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Background/Objectives: The use of miniplates for stabilizing bones post orthognathic surgery has surged in popularity due to their efficacy in ensuring stability and hastening recovery. However, controversy exists regarding what should be done with these miniplates after surgery. Some surgeons advocate for their removal, while others suggest leaving them in place. This study sought to assess the frequency, causes, and potential risk factors linked with miniplate removal in orthognathic procedures. Methods: A thorough meta-analysis was conducted by scrutinizing studies from various databases including PubMed, Google Scholar, Embase, and Scopus, focusing on publications spanning from 1989 to 2023. Results: Ten studies meeting the inclusion criteria, encompassing 1603 patients, were chosen for inclusion in the meta-analysis. The male-to-female ratio varied from 0.7:1 to 4:1. Overall, 5595 miniplates were inserted, with 294 (5.3%) being subsequently removed. Primary reasons for miniplate removal included infection (161 cases, 2.9%), exposure of miniplates (34 cases, 0.6%), and palpable plates (23 cases, 0.4%). Other indications comprised pain, patient preference, and temperature sensitivity. Less frequent causes for miniplate removal included sinusitis, secondary surgery, and dental pathology. The mean duration of miniplate removal was 5.5 months, with the majority (56.1%) being removed from the mandible rather than the maxilla. In conclusion, this meta-analysis underscores the importance of miniplate removal when hardware causes complications and physical discomfort. The primary reasons for removing miniplates were infection and plate exposure, with the mandible being the most common removal site. Conclusions: These findings emphasize the need for continued monitoring to assess the fate of miniplates in orthognathic surgery and provide valuable information for future clinical decision-making.
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BACKGROUND: Intraoral adenoid cystic carcinoma (ACC) arising from minor salivary glands (MSG) is a rare malignancy associated with delayed diagnosis and unfavorable outcomes. This study aimed to comprehensively review ACC of MSGs, focusing on clinical characteristics, imaging modalities, treatment approaches, and long-term outcomes. METHODS: A systematic search was conducted in PubMed, Web of Science, and MEDLINE databases to identify relevant articles reporting cases of ACC of MSGs between January 1997 and March 2023. The study was registered in PROSPERO (ID: CRD42023449478). A total of 10 studies that met the inclusion criteria were selected for critical review. In total, 902 patients were diagnosed with ACC of MSGs with an age range of 44.3 to 63 years, and an average age of 56.6 years. The female to male ratio ranges from 1:1 to 2.4:1. Regarding the primary site of ACC, the palate was the most common location, accounting for 30.5% to 83.3%, followed by the buccal mucosa, floor of the mouth, and lip and the retromolar area. For histology, the solid mass pattern was the most prevalent, seen in 95.2% of patients, followed by the cribriform pattern. Regarding treatment modalities, surgery was the most common approach, applied in 76.3% of cases, with a combination of surgery and radiotherapy used in 29.0% of cases. A smaller fraction, 3.2%, received a combination of surgery, chemotherapy, and radiotherapy, and 8.3% underwent radiotherapy alone. Local recurrence rates varied between 1% and 28.5%, and distant metastasis occurred in 18.2% to 33.3% of cases, predominantly to lymph nodes (14.5%). An analysis of overall survival across various stages and patient numbers indicated a 5-year survival rate of 68.0%. The findings of this study provide valuable insights for physicians in making treatment decisions and emphasize the need for ongoing research and collaborative clinical efforts to improve the management and outcomes of this challenging disease. CONCLUSION: ACC of MSGs is a multifaceted condition typically manifesting as asymptomatic enlargement and ulceration. This disease is marked by distinct histopathological patterns and perineural invasion (PNI). Recognizing these distinctive aspects is key in shaping the treatment plan, which can range from surgical procedures to radiation therapy, chemotherapy, and evolving targeted treatments. Continuous research and collaborative clinical efforts remain critical for ongoing progress in the treatment and management of this challenging condition.
