Concordance Analysis of Lower Third Molar Surgery Classifications: A Comparative Study.

The high frequency and complexity of mandibular third molar (M3M) surgery have led several authors to the development of classification systems for better evaluation and management in oral surgery. This study compared the classifications of Juodzabalys and Daugela et al. (JD), Sammartino et al., Chang et al., Jhamb et al., Maglione et al., and Nemsi et al. to understand the concordance between the scores of M3M surgery. Two types of analysis were conducted: the relationship between the M3M and the inferior alveolar nerve (IAN), and the overall difficulty score based on the tooth's angulation and its spatial position with the adjacent structure. The analysis of the classifications on the relationship between M3M and IAN resulted in a concordance of 26.1%. In the pairwise comparisons, the classifications of Nemsi et al. and Jhamb et al. showed the highest concordance of 59.5%. Analyzing the total scores difficulty, the JD et al., Chang et al., and Sammartino et al. classifications demonstrated a concordance level of 25.5%. A pairwise assessment revealed a higher concordance degree between the classifications of Sammartino et al. and Chang et al. (57.4%). The results highlight the limits in establishing a comprehensive and objective classification for the surgical difficulty of M3M, possibly attributed to variations in the methodology for computing total scores. An objective, automated, and non-operator-dependent classification method for assessing the surgical difficulty of M3M is still needed.

Can different osteotomies have an influence on surgically assisted rapid maxillary expansion? A systematic review.

The purpose of this study was to systematically review the randomized and non-randomized clinical trials (RCT; nRCT) concerning the different available osteotomies for surgically assisted rapid maxillary expansion (SARME): pterygomaxillary disjunction (SARME + PD vs SARME-PD) and segmental Le Fort I osteotomy (2-piece vs 3-piece). Outcomes focused on skeletal, dental, upper airway changes, complications, and relapse. Two authors investigated five databases (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science) until August 2023. The Cochrane Collaboration Tool and the Newcastle-Ottawa scale were used for the quality assessment of the included RCTs and nRCTs, respectively. A total of 554 articles were retrieved and after duplicates removing and full-text reading, 40 studies were included. Two RCTs showed a low risk of bias, one an unclear risk and one a high risk. Among the non-RCTs, 15 studies showed a good quality, while 21 exhibited a fair quality score. SARME + PD resulted in more homogeneous posterior bone expansion, with minimal dental effects. No difference between 2-piece and 3-piece in asymmetric expansion was observed, although 3SO showed 1-2 mm of more transverse increase. The oropharynx minimum cross-sectional area, the nasopharynx and the oropharynx volume were greater in SARME + PD. Both dental and bone relapse can occur but no differences between the groups were observed. All osteotomies guaranteed a correction of transverse maxillary deficiency. Lower side effects were described in SARME + PD. Two-piece and 3-piece segmental Le Fort I osteotomies did not show any differences in the symmetry and amount of expansion.

Short- and Long-Term Effects of Maxillary Expander with Tongue Crib in Growing Open-Bite and Skeletal Class II Patients: A Retrospective Study.

The purpose of this study was to evaluate short- and long-term changes in growing patients with Class II malocclusion and open bite after rapid maxillary expansion (RME). A retrospective cohort study was conducted with 16 growing patients with open-bite malocclusion enrolled in a group treated with a rapid maxillary expander (RME) with a crib (TG), and 16 untreated patients with similar malocclusion in the control group (CG). Cephalograms were recorded before starting the treatment (T0), at the end of the latency phase (T1), and before the fixed therapy (T2) in order to analyze skeletal and dental changes in vertical, transversal, and sagittal relationships. Statistical analysis was performed with α = 0.05 as level of significance. At the end of the active expansion (T1), all subjects in the TG showed a corrected overbite with a statistically significant difference compared to the CG (p > 0.05). A significant decrease in jaw divergence was found in the TG compared to the CG (p < 0.05). At T2, all treated patients maintained a correct overbite. Statistical analysis revealed a significant decrease in maxillary, mandibular, and intermaxillary divergence in the TG compared to the CG (p < 0.05). This protocol could be effective in growing open-bite patients, showing a long-term decrease in facial divergence. The fixed crib allowed to normalize myofunctional activity.

Effect of Implant Macro-Design and Magnetodynamic Surgical Preparation on Primary Implant Stability: An In Vitro Investigation.

