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Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Materials Science and Engineering".

Deadline for manuscript submissions: closed (15 May 2022) | Viewed by 75366

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Prof. Dr. Raffaele Rauso

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Maxillofacial Surgery Complex Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: facial plastic surgery; head and neck reconstruction; rhinoplasty; cleft surgery; microsurgery; cosmetic medicine

Prof. Salvatore D’Amato

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Multidisciplinary Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, AOU University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: oral surgery; maxillo-facial surgery; prosthesis; software in dentistry; dentistry

Dr. Mario Santagata

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Guest Editor

Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
Interests: orthognathic surgery; facial trauma; oral surgery; implant dentistry

Special Issue Information

Dear Colleagues,

Oral and maxillo-facial surgery is a wide field of surgical, medical and dental sciences often and often involved with the use of new medical devices, drugs and biomaterials. At the same time, different medical and dental specialities are involved in this field, such as: maxillo-facial surgeon, dentist, orthodontist, otolaryngologist, plastic surgeon and so on.

The developments of “new tools”, during last 20 years, for physicians involved in head and neck healthcare, have focused on a more predictable surgery, on a reduction of post-operative days and discomfort for the patient, and when possible to avoid a surgical approach opting for the use of drugs or medical devices.

We welcome all healthcare professionals, involved in the different oral and maxillo-facial surgery activities, to submit their work regarding the use of medical devices, drugs and biomaterials in this field, in order to share their experience.

Prof. Raffaele Rauso
Prof. Salvatore D’Amato
Dr. Mario Santagata
Guest Editors

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Keywords

software in oral and maxillo-facial surgery
medical devices in oral and maxillo-facial surgery
drugs delivery in oral and maxillo-facial surgery
biomaterials in oral and maxillo-facial surgery
new tools in facial plastic surgery
new tools in facial cosmetic medicine
facial lipoatrophy, surgical and medical treatment
TMJ disorders
BRONJ and medical treatment
minimally invasive procedure
new tools in oral cancer diagnosis
oral cancer management
biomaterials in facial trauma
orthognathic surgery

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Published Papers (11 papers)

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Research

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15 pages, 13635 KiB

Open AccessArticle

Fat Graft in Surgical Treatment of Medication-Related Osteonecrosis of the Jaws (MRONJ)

by Davide De Cicco, Gianpaolo Tartaro, Giuseppe Colella, Giovanni Dell’Aversana Orabona, Mario Santagata, Ivo Ferrieri, Antonio Troiano, Samuel Staglianò, Andrea Salvatore Volgare and Salvatore D’Amato

Appl. Sci. 2021, 11(23), 11195; https://doi.org/10.3390/app112311195 - 25 Nov 2021

Cited by 2 | Viewed by 2003

Abstract

Background: Although the published literature has grown exponentially during the last few decades, managing medication-related osteonecrosis of the jaws (MRONJ) remains challenging. Since the first description of adipose-derived stem cells, cell therapy showed promising perspectives in surgical treatment of MRONJ. In this study, the beneficial effect of fat graft in surgical treatment of stage 2 and 3 MRONJ patients was assessed. Methods: A retrospective analysis of the evolution pattern of the disease was conducted comparing the outcomes of MRONJ patients who underwent sequestrectomy followed by fat graft (n = 9) and those who received sequestrectomy alone (n = 12). Results: Improvement of the disease stage was observed in 77.8% vs. 22.2% cases in group A and B, respectively (p = 0.030); disease stability was documented in 11.1% vs. 25.0% cases in group A and B, respectively (p = 0.603); worsening of MRONJ stage was observed in 11.1% vs. 50.0% cases in group A and B, respectively (p = 0.159). Conclusions: Despite the small sample size, this study suggests that fat graft may represent a promising low-risk and cost-efficient adjunctive therapy in the surgical treatment of MRONJ patients. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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7 pages, 1451 KiB

Open AccessArticle

Short-Facelift Approach in Temporal Artery Biopsy: Is It Safe?

