Dexamethasone and concentrated growth factors on peripheral nerve injury: A clinic-relevant animal study.

BACKGROUND: Mandibular nerve injury is a common clinical condition that affects clinicians' management and patients' quality of life. In the literature, there are various effective treatments available. The primary purpose of this study was to determine and compare the effects of dexamethasone and concentrated growth factor (CGF) on regeneration in patients with nerve trauma that mimics clinical situations. METHODS: In this study, 36 rats were divided into 3 groups: the control, dexamethasone and CGF groups. The inferior alveolar nerve was traumatized through the extraction socket after mandibular molar tooth extraction in each group. RESULTS: The data showed a decrease in the control (4.5-4), dexamethasone (3-2), and CGF (4-3) groups according to the histological injury severity score (HISS) results. Compared with those in the other groups, the number of degenerative axons and edematous areas observed via histological examination were significantly lower in the CGF groups. Similarly, compared with those in the control group, the nNOS and Neurofilament-H positivity in the dexamethasone group on the 30th day (2,2 to 1,1 respectively) was significantly lower. The positivity of all the primary antibodies in the 3rd and 30th day CGF groups was significant compared than that in the dexamethasone 30th day group. CONCLUSION: According to the results of the analysis of the immunohistopathological and HISS data, the CGF groups exhibited greater regeneration than did the dexamethasone groups.

Preoperative and postoperative assessment of temporal and masseter muscle size with magnetic resonance imaging in patients undergoing unilateral temporomandibular joint surgery.

The aim of this study was to assess any change between the preoperative and postoperative sizes of temporal and masseter muscles with magnetic resonance imaging (MRI) in patients undergoing unilateral temporomandibular joint surgery. This study was designed and implemented retrospectively. For clinical evaluation, a visual analog scale (VAS) and maximum mouth opening (MMO) were used. In order to make a preoperative diagnosis and perform a 6-month control, muscle size was measured in millimeters (mm) on T1 axial sections in MRI. Statistical analyses were performed using the SPSS 23.0 software package. Numeric variables were compared between two dependent groups using the Wilcoxon signed rank test. Statistical significance was set at p < 0.05. Twelve patients who underwent unilateral discectomy plus dermis-fat grafting, with classical preauricular inverse L incision, were included in the study, and data for eleven female patients were evaluated. The difference in size between the operated and non-operated sides was found to be statistically insignificant at the preoperative stage for both masseter muscle (operated side mM: 13.264 ± 1.822 mm; non-operated side mM: 13.264 ± 2.315 mm; pM = 0.929) and temporal muscle (operated side mT: 20.345 ± 2.609 mm; non-operated side mT: 20.582 ± 2.366 mm; pT = 0.594). There was a significant size reduction in the masseter muscle on the operated side in the postoperative period (preop mM: 13.264 ± 1.822 mm; postop mM: 12.036 ± 1.728 mm; pM = 0.018). Although there was also a size reduction in the operated side of the temporal muscle in the postoperative period, that difference did not reach statistical significance (preop mT: 20.345 ± 2.609 mm; postop mT: 19.445 ± 1.603 mm; pT = 0.182). On the non-operated side, there were no significant postoperative changes in the sizes of either the masseter muscle (preop mM: 13.264 ± 2.315 mm; postop mM: 12.682 ± 2.059 mm; pM = 0.248) or the temporal muscle (preop mT: 20.582 ± 2.366; postop mT: 19.891 ± 3.487 mm; pT = 0.625). Considering the study findings as a whole, a size reduction was observed in the operated side of the masseter muscle after TMJ surgery. The etiology of this change may be surgical trauma to the temporal and masseter muscles, skeletal alteration resulting from condylar change secondary to discectomy, and patients restraining themselves from application of maximum bite force as a result of a self-protection mechanism due to postoperative pain.

Is there a relationship between third-molar impaction types and the dimensional/angular measurement values of posterior mandible according to Pell & Gregory/Winter Classification?

OBJECTIVE: The aim of this study was to examine the relationship between ramus height, gonial angle and impaction classifications of mandibular third molars. METHODS: A total of 829 mandibular third molars in 601 patient's orthopantomography (OPG) and cephalometric radiography records were evaluated. Gonial angle was measured on cephaloametric radiography and ramus height was measured on OPG. Impacted third molars were classified according to Pell & Gregory Vertical/Winter classification on OPG. The relationship between the impaction classifications and ramus height/gonial angle was evaluated. RESULTS: Statistically significant difference was found in Pell & Gregory Classification types in terms of ramus height/gonial angle (p < 0.001). Significant difference was found in terms of Gonial angle in Winter Classifications (p < 0.001). Ramus height was found to be lower than 3.8 cm in patients with an angle less than 123.8° (sensitivity 78%, specificity 84%). CONCLUSIONS: Correlation between ramus height/gonial angle and impaction classification types of mandibular third-molar teeth was detected.

Management of Recurrence of Ameloblastoma and Odontogenic Keratocyst: A Cross-Sectional Study / Manejo de la recurrencia del ameloblastoma y keratoquiste odontogénico: Estudio de corte transversal

Abstract Objectives: Odontogenic keratocyst (OKC) and ameloblastoma are slowly growing and locally invasive tumors with high recurrence rate. The aim of this study was to investigate the clinicopathologic features of recurrent ameloblastoma and OKC cases, and evaluate outcomes of our treatments in terms of recurrence. Material and Methods: A total of 23 patients with confirmed recurrent ameloblastoma or OKC and treated in our clinic within eleven years period were reviewed retrospectively. Results: Eleven recurrent OKC cases and twelve recurrent ameloblastoma cases were included. Most recurrences occurred within five years after the initial treatment (69.6%). Enucleation had the highest recurrence rate among the first treatments (18/23). All recurrences were located in the mandible, with one exception (22/23). All recurrent OKCs were multilocular. Different histopathologic subtypes of ameloblastoma were seen in our study, follicular ameloblastoma was the most common (8/12). The mean diameter of the lesions was 4.3 cm (ranging from 2 cm to 7 cm). Statically significant relation was found between location and diameter of lesion and year of recurrence onset (p=0.004; p=0.026). We performed radical treatments in these cases (ten patients underwent marginal resections, and thirteen patients underwent segmental resection), and no recurrence was observed during the follow-up period. Conclusion: Previous inadequate surgical procedures were the most important cause of recurrence. Marginal or segmental resection with safety margins is the best method to treat recurrences of OKC or ameloblastoma cases.

Resumen Objetivo: Los keratoquistes odontogénicos (KQO) y ameloblastomas son tumores invasivos de lento crecimiento local con una alta tasa de recurrencia. El propósito de este estudio fue investigar las características clínico patológicas de los casos de ameloblastoma y KQO recurrentes y evaluar los resultados de tratamientos en término de recurrencia. Materiales y Métodos: Un total de 23 pacientes con casos confirmados de ameloblastomas o KQO recurrentes tratados en nuestra clínica en un período de once años fueron incluidos. Resultados: Once casos de KQO recurrentes y doce ameloblastomas recurrentes fueron incluidos. La mayoría de las recurrencias ocurrieron en los primeros 5 años posteriores al tratamiento inicial (69.6%). La enucleación mostró la tasa de recurrencia más alta entre los tratamientos iniciales (18/23). Todas las recurrencias se presentaron en la mandíbula excepto por un caso (22/23). Todos los KQO fueron multiloculares. Distintos subtipos histológicos del ameloblastoma fueron detectados en el estudio y el ameloblastoma folicular fue el más común (8/12). El diámetro promedio de las lesiones fue de 4.3cm en un rango de 2cm a 7cm. Una relación estadísticamente significativa se encontró entre la ubicación y el diámetro de la lesión y el tiempo de aparición de la recurrencia (p=0.004; p=0.026). Se realizaron tratamientos radicales en los siguientes casos, diez pacientes tuvieron resecciones marginales y trece pacientes resección segmental; no se observaron recurrencias en el período de seguimiento. Conclusión: Procedimientos previos inadecuados fueron la causa más relevante de recurrencia. Resección marginal o segmental con márgenes de seguridad son el mejor método para tratar casos de ameloblastoma y KQO recurrentes.

Corrigendum: Evaluation of success criteria for temporomandibular joint arthrocentesis.

[This corrects the article on p. 15 in vol. 45, PMID: 30847292.].

Evaluation of success criteria for temporomandibular joint arthrocentesis.

OBJECTIVES: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). MATERIALS AND METHODS: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ≥35 mm and visual analogue scale [VAS] score ≤3), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ≥35 mm and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). RESULTS: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). CONCLUSION: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

Evaluation of effectiveness of concentrated growth factor on osseointegration.

BACKGROUND: Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration. METHODS: Twelve patients with maxillary anterior toothless were included in the study. Implant cavities prepared in the study group were covered with CGF membrane before implant placement, but conventional implant placement was performed in the control group. Resonance frequency measurements were performed with the Osstell device intra-operatively, post-operatively, at the 1st week, and at the 4th week. RESULTS: The mean ISQ values were found to be 79.40 ± 2.604 for the study group and 73.50 ± 5.226 for the control group at 1st week, 78.60 ± 3.136 for the study group and 73.45 ± 5.680 for the control group at 4th week. The differences between the groups were statistically significant (p < 0.05). CONCLUSIONS: It was observed that the concentrated growth factor had positive effects on implant stabilization. The ISQ measurements at week 1 and week 4 were notably higher in the study group. Application of this material seems to accelerate osseointegration.