Digital planning and decision making for severe congenital oligodontia with Angle class-III malocclusion.

As maxillofacial surgery becomes increasingly digitized and the transformative impact of pre-surgical scanning and computer simulation is recognized, this clinical paper presents an algorithm for the selection of interventions in severe congenital oligodontia with Angle class-III malocclusion (OCIII) utilizing such technologies. A complex, multifactorial condition with varying degrees of craniofacial involvement, OCIII is associated with edentulous facial appearance, mandibular prognathism and deep underbite, as well as malocclusion. Our methodology involves the integration of CBCT imaging, intra- and extra- oral scanning, and 3D planning with the assessment of bone volume, number of missing teeth, skeletal discrepancies, and patient compliance in the selection of suitable treatments.

Application of Handheld Point-of-Care Ultrasound in the Setting of Craniomaxillofacial Trauma: A Technical Note.

Computed tomography (CT) is the standard of care imaging in craniomaxillofacial (CMF) trauma. Despite the clear advantages of high-resolution multiplanar and three-dimensional reconstructions, which facilitate accurate diagnosis and provide intraoperative (IO) real-time visual feedback, CT's main drawbacks remain availability, cost, and high radiation exposure. The decision to perform a CT scan is based on the integration of the patient's trauma mechanism, clinical examination, subjective judgment of the CMF surgeon, and the complexity of the surgery if used IO.

Three-dimensional secondary reconstruction of mistreated zygomatic fractures using patient specific surgical guides and implants.

Introduction: The zygomatic bone has a great impact on the anterior and lateral projection of the midface as well as the proper position of the globe. Primary alignment of zygomatic fractures is very important as secondary reconstruction is far more challenging. Treatment of misaligned zygoma requires refracturing of the bone to allow for repositioning.

Real-time Reconstruction of Comminuted Mandibular Fractures Using 3D Printing.

Background: Comminuted fractures of the jaws are complex injuries requiring special attention. In the past, treatment included closed reduction using maxillomandibular fixation. With advancements in technology and fixation systems, open reduction became a prevalent option.

Central giant cell granuloma of the jaws-long-term clinical and radiological outcomes of surgical and pharmacological management.

Objectives: To compare long-term results of different treatment modalities in central giant cell granuloma of the maxillofacial-skeleton. Primary resection may result in major defects. Alternative treatments include pharmacological agents.

Comparison of patient specific implant reconstruction vs conventional titanium mesh reconstruction of orbital fractures using a novel method.

To compare the reconstruction of orbital fractures using patient-specific implants (PSI) and conventional pre-formed titanium mesh; to develop a method of three-dimensional (3D) superimposition and analysis of the reconstructed orbits; and to present the pitfalls in 3D planning of orbital PSI and how to avoid them. This was a retrospective study of patients with orbital fractures who were treated in our institution between the years 2022 and 2023 using PSI or conservative prefabricated titanium mesh. Three different methods for virtual reconstruction of orbital fractures were used and are detailed with advantages, disadvantages and indications.

Evaluation of parental perceptions of lingual and labial frenectomy on their child: a comparison of CO laser and conventional scalpel.

To evaluate parental reports of postoperative pain, improvement and satisfaction following frenectomy with scalpel versus carbon dioxide (CO) laser treatment. Forty-nine patients aged 2-6 years with a short labial or lingual frenulum who required frenectomy were randomly assigned to undergo CO laser or scalpel treatment. They were divided into a labial and a lingual frenulum group based on the severity of attachment.

Treatment of Facial Asymmetry Using Distraction Osteogenesis in a Mandible First Approach.

Background: Facial asymmetry includes several etiologies, among them trauma to the condylar area during early childhood and congenital malformations such as hemifacial microsomia. This article describes the management of facial asymmetry in adolescents and young adults using a mandible first approach by distraction osteogenesis, followed by maxillary Le-Fort I as a second stage.

Methods: Eighteen patients 14-25 years of age presented with unilateral hypoplasia of the jaws which manifested clinically by deviation of the chin and canting of the occlusal plane.

A Comparative Study of Mucosal Wound Healing after Excision with a Scalpel, Diode Laser, or CO Laser.

Unlabelled: We aimed to compare the clinical and histological secondary healing effectiveness of various types of high-level laser versus scalpel excision in mucosa frenectomy.

Methods: Forty-five Sprague Dawley rats were used in this study. These rats were divided into two laser intervention groups (CO, n = 15; diode, n = 15) and one control group with scalpel excision (n = 15).

Patient-specific Implants for Treating Atrophic Mandibles.

Extremely atrophic mandibles are difficult to treat. Most patients choose to live with removable dentures. However, what if the atrophy is so extreme that spontaneous fractures occur? The objective of this report is to offer a single-stage augmentation method, which uses patient-specific crib-shaped implants (PSI) combined with autogenous free bone grafts.

The Relationship Between Morphometric Measurements, Severity, and Success of Zygomatic Arch Fracture Reduction.

Purpose: Identify associations between preoperative radiographic measurements and clinical findings of zygomatic arch fractures and postoperative radiographic measurements. Based on those findings, propose a comprehensive treatment algorithm for the solitary zygomatic arch fracture and combined zygomatic arch-zygomatic complex fracture.

