropriate treatment can significantly improve patient quality of life.
Submandibular gland obstruction caused by an implant-retained lower denture: a report of three cases
E.H.van der Meij1L.J.Beumer1A.Matthews-Brzozowski1J.G.A.M.de Visscher2
doi : 10.1016/j.ijom.2021.02.002
Volume 50, Issue 10, October 2021, Pages 1298-1302
The aim of this study was to investigate the role of lower dentures in the development of distally located stenoses of Wharton’s duct and to further identify contributing factors to this mechanism.
Ocular and adnexal anomalies in craniofacial microsomia: Type and prevalence in a multicentre cohort study
W.RooijersaR.W.RenkemaaS.E.LoudonbT.KhoshnawaB.L.PadwacD.J.DunawaydM.J.KoudstaalacdC.R.ForresteC.J.J.M.Carona
doi : 10.1016/j.ijom.2021.02.032
Volume 50, Issue 10, October 2021, Pages 1303-1311
The aim of this multicentre retrospective cohort study was to describe and categorize the types of ocular and adnexal anomalies seen in patients with craniofacial microsomia (CFM) and to determine their prevalence. In addition, the relationship between the OMENS-Plus and Pruzansky–Kaban classification for each patient and the presence of ocular anomalies was investigated. A total of 881 patients with CFM from four different craniofacial centres were included. Data on ocular anomalies were gathered from the patient charts. Ocular anomalies were present in 33.9% of patients. Four subgroups of ocular and adnexal anomalies were identified. Type I ocular anomalies were present in 22.2%, type II in 19.0%, type III in 18.4%, and type IV in 14.5%. Several potentially preventable and treatable ocular anomalies were identified. Higher OMENS-Plus classification orbit and soft tissue scores and Pruzansky–Kaban classification mandible scores were associated with an increased risk of ocular anomalies. Based on these results and the clinical implications ocular anomalies may have, we underline the importance of targeted ophthalmological screening in CFM. Healthcare professionals should be aware of the possibility of ocular anomalies in these patients, especially during the critical period for visual development.
Quantitative description of masseter muscle involvement in craniofacial microsomia
W.Han†X.Yang†X.ChenW.MooiZ.M.AungM.SunH.XuY.ZhangG.Chai
doi : 10.1016/j.ijom.2020.09.028
Volume 50, Issue 10, October 2021, Pages 1312-1319
Masseter deficits are common in craniofacial microsomia (CFM), however studies on masseter muscle involvement are limited. The aim of this study was to describe the morphology and functional involvement of the masseter muscles quantitatively. Ninety-eight patients with CFM who underwent three-dimensional computed tomography and surface electromyography were included. The mean action potential during maximum voluntary contraction in the intercuspal position was recorded. Asymmetry of the compound muscle action potential (ACMAP) was calculated as an indicator of functional involvement. Differences between the affected and unaffected sides, the correlation between morphology and function, and the relationship between ACMAP and the OMENS-Plus classification were assessed by paired t-test, Pearson correlation analysis, and Spearman correlation analysis. The masseter muscle was absent on the affected side in 11 patients. In the remaining 87 patients, the mean volumes of the affected and unaffected masseters were 5.22 ± 2.47 cm3 and 9.62 ± 3.30 cm3, respectively, with mean action potentials of 41.40 ± 28.52 uV and 73.78 ± 45.90 uV, respectively. Both morphology and the function of the masseter showed moderate correlation with the OMENS ‘M’ classification. No significant correlation was found between ACMAP and the OMENS-Plus soft tissue grading. A masseter function classification is proposed: type I, ACMAP < 0.2; type II, ACMAP 0.20–0.34; type III, ACMAP 0.35–0.54; type IV, ACMAP ? 0.55. The masseter function classification may be a beneficial tool in patients with CFM.
Effect of computer-assisted design and manufacturing cutting and drilling guides accompanied with pre-bent titanium plates on the correction of skeletal class II malocclusion: a randomized controlled trial
S.Liu1J.Li2C.Xu3H.Zhou3C.Liao3W.Fei3E.Luo1
doi : 10.1016/j.ijom.2021.01.023
Volume 50, Issue 10, October 2021, Pages 1320-1328
This study was performed to assess the effect of correcting skeletal class II malocclusion based on the application of computer-assisted design and manufacturing (CAD/CAM) cutting and drilling guides accompanied with pre-bent titanium plates. Fifty patients with skeletal class II malocclusion were recruited into this prospective randomized controlled clinical trial and assigned to two groups. Patients underwent bilateral sagittal split ramus osteotomy directed by CAD/CAM cutting and drilling guides accompanied with pre-bent titanium plates (group A) or CAD/CAM splints (group B). Postoperative assessments were performed. Differences between the virtually simulated and postoperative models were measured. Patients in both groups had a satisfactory occlusion and appearance. More accurate repositioning of the proximal segment was found in group A than in group B when comparing linear and angular differences to reference planes; however, no significant difference was revealed for the distal segment. In conclusion, CAD/CAM cutting and drilling guides with pre-bent titanium plates can provide considerable surgical accuracy for the positional control of the proximal segments in bilateral sagittal split ramus osteotomy for the correction of skeletal class II deformities.
