Lingual Application of Pre-Bent Reconstruction Plate for Segmental Mandibular Defect: Easy and Accurate Method Through the Buccal Drilling Approach Using Computer-Aided Design/Computer-Aided Manufacturing Surgical Guides.

To prevent or treat for complications of reconstruction plate, such as metal plate fracture, plate exposure, and formation of skin fistula, the use of reconstruction plates on the mandibular lingual aspect has been introduced. However, this method increases the difficulty of surgery and lengthens the surgery time. In this study, the authors aimed to present a method to apply for reconstruction plates on the lingual side of the mandible to overcome the complications associated with the use of these plates. In the proposed method, the reconstruction plate was bent and fixed by a specially designed screws on a three-dimensional model created through a pre-operative virtual surgical simulation. Next, the model, prebent reconstruction plant, and screw were 3-dimensionally scanned and then superimposed precisely onto the three-dimensional model generated through the virtual surgical simulation. After extracting the three-dimensional path of the screws on the superimposed model, a surgical guide was prepared to drill screw holes in the buccal side of the mandible by transferring the extracted paths. The proposed surgical method using virtual surgical planning and surgical guides makes mandibular lingual application of the prebent reconstruction plates convenient, fast, and precise through drilling in the buccal side of the mandible.

Validation of a three-dimensional printed model for training of surgical extraction of supernumerary teeth.

INTRODUCTION: This study aimed to validate a three-dimensional (3D) printed model to provide training for supernumerary teeth (SNTs) extraction. MATERIALS AND METHODS: Each of the 30 participants, grouped as experienced and without experience, conducted two identically simulated surgeries on a 3D-printed replica of human mixed dentition with a SNT. The surgery time, area of bony window and volume of removed material were measured; subsequently, responses to a five-item questionnaire were recorded. The collected data were statistically analysed. RESULTS: The surgery time was 228.37 ± 141.53 seconds and 125.47 ± 53.03 seconds in the first and second surgery, respectively. The training significantly decreased the surgery time in the participants without experience (P = .000). However, there were no significant differences in the area of window opening (P = .271) and volume of removed material between the two surgeries (P = .075). The participants who perceived educational benefits accounted for more than 60% of the respondents for every question. Participants without experience in SNT extraction showed a tendency to rate a higher score than did those with experience. CONCLUSIONS: A 3D-printed model for surgical extraction of a SNT can improve surgical skill and, especially, shorten the learning curve in beginners.

Comparison of Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography and Computed Tomography for the Evaluation Bone Invasion in Upper and Lower Gingival Cancers.

PURPOSE: Preoperative detection of bone invasion is important in cases of gingival cancer. The aim of this study was to compare the diagnostic value of 3 imaging methods for the detection of bone invasion in upper and lower gingival cancer: computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) and CT. MATERIALS AND METHODS: This retrospective cohort study enrolled patients who underwent a maxillectomy or a mandibulectomy for gingival cancer. Each preoperative image (CT, MRI, or PET/CT) was reviewed for the presence of bone invasion, and the possibility for bone invasion was graded. These results were verified with pathology reports. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of mandibular involvement in alveolar bone were calculated, and a receiver operating characteristics (ROC) curve analysis was performed. RESULTS: Forty patients (27 men and 13 women) were enrolled. Pathologic examination disclosed bone invasion in 25 of the 40 patients. Of these patients, 13 had maxillary and 12 had mandibular alveolus involvement. The diagnostic accuracy of CT (90.0%) was highest among the 3 modalities for the detection of bone invasion. In the ROC curve analysis, values for the area under the curve for upper gingival cancer were lower than those for lower gingival cancer. CONCLUSIONS: The 3 imaging methods were less sensitive for the detection of bone invasion in upper gingival cancer than in lower gingival cancer. Cases of upper gingival cancer should be evaluated more carefully for bone invasion before surgery.

Soft, thin skin-mounted power management systems and their use in wireless thermography.