BACKGROUND: Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques in low-density bone. The parameters examined included peak insertion torque (PIT), implant stability quotient (ISQ), and peak removal torque (PRT). METHODS: Four groups of 34 implants each were identified in accordance with the surgery and implant shape: T5 group (Five implant and osteotomy using drills); M5 group (Five implant and magnetodynamic osteotomy using Magnetic Mallet); TT group (TiSmart implant and osteotomy with drills); and MT group (TiSmart implant and magnetodynamic osteotomy). Every implant was placed into a low-density bone animal model and scanned using CBCT. The PIT and PRT were digitally measured in Newton-centimeters (Ncm) using a torque gauge device. The ISQ was analyzed by conducting resonance frequency analysis. RESULTS: The PIT values were 25.04 ± 4.4 Ncm for T5, 30.62 ± 3.81 Ncm for M5, 30 ± 3.74 Ncm for TT, and 32.05 ± 3.55 Ncm for MT. The average ISQ values were 68.11 ± 3.86 for T5, 71.41 ± 3.69 for M5, 70.88 ± 3.08 for TT, and 73 ± 3.5 for MT. The PRT values were 16.47 ± 4.56 Ncm for T5, 26.02 ± 4.03 Ncm for M5, 23.91 ± 3.28 Ncm for TT, and 26.93 ± 3.96 Ncm for MT. Based on our data analysis using a t-test with α = 0.05, significant differences in PIT were observed between TT and T5 (p < 0.0001), M5 and T5 (p < 0.0001), and MT and TT (p = 0.02). Significant differences in the ISQ were found between TT and T5 (p = 0.001), M5 and T5 (p < 0.001), and MT and TT (p = 0.01). The PRT also exhibited significant differences between TT and T5, M5 and T5, and MT and TT (p < 0.0001). CONCLUSION: Our data showed favorable primary implant stability (PS) values for both implant macro-geometries. Furthermore, the magnetodynamic preparation technique appears to be more effective in achieving higher PS values in low-density bone.

Oral Health-Related Quality of Life and Mental Health Impairment in Patients Affected by Medication-Related Osteonecrosis of the Jaws: A Case-Control Pilot Study.

In the present case-control study, the impact of medication-related osteonecrosis of the jaws (MRONJ) on patients' oral health-related quality of life (OHRQoL), overall quality of life (QoL), and psychological status was evaluated using a set of questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14), the Short Form 36 Health Survey Questionnaire (SF-36), and the hospital anxiety and depression scale (HADS). A total of 25 MRONJ patients and 25 controls were included in the study. The results showed that MRONJ patients had a significantly poorer OHRQoL (OHIP-14 score p-value: 0.003) and lower general QoL, particularly in the domains of "physical functioning", "physical role", "body pain", "general health", and "vitality" in the SF-36 questionnaire (p-values: 0.001, 0.001, 0.013, 0.001, and 0.020). Although there were no significant differences between the groups in the SF-36 domains of "social functioning", "emotional role", and "mental health", the mean sub-scores of the HADS, specifically the depression and anxiety scores (HADS-D and HADS-A), were significantly higher in MRONJ patients (p-values: 0.002 and 0.009). However, the "mental health" domain of the SF-36 questionnaire showed a correlation with both HADS-A and HADS-D scores (p-values: 0.003 and 0.031). Therefore, a comprehensive clinical examination of MRONJ patients should include the assessment of OHRQoL, overall QoL, and psychological profile using different questionnaires. This approach aims to gather detailed information about patients' physical and psychological well-being, enabling the development of tailored treatments.

Oral Malignant Non-Hodgkin Lymphoma: A Retrospective Single-Center Study.

This study aimed to retrospectively evaluate the incidence of oral non-Hodgkin lymphoma (NHL) in patients referred to the Academic Hospital of the Magna Graecia University of Catanzaro from 2002 to 2020. A retrospective single-center study was performed. Patients with a histologically confirmed diagnosis of oral NHL were included. Demographic data and clinical parameters were digitally recorded, focusing on the NHL-specific localization and symptomatology. The study sample was evaluated by analyzing descriptive statistics with absolute and relative frequencies. A total of 26 patients with intraoral NHL were identified with a progressive increase in NHL occurrence during the observation period. Clinical manifestations included swelling/mass (80.7%), eventually associated with pain and ulcerations. The most common localizations were in soft tissues: buccal mucosa (38.4%), tongue (19.2%), gingiva (11.5%), cheek (11.5%). Oral NHL is rare. Clinical manifestations were unspecific, so a misdiagnosis could occur. The extranodal B-cell form of oral NHL, particularly diffuse large B-cell lymphoma, was the most common frequent oral NHL in this southern Italian population, with a progressively increased occurrence in almost 20 years.