A study of unfavorable splits in the sagittal ramus osteotomy with a short lingual cut
N.TomomatsuN.TakaharaK.NakakukiA.KimuraY.KurasawaM.TerauchiT.Yoda
doi : 10.1016/j.ijom.2021.02.024
Volume 50, Issue 10, October 2021, Pages 1329-1335
In the bilateral sagittal split osteotomy, a short lingual cut is made on the medial side of the ramus; however, in some cases, a true fracture occurs on the buccal side of the ramus. The purpose of this study was to evaluate the relationship between the splitting pattern of the mandible and the form of the mandible, the surgical technique used, and the postoperative occurrence of relapse after ‘unfavorable’ splits. The investigation examined 143 patients in whom a short lingual cut was attempted. The rate of unfavorable split was 14.7% (42/286). A strong correlation was observed between the reach of the lateral bone cut to the inferior border of the mandible and an unfavorable split. According to multivariate regression, the factors leading to an insufficient lateral bone cut were the degree of inward curvature of the ramus (P = 0.001) and the position of the lateral bone cut (P = 0.002). There was no significant difference in relapse between cases of unfavorable and normal splits. An unfavorable split does not affect the prognosis of the occlusion, but it is important to confirm the inward curvature of the ramus and set the position of the lateral bone cut adequately to avoid unfavorable splits.
The impact of a surgery-first approach on oral health-related quality of life
S.Vongkamolchoon12S.P.Sinha12Y.-F.Liao123Y.-R.Chen134C.S.Huang123
doi : 10.1016/j.ijom.2021.02.010
Volume 50, Issue 10, October 2021, Pages 1336-1341
Orthognathic surgery using a surgery-first approach (SFA) has been shown to result in better quality of life (QoL) throughout the treatment duration; however, the effects of gender, age and type of dentofacial deformity on SFA-related QoL remain unknown. In total, 228 consecutive patients underwent SFA for correction of dentofacial deformities (skeletal class III, bimaxillary protrusion and facial asymmetry). We assessed their QoL before surgery and at 1, 6 and 12 months after surgery using the Orthognathic Quality of Life Questionnaire (OQLQ). The results indicated a significant decrease in the total OQLQ, facial aesthetics and social aspect domain scores 1, 6 and 12 months after surgery. Among all domains, the greatest improvement was noted in the facial aesthetics domain. The oral function scores declined significantly immediately after surgery, but improved significantly 6 and 12 months after surgery; however, the awareness scores remained relatively stable. At each time point, women and the bimaxillary protrusion group exhibited a significantly higher total and specific domain scores. Patients aged 18–22 years exhibited lower total and four specific domain scores than older patients. Thus, QoL improves in all aspects, except awareness domain, by 12 months after SFA, but gender, age, and type of dentofacial deformity affect this improvement.
Intraoperative real-time navigation and intraoperative three-dimensional imaging for patient-specific total temporomandibular joint replacement
M.-T.Neuhaus123A.-N.Zeller13P.Jehn1B.Lethaus2N.-C.Gellrich1R.M.Zimmerer2
doi : 10.1016/j.ijom.2021.02.020
Volume 50, Issue 10, October 2021, Pages 1342-1350
Customized solutions for replacement of the temporomandibular joint (TMJ) along with surgical guides enable precise and fast transfer of the virtual plan to the patient. However, these guides lack information on screw vectors and length, and well-defined borders for bony resections towards the medial skull base. This retrospective study was performed to investigate the feasibility and benefit of real-time navigation and intraoperative three-dimensional imaging during total TMJ replacement (TJR), as well as patient clinical outcomes. Between 2016 and 2020, 26 customized prostheses were implanted in 21 patients either with or without real-time navigation and instrument tracking. The clinical, surgical, radiological, and navigational data were analysed. The accuracy of navigation registration with instrument tracking, precision of screw insertion, and implant and screw positions were analysed by fusion of the virtual plan and surgical outcome. Real-time navigation aided orientation during lateral skull base dissection and resection. However, the results of real-time navigation-aided drilling were inconclusive regarding vector and length control. At a mean 15.3 ± 3.0 months of follow-up, average mouth opening had improved from 21.69 ± 2.80 mm to 36.40 ± 1.25 mm; the average pain score decreased from 6.18 ± 0.74 to 1.06 ± 0.52. Thus, intraoperative real-time navigation for TJR assists lateral skull base dissection and resection.
