Role of Sticky Bone in the Management of Various Alveolar Bone Defects: A Systematic Review.

AIM: This systematic review aimed to evaluate the effectiveness of sticky bone in managing various alveolar bone defects, examining both its benefits and drawbacks. MATERIALS AND METHODS: The review adhered to PRISMA guidelines and employed a thorough search strategy using major databases, medical subject headings (MeSH) keywords, and Boolean operators. As a result, the systematic review identified 12 studies focusing on the efficacy of sticky bone in treating alveolar bone defects. Inclusion criteria consisted of randomized controlled trials and case series reporting on the outcomes of sticky bone use for bone defect treatment. Two examiners meticulously performed screening, data extraction, and bias assessment, with the risk of bias evaluated using the Cochrane tool. RESULT: The findings indicated significant improvements in bone quality, width, height, and volume, with enhanced predictability in socket preservation and implant placement. Sticky bone was particularly effective in ridge augmentation, guided bone regeneration, and filling periodontal defects, often outperforming alternatives like concentrated growth factors (CGFs) and autologous fibrin glue (AFG). It simplified procedures and reduced resorption during healing, underscoring its value as a versatile adjunct in bone reconstruction surgery. CONCLUSION: Sticky bone demonstrated exceptional results in various oral surgeries, effectively addressing issues such as furcation defects, bone loss, and ridge augmentation, with significant clinical and radiographic improvements. Further research is needed to explore its full potential and refine protocols for broader oral surgery and periodontics applications.

Prevalence and Anatomical Characteristics of Bifid and Trifid Mandibular Canals: A Computer Tomography Analysis.

PURPOSE: To assess the prevalence and configuration of bifid (BMC) and trifid (TMC) mandibular canals using computed tomography (CT), describing the anatomical characteristics of the accessory canals, especially of the retromolar type. MATERIALS AND METHODS: CT scans of 123 patients were analysed. BMCs were identified and the patterns of bifurcation were classified, including trifid canals. The width of accessory canals was measured. Retromolar canals were further classified according to their course and morphology, while their position and width were evaluated using linear measurements on CT images. RESULTS: The majority of patients (53.6%) presented at least one BMC or TMC. 36.2% of mandibular canals were bifid, while 4.5% were trifid. The forward canals (12.6%) and retromolar canals (10.2%) were the most common among BMCs. In relation to the retromolar canals, 60% were vertical and 40% curved, with a mean width of 1.03 ± 0.28mm. CONCLUSION: BMCs and TMCs are common 3D radiographic findings, so that they should be considered as anatomical variations, not anomalies. Preoperative CT or CBCT evaluation should aid in identifying these variations and analysing their position and course in surgical planning.

Peripherally induced movement disorders in the stomatognathic system after oral surgical or dental procedures.

OBJECTIVES: Peripherally induced movement disorders (PIMD) are hyperkinetic movement disorders that can occur after injury to a part of the body. This study aimed to identify PIMD in the stomatognathic system following dental or oral surgical procedures. MATERIALS AND METHODS: A total of 229 patients with PIMD (144 women and 85 men; mean age: 53.4 years) triggered by oral surgical or dental interventions were evaluated retrospectively. RESULTS: The average latency between the procedures and onset of PIMD was 14.3 days. Oral surgery (40.2%), including tooth extraction, trauma treatment, and other surgical procedures, was the most frequent trigger of PIMD. This was followed by general dental treatment, including periodontal, endodontic, and restorative procedures (36.7%), prosthetic treatment (19.7%), and orthodontic treatment (3.5%). PIMD consisted of oromandibular dystonia (73.8%), functional (psychogenic) movement disorders (11.4%), orolingual dyskinesia (7.9%), and hemimasticatory spasms (5.7%). CONCLUSIONS: These results suggest that even minor alterations in normal anatomy or physiology after dental procedures may result in PIMD in predisposing patients. CLINICAL RELEVANCE: Dental professionals should be aware that although infrequently, PIMD can develop after various dental treatments. If such symptoms precipitate, the attending physician should properly explain them to the patient and provide appropriate treatment or consultation with a movement disorder specialist.

