Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials

A special issue of Surgeries (ISSN 2673-4095).

Deadline for manuscript submissions: 20 September 2024 | Viewed by 12398

Special Issue Editors


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Guest Editor
1. Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland
2. Department of Maxillofacial Surgery, University Clinical Hospital, Witosa 26, 45-401 Opole, Poland
Interests: temporomandibular joint; mandibular condyle; osteosynthesis; osteonecrosis; Arthrocentesis; intra-articular injections

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Guest Editor
Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, 2 Traugutta sq, 41-800 Zabrze, Poland
Interests: Cannabidiol; CBD; myofascial pain; tmd; bruxism; emg; masseter muscle

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Guest Editor
Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 61000, Israel
Interests: evidence based endodontics
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Special Issue Information

Dear Colleagues,

The clash between experience and modernity is a particularly delicate issue in medicine. Effective and safe treatments are always a balance between the old and the new. The choice between that which has been repeatedly confirmed and what is potentially better, although burdened with a higher risk, affects the course of diagnostic and therapeutic processes. Additional factors in the degree of the difficulty of procedures, the availability of medical equipment and cost-effectiveness further complicate the choices that, in theory, should be dictated solely by medical considerations. I consider these topics worth covering in this Special Issue, which I invite you to cocreate, with the aim of presenting the best proven practices, innovative clinical management and prospects for the development of oral and maxillofacial surgery.

Potential topics include, but are not limited to:
best proven vs. the latest diagnostic methods; advances in craniofacial traumatology; predictable orthognathics in the context of digitization; innovations in the treatment of temporomandibular joints; apparent stagnation in inflammation therapy; constant and developing aspects of oncology; novelties vs. traditional methods in reconstructive surgery; dental implantology: the evidence-based race of innovation; postsurgical maxillofacial prosthetics; importance and new possibilities of postoperative observation; failures necessary to share to avoid their occurrence.

Dr. Maciej Chęciński
Dr. Karolina Walczyńska-Dragon
Prof. Dr. Igor Tsesis
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnostic techniques and procedures
  • maxillofacial injuries
  • orthognathic surgery
  • temporomandibular joint disorders
  • oral and maxillofacial pathology
  • reconstructive surgery
  • iatrogenic disease

Published Papers (7 papers)