Power supply represents a critical challenge in the development of body-integrated electronic technologies. Although recent research establishes an impressive variety of options in energy storage (batteries and supercapacitors) and generation (triboelectric, piezoelectric, thermoelectric, and photovoltaic devices), the modest electrical performance and/or the absence of soft, biocompatible mechanical properties limit their practical use. The results presented here form the basis of soft, skin-compatible means for efficient photovoltaic generation and high-capacity storage of electrical power using dual-junction, compound semiconductor solar cells and chip-scale, rechargeable lithium-ion batteries, respectively. Miniaturized components, deformable interconnects, optimized array layouts, and dual-composition elastomer substrates, superstrates, and encapsulation layers represent key features. Systematic studies of the materials and mechanics identify optimized designs, including unusual configurations that exploit a folded, multilayer construct to improve the functional density without adversely affecting the soft, stretchable characteristics. System-level examples exploit such technologies in fully wireless sensors for precision skin thermography, with capabilities in continuous data logging and local processing, validated through demonstrations on volunteer subjects in various realistic scenarios.

Miniaturized Battery-Free Wireless Systems for Wearable Pulse Oximetry.

Development of unconventional technologies for wireless collection, storage and analysis of quantitative, clinically relevant information on physiological status is of growing interest. Soft, biocompatible systems are widely regarded as important because they facilitate mounting on external (e.g. skin) and internal (e.g. heart, brain) surfaces of the body. Ultra-miniaturized, lightweight and battery-free devices have the potential to establish complementary options in bio-integration, where chronic interfaces (i.e. months) are possible on hard surfaces such as the fingernails and the teeth, with negligible risk for irritation or discomfort. Here we report materials and device concepts for flexible platforms that incorporate advanced optoelectronic functionality for applications in wireless capture and transmission of photoplethysmograms, including quantitative information on blood oxygenation, heart rate and heart rate variability. Specifically, reflectance pulse oximetry in conjunction with near-field communication (NFC) capabilities enables operation in thin, miniaturized flexible devices. Studies of the material aspects associated with the body interface, together with investigations of the radio frequency characteristics, the optoelectronic data acquisition approaches and the analysis methods capture all of the relevant engineering considerations. Demonstrations of operation on various locations of the body and quantitative comparisons to clinical gold standards establish the versatility and the measurement accuracy of these systems, respectively.

Volume stability of hydroxyapatite and ß-tricalcium phosphate biphasic bone graft material in maxillary sinus floor elevation: a radiographic study using 3D cone beam computed tomography.

OBJECTIVES: The purpose of this study was to confirm volume stability of biphasic calcium phosphate (BCP) through the changes of grafted volume over the time by 3D CT analyzing software program. PATIENTS AND METHODS: Fifteen patients, 16 sinuses who were scheduled a staged implantation through sinus floor elevation (SFE)-lateral window technique from 2009 to 2011 were included in the study. Of the 15 patients, eight were male and seven were female (mean age 50.1). For sinus floor augmentation, BCP with local blood was packed loosely into the maxillary sinus and the grafted site was covered with a collagen membrane. For the evaluation of volume change, 3D CBCT scans were taken five times at pre-operatively (To), post-op 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4). 3D image processing software (OnDemand3DTM software) was used for this study. The time sequential change was statistically evaluated. RESULT: 84.32% grafted BCP is maintained until post-op 6 month (T4), and the average volume loss is 207.7 mm(3) (about 0.21 cc). Statistically, a significant volume change (decreasing) was observed in three groups (T2-T1, T3-T2, T4-T3). CONCLUSION: Biphasic calcium phosphate, as a synthetic material, has high volume stability and is a predictable graft material for the successful SFE. Although some limitations of the 3D analyzing software program, it is a fast, simple, relatively accurate and promising approach to quantifying long-term changes in the grafted area.

Three-dimensional evaluation of the pharyngeal airway using cone-beam computed tomography following bimaxillary orthognathic surgery in skeletal class III patients.

OBJECTIVE: The study aims to evaluate the pharyngeal airway space (PAS) following bimaxillary surgery in skeletal class III patients and to compare the changes in PAS between genders using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In all, 38 patients (16 male and 22 female) with skeletal class III malocclusion underwent bimaxillary surgery. CBCT scans were acquired approximately 1 month before surgery, 3 months after surgery, and 6 months after surgery. The oropharyngeal volume and the minimum cross-sectional area (CSA) were characterized using the InVivoDental imaging software package at each time point. RESULTS: The volume and minimum CSA decreased significantly postoperatively, which was maintained until 6 months postoperatively (p < 0.01). The location of the minimum CSA tended to move into the retropalatal and retroglossal areas postoperatively. A strong correlation between volume and minimum CSA was found. The amount of mandibular setback was not correlated with the change in the airway. By gender, significant decreases in both the volume and minimum CSA were found in females (p < 0.05) but not in males. CONCLUSION: Bimaxillary surgery significantly affects PAS. Gender differences should also be considered when considering changes in PAS. CLINICAL RELEVANCE: An awareness of the effects of bimaxillary setback surgery on the airway should be considered when implementing an orthognathic treatment plan.

Fabricating a tooth- and implant-supported maxillary obturator for a patient after maxillectomy with computer-guided surgery and CAD/CAM technology: A clinical report.

An obturator prosthesis with insufficient retention and support may be improved with implant placement. However, implant surgery in patients after maxillary tumor resection can be complicated because of limited visibility and anatomic complexity. Therefore, computer-guided surgery can be advantageous even for experienced surgeons. In this clinical report, the use of computer-guided surgery is described for implant placement using a bone-supported surgical template for a patient with maxillary defects. The prosthetic procedure was facilitated and simplified by using computer-aided design/computer-aided manufacture (CAD/CAM) technology. Oral function and phonetics were restored using a tooth- and implant-supported obturator prosthesis. No clinical symptoms and no radiographic signs of significant bone loss around the implants were found at a 3-year follow-up. The treatment approach presented here can be a viable option for patients with insufficient remaining zygomatic bone after a hemimaxillectomy.

Epidermal electronics with advanced capabilities in near-field communication.

Epidermal electronics with advanced capabilities in near field communications (NFC) are presented. The systems include stretchable coils and thinned NFC chips on thin, low modulus stretchable adhesives, to allow seamless, conformal contact with the skin and simultaneous capabilities for wireless interfaces to any standard, NFC-enabled smartphone, even under extreme deformation and after/during normal daily activities.

Combined effects of dentin sialoprotein and bone morphogenetic protein-2 on differentiation in human cementoblasts.

The aim of this study is to determine the effects of the combination of recombinant human BMP-2 (rh-BMP-2) and dentin sialoprotein (rh-DSP) on growth and differentiation in human cementoblasts and determine the underlying signal transduction mechanism. Compared to treatment of cementoblasts with either rh-BMP-2 or rh-DSP alone, the combination of rh-BMP-2 and rh-DSP synergistically increased cell growth, ALP activity, nodule formation and expression of differentiation markers. The differentiation-promoting effect was also observed in periodontal ligament cells and an osteoblastic cell line. Likewise, combination of rh-DSP and rh-BMP-2 increased BMP-2 mRNA expression and Smad1/5/8 phosphorylation, which was blocked by the BMP antagonist noggin. The expression levels of α2ß1 integrin and RhoA, as well as the phosphorylation status of FAK and Akt, were increased by the combination of rh-BMP-2 and rh-DSP in a time-dependent manner. In addition, rh-BMP-2 and rh-DSP enhanced expression of Wnt ligands, ß-catenin activation and GSK-3ß phosphorylation, all of which were inhibited by the Wnt receptor antagonist DKK1. Furthermore, treatment with rh-DSP plus rh-BMP-2 resulted in phosphorylation of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 and also induced the nuclear translocation of the NF-κB p65 subunit, which was blocked by noggin. This study demonstrates for the first time that rh-DSP and rh-BMP-2 act synergistically, enhancing each other's ability to stimulate cementoblastic cell growth and differentiation in vitro via autocrine BMP, integrin, Wnt/ß-catenin, MAP kinase and NF-κB pathways. These results support the therapeutic potential of a combination strategy for aiding periodontal regeneration.

Clinical outcomes of magnesium-incorporated oxidised implants: a randomised double-blind clinical trial.

