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1.
Cureus ; 16(3): e57305, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38690476

RESUMEN

Von Willebrand's disease (VWD), characterized by quantitatively or qualitatively abnormal von Willebrand factor (VWF), is the most common inherited bleeding disorder. There is limited evidence of treatment using orthognathic surgery in patients with VWD. This report focuses on four patients with VWD who underwent orthognathic surgery and received Factor VIII/VWF concentrates (Confact F) preoperatively. One patient with type 3 (severe) VWD underwent delayed extubation owing to laryngeal edema and exhibited epistaxis thereafter. No perioperative complications were observed in any of the other patients. Two of the four patients were diagnosed with VWD during preoperative screening. Most young adults do not experience general anesthesia and, therefore, may not have undergone blood tests at a hospital. Thus, preoperative screening and adoption of a multidisciplinary approach to orthognathic surgery is important in patients with bleeding disorders such as VWD. Close communication between anesthetists, surgeons, and hematologists is essential to ensure effective management during the perioperative period.

2.
Oral Maxillofac Surg ; 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38418701

RESUMEN

We describe a case of mandibular gingival carcinoma with hypercalcaemia and leukocytosis caused by tumour-derived parathyroid hormone-related protein (PTHrP) and granulocyte colony-stimulating factor (G-CSF). A 54-year-old man presented to our Department of Oral and Maxillofacial Surgery with a chief complaint of a left-sided mandibular gingival ulcer. A 42 mm × 20 mm sized ulcer was found on the left lower molar gingiva. Squamous cell carcinoma was pathologically diagnosed. The patient underwent a hemimandibulectomy, left-sided radical neck dissection, plate reconstruction, pectoralis major musculocutaneous flap reconstruction, and tracheostomy under general anaesthesia. Pathologically, two metastatic lymph nodes were identified. Residual tumour was suspected at the resection margins. Eight weeks after surgery, the patient started postoperative concurrent chemoradiotherapy (CCRT). Two weeks after CCRT, the patient developed hypercalcaemia. Serum levels of PTHrP and G-CSF increased in parallel with the progression of hypercalcaemia and leukocytosis. Immunohistochemical analysis of the surgical specimen showed positivity for G-CSF. Based on these clinical and pathological findings, the patient was diagnosed with hypercalcaemia and leukocytosis associated with malignancy and was treated with denosumab. Irradiation was terminated at 50 Gy because CT showed rapid disease progression. Chemotherapy was initiated, however, four weeks after the start of chemotherapy, a CT scan showed increased metastases and pleural dissemination. Therefore, chemotherapy was discontinued. One week after the chemotherapy was discontinued, the patient died of respiratory failure.

3.
J Craniofac Surg ; 35(1): e44-e45, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38294303

RESUMEN

Tracheotomy is a routine surgical procedure in oral and maxillofacial surgery. After decannulation, spontaneous tracheostoma closure is usually expected. However, wound healing is often delayed, requiring 1 to 2 weeks for healing and resulting in the need for surgical closure. Although many reports have described the surgical closure of a tracheostoma, few reports have focused on the dressing methods for closure of tracheal openings after decannulation. Herein, the authors report a new tracheostoma closure method that does not rely on surgical closure or the adhesive strength of the tape. The authors' conventional dressing method was to place gauze over the tracheostoma after decannulation and apply pressure through elastic tape or with a film dressing to seal the tracheostoma and achieve natural closure by reducing the leakage of air and tracheal secretions. However, the conventional method cannot completely prevent the leakage of air and tracheal secretions. We developed a novel method to achieve early closure by markedly reducing the leakage by partially inserting the gauze into the tracheostoma.


