Clinical evaluation of bone quality of particulate cancellous bone and marrow, and implant prosthetic rehabilitation.

This study aimed to subjectively evaluate bone quality in the particulate cancellous bone and marrow (PCBM) graft area and to assess the survival rates of implants. A retrospective review was conducted based on patient age, sex, diagnosis, reconstructed site, number of implants, prosthetic type, and duration of follow-up. Images from computed tomography (CT) before implant insertion were obtained and used in this study. We selected a 4.0-mm diameter × 8.0-mm length region of interest in the implant placement area, and measured the CT attenuation value. No significant correlations were seen between CT attenuation values and implant survival rates in the maxilla and mandible. On the other hand, CT attenuation values and implant survival rates were significantly lower in patients with malignancy than in non-malignant cases. Placing implants in PCBM grafted bone requires a full understanding of bone quality before surgery and drilling to ensure primary stability, along with consideration of soft tissue management and maintenance programs.

Factors influencing delayed referral of oral cancer patients from family dentists to the core hospital.

Background/purpose: Most oral cancer (OC) cases are identified by family dentists in Japan. However, a significant number of patients with OC in Japan are referred to core hospitals at advanced stages. Therefore, identifying the factors that contribute to delayed referrals from family dentists to core hospitals is crucial for detecting OC in its earlier stages. The aim of this retrospective study was to identify the risk factors for referral delays from family dentists to core hospitals. Materials and methods: The study included 63 patients with OC who were referred by family dentists to the Yamagata University Hospital between 2010 and 2022. The clinical parameters related to referral delays were retrospectively investigated using letters of reference provided by the family dentists and patient charts. Backward multiple regression analysis was performed to identify the relationships between the length of referral delay and potential risk factors. Additionally, backward multivariate logistic regression analysis was performed to examine the independent association between referral delays of >4 weeks and several clinical parameters. Results: Multiple regression analysis revealed that misdiagnosis of malignant lesions by family dentists (P = 0.047) was significantly associated with longer referral delays. Additionally, misdiagnosis of malignant lesions by family dentists was also an independent risk factor for referral delays of >4 weeks (odds ratio, 10.387; P = 0.006). Conclusion: Misdiagnosis of malignant lesions by family dentists was a significant risk factor for referral delays from family dentists to core hospitals. Our results will motivate family dentists to improve their ability to diagnose OC.

Measures of oral health-related quality of life in patients with bone graft and implant prosthetic rehabilitation at the anterior of mandible/maxilla among young and middle-aged adults: a retrospective pilot study.

OBJECTIVES: Dental implants are believed to contribute to improved masticatory function and oral health-related quality of life (OHRQOL), but the details remain unclear. The aim of this study was to evaluate the clinical outcomes of dental implant prosthetic rehabilitation after bone graft at the anterior mandible/maxilla based on OHRQOL, particularly in young and middle-aged patients. METHODS: This retrospective study included 11 patients who received bone grafts at the anterior mandible/maxilla and dental implant surgery. Chewing function score and OHRQOL (using the Oral Health Impact Profile-14 questionnaire) were evaluated before and after completion of an implant-retained bridge or removable implant-supported denture. RESULTS: Chewing function score tended to improve slightly after dental implant prosthetic rehabilitation, but none of the observed differences were significant. In the assessment of OHRQOL, relatively worse domain scores before completion of dental implant prosthetic rehabilitation were seen for Functional limitation, Psychological discomfort, and Psychological disability. Conversely, Social disability seemed relatively unaffected by tooth loss. All domain scores and total scores for items other than Physical disability and Social disability were significantly improved after completion of dental implant rehabilitation. CONCLUSIONS: Tooth loss in the anterior region may not significantly affect chewing function score, but can have a significant impact on OHRQOL. Bone grafts and dental implant prosthetic rehabilitation can resolve these problems, and the results of this study will benefit both patients and medical professionals in terms of treatment planning and informed consent.

Evaluation of radiographic characteristics and surgical removal of 147 mesiodens.

The aim of this study was to evaluate the radiographic characteristics and surgical removal of mesiodens among patients who had attended the Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery of the Faculty of Medicine, Yamagata University. This study included 121 patients in the final analysis. We retrospectively reviewed medical records including patient age, sex, mesiodens number, direction, position, opportunity for detection, surgical approach and operating time. The 121 patients comprised 82 males and 39 females. Mean age was 7.6 ± 3.1 years (range, 4-35 years). The total number of mesiodens among these 121 patients was 147. Ninety-six patients had one mesiodens, 24 patients had two mesiodens and 1 patient had 3 mesiodens. Seventy-nine mesiodens were detected while taking X-rays for routine dental examination and/or orthodontic treatment at their family dental/orthodontic clinic. Mean operating time for removal of the 147 mesiodens was 32.2 ± 18.1 min. Among the 96 patients with one mesiodens, mean operating time for removal of the mesiodens was 30.7 ± 16.5 min. Operating time for removal of a mesiodens tended to be prolonged with increased distance from the alveolar crest. Early detection of mesiodens on routine radiographic check-ups and surgical planning considering patient age, crown direction, position of the mesiodens will contribute to improved treatment of mesiodens.

Association between the duration of antibiotic prophylaxis and surgical site infection after orthognathic surgery in Japan.

PURPOSE: This study aimed to evaluate the risk factors for surgical site infection (SSI) after orthognathic surgery, focusing on the duration of prophylactic antibiotic administration in Japan. STUDY DESIGN: The study included 181 patients who underwent orthognathic surgery at the Department of Oral and Maxillofacial Surgery of Yamagata University Hospital between 2012 and 2021. The clinical parameters of SSI were retrospectively investigated using patient charts. Logistic regression analysis was used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for risk factors for SSI after orthognathic surgery. RESULTS: Nineteen patients (10.5%) were complicated with SSI. Male sex (OR, 3.638; 95% CI, 1.316-10.058) and an antibiotic prophylaxis duration ≤3 days (OR, 12.718; 95% CI, 1.639-98.673) were independent risk factors for SSI after orthognathic surgery. CONCLUSION: Extended-term antibiotic prophylaxis was more effective for prevention of SSI after orthognathic surgery than short-term in this study.