Impact of orthognathic surgery on the cheek area using the Barcelona line.

A facial appearance of premature aging due to poor bone support of the soft tissues is frequently found in patients with midface hypoplasia. This study was performed to evaluate the changes in the soft tissues of the cheek area in patients subjected to bimaxillary orthognathic surgery. The cheek line angle and length of 27 consecutive patients who underwent bimaxillary surgery, were measured on cone beam computed tomography scans obtained before surgery and at 1 and 12 months after surgery using 3D software.

Simultaneous ortho-surgical expansion and protraction of the maxilla in patients with mature midpalatal suture: A technical note.

The authors aim to propose combination of Surgically Assisted Miniscrew-Assisted Rapid Palatal Expansion (SAMARPE) with orthopedic traction miniplates placement in cases where a sagittal deficiency coexists with the necessity of carrying out a surgical maxillary expansion. Unlike the conventional orthopedic traction technique, where the miniplates are placed bilaterally in the infrazygomatic crest of the maxillary buttress, in this scenario the upper miniplates should be placed below the LeFort I osteotomy, and therefore a little bit angulated.

Immediate Implant Placement with Soft Tissue Augmentation Using Acellular Dermal Matrix Versus Connective Tissue Graft: A Systematic Review and Meta-Analysis.

This systematic review investigates the efficacy of using connective tissue grafting (CTG) versus an acellular dermal matrix (ADM) for soft tissue management in immediate implant placement (IIP). The study focuses on comparing the soft tissue thickness (STT) and keratinized tissue width (KTW) changes post-implantation. Adhering to the PRISMA guidelines, a comprehensive literature search was conducted, targeting randomized clinical trials and cohort studies involving soft tissue grafting in conjunction with IIP.

'Puzzle' cutting guides for minimally invasive Le Fort I: technical note.

There has been substantial progress in orthognathic surgery over the last 20 years, propelled by developments in 3D technology. These have led to enhanced predictability and precision, and simplified surgical planning. This transformative shift has introduced patient-specific implants (PSI) and cutting guides as viable alternatives to conventional techniques, elevating the overall effectiveness of surgical procedures.

Can the Upper Vermilion and the Nasolabial Fold Be Changed With Orthognathic Surgery?

Background: Retrusive profiles show an appearance of aging with an under-projected vermilion and pronounced nasolabial folds due to deficient bone support.

Purpose: A study was made of the association between orthognathic surgery and changes in the nasolabial and vermilion areas in patients with retrusive profiles.

Study Design, Setting, Sample: A retrospective cohort study evaluated patients subjected to bimaxillary surgery according to the Barcelona Line (BL) protocol during 2021 at Teknon Medical Center (Barcelona, Spain).

In-house protocol for fully guided zygomatic implant surgery and prosthesis repositioning. A technical note.

Aim: The present study aims to describe an in-house protocol for fully guided zygomatic implant surgery and prosthesis repositioning.

Materials And Methods: Four extramaxillary zygomatic dental implants (ZIs) were placed in one patient. The preoperative phase included digital planning, through which a surgical guide was designed and created.

Peri-implantitis and maxillary sinus membrane thickening: A retrospective cohort study.

Objective: The objective of this study is to investigate the association of peri-implantitis (PI) and sinus membrane thickening and to assess the resolution of membrane thickening following intervention (implant removal or peri-implantitis treatment) aimed at arresting PI.

Materials And Methods: Forty-five patients with 61 implants in the posterior maxillary region were retrospectively included in the study. Twenty-four patients were diagnosed with peri-implantitis (PI) and 21 had peri-implant health (PH).

Immediate Implant Placement in the Aesthetic Area using Inverted Body-shift Design: A Prospective Clinical Pilot Study.

A prospective clinical pilot study was carried out to evaluate a novel macroimplant design with a 12° angled platform. The implant is placed at the center of the socket, optimizing all the alveolar bone. In addition, the prosthetic emergence should be ideal, as it is corrected and emerges through the cingulate area.

On the feasibility of minimally invasive Le Fort I with patient-specific implants: Proof of concept.

A novel approach to Le Fort I osteotomy is presented, integrating patient-specific implants (PSIs), osteosynthesis and cutting guides within a minimally invasive surgical framework, and the accuracy of the procedure is assessed through 3D voxel-based superimposition. The technique was applied in 5 cases. Differences between the surgical plan and final outcome were evaluated as follows: a 2-mm color scale was established to assess the anterior surfaces of the maxilla, mandible and chin, as well as the condylar surfaces.

Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study.

Objectives: The aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery.

Methods: The study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions.

Vascular Delay Soft Tissue Technique in Oral/Maxillary Bone Reconstructive Surgery: A Technical Note.

Purpose: The present study describes a new presurgical soft tissue technique in oral/maxillary bone reconstructive surgery for reducing the risk of soft tissue dehiscence and its related complications.

Materials And Methods: Ten consecutive patients with Cawood and Howell type V atrophy were scheduled for CAD/CAM titanium mesh bone reconstructive surgery after applying the vascular delay technique 21 days before regenerative surgery. The surgical and healing complications were clinically assessed at nine time points, ranging from the time of bone regenerative surgery to 9 months after surgery.

Effectiveness of virtual reality in relieving anxiety and controlling hemodynamics during oral surgery under local anesthesia: A prospective randomized comparative study.

It was the aim of the study to evaluate the contribution of a relaxing immersive experience with virtual reality (VR) goggles in reducing patient anxiety related to wisdom tooth extraction under local anesthesia. A prospective randomized comparative study in consecutive patients scheduled for bilateral wisdom tooth extraction under local anesthesia was carried out between March and December 2022. Both sides were operated upon in the same surgery, but on one side VR goggles were applied (VR), while on the other they were not (noVR).

Mouth opening limitation and influence of age and surgical location for static fully guided dental implant placement: an observational, cross-sectional clinical study.

The influence of age and region of the mouth was assessed in regard to mouth opening in fully guided implant placement. Ninety patients were included in this study, 30 in each of three age groups (20-34, 35-55, and >55 years). Maximum passive mouth opening was recorded in three locations: incisal, canine, and molar.

Surgery-first in interdisciplinary class II cases.

Objectives: To present an interdisciplinary case treated with a surgery-first orthognathic approach, followed by orthodontic and prosthodontic treatment.

Clinical Considerations: After an accurate pre-operative virtual planning, a young patient with skeletal class II, retrognathia, and an anterior open bite was treated with bimaxillary orthognathic surgery without pre-surgical orthodontic decompensation. Orthodontic treatment was carried out post-operatively.

Ultrasound-Guided Suprazygomatic Maxillary Nerve Block Is Effective in Reducing Postoperative Opioid Use Following Bimaxillary Osteotomy.

Background: Ultrasound-guided maxillary nerve block has recently been described, though its impact upon bimaxillary osteotomy has not been formally investigated.

Purpose: The present study was carried out to determine whether the addition of ultrasound-guided maxillary nerve block in subjects undergoing bimaxillary osteotomy reduces opioid use.

Study Design, Setting, Sample: A randomized clinical trial was carried out in adults undergoing bimaxillary osteotomy between April 2019 and January 2020 at Teknon Medical Center (Barcelona, Spain).

Le fort I osteotomy with or without concomitant removal of upper third molars: A prospective cohort study of intraoperative findings, related complications, and level of pterygomaxillary separation after down-fracture.

The main objective of our study was to assess the clinical implications of concomitant intraoperative removal of maxillary third molars (M3M) with the Le Fort I osteotomy 'twist' technique (LF1twist). A prospective comparative study was carried out regarding the necessity of bone trimming around the pedicle, intra- and postoperative complications, surgery time, and the level of pterygomaxillary junction (PMJ) separation following LF1twist with concomitant intraoperative removal of M3M (test group) versus LF1twist alone (control group). Outcome parameters were assessed from clinical and radiographic measurements.

Guided Customization and Fixation of Allogenic Cortical Lamina in Alveolar Bone Regeneration. A Case Report.

Bone reconstruction surgeries such as the autogenous and allogenic shell techniques where cortical laminates are used to regenerate bone defects, requires time and expertise to adapt and fix the laminated cortical blocks onto the defect area. This case report illustrates the process of customizing and fixing an allogenic cortical laminate (ACL) to reconstruct a horizontal bone defect with guided surgical stents. Two types of surgical stents were designed: one to aid in cutting a prefabricated ACL into the desired shape for the defect to be regenerated, and the other type of stent, was used to assist in the positioning and fixation of the resulting laminates.