Asunto(s)
Vendajes , Cirugía Bucal , Humanos , Tráquea , Traqueostomía , Traqueotomía
4.
Bioengineering (Basel) ; 10(10)2023 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-37892927

RESUMEN

Human dental pulp stem cells (DPSCs) exhibit multilineage differentiation capabilities and superior clonogenic and proliferative properties. However, the use of animal-derived components such as FBS raises concerns regarding the clinical application of stem-cell-based therapies. Platelet-rich fibrin (PRF) derived from human blood is rich in fibrin, platelets, and growth factors and acts as a bioactive scaffold for grafting with biomaterials. In this study, we assessed the efficacy of PRF-conditioned medium (CM) in promoting DPSCs proliferation and osteogenic differentiation compared with the standard culture medium supplemented with FBS. A comparison of DPSCs cultured in FBS and PRF-CM revealed no differences in characteristics or morphology. However, cells cultured with PRF-CM exhibited inferior proliferation rates and cell numbers during passage in comparison with those cultured with FBS. In contrast, DPSCs cultured in PRF-CM showed significantly higher levels of calcification, and RT-PCR confirmed that the gene expression levels of markers associated with osteoblast differentiation were significantly increased. The PRF-CM approach offers a convenient, straightforward, and advantageous method for culturing DPSCs, without relying on animal-derived components. In summary, this study introduces a novel application of PRF-CM for enhancing the osteogenesis of DPSCs, which provides an alternative to FBS culture medium and addresses concerns associated with the use of animal-derived components in clinical settings.

5.
PLoS One ; 18(3): e0279850, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36862692

RESUMEN

Sagittal split ramus osteotomy (SSRO) sometimes induces an irregular split pattern referred to as a bad split. We investigated the risk factors for bad splits in the buccal plate of the ramus during SSRO. Ramus morphology and bad splits in the buccal plate of the ramus were assessed using preoperative and postoperative computed tomography images. Of the 53 rami analyzed, 45 had a successful split, and 8 had a bad split in the buccal plate. Horizontal images at the height of the mandibular foramen showed that there were significant differences in the ratio of the forward thickness to the backward thickness of the ramus between patients with a successful split and those with a bad split. In addition, the distal region of the cortical bone tended to be thicker and the curve of the lateral region of the cortical bone tended to be smaller in the bad split group than in the good split group. These results indicated that a ramus shape in which the width becomes thinner towards the back frequently induces bad splits in the buccal plate of the ramus during SSRO, and more attention should be paid to patients who have rami of these shapes in future surgeries.


Asunto(s)
Hueso Cortical , Osteotomía Sagital de Rama Mandibular , Humanos , Osteotomía Sagital de Rama Mandibular/efectos adversos , Factores de Riesgo , Placas Óseas , Polímeros , Tomografía Computarizada por Rayos X
7.
Bone ; 166: 116575, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36195245

RESUMEN

INTRODUCTION: Dental pulp stem cells (DPSCs) have high proliferative and multilineage differentiation potential in mesenchymal stem cells. However, several studies have indicated that there are individual differences in the potential for osteogenic differentiation of DPSCs, and the factors determining these differences are unknown. OBJECTIVE: To identify the genes responsible for the individual differences in the osteogenic differentiation ability of DPSCs. METHODS: We divided DPSCs into high and low osteogenic differentiation ability groups (HG or LG) with ALP and von Kossa stain, and compared the gene expression patterns using RNA-seq. In addition, genes that may affect osteogenic differentiation were knocked down using small interfering RNA (siRNA) and their effects were investigated. RESULTS: The RNA-seq patterns revealed that VCAM1 and GFPT2 were significantly expressed at higher levels in the HG than in the LG. The results of siRNA analysis showed that VCAM1 and GFPT2 knockdown significantly reduced the expression of osteogenic markers. Furthermore, we analyzed the involvement of these two genes in cell signaling in DPSC differentiation. The results indicated that the VCAM1-mediated Ras-MEK-Erk and PI3K/Akt pathways are involved in the osteogenic differentiation of DPSCs, and that GFPT2-mediated HBP signaling influences the osteogenic differentiation of DPSCs. CONCLUSIONS: These findings indicate that DPSCs that highly express VCAM1 and GFPT2 have a high capacity for osteogenic differentiation. Evaluation of VCAM1 and GFPT2 expression in undifferentiated DPSCs may predict the outcome of bone regenerative therapy using DPSCs. Moreover, the expression levels of VCAM1 and GFPT2 in DPSCs may be useful in setting criteria for selecting donors for allogeneic cell transplantation for bone regeneration.


Asunto(s)
Glutamina-Fructosa-6-Fosfato Transaminasa (Isomerizadora) , Osteogénesis , Molécula 1 de Adhesión Celular Vascular , Humanos , Biomarcadores/metabolismo , Diferenciación Celular/genética , Proliferación Celular , Células Cultivadas , Pulpa Dental , Osteoblastos , Osteogénesis/genética , Fosfatidilinositol 3-Quinasas/metabolismo , ARN Interferente Pequeño/metabolismo , Células Madre/metabolismo , Molécula 1 de Adhesión Celular Vascular/genética , Molécula 1 de Adhesión Celular Vascular/metabolismo , Glutamina-Fructosa-6-Fosfato Transaminasa (Isomerizadora)/genética , Glutamina-Fructosa-6-Fosfato Transaminasa (Isomerizadora)/metabolismo
8.
Plast Reconstr Surg Glob Open ; 10(4): e4257, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35433154

RESUMEN

Spinocerebellar ataxia (SCA) is a progressive neurodegenerative disease that can cause various ataxia symptoms. Here we report a patient with spinocerebellar ataxia who underwent orthognathic surgery to correct a mandibular protrusion with facial asymmetry. A 33-year-old woman was admitted to our hospital for orthognathic surgery. She started preoperative orthodontic treatment after a diagnosis of mandibular protrusion with facial asymmetry. Two and a half years later, after completing preoperative orthodontic treatment, she returned to our hospital after being diagnosed with spinocerebellar ataxia. After discussing the risk of surgery with the anesthesiologist and neurologist, we elected to perform orthognathic surgery after the patient provided informed consent. Sagittal split ramus osteotomy and intraoral vertical ramus osteotomy were performed under general anesthesia, but no remarkable perioperative complications occurred. After a 3-year follow-up, the occlusion has remained stable, and no postoperative relapse occurred. Whether we should provide surgical treatment for SCA patients is controversial. However, when long-term predictions were considered, altering an occlusion could improve a patient's quality of life in the present case.

9.
J Craniofac Surg ; 32(4): 1480-1482, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33645958

RESUMEN

ABSTRACT: Noncontact optical surface scanners have been used to evaluate facial soft tissues. Appropriate evaluation of patients with cleft lip and palate requires comprehensible assessment of the changes in their pre- and post-orthodontic soft tissue and facial growth during chairside assistance. The authors developed a new scanning system that required a shorter measurement time than conventional modalities. The system was implemented on a mannequin and a 6-year-old patient. Seven midfacial landmarks were identified on their faces. The authors measured these landmarks 5 times daily. An experienced orthodontist evaluated and recorded the scores. The scores obtained from the mannequin had a variation of within 0.2 mm, while those obtained from the patient varied within 0.8 mm, except that of the inferior limit of the lips. The study findings suggest that the new laser scanning system can accurately measure facial soft tissue. Further studies should fix patients' head at a definite position for more accurate measurements. An appropriately angled laser sensor would eliminate distortions, thereby increasing the measurement validity.


Asunto(s)
Labio Leporino , Fisura del Paladar , Cefalometría , Niño , Fisura del Paladar/cirugía , Humanos , Maxilar
10.
Int J Mol Sci ; 21(23)2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33271795

RESUMEN

Bone defects affect patients functionally and psychologically and can decrease quality of life. To resolve these problems, a simple and efficient method of bone regeneration is required. Human dental pulp stem cells (DPSCs) have high proliferative ability and multilineage differentiation potential. In our previous study, we reported a highly efficient method to induce osteogenic differentiation using DPSC sheets treated with a helioxanthin derivative (4-(4-methoxyphenyl)pyrido[40,30:4,5]thieno[2,3-b]pyridine-2-carboxamide (TH)) in a mouse calvarial defect model. However, the localization of the DPSCs after transplantation remains unknown. Therefore, in this study, we investigated the localization of transplanted DPSCs in a mouse fracture model. DPSCs were collected from six healthy patients aged 18-29 years, cultured in normal medium (NM), osteogenic medium (OM), or OM with TH, and fabricated them into cell sheets. To evaluate the efficacy of fracture healing using DPSCs treated with OM+TH, and to clarify the localization of the transplanted DPSC sheets in vivo, we transplanted OM+TH-treated DPSC sheets labeled with PKH26 into mouse tibiae fractures. We demonstrated that transplanted OM+TH-treated DPSCs sheets were localized to the fracture site and facilitated bone formation. These results indicated that transplanted OM+TH-treated DPSCs were localized at fracture sites and directly promoted fracture healing.


Asunto(s)
Regeneración Ósea , Pulpa Dental/citología , Curación de Fractura , Lignanos/farmacología , Células Madre/efectos de los fármacos , Células Madre/fisiología , Animales , Biomarcadores , Diferenciación Celular/efectos de los fármacos , Técnica del Anticuerpo Fluorescente , Humanos , Inmunohistoquímica , Ratones , Osteogénesis/efectos de los fármacos
11.
Int J Mol Sci ; 21(20)2020 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-33086667

RESUMEN

Human dental pulp stem cells (DPSCs) have high clonogenic and proliferative potential. We previously reported that a helioxanthin derivative (4-(4-methoxyphenyl)pyrido[40,30:4,5]thieno[2-b]pyridine-2-carboxamide (TH)) enhances osteogenic differentiation of DPSCs derived from young patients. However, in the clinical field, elderly patients more frequently require bone regenerative therapy than young patients. In this study, we examined and compared the osteogenic differentiation potential of TH-induced DPSCs from elderly patients and young patients to explore the potential clinical use of DPSCs for elderly patients. DPSCs were obtained from young and elderly patients and cultured in osteogenic medium with or without TH. We assessed the characteristics and osteogenic differentiation by means of specific staining and gene expression analyses. Moreover, DPSC sheets were transplanted into mouse calvarial defects to investigate osteogenesis of TH-induced DPSCs by performing micro-computed tomography (micro-CT). We demonstrated that osteogenic conditions with TH enhance the osteogenic differentiation marker of DPSCs from elderly patients as well as young patients in vitro. In vivo examination showed increased osteogenesis of DPSCs treated with TH from both elderly patients and young patients. Our results suggest that the osteogenic differentiation potential of DPSCs from elderly patients is as high as that of DPSCs from young patients. Moreover, TH-induced DPSCs showed increased osteogenic differentiation potential, and are thus a potentially useful cell source for bone regenerative therapy for elderly patients.


Asunto(s)
Regeneración Ósea/efectos de los fármacos , Pulpa Dental/citología , Lignanos/farmacología , Osteogénesis/efectos de los fármacos , Células Madre/citología , Adolescente , Adulto , Anciano , Animales , Diferenciación Celular , Subunidad alfa 1 del Factor de Unión al Sitio Principal/metabolismo , Humanos , Masculino , Ratones , Persona de Mediana Edad , Cráneo/diagnóstico por imagen , Cráneo/efectos de los fármacos , Cráneo/patología , Tienopiridinas/farmacología
12.
Regen Ther ; 14: 128-135, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32099873

RESUMEN

INTRODUCTION: Cell-based therapies require an emerging alternative treatment using easily harvested cell sources. Neural stem cells derived from various tissues, including brain, bone marrow, skin and retina can give rise to both neurons and glial cells. Recently, human dental pulp stem cells (DPSCs) and stem cells from human exfoliated deciduous teeth (SHED) were demonstrated to have mesenchymal stem cell-like abilities such as self-renewal and multi-lineage differentiation, including neuron and glial cells. Moreover, DPSCs and SHED show a higher proliferation rate and a higher number of population doublings compared with adult bone marrow stromal stem cells. Therefore, DPSCs are a useful source that can be applied in cell replacement therapy for various neurological disorders. Generally, the conventional culture methods for DPSCs have used serum, therefore the undefined components in culture medium may complicate investigations of the molecular mechanisms that control the self-renewal and differentiation of DPSCs. However, neural stem cells proliferate to form 'neurospheres' in suspension in vitro in the presence of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF). No study to date has obtained neurospheres from DPSCs in serum-free conditions in primary culture. Thus, the aim of this study was to establish a method for the proliferation and neural differentiation of DPSCs in xeno- and serum-free conditions in primary culture. METHODS: DPSCs were obtained from the dental pulp of wisdom teeth from healthy individuals (18-41 years old) and cultured in conventional medium containing 15% fetal bovine serum and xeno-/serum-free medium. We evaluated the proliferation of DPSCs, neurosphere generation, and neural differentiation under xeno-/serum-free conditions by flow cytometry, immunohistochemistry, and real-time polymerase chain reaction. RESULTS: In proliferation medium without xeno/serum, DPSCs can proliferate and generate neurospheres, however, the neurospheres had limited self-renewal ability. Under differentiation conditions, class III ß-tubulin (TUBB3) and microtubule-associated protein (MAP2) were more significantly expressed in neurospheres derived from DPSCs in xeno-/serum-free culture conditions than in DPSCs in conventional culture conditions. CONCLUSIONS: Our result demonstrated that neurosphere generation from DPSCs in xeno-/serum-free culture may be an accessible source for clinical cell replacement therapies for neuronal degenerative diseases.

13.
Anat Sci Educ ; 13(5): 628-635, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31608585

RESUMEN

The purpose of this study was to assess the usefulness of saturated salt solution-embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half-day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self-confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed-rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self-assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution-embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well-preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution-embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.


Asunto(s)
Embalsamiento/métodos , Procedimientos Quirúrgicos Orales/educación , Cirugía Bucal/educación , Cadáver , Humanos , Solución Salina Hipertónica
14.
BMC Oral Health ; 19(1): 243, 2019 11 11.
Artículo en Inglés | MEDLINE | ID: mdl-31711493

RESUMEN

BACKGROUND: Follicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically. CASE PRESENTATION: We report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively. CONCLUSIONS: We diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.


Asunto(s)
Tejido Linfoide/patología , Maxilar/patología , Biopsia , Diagnóstico Diferencial , Femenino , Humanos , Hiperplasia , Persona de Mediana Edad
15.
J Craniofac Surg ; 29(4): e404-e405, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29489573

RESUMEN

Sagittal split ramus osteotomy and intraoral vertical ramus osteotomy are commonly performed for the correction of jaw deformities. However, during mandibular orthognathic surgeries such as sagittal split ramus osteotomy and intraoral vertical ramus osteotomy , the authors sometimes encounter exposure of the buccal fat pad (BFP), which decreases the surgical field. The exposed BFP makes it difficult to perform these operations, may result in unexpected complications, and may increase the operation time. Therefore, the authors herein describe a simple, safe, and convenient technique for reducing the volume of the exposed BFP during mandibular orthognathic surgery using an electric knife in the coagulation mode.


Asunto(s)
Tejido Adiposo/cirugía , Mejilla/cirugía , Mandíbula/cirugía , Cirugía Ortognática/métodos , Osteotomía Sagital de Rama Mandibular/métodos , Humanos
16.
Stem Cell Res Ther ; 9(1): 24, 2018 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-29391049

RESUMEN

BACKGROUND: Human dental pulp stem cells (DPSCs), which have the ability to differentiate into multiple lineages, were recently identified. DPSCs can be collected readily from extracted teeth and are now considered to be a type of mesenchymal stem cell with higher clonogenic and proliferative potential than bone marrow stem cells (BMSCs). Meanwhile, the treatment of severe bone defects, such as fractures, cancers, and congenital abnormalities, remains a great challenge, and novel bone regenerative techniques are highly anticipated. Several studies have previously shown that 4-(4-methoxyphenyl)pyrido[40,30:4,5]thieno[2,3-b]pyridine-2-carboxamide (TH), a helioxanthin derivative, induces osteogenic differentiation of preosteoblastic and mesenchymal cells. However, the osteogenic differentiation activities of TH have only been confirmed in some mouse cell lines. Therefore, in this study, toward the clinical use of TH in humans, we analyzed the effect of TH on the osteogenic differentiation of DPSCs, and the in-vivo osteogenesis ability of TH-induced DPSCs, taking advantage of the simple transplantation system using cell-sheet technology. METHODS: DPSCs were obtained from dental pulp of the wisdom teeth of five healthy patients (18-22 years old) and cultured in regular medium and osteogenic medium with or without TH. To evaluate osteogenesis of TH-induced DPSCs in vivo, we transplanted DPSC sheets into mouse calvaria defects. RESULTS: We demonstrated that osteogenic conditions with TH induce the osteogenic differentiation of DPSCs more efficiently than those without TH and those with bone morphogenetic protein-2. However, regular medium with TH did not induce the osteogenic differentiation of DPSCs. TH induced osteogenesis in both DPSCs and BMSCs, although the gene expression pattern in DPSCs differed from that in BMSCs up to 14 days after induction with TH. Furthermore, we succeeded in bone regeneration in vivo using DPSC sheets with TH treatment, without using any scaffolds or growth factors. CONCLUSIONS: Our results demonstrate that TH-induced DPSCs are a useful cell source for bone regenerative medicine, and the transplantation of DPSC sheets treated with TH is a convenient scaffold-free method of bone healing.


Asunto(s)
Regeneración Ósea , Células Inmovilizadas , Pulpa Dental , Lignanos/química , Trasplante de Células Madre , Células Madre/metabolismo , Animales , Diferenciación Celular , Células Inmovilizadas/metabolismo , Células Inmovilizadas/trasplante , Pulpa Dental/metabolismo , Pulpa Dental/trasplante , Xenoinjertos , Humanos , Ratones , Ratones Endogámicos NOD , Ratones SCID , Osteogénesis
17.
J Craniofac Surg ; 29(4): 900-903, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29381624

RESUMEN

The aim of this study was to evaluate the effects of early removal of fixed plates in patients with occlusal discrepancies after sagittal split ramus osteotomy (SSRO) with a focus on the positional relationship of the temporomandibular joint (TMJ). Sagittal split ramus osteotomy with/without Le Fort I osteotomy was performed on 98 patients with mandibular prognathism. Of these 98 patients, 15 with occlusal discrepancies and/or TMJ symptoms underwent early plate removal after SSRO. Finally, 12 consecutive patients were evaluated in this study: 7 underwent bilateral SSRO, 1 underwent unilateral SSRO, and 4 underwent bilateral SSRO with maxillary advancement. The axiolateral TMJ Schuller method was used to evaluate the TMJ position. The authors measured 3 spaces (anterior, superior, and posterior joint spaces) between the condyle and glenoid fossa in the sagittal plane. The anterior and superior joint spaces were significantly larger immediately after the operation than before the operation. After early plate removal, these spaces significantly decreased in size. The posterior joint space increased, but with no significant difference. Three months after SSRO, the size of each of the 3 spaces was closely related to its preoperative size. In conclusion, these results suggest that early removal of fixed plates is 1 treatment option for postoperative occlusal discrepancies after SSRO.


Asunto(s)
Placas Óseas , Osteotomía Sagital de Rama Mandibular/métodos , Articulación Temporomandibular/cirugía , Humanos
18.
J Oral Maxillofac Surg ; 75(6): 1257-1262, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28157491

RESUMEN

PURPOSE: Dexamethasone seems to suppress postoperative swelling. However, the standard administration dose of dexamethasone for bilateral sagittal split osteotomy (BSSO) has not been reported. This study focused on clarifying the most effective dose of dexamethasone for BSSO. MATERIALS AND METHODS: This research was planned as a prospective, randomized controlled, double-blind study. Patients undergoing BSSO were randomly assigned to receive intravenous preoperative dexamethasone under 3 different dose conditions: 16 mg, 8 mg, and 0 mg (control). The endpoints of this study were 1) postoperative changes in masseter muscle thickness and buccal soft tissue thickness; 2) postoperative changes in maximum incisal opening; 3) postoperative changes in sensation of the chin and lower lip region; 4) postoperative changes in blood examination findings (white blood cell count, neutrophil count, C-reactive protein level, and lymphocyte count); and 5) types of complications. Data were recorded at 2 to 4 time intervals: before surgery, postoperative day 1, postoperative day 2, and postoperative day 3. Average age, gender, average body mass index, average surgery time, and average blood loss also were examined. Data were analyzed by 1-way analysis of variance (Bonferroni multiple-comparisons test) after the Bartlett test. RESULTS: We enrolled 24 patients, including 5 men and 19 women, in this study. The rate of increase in the thickness of the masseter muscle 24 hours after BSSO was 38.4% in the 16-mg group (n = 8), 57.7% in the 8-mg group (n = 8), and 56.1% in the 0-mg group (n = 8). The rate of increase in masseter muscle thickness in the 16-mg group was significantly lower than that in the 0-mg group (P < .05). Regarding the number of lymphocytes after surgery, the 16-mg and 8-mg groups maintained preoperative levels whereas there was a reduced number of lymphocytes in the control group. No statistically significant results were obtained for the following study endpoints: postoperative changes in maximum incisal opening and postoperative changes in sensation of the chin and lower lip region. CONCLUSIONS: This investigation showed that the most effective dose of dexamethasone for BSSO is 16 mg.


