Effect of platelet indices on postoperative pain and edema in bimaxillary surgery.

OBJECTIVES: To investigate the influence of platelet volume indices (PVI) on postoperative pain and edema in patients undergoing bimaxillary surgery and assessed the associations between PVI parameters and other clinical factors. METHODS: We examined the medical records of 50 patients aged 18-40, treated between 2019 and 2020. Platelet indices (platelet count [PLT]), mean platelet volume, platelet distribution width, plateletcrit (PCT), and platelet large cell ratio) were analyzed. Postoperative pain and edema were assessed based on the frequency of intravenous (IV) analgesic administration and 3D imaging. A lasso-penalized regression was used for the analysis. RESULTS: Significant positive correlations were observed between PLT and postoperative edema on the first (T1-0) and third (T3-0) postoperative days. Furthermore, PLT was positively associated with the number of IV analgesic drug administrations from 24 to 72 hours after surgery. Additionally, a discernible positive correlation was identified between PCT levels and the quantity of IV analgesic drugs administered within the first 24 hours after surgery. CONCLUSION: Platelet indices, particularly PLT and PCT levels, were associated with postoperative pain and edema in patients undergoing bimaxillary surgery. These indices have the potential to serve as biomarkers for predicting and managing postoperative complications of orthognathic surgery. Further studies are required to explore the clinical utility and implications of these findings.

Fractal analysis as a useful predictor for determining osseointegration of dental implant? A retrospective study.

PURPOSE: The present study aimed at evaluating the effectiveness of fractal analysis on determining the osseointegration of dental implants. MATERIAL AND METHODS: In a single center, retrospective clinical trial, patients with dental implants in the mandibular premolar/molar region, ASA I-II and < 65-year-old patients were included. Orthopantomograph (OPG) were taken before implant surgery (t0), within a week of surgery (t1), and 1 (t2) and 2 (t3) months after surgery, respectively. Three regions of interest (ROIs) from mesial, distal, and apical sites of the implants were chosen and fractal analysis (FA) was conducted with the box-counting algorithm using White and Rudolph's method. RESULTS: A total of 39 patients 19 women and 20 men, with a mean age of 52.2 years (52.3 and 52.1 years, respectively) were included. The mean, minimum and maximum values of mesial (roi1), distal (roi2), and apical (roi3) surfaces were compared. The fractal dimension (FD) values of t1 were significantly lower compared with t0 as they decreased during the first week. FD values gradually increased after the first week although never exceeded the FD values of t0. Also, difference between mean FD values of t0 and t3 were found statistically significant (p < 0.05). DISCUSSION: FA is a promising and noninvasive method to predict osseointegration of a dental implant based on dental radiographs, and it can help shorten the total treatment time.

Is Ultrasonic Bone Scalpel Useful in Le Fort I Osteotomy?

PURPOSE: Safety and precision are 2 main goals in research to improve bone cutting in maxillofacial surgery. The aim of this prospective clinical study was to analyze the outcomes using an ultrasonic bone scalpel versus a piezoelectric surgical device and the conventional technique in a Le Fort I osteotomy. MATERIALS AND METHODS: We designed a prospective, randomized, single-blind cohort study. The predictor variables were the devices used to perform the Le Fort I osteotomy, divided into 3 groups: 1) ultrasonic bone scalpel (BoneScalpel; Misonix, Farmingdale, NY), 2) piezoelectric surgical device, and 3) conventional technique (Lindeman burr and reciprocal saw). The primary outcome of the study was cutting time, whereas secondary outcomes were length of the procedure, total blood loss, intraoperative complications, and postoperative edema. Other variables of interest were age and gender. Data were analyzed using 1-way analysis of variance and the Kruskal-Wallis test. RESULTS: The study sample was composed of 34 patients with a mean age of 21.5 years, and 63.3% of patients were women. The mean cutting time (P < .001) and length of the procedure (P = .012) were significantly shorter with the bone scalpel than with the other types of surgery. The ultrasonic bone scalpel showed a significant reduction in intraoperative blood loss of up to 45% compared with the piezoelectric surgical device and the conventional technique (P = .038). CONCLUSIONS: The results of this study suggest that the ultrasonic bone scalpel is an effective ultrasonic bone-cutting instrument in a Le Fort I osteotomy as evidenced by the significant decrease in the cutting time, intraoperative blood loss, and postoperative edema compared with the other techniques.