Blended learning compared to traditional learning for the acquisition of competencies in oral surgery by dental students: A randomized controlled trial.

OBJECTIVE: To determine whether blended learning results in better educational outcomes compared to traditional learning in the acquisition of oral surgery technical skills for 4th-year undergraduate dental students. MATERIALS AND METHODS: Seventy-three students participated in this two-arm parallel randomized controlled trial. Only students in the blended learning group had access to the online preparation platform for oral surgery practical work (PW) on a pig's jaw and to the debriefing. Kirkpatrick's four-level model was used to assess the educational outcomes directly after (levels 1 and 2) and 6 months later, after the start of the students' clinical activity (levels 3 and 4). RESULTS: For level 1, higher global satisfaction scores were found for students in the blended learning compared to the traditional learning group (p = .002). For level 2, blended learning resulted in an increase in knowledge score (p < .01), comparable to that observed in the traditional learning group. For level 3, students in the blended group made more progress in 6 months than those in the traditional group in terms of feeling able to assess and perform anaesthesia (p = .040) and surgical tooth extraction (p = .043). No difference in level 4 was found for the 6-month clinical surgical activity between groups, but students in the blended group felt more able to assess and perform the surgical management of a failed extraction requiring bone removal (p = .044). CONCLUSION: Blended learning for oral surgery PW had a positive impact on three of the four Kirkpatrick levels (level 1, 3 and 4). Efforts should focus on the procedures that are perceived as the most difficult.

Evaluation of Tensile Strength of Surgically Absorbable Suture Materials Used in Oral Surgery after Immersion in Different Beverages: An In Vitro Study.

Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages.

A Case Report of Mandibular Gingival Metastasis From Sigmoid Colon Adenocarcinoma With Phenotypical Transformation Into Neuroendocrine Carcinoma.

This case report presents a 59-year-old female patient with mandibular gingival metastasis from adenocarcinoma of the sigmoid part of the colon, who underwent radical colectomy with simultaneous hysterectomy involving and left oophorectomy (due to tumor involvement) eight years ago. Because of metastatic spread to the liver, a partial left lateral lobectomy was performed, and because of a metastatic lesion in the left adrenal gland, the latter was excised and a partial resection of the left kidney was performed. The patient was given a number of courses of chemotherapy, target therapy, and immunotherapy. In 2024, because of a tumor mass in the oral cavity that was growing and interfering with normal nutrition and speech, she was hospitalized and a radical resection of the lesion was performed along with the involved underlying bone of the lower jaw on the right. The morphological analysis revealed metastasis from large cell neuroendocrine carcinoma and the immunohistochemical stains verified the gastrointestinal origin of the lesion. The lesion was accepted as being a result of the phenotypical transformation of the primary adenocarcinoma of the sigmoid colon. The patient had a normal postoperative period and a smoothly healing wound and continued to be under the management of clinical oncologists supporting chemo-, targeted, and immunotherapy. However, five months after the appearance of the lesion and three months after its surgical removal, after a serious deterioration of her general condition, she passed away at home.

To what extent is oral and maxillofacial surgery educational content posted on Instagram?

Hashtags on Instagram help users globally search for posts to their liking. This study aimed to determine who posts the most popular oral and maxillofacial surgery (OMS) hashtags on Instagram and to evaluate the impact of educational content. The posts were analyzed for the type of post and differences between content creators when posting OMS-related content. This cross-sectional study evaluated OMS content categorized by 36 hashtags. The top 9 posts with each hashtag were evaluated based on the type of content creator, if it was a video or picture, and if it was educational or for marketing purposes. 6 million posts existed among 36 hashtags. Regarding the categories of person/organization posting the content (US or non-US oral and maxillofacial surgeon, residency program, patient, and 'other'), the top posts (N = 295) were posted by 'other' and the least by 'residency program'. Among the posts by non-US oral and maxillofacial surgeons, there was 3.8-fold more marketing content, while among the posts by US oral and maxillofacial surgeons, there was 2-fold more educational content. Educational posts achieved the highest engagement in terms of 'likes'. This study highlights how oral and maxillofacial surgeons can educate the general population and expand their reach.

Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel.

BACKGROUND: This study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers. METHODS: This randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests. RESULTS: Pain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all). CONCLUSIONS: In conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser. TRIAL REGISTRATION: The study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials ( www.irct.ir ) (registration number: IRCT20220630055326N1).

Additively manufactured custom-made subperiosteal implant rehabilitation for severely atrophic maxillary molar area: A technical note.

Implant-prosthetic rehabilitations of severely atrophic posterior maxillary sectors currently is challenging, often requiring multiple surgeries and long rehabilitation times. Recently, graftless techniques (e.g. zygomatic, pterygoid and nasal implants) have gained popularity as they offer a reduction in rehabilitation time, aligning more closely with patient preferences but may not be feasible for sectorial rehabilitations. Subperiosteal implants, suggested for full-arch rehabilitations of atrophic maxilla, haven't been explored for sectorial rehabilitations. In this report we present the case of a patient with maxillary molar edentulism, rehabilitated with a subperiosteal implant.

Ridge Preservation Combined With Open Barrier Membrane Technique in Case of Postextractive Oroantral Communication: A Case Series Retrospective Study.

After dental extraction, a physiological phenomenon of reabsorption of the dentoalveolar process is triggered, especially if periradicular lesions are present, which can sometimes be associated with oroantral communication in the upper posterior maxilla. To investigate a minimally invasive approach, 19 patients undergoing tooth extraction in the posterosuperior maxilla were recruited. All cases presented an oroantral communication with a diameter of 2-5 mm after tooth extraction and the alveolar process and, in some cases, with a partial defect of 1 or more bony walls. In these cases, a single surgical procedure was used to preserve the alveolar ridge using an open barrier technique with an exposed dense polytetrafluoroethylene membrane. The bottom of the extraction socket was filled with a collagen fleece. The residual bone process was reconstructed using a biomaterial based on carbonate-apatite derived from porcine cancellous bone. After 6 months, all patients were recalled and subjected to radiographic control associated with an implant-prosthetic rehabilitation plan. Data relating to the sinus health status and the average height and thickness of the regenerated bone were collected. Radiographic evaluation verified the integrity of the maxillary sinus floor with new bone formation, detecting a vertical bone dimension between 3.1 mm and 7.4 mm (average 5.13 ± 1.15 mm) and a horizontal thickness between 4.2 mm and 9.6 mm (average 6.86 ± 1.55 mm). The goal of this study was to highlight the advantage of managing an oroantral communication and, simultaneously, obtain the preservation and regeneration of the alveolar bone crest. The open barrier technique appears to be effective for the minimally invasive management of oroantral communication up to 5 mm in diameter in postextraction sites, with a good regeneration of hard and soft tissue.

Preoperative Assessment for Surgical Accuracy in Maxillofacial Surgery Cases Using Stereolithographic Models.

Recent advancements in imaging technologies, particularly stereolithography, have transformed medical and surgical practices, including oral and maxillofacial surgery. Utilizing precise three-dimensional (3D) models crafted from virtual representations, these innovations have revolutionized diagnosis, treatment planning, and surgical simulation. In a study conducted at the Department of Oral and Maxillofacial Surgery, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, five patients with complex maxillofacial deformities underwent surgical interventions guided by stereolithographic models. Despite challenges such as fabrication time and cost constraints, the integration of 3D models significantly streamlined preoperative planning, reduced operative time, and facilitated precise surgical execution. Customized implants and pre-bent plates, based on model simulations, enabled conservative surgical approaches and optimal fit and function. The integration of stereolithography with computer-aided design/computer-aided manufacturing (CAD/CAM) software represents a significant advancement in enhancing surgical precision and improving patient outcomes in cranio-maxillofacial surgery.

Full-arch rehabilitation of severely atrophic maxilla with additively manufactured custom-made subperiosteal implants: A multicenter retrospective study.

