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Objective: To investigate the effect of platelet-rich fibrin application on implant stability. Study design: Five databases, namely, PubMed, Embase, Web of Science, Wiley, and China National Knowledge Infrastructure, were searched for reports published up to November 20, 2022. Randomized controlled trials (RCT), including parallel RCTs and split-mouth RCTs, with at least 10 patients/sites were considered for inclusion. Results: After screening based on the inclusion criteria, ten RCTs were included. Low heterogeneity was observed in study characteristics, outcome variables, and estimation scales (I2 = 27.2%, P = 0.19). The qualitative and meta-analysis results showed that PRF increased the effect of implant stabilizers after implant surgery. Conclusions: The results of the present systematic review and meta-analysis suggest that PRF can increase implant stability after implant surgery. PRF may also have a role in accelerating bone healing and tends to promote new bone formation at the implant site.
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PURPOSE: As maxillofacial surgical techniques have advanced, vascularized bone free flap transplantation has become the standard treatment for repairing maxillofacial defects. In this meta-analysis, we summarize the survival rates of implants after VBFF surgery for maxillary and mandibular reconstructions and investigate the factors affecting patient outcomes. METHODS: The PubMed, Embase, and Wanfang databases were searched up to May 31, 2022. The results of the treatment effect are presented as the risk ratio or odds ratio, using 95% confidence intervals. Statistical significance was calculated at α = 0.05 (two-tailed z tests). RESULTS: 35 studies were included in our analysis. The results revealed a 3-year and 5-year implant survival rate of 95.2% and 85.4% in VBFFs, respectively. The location of jaw defects (maxilla or mandible) or timing of implantation was not found to have a statistically significant influence on the survival rate. However, statistically significant differences were observed in the failure of implants placed in irradiated bone tissue. CONCLUSIONS: Statistically significant differences were not found in the implant survival rate between simultaneous and delayed implantation, or between maxillary and mandibular defects. However, dental implants placed in irradiated flaps tended to have a lower survival rate than those surgically placed in non-irradiated flaps.
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Dental Implants , Free Tissue Flaps , Plastic Surgery Procedures , Humans , Free Tissue Flaps/surgery , Survival Rate , Mandible/surgeryABSTRACT
OBJECTIVES: This study aimed to compare the inhibition of anterior and posterior scars of the hard palate on maxillary growth after cleft palate surgery. METHODS: Ansys was used to establish two 3D finite element models of maxilla with complete and incomplete cleft palate. The palatal scar force with same magnitude and direction but different areas was applied in four groups in the two models. The loading force was applied to 1/4 of the anterior oral surface of the hard palate (group 1), 1/4 of the middle and anterior oral surface of the hard palate (group 2), 1/4 of the middle and posterior oral surface of the hard palate (group 3), and 1/4 of the posterior oral surface of the hard palate (group 4). The displacement of each group after loading was analyzed and compared. RESULTS: In the two models, maxillary deformation occurred in all groups. The total displacement and 3D displacement comparison of each group was arranged as follows: group 1>group 2>group 3>group 4. CONCLUSIONS: Scars from different parts of the hard palate after cleft palate surgery can inhibit maxillary growth in a 3D direction. The anterior scars have more serious inhibition than the posterior scars.
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OBJECTIVE: Parotidectomy is the most classic and unequivocal intervention for parotid neoplasm. The operative outcomes and postoperative complications of parotidectomy between harmonic scalpel and electrocautery gained more prominence in physician. In spite of much research work within the past years, there was an obvious lack of randomized controlled trial to resolve this question. Hence, a quantitative and qualitative meta-analysis was essential to evaluate the differences in these two types of hemostasis method. METHOD: The major electronic databases, including Pubmed, Embase, Cochrane library, Google Scholar, China National Knowledge Infrastructure and Chinese Scientific and Technological Journal databases were using the key words "electrocautery", "electrocoagulation", "harmonic scalpel", "ultrasonic scalpel", "ultrasonic dissector", "parotidectomy" and "parotid surgery". 9 articles were included in our systematic review and meta-analysis. The operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis were the outcome measures. Odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the effect size for categorical outcomes and mean differences (MDs) with 95% confidence intervals (CIs) for continuous outcomes. RESULTS: In our meta-analysis, there was a significant reduction in operation time [mean difference: -20.97; 95%CI=(-24.02,-17.92); P < 0.00001], intraoperative blood loss [mean difference: -20.75, 95%CI=(-22.32,-19.18); P < 0.00001], hospital stay [mean difference: -0.83; 95%CI=(-1.10,-0.57); P < 0.00001], salivary fistula [ORs: 0.30, 95%CI=(0.08,1.14)] and transient facial nerve paralysis [OR:0.33, 95%CI=(0.19,0.58),P = 0.0001] in harmonic scalpel group compared with electrocautery group. CONCLUSION: This meta-analysis indicated that compared with electrocautery, harmonic scalpel (HS)was transcendent in the aspects of operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis. The harmonic scalpel, as an efficient and useful instrument, was advocated in parotidectomy.
Subject(s)
Electrocoagulation , Surgical Instruments , Blood Loss, Surgical , China , Humans , Operative TimeABSTRACT
BACKGROUND: The purpose of this research was to determine whether neck dissection is necessary for the adenoid cystic carcinoma (ACC) of head and neck. MATERIALS AND METHODS: This article screened the abstract and full-text papers that investigated salivary gland primary ACC of head and neck. Two independent reviewers searched for articles published before October 2017 in three databases (Web of Science, PubMed, and Ovid), having no limits in date and language. Statistical data were analyzed statistically by Review Manager 5.3. RESULTS: In total, 18 studies involving 2993 patients were included in the analysis. Of the 2993 patients, 473 patients had cervical lymph node metastasis, with a merge frequency of 16% (95% CI: 13-19). Among included articles, only 4 involved cervical lymph node occult metastases, with a merge frequency of 14% (95% CI: 9-20). There were 5 articles containing minor salivary glands (MiSGs) involving 370 patients of which 92 patients had cervical lymph node metastases and the merge frequency was 25% (95% CI: 11-38). Moreover, there were 4 studies on major salivary glands involving 904 patients of which 158 patients had cervical lymph node metastases and the merge frequency was 17% (95% CI: 15-20). CONCLUSION: Elective neck dissection is unnecessary for all patients with salivary gland ACC of head and neck. Moreover, compared with major salivary glands, MiSGs have a higher cervical lymph node metastases rate in ACC. The overall cervical lymph node metastases rate of MiSGs is 25%, which is enough to attract our attention. Therefore, we suggest that neck dissection might be applied to ACC of MiSGs.
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PURPOSE: The aim of this study was to clarify whether level IIb dissection should be performed or avoided in the treatment of oral squamous cell carcinoma by meta-analysis. MATERIALS AND METHODS: Articles that were published before June 2017 were searched electronically in four databases (Web of Science, PubMed, Ovid and China National Knowledge Infrastructure) without any date or language restrictions by two independent reviewers. Abstracts and full-text papers which investigated the cervical metastases to level IIb from primary head and neck cancers and were deemed potentially relevant were screened. Data were analyzed using RevMan 5.3. RESULTS: Four hundred and fifty-five abstracts and 129 full-text papers were screened, and 22 studies were included in the analysis. Among the 2001 patients included, 112 patients had level IIb metastases, the pooled frequency of which was 6% (95% confidence interval [CI]: 4.0-7.0). Among the 400 patients with tongue squamous cell carcinoma from 12 studies, 37 patients had level IIb metastases, the pooled incidence of which was 7% (95% CI: 5.0-10.0). Metastases to level IIb always went together with level IIa, and only three patients were found to have isolated level IIb metastases without involving the other levels. CONCLUSION: Due to the low frequency of level IIb nodal metastases in oral squamous cell carcinoma patients and rare occurrence of isolated level IIb, level IIb dissection could be avoided when the primary lesions were in early stages (T1 and T2), with the exception of tongue cancer. It is recommended to dissect level IIb tongue cancers without considering the stages of primary lesions and the lymph nodes status. It is also suggested that level IIb dissection should be performed in patients preoperatively or intraoperatively found with multilevel neck metastasis, especially level IIa metastasis.