OBJECTIVES: This study evaluated implant stability and clinical outcomes obtained with magnesium-incorporated oxidised implants (Mg titanate) and compared them to those blasted magnesium-incorporated oxidised implants (blasted Mg titanate). PATIENTS AND METHODS: Mg titanate was manufactured using the microarc oxidation (MAO) process. To obtain blasted Mg titanate, the MAO process was performed after blasting with TiO2 particles. The 15-month, randomised, double -blind clinical trial was conducted on 54 implants in 40 patients (Mg titanate, 27 implants in 18 subjects; blasted Mg titanate, 27 implants in 22 subjects), in whom 4.0 mm × 10 mm implants were placed to restore the unilateral loss of one or two molars in the mandible. The final prosthesis was attached 3 months postoperatively. Implant stability was measured by the implant stability quotient (ISQ) and periotest value (PTV) at the time of implant insertion, and 2, 3, and 15 months postoperatively. Marginal bone loss was evaluated at 2, 6, and 15 months postoperatively. Soft tissue analysis was performed at 15 months postoperatively. RESULTS: Both implant systems showed high stability at all time points (>71). Mean marginal bone loss was 0.71 ± 0.65 mm and 0.75 ± 0.73 after 15 months in Mg titanate and blasted Mg titanate, respectively. There were no significant differences between the two implant surfaces with respect to ISQ(P = 0.988), PTV(P = 0.935), and marginal bone loss(P = 0.807) after 15 months. CONCLUSION: The success rate after 1 year of follow-up was 100% for both magnesium-incorporated oxidised implants. There were no significant differences in the clinical outcomes between the two surfaces at 15 months follow-up.

Biomechanical evaluation of magnesium-based resorbable metallic screw system in a bilateral sagittal split ramus osteotomy model using three-dimensional finite element analysis.

PURPOSE: The aim of this study was to evaluate the stress distribution of a magnesium (Mg)-based resorbable screw system in a bilateral sagittal split ramus osteotomy (BSSO) and to compare its biomechanical stability with those of titanium (Ti)-based and polymer (IN)-based systems. MATERIALS AND METHODS: A 3-dimensional BSSO model (10-mm advancement and setback) was constructed with Mimics. Bicortical screw fixation using Ti, IN, and Mg screws was performed with 4 different geometries of fixation. With an occlusal load of 132 N on the lower first molar, the von Mises stress (VMS) distribution was calculated using ANSYS. RESULTS: The VMS distribution of Mg was more similar to that of Ti than to that of IN. In all cases, the highest VMS was concentrated on the screw at the most posterior and superior area. Stress was distributed mainly around the screw holes (cancellous bone) and the retromolar area (cortical bone). In the advancement surgery, fixation with 5 Mg screws (5A-Mg, 99.810 MPa at cortical bone) showed biomechanical stability, whereas fixation with the same number of IN screws did not (5A-IN, 109.021 MPa at cortical bone). In the setback surgery, although the maximum VMSs at cortical bone for Mg, IN, and Ti were lower than 108 MPa (yield strength of cortical bone), Mg screws showed more favorable results than IN screws because the maximum VMSs of Mg at cancellous bone were lower than those of IN. CONCLUSION: The Mg-based resorbable screw system is a promising alternative to the IN-based system.

Comparison of ultrasonography-based masticatory muscle thickness between temporomandibular disorders bruxers and temporomandibular disorders non-bruxers.

To compare masticatory muscle thickness in patients with temporomandibular disorders (TMDs) during rest and clenching, and by body position, using ultrasonography. This prospective study included 96 patients with TMD (67 females, 29 males; mean age: 40.41 ± 17.88 years): group 1, comprising 66 patients with TMD without bruxism (TMD_nonbruxer), and group 2, comprising 30 patients with concurrent TMD and bruxism (TMD_bruxer). In patients with TMD, bruxism was correlated with the presence of tinnitus, muscle stiffness, sleep problems, psychological stress, and restricted mouth opening. The masseter muscle significantly thickened during clenching (11.16 ± 3.03 mm vs 14.04 ± 3.47 mm, p < 0.001), whereas the temporalis muscle showed no significant increase in thickness from resting to clenching in an upright position (7.91 ± 1.98 vs 8.39 ± 2.08, p = 0.103). Similarly, during clenching in the supine position, the masseter muscle was significantly thicker compared with rest (11.24 ± 2.42 vs 13.49 ± 3.09, p < 0.001), but no significant difference was observed in temporal muscle thickness (8.21 ± 2.16 vs 8.43 ± 1.94, p = 0.464). In comparison between two groups, the average thickness of the masseter muscle was greater among TMD_bruxers than among TMD_nonbruxers in both the upright and supine positions (all p < 0.05). In the generalized lineal model, female sex (B = - 1.018, 95% confidence interval [CI] - 1.855 to - 0.181, p = 0.017) and bruxism (B = 0.868, 95% CI 0.567 to 1.169, p = 0.048) significantly predicted changes in masseter muscle thickness. Female sex (B = - 0.201, 95% CI - 0.299 to - 0.103, p = 0.011), increased age (B = - 0.003, 95% CI - 0.005 to 0.000, p = 0.038), and muscle stiffness (B = - 1.373, 95% CI - 2.369 to - 0.376, p = 0.007) were linked to decreased temporal muscle thickness. Comparing TMD nonbruxer and bruxer muscle thicknesses in upright and supine positions revealed significant increased thickness in the masseter muscle during clenching but not in the temporalis muscle. Masseter muscle thickness varied significantly by sex, body position, and resting/clenching, notably influenced by bruxism. These findings emphasize the relevance of these factors in clinical examinations of patients with TMD.

