The use of Titanium Meshes in Surgical Closure of the Oroantral Fistula. A Randomized Clinical Trial Study.

The closure of oroantral communications (OACs) is challenging. The study aimed to assess the effect of titanium meshes in the outcome of OAC closure by local flaps. This is a prospective randomized, nonblinded clinical trial. Patients with a delay and large (≥7 mm 2 ) OAC were studied. Patients were randomly divided into 2 groups: in group 1, patients underwent OAC closure through a modified Rehrmann buccal advancement flap with a titanium mesh, and in group 2, the modified Rehrmann buccal advancement flap. The primary predictive factor was the use of titanium mesh. Dehiscence (the breakdown of the edge of flaps without the complete reopening of the defect) was a primary outcome. The defect's reopening was considered a secondary outcome. Nineteen patients in group 1 and 20 in group 2 were studied. In 2 months after treatments, the prevalence of dehiscence in group 1 was 3, and 10 patients in group 2 ( P =0.041). In group 1, patients did not show OAC exposure. However, OAC exposure was observed in 2 patients in group 2. This study demonstrates that using titanium mesh in combination with a modified Rehman flap decreases the prevalence of dehiscence compared with a flap alone.

Effect of Preoperative Anesthesia Consultation on Decreasing Anxiety in Patients Undergoing Oral and Maxillofacial Surgery.

STATEMENT OF THE PROBLEM: Preoperative anxiety is the subject of major concern for many patients. PURPOSE: The current study aimed at determining the effect of anesthesia consultation on decreasing anxiety in patients undergoing oral and maxillofacial surgery. MATERIALS AND METHOD: This randomized clinical trial was conducted on 250 patients undergoing different maxillofacial surgeries. The data collection instruments included a questionnaire containing the Spielberger state-trait anxiety inventory (STAI) and a researcher-made questionnaire with queries on the demographic characteristics and surgery-related information. Analysis of the data was performed in SPSS, using descriptive and inferential statistics. RESULTS: The findings showed that the majority of patients (38.4%) had moderate anxiety; there was no significant difference between the consultation and control groups in terms of age and gender. Also, the scores of state and trait anxiety were significantly lower in the consultation group, compared with the control group. CONCLUSION: The present results showed that preoperative anesthetic consultation reduced preoperative anxiety, compared with the control group. Our findings suggest that anesthetic counseling services should be provided for individuals experiencing high levels of stress.

Improved bone regeneration through amniotic membrane loaded with buccal fat pad-derived MSCs as an adjuvant in maxillomandibular reconstruction.

BACKGROUND: Human amniotic membranes (HAMs), as a biological membrane with healing, osteogenic, and cell therapy potential, has been in the spotlight to enhance the outcomes of treating bone defects. Present study aims to clinically assess the potential of HAM loaded with buccal fat pad-derived stem cells (BFSCs) as an osteogenic coverage for onlay bone grafts to maxillomandibular bone defects. MATERIALS AND METHODS: Nine patients with jaw bone defects were enrolled in the present study. The patients were allocated to two study groups: Iliac crest bone graft with HAM coverage (n = 5), and Iliac bone grafts covered with HAM loaded with BFSCs (n = 4). Five months following the grafting and prior to implant placement, cone beam computed tomography was performed for radiomorphometric analysis. RESULTS: The mean increase in bone width was found to be significantly greater in the HAM + BFSCs group (4.42 ± 1.03 mm versus 3.07 ± 0.73 mm, p < 0.05). Further, the changes in vertical dimension were greater in the HAM + BFSCs group (4.66 ± 1.06 mm versus 4.14 ± 1.03 mm, p > 0.05). CONCLUSION: Combined use of HAM with mesenchymal stem cells may enhance bone regeneration specifically in the horizontal dimension. Moreover, this methodology reduces the amount of harvested autogenous bone and diminish secondary bone resorption.

Response of Dental Pulp Stem Cells to Synthetic, Allograft, and Xenograft Bone Scaffolds.