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12 pages, 3813 KiB  
Article
Surgical Lip Cancer Reconstruction in the COVID-19 Era: Are Free Flaps or Loco-Regional Flaps Better?
by Samuel Staglianò, Gianpaolo Tartaro, Ciro Emiliano Boschetti, David Guida, Giuseppe Colella and Raffaele Rauso
Surgeries 2023, 4(1), 108-119; https://doi.org/10.3390/surgeries4010012 - 3 Mar 2023
Viewed by 2728
Abstract
Lip carcinoma is one of the most frequent conditions affecting the general population. It is among the ten most common neoplasms, but despite advances in research and therapy, its prognosis has not improved in a significant way in the past few years, making [...] Read more.
Lip carcinoma is one of the most frequent conditions affecting the general population. It is among the ten most common neoplasms, but despite advances in research and therapy, its prognosis has not improved in a significant way in the past few years, making it a challenge in the medical research field and in surgical treatment. This study was conducted with the aim of evaluating the available reconstructive surgical options for the treatment of lip carcinomas in order to define which could be the most appropriate technique to achieve satisfying aesthetic and functional outcomes considering hospital resources in the COVID-19 era. Seventeen patients were included in this retrospective study, which took place between January 2019 and April 2021. There were two groups: seven patients who underwent a radial forearm free flap and ten who underwent locoregional flaps. The statistical analysis was performed to evaluate four different endpoints. Surgical length, ICU stay, and hospitalization time were minor for locoregional flaps. There was no statistically significant difference between the two groups when considering post-operative complications. Locoregional flaps have a more aesthetically pleasing result, but from a functional point of view, the results can be superimposable. Both techniques are associated with adequate speech, mouth opening, sealing, and symmetry. Given the impact of the COVID-19 pandemic on the healthcare system, locoregional flaps have been proven to be a good surgical option in the reconstruction of lip defects both in terms of aesthetics and functional outcome. Full article
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17 pages, 681 KiB  
Systematic Review
Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review
by Miriam Alves de Oliveira, Alexandra Arcanjo, Filipe Castro, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes
Surgeries 2024, 5(2), 350-366; https://doi.org/10.3390/surgeries5020029 - 8 May 2024
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Abstract
Objective: This systematic review was carried out with the primary objective of verifying which suture (polyamide or silk) of two non-resorbable suture materials with different structures had better/greater tensile strength/resistance to tension, thereby presenting better mechanical behavior. The secondary objective was to verify [...] Read more.
Objective: This systematic review was carried out with the primary objective of verifying which suture (polyamide or silk) of two non-resorbable suture materials with different structures had better/greater tensile strength/resistance to tension, thereby presenting better mechanical behavior. The secondary objective was to verify which one had better performance. The null hypothesis was that both types of sutures had the same behavior. Methods: This systematic study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The focused clinical question was: “In patients that underwent oral surgery treatment (P), is there significantly higher tensile strength/resistance for silk sutures (I) or for polyamide sutures (C) when comparing the outcomes (O)?”. The bibliographic search was conducted on ScienceDirect, B-On, and PubMed/MedLine between March and May 2023. The following MeSH terms were defined: sutures, breaking strength, tensile strength, oral surgery, and dentistry, which were articulated and combined using Boolean operators. There were restrictions, such as articles published in Portuguese, Spanish, or English between 1 January 2018 and 3 April 2023. The quality assessment involved the use of the Joanna Briggs Institute (JBI) checklist for RCTs and the QUIN tool (Quality Assessment Tool For In Vitro Studies) for in vitro assays. Results: Ten articles were included in this review (eight in vitro studies and two RCTs). For the RCTs, there were moderate and high levels of bias, whereas in the in vitro studies, three were classified as having a high risk of bias and five as moderate risk. The results proved that suture thread with a monofilament polyamide physical structure causes a less inflammatory reaction owing to less bacterial retention and capillarity, while multifilament sutures, such as silk, have superior mechanical characteristics. Regarding hydration, the evidence demonstrated that the preservation and stability of mechanical properties lacked uniformity. Otherwise, hyaluronic acid (HA) presents a promising solution with the same characteristics and antibacterial capabilities. Conclusion: It was possible to reject the null hypothesis that both types of sutures had the same behavior and result. It was proven by the results above that sutures with a monofilament polyamide physical structure cause a less inflammatory reaction owing to less bacterial retention and capillarity. In contrast, multifilament sutures (silk) have superior mechanical characteristics. Regarding hydration using chlorohexidine in surgical sites, the evidence demonstrated in the preservation and stability of mechanical properties lacks uniformity and congruence. However, HA seems to present a promising option with the same characteristics and antibacterial capabilities. Full article
