Quality of life in oncologic patients after maxillectomy operations: clinical case series on different rehabilitation protocols.

OBJECTIVE: The study's purpose was to compare the quality of life (QoL) in oncologic patients treated with different rehabilitation protocols following maxillary tumor resections. PATIENTS AND METHODS: The patients were divided into three groups. Group A: 18 Patients with maxillary obturator prosthesis. Group B: 17 Patients with simultaneous autologous tissue reconstruction. Group C: 12 Patients with prosthesis on zygomatic implants. The post-operative QoL was compared using standard questionnaires, investigating items like pain, mood, social relations, and specific functions that could potentially compromise the post-operative QoL. A secondary analysis compared reconstructed vs. non-reconstructed patients. RESULTS: Most questionnaire items did not show significant differences among groups. Statistically significant outcomes were found in two parameters (social contact and sexuality), in which patients treated with zygomatic implants had the best satisfaction, and patients with obturator prostheses showed the lowest satisfaction. Patients belonging to the non-reconstructed group showed better moods than those in the reconstructed group, while taste problem complaints and pain were lower in the reconstructed group. CONCLUSIONS: Although the type of reconstruction procedure depends on the type of maxillectomy to be performed and on the general health situation of each patient, the impact of the rehabilitation protocol on the patients' QoL should be accounted for when planning the treatment.

Histomorphometric evaluation of delayed changes in masseter muscle after lengthening the rabbit mandible by distraction osteogenesis.

OBJECTIVE: The aim of the study was to evaluate the delayed responses and changes of gradually lengthened masseter muscles of rabbit mandibles. STUDY DESIGN: Unilateral lengthening of rabbit mandibles was performed in 18 New Zealand rabbits for 7 days at the rate of 1 mm day(-1). Mandibles of animals were removed at months 3, 4, and 6 after distraction. Biopsy samples of distracted and contralateral side masseter muscles were histopathologically evaluated and mean area of muscle fibers (MAF) was evaluated with histomorphometric methods. Results were statistically analyzed. RESULTS: Mild to moderate atrophy of the fibers, and necrosis and myophagocytosis in some areas were the leading features at month 3 and which were decreased at month 4 in distracted side-muscle specimens, with no statistically significant differences when compared with non-distracted side muscles at the same periods. Almost completely, normal fibers were detected in distracted muscle specimens at month 6. Evidence of myopathic changes was found to disappear at month 6 and no significant difference was found in the MAF of distracted side muscles. CONCLUSION: This study showed that the masseter muscle could adapt to gradual lengthening of the mandible within 6 months. Regenerative features and some degree of atrophic changes that could be observed at months 3 and 4 disappeared at month 6, with adaptation of the fibers.

Calibre persistent labial artery: clinical features and noninvasive radiological diagnosis.

Calibre persistent labial artery (CPLA) is defined as a primary arterial branch that penetrates into the submucosal tissue without division or decrease in diameter. It usually presents as an asymptomatic papule on the lower lip and can be easily misdiagnosed as a varix, haemangioma, venous lake, mucocele or fibroma. When it is ulcerated, squamous cell carcinoma is the most usual differential diagnosis. The most frequently used method to confirm the diagnosis of CPLA has been excisional biopsy, which carries the risk of profuse bleeding. Angiography, another invasive method, has also been used. Here, we report a case of a 20-year-old woman with a 5-year history of multiple CPLA lesions involving both upper and lower lips. In this case, the diagnosis was made clinically and confirmed by Doppler ultrasonography, which is a noninvasive and simple diagnostic tool.

Distraction osteogenesis in Silver Russell syndrome to expand the mandible.

Distraction osteogenesis is a method commonly used to activate bone regeneration in nonunions and osseous defects and for lengthening procedures of tubular bones. This technique involves the sectioning of a bone and the subsequent deliberate, controlled movement of the opposing sectioned edges to lengthen, widen, or reposition a bone, or all three. In this report, a patient with Silver Russell syndrome and severe mandibular hypoplasia was treated by means of distraction osteogenesis of the midsymphysis to widen the mandible in concert with sagittal-ramus osteotomies to lengthen the mandible. This treatment created significantly increased arch length in the mandible, which was necessary to facilitate the patient's orthodontic treatment. We believe this is the first reported case of distraction osteogenesis to widen the mandible with the use of a tooth-borne appliance.

Idiopathic swelling of the lower lip associated with topical anaesthesia. Report of three cases.

Three cases of idiopathic swelling of the lower lip are presented. Each developed following administration of a topical anaesthetic agent with unusual clinical manifestations closely resembling allergic angio-oedema. The possibility of psychogenically mediated reactions was considered the contributing aetiological factor which showed as a somatic manifestation in the lower lips.

Stereophotogrammetric and clinical evaluation of morbidity after removal of lower third molars by two different surgical techniques.

PURPOSE: This study compared swelling, pain, and trismus after using the conventional buccal approach and the lingual split technique for the removal of impacted third molars. MATERIALS AND METHODS: Twenty patients with a mean age of 21.5 years were included. Postoperative edema was followed stereophotogrammetrically for 48 hours by transferring photogrammetric data from three-dimensional profile views into orthographic maps. A visual analog scale was used for 6 days for determining pain. Mouth opening was measured on the 1st, 2nd, and 7th postoperative days. RESULTS: Maximal swelling was noted in both groups on the second postoperative day. In both groups, maximal trismus was noted on the first postoperative day. Approximately 98% of the measurements of interincisal distances had returned to the preoperative values by the 7th day. There was no significant difference in the pain intensity between the two groups on postoperative days 1 through 6. Swelling (P = .88) and pain (P = .12) were not significantly different in either groups. Trismus was found to be significantly less (P = .03) in the lingual split group. CONCLUSION: Although swelling and pain were comparable in both groups, the amount of trismus was less with the lingual split technique. This may be an advantage of the latter technique.