ABSTRACT
Objective: Le Fort I osteotomy (LF-IO) is widely used for the correction of dentofacial deformities, which may cause changes in the postoperative nasal septum (NS). The objective of this study was to evaluate the effects of LF-IO on the NS deviation and to determine whether the NS was affected by differences in the direction of maxilla movement. Materials and Methods: A retrospective study including 57 patients who underwent LF-IO and received cone beam computed tomography (CBCT) preoperatively and 6-12 months postoperative evaluation was performed. The NS angle of each patient was measured both pre- and postoperatively in the two coronal sections (nasion and ostium levels). The patients were divided into five paired groups and calculated. Group 1 to 4 were divided depending on the differences in the direction of maxilla movement (Group 1. Impaction ≥ 5 mm vs. Impaction < 5 mm; Group 2. Anterior movement vs. Non-anterior movement; Group 3. Impaction symmetry vs. Impaction asymmetry; and Group 4. Impaction vs. Inferior repositioning). Group 5 was divided as One-piece osteotomy vs. Multi-segmental osteotomy. Results: The mean NS angles at both nasion and ostium levels of all patients were significant increased after LF-IO. However, there were no statistical significant differences of the five paired groups. Conclusions: LF-IO osteotomy influenced increasing of the NS deviation at both the nasion and ostium levels. However, differences in the direction of the maxilla movement and maxilla segmentation showed no statistically significant changes.
ABSTRACT
Objectives: This retrospective study aimed to determine the angulation changes of the proximal segment following bilateral sagittal split osteotomy (BSSO) setback and its correlation with the amount of immediate postoperative surgical movement. The correlation between postoperative relapse of the distal and proximal segment at six months postoperatively was also evaluated. Materials and methods: The CBCT-generated lateral cephalometric images of 39 patients who underwent BSSO setback with or without Le Fort I osteotomy were evaluated preoperatively (T0), immediately postoperative (T1), and six months postoperatively (T2). Results: The mean surgical setback was 7.28 ± 4.45 mm at B point. The proximal segment's immediate postoperative mean posterior rotation was 2.13 ± 3.59 degrees. Six months after the operation, the mean distal segment relapse was 0.89 ± 3.03 mm at B point. The proximal segment relapse was 0.81 ± 1.63 degrees. A significant moderate correlation was found (P < 0.05) between the surgical movement and the immediate postoperative proximal segment rotation and between the surgical movement and the distal segment relapse. A significant correlation was found between the distal segment relapse and the average and left proximal segment relapse. There was no significant correlation between immediate postoperative proximal segment rotation and distal segment relapse. Conclusion: The immediate postoperative posterior rotation of the proximal segment had a negligible effect on mandibular relapse. The amount of surgical movement, on the other hand, was more related to distal segment relapse. The intraoperative proximal segment rotation should thus be minimized in cases with a significant surgical setback.
ABSTRACT
BACKGROUND: Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners. METHODS: Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores. RESULTS: A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were 2.5 ± 1.85 and 2.1 ± 1.8 while injecting and delivering local anesthesia, respectively. CONCLUSIONS: The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.
ABSTRACT
PURPOSE: To evaluate the host ß-globin gene fragment lengths in the cell-free peri-implant crevicular fluid (PICF) during the wound healing process. MATERIALS AND METHODS: Nineteen patients (25 implants) were recruited into this study. As part of the control group, gingival crevicular fluids (GCF) from healthy teeth were collected before implant placement. PICF specimens from each implant were collected during weeks 2 to 12 after implant placement. All GCF and PICF specimens were centrifuged to collect the supernatant as cell-free DNA. Five primer pairs specific to the ß-globin gene for amplifying 110-base pair (bp), 325-bp, 408-bp, 536-bp, and 2-kilo-base pair (kb) amplicons were used to evaluate DNA fragment lengths with conventional polymerase chain reaction (PCR). The longest PCR amplicon of each specimen was recorded. RESULTS: The number of 536-bp amplicons (10 of 25 implant specimens) and 2-kb amplicons (8 of 25 implant specimens) in week 2 was higher than at the other visits. In the study, the mucositis group showed the highest number of 536-bp amplicons (22 of 34 implant specimens) and 2-kb amplicons (12 of 34 implant specimens), whereas the healthy implant group showed a low number of 536-bp amplicons (3 of 66 implant specimens), and the cell-free PICF specimens had no 2-kb amplicons. Furthermore, 325-bp and 110-bp amplicons were similar in number in the control teeth and healthy implants. CONCLUSION: There was a difference in the number of the longest amplicons of cell-free PICF specimens between the mucositis and healthy implant groups. This pilot study suggests that the PCR amplicon lengths of ß-globin gene fragments in cell-free PICF specimens might be used as a biomarker to monitor soft tissue inflammation around implants.