Minimal invasive and cost-effective method in reduction of maxillofacial fracture by using a Foley catheter ballooning technique.

The purpose of this study was to introduce 2 successful cases of orbital inferior wall fracture and maxillary sinus anterior wall fracture using the Foley catheter ballooning technique. One patient is a 43-year-old man with left orbital inferior wall fracture. A window on the sinus was made for visualization, and a Foley catheter was accessed through the natural ostium. The ballooned catheter was inflated to lift the inferior orbital wall rim and stationed for 2 weeks. The window was closed using metal plates and screws. Another patient is a 64-year-old woman with right maxillary sinus anterior wall fracture, nasal fracture, and orbital blow-out fracture. A Foley catheter was accessed through the fractured maxillary sinus and reduced into place and fixed with absorbable plates screws. The technique of stabilization of reduced maxillofacial fractures using a Foley balloon catheter with restorable plates and titanium plates showed stable results. This technique is relatively easy to undergo with minimal or no complications because of reduced operation time. Also, it is cost-effective compared with other materials providing similar results and heightens patient satisfaction.

Long-Term Follow-Up of a Novel Surgical Option Combining Fibula Free Flap and 3D-Bioprinted, Patient-Specific Polycaprolactone (PCL) Implant for Mandible Reconstruction.

As the fibula free flap became the gold standard in mandibular reconstruction that required both hard tissue and soft tissue, various methods have been sought to solve the height discrepancy between the mandible and fibula. The purpose of this paper was to propose a surgical option that combined the microvascular fibula free flap with a 3D-bioprinted, patient-specific polycaprolactone (PCL) implant as a safe and simple novel method that achieved the best functional and aesthetic results in mandibular reconstruction surgery for young patients with malignant tumors. The patient's reconstructed mandible maintained volume symmetry without any deformation or complications for over 6 years. Computer-aided design/computer-aided manufacturing (CAD/CAM) and 3D printing technology enabled accurate and safe surgical results.

Retrospective clinical study of mandible fractures.

BACKGROUND: As society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors of mandibular fractures to use them in future treatments. MATERIAL AND METHODS: Data were collected from 224 patients who visited the department of oral and maxillofacial surgery at the Kyung Hee Medical Center dental hospital during a 6-year period (2016 to 2021). A logistic regression model was used for data analysis. RESULTS: In a total of 224 patients, 362 fractures were appeared. The average age of the patients was 34.1 years, with the highest incidence in the 20s. And the ratio between male and female was 4.09:1. Symphysis fractures were the most prevalent of all patients (52.7%), followed by unilateral condyle (37.1%), angle (36.2%), bilateral condyle (9.4%), body (8%), and coronoid (2.2%). The most common cause of fracture was daily-life activity (57.6%), followed by violence (30.4%), traffic accidents (8.5%), and syncope (3.6%). Patients with symphysis fracture were at low risk (OR < 1) of angle, body, and unilateral condyle fractures. Similarly, patients with unilateral fracture were at low risk (OR < 1) of symphysis, angle, body, and others site fractures. In contrast, patient with bilateral condyle fracture were at high risk (OR > 1) of coronoid fractures. And younger patients were high risk of mandibular angle fractures. CONCLUSION: Through this study, it was confirmed that etiological factors of mandibular fractures were like those of previous studies.

