Effects of NGF and Photobiomodulation Therapy on Crush Nerve Injury and Fracture Healing: A Stereological and Histopathological Study in an Animal Model.

Study Design: A stereological and histopathological study in an animal model. Objective: This study explores the effects of the nerve growth factor and photobiomodulation therapy on the damaged nerve tissue and fracture healing. Methods: A total of 24 rabbits were divided into 4 groups: control group (n = 5), nerve growth factor (NGF) group (n = 7), photobiomodulation (PBMT) group (n = 6), and nerve growth factor and photobiomodulation therapy (NGF+PBMT) group (n = 6). The vertical fracture was performed between the mental foramen and the first premolar, and the mental nerve was crushed for 30 seconds with a standard serrated clamp with a force of approximately 50 N in all groups. The control group received an isotonic solution (.02 mL, .09% NaCl) to the operation site locally. The NGF group received 1 µg human NGF-ß/.9% .2 mL NaCl solution for 7 days locally. The PBMT group received PBMT treatment (GaAlAs laser, 810 nm, .3 W, 18 J/cm2) every 48 hours for 14 sessions following the surgery. The NGF+PBMT group received both NGF and PBMT treatment as described above. After 28 days, the bone tissues and mental nerves from all groups were harvested and histologically and stereologically analyzed. Results: According to the stereological results, the volume of the new vessel and the volume of the new bone were significantly higher in the PBMT group than in other groups (P < .001). According to the histopathological examinations, higher myelinated axons were observed in experimental groups than in the control group. Conclusions: As a result, PBMT has beneficial effects on bone regeneration. Based on the light microscopic evaluation, more regenerated axon populations were observed in the NGF group than in the PBMT and PBMT + NGF groups in terms of myelinated axon content.

Comparison of the efficacy of occlusal splint and botulinum toxin therapies in patients with temporomandibular disorders with sleep bruxism.

PURPOSE: This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB). MATERIALS AND METHODS: A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1­, 3­, and 6­month follow-up were analyzed to evaluate the clinical outcomes. RESULTS: A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment (P > 0.05). CONCLUSIONS: Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain.

Cleft Palate Repair with Orbicularis Oris Plus Buccal Mucosal Flap: A New Double Layered-Technique.

Recurrent oronasal fistula closure is a challenging phenomenon that has been managed with many surgical or flap techniques, such as local, regional, and distant flaps, with various modifications. Despite these options, the ideal method to repair this kind of chronic fistula has not yet been established. It is difficult to repair because recurrent surgical repairs or interventions cause this region to become more fibrotic with less vascular tissue, which considerably reduces the likelihood of closing this kind of fistula. For this reason, surgeons and researchers continue to work to overcome these obstacles by using more regional, vascular, and neighboring tissue. Classic cleft palate repair techniques use double-layered, nasal, and oral side closure and even a three-layered technique (e.g. plus levator veli palatini and tensor veli palatini muscular repair) in the soft palate region. Hence, we used partial orbicularis oris muscle with enough vascular supply to repair the nasal side and cheek mucosal flap to repair the oral side as a double-layered repair technique. Two years later, during routine patient follow-up, no complications were identified, and the patient's satisfaction with this treatment was acceptable.

Ultrasonographic evaluation of changes in the thickness, width, elasticity index and echogenic pattern of the masseter muscle after mandibular set-back surgery.

INTRODUCTION: The masseter muscle is one of the structures that undergoes significant changes following jaw movements in orthognathic surgery. This study aims to investigate the effects of mandibular setback surgery, performed in patients with skeletal class III deformity, on the thickness, width, elasticity index, and echogenic pattern of the masseter muscle. MATERIAL AND METHODS: This prospective case-control study enrolled patients with class III deformity who underwent mandibular setback surgery, while the control group consisted of class I patients. The predictor variable was the time measured at two different points: preoperative (T1) and postoperative 6 months (T2). The primary outcome variable focused on changes in the internal echogenic pattern of the masseter muscle. Secondary, tertiary, and quaternary outcome variables included changes in the thickness, width, and elasticity index of the masseter muscle, respectively. Gender, age, type of operation, and amount of movement were considered as covariates. Ultrasonography was employed to evaluate the outcome variables. RESULTS: The study group comprised 31 patients, including 17 females (mean age 22.24 ± 3.52 years) and 14 males (mean age 23.14 ± 2.65 years). The control group consisted of 16 females (mean age 23.34 ± 1.22 years) and 15 males (mean age 23.12 ± 1.76 years). Masseter muscle thickness increased significantly after mandibular setback surgery (p = 0.015). However, there was no statistically significant difference in masseter muscle width before and after surgery (p = 0.627), nor in the elasticity index (p = 0.588). Furthermore, a statistically significant transformation from Type I to Type II was observed in the internal echogenic pattern of the muscle (p = 0.039). Additionally, there was no statistically significant correlation between the amount of mandibular movement performed and the changes in the masseter muscle. CONCLUSIONS: Mandibular setback surgery leads to changes in both the physical and structural properties of the masseter muscle.

Evaluation of the effect of changes in cephalometric values after orthognathic surgery on estimated age and facial aesthetics.

INTRODUCTION: The aim of this study is to examine the effects of changes in some cephalometric values on the changes in facial age and facial aesthetics scores after surgery in patients undergoing orthognathic surgery. MATERIAL AND METHODS: Preoperative and postoperative photographs of 50 patients who underwent bilateral sagittal split osteotomy and LeFort I osteotomy were evaluated by 189 evaluators. Evaluators were asked to look at the photographs and estimate the age of the patient and give a score between 0 and 10 for facial aesthetics. RESULTS: The mean age of 33 female patients was 22.84±0.81, while the mean age of 17 male patients was 24.52±1.21. Class 2 and Class 3 patients were affected at varying rates by changes in cephalometric values. There were also differences in the evaluation of full-face photographs and the evaluation of lateral profile photographs. The data obtained as a result of the analysis are summarized in the tables. CONCLUSIONS: Although the data of our present study presents the relationship between facial age and facial aesthetics and cephalometric analysis results with quantitative data, it has been concluded that the evaluation process of these parameters is quite complex and may not yield optimum results in clinical evaluation.

Effects of modified step Le Fort I advancement surgery on nostril area and inferior nasal structures volume in class III patients: a retrospective clinical study.

OBJECTIVE: The effect of the modified step Le Fort I osteotomy on the inferior nasal structures and the nostril area was evaluated. MATERIALS AND METHODS: This study included 24 patients who had modified step Le Fort I osteotomy. Inferior nasal concha volume (INCV), meatus nasi inferior volume (MNIV), the sum of both structures volume (TV), and nostril area (NA) were evaluated in pre- (T0) and postoperative (T1) periods. RESULTS: For all patients, NA increased both on the right side (p = 0.011) and left side (p = 0.050) after surgery. The INCV and TV values were lower in T1 than those in T0; however, a statistically significant decrease of INCV and TV was found only in the right side of males (p = 0.039 and p = 0.050, respectively). No significant difference was found in MNIV between T0 and T1 measurements (p > 0.05). CONCLUSION: Maxillary advancement with the modified step Le Fort I osteotomy technique increased the NA, which may have a positive effect on breathing function. On the other hand, although TV tended to decrease, MNIV did not change after surgery as the same decreasing tendency also existed in INCV. CLINICAL RELEVANCE: Step Le Fort I advancement surgery technique usually affects nasal structures positively regarding the nasal airway.

Evaluation of the detectability of early mandible fracture healing findings in terms of vitality aspect by using micro-CT technology in postmortem interval.

The purpose of the present study was to investigate the vitality aspect of mandibular fractures using micro-CT in the analysis of bone mineral density and other bone microstructure trabecular parameters in the postmortem interval. This study included 72 female Wistar rats. In the study groups, the rats' mandibles were first fractured and after three days of living, the rats were sacrificed. In the control groups, the rats were sacrificed first and then the mandibles were fractured. All rats were left for a natural putrefaction period according to their group's time as week-0, week-1, week-2, week-4, week-8, and week-12. All fractured hemi-mandibles were scanned by micro-CT and analyzed in terms of BMD and other bone trabecular microstructures. BMD and the other bone trabecular microstructures, such as bone volume, percent bone volume, trabecular separation, and trabecular pattern factor, showed statistically significant differences in both the study and control groups (p ≤ 0.05). There were statistically significant differences between the study and control groups in comparisons of BMD in groups 1, 2, 3, 4 and 5, bone volume and percent bone volume in groups 1 and 3, bone surface and bone surface density in group 6, trabecular separation in group 1, and trabecular number, trabecular pattern factor, and structural model index in group 6. Micro-CT scanning and analysis of BMD and other bone trabecular microstructure parameters for evaluation of vitality aspects of mandible fractures in the PMI has various valuable results that should provide guidance for possible studies in the future.