Immediate Implants in Fibulas: Does the Implant to Fibula Osteotomy Distance Impact Early Implant Failure?

Background: When placing dental implants in the free fibula flap, the osteotomy cut edge poses a unique challenge in that an optimal distance has not yet been established.

Purpose: The study aimed to measure the association between implant-to-fibula osteotomy edge distance and early implant failure in patients who received free fibula flap reconstruction with immediate implants.

Study Design, Setting, Sample: A retrospective cohort study was designed and implemented.

Evaluation of postoperative peri-implant reactive tissues following implant supported prosthetic rehabilitation in fibula free flaps.

Objectives: The purpose of this study was to measure the frequency of peri-implant reactive tissue development in a cohort of patients following immediate implant supported prosthetic rehabilitation in fibula free flaps at our institution and to document 2 cases of management based on our institution's experience.

Study Design: To address this question of study design, a case series was performed from October 2014 to May 2022. We included patients that underwent a fibula free flap reconstruction of the mandible or maxilla with immediate implant placement and dental prostheses fabrication.

The effect of free flap surgery for oral cancer on laryngeal grade and intubation difficulty.

Objective: The purpose of this study was to evaluate the change in laryngeal grade and intubation difficulty at subsequent surgery in patients with prior free flap reconstruction for oral cancer.

Study Design: This retrospective case series included patients with a diagnosis of oral cancer who underwent free flap reconstruction (FFR) (S1) followed by a subsequent surgery (S2) which required intubation. The primary predictor variable was FFR.

Immediate dental rehabilitation in fibula free flaps for malignancy: Is it feasible?

Background: Fibula free flap reconstruction has revolutionized maxillofacial reconstruction. While immediate dental rehabilitation with dental implants and teeth has shown benefits, it remains uncommon, especially for patients with malignancy.

Methods: A retrospective cohort study at a single institution explored immediate dental rehabilitation in fibula flaps for patients with malignant disease.

The utility of cone-beam computed tomography and multislice computed tomography scan for the evaluation of invasion versus erosion by mandibular squamous cell carcinoma as viewed on medical PACS.

Introduction: The degree of bone involvement in mandibular squamous cell carcinoma has a significant impact on surgical planning. The purpose of this study was to determine the utility of cone-beam computed tomography (CBCT) for the evaluation of invasion by mandibular squamous cell carcinoma.

Methods: A retrospective review was conducted to identify subjects treated for oral squamous cell carcinoma (OSCC).

Immediate Teeth in Fibulas Versus Standard Fibula Free Flap: A Comparison of Donor Surgical Site Infections.

Background: Immediate placement of dental implants with dental restoration at the leg donor site requires implant components and prosthetic materials that are not packaged sterile.

Purpose: This study aimed to determine if there was a difference in donor surgical site infection between patients that received a fibula free flap with dental implants and immediate teeth (ITFFF: immediate teeth fibula free flap) before flap transfer to the defect site when compared to standard fibula free flaps (SFFFs) without dental implant placement.

Study Design, Setting, Sample: A retrospective cohort study was designed and implemented.

Does Immediate Long-Span Nerve Allograft Reconstruction Affect the Incidence of Chronic Postsurgical and Neuropathic Pain in the Reconstructed Mandible Following Resection for Benign and Malignant Disease.

Background: Peripheral nerve injury can lead to chronic postsurgical pain (CPSP) and neuropathic pain following major surgery.

Purpose: Determine in patients undergoing ablative mandibular operations with transection of the trigeminal nerve: do those who undergo immediate repair, when compared to those whose nerves are not repaired, have a decreased or increased risk for CPSP or post-traumatic trigeminal neuropathic pain (PTTNp)?

Study Design, Setting, Sample: A multisite, retrospective cohort of patients who underwent resection of the mandible for benign or malignant disease with either no repair or immediate repair of the intentionally transected trigeminal nerve with a long-span nerve allograft were analyzed for the presence or absence of CPSP and PTTNp at 6 months.

Predictor Variable: The primary predictor was the immediate repair or no repair of the trigeminal nerve.

A rare incidence of mandibular metastasis of papillary thyroid carcinoma: A case report and review of literature.

Papillary Thyroid Carcinoma (PTC) primarily metastasizes via regional lymphatics making its spread to the oral cavity exceedingly rare. Although this disease remains the most common endocrine malignancy, comprising roughly 85%-90% of all thyroid cancers, its occurrence within the oral cavity happens in less than 1% of oral malignancies. This study identifies a case involving a 77-year-old male with a history of well-differentiated PTC that was initially treated with a total thyroidectomy and adjuvant radioactive iodine.

Individualized implants using point-of-care printed models in the treatment of orbital blowout fractures.

Objective: This case series aims to highlight the digital workflow used by our institution to treat orbital fractures by creating individualized implants using point-of-care, 3-dimensional (3D) printed models.

Study Design: The study population comprised consecutive patients who presented to John Peter Smith Hospital with isolated orbital floor and/or medial wall fractures from October 2020 to December 2020. Patients treated within 14 days of their initial injury and with 3 months postoperative follow-up were included.

Early Stage Melanoma of the Vermillion with Mucosal Melanoma in Situ: A Clinical Conundrum.

Background: Melanoma is a predominantly cutaneous malignancy associated with sun exposure. Mucosal melanoma is rare and carries a distinct pathogenesis from cutaneous tumors. The vermillion of the lip is a unique site that divides cutaneous from mucosal tissues.

Does Bulky Adenopathy in Human Papilloma Virus-Positive Oropharyngeal Squamous Cell Carcinoma Require a Planned Post-Treatment Neck Dissection for Occult Residual Disease?

Purpose: A planned neck dissection was traditionally considered for a large nodal disease after definitive chemoradiation, yet controversy exists for the human papilloma virus-positive oropharyngeal squamous cell carcinoma (HPV OPSCC). We aimed to measure the frequency of persistent occult neck disease in planned neck dissection for HPV OPSCC presenting with a large (≥3.0 cm) nodal burden.

Does the use of a "wrap" in three-dimensional surgical planning influence the bony margin status of benign and malignant neoplasms of the oral, head, and neck region? An initial investigation.

Purpose: Three-dimensional surgical planning (3-DSP) is becoming commonplace in the management of benign and malignant disease for oral and maxillofacial surgery practice within the last decade. Surgeons utilize a virtual "wrap" to preoperatively delineate and define maxillofacial tumor resection margins. The investigators hypothesized that the use of a wrap is a predictable method to obtain negative bony margins.

Synchronous oral squamous cell carcinoma and a lymphoproliferative disorder in an adult: a challenge in diagnosis and management.

Synchronous primary malignancies present challenges in diagnosis, treatment sequencing and management. We present a rare case of a synchronous oral cavity and lymphoproliferative malignancy in a middle-age man. Our patient presented with a primary oral cavity squamous cell carcinoma and was subsequently found to have a secondary lymphoproliferative malignancy (chronic lymphocytic leukaemia/small lymphocytic lymphoma).

Skin hypersensitivity following application of tissue adhesive (2-octyl cyanoacrylate).

Tissue adhesives are commonly used for skin closure in both surgical and nonsurgical specialties. Although they are very well tolerated, tissue adhesives can induce a localized allergic response in 0.5% to 14% of patients.

What is the Resident Perception of Physician Assistants in an Oral and Maxillofacial Training Program?

Purpose: Physician assistants (PAs) are not employed in a widespread manner in the academic oral and maxillofacial surgery setting despite being able to assist with resident workload. We aim to measure residents' perception of PAs employed by an academic oral and maxillofacial surgery department after the addition of 2 PAs to the department.

Methods: The investigators conducted an anonymous cross-sectional survey study addressing resident perception of PA's on reducing their working hours, the scope of PA's role, and the positive and negatives of working with a PA.

Management of Salivary Gland Injury.

Although a rare sequala of soft tissue injury, salivary gland trauma may result in significant morbidity. Salivary gland injury can involve the major as well as the minor glands. Because of the proximity of adjacent vital structures, a thorough history and physical examination are mandatory during patient evaluation.

Immediate Teeth in Fibulas: Expanded Clinical Applications and Surgical Technique.

Purpose: The placement of immediate implants and teeth during jaw reconstruction using a fibula free flap has increased in recent years. Modifications of traditional fibula reconstructive techniques are needed to maximize success. This technique has not been described in patients requiring simultaneous soft tissue reconstruction.

Substernal goiter excision in a Jehovah's Witness.

Jehovah's Witnesses present a unique challenge in oral and head and neck surgery. We report a case of a substernal goiter excised on a Jehovah's Witness without the use of blood transfusion, in accordance with the patient's beliefs. Additionally, we review the literature on the care of this patient population, focusing on preoperative optimization, perioperative management, and postoperative care.

Immediate Teeth in Fibulas: Planning and Digital Workflow With Point-of-Care 3D Printing.

Purpose: Point-of-care 3-dimensional (3D) printing has become more common in recent years because many hospitals have created 3D printing laboratories. Traditional techniques to fabricate an immediate dental prosthesis for fibula and implant reconstructions have involved outsourcing to dental laboratories. This results in delays, making it suitable only for benign disease.

Role of Free Tissue Transfer in Facial Trauma.

For large composite traumatic defects of the head and neck, free tissue transfer presents a reconstructive allowing for the reconstitution of both form and function. Furthermore, the ability to provide bulk, soft, and hard tissue, as well as immediate dental rehabilitation, makes free tissue transfer an efficient and attractive option for head and neck reconstruction. Herein, we discuss the utility of free tissue transfer in facial trauma, its problems, complications, and controversies.

Nasal Sebaceous Carcinoma: A Case Report and Review of the Literature.

Sebaceous carcinoma arising from the nasal vestibule is exceedingly rare, with 3 cases previously reported. We have described the case of a 69-year-old man with an indolent exophytic growth on the medial aspect of his right nasal vestibule. Incisional biopsy demonstrated sebaceous carcinoma.