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45 pages, 22119 KiB  
Systematic Review
The Effect of Antihypertensive Agents on Dental Implant Stability, Osseointegration and Survival Outcomes: A Systematic Review
by Dary Jones, Rabia S. Khan, John D. Thompson, Cemal Ucer and Simon Wright
Surgeries 2024, 5(2), 297-341; https://doi.org/10.3390/surgeries5020027 - 29 Apr 2024
Viewed by 379
Abstract
Antihypertensive agents are commonly prescribed to manage hypertension and are known to be beneficial for bone formation and remodeling. The aim of this systematic review was to assess the impact that antihypertensive agents have on dental implant stability, osseointegration, and survival outcomes. A [...] Read more.
Antihypertensive agents are commonly prescribed to manage hypertension and are known to be beneficial for bone formation and remodeling. The aim of this systematic review was to assess the impact that antihypertensive agents have on dental implant stability, osseointegration, and survival outcomes. A review of the literature was conducted using articles from 11 data sources. PRISMA guidelines were followed, and a PICO question was constructed. The search string “Antihypertensive* AND dental implant* AND (osseointegration OR stability OR survival OR success OR failure)” was used for all data sources where possible. The Critical Appraisal Skills Programme (CASP) was used for study appraisal, including the risk of bias. The search resulted in 7726 articles. After selection according to eligibility criteria, seven articles were obtained (one randomized control trial, two prospective cohort studies, three retrospective cohort studies, and a case control study). Five papers investigated the effects of antihypertensive agents on primary stability, but there were discrepancies in the method of assessment. Inhibition of the renin–angiotensin–aldosterone system was linked to higher primary stability. Secondary stability was usually higher than primary stability, but it is unknown if antihypertensive agents caused this. Survival outcomes were increased with certain antihypertensive agents. It is possible that inhibition of the renin–angiotensin–aldosterone system may lead to greater bone mineral density, improved primary stability, and improved survival outcomes although the effects on osseointegration are unknown. However, more research is needed to confirm this theory. Full article
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12 pages, 1934 KiB  
Case Report
Dermal Cosmetic Migration after Lip Augmentation Procedure: Clinical Management and Histological Analysis in a Case Report with Review of the Literature
by Antonio Scarano, Francesco Inchingolo, Maristella Di Carmine, Marco Marchetti, Felice Lorusso, Roberto Amore and Domenico Amuso
Surgeries 2023, 4(2), 223-234; https://doi.org/10.3390/surgeries4020023 - 15 May 2023
Cited by 3 | Viewed by 2261
Abstract
Lip augmentation procedures have become gradually more popular and common due to cultural tendencies and an increasing association of the appearance of the lips with both beauty and youth. Different dermal fillers have been proposed for lip augmentation—such as collagen, calcium hydroxylapatite, hyaluronic [...] Read more.
Lip augmentation procedures have become gradually more popular and common due to cultural tendencies and an increasing association of the appearance of the lips with both beauty and youth. Different dermal fillers have been proposed for lip augmentation—such as collagen, calcium hydroxylapatite, hyaluronic acid, and polylactic acid—which are used as temporary fillers. The present case report describes the histopathologic and clinical management of one case of HA filler migrating into the intraoral cheek, which caused discomfort by intraoral swelling. There is also a review of the relevant literature. A female patient, V.A., 34 years old, smoker, no allergies to drug and food substances, came to our attention. The patient was referred to the Department of Innovative Technology in Medicine and Dentistry of the University “G. D’Annunzio” of Chieti-Pescara in Italy by her dentist for the removal of a mass present in the right cheek. The clinical examination of the patient revealed a single mobile mass mimicking a soft tissue tumor in the right anterior cheek. The mass was palpable and approximately 2 cm long and was causing pain and swelling. The mucosa appeared healthy without ulcers. The filler, which had migrated into the cheek, was removed by reaching it with a scalped blade. The material was stored immediately in 10% buffered formalin and processed for histological analysis. The literature search was carried out in accordance with the criteria of the PICO guidelines. Observed histologically, the filler was surrounded by fibroblasts and a few inflammatory cells and giant cells without granuloma formation. The clinical diagnosis was swelling and discomfort caused by chewing trauma, while the histological examination excluded discomfort due to a foreign body reaction caused by the HA used for a lip augmentation procedure. In conclusion, the high-pressure and high-volume filler injections probably caused a detachment of the tissues, with the orbicularis oris muscle concurrently acting as a pump and moving the HA implant, causing migration to the area with low-density tissue such as the cheek. Full article
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8 pages, 2442 KiB  
Case Report
Nasal Floor Elevation—An Option of Premaxilla Augmentation: A Case Report
by Ante Jordan, Marko Vuletić, Mato Sušić, Luka Stojić and Dragana Gabrić
Surgeries 2022, 3(4), 306-313; https://doi.org/10.3390/surgeries3040033 - 29 Oct 2022
Cited by 1 | Viewed by 2296
Abstract
The atrophic edentulous maxilla is demanding for dental implant placement because of extensive resorption of the alveolar ridge after teeth loss and, consequently, the proximity of the anatomical structures, nasal cavity, and maxillary sinus. Treatment options are short implants, guided bone regeneration, onlay [...] Read more.
The atrophic edentulous maxilla is demanding for dental implant placement because of extensive resorption of the alveolar ridge after teeth loss and, consequently, the proximity of the anatomical structures, nasal cavity, and maxillary sinus. Treatment options are short implants, guided bone regeneration, onlay grafts, Le Fort I osteotomy with interpositional bone grafting, distraction osteogenesis, or nasal floor elevation. Nasal floor elevation is a method of augmentation of premaxilla by raising the base of the nose. The aim of this case report is to evaluate the success of implants placed after nasal floor elevation. A 75-year-old female patient came to the Clinical Department of Oral Surgery, University Hospital Centre Zagreb, unsatisfied with her complete removable denture. Clinical and radiological examination revealed severe maxillary alveolar ridge atrophy. Nasal floor elevation was made under local anesthesia through aperture piriformis and lateral window in the distal part. After eight months, four implants were placed and, after period of osseointegration, a bar-retained implant overdenture was made. This case report shows that nasal floor augmentation can be considered among the surgical techniques to allow implant-supported rehabilitation of the atrophic anterior maxilla. Full article
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9 pages, 11116 KiB  
Case Report
Guided Biopsy of a Radiopaque Lesion Simultaneous with Dental Implants’ Placement: A Multidisciplinary Approach
by Diana Parise, Federica Sartorato, Enrico Fabris, Andrea Scarpa, Tiziano Baesso, Luca Sbricoli, Omnia Abdelwahab, Marny Fedrigo and Christian Bacci
Surgeries 2022, 3(4), 297-305; https://doi.org/10.3390/surgeries3040032 - 11 Oct 2022
Viewed by 1471
Abstract
Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery [...] Read more.
Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery decreases surgical risks and is less invasive. The aim of this article is to present a case of guided osteotomy for bone biopsy and implant placement. Methods: CBCT was performed for the patient’s bone examination, an optical scanner was used for intra-oral images, and surgical certified software was applied for the osteotomy planning and the surgeon’s guide realization. Case report: The patient’s question is about left maxilla prosthetic rehabilitation. During the oral cavity and X-ray examination, a radiopacity with a feathered edge was found; in order to detect the finding, a CBCT was performed, and the surgery was planned. A bone biopsy was performed simultaneously with the implant’s placement through a drill guide. The specimen sent for histological exam showed osteosclerosis. Conclusions: It is the opinion of the authors that by involving and combining close collaboration and communication, several professional specializations (clinicians and radiologists) can improve the treatments for better patient care. Full article
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11 pages, 7540 KiB  
Case Report
Medication-Related Osteonecrosis of the Mandible Treated with Marginal Resection: A Case Report
by Maciej Chęciński, Krzysztof Wróbel and Maciej Sikora
Surgeries 2022, 3(2), 142-152; https://doi.org/10.3390/surgeries3020016 - 15 Jun 2022
Cited by 1 | Viewed by 1866
Abstract
The aim of this report is to present a successful combined surgical and pharmaceutical treatment in the highest stage of medicine-related osteonecrosis of the jaw (MRONJ). A 70-year-old man treated for metastatic prostate cancer concomitant with hypertension and diabetes presented due to the [...] Read more.
The aim of this report is to present a successful combined surgical and pharmaceutical treatment in the highest stage of medicine-related osteonecrosis of the jaw (MRONJ). A 70-year-old man treated for metastatic prostate cancer concomitant with hypertension and diabetes presented due to the exposure of the jawbone. Initial imaging studies suggested MRONJ, and the biopsy did not confirm bone metastasis in the oral cavity. Marginal resection of the mandible was performed after the administration of antibiotics and anticoagulants. There was no recurrence of mandibular necrosis during the 3-year follow-up. MRONJ can develop covertly, with scanty clinical symptoms, and can be easily overlooked. Radical combined treatment may, in some cases, prevent further progression of the disease, which was successful in this case. Full article
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