Ameloblastoma is the most common among all oral cavity neoplasms. It is benign and happens because of a genetic malfunction of the cells responsible for the enamel, called ameloblasts. These tumors ...may occur in any place of the oral cavity, and often present quick growth. Surgery is the main course of treatment, seeking full tumor excision. Surgery may be associated with chemotherapy or radiation. This paper aims to report a case of bilateral total mandibulectomy of a patient with ameloblastoma. The patient had no previous medical history and had a large jaw tumor that caused sialorrhea with blood streaks, cachexia, problems with mouth occlusion, pain and anemia. Left total mandibulectomy was the first-choice treatment, but a right partial mandibulectomy was needed afterwards. However, 2 other reinterventions were necessary, which led to total bilateral mandibulectomy. In conclusion the chosen procedure was effective in bringing quality of life and well-being to the patient.
Dentre as neoplasias de cavidade oral a mais frequente é o ameloblastoma, uma neoplasia benigna de origem odontogênica, derivada da disfunção genética de células responsáveis pela síntese do esmalte dentário, os ameloblastos. Estes tumores podem ocorrer nas mais diversas localidades da cavidade oral e, habitualmente, possuem características de evolução rápida. O principal tratamento baseia-se na exérese tumoral cirúrgica associada ou não a tratamentos adjuvantes como a radioterapia ou quimioterapia. Este trabalho tem como objetivo relatar um caso de mandibulectomia total bilateral com diagnóstico de ameloblastoma. O paciente chegou sem histórico anterior com massa mandibular de grandes proporções e apresentando sialorreia com estrias de sangue, caquexia, dor, dificuldade em ocluir a cavidade oral e anemia. Inicialmente foi realizada mandibulectomia total esquerda e parcial direita, em seguida necessitou de duas reintervenções culminando em mandibulectomia total bilateral, concluiu-se que o procedimento estabelecido foi eficaz como tratamento, trazendo melhor qualidade de vida, conforto e bem-estar ao paciente.
ABSTRAK Pendahuluan: Penggunaan plat rekonstruksi setelah tindakan reseksi mandibula adalah hal yang umum digunakan pada kasus tumor rongga mulut. Komplikasi ekspos plat pada pasien dengan penggunaan ...plat rekonstruksi tanpa adanya bone graft cukup tinggi sekitar 20%. Fasciocutaneous advancement flap adalah teknik yang dapat digunakan untuk merekonstruksi dan memperbaiki defek jaringan lunak pada rekonstruksi plat. Teknik ini sederhana, singkat dalam proses pembedahan dan perawatan pasca operasi yang mudah untuk dokter dan pasien. Tujuan laporan kasus ini adalah melaporkan rekonstruksi defek plat mandibula dengan fasciocutaneous advancement flap. Laporan kasus: Pasien laki-laki 44 tahun datang ke rumah sakit dengan ekspos plat sejak 1 bulan sebelum masuk rumah sakit. Pasien riwayat dilakukan hemimandibulektomi 1 tahun yang lalu dengan diagnosis calcifying epithelial odontogenic tumor dan direkonstruksi menggunakan protesa condyle dan rekonstruksi plat. Perawatan yang dilakukan meliputi debridemen dan fasciocutaneous advancement flap untuk menutup defek ekspos plat rekonstruksi. Simpulan: Rekonstruksi defek plat mandibula dengan fasciocutaneous advancement flap dapat memberikan hasil yang baik, proses pembedahan yang singkat dan sederhana. Kata kunci: ekspos plat; fasciocutaneous advancement flap; rekonstruksi mandibula ABSTRACT Introduction: The use of a reconstruction plate after mandibular resection is common in cases of oral tumours. Complications of plate exposure in patients using a reconstructed plate without a bone graft are quite high, around 20%. Fasciocutaneous advancement flap is a technique used to reconstruct and repair soft tissue defects in plate reconstruction. This technique is simple, short in surgery, and easy for postoperative care for doctors and patients. This case report aims to present the reconstruction of the mandibular plate defect with a fasciocutaneous advancement