Solitary plexiform neurofibroma of the tongue: report of a case with no evidence of neurofibromatosis type 1.

Neurofibromas are frequently present in the skin, but are uncommon in the oral and maxillofacial region. There are three histological variants of neurofibroma: localized, diffuse, and plexiform. The plexiform histological variant of neurofibroma is the least common and is a rare occurrence in the oral cavity. Furthermore, plexiform neurofibroma is usually pathognomonic of neurofibromatosis type 1. A case of solitary plexiform neurofibroma of the tongue with no evidence of neurofibromatosis in a 50-year-old female Chinese patient is reported here. The lesion presented as a single, large, well-circumscribed rounded mass in the left hemi-tongue. The tumour was completely excised. No recurrence was observed at the 6-month follow-up.

Surgical cutting guide and single plate fixation for intraoral vertical ramus osteotomy.

With the advancement of digital technology over the last few decades, the use of virtual surgical planning and fabrication of surgical guides have tremendously improved the outcomes of various maxillofacial surgical procedures. The intraoral vertical ramus osteotomy (IVRO) is an orthognathic surgical procedure largely employed for mandibular setback in correcting dentofacial deformities. This study describes the design and application of a surgical cutting guide for IVRO. The guide can also be used to facilitate the placement of miniplate fixation. The initial experience at the authors' centre suggests that the guide has allowed the osteotomy to be performed with increased precision and confidence. Furthermore, the use of miniplate fixation decreased the period of maxillomandibular fixation. However, a larger series is required to evaluate the utility of this system more thoroughly.

The role of anterior segmental osteotomies in orthognathic surgery for protrusive faces in a Southeast Asian population: 10-year retrospective data of 51 patients treated in a single centre.

Bimaxillary protrusion is a dentofacial deformity common in the East Asian population. It is often difficult to decide between orthodontic and surgical retraction to treat patients with bimaxillary protrusion, especially if surgery to correct skeletal base discrepancies is also required. The objective of this study was to investigate the treatment outcomes of surgical versus orthodontic retraction in patients with bimaxillary protrusion undergoing orthognathic surgery. A retrospective cohort study was conducted, where the medical records and radiographs of 51 patients with bimaxillary protrusion who had an anterior segmental osteotomy concomitant with orthognathic surgery were examined. Patients who had bimaxillary anterior segmental osteotomies were more likely to achieve an inter-incisal angle of 135 ± 5° at the end of treatment, when compared to patients who had orthodontic retraction (P < 0.01). The total treatment duration of patients who had bimaxillary anterior segmental osteotomies was significantly shorter as compared to that of the patients who only had these osteotomies in the maxilla (P < 0.001) or mandible (P = 0.012). Complications and permanent long-term sequelae following anterior segmental osteotomies were uncommon. It is concluded that bimaxillary anterior segmental osteotomies are a viable alternative for patients with concomitant bimaxillary protrusion and skeletal base discrepancies. This allows for a significantly shorter treatment time and greater correction of inter-incisal angles, without a significant increase in complications.

Unusual metastatic presentations of a primary right parapharyngeal acinic cell adenocarcinoma.

Acinic cell adenocarcinoma (ACA) is a malignant epithelial neoplasm of the salivary glands. The patient reported herein presented with an unusual case of a metastatic ACA originating from the right parapharyngeal region, which eventually metastasized to the ipsilateral cavernous sinus and the contralateral mandibular ramus. The trigeminal nerve may have served as a channel for the spread of the cancer from the right parapharyngeal region to the cavernous sinus, and subsequently to the left mandibular ramus. The widening of the left inferior alveolar nerve canal was an early sign of metastasis in this case.

Changes in bite force after orthognathic surgical correction of mandibular prognathism: a systematic review.

Patients requesting treatment for mandibular prognathism seek functional and aesthetic improvements. Improvements in bite force and efficiency are generally used as measures of better function. It is unclear what effect the surgical correction of mandibular prognathism will have on the patient's occlusal forces. The literature was searched using medical subject heading (MeSH) and key word terms 'bite force', 'osteotomy', 'orthognathic surgery', and 'prognathism'. A total of 17 articles were included in this review. These included a total of 697 patients, who ranged in age from 15 to 44 years. Male patients outnumbered female patients in only one study. Five hundred and thirty-two patients underwent bilateral sagittal split osteotomy, 108 patients underwent intraoral vertical ramus osteotomy, and 24 patients underwent extraoral vertical ramus osteotomy (approach unspecified). In general, masticatory efficiency at 3 months after surgery was greater than that found pre-surgically; the increase was significant at 6 months after surgery. The occlusal contact area and points tended to increase from 3 months after surgery, and there was a significant increase at 12 months after surgery. Occlusal forces, although improved, will be lower in corrected prognathic patients than in normognathic patients even at 2 years after surgery.