Reconstruction of Maxillary Bone Defects With Cellular Bone Matrix Allografts.

Study Design: Retrospective Cohort Study.

Objective: Reconstruction of maxillary bone defects can be completed with vascularized and non-vascularized autografts. Cellular bone matrix allografts (CBMs), which have lineage committed bone cells, has risen as an alternative.

Are Cellular Bone Matrix Allografts a Viable Option for Mandibular Tissue Engineering and Reconstruction?

Background: Traditional mandibular reconstruction has relied on the use of vascularized and non-vascularized autografts. The use of allografts and tissue engineering modalities has risen as an alternative.

Purpose: The purpose of this study was to determine the success of a cellular bone matrix (CBM) allograft composed of lineage committed bone forming cells for mandibular tissue engineering and reconstruction.

Can a Point-of-Care 3D Printing Workflow Produce Accurate and Successful Results for Craniomaxillofacial Trauma?

Background: Computer-aided design and manufacturing (CAD/CAM) is having a profound impact on craniomaxillofacial surgery, and point-of-care (POC) solutions for repairing facial trauma are starting to emerge.

Purpose: The purpose of this study was to demonstrate the success and accuracy of a POC 3D printing workflow for craniomaxillofacial trauma.

Study Design, Setting, Sample: A retrospective cohort study was undertaken to analyze subjects presenting to a level 1 trauma center after sustaining facial trauma and were then treated using the POC 3D printing workflow.

Intermaxillary Fixation in the Primary and Mixed Dentition.

Anatomic differences of the primary dentition may hinder traditional methods of intermaxillary fixation. Furthermore, the presence of both the primary and permanent dentition can complicate establishing, and maintaining, the preinjury occlusion. The treating surgeon must be aware of these differences for optimal treatment outcomes.

Immediate Reconstruction of Segmental Mandibular Defects With Nonvascular Bone Grafts: A 30-Year Perspective.

Purpose: The use of nonvascular bone grafts for immediate mandibular reconstruction has remained a controversial topic. The purpose of the present study was to investigate the variables that might influence graft survival examining the outcomes from 30 years of experience.

Materials And Methods: We designed a retrospective cohort study to analyze the data from patients at a tertiary university medical center who had undergone segmental mandibular resection with immediate reconstruction with a nonvascularized free bone graft with or without adjuncts from 1989 to 2019.

Are Psychiatric History and Substance Use Predictors of Mortality in Self-Inflicted Gunshot Wounds to the Face?

Purpose: Self-inflicted gunshot wounds to the face are one of the most challenging clinical scenarios encountered by oral and maxillofacial surgeons. Knowledge is lacking regarding which factors might influence survival after these devastating injuries, especially pertaining to psychiatric history and substance use. The purpose of the present study was to evaluate the risk factors that might influence the survival of subjects with self-inflicted gunshot wounds to the face.

In-House Digital Workflow for the Management of Acute Mandible Fractures.

Computer-aided design and additive manufacturing are revolutionizing oral and maxillofacial surgery. Current methods use virtual surgical planning sessions and custom plate milling via third-party vendors, which is costly and time-consuming, negating the effectiveness in acute facial trauma. This technical note describes a state-of-the-art in-house expedited digital workflow for computer-aided virtual fracture reduction, 3-dimensional printing, and preoperative reconstruction plate adaptation for the management of an acute mandible fracture.

Management of Mandibular Osteomyelitis With Segmental Resection, Nerve Preservation, and Immediate Reconstruction.

Purpose: The purpose was to present our experience with management of mandibular osteomyelitis with segmental resection, nerve preservation, and immediate reconstruction with nonvascularized bone grafts.

Patients And Methods: We completed a retrospective analysis of 18 cases overseen by a single practitioner at a university medical center from June 2011 to July 2018. All patients had osteomyelitis and were treated with segmental mandibular resection, inferior alveolar nerve (IAN) preservation, and immediate reconstruction with autogenous bone graft from the tibia.

Dental Problems in Primary Care.

Oral health directly affects overall health and quality of life. More Americans lack dental insurance than medical insurance. Patients with poor oral health are more likely to have respiratory and cardiovascular diseases, adverse pregnancy outcomes, and diabetes mellitus.

Aggressive histologic features do not predict biologic behavior in melanotic neuroectodermal tumor of infancy.

While generally benign, occasional aggressive histologic features in the melanotic neuroectodermal tumor of infancy (MNTI) have been used to justify a diagnosis of malignancy; this could lead to overtreatment. We report a case with presumed aggressive histologic features that did not recur following conservative treatment. This adds evidence that histologic features are not predictive of clinical behavior in MNTI.