The aim of this retrospective study was to analyze a series of patients who underwent full-arch rehabilitation of the atrophic maxilla using additively manufactured subperiosteal implants, between August 2018 and January 2023, at the Universities of Sassari and Poznan. In total, 36 patients and 72 implants were included, with no implants lost during follow-up, and a success rate of 90.3%. Seven (9.7%) of the implants showed class 1 exposure. Bleeding on probing was detected in 10.4% of the abutments at 6 months, 7.9% at 1 year, 10% at 2 years, 7% at 3 years, and 11.4% at 4 years. No significant bone resorption under the abutments was detected during the whole observation period. Based on the findings from this study, additively manufactured subperiosteal implants could represent a safe and reliable technique for full-arch rehabilitation in patients with severe maxillary atrophy.

Utility of Cadaveric Porcine Heads for Teaching Oral Surgical Procedures in an Australian Dental School: A Pilot Study.

Background/Objectives: Cadaveric models have traditionally been a mainstay of dental and medical education worldwide since their inception. In Australia, educators at dental schools were among the first to use cadaveric porcine heads in formal teaching in oral surgery. This practice has since fallen out of favour in most modern dental curricula. The aim of this pilot study was to determine the utility of cadaveric porcine models for oral surgery training from a student perspective (Griffith University, Gold Coast, Australia). Methods: Thirty participants who were all third-year dental students attended a two-hour session comprising a 30 min lecture followed by a 90 min practical workshop. The lecture outlined the steps and supervision of students during the practical and was provided by a consultant maxillofacial surgeon. At the conclusion of the workshop, participants were asked to anonymously complete a printed questionnaire with eight questions related to their experience. Results: Prior to the workshop, two-thirds (61%) of participants felt that they had been taught the surgical procedure for raising mucoperiosteal flaps adequately in their dental school curriculum during their third year, although only 43% of students had assisted specialty residents in raising a mucoperiosteal flap and 14% reported having performed the procedure themselves. Almost all students (96%) agreed that the porcine model was useful for their dental education and that they would practice the exercise using the model again if provided with the opportunity. The questionnaire had a 93.33% completion rate. Conclusions: This pilot study indicates that porcine heads present a useful, low-cost adjunct in the learning of basic oral surgical procedures.

Bibliometric Network Analysis and Visualization of Research Trends in Gingivectomy.

Background: Gingivectomy has been the preferred method since the findings in 1884. It evolved from "blind" subgingival scaling to "the excision of the soft tissue". The use of these techniques is no longer mandatory in clinical situations; therefore, researchers have searched for numerous publications that have been registered regarding gingivectomy. This research aims to fill the niche area by assessing more about gingivectomy and it's trend among the periodontology topic of discussion. Methods: Descriptive and analytical observation by evaluating the result of the VOS viewer mapping and calculation throughout the bibliographic data from publications obtained from SCOPUS in July 2022. Results: There are 660 publications from six types of publication. Related keywords are compiled and visualized by network mapping. There is a significant gap among the contributing countries in the number of documents and number of citations per journal. However, a minimal gap is seen in other objectives, such as authors, journals, and institutions on their contribution towards the publication of gingivectomy topics. Conclusion: A total of 660 of 1914 articles were included in the analysis after the filtering process, and these articles were cited 5910 times, with an average of 9 citations per article.

Surgical treatment compared with "wait and see" in patients affected by oral leukoplakia to prevent oral cancer: Preliminary data from a multicenter randomized controlled trial.

