Determination of safety margin of nasal septum osteotomy for sphenoid sinus in cleft lip and palate patients.

BACKGROUND: Nasal septum osteotomy is used for separating the nasal septum and maxilla during a Le Fort I osteotomy. If this osteotomy is applied too high or is tilted into the nasal cavity, the sphenoid sinus and various adjacent vital structures may be damaged, and serious bleeding, neurological complications, blindness or even death may occur. The aim of this study is to determine the safety margin of the nasal septum osteotomy for sphenoid sinus during the Le Fort I surgery in cleft lip and palate (CLP) patients. METHODS: Twenty cleft lip and palate (the CLP group) and 20 healthy individuals (the control group) were included in this study. Three values (two lines and an angle) were measured by cone beam computed tomography (CBCT). The first line is the line passing through the junction of the spina nasalis anterior point and the lower point of the perpendicular lamina of the palatine bone. The undersired line is the line passing through the junction of the spina nasalis anterior point and the lower anterior border of the base of the sphenoid sinus. The osteotomy angle is the angle between these two lines. RESULTS: In the control group; a surgical line of 44.11-61.14 mm (mean 51.91 ± 4.32), an undesired line of 52.48-69.58 mm (mean 59.14 ± 5.08) and an angle of 18.22-27.270 (mean 22.66 ± 2.55) were found, while in the CLP group, a surgical line of 34.53-51.16 mm (mean 43.38 ± 4.79), an undesired line of 46.86-61.35 mm (mean 55.02 ± 3.24) and an angle of 17.60-28.810 (mean 22.60 ± 2.81) were found. CONCLUSIONS: Although the angle to the sphenoid sinus was not significantly affected by CLP, careful planning and consideration of these anatomical differences are crucial to prevent complications and ensure the safety of Le Fort I surgery in CLP patients. Further research with larger sample sizes and subgroup analysis of unilateral and bilateral CLP cases is needed to improve our understanding of these anatomical variations and improve surgical approaches to individuals with CLP undergoing orthognathic procedures.

Evaluation of complications and quality of life of patient after surgical extraction of mandibular impacted third molar teeth.

BACKGROUND: The aim of our study is to evaluate the postoperative complications after the extraction of impacted third molar teeth and to investigate the effects of these complications on the quality of life of patients. METHODS: Demographic, clinical, and radiological evaluations were conducted, covering factors like age, gender, and tooth position. Clinical measurements, pain and edema assessments, and quality of life evaluations through OHIP-14 scores were performed. Preoperative and postoperative mouth opening, trismus, alveolitis and dehiscence were evaluated. RESULTS: A total of 100 patients were included in our study. No significant gender-based differences were found in measurements, pain, or swelling. There was no statistically significant difference between the preoperative and postoperative results of difference A-C, difference B-E, difference A-D, and difference mouth opening. Procedure duration correlated positively with age, alveolar osteitis, trismus, and swelling. Postoperative quality of life, assessed by OHIP-14, demonstrated a negative correlation with age and trismus. It was observed that the gender and the tooth positions of the patients had no effect on the severity of postoperative pain and edema. CONCLUSIONS: As the age of the patients increases and the duration of the procedure increases, the rate of postoperative complications increases and it is concluded that the quality of life decreases significantly.

Determining the safety margin of mandibular lingula in sagittal split ramus osteotomy.

PURPOSE: The anatomical position of the lingula is clinically very important to prevent injuries during sagittal split ramus osteotomy. Our study aims to evaluate the localisation of the lingula by cone beam computed tomography (CBCT) and to compare the localisation of the lingula between malocclusion, gender, and lingula types. METHODS: A retrospective study was conducted to evaluate the shape and location of the lingula using CBCT. A total of 250 CBCT images were included in this study. The lingula was classified as nodular, assimilated, truncated, or triangular type. Six defined distances from the top of the lingula were measured: anterior border of the ramus (L-A), posterior border of the ramus (L-P), internal oblique ridge (L-IOR), mandibular notch (L-N), and distal surface of the mandibular second molar (L-M2) and occlusal plane (L-OP). The measured distances were compared between gender, malocclusion, and lingula types. RESULTS: The most common type of lingula was nodular (32.4%). The L-N, L-P, L-M2, and L-OP distances between genders were statistically higher in male patients than in female patients. The L-IOR, L-M2, and L-OP distances exhibited statistically significant differences found between malocclusions. No statistically significant difference was found when the distances of the lingula to the anatomical points were compared between the lingula types. CONCLUSION: These variations in positioning of the lingula depending on the dysmorphoses are developing towards a systematic 3D examination before any mandibular osteotomy to precisely visualize the position and shape of the lingula.

The Comparison of Dental Anxiety between Patients Treated with Impacted Third Molar Surgery and Conventional Dental Extraction.

BACKGROUND: The aim of the present study is to compare the dental anxiety levels between two outpatient clinics. METHODS: Two hundred and seventy patients treated in two different clinics of minor oral surgery and dental extraction polyclinic in the Dental Faculty of Eskisehir Osmangazi University were included in the study. The impacted third molar surgery group and conventional dental extraction group consisted of 101 and 169 patients, respectively. The Modified Dental Anxiety Scale (MDAS) and Dental Fear Scale (DFS) were used to measure anxiety levels in patients treated in both clinics. Tests were made in an isolated room preoperatively. The differences in anxiety levels according to education status and gender were also evaluated. RESULTS: The impacted third molar surgery group showed a significant increase in dental anxiety measured with DFS questionnaire (p < 0.05). However, MDAS revealed that there was no difference between anxiety levels between the impacted third molar surgery and conventional dental extraction groups (p > 0.05). There was also no difference in anxiety levels between patients with different education status (p > 0.05). Female patients demonstrated higher levels of anxiety in both MDAS and DFS indexes (p < 0.05). CONCLUSION: Dental anxiety may be higher in patients treated with impacted third molar surgery compared with conventional dental extraction. The education status of patients may not affect dental anxiety. Female patients may show increased levels of dental anxiety in conventional dental and impacted third molar extractions.

Two-Dimensional Change in the Cystic Defects after Decompression and Enucleation of Jaw Cysts - A Comparative Study.

Introduction: To compare the treatment methods of enucleation and decompression with regards to reduction of the dimension of the cystic defect with the aid of a software program. Materials and Methods: Thirty patients with regular controls of 3, 6, and 12 months treated between January 1, 2013, and January 1, 2021, were selected and included in the study. Sixteen patients were treated with enucleation and 14 patients with decompression. All preoperative and control radiographic and clinical data were retrieved from the archives. The area measurement of cystic cavities was made on panoramic radiographs taken at preoperative (T0), 3-month (T1), 6-month (T2), and 12-month (T3) control periods with a software program. Intra-group and inter-group analyses were made to compare the reduction of cystic defects between two treatment methods. Results: The mean age of study patients was 45.2 ± 7.3. Eighteen of them were male and 12 of them were female. Statistically, a significant difference was not observed between decompression and enucleation groups at T0, T1, T2, and T3 control periods (P > 0.05). There was a statistically significant difference in the defect dimensions between all control periods in both decompression and enucleation groups (P < 0.05). Discussion: Decompression and enucleation of jaw cysts are both successful in reducing cystic cavities. However, there is no superiority between the two treatment modalities regarding the defect reduction at the 12-month control period.