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OBJECTIVES: In this article, we explored the level of knowledge and practice of licensed dentists in the United Arab Emirates regarding managing patients on antithrombotic medications. Moreover, to assess the need for educational intervention in this area is one of the objectives. MATERIALS AND METHODS: A total of 502 dentists answered 22 close-ended questionnaires. The sample size was determined based on the registry of the Ministry of Health. RESULTS: Only 5.6 and 5.9% showed satisfactory overall awareness about aspirin and plavix, respectively, as drugs may hamper hemostasis. A substantial proportion of dentists consider aspirin (63.1%) and clopidogrel (52.2%) discontinuation before treatment. More than one-third of the participants shall not consider extracting teeth before physician approval, and one-quarter to one-third of them refer patients on such medications to oral surgeons to perform tooth extraction. Most respondents did not adequately answer the questions about the additional hemostatic measures and postoperative analgesia. A significantly high number of participants (n = 440, 87.6%) want to attend updated courses on the dental management of such patients. CONCLUSIONS: The dentists demonstrate a contrasting diversity of knowledge and practice approaches to patient management on antiplatelet agents. There is an apparent demand to raise understanding of the evidence-based management of a patient on such medications. It is vital to keep formalized training sessions and provide the necessary expertise to students and dentists to prevent unwanted complications.
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BACKGROUND: In the current research, Er,Cr:YSGG laser been used in ablative mode to peel the pigmentation, and many sessions were done to completely remove the melanin pigmentations. MATERIALS AND METHODS: 85 patients were selected and Er,Cr : YSGG laser with 2780 nm wavelength in ablative mode (iPlus, Biolase, USA) was used to treat patients with dark lip melanin pigmentation, using gold handpiece and MZ 10 tip (diameter of 1 mm), and the parameters were set as follows: energy density 28.7 J/cm2, frequency 30 Hz, water cooling 100%, and air cooling 60%. RESULTS: The vast majority of the patients (82.4%) had mild adverse effects after the lip depigmentation and 74.1% of patients reported complete improvement of the lip with a high satisfaction rate (84.7%) during the follow-up period with a low level of relapse. CONCLUSION: Er,Cr:YSGG 2670 nm is an effective tool to achieve excellent esthetic results in the treatment of lip melanin pigmentation; it is very well tolerated by patients with minimal adverse effects.
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OBJECTIVE: To determine the mean soft tissue facial profile for Circassian adults as determined by Legan-Burstone cephalometric analysis. MATERIALS AND METHODS: 71 lateral cephalometric radiographs for nongrowing Circassian adults with normal occlusion were traced and accurately measured. RESULTS: With regard to facial form analysis, Circassian adults showed higher facial convexity angle, retruded mandible, and obtuse lower face-throat angle. When compared with lip form norms, Circassians showed increased nasolabial angle, deeper mentolabial sulcus, and increased maxillary incisor exposure. Comparison between men and women showed that mentolabial sulcus depth was significantly increased in Circassian men compared with Circassian women. CONCLUSION: The results of this study showed that soft tissue facial profiles for Circassians and Caucasians are different in certain values. Such differences should be taken into account when formulating a treatment plan for Circassian patients seeking orthodontic treatment and orthognathic surgery.
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OBJECTIVE: The purpose of this study was to determine the perception of trained dental professionals and laypersons toward the esthetic impact of variations in the vertical position, width, and gingival height of the maxillary lateral incisor. MATERIALS AND METHODS: The present study analyzed the perspective of smile photographs by dental professionals such as "fifty orthodontics and fifty general dental practitioners (GDPs)" as well as fifty laypersons, consisting of an equal number of male and female participants. Photographs edited to depict alteration of golden proportion, incisal length, and gingival height of lateral incisor. SPSS software was used to analyze the data and determine the significant difference within all the participants, at 0.05% level (95% confidence interval). RESULTS: There was no significant difference in ranking between the genders. Golden proportion of 62%-67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Regarding gingival display, corrected height of -0.5 and -1 mm received highest ranking from all the three groups. In case of lateral incisal length, -0.5 mm was ranked highest by laypersons, in contrast to -1 mm by orthodontists and GDPs. CONCLUSION: Specific differences were observed in the ranking of smile esthetics by health-care professionals and laypersons. Golden proportion of 62% and 67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Corrected gingival height of -0.5 and -1 mm received highest ranking from all the three groups. In case of lateral incisal length, -0.5 mm was ranked highest by laypersons, in contrast to -1 mm by orthodontists and GDPs.