OBJECTIVE: Oral leukoplakia (OL) is one of the most common and investigated oral potentially malignant disorders (OPMD). Preventing OSCC occurrence should be the primary outcome in the clinical management of OL. Surgical removal of OL is performed by most clinicians, although its effectiveness in reducing OSCC onset has still not been established by randomized controlled trials (RCT). Wait and see approach is characterized by frequent clinical examinations and periodical biopsies of OL, avoiding unnecessary surgical procedures. This is the first multicenter RCT in literature aiming at comparing the effectiveness of surgical removal and the "wait and see" approach in preventing OSCC onset in patients affected by dysplastic and non-dysplastic OL. METHODS: Two Italian referral care centres for oral diseases were involved in this multicenter two-arm RCT comparing the surgical removal of OL (group A) and the "wait and see" approach (group B), with the aim of reducing oral cancer onset. RESULTS: This report shows preliminary data on the first 161 patients, with a mean follow-up of 19.14 ± 11.25 months. Eight cases of OSCC occurred (6 out 8 involving the tongue): one case in group A and seven cases in group B. Moreover, OL recurred in 13 (20%) cases after surgical excision. CONCLUSIONS: Within the limitations of this preliminary report, these initial data underline the increased risk of OSCC onset in the case of OL of the tongue in the presence of epithelial dysplasia in group B ("wait and see") compared to group A (surgery). This RCT is currently ongoing at the same clinical departments, with the aim of enrolling 310 patients and collecting data at 5-year follow-up, in order to achieve conclusive results, in an evidence-based medicine approach.

Near-infrared fluorescence imaging technology guided margin design in oral squamous cell carcinoma: a single-centre retrospective study.

Objective: The margin status of oral squamous cell carcinoma patients is considered to be predictive of recurrence and long-term survival. Therefore, precise intraoperative margin assessment is crucial. This study investigated the feasibility of using near-infrared fluorescence imaging technology to guide margin design in oral squamous cell carcinoma patients. Methods: In this retrospective study, indocyanine green solution was intravenously injected preoperatively into patients. Intraoperatively, the surgical area was illuminated using a near-infrared fluorescence imaging system, which caused the lesion to fluoresce in the surgical area. Surgery was performed with the assistance of fluorescence imaging. The fluorescence intensity of the lesion area and surrounding normal tissue was recorded during surgery. Intraoperative margins were sent for rapid pathology, and postoperative margin pathology results were documented. Results: Sixteen patients were included in this study (7 males, 9 females), with an average age of 65.65 ± 12.37 years. Preoperative biopsy and postoperative pathology confirmed oral squamous cell carcinoma in all patients. No cancer cells were found in the margin pathology results. The average fluorescence intensity of the lesion area was 214 ± 4.70, and that of the surrounding normal tissue was 104.63 ± 3.14. There was no significant difference in the fluorescence intensity values of the lesion areas among all patients (F=0.38, P>0.05). There was a significant difference in fluorescence intensity between the lesion area and surrounding normal tissue (t=33.76, P<0.05). Conclusion: Near-infrared fluorescence imaging technology can aid in real-time imaging differentiation of lesion areas based on differences in fluorescence intensity during surgery. The use of this technology can assist surgeons in assessing the safety margin and reliably guide surgery.

A Systematic Review and Meta-Analysis Comparing Surgical and Nonsurgical Treatments for Excessive Gingival Display.

Excessive gingival display (EGD) is defined as more than 2 mm of gingiva display above the maxillary incisors at maximum smile. Various skeletal, dental, and soft tissue etiological factors for EGD have been suggested. This study assessed the effectiveness and stability of surgical (SX) and nonsurgical (NSX) interventions for correction of EGD through a systematic review and meta-analysis following PRISMA 2020 guidelines. An electronic search of Ovid MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science, and LILACS was conducted (2010-2023). Results were expressed as mean change in gingival display using the random-effects model at 1, 3, 6, and 12-month follow-up. At 1 month, SX and NSX treatments yielded a comparable mean reduction of 3.50 mm (2.13-4.86) and 3.43 mm (2.67-4.19) in gingival display, respectively. However, by 6 months, NSX treatments showed a reduction of 0.51 mm compared to 2.86 mm with SX treatments. SX outcomes remained stable past 6 months, while NSX outcomes partially relapsed at 6 months and returned to baseline levels at 12 months. Notably, NSX treatments were more effective in cases with mild initial EGD, while SX treatments showed a better outcome in severe cases. To draw more robust conclusions regarding the treatment outcomes, future primary studies of greater rigor are required.