A 7-Year Retrospective Analysis of Titanium Plates Removal Following Orthognathic Surgery.

Objective: The aim of this study was to investigate the incidence of plate removal in orthognathic surgery patients and the reasons for their removal and to potentially identify the factors that may contribute to it. Methods: A retrospective study included all patients who underwent orthognathic surgery at Selayang Hospital from January 2011 to December 2017. The variables of interest recorded included patient age, gender, the existing skeletal deformity, type of surgery undertaken and number and location of plates inserted and removed. In addition, the reasons for plate removal and duration between plate insertion and removal were also recorded. Results: Ninety-seven patients with a mean age of 21.33 were included in the study. Nine patients with total of 33 plates had their miniplate fixation removed. Three patients underwent bi-maxillary surgery, and six patients underwent BSSO. The average time from insertion to removal was 22.33 months. The reasons for removal included pain, palpable and exposed plates, infection and on patient request. Conclusion: We report a 9.28% incidence of plate removal in patients who undergo orthognathic surgery which is comparable to the existing literature.

Treatment of oral submucous fibrosis using split skin graft and a polyethylene stent: a prospective study.

AIM: Aim of this study was to evaluate the split skin graft held in place with a polyethylene stent for the treatment of oral submucous fibrosis. METHODS: Fifteen prospective patients diagnosed clinically with oral submucous fibrosis, from June 2011 to 12 December 2012, were recruited for this study. All patients were treated surgically using the same surgical technique of fibrotomy followed by split skin graft along with a polyethylene stent. Preoperative and postoperative mouth opening measurements at 1 week and after a minimum of 6 months were evaluated by measuring the inter incisal distance. RESULTS: Mean follow up was 9.8 months with a minimum of 6 months. Mean preoperative mouth opening was 12.9 mm (6-20 mm). Intraoperatively mean mouth opening was 37.9 mm (36-41 mm). After 1 week mean mouth opening was 35.8 mm (31-40 mm). At 6 months follow up, mean mouth opening was 33 mm (20-40 mm). CONCLUSION: Fibrotomy followed by split skin graft along with a polyethylene sheet stent and sufficient postoperative physiotherapy is a simple, cost effective and viable treatment modality for oral submucous fibrosis.

Split-mouth comparison of physics forceps and extraction forceps in orthodontic extraction of upper premolars.

We compared outcome variables (operative complications, inflammatory complications, and operating time) in patients being treated by orthodontic extraction of upper premolars with the Physics forceps or the universal extraction forceps. We organised a single blind, split-mouth clinical trial to compare the outcomes of the 2 groups (n=54 premolars). The Physics forceps group had lower mean (SD) visual analogue scores (VAS) for pain (0.59 (0.57)) on the first postoperative day than the other group (1.04 (0.85)) (p=0.03). There were no other significant differences between the 2 groups in any other variable studied.

Effectiveness of tranexamic acid on intraoperative blood loss in isolated Le Fort I osteotomies--a prospective, triple blinded randomized clinical trial.

The aim of this triple blinded randomized clinical trial was to evaluate the efficacy of tranexamic acid when used in conjunction with hypotensive anaesthesia exclusively for Le Fort I osteotomies. 49 patients undergoing Le Fort I osteotomy for correction of dentofacial deformity were divided into two groups; Group 1 received a placebo of saline 5 ml and Group 2 received 10 mg/kg body weight of tranexamic acid. The operating surgeon, anaesthetist and investigator were blinded. The variables of interest recorded in this study included the change in Hb%, PCV, total blood loss, total operating time and quality of the surgical field using Fromme's Ordinal Scale. Statistically significant differences between the two groups were found between the following variables: post-operative Hb%, drop in Hb%, post-operative PCV, drop in PCV, total surgical blood loss, total operating time and quality of surgical field (P < 0.05). Group 2 patients exhibited a smaller drop in Hb% and PCV, with a lower Fromme's Ordinal Scale value and decreased total blood loss and operating time. In conclusion single preoperative administration of tranexamic acid in the dose of 10 mg/kg, when combined with hypotensive anaesthesia is effective in controlling blood loss with regards to single piece Le Fort I surgery.