flap. Case report: A 44-year-old male patient came to the hospital with plate exposure one month before hospital admission. The patient had a history of hemimandibulectomy one year prior with a calcifying epithelial odontogenic tumour diagnosis and was reconstructed using a condyle prosthesis and plate reconstruction. Treatment includes debridement and a fasciocutaneous advancement flap to cover the exposed defect of the reconstruction plate. Conclusion: Reconstruction of the mandibular plate defect with a fasciocutaneous advancement flap can give good results with a brief and simple surgical process. Keywords: plate exposure; fasciocutaneous advancement flap; mandibular reconstruction
The aim of the study is to evaluate pharyngeal airway dimensions and hyoid bone position according to different Class II malocclusion types in Turkish population. Materials and Methods: The ...retrospective clinical study consisted of patients divided into 3 subgroups with skeletal Class II malocclusion. A total of 221 individuals (131 females and 90 males) were included in the study. Individuals with skeletal Class II malocclusion were divided into three subgroups as maxillary prognathia, mandibular retrognathia and combined. In the cephalometric analysis; 8 nasopharyngeal, 7 oropharyngeal, 2 hypopharyngeal, 9 hyoid measurements and 4 area measurements were used. The distribution of sex and growth-development stages of the patients were compared with the Pearson chi-square test. One-way ANOVA was used to evaluate patients. Tukey Post-Hoc tests were used for bilateral comparisons for significant parameters. SPSS package program was used for data analysis. Results were considered statistically significant at p<0.05 significance level. Results: According to findings, there was no significant difference between the groups in nasopharyngeal airway and area measurements (p>0.05). When the position of the hyoid bone was evaluated, a statistically significant difference was found between the three groups in the measurements of Hy-Pg (mm) (p<0.05). Conclusion: Linear and areal nasopharyngeal airway dimensions are similar in subgroups of Class II malocclusions, while the distance of the hyoid bone from the pogonion is less in the mandibular retrognathia group.
El objetivo del estudio es evaluar las dimensiones de las vías respiratorias faríngeas y la posición del hueso hioides según los diferentes tipos de maloclusión de clase II en la población turca. Materiales y métodos: El estudio clínico retrospectivo consistió en pacientes divididos en 3 subgrupos con maloclusión esquelética de Clase II. Un total de 221 individuos (131 mujeres y 90 hombres) fueron incluidos en el estudio. Los individuos con maloclusión esquelética de Clase II fueron divididos en tres subgrupos como prognatismo maxilar, retrognatismo mandibular y combinados. En el análisis cefalométrico se utilizaron 8 medidas nasofaríngeas, 7 orofaríngeas, 2 hipofaríngeas, 9 medidas hioides y 4 medidas de área. La distribución del sexo y las etapas de desarrollo del crecimiento de los pacientes se compararon con la prueba de chi cuadrado de Pearson. Se utilizó un ANOVA unidireccional para evaluar a los pacientes. Las pruebas Tukey Post-Hoc se usaron para comparaciones bilaterales de parámetros significativos. El programa del paquete SPSS se usó para el análisis de datos. Los resultados se consideraron estadísticamente significativos a un nivel de significación p<0,05. Resultados: De acuerdo con los hallazgos, no hubo diferencias significativas entre los grupos en las mediciones de las vías respiratorias nasofaríngeas y el área (p>0.05). Cuando se evaluó la posición del hueso hioides, se encontró una diferencia estadísticamente significativa entre los tres grupos en las mediciones de Hy-Pg (mm) (p<0.05). Conclusión: Las dimensiones de las vías respiratorias nasofaríngeas lineales y areales son similares en los subgrupos de maloclusiones de Clase II, mientras que la distancia del hueso hioides al pogonion es menor en el grupo de retrognacia mandibular.
