Evaluation of the Efficacy of Biodegradable Plates in Maxillofacial Fractures.

BACKGROUND: Maxillofacial fractures require stable fixation for uneventful bony healing and optimal remodeling. Conventional titanium plates considered the gold standard of rigid internal fixation for many years, however due to the inherent drawbacks associated with metal devices biodegradable plates have been developed. AIM OF THE STUDY: To evaluate the efficacy of biodegradable plates as a treatment modality of rigid internal fixation for facial fractures and to assess the perioperative complications experienced with their utilization. PATIENTS AND METHODS: This prospective clinical study included 10 Iraqi patients, met the eligibility criteria and subjected to open reduction and internal fixation with biodegradable plates system. The data were analyzed according to the age, gender, etiology of the fracture, fracture site, surgical approach, plate application time, fracture reduction, screw holes ossification, and patient's satisfaction. The patients were radiographically followed up with either computed tomography or CBCT at 3, 24, and 48 weeks with regular follow up intervals. The statistical analysis was performed using percentages, the mean ±â€Šstandard deviation, Shapiro-Wilk test and Mann-Whitney U test. RESULTS: The age of patients ranged from 9 to 65 years with an average of 26.1 years and a standard deviation of ± 12.9. Regarding gender, males showed a higher percentage than female (80% versus 20%), respectively. There was a significant difference between the mean time of plate application in midface and mandible (53 versus 32.9 minutes), respectively. All cases end up with complete screw holes ossification. CONCLUSIONS: This study demonstrated that biodegradable plating system was a sensitive procedure and greatly depended upon surgeon's experience and improvement of the learning curve.

Effect of Implant Surface Modification on Bone Mineral Density and Survival Rate in the Maxilla After a Short Period Using Cone Beam Computed Tomography.

ABSTRACT: This study was aimed to objectively measure the changes in bone density amount obtained through cone-beam computed tomography around dental implants after a short period of time in the maxilla. Thirty-two SLActive Straumann implants were inserted into 12 healthy patients. Changes in bone density were measured at the surgery time (Bone mineral density (BMD)0) and 60 days after investment (Bone mineral density (BMD)60). Statistically, significant differences were observed between traumatic and sinus zones at the time of surgery and after 60 days respectively (P ≤ 0.05). For each group, a significant decrease in density was observed with the following variables (male, age of 18-40 years, sinus zone, and implant diameter of 4.1 mm). The survival rate was 83.8% after 60 days. Implant surface modification has no significant effect on bone mineral density after a short period of time in the sinus zone. Early loading of the prosthesis can be performed in the traumatic zone only.

Presurgical Assessment of Anatomical Landmark Position Using Two Views of Cone Beam Computed Tomography: A Comparative Radiological Study.

BACKGROUND: Cone beam computerized computed tomography (CBCT) has been widely indicated in dental implant procedure. The first step that the doctors should perform in local hospitals is to use orthopantomography for surgical planning to avoid and limit the risk of complications. As a result, determining the magnification amount of orthopantomography to achieve a precise diagnosis is clinically important. This study investigated the difference in measurement of the mental foramen (MF) position before dental surgery using 2 views of CBCT. MATERIALS AND METHODS: Cone beam computed tomography scan was performed for 100 patients who required implant placement. In the panoramic and three-dimensional views of CBCT, the vertical distance between the margin of the mandible and the lower border of MF, and the horizontal distance between the mandibular symphysis and the mesial anterior border of MF were calculated. The differences between the 2 views were compared using Wilcoxon-rank U test with P value ≤ 0.05 considered statistically significant. RESULTS: The findings of this study showed a substantial statistical difference in the horizontal distance for the dentate patients in panoramic and three-dimensional views (22.7 ±â€Š3.04 versus 21.1 ±â€Š1.6), (22.5 ±â€Š2.4 versus 20.9 ±â€Š1.5) and left side (22.4 ±â€Š2.8 versus 21.2 ±â€Š1.6), (22.4 ±â€Š2.8 versus 20.6 ±â€Š1.4) of both genders. Concerning the vertical distance, a significant difference was also observed in the dentate (12.1 ±â€Š2.1 versus 11.1 ±â€Š1.4), (10.6 ±â€Š1.4 versus 9.6 ±â€Š1.3) and left side of the jaw (11.6 ±â€Š1.95 versus 10.9 ±â€Š1.2), (10.5 ±â€Š1.2 versus 9.96 ±â€Š1.4) for both genders in both views. In the edentulous and right side of the jaw, however no statistical difference was observed between male and female patients in terms of horizontal and vertical measurements.

Morphometric Analysis of the Mental Foramen Variation in an Iraqi Population by Using Cone-Beam Computed Tomography.

ABSTRACT: The effects of gender, side, and ridge condition on the position of the mental foramen (MF) were investigated in this research. A total of 122 cone-beam computed tomography scans were chosen from healthy patients with age ranging from 18 to 72 years. The following parameters were used to evaluate images: MS-MF (horizontal distance to the mandibular symphysis from the anterior MF limit) and MB-MF (vertical measurement of distance from the inferior boundary of the mandible to the lower border of the MF). The mean distance between the MF and mandibular symphysis was 20.98 ±â€Š1.95. The average measurement between the MF and the mandible's lower boundary was 10.36 ±â€Š1.63. The horizontal distance was slightly different between males and females (21.5 ±â€Š1.59 and 20.6 ±â€Š1.6, respectively). In terms of gender and ridge condition, a significant difference in vertical distance (10.97 ±â€Š1.14 versus 9.9 ±â€Š1.24 and 10.13 ±â€Š1.5 versus 10.55 ±â€Š1.07, respectively) was observed. By contrast, in vertical and horizontal distances, significant differences were noted between edentulous men and women. Meanwhile, a significant difference between dentate male and female patients was found at vertical distances only. In conclusion, in both vertical and horizontal measurements, the location of the MF was higher in males than in females and edentulous more than dentate.