effect of barrier membranes on regeneration of bony defects in human and animal models a systematic review

Barrier membranes have been extensively used for bone regeneration. However their effectiveness is still under investigation. This review was designed to answer the following question: [Do barrier membranes affect the successfulness of bone graft/ bone substitute materials?]. Published articles were collected through hand and electronic searching in medline, embase and central databases. Controlled animal and human studies which had evaluated efficacy of membranes in defects other than periodontal lesion, extraction socket preservation and maxillary sinus graft, and had more than 4 weeks follow-up period were considered. Articles which had assessed membrane effect on oseointegration of implants, or had used osteoinductive materials in the bony defect were excluded. Meta-analysis was performed in the following groups: vertical bone augmentation, horizontal bone augmentation and eventful healing. Due to different outcome measurement, analysis was not done for horizontal bone augmentation. A total of 34 studies were selected. Meta-analysis of studies for vertical bone augmentation revealed that membranes may increase the amount of augmented bone [mean difference= 0.32 mm; P=0.006]. No statistically significant differences were observed among groups in case of eventful healing both in human [odds ratio- 5.67; P-0.32] and animal studies [odds ratio- 3.35; P=0.12]. Available evidence suggested that membranes might be useful for vertical bone augmentation. There was not strong evidence that membranes have an adverse effect on the healing process of the wound. More randomized clinical trials are necessary for applicable results

[Knife inflicted injury in cheek piercing through the throat [a case report]]

Penetrating Knife injuries to the maxillofacial region are quiet rare and infrequently reported. In these few reports knife involves various fossae: Orbit, Maxillary and etmoidal sinus, blood vessel or throat. It can cause hemorrhages, neurological lesions, visual acuity loss and fracture. The reported case is a 28 y/o man in whom a knife has penetrated from below the zygomatic arch crossing the intercondylar notch and coronoid, petrigoid plate and reach throat fossa without affecting vital structures such as skull, sinuses or main vascular branches. The approach to treatment and surgery plan should be V multidisciplinary. Surgical removal of complicated foreign body penetrations involving vital structures in maxillofacial region, is a very tender and sensitive approach. Knife specially endangers some important organs such as facial nerves and main vascular trunks. The knife was removed from the entrance wound in throat and no complications were observed either during or after surgery with any untoward sequelae