ABSTRAK Pendahuluan: Fraktur kondilus dan Korpus mandibula merupakan fraktur pada mandibula yang cukup sering terjadi pasca trauma. Komplikasi yang sering terjadi akibat fraktur kondilus dan korpus ...mandibula pada anak adalah ankilosis dan gangguan sendi sendi temporomandibula. Perawatan fraktur mandibula dapat dengan reduksi terbuka atau reduksi tertutup. Penanganan fraktur secara sederhana dan teknik yang tepat dapat mencegah komplikasi lebih lanjut. Tujuan laporan kasus ini memaparkan dan membahas penatalaksanaan kegawatdaruratan pada pasien remaja yang menderita fraktur kondilus dan korpus mandibula dengan reduksi tertutup. Laporan kasus: Pasien perempuan usia 16 tahun datang ke Rumah Sakit Gigi dan Mulut Unpad dengan keluhan perdarahan dari mulut dan sulit membuka mulut akibat kecelakaan lalu-lintas. Pemeriksaan klinis dan radiografis menunjukan adanya fraktur kondilus bilateral dan fraktur korpus mandibula. Pasien dilakukan pembersihan dan penjahitan luka, perawatan fraktur kondilus dengan reduksi tertutup dan fiksasi maksilomandibular dengan arch bar. Kontrol pada minggu ke 12 menunjukkan hasil perbaikan. Simpulan: Penatalaksanaan fraktur kondilus dan Korpus mandibula dengan reduksi tertutup yang tepat menunjukkan hasil yang memuaskan secara anantomi dan fungsi pada saat penatalaksaan kedaruratan trauma. Kata kunci: fraktur kondilus bilateral; fraktur korpus mandibula; reduksi tertutup; fiksasi maksilomandibular ABSTRACT Introduction: Condyle and mandibular corpus fractures are quite common post-trauma mandibular fractures. Complications that often occur due to condyle and mandibular corpus fractures in children are ankylosis and temporomandibular joint disorders. Mandibular fractures can be treated with open reduction or closed reduction. Simple fracture management and proper technique can prevent further complications. This case report aimed to present and analyse the emergency management of condyle and mandibular corpus fractures in an adolescent patient with closed reduction. Case report: A 16-year-old female patient came to Universitas Padjadjaran Dental Hospital with complaints of oral bleeding and mouth-opening difficulty due to a traffic accident. Clinical and radiographic examination revealed bilateral condylar and mandibular corpus fractures. The patient was cleaned and sutured, treated for condylar fractures with closed reduction and maxillomandibular fixation with arch bars. The improvement showed at the control visit after 12 weeks. Conclusion: Management of condylar and mandibular corpus fractures with properly closed reduction showed satisfactory anatomical and functional results. Keywords: bilateral condyle fracture; mandibular corpus fracture; closed reduction; maxillomandibular fixation
Craniomaxillofacial bone defects represent a clinical challenge in the fields of maxillofacial surgery and (implant) dentistry. Regeneration of these bone defects requires the application of bone ...graft materials that facilitate new bone formation in a safe, reliable, and predictive manner. In addition to autologous bone graft, several types of (synthetic) bone substitute materials have become clinically available, and still major efforts are focused on improving such bone substitute materials by optimizing their properties. Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal. As examples of bone substitute materials, we utilize both the clinically used BioOss granules and an experimental calcium phosphate cement for filling the created defects. Regarding the latter, its advantages are the injectable application within the defect site, in which the material rapidly sets, and the tailorable degradation properties via the inclusion of hydrolytically degrading polymeric particles. For both bone substitute materials, we show the suitability of the bone defect model to assess bone regeneration via histology and micro-computed tomography. Impact statement Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to the human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal that can be used for the evaluation of the bone regenerative capacity of new bone grafting materials as well as tissue-engineered products for alveolar bone regeneration.
Objectives
Vascularized fibula flap transplantation is the most effective and common method to repair the jaw defects. In addition, implantation is the first choice to restore dentition on the graft ...fibula. Implants are usually implanted at least 6 months after fibula transplantation. Primary implantation of implants during surgery can restore the dentition earlier, but whether this method can achieve the same restorative effect as secondary implantation is still uncertain. This article aims to compare the survival rate and complications between primary and secondary implantation through meta-analysis.
Methods
This meta-analysis was conducted according to PRISMA protocol and the Cochrane Handbook of Systematic Reviews of Interventions. According to the inclusion and exclusion criteria, we selected the PubMed, Embase, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM) according to established inclusion and exclusion criteria. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. Meta-analysis was conducted to compare the survival rate and postoperative infection rate of primary and secondary implantation.
Results
Seven studies were involved in our research, involving 186 patients. Five of the studies detailed implant success in 106 patients (primary implantation 50, secondary implantation 56), and four studies documented infection after implantation in 117 patients (primary implantation 52, secondary implantation 65); the survival rate of the primary implantation was 93.3%, and the incidence of postoperative infection was 17.3%. The survival rate of the secondary implantation was 93.4%, and 23.1% had postoperative infection. Meta-analysis showed that there was no significant difference in the survival rate between primary implantation and secondary implantation, OR = 0.813 (95% CI 0.383–1.725,
P
= 0.589 > 0.05), and there was no significant difference in the incidence of postoperative infection, OR = 0.614 (95% CI 0.239–1.581,
P
= 0.312 > 0.05).
Conclusions
Based on the results of this study, the research found no significant difference in the survival rate or infection rates between primary and secondary implantation. After appropriate indications selection, primary implantation can be used to reconstruct the dentition with less waiting time, reduce the impact of radiotherapy, and bring a higher quality of life for patients.