Methods: Retrospective cohort study with patients referred to our department for zygomatic arch fractures between 2013 and 2018.

Solitary Extraosseous Neurofibroma in a 5-Year-Old Child - A Case Report.

Rationale: Neurofibroma (NF) is the most common benign peripheral nerve sheath tumour that most often occurs as a solitary tumour. A clinical and imaging diagnosis may be challenging since no distinctive features are unique for this lesion. Solitary NFs are treated by complete resection that may sometimes require a nerve sacrifice, ending with a neurological deficit.

Trends in cleft palate incidence in the era of obstetric sonography and early detection.

Background: The effect of improvement in prenatal identification of cleft lip or palate (CL/P) on termination of pregnancy (TOP) worldwide is scarcely reported. Our aim was to assess changes in the prevalence of cleft palate attributed to the high access and availability of prenatal advanced screening and pregnancy termination in Israel.

Methods: A retrospective study was conducted on CL/P patients which were treated in our institute and born between January 2000 and December 2018.

Intraoral and transcutaneous point-of-care-ultrasound: an adjunct bedside tool for oral and maxillofacial clinicians.

Point-of-care-ultrasound (PoCUS) is performed by the clinician at the patient's bedside and is an essential diagnostic tool in many medical subspecialties, in hospital-based care, emergencies, trauma, and in general practice. A simple, novel approach for implementation of PoCUS of the oral cavity and maxillofacial complex is introduced. Relevant indications include differentiating abscess from cellulitis, detecting jaw and facial fractures, assessment of surgical complications, removing foreign bodies, and evaluating soft tissue masses.

The Relationship Between Morphometric Measurments, Severity and Success of Zygomatic Arch Fracture Reduction.

Purpose: Zygomatic arch fractures are commonly treated by closed reduction. This kind of treatment is highly influenced by the treating surgeon and type of fracture. Thus, it is important to choose the optimal treatment for different fractures.

Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think?

Titanium plats are the gold-standard for fracture fixation. Titanium is considered biocompatible, corrosion resistant with an elasticity-modulus closest to bone. Nonetheless, titanium plates are not always as inherent as hoped.

The impact of lymph node density as a predictive factor for survival and recurrence of tongue squamous cell carcinoma.

The oral tongue is considered the most frequently involved site in cases of oral squamous cell carcinoma (OSCC). Lymph node (LN) density, defined as the number of positive LNs divided by the total number of resected LNs, is considered an important prognostic factor in OSCC; however the cut-off point remains uncertain. A retrospective study was performed involving 104 patients who underwent a glossectomy procedure for oral tongue squamous cell carcinoma (OTSCC) between the years 2008 and 2018.

Osteotomy of the Premaxilla in Bilateral Cleft Lip: A Useful Technique Following Failure of Primary Lip Closure.

Objectives: Successful aesthetic repair of the bilateral cleft lip and palate (BCLP) is one of the most challenging cases encountered by a surgeon. This challenge is heightened when the premaxilla is anteriorly protruded in relation lateral maxillary segments. Our aim is to demonstrate a useful technique for reducing the cleft size before secondary lip repair.

Postextraction Mucormycosis in Immunocompromised-Patient Management and Review of Literature.

Purpose: Mucormycosis is an uncommon aggressive, opportunistic infection that can produce widespread orofacial tissue necrosis. This primarily affects immunocompromised individuals. It is the deadliest and most rapidly progressing type of human-affecting fungal infection.

Management of Pediatric Orbital Fractures.

Introduction: Although uncommon in children, orbital fractures can be devastating to both vision and appearance. Due to the scarce information in the literature, the authors here present our experience and management with all pediatric orbital fracture patients.

Material And Methods: A 6-years retrospective study was conducted on pediatric patients presented with orbital wall fracture (OFx).

Surgically Assisted Rapid Palatal Expansion to Correct Maxillary Transverse Deficiency.

Background: Transverse maxillomandibular discrepancies are widespread. Treatment is comprised of orthodontic expansion in patients younger than 15 years or by surgically assisted rapid palatal expansion (SARPE) in skeletally mature patients where the possibility of successful orthodontic maxillary expansion decreases as sutures close and resistance to mechanical forces increases.

Aim: To present our experience of treating transverse maxillary deficiency using a unique L-shaped osteotomy and to demonstrate stable results.

3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects.

We are in the midst of the 3D era in most aspects of life, and especially in medicine. The surgical discipline is one of the major players in the medical field using the constantly developing 3D planning and printing capabilities. Computer-assisted design (CAD) and computer assisted manufacturing (CAM) are used to describe the 3D planning and manufacturing of the product.

Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants.

Technological advancements in surgical planning and patient-specific implants are constantly evolving. One can either adopt the technology to achieve better results, even in the less experienced hand, or continue without it. As technology develops and becomes more user-friendly, we believe it is time to allow the surgeon the option to plan his/her operations and create his/her own patient-specific surgical guides and fixation plates allowing him full control over the process.