Arthroscopic versus open disc repositioning and suturing techniques for the treatment of temporomandibular joint anterior disc displacement: 3-year follow-up study
A.Abdelrehem1aY.-K.Hu2aC.Yang2J.-S.Zheng2P.Shen2Q.-C.Shen3
doi : 10.1016/j.ijom.2021.02.018
Volume 50, Issue 10, October 2021, Pages 1351-1360
The aim of this study was to evaluate the outcomes of temporomandibular joint (TMJ) arthroscopic and open disc repositioning procedures in the management of anterior disc displacement (ADD). All consecutive patients treated with arthroscopic (group I) or open (group II) disc repositioning between April 2014 and August 2018 were included prospectively. The patients were assessed clinically (1, 3, 6, 12, 24, and 36 months postoperative) and with magnetic resonance imaging (MRI). The statistical analysis was performed using IBM SPSS Statistics v.22.0; P?<?0.05 was considered significant. A total of 177 patients (227 joints) were included: 104 patients (130 joints) in group I and 73 patients (97 joints) in group II. There were statistically significant improvements in pain score, clicking, quality of life, diet, and maximum inter-incisal opening when comparing pre- and postoperative clinical parameters within the two groups (P?<?0.05 at all time-points for all clinical parameters); however, improvements occurred earlier in group I (at 1 month) than in group II (6 months). Postoperative MRI revealed an overall success rate of 98.1% in group I and 97.3% in group II. New bone formation was found in 70.2% in group I and 30.1% in group II. Arthroscopy may be a better choice for ADD patients, with the advantages of faster clinical improvement and recovery, minimal invasiveness, and better condylar remodelling.
The effect of zirconia and titanium surfaces on biofilm formation and on host-derived immunological parameters
K.Kniha12N.Heussen3A.Modabber1F.Hölzle1S.C.Möhlhenrich4
doi : 10.1016/j.ijom.2021.01.021
Volume 50, Issue 10, October 2021, Pages 1361-1374
The aim of this study was to analyse the effect of zirconia and titanium surfaces on biofilm formation and host-derived parameters. Studies comparing zirconia and titanium surfaces were selected up to September 1, 2019. The outcome measures were surface roughness, contact angle, bacterial count, bacterial adherence, biofilm thickness, bacterial distribution, and specifically investigated biofilm and specific host-derived immunological parameters. Random-effects meta-analyses of in vitro and in vivo studies were conducted. A total of 39 studies were included for data extraction. In the systematic review data, 10 studies stated that zirconia accumulated less initial oral biofilm parameters, 16 investigations showed negligible inter-material differences, and only one study showed that zirconia attracted the most biofilm. However, in the meta-analysis, the bacterial coverage was found to be significantly superior for zirconia surfaces (P < 0.00001); the other outcome measures did not show any statistically significant differences between zirconia and titanium for the remaining parameters and the studies presented a substantial degree of heterogeneity. Overall, on the basis of the meta-analysis, the current data situation does not allow a clear preference for the use of zirconia or titanium.
Outcomes of osseointegrated implants in patients with benign and malignant pathologies of the head and neck: a 10-year single-centre study
D.Khadembaschi1S.C.Borgna2N.Beech2M.D.Batstone2
doi : 10.1016/j.ijom.2021.02.019
Volume 50, Issue 10, October 2021, Pages 1375-1382
The surgical management of head and neck pathologies involving the maxilla and mandible results in significant functional and aesthetic deficits, and ultimately reduced quality of life. Composite free flaps used for reconstruction address many of these deficits and create a foundation for the use of osseointegrated implants to support prosthetic replacement of the dentition. There are few comparative studies examining outcomes of implants in native and reconstructed bone in head and neck cancer patients. The aim of this retrospective cohort study was to compare survival rates and the effects of risk factors between implants placed in native and reconstructed bone. The Kaplan–Meier method estimated cumulative 1- and 5-year implant survival rates of 99.5% and 95% for native bone and 96% and 88% for reconstructed bone. Multivariate Cox regression found an increased risk of implant failure in reconstructed bone (hazard ratio (HR) 9.9, 95% confidence interval (CI) 3.4–29.7, P < 0.001). Subgroup analysis of the cohorts found an increased risk of failure in the reconstructed group associated with radiotherapy (HR 6.4, 95% CI 1.8–22.3, P = 0.004), current smoking (HR 23.2, 95% CI 2.7–198.6, P = 0.004), and previous smoking (HR 9.0, 95% CI 1.1–71.9, P = 0.038). There was no effect in the native bone group. Implants placed into reconstructed bone had higher rates of failure, and smoking status and radiotherapy increased the risk of implant failure.
