Complications associated with the treatment of fractures of the dentate portion of the mandible in paediatric patients: a systematic review.

This study aimed to answer the following question: What is the best treatment option for fractures of the dentate portion of the mandible in paediatric patients when considering the occurrence of postoperative complications? A systematic literature review was done using the PubMed, Scopus, and Cochrane Library databases, and 1186 articles on the topic were found. Twelve of these articles were included in the final review after the full texts had been read. A sample of 178 paediatric patients was obtained. In the six cases in which treatment was surgery with titanium plate fixation, there were no postoperative complications, whereas in the 141 cases in which treatment was surgery with biodegradable plates, there were 12 postoperative complications, and in the 31 cases in which treatment was non-surgical, there were three postoperative complications. A connection between the best treatment and the number of postoperative complications in fractures of the dentate portion of the mandible in paediatric patients could not be established; however, the occurrence of postoperative complications was low for both surgical and non-surgical treatments.

Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review.

The restoration of mandibular bone defects with non-vascularized bone grafts depends on the diagnosis, anatomical site, extent of the defect, and the patient's age, as well as the surgeon's experience. The aim of this study was to perform a systematic literature review on mandibular reconstruction for segmental mandibular bone defects using non-vascularized bone grafts to answer the following question: Is there scientific evidence to support the use of this technique? The initial literature search in PubMed, Scopus, and Cochrane databases identified 862 articles. Of these, 25 were included in the final review. These articles encompassed 926 procedures with non-vascularized bone grafts; 76.1% were from the iliac crest. Benign tumours were the major cause of these defects (56.8%), and 44.7% of defects were located in the lateral mandibular area. Although this technique showed a high occurrence of complications (290 in 873 patients, some with more than one complication), these did not account for treatment failure. The restoration of bone defects due to malignant tumours treated with radiation therapy had lower success rates, and these appear to be a contraindication for the technique. Although standardized randomized controlled clinical studies are needed to obtain better clinical evidence for treatment choices in general, the use of non-vascularized bone grafts for mandibular reconstruction showed an 87.6% success rate in this review.

Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review.

Inferior alveolar nerve (IAN) repositioning has been used widely in recent years as an alternative approach for dental implant placement in the atrophic posterior mandible. The aim of this study was to answer the question: What are the complications associated with IAN repositioning? A systematic literature review performed in accordance with the PRISMA statement, using the PubMed (MEDLINE), Cochrane Library, and Scopus databases, identified a total of 116 articles related to this technique. Of those articles, 24 were included in the final review. Lateralization was the chosen technique in seven studies, transposition in 15 studies, and two studies reported both techniques. The longest follow-up period was 49.1 months and the shortest 6 months. Of the patients who underwent lateralization, 95.9% initially showed a neurosensory disturbance, and the condition remained at the end of the study for 3.4% of those patients. With regard to the patients who underwent transposition, neurosensory alterations were observed in 58.9% of patients initially, and the condition remained for 22.1% of those affected at the end of the study. Only one study found no neurosensory disturbance at any time. More data consolidation is necessary to determine scientifically if, which, and when the IAN repositioning technique can be recommended.

Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review.

The manipulation of the maxillomandibular complex (MMC) in orthognathic surgery has been used widely in the treatment of dentofacial deformities so as to optimize aesthetic and functional results, making these more stable in the long term. The aim of the present study was to perform a systematic literature review of the aesthetic and functional implications following rotation of the occlusal plane in orthognathic surgery, by evaluating skeletal stability, facial harmony, respiratory function, and temporomandibular joint (TMJ) function after clockwise or counterclockwise rotation of the MMC. A survey of Scopus, PubMed, and Cochrane databases was performed through which 10 papers were selected for the final review. From this review, it could be concluded that facial aesthetics, TMJ function, and skeletal and occlusal stability in the orthosurgical treatment of dentofacial deformities may be influenced by the surgical manipulation of the MMC (clockwise or counterclockwise rotation). However, although this treatment technique is used widely today, the results of the present study do not provide sufficient scientific evidence with regard to the choice of this approach.