Ultrahigh Sensitive Au-Doped Silicon Nanomembrane Based Wearable Sensor Arrays for Continuous Skin Temperature Monitoring with High Precision.

Monitoring the body temperature with high accuracy provides a fast, facile, yet powerful route about the human body in a wide range of health information standards. Here, the first ever ultrasensitive and stretchable gold-doped silicon nanomembrane (Au-doped SiNM) epidermal temperature sensor array is introduced. The ultrasensitivity is achieved by shifting freeze-out region to intrinsic region in carrier density and modulation of fermi energy level of p-type SiNM through the development of a novel gold-doping strategy. The Au-doped SiNM is readily transferred onto an ultrathin polymer layer with a well-designed serpentine mesh structure, capable of being utilized as an epidermal temperature sensor array. Measurements in vivo and in vitro show temperature coefficient of resistance as high as -37270.72 ppm °C-1 , 22 times higher than existing metal-based temperature sensors with similar structures, and one of the highest thermal sensitivity among the inorganic material based temperature sensors. Applications in the continuous monitoring of body temperature and respiration rate during exercising are demonstrated with a successful capture of information. This work lays a foundation for monitoring body temperature, potentially useful for precision diagnosis (e.g., continuous monitoring body temperature in coronavirus disease 2019 cases) and management of disease relevance to body temperature in healthcare.

Particle manipulation in a microfluidic channel using acoustic trap.

A high frequency sound beam was employed to explore an experimental method that could control particle motions in a microfluidic device. A 24 MHz single element lead zirconate titanate (PZT) transducer was built to transmit a focused ultrasound of variable duty factors (pulse duration/pulse repetition time), and its 1-3 piezocomposite structure established a tight focusing with f-number (focal depth/aperture size) of one. The transducer was excited by the Chebyshev windowed chirp signal sweeping from 18 MHz to 30 MHz with a 50% of duty factor, in order to ensure that enough sound beams were penetrated into the microfluidic device. The device was fabricated from a polydimethylsiloxane (PDMS) mold, and had a main channel composed of three subchannels among which particles flowed in the middle. A 60~70 µm diameter single droplet in the flow could be trapped near the channel bifurcation, and subsequently diverted into the sheath flow by releasing or shifting the acoustic trap. Hence, the results showed the potential use of a focused sound beam in microfluidic devices, and further suggested that this method could be exploited in the development of ultrasound-based flow cytometry and cell sorting devices.

Posterior bending osteotomy: An effective measure to secure facial symmetry in orthognathic surgery.

This study aimed to compare the effectiveness of posterior bending osteotomy and grinding techniques for orthognathic surgery in patients with facial asymmetry. Patients who had undergone Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, and who presented with a menton shift and setback difference exceeding 4 mm, were enrolled. Cone-beam computed tomography was performed before surgery (T0), immediately after surgery (T1), and 6 months after surgery (T2). Overall, 38 patients were included and divided into posterior bending osteotomy (n = 23) and grinding (n = 15) groups. Significant differences were observed between the posterior bending osteotomy and grinding groups on the treated side. In the grinding group, the gonion on the treated side was displaced slightly outward, resulting in a significant difference between both sides (non-treated side: 50.52 ± 4.20 [T0] and 48.67 ± 4.37 [T2]; treated side: 50.88 ± 4.55 [T0] and 51.00 ± 3.95 [T2]; p = 0.038). In the posterior bending osteotomy group, bilateral inward movements of the gonion were observed, and the distance from the midsagittal plane to the gonion did not differ significantly between the sides (non-treated side: 46.74 ± 4.41 [T0] and 45.54 ± 3.95 [T2]; treated side: 47.43 ± 4.93 [T0] and 45.18 ± 3.52 [T2]; p = 0.224). The yawing movement of the proximal segment was greater in the grinding group than in the posterior bending osteotomy group (non-treated side: p = 0.839; treated side: p = 0.025). Posterior bending osteotomy is recommended over the grinding method for patients with severe facial asymmetry, in order to ensure a symmetric and esthetic facial profile by allowing passive adaptation between the mandibular segments.

Removal of a suture needle: a case report.

BACKGROUND: Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event. CASE PRESENTATION: In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician. CONCLUSION: CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.