Endoscopic-assisted intraoral approach for mandibular condyle fracture management: A systematic review and meta-analysis.

OBJECTIVE: Surgical innovation led to an endoscopic-assisted intraoral approach for managing condyle fractures. The purpose of this systematic review is to purview the role of the endoscope and determine the range of information, summarizing the evidence for the benefit of surgeons on an endoscopic-assisted intraoral approach. STUDY DESIGN: A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases for studies mentioning the endoscopic intraoral approach for managing mandibular condylar fractures. Outcomes include the role of the endoscope, challenges, adjunct armamentarium, duration, and complications associated with the transoral and transbuccal approach for screw fixation. The meta-analysis was conducted with prevalence estimates and standardized means using STATA. RESULTS: Thirty-nine studies were included. A 30° angulated, 4-mm-thick endoscope was the most commonly used endoscope. Two mini plates were most commonly used for fixation. Facial nerve weakness was higher in the transbuccal approach (1.24%) than in the transoral approach (0.8%). Pooled analysis (6 studies) showed that the duration of the surgical procedure was less in the transoral approach compared with the transbuccal approach for screw fixation. The bailout was 1.49%. CONCLUSIONS: The endoscopic-assisted intraoral approach is reliable for condylar fracture management. The transoral and transbuccal approaches can be used for screw fixation with comparable outcomes.

Role of iodoform in jaw lesions: a systematic review.

Iodoform formulations are used as packing material following the surgical removal of jaw lesions. The purpose of this review was to explore the evidence and efficacy of iodoform-based dressings. We have systematically reviewed published articles according to the PRISMA statement. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library database for articles mentioning the use of iodoform as dressing material for jaw lesions from January 2000 to March 2022. Finally, 92 studies were included. A total of 386 patients whose ages ranged from five months to 86 years (male n = 180, female n = 117). Different formulations of iodoform used were BIPP (n = 67), Whitehead's varnish (n = 17), iodoform (n = 7) and, iodine (n = 1) for its antiseptic properties. An iodoform impregnated gauze pack was changed once a week, most commonly, for a stipulated duration, until complete healing of the cavity. In the present review, iodoform was used, most commonly, in pathological cavities following surgical treatment of ameloblastoma and odontogenic keratocyst. Toxicity was reported in two studies. Based on the current review, iodoform is relatively safe and can be used in the management of extensive jaw lesions in which secondary healing is expected. Prospective and randomised control trials are recommended to assess the efficacy of various formulations and to delineate the timeframe for patient compliance.

Nonendoscopic intraoral approach for condylar fracture management-a systematic review.

OBJECTIVE: The recent trend favors the open reduction and internal fixation of condylar fractures to prevent long-term consequences. Nonendoscopic intraoral approach is an option for management without a visible scar. The purpose of this systematic review was to explore the evidence, armamentarium, methods of reduction and fixation, challenges, and complications. STUDY DESIGN: We have systematically reviewed published articles on the intraoral approach for condylar fracture management following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane library database, to find relevant articles from January 1980 to March 2022. Descriptive statistics were applied to obtain the results. RESULTS: Finally, 23 studies were included. The incision described for the intraoral approach was similar to sagittal split osteotomy in all studies. A wide array of specialized instruments, methods, and challenges has been outlined for visualization, reduction, and fixation. The incidence of complications in the entire review was 23% (72/306). CONCLUSION: The challenges encountered in the nonendoscopic intraoral approach for condylar fracture management can be negated with the use of specialized instruments and with experience. However, further research is warranted for a specialized set of miniature instruments to ease the procedure, make it time-efficient and optimize hardware selection.