Zygomaticomaxillary complex fractures: finding the least complicated surgical approach (A Randomized Clinical Trial).

BACKGROUND: Many approaches have been suggested for management of zygomaticomaxillary fractures. Each approach has its own advantages and limitations. AIM OF THIS STUDY: The study is intended to compare between the subtarsal approach, conventional transconjuctival approach and the Y- modification of the transconjuctival approach in the management of zygomatico-maxillay complex fractures. MATERIALS AND METHODS: Twenty-four patients with age range of 20-50 years requiring open reduction and fixation of a fractured zygomatic complex were randomly divided into three equal groups. Group A: subtarsal approach group, group B: a conventional transconjunctival approach group and group C: Y- modification of the transconjunctival approach group. Intraoperative and postoperative parameters were evaluated. RESULTS: As for the exposure time, group C had the longest duration. Easy access to the site of fracture was reached in all groups with no statistically significant difference. During the first 24 h, the pain was only statistically significant between groups A and B with higher pain level in group A. After the first week, pain was significantly higher in groups A and C, with respect to group B. The least edema was observed in group B after 24 h, one week and four weeks postoperatively. Regarding ocular complications, wound healing and sensory nerve function, there was no statistically significant difference between the groups. Scarring was only noticeable in group A patients. CONCLUSION: The transconjunctival approach provides adequate exposure with excellent esthetics and minor complications. The Y-modification also delivers an esthetic access with inconspicuous scar to the frontozygomatic region. TRIAL REGISTRATION: The trial has been registered on clinicaltrials.gov (ID: NCT05695872).

Comparison of Single Versus Multiple Low-Level Laser Applications on Bone Formation in Extraction Socket Healing in Rabbits (Histologic and Histomorphometric Study).

PURPOSE: This study evaluated the effect of low-level laser therapy (LLLT) on bone healing after tooth extraction in healthy rabbits and compared the effect between single and multiple doses of laser therapy. MATERIALS AND METHODS: Thirty-six New Zealand white male rabbits were randomly divided into 3 equal groups: a control (C) group, a single laser (SL) group, and a multiple laser (ML) group. The mandibular right first premolar was extracted. The SL group received a single dose of diode laser immediately after extraction. The ML group received a dose immediately after extraction and then every 72 hours for 12 days. The C group extraction sites were left untreated by laser. Eighteen animals were sacrificed at each of the experimental periods 3 and 6 weeks after extraction. The sockets were removed from the harvested mandibles and prepared for light microscopic examination and histomorphometric analysis. RESULTS: The SL and ML groups showed more bone formation and rapid maturation compared with the C group at 3 and 6 weeks postoperatively. At 6 weeks, the SL group showed the formation of compact bone. Furthermore, the ML group exhibited well-vascularized bone marrow spaces. Histomorphometric analysis showed an increase in the percentage of newly formed bone in the SL and ML groups compared with the C group. Moreover, the difference in the percentage of newly formed between the SL and ML groups was not statistically relevant. CONCLUSION: This rabbit model showed that single or multiple diode laser applications can be used to enhance bone formation after tooth extraction.