Efficiency of maxillomandibular advancement for the treatment of obstructive apnea syndrome: a comprehensive overview of systematic reviews.

OBJECTIVES: To evaluate the efficiency of maxillomandibular advancement using aggregated individual patient data from multiple studies. MATERIALS AND METHODS: This overview was structured according to the PICO strategy. It adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and was recorded on the international prospective register of systematic reviews (PROSPERO-CRD42020206135). Searches were conducted in the PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, and Cochrane databases for studies published until January 1, 2021. Data from the included studies were collected by one author, while another reviewed the compilation. RESULTS: Twelve systematic reviews were included. The outcome measures studied were the apnea-hypopnea index, respiratory disturbance index, mean oxygen saturation, lowest oxygen saturation, sleepiness data, posterior air space, sella-nasion point A angle, sella-nasion point B angle, surgical success, and surgical cure in patients who underwent surgery. The AMSTAR scale presented moderate evaluations, with grades varying between 6 and 10 points. The Glenny scale revealed that the study selection did not include all languages. Only three reviews identified quality assessments conducted by at least two reviewers and only five related possible searches for unpublished data. CONCLUSIONS: Bimaxillary advancement surgery improved respiratory indicators, sleepiness data, and increased upper airway size. However, it is necessary to standardize the surgical criteria to establish measurable efficiency of the procedure. CLINICAL RELEVANCE: This overview makes a critical analysis of the results of the selected systematic reviews with the aim of presenting the most clinically relevant data on the maxillomandibular advancement for treating obstructive apnea syndrome, with a focus on improving respiratory, anatomical, and quality of life indices. There are no overviews that approach this theme from a well-structured perspective.

Comparison of three anesthetic techniques for the removal of posterior mandibular teeth with 2% lidocaine: a systematic review.

OBJECTIVES: The present systematic review aimed to evaluate whether the IANB (conventional inferior alveolar nerve block) technique is superior to the VA (Vazirani-Akinosi) or GG (Gow-Gates) techniques for anesthesia in the removal of posterior mandibular teeth. MATERIALS AND METHODS: This systematic review was structured according to the PICO strategy, adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist, and was recorded on the international prospective register of systematic reviews (PROSPERO-CRD42020153130). Studies were included based on the eligibility criteria and data from the included studies were collected by one author, while another reviewed the compilation. RESULTS: Eight studies were included, all of which were randomized controlled trials. Three studies tested the techniques by exclusively performing lower third molar removal; the others covered other posterior lower teeth. All studies used the same local anesthetic and the same vasoconstrictor: lidocaine 2% with epinephrine/adrenaline. A total of 1056 patients were evaluated. CONCLUSIONS: Some differences were observed between the techniques. Because of the heterogeneity between studies, clinical trials with more specific methodologies, such as comparisons of GG and VA with IANB for mandibular tooth removal, and the same clinical homogeneity will be worthwhile. CLINICAL RELEVANCE: A systematic review of which anesthetic technique is most effective for mandibular teeth removal may positively impact the population's life. There are no systematic reviews which approach this theme in a well-structured perspective.

Intraosseous Mucoepidermoid Carcinoma in the Mandible.

Although it is a rare neoplasm, intraosseous mucoepidermoid carcinoma is the most common and well-recognized intraosseous salivary gland tumor. Usually, it presents as an asymptomatic volume increase and most patients perceive the presence of the lesion within a year or less of evolution. They are more common in middle-aged adults and have a slight female predilection. They are three times more common in the mandible than in the maxilla and are most often found in the area of the molars and mandibular ramus. The most frequently present symptom is cortical bulging, although some lesions may be discovered as an accidental finding on radiographs. The main modality of treatment for patients with this neoplasm is radical surgical resection, offering a greater chance of cure than the more conservative procedures, such as enucleation or curettage, due to the great possibility of recurrence and tumor metastasis. This paper reports a rare case of intraosseous mucoepidermoid carcinoma occasionally discovered after panoramic radiography of the jaws, which was treated with segmental resection through hemimandibulectomy.