by Mario Faenza, Giuseppina Piccolo, Mariano Funaro, Roberto Grella, Ilenia Pantano and Francesco Ciccia

Appl. Sci. 2021, 11(22), 10739; https://doi.org/10.3390/app112210739 - 14 Nov 2021

Viewed by 5143

Abstract

Giant cell arteritis (GCA) is a quite common panarteritis of the elderly that affects medium- and large-size arteries. Despite the increasing role of imaging with advancing technology, the gold standard for the diagnosis of GCA is still the temporal artery biopsy. A described complication of superficial temporal artery biopsy (STAB), for which incidence is not clear, is the accidental damage of the frontal branch of the facial nerve. In this paper, we described the short-scar facelift surgical approach for STAB on 23 consecutive patients who underwent unilateral superficial temporal artery biopsy for GCA suspicion. We collected data in terms of postoperative complications, biopsy specimen length, biopsy result and cosmetic appearance of the scar. In our experience, this surgical approach combines the advantage of avoiding incisions within the dangerous anatomical area, minimizing the risk of facial nerve damage, with an acceptable complication rate and a good final aesthetic result which avoids visible scarring. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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17 pages, 3709 KiB

Open AccessArticle

Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw

by Salvatore D’Amato, Antonio Troiano, Giorgio Lo Giudice, Davide De Cicco, Mario Rusciano, Gianpaolo Tartaro and Giuseppe Colella

Appl. Sci. 2021, 11(18), 8553; https://doi.org/10.3390/app11188553 - 15 Sep 2021

Cited by 4 | Viewed by 3129

Abstract

The aim of this study is to analyze surgical and functional outcomes in order to verify the applicability of surgical treatment guidelines as foreseen by MASCC/ISOO/ASCO 2019. Patients affected by stage 2 MRONJ refractory to conservative management were grouped if underwent surgical resection (Group A) or debridement (Group B). Health-related quality of life was evaluated by using the European Organization for Research and Treatment of Cancer questionnaires, QLQ-C30 and H&N35. Statistical analysis was performed using Wilcoxon/Mann–Whitney test, Kaplan–Meier test, Cox regression model and Cox multivariate regression. Group A showed higher complete healing cases vs. group B. Recurrence rate difference in group A vs. group B was statistically significant. Debridement is an unfavorable prognostic factor when compared to surgical resection (p = 0.0032, HR 4.9). Quality of life mean values showed a marked improvement in Group A and a slight improvement in Group B. Debridement has 4.9 times more risk to develop recurrence when compared to surgical resection. A more satisfactory quality of life was shown in patients subject to resective surgery with an improving trend from baseline. Debridement patients showed more variability of results and an overall negative trend at the end of the 6-month follow-up. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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31 pages, 62946 KiB

Open AccessArticle

Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery

by Fabrizio Chirico, Giuseppe Colella, Antonio Cortese, Pierfrancesco Bove, Romolo Fragola, Luigi Rugge, Giovanni Audino, Nicola Sgaramella and Gianpaolo Tartaro

Appl. Sci. 2021, 11(16), 7507; https://doi.org/10.3390/app11167507 - 16 Aug 2021

Cited by 8 | Viewed by 5961

Abstract

The use of hyaluronic acid (HA) injectable fillers has become increasingly widespread in facial recontouring and rejuvenation. We report our experiences to emphasize the role of HA fillers as tools beyond aesthetic treatments in cases of post-surgical facial sequelae. HA fillers are generally used for aesthetic rejuvenation, but one potential new horizon could be their application in trauma, reconstructive, and craniofacial surgery. This study was conducted retrospectively, evaluating medical reports of patients treated at the Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, for lip incompetence, trauma, oncological, reconstructive, and craniosynostosis surgery sequelae. Visual analog scale (VAS) evaluation was performed to assess patient satisfaction. No major complications (i.e., impending necrosis or visual loss) were reported. Bruising and swelling was reported for 48 h after lip injection. At the immediate VAS evaluation, 67% of the patients were “extremely satisfied” and 33% “satisfied”. In those 33%, VAS scores changed to “extremely satisfied” at 6–9 weeks and 3–6 months of VAS evaluation (contextually to improvement in tissue flexibility, elasticity, and aesthetic appearance). Results indicate that this minimally invasive approach achieves a high level of aesthetic enhancement, improving patient satisfaction. The concept of HA filler applications could be a frontier that may be applicable to other areas of reconstructive facial plastic surgery. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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16 pages, 1723 KiB

