Traumatic Genial Tubercle Fractures of the Mandible: Airway Concerns and Invasive Management-A Report of 2 Cases.

Traumatic genial tubercle fracture of the mandible is a rare event that may cause airway compromise owing to loss of the support to the base of the tongue. Over the last 70 years, only 7 known cases of traumatic genial tubercle fractures have been reported. We detail the surgical management of 2 traumatically induced genial tubercle fractures that involved varying levels of airway compromise.

Neurosensory Recovery Following Mental Nerve Skeletonization in Intraoral Open Reduction and Internal Fixation of Mandible Fractures.

Purpose: The purpose of this study was to evaluate neurosensory recovery after mental nerve skeletonization in open reduction and internal fixation (ORIF) of mandible fractures.

Methods: This was a prospective nonrandomized observation study of adult subjects treated at a Level I trauma center between April 1, 2016 and December 31, 2019, with mental nerve skeletonization for ORIF of mandible fractures. Age, sex, and mandibular injury severity score (MISS), and functional sensory recovery (FSR) and subjective neurosensory recovery of skeletonized mental nerve were recorded at preoperative and regularly scheduled follow-up appointments.

Rare Oral Presentation of a Mycophenolate Mofetil-Related Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorder (MMF-OIA-LPD) Lesion: A Case Report and Literature Review.

Oral manifestations of side effects of medications, such as methotrexate (MTX) for management of rheumatoid arthritis (RA) and mycophenolate mofetil (MMF) for solid organ transplant (SOT), are very rare. The known side effects include entities called other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD) due to immunosuppression caused by these medications. While there has been an increased incidence of oral cavity LPD reported in the literature associated with MTX, oral presentations that involve MMF are rare.

Edentulism Is Associated With More Severe Obstructive Sleep Apnea Syndrome.

Purpose: The relationship between edentulism and the severity of obstructive sleep apnea syndrome (OSAS) is not well established. The purpose of the present study was to evaluate the relationship of edentulism on the severity of OSAS compared with equally at-risk dentate subjects.

Patients And Methods: We performed a retrospective matched cohort study of edentulous and dentate subjects with OSAS matched by age, gender, and body mass index (BMI).

Oral Functional Behavior and Neurosensation After Adult Maxillomandibular Advancement for Obstructive Sleep Apnea in the Long-Term.

Purpose: We evaluated and correlated the long-term subjective perioral neurosensory deficit intensity and oral functional behavior difficulty after maxillomandibular advancement (MMA) for adult obstructive sleep apnea (OSA).

Patients And Methods: We implemented a long-term retrospective cohort study of adult subjects who had undergone MMA for OSA, with subjective assessments using 7-point visual analog scales. Adult subjects who had undergone MMA for OSA with a minimum of 5 years of follow-up data available who had agreed to participate were included in the present study.

Maxillomandibular Advancement for Obstructive Sleep Apnea Produces Long-Term Horizontal Advancement of the Maxilla and Mandible.

Purpose: Because limited data have been reported, the purpose of the present study was to evaluate the long-term craniofacial cephalometric skeletal changes associated with maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA).

Materials And Methods: We performed a retrospective cephalometric cohort study of craniofacial skeletal changes in patients who had undergone MMA for OSA. The primary predictor and outcome variables were time and the change in SNB over time, respectively.

Maxillomandibular Advancement for Obstructive Sleep Apnea Is Associated With Very Long-Term Overall Sleep-Related Quality-of-Life Improvement.

Purpose: We sought to evaluate the effect of maxillomandibular advancement (MMA) on long-term subjective quality of life (QOL) in obstructive sleep apnea (OSA).

Patients And Methods: This was a retrospective cohort analysis of long-term postoperative QOL issues in patients who underwent MMA for polysomnogram-confirmed severe OSA (apnea-hypopnea index > 30). The inclusion criteria included a history of MMA in the treatment of OSA, willingness to complete the Ottawa Sleep Apnea Questionnaire (OSA-Q) survey, and minimum of 5-year follow-up.

Adalimumab-Related Dental Implant Infection.

We present an adalimumab-related dental implant surgical-site infection. A 55-year-old patient with a history of twice-weekly adalimumab subcutaneous injections for ulcerative colitis underwent mandibular extractions and placement of 5 immediate dental implants. She experienced intraoral purulent drainage from all 5 dental implant sites with submental and submandibular space infections 2 weeks after surgery.

Maxillomandibular Advancement for Severe Obstructive Sleep Apnea Is a Highly Skeletally Stable Long-Term Procedure.

Purpose: To evaluate long-term clinically significant cephalometric skeletal stability with maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA).

Materials And Methods: We performed a retrospective cohort analysis of long-term clinically significant skeletal stability in patients who underwent MMA for OSA. The primary predictor and outcome variables were the occurrence of and time to loss of clinically significant skeletal stability, respectively, at sella-nasion-B point (SNB).

Maxillomandibular Advancement Improves Multiple Health-Related and Functional Outcomes in Patients With Obstructive Sleep Apnea: A Multicenter Study.

Purpose: To comprehensively determine the effectiveness and safety of maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea (OSA).

Patients And Methods: We designed and implemented a prospective multicenter cohort study to evaluate OSA patients who underwent MMA. The primary outcome measures and associated instruments included sleepiness (Epworth Sleepiness Scale [ESS]), quality of life (QOL) (Functional Outcomes of Sleep Questionnaire [FOSQ]), sleep-disordered breathing (apnea-hypopnea index), cardiovascular risk (office blood pressure and levels of high-sensitivity C-reactive protein), and neurocognitive performance (psychomotor vigilance testing [PVT]).

Proceedings of the American Association of Oral and Maxillofacial Surgeon's 2017 Clinical and Scientific Innovations in Oral and Maxillofacial Surgery (CSIOMS).

The sixth biennial Clinical and Scientific Innovations in Oral and Maxillofacial Surgery, formerly the Research Summit, of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois from April 28 to 30, 2017. The goal of the symposium is to provide a forum for the latest clinical and scientific advances to be brought to the specialty. It also nurtures collaboration and the development of relationships between oral and maxillofacial surgeons and researchers to bridge the gap between clinical and basic science.

Interpersonal Violence Is Associated With Increased Severity of Geriatric Facial Trauma.

Purpose: The geriatric population is rapidly increasing in number with increased demand on health care resources including those spent on the treatment of maxillofacial trauma. The purpose of this analysis was to investigate the independent and cumulative associations between potential risk factors (age, gender, mechanism of injury, drug use, and alcohol use) for and the severity of geriatric facial trauma.

Methods: This was a cross-sectional analysis of secondary data of geriatric (individuals aged ≥65 years) facial trauma using the Allegheny General Hospital Trauma Registry database.

Proceedings of the American Association of Oral and Maxillofacial Surgeons 2015 Research Summit.

The Fifth Biennial Research Summit of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois on May 6 and 7, 2015. The goal of the symposium is to provide a forum for the most recent clinical and scientific advances to be brought to the specialty. The proceedings of the events of that summit are presented in this report.

Early major medical complications after surgical management of obstructive sleep apnea: a retrospective cohort analysis and case series.

Purpose: The purpose of this study was to determine the frequency and relative risk (RR) of early postoperative major medical complications after surgery for the management of obstructive sleep apnea.

Patients And Methods: This was a retrospective cohort analysis of patients who had undergone surgery for the treatment of polysomnogram-confirmed obstructive sleep apnea at 2 hospitals in Pittsburgh, PA, between 1992 and 2013. Early postoperative major medical complications were defined as either a life-threatening complication requiring intensive care unit intervention or death within the immediate hospital course.

Pre-emptive analgesia with pregabalin and celecoxib decreases postsurgical pain following maxillomandibular advancement surgery: a randomized controlled clinical trial.

Purpose: The purpose of this study was to determine the efficacy of pre-emptive analgesia with pregabalin and celecoxib on narcotic consumption and perceived pain in adult patients undergoing maxillomandibular advancement surgery for obstructive sleep apnea.

Patients And Methods: This was a prospective, randomized, double-blinded, placebo-controlled study of adult patients undergoing elective maxillomandibular advancement surgery for obstructive sleep apnea. The groups received a masked 1-time preoperative oral dose of pregabalin 150 mg and celecoxib 400 mg (experimental group) or lactose powder 2 g (placebo group).

Proceedings from the 2013 American Association of Oral and Maxillofacial Surgeons Research Summit.