Use of a stackable surgical guide to improve the accuracy of the lateral wall approach for sinus grafting in the presence of a sinus septum
K.N.Teixeira1M.A.Sakurada2A.G.Philippi2T.M.S.V.Gonçalves2
doi : 10.1016/j.ijom.2021.02.023
Volume 50, Issue 10, October 2021, Pages 1383-1385
The identification and management of interfering maxillary sinus septa is essential to anticipate and prevent membrane perforation and other complications during sinus grafting. A computer-guided sinus approach based on a new magnetic stackable surgical guide was planned, to transfer the exact position of the septum and optimize the positioning of the lateral access windows. This technique reduces the risk of sinus membrane injury, thereby increasing the safety and efficacy of the procedure.
Registration of magnetic resonance and computed tomography images in patients with oral squamous cell carcinoma for three-dimensional virtual planning of mandibular resection and reconstruction
M.Polfliet123M.S.Hendriks4J.-M.Guyader35I.ten Hove4H.Mast4J.Vandemeulebroucke12A.van der Lugt6E.B.Wolvius4S.Klein3
doi : 10.1016/j.ijom.2021.01.003
Volume 50, Issue 10, October 2021, Pages 1386-1393
The aim of this study was to evaluate and present an automated method for registration of magnetic resonance imaging (MRI) and computed tomography (CT) or cone beam CT (CBCT) images of the mandibular region for patients with oral squamous cell carcinoma (OSCC). Registered MRI and (CB)CT could facilitate the three-dimensional virtual planning of surgical guides employed for resection and reconstruction in patients with OSCC with mandibular invasion. MRI and (CB)CT images were collected retrospectively from 19 patients. MRI images were aligned with (CB)CT images employing a rigid registration approach (stage 1), a rigid registration approach using a mandibular mask (stage 2), and two non-rigid registration approaches (stage 3). Registration accuracy was quantified by the mean target registration error (mTRE), calculated over a set of landmarks annotated by two observers. Stage 2 achieved the best registration result, with an mTRE of 2.5 ± 0.7 mm, which was comparable to the inter- and intra-observer variabilities of landmark placement in MRI. Stage 2 was significantly better aligned compared to all approaches in stage 3. In conclusion, this study demonstrated that rigid registration with the use of a mask is an appropriate image registration method for aligning MRI and (CB)CT images of the mandibular region in patients with OSCC.
Levels of evidence and journal impact factor in oral and maxillofacial surgery: a 15-year follow-up
S.Nabil1N.Samman23
doi : 10.1016/j.ijom.2020.11.021
Volume 50, Issue 10, October 2021, Pages 1394-1399
This study was performed to assess changes over time in the quality of research in oral and maxillofacial surgery (OMS) by examining the level of evidence of published articles. A secondary aim was to determine the relationship of the journal impact factor to these levels of evidence. The four major OMS journals with an impact factor were assessed. Articles published in 2017 and 2018 were categorized based on their level of evidence, and their correlation with the 2019 journal impact factor was investigated using Spearman’s rank correlation coefficient (rho). The total number of published articles increased by a factor of 2.4 over a 15-year period, from 932 in 2002–2003 to 2253 in 2017–2018. The percentage of articles increased by 1.0% for level I evidence, 3.4% for level II, 8.2% for level III, and 4.1% for level IV. Non-evidence articles reduced by 16.7%. All journals showed an increase in impact factor, and a significant correlation was noted between the proportion of published higher-level evidence articles and the impact factor over time (rho = 0.811, P = 0.001). It is concluded that OMS journals currently display a higher proportion of good quality articles leading to a better impact factor than 15 years ago.
Ectomesenchymal chondromyxoid tumour on the lateral border of the tongue: some historical and clinical considerations
F.Ide12Y.ItoM.NishimuraK.Kikuchi
doi : 10.1016/j.ijom.2020.11.025
Volume 50, Issue 10, October 2021, Pages 1400-1401
Response to Letter to the Editor “Ectomesenchymal chondromyxoid tumour on the lateral border of the tongue: some historical and clinical considerations”
K.SakuraiK.NakamoriM.YamazakiJ.-i.Tanuma
doi : 10.1016/j.ijom.2020.11.026
Volume 50, Issue 10, October 2021, Page 1401