Different degrees of clinical success have been reported for synthetic, allograft, and xenograft bone substitutes in human trials. Although these substitutes have been clinically investigated, their in vitro effects on cell differentiation remain unclear. Proliferation, differentiation, and attachment of dental pulp stem cells (DPSCs) to ß-tricalcium phosphate (ß-TCP), freeze-dried bone allograft (FDBA), and deproteinized bovine bone mineral (DBBM) were compared in this study. MTT assay, measurement of total DNA, and reverse transcriptase polymerase chain reaction were performed. ß-TCP had the highest potential for DPSC attachment and proliferation, while FDBA induced osteoblastic differentiation of DPSCs. Further in vivo investigations are necessary to select a clinically appropriate scaffold.

Limitation of Mandibular Movement: A Rare Case Report of Unilateral Zygomatico-Coronoid Interference.

INTRODUCTION: Zygomatico-coronoid interference is a rare type of mandibular extracapsular ankylosis. There is a lack of information on the treatment of these cases in the literature. Condylectomy and coronoidectomy are not always the best options for the treatment of limitations in mandibular movement. CASE PRESENTATION: A 51-year-old woman presented with mouth-opening limitation due to zygomatic bone displacement and interference with the coronoid process. The treatment plan was bilateral coronoidectomy through an intraoral approach and osteotomy of the right zygomatic arch through an extraoral incision. The patient was able to open her mouth to approximately 40 mm after surgery. The patient underwent physiotherapy during follow-up appointments. There was no relapse after three months of follow-up. CONCLUSIONS: This study shows that simultaneous arch osteotomy and coronoidectomy may be an appropriate treatment procedure for zygomatico-coronoid interference.

Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review.

CONTEXT: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. EVIDENCE ACQUISITION: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. RESULTS: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. CONCLUSIONS: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications.

Evaluation of neo-adjuvant, concurrent and adjuvant chemotherapy in the treatment of head and neck squamous cell carcinoma: a meta-analysis.

OBJECTIVE: Squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity. This study aims to evaluate different treatment procedures including neo-adjuvant, concurrent and adjuvant therapy in treating squamous cell carcinoma of the head and neck by a meta-analysis. MATERIALS AND METHODS: The authors searched all electronic databases (Medline, Embase and Cochrane) for all the articles published from 1970 to January 2011. Data of the evaluated treatment procedures (chemotherapy or radiotherapy), number of patients, publishing date and the authors' names have all been extracted from the articles and have been categorized in a table. RESULTS: Forty-six researches are included in this study. All three ways show that using chemotherapy after or with radiotherapy improves the vitality rate significantly (p-value< 0.01). CONCLUSION: It is concluded that after deciding not to perform a surgery for treating SCC, the recommended treatment plan is chemotherapy and radiotherapy simultaneously.

Evaluation of PKM2 and MAPK8IP2 Polymorphism in Ameloblastic Carcinoma: A Retrospective Quantitative Study.

Ameloblastic carcinoma (AC) is a rare malignant epithelial odontogenic tumor that histologically retains the features of ameloblastic differentiation and exhibits cytological features of malignancy in the primary or recurrent tumor. It may develop within a preexisting ameloblastoma or arise de novo or from an odontogenic cyst. Epidemiological evidence shows that human cancer is generally caused by genotoxic factors, genes involved in the susceptibility of cancer, including those involved in metabolism or detoxification of genotoxic environment and those controlling DNA replication. Nowadays, gene polymorphism has an important role in development of malignant tumor. We report a case series study of ameloblastic carcinoma and ameloblastoma to show the role of PKM2 and MAPK8IP2 polymorphisms in these tumors. The DNA was extracted separately from specimens in paraffin sections of the tumor. Polymorphism of these genes was determined by PCR-RFLP (Polymerase Chain Reaction-Restriction fragment length polymorphism) method. The allele distributions of all samples were in Hardy-Weinberg equilibrium. The genotype and allele distribution in these genes were not statistically different between patients and controls.