ABSTRACT
Removal of miniplates is a controversial topic in oral and maxillofacial surgery. Originally, miniplates were designed to be removed on completion of bone healing. The introduction of low profile titanium miniplates has led to the routine removal of miniplates becoming comparatively rare in many parts of the world. Few studies have investigated the reasons for non-routine removal of miniplates and the factors that affect osteosynthesis after osteotomy in large numbers of patients. The aim of the present study was to investigate complications related to osteosynthesis after bilateral sagittal split osteotomy (BSSO) in a large number (n=153) of patients. In addition to the rates of removal, emphasis was placed on investigating the reasons and risk factors associated with symptomatic miniplate removal. The rate of plate removal per patient was 18.6%, the corresponding rate per plate being 18.2%. Reasons for plate removal included plate-related complications in 16 patients and subjective discomfort in 13 patients. Half of the plates were removed during the first postoperative year. Smoking was the only significant predictor for plate removal. Patients undergoing orthognathic surgery should be screened with regard to smoking and encouraged and assisted to cease smoking, at least perioperatively.
Subject(s)
Bone Plates/adverse effects , Device Removal , Jaw Fixation Techniques/instrumentation , Mandible/surgery , Orthognathic Surgical Procedures/instrumentation , Smoking/adverse effects , Adolescent , Adult , Bone Plates/psychology , Chi-Square Distribution , Equipment Failure , Female , Humans , Logistic Models , Male , Middle Aged , Osteotomy/instrumentation , Retrospective Studies , Risk Factors , Surgical Wound Infection/etiology , Surgical Wound Infection/surgery , Titanium , Young AdultABSTRACT
An asymptomatic cystic lesion in the corpus region on the right side of the mandible was detected in a panoramic radiograph of a 13-year-old girl, taken for orthodontic reasons. MR examination revealed a cavity filled with fluid and thin-rim peripheral contrast enhancement of the lesion similar to an odontogenic cyst lined with epithelium. The clinical and histological diagnosis of the lesion was a simple bone cyst. This report demonstrates the confounding similarity of the MR findings of a simple bone cyst to an odontogenic cyst.
Subject(s)
Jaw Cysts/diagnostic imaging , Mandibular Diseases/diagnostic imaging , Adolescent , Biopsy , Contrast Media , Diagnosis, Differential , Female , Gadolinium , Humans , Image Enhancement/methods , Jaw Cysts/pathology , Magnetic Resonance Imaging/methods , Mandibular Diseases/pathology , Meglumine , Odontogenic Cysts/diagnosis , Odontogenic Cysts/pathology , Organometallic Compounds , Radiography, PanoramicABSTRACT
Oral lichen planus (OLP) carries a very small probability of becoming malignant. Our Finnish series comprised eight patients suffering from OLP and concurrent or subsequent oral squamous cell carcinoma over a 10-year period. The mean interval between the histologically suggested initial diagnosis of OLP and carcinoma was 3.4 years. An oral ulcer as a clinical manifestation of malignant change appeared in seven of these eight patients; five of the eight died of carcinoma on average 13 months (range 7-20) after the final squamous cell carcinoma diagnosis. These eight patients were compared to eight control OLP patients without malignant transformation matched as to follow-up time, age, gender, sites of the lesions, etc. We could discover no histological features leading to malignant development. However, the clinically unilateral atrophic/erosive type of OLP more often preceded the malignant change, compared to the situation for control patients, in whom the most prevalent type was the bilateral reticular OLP. However, the probability seems to be very small.
