Protective Effects of Helmet Type on Facial Injuries.

ABSTRACT: The compulsory use of helmet by motorcyclists has lowered the incidence of facial trauma, but there are few studies evaluating the effects of different helmet types on such injuries. The authors collected retrospective data from the medical records of 287 motorcyclists presenting facial injuries treated at the maxillofacial surgery department of the "University Magna Graecia" of Catanzaro city in South Italy between 1 January 2007 and 1 August 2018. Patients were wearing 2 types of crash helmets at the time of the trauma, full face ones or open-face ones, and were compared using the Facial Injury Severity Scale (FISS). Those wearing open-face helmet were 3 times more than those wearing full-face helmet, with a higher FISS score.The purpose of this study was to investigate the impact of Italy's compulsory helmet law on the change in helmet use and in particular if protection offered by helmets w4as different according to helmet type. The authors correlated the FISS scores among motorcyclists wearing these 2 tipologies of crash helmet.

Efficacy of SMAS flap technique to prevent Frey's syndrome and aesthetic outcomes. A retrospective cohort analysis.

AIM: The aim of this retrospective cohort study was to evaluate the efficacy of Superficial Musculoaponeurotic System (SMAS) flap technique to prevent Frey's Syndrome (FS) and improve aesthetic outcomes following superficial parotidectomy. MATERIALS AND METHODS: A total of 140 patients were treated between January 2003 and December 2018 at the Maxillofacial Unit of Magna Graecia University of Catanzaro with Superficial Parotidectomy (SP) for benign tumor and divided in two groups: Group 1 (78 patients) underwent SMAS flap reconstruction of the parotid lodge through a modified facelift incision and Group 2 (62 patients) underwent to SP without the use of SMAS interposition through a Redon type incision. RESULTS: Significant statistical difference concerning FS, transient facial nerve injury, facial paralysis, salivary fistula, haematoma and skin deepness were found between Group 1 and Group 2, (0,00% vs 6,45% [p < 0,036], 2,56% vs 16,12% [p = 0,005], 0,00% vs 9,67% [p= 0,006], 1,28% vs 9,67% [p= 0,044], 1,28% vs 19,35% [p = 0,0002]) respectively. No significant statistical differences between the two groups were observed about wound infections (3,84% vs 8,06% [p= 0,466]). DISCUSSION: SP represents the gold standard for the surgical treatment of benign tumors of the parotid gland greater than 3,5 cm in size involving superficial portion of the gland, for the low rate of recurrences over time and lower incidence of transient or permanent facial paralysis to which this technique leads. However, SP is not free from other complications such as FS, haematoma, salivary fistula and aesthetic results like facial contour deformity due to surgical site depression and visible scar. A reconstructive technique to reduce the impact of complications after SP is the SMAS flap because its preparation is easy, contextual to the parotidectomy and increases a little the surgical time. CONCLUSIONS: This study highlights the advantages of SMAS flap technique in reducing complications following parotid surgery, particularly FS, and in improving the quality of life. KEY WORDS: Frey's Syndrome, Minor test, Parotid benign tumor, SMAS flap, Superficial parotidectomy.

Malignant transformation of oral lichen planus. A retrospective analysis from 2003-2014: our experience.

AIM: The aim of the study is to describe both the clinical characteristics and the prevalence of Oral lichen planus (OLP) in a group of patients from a region of Southern Italy. MATERIAL AND METHODS: Among the patients who referred to outpatient visit, 96 (35 men and 61 women) received diagnosis of OLP according to Van der Meij and Van der Wall criteria. RESULTS: Nine of ninty-six cases observed developed squamous cell carcinoma (9,37%). The risk of malignant transformation was significantly higher among OLP patients who smoked (OR=2,5 P< 0,05), consumed alcohol (OR=3 P< 0,05), came from the province with a ratio province: city of 4,5:1 and had the reticular form (44.4%). DISCUSSION: Oral lichen planus (OLP) is an oral subtype of lichen planus with a prevalence in the world population estimated between 0.22% and 5% and an incidence approximately of 2.2%. The analysis of our results revealed an important information about the prevalence of malignant transformation, which is 9.37%. CONCLUSION: The transformation of the oral lichen planus may not be as rare as one would expect. The malignant transformation rates of OLP are underestimated due essentially to restrictive diagnostic criteria, inadequate follow-up periods, and/or low quality of studies. Close surveillance is mandatory to monitoring the growth and evolution of lesions in order to reduce the morbidity of OSCC. KEY WORDS: Malignant transformation, Oral lichen Planus, Squamous cell carcinoma of the oral cavity.

Telemedicine in Oral and Maxillo-Facial Surgery: An Effective Alternative in Post COVID-19 Pandemic.

The aim of this work was to demonstrate the advantages of using telemedicine (TM) in the management of the outpatients with maxillofacial surgical pathologies during the COVID-19 pandemic. The study was conducted at the MaxilloFacial Surgery Unit of "Magna Graecia" University of Catanzaro, on two different groups of patients: a group of follow-up patients (A1: patients in oncological follow-up after surgical treatment performed before the COVID-19 pandemic; A2: suffering from chronic lesions such as precancerous lesions), and a group B of patients with first urgent visits (B1: patients with suspected oncological pathology; B2: patients with suspected urgent disease such as medication-related osteonecrosis of the jaws (MRONJ), odontogenic abscesses, temporomandibular joint (TMJ) dislocation, etc.). Participation in the study required possession of a smartphone with Internet access, e-mail and the use of a messaging service (WhatsApp or Telegram) to send photos and messages; completion by the patient of a COVID-19 screening questionnaire; submission of a satisfaction questionnaire by the doctors and patients. A total of 90 patients were included in this study. A high percentage of satisfaction emerged from the analysis of the satisfaction questionnaires of both patients and doctors.TM thus represents an excellent opportunity to improve accessibility to oncological and non-management activities, reducing the risk of Covid-19 dissemination and should be promoted and implemented in the post-pandemic era.

Management in oral and maxillofacial surgery during the COVID-19 pandemic: Our experience.

A novel ß-coronavirus (2019-nCOV), identified in Wuhan City in late December 2019, is generating a rapid and tragic health emergency in Italy due to the need to provide assistance to an uncontrollable number of infected patients and, at the same time, treat all the non-deferrable oncological and traumatic maxillofacial conditions. This article summarises the clinical and surgical experience of Maxillofacial Surgery Unit of "Magna Graecia" University (Catanzaro -Italy) during the COVID-19 pandemic and would like to provide a number of recommendations that should facilitate the scheduling process of surgical activities during the COVID-19 pandemic and reduce the risk of infection among healthcare professionals.

Abrikossoff's tumor of the tongue: Report of three cases and review of the literature.

Abrikossoff 's tumor, also called granular cell tumor (GCT), is a rare benign neoplasm of the soft tissues. In almost 70% of the cases, it occurs in the head-and-neck region (especially in the tongue), even though it may present in every other part of the body. This neoplasm has a benign behavior usually, but there have been described a malignant transformation in 2%-3% of the cases. The characterization of this tumor depends on its clinical and histopathological findings. The purpose of our work is to report three uncommon cases of oral Abrikossoff 's tumor located on the tongue in young patients referred to our department of maxillofacial surgery of "University Magna Graecia" in Catanzaro, also reviewing of the literature.

Mini-retromandibular transparotid approach to subcondylar fractures of the mandible A single Center clinical experience.

AIM: We evaluated the safety and efficacy using a mini-retromandibular transparotid approach to reduce and rigidly fix displaced mandibular condylar neck fractures. MATERIAL OF STUDY: Retrospective evaluation of patients who underwent surgical reduction of condylar fracture from January 2012 to December 2014 at the Department of Cranio Maxillo-Facial Surgery of the University Hospital of Catanzaro, Italy. All the patients were clinically assessed for signs/symptoms of infection, signs of Frey's syndrome or salivary fistula, facial nerve palsy ,postoperative scar, TMJ function, and occlusion with range of mouth opening and deviation. RESULTS: The sample was composed of 15 patients. Good results were achieved in all patients and with an average follow- up of 20 months. No major intraoperative or postoperative complication remained at 6 months of postoperative follow- up. DISCUSSION: Management of condylar fractures is still one of the most controversial topics in maxillofacial surgery. Regarding our experience with the mini-retromandibular approach, we evaluate the advantages in comparison with other extra-oral approaches. Advantages include the shorter working distance from the skin incision to the condyle with direct alignment of the fractured segments, less conspicuous facial surgical scarring with good cosmetic result, short operation time, with a low risk of postoperative complications and possible injuries of the facial nerve. CONCLUSIONS: According to our results, we believe that the mini-retro-mandibular approach is a viable and safe approach for the surgical treatment of condylar fractures, with a relatively low risk of postoperative complications. KEY WORDS: Condylar fracture, Extraoral approach, Mini-retromandibular access.

Jaw bones regeneration using mesenchymal stem cells. A single-center experience.

PURPOSE: Mesenchymal stem cells (MSC), which are multipotent stromal cells, are considered to be a promising resource in tissue engineering and tissue regeneration. MSCs have been used to generate new maxillary bone with clinically successful results. The aim of this study was to determine the role of MSC in bone regeneration procedures in patients with benign maxillary lesions. METHODS: A study was conducted on five patients treated for maxillary bone defects resulting from biopsy of benign lesions at the University Hospital of Magna Græcia, Catanzaro, Italy from January 2015 to October 2016. MSC from autologous bone marrow were used for bone regeneration. The bone mineral density was compared, using the Hounsfield scale, before and after treatment. Follow-up was monthly for six months, and the patients underwent a computed tomography scan of the maxilla at 6 months. RESULTS: Five patients, who underwent biopsy of osteolytic odontogenic benign tumors, were included in the study. There were no intraoperative or postoperative complications. The mean volume of the newly formed bone was 2.44cm3 (range 2,0-3,1) and the mean bone density was 1137 Hounsfield Units (range 898-1355). CONCLUSIONS: Bone regeneration with MSC from autologous bone marrow appears to be a valid treatment option for maxillary bone defects. KEY WORDS: Bone regeneration, Mesenchymal stem cells, BM-MSC, Upper jaw, Mandible.