ABSTRACT
BACKGROUND: This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. METHODS: A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. RESULTS: In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). CONCLUSION: In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.
ABSTRACT
AIMS AND OBJECTIVES: The purpose of this study was to examine the magnitude of cancer stigma, social support, coping strategies and psychosocial adjustment among breast cancer survivors and to identify the factors associated with patients' psychosocial adjustment. BACKGROUND: Few studies have examined the association between cancer stigma and adaptation outcomes, which are considered interpersonal stressors for breast cancer survivors. DESIGN: A correlational, cross-sectional research design was used. METHODS: This study was designed based on the stress-coping theory of Lazarus and Folkman. This descriptive cross-sectional study included 158 breast cancer survivors who visited a Korean tertiary hospital. Data collection was performed using a structured questionnaire and electronic medical records between March-May 2018. Data analyses included descriptive statistics, independent t test, one-way ANOVA, Kruskal-Wallis test, partial correlation analysis and hierarchical regression analysis and were performed with the SPSS WIN 25.0 program. This study adheres to STROBE guidelines. RESULTS: Cancer stigma had the strongest association with psychosocial adjustment among Korean breast cancer survivors, followed by social support and coping strategies. These variables accounted for approximately 44% of the variance in psychosocial adjustment. CONCLUSION: Cancer stigma had the strongest association with psychosocial adjustment. Healthcare professionals should assess patients' cancer stigma to develop patient-tailored stigma management programmes. RELEVANCE TO CLINICAL PRACTICE: Interventions to alleviate cancer stigma should be developed, and social support and coping strategies for breast cancer survivors should be considered in clinical oncology settings.
Subject(s)
Breast Neoplasms , Cancer Survivors , Social Support , Adaptation, Psychological , Cross-Sectional Studies , Humans , Social Adjustment , Social Stigma , Surveys and QuestionnairesABSTRACT
OBJECTIVES: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. MATERIALS AND METHODS: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. RESULTS: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P <0.05). CONCLUSION: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.