Topical application of a mucoadhesive freeze-dried black raspberry gel induces clinical and histologic regression and reduces loss of heterozygosity events in premalignant oral intraepithelial lesions: results from a multicentered, placebo-controlled clinical trial.

Purpose: Approximately 30% higher grade premalignant oral intraepithelial neoplasia (OIN) lesions will progress to oral cancer. Although surgery is the OIN treatment mainstay, many OIN lesions recur, which is highly problematic for both surgeons and patients. This clinical trial assessed the chemopreventive efficacy of a natural product-based bioadhesive gel on OIN lesions.

Failed Fixation in Atrophic Mandibular Fractures: The Case against Miniplates.

Despite advances in the treatment of the fractured atrophic edentulous mandible, treatment continues to be difficult. Patient management is more complicated due to patients often being elderly with more complex medical problems. Rigid internal fixation has greatly improved outcomes with shorter treatment times, yet a consensus has yet to be reached regarding which method yields the most predictable results.

Facial skeletal trauma in the growing patient.

The management of pediatric craniomaxillofacial trauma requires the additional dimension of understanding growth and development. The surgeon must appreciate the considerable influence of the soft tissue envelope and promote function when possible. Children heal well but with an exuberant tissue response that may contribute to greater scarring, therefore, careful and prudent attention given to meticulous soft tissue repair and support is critical.

Bisphosphonate-related osteonecrosis of the jaws.

Purpose Of Review: The purpose of this article is to review a new pathologic entity named bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Recent Findings: BRONJ was observed and first reported in 2001-2002 when clinicians noticed cases of refractory osteomyelitis after simple dental procedures such as dental extractions in patients who had received bisphosphonate therapy. The condition was initially seen in patients who received i.

Management of comminuted fractures of the mandible.

Comminuted fractures of the mandible are unusual but not rare. They are complex injuries with a high complication rate. Gunshot wounds are a frequent cause.

Fractures of the growing mandible.

Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures.

Contemporary management of infected mandibular fractures.

The treatment of infected mandibular fractures has advanced rather dramatically over the past 50 years. Immobilization with maxillomandibular fixation and/or splints, removal of diseased teeth in the fracture line, external fixation, use of antibiotics, debridement, and rigid internal fixation has played a role in management. Perhaps the most important advance was the realization that infected fractures also result from moving fragments and nonvital bone, not just bacteria.

Management of impacted teeth in children.

Ankylosis remains one of the major complications associated with impacted teeth in children. Orthodontically-assisted eruption of an ankylosed tooth may intrude or displace the adjacent teeth. Children who undergo orthodontically assisted eruption should be followed closely to ensure that movement of an impacted tooth is occurring.

Lag screw fixation of anterior mandibular fractures: a retrospective analysis of intraoperative and postoperative complications.

Purpose: To review, retrospectively, the outcomes of 102 patients who underwent lag screw technique fixation of fractures of the anterior mandible.

Patients And Methods: A total of 102 consecutive, skeletally mature patients who have undergone open reduction internal fixation for fractures of the anterior mandible utilizing the lag screw technique were reviewed. All patients had a clinically mobile fracture between the mental foramina of the mandible.

Cone beam computed tomographic findings in refractory chronic suppurative osteomyelitis of the mandible.

Aims: To report the imaging features of osteomyelitis of the mandible in various two-dimensional multiplanar and three-dimensional reformations using cone beam computed tomography (CBCT).

Methods: The images were 12-bit DICOM files acquired with a 10cm field of view and voxel resolution of 0.4mm.

Maxillary sinus augmentation.

Attention to the principles of bone grafting, bone healing, and maxillary sinus physiology as well as anatomy is critical to the successful placement of dental implants in the posterior maxilla. The integration of these principles must take into account the restorative dental requirements and the patient's autonomy in guiding implant reconstruction. As in so many clinical disciplines, additional research is needed to provide better guidance for clinicians.

The use of immediate bone grafting in reconstruction of clinically infected mandibular fractures: bone grafts in the presence of pus.

Purpose: Current approaches to the treatment of infected mandibular fractures include antibiotics, drainage, immobilization of the segments, and debridement followed by secondary bone grafting of residual defects once the infection is resolved and the wound healed. Over the past 30 years, the time from debridement to grafting has diminished from several months to a few weeks. We present our experience with a treatment model managing clinically infected fractures of the mandible with antibiotics, debridement, rigid internal fixation, and immediate autogenous bone grafting.