Does Aesthetic Osseous Genioplasty Impact Upper Airway Volume?

Background: Although maxillomandibular advancement is the treatment of choice for obstructive sleep apnea syndrome (OSAS) in the presence of underlying maxillomandibular complex hypoplasia, there is still a gap in the literature regarding the impact of genioplasty upon upper airway volume (UAV).

Objectives: The aim of this study was to evaluate the impact of isolated osseous genioplasty upon UAV.

Methods: A retrospective analysis of all patients subjected to isolated osseous genioplasty between July 2015 and July 2022 was conducted.

Dental Implant Positioning Accuracy Using a Key or Keyless Static Fully Guided Surgical System: A Prospective Systematic Review and Meta-analysis.

Purpose: To realize a systematic review with prospective meta-analysis aiming to compare the accuracy of static fully guided implant placement depending on the drill key modality (conventional drill key surgery systems vs newer keyless systems) and evaluate the impact of deviation factors.

Materials And Methods: An electronic systematic search was conducted to identify prospective clinical trials matching inclusion criteria. The variables of interest were coronal global, apical, vertical, and angular deviations.

Three-Dimensional Evaluation of the Accuracy of Zygomatic Implant Placement Through an In-House Fully Guided Approach.

To validate guided surgery for zygomatic implants (ZIs) by analyzing the final position of the implants relative to the preoperatively planned position. Five patients with fully edentulous atrophic maxillae treated with four ZIs through a fully guided implant surgical approach were evaluated. The preoperative phase included digital planning, through which the surgical guide was designed and created.

Dynamic Implant Surgery-An Accurate Alternative to Stereolithographic Guides-Systematic Review and Meta-Analysis.

(1) Background: Dynamic guided surgery is a computer-guided freehand technology that allows highly accurate procedures to be carried out in real time through motion-tracking instruments. The aim of this research was to compare the accuracy between dynamic guided surgery (DGS) and alternative implant guidance methods, namely, static guided surgery (SGS) and freehand (FH). (2) Methods: Searches were conducted in the Cochrane and Medline databases to identify randomized controlled clinical trials (RCTs) and prospective and retrospective case series and to answer the following focused question: "What implant guidance tool is more accurate and secure with regard to implant placement surgery?" The implant deviation coefficient was calculated for four different parameters: coronal and apical horizontal, angular, and vertical deviations.

Additional pre-extubation local anaesthetic application to improve the postoperative course in orthognathic surgery: a randomised controlled trial.

A clinical trial was performed to assess the analgesic efficacy of adding ropivacaine pre-extubation for pain management after bimaxillary osteotomy. Forty-eight patients were assigned to receive general anaesthesia followed by either a single pre-incisional infiltration with lidocaine (control group, n = 24) or the same pre-incisional infiltration with lidocaine and an additional second infiltration with ropivacaine before awakening (test group, n = 24). Postoperative pain was assessed subjectively using a visual analogue scale and objectively based on the frequency of postoperative rescue opioid consumption.

Narrow diameter titanium-zirconium tissue-level implants supporting multi-unit FDPs in the anterior area: A 5-year prospective study.

Background: Narrow diameter implants (NDIs) are used in cases of limited mesio-distal space, or if the alveolar ridge does not allow placement of a standard diameter implant.

Purpose: The aim of this prospective case series study is to present the 5-year clinical-, radiological-, and patient-reported outcome measures (PROMs) of patients with partial edentulism in the anterior area of the jaws requiring the placement of two narrow diameter implants to support a 3- or 4-unit fixed partial denture (FPD).

Materials And Methods: Thirty partially edentulous patients missing 3 or 4 adjacent teeth in the anterior area of the jaws were included in the study.

Does orthognathic surgery have an incidentally beneficial effect on mild or asymptomatic sleep apnoea?

A prospective study was performed to assess the effect of orthognathic surgery on mild obstructive sleep apnoea (OSA) in patients with an underlying dentofacial deformity treated for occlusal and/or aesthetic reasons. As the main outcome variables, changes in upper airway volume and apnoea-hypopnoea index (AHI) were evaluated at 1 and 12 months of follow-up, in patients undergoing orthognathic surgery with widening movements of the maxillomandibular complex. Descriptive, bivariate, and correlation analyses were performed; significance was set at P < 0.