Epidemic of Zika virus and maxillofacial surgery.

Zika is a RNA virus spread by the ubiquitous Aedes mosquitoes. It was first discovered in Uganda in 1947, and arrived in south-east Asia by the middle of the 20th century. In 2014 the virus started to spread across the Pacific Islands to reach South America. Since then it has spread rapidly northwards, and reached Mexico and the Caribbean in November 2015. Clinically it presents as a self-limiting febrile illness. However, there is increasing evidence of a link between Zika virus and the Guillain-Barré syndrome, and maternal Zika virus infection and microcephaly of the fetus.

Recent advances in the management of oral and maxillofacial trauma.

This review summarises recently published papers on maxillofacial trauma in 2 widely read journals: the British Journal of Oral and Maxillofacial Surgery (BJOMS) and the International Journal of Oral and Maxillofacial Surgery (IJOMS). Since a large proportion of the injuries seen in oral and maxillofacial surgery (OMFS) departments are fractures of the facial skeleton, we primarily focus on their assessment and treatment, but also cover problems that affect the temporomandibular joint (TMJ) (including ankylosis), military injuries, polytrauma, and the use of perioperative drugs. Between 2012 and 2013, 121 articles were published in the 2 journals. Most of the research concerned mandibular fractures, particularly those involving the condyle, but epidemiological studies and midfacial fractures were also well represented. Even though the incidence of facial injury is high, it is difficult to collect data particularly when long-term evaluation is required, as rates of compliance and attendance at follow up tend to be low. The number of large-scale studies was therefore small. A concerted effort to collaborate nationally and across specialties to undertake larger studies will help to improve outcomes.

Tetracycline: a cure all?

Tetracyclines are used to treat a range of oral conditions. Their efficacy in the treatment of periodontitis is well established, and they are authoritatively recommended in the management of avulsed teeth. There is a growing evidence base to support the use of tetracycline to treat recurrent aphthous stomatitis, but its use in white spongy naevus is limited to a handful of case reports. The mechanism of action in these conditions is either unknown or indicated to be through the inhibition of matrix metalloproteinases (MMP). The use of a single agent to treat diverse oral conditions has important implications for oral medicine.

Regenerative nanotechnology in oral and maxillofacial surgery.

Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future.

Analysis of the compatibility of dental implant systems in fibula free flap reconstruction.

As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement's site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement.The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region.Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor.In the right fibula (dry bone), 90% of the samples measured had a width of 13.1 mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3 mm. Fibulas measured on radiographs had a width of 14.3 mm in 90% of the samples. The length ranges of the dental implants used in this study were: 7-13 mm (Biomet 3i), 10-13 mm (Nobel biocare), 8-13 mm (Astra Tech), 8-12 mm (Straumann ) and 8-11 mm (Ankylos).This study reached a conclusion that the width of fibula is sufficient for placement of most frequently used dental implants for oral rehabilitation after mandibular reconstructive procedures.

Post operative maxillary cyst: report of an unusual presentation.

A postoperative maxillary cyst is a rare, delayed complication of operations on the maxillary sinus, trauma. or infection, particularly in Japan. As far as we know this is the first reported case in a patient of African origin. The cyst presented as a midline palatal swelling that arose from the nasal, rather than the antral, mucosa. Awareness of this condition will expedite its correct diagnosis and management. In most cases, enuclcation is the treatment of choice.