Asunto(s)
Antiinflamatorios/administración & dosificación , Dexametasona/administración & dosificación , Edema/prevención & control , Músculo Masetero/efectos de los fármacos , Osteotomía Sagital de Rama Mandibular , Complicaciones Posoperatorias/prevención & control , Adulto , Método Doble Ciego , Femenino , Humanos , Infusiones Intravenosas , Masculino , Procedimientos Quirúrgicos Ortognáticos , Cuidados Preoperatorios , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
19.
J Craniofac Surg ; 26(7): e567-8, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26468821

RESUMEN

Short lingual osteotomy is a useful method for the performance of sagittal split ramus osteotomy involving interference between the proximal and distal bone fragments when lateral differences exist in the setback distance. However, this procedure occasionally results in abnormal fracture and nerve injury; expert surgical skill is thus required. We herein describe a novel technique involving the use of an ultrasonic bone-cutting device (Piezosurgery; Mectron Medical Technology, Carasco, Italy) for vertical osteotomy posterior to the mandibular foramen. Successful short lingual osteotomy was performed using this technique with avoidance of abnormal fracture and neurovascular bundle damage.


Asunto(s)
Osteotomía Mandibular/métodos , Osteotomía Sagital de Rama Mandibular/métodos , Piezocirugía/métodos , Placas Óseas , Humanos , Complicaciones Intraoperatorias/prevención & control , Mandíbula/anomalías , Mandíbula/irrigación sanguínea , Mandíbula/inervación , Nervio Mandibular/fisiología , Osteotomía Mandibular/instrumentación , Tempo Operativo , Osteotomía Sagital de Rama Mandibular/instrumentación , Periostio/cirugía , Piezocirugía/instrumentación
20.
PLoS One ; 10(4): e0125608, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25915664

RESUMEN

The proper development of the mammalian cerebral cortex requires precise protein synthesis and accurate regulation of protein expression levels. To reveal signatures of protein expression in developing mouse cortices, we here generate proteomic profiles of cortices at embryonic and postnatal stages using tandem mass spectrometry (MS/MS). We found that protein expression profiles are mostly consistent with biological features of the developing cortex. Gene Ontology (GO) and KEGG pathway analyses demonstrate conserved molecules that maintain cortical development such as proteins involved in metabolism. GO and KEGG pathway analyses further identify differentially expressed proteins that function at specific stages, for example proteins regulating the cell cycle in the embryonic cortex, and proteins controlling axon guidance in the postnatal cortex, suggesting that distinct protein expression profiles determine biological events in the developing cortex. Furthermore, the STRING network analysis has revealed that many proteins control a single biological event, such as the cell cycle regulation, through cohesive interactions, indicating a complex network regulation in the cortex. Our study has identified protein networks that control the cortical development and has provided a protein reference for further investigation of protein interactions in the cortex.


Asunto(s)
Corteza Cerebral/crecimiento & desarrollo , Proteínas del Tejido Nervioso/fisiología , Animales , Corteza Cerebral/química , Corteza Cerebral/embriología , Corteza Cerebral/metabolismo , Perfilación de la Expresión Génica , Ratones , Ratones Endogámicos C57BL , Proteínas del Tejido Nervioso/análisis , Proteómica , Espectrometría de Masas en Tándem
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