The American Association of Oral and Maxillofacial Surgeons, the Oral and Maxillofacial Surgery Foundation, and the International Association of Oral and Maxillofacial Surgeons sponsored the fifth research summit, which convened on May 2 and 3 in Rosemont, Illinois. The Research Summits are convened biennially to facilitate the discussion and collaboration of oral and maxillofacial surgeons with clinical and basic science researchers in fields affecting the specialty. The goal is to advance the field of oral and maxillofacial surgery through exposure and education in topics that ultimately benefit the oral and maxillofacial surgical patient.

Management of bilateral mandibular angle fractures with combined rigid and nonrigid fixation.

Purpose: There is very limited evaluation of the management of fractures of the bilateral mandibular angles. The purpose of this study was to determine the incidence, etiology, and outcomes of bilateral mandibular angle fractures treated with the transoral application of rigid fixation on one side and nonrigid fixation on the other.

Patients And Methods: Patients 18 years of age or older with isolated, noncomminuted fractures through the right and left mandibular angles and treated solely with 2.

Combined elliptical window genioglossus advancement, hyoid bone suspension, and uvulopalatopharyngoplasty decrease apnea hypopnea index and subjective daytime sleepiness in obstructive sleep apnea.

Purpose: The objective and subjective outcomes of combined mandibular elliptical window genioglossus advancement, hyoid bone suspension, and uvulopalatopharyngoplasty procedures have not been evaluated. This study was conducted to evaluate postoperative changes in the apnea hypopnea index (AHI) and subjective daytime sleepiness with this combination of procedures in the surgical management of obstructive sleep apnea (OSA).

Patients And Methods: This was a retrospective cohort analysis of patients who had undergone combined elliptical window genioglossus advancement, hyoid bone suspension, and uvulopalatopharyngoplasty performed at Allegheny General Hospital (Pittsburgh, PA) from July 1, 2006 through December 31, 2008 for polysomnogram-confirmed OSA.

Relations between obstructive sleep apnea syndrome and specific cephalometric measurements, body mass index, and apnea-hypopnea index.

Purpose: To evaluate the relation of specific cephalometric landmarks, body mass index, and the apnea-hypopnea index in patients diagnosed with obstructive sleep apnea syndrome (OSAS) and treated with functional upper airway surgery.

Materials And Methods: This was a retrospective cohort analysis of 89 consecutive patients over a 3-year period diagnosed with overnight-attended polysomnogram-confirmed OSAS who underwent functional upper airway surgery. Five predetermined specific cephalometric parameters were analyzed: posterior airway space, soft palate length, hyoid to mandibular plane angle, sella-nasion to mandibular plane angle, and gonion to gnathion length.

Analysis of propofol and low-dose ketamine admixtures for adult outpatient dentoalveolar surgery: a prospective, randomized, positive-controlled clinical trial.

Purpose: The purpose of this study was to evaluate the hemodynamic stability and efficacy of 3 different propofol-ketamine admixtures compared with a propofol-saline solution admixture for continuous-infusion intravenous general anesthesia in outpatient adult dentoalveolar surgery.

Patients And Methods: This was a prospective, randomized, positive-controlled clinical trial between a propofol-saline solution admixture and 3 propofol-ketamine admixtures comprising 4 groups: group A (control), propofol and saline solution; group B, 10:1 propofol-ketamine ratio; group C, 5:1 propofol-ketamine ratio; and group D, 3:1 propofol-ketamine ratio. The bispectral index (BIS) was used to monitor all patients for time to induction (BIS <70) to recovery time (BIS >90).

Cephalometric soft tissue analysis of combined elliptical-window genioglossus advancement and hyoid suspension for obstructive sleep apnea.

Purpose: This study sought to determine the changes in cephalometric facial profile soft tissue measurements after simultaneous elliptical-window genioglossus advancement and hyoid suspension procedures for obstructive sleep apnea.

Patients And Methods: A retrospective analysis of preoperative and postoperative lateral cephalometric soft tissue changes in 23 consecutive patients who had undergone combined elliptical-window genioglossus advancement and hyoid bone suspension for polysomnogram-confirmed obstructive sleep apnea. Six cephalometric soft tissue measurements of the lower face were evaluated: pogonion (Pg'-Pg), menton (Me'-Me), gnathion (G'-G), lower lip (LI-L1i), B point (B-B'), and horizontal distance from subnasale perpendicular to the soft tissue chin at the level of pogonion (SN-Pg').

The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible.