Surgical treatment of condylar head fractures, the way to minimize the postraumatic TMJ ankylosis.

Management of condylar head fractures (CHF) of the temporomandibular joint (TMJ) remains a source of controversy. Based on established literature, group of CHFs and conservative treatment connected with period of maxillomandibular fixation (MMF) increases the risk for TMJ ankylosis. This paper presents anatomical and functional results of surgical treatment of condylar head fractures in a group of 24 patients (29 joints). Fractures were diagnosed based on conventional radiographs and computed tomography (CT) scans. Utilising an intraoperative arthroscopy authors evaluated actual intraarticular posttraumatic changes. This study presents acceptable functional and radiological results of surgical treatment of condylar head fractures with more than 3-year follow-up. The authors believe that re-establishing the pretraumatic anatomic position of the TMJ components (fragment and the disc) and early postoperative rehabilitation are inevitable to minimize the risk of postraumatic TMJ ankylosis (Tab. 2, Fig. 8, Ref. 31).

Is the prevalence of the medication-related osteonecrosis of the jaws underestimated, evaluation in oncological and non-oncological disease.

OBJECTIVES: The purpose of this study was to evaluate the prevalence of medication-related osteonecrosis of the jaw in Slovak population and compare the literature findings, whether the prevalence of MRONJ is underestimated. BACKGROUND: Antiresorptive drugs significantly increase quality of life, although during therapy, or in post-treatment period, osteonecrosis of the jaws might occur as a severe adverse effect. Medication-related osteonecrosis of the jaws (MRONJ) is a severe problem that has been observed in the past few years. METHODS: This multi-centric study evaluates the prevalence in Slovak population, assesses the values from 4 largest centres of maxillofacial surgery in Slovakia (1166 patients with MRONJ) and provides the comparison of literature review. RESULTS: Between 2010-2015, there was increasing number of newly diagnosed patients with MRONJ (1166 overall MRONJ patients) annually, except 2012 (mean growth of 123.88 %). This finding was supported by a statistical analysis of the rising tendency of prevalence in literature, where there was a significant difference in prevalence of non-oncologic patients before and after 2010 t(15) = 2.725, p = 0.016. The 6-year prevalence was 1.34 % in population with antiresorptive drugs intake, for osteoporosis 0.47 %, for breast cancer 4.10 %, prostate cancer 3.99 % and multiple myeloma 21.26 %. CONCLUSION: This study considers that there is a significant rising tendency of MRONJ in non-oncological patients, what could be caused by underestimation of the risk for development MRONJ in these patients. There should be a better cooperation and information among dentists and doctors indicating the antiresorptive treatment and strong emphasis on primary prevention before the initial treatment even in non-oncological patients (Tab. 5, Fig. 7, Ref. 69).

Long-term results of maxillary distraction osteogenesis in nongrowing cleft: 5-years experience using internal device.

Patients with cleft lip and palate (CLP) related deformities frequently have maxillary hypoplasia in all dimensions. These patients usually present with class III malocclusions, retruded midfaces and narrow hard palates. The skeletal problems can be treated by means of Le Fort I maxillary procedures. Surgical and orthodontic correction of severe maxillary hypoplasia, as often seen in CLP patients, has however proved to be challenging. The magnitude of the advancement is often hampered and the post operative stability significantly affected by palatal soft tissue scarring. The slow distraction of bone and the histogenic abilities of distraction osteogenesis (DO) have made it an atractive alternative treatment option for the management of maxillary hypoplasia in these patients. This paper presents the treatment results of 15 nongrowing CLP patients with severe maxillary hypoplasia treated by means of intra oral distraction. The mean anterior distraction of the maxillas was 12.7 mm (9-15.0 mm). The long-term cephalometric and clinical evaluation after a minimum of 60 months (mean follow-up 71 months) proved to be stable. The treatment results revealed, that distraction osteogenesis in nongrowing CLP patients with severe maxillary hypoplasia proved to be a predictable and stable option (Tab. 2, Fig. 3, Ref. 26).