The inability to differentiate skeletal remains belonging to the ferret from those of its wild ancestor, the European polecat, presents a particular challenge for zooarchaeologists which currently ...hinders a better understanding of ferret domestication history. Using a geometric morphometric approach on the mandible, this study provides a new method to distinguish the two forms. Despite a small sample size and some overlap in the dataset, this method allowed the identification of a (post)medieval specimen from Mechelen (Belgium) as a wild polecat. Results demonstrate that ferrets can largely be distinguished from polecats based on mandibular morphology.
Pendahuluan: Beberapa tahun terakhir, hubungan antara cervical vertebral maturation (CVM) dengan pertumbuhan mandibula yang dinilai melalui panjang mandibula mendapat perhatian. Pemahaman mengenai ...pertumbuhan dan perkembangan kraniofasial pasien sangat penting dalam membantu menegakkan diagnosis, merencanakan perawatan, dan keberhasilan perawatan ortodonti. Waktu perawatan ortodonti berhubungan dengan keparahan dan tipe maloklusi yang dikaitkan dengan tingkat maturitas pasien. Tujuan penelitian ini adalah untuk menganalisis hubungan tingkat maturitas vertebra servikalis dengan panjang mandibula. Metode: Jenis penelitian analitik dengan rancangan cross sectional. Sampel penelitian menggunakan 100 foto sefalogram lateral pasien usia 8-18 tahun dengan Klas I skeletal. Kualitas foto sefalogram lateral baik dan berasal dari laboratorium yang sama. Pengumpulan data dilakukan dengan menganalisis tingkat maturitas vertebra servikalis dan mengukur panjang mandibula pada sefalogram lateral. Uji statistik yang digunakan ANOVA dan Kruskal-Wallis, analisis korelasi menggunakan Pearson. Hasil: Terdapat perbedaan yang bermakna pada panjang mandibula laki-laki dan perempuan, dengan nilai p=0,009. Panjang mandibula pada laki-laki lebih besar dibandingkan perempuan. Peningkatan panjang mandibula tertinggi pada laki-laki terjadi dari cervical vertebrae maturation stages (CVMS) 3 ke CVMS 4 sebesar 8,19±5,79 mm dan pada perempuan terjadi dari CVMS 3 ke CVMS 4 sebesar 6,38±4,51 mm. Hubungan yang paling erat adalah pada tahap CVMS 3 ke CVMS 4 sebesar 0,858 yang bersifat kuat. Simpulan: Terdapat hubungan antara tingkat maturitas vertebra servikalis dengan panjang mandibula, pada setiap tingkat maturitas vertebra servikalis terjadi peningkatan panjang mandibula. Hal ini menunjukkan bahwa pertumbuhan mandibula sejalan dengan maturitas vertebra servikalis. Kata kunci: Maturitas, vertebra servikalis, panjang mandibula. ABSTRACT Introduction: In recent years, the relationship between cervical vertebral maturation (CVM) and mandibular growth assessed by mandibular length has received attention. Understanding the patient’s craniofacial growth and development is very important in helping make the diagnosis, planning treatment, and the success of orthodontic treatment. The orthodontic treatment timing was related to the severity and type of malocclusion associated with the patient’s maturity level. This study was aimed to analyse the relationship between cervical vertebrae maturity level and mandibular length. Methods: This was an analytic study with a cross-sectional design. The study sample used 100 lateral cephalogram photos of patients aged 8-18 years with skeletal Class I. The quality of the lateral cephalogram images was good and came from the same laboratory. Data collection was carried out by analysing the cervical vertebrae’s maturity level and measuring the mandibular length on the lateral cephalogram. The statistical test used was ANOVA and Kruskal-Wallis, and the correlation analysis used was Pearson. Results: There were significant differences in the male and female mandibular length, with the p-value = 0.009. The mandibular length in male was higher than in the female. The highest increase in the male mandibular length occurred from cervical vertebrae maturation stages (CVMS) 3 to CVMS 4 by 8.19 ± 5.79 mm, and in women occurred from CVMS 3 to CVMS 4 by 6.38 ± 4.51 mm. The closest relationship was at the CVMS 3 to CVMS 4 stage of 0.858, which was categorised as strong. Conclusion: There is a relationship between the maturity level of the cervical vertebrae and the mandibular length. At each maturity level of the cervical vertebrae, there is an increase in the mandibular length. These results suggest that the mandibular growth is in line with the maturity of the cervical vertebrae. Keywords: Maturity, cervical vertebrae, mandibular length.
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