Open AccessArticle

Biphasic Injection for Masseter Muscle Reduction with Botulinum Toxin

by Fabrizio Chirico, Pierfrancesco Bove, Romolo Fragola, Angelo Cosenza, Nadia De Falco, Giorgio Lo Giudice, Giovanni Audino and Giuseppe Mario Rauso

Appl. Sci. 2021, 11(14), 6478; https://doi.org/10.3390/app11146478 - 14 Jul 2021

Cited by 6 | Viewed by 33122

Abstract

Masseter Muscle Hypertrophy (MMH) is a well-known clinical benign condition that is not gender-specific and it can be monolateral or bilateral. Botulinum Toxin type A (BoNTA) injection has been widely described for MMH treatment and non-surgical facial slimming. BoNTA masseter injections have high efficacy and safety profile, but the risks of side effects remain. Muscular bulging during mastication is a complication due to the superficial overcompensation of masseteric fibers in response to neurotoxic weakening of the deep masseter. We present a biphasic-injection technique for BoNTA administration, based following anatomical concept and developed in order to prevent paradoxical bulging. A total of 98 treatments from 2015 to 2020 were performed with this technique. No remarkable complications occurred in our study. No cases of loss of full smile, difficulty in mouth opening, dizziness, headache, neurapraxia, and xerostomia were reported. A case of asymmetric smiling was self-resolved within a week. No patient claimed transient muscle weakness as distressing. No cases of paradoxical bulging were observed. Extensive knowledge of muscular anatomy and appropriate injection technique are key factors in achieving the desired result and avoiding complications. We feel that sharing this tip could be helpful for all the physicians involved in MMH treatment with BoNTA. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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11 pages, 2534 KiB

Open AccessArticle

Facial Anti-Aging Treatments with Soft Peeling and Microneedling Technique

by Roberto Amore, Fiorella Deriu, Andrea Sbarbati, Domenico Amuso, Massimo Vitale, Ilaria Patruno, Anna Perna and Antonio Scarano

Appl. Sci. 2021, 11(13), 6068; https://doi.org/10.3390/app11136068 - 30 Jun 2021

Cited by 2 | Viewed by 6206

Abstract

Background: The interest in maintaining a young and attractive appearance in an era with increasingly hectic rhythms has generated a pressing demand for effective aesthetic procedures with the shortest possible recovery period, stimulating the search for non-invasive, yet successful, solutions. The aim of this study was to evaluate the effectiveness of the combined soft peeling and MN technique on the various imperfections typical of facial aging. Methods: This multicentric uncontrolled experimental study recruited a population of healthy subjects of both sexes with advanced signs of photo- and chrono-aging. These subjects were provided with a single session of microneedling and peeling at the same time. Recruited subjects were re-evaluated 30 (±4) and 60 (±4) days after treatment by photographic comparison before and after treatment. The physicians evaluated the improvement of facial wrinkles according to the Wrinkle Assessment Scale of Lemperle. Forty-nine subjects completed the study and showed a significant improvement in wrinkles in all areas of the face. Results: There were no significant differences in the different subpopulations compared: males–females, Glogau 3–Glogau 4, smokers–non-smokers, phototypes 1–4, and check up at 30 days–control at 60 days. The adverse events manifested were localized edema in four cases (8.2%) lasting an average of 3–4 days, very fine crustiness in four cases (8.2%), transient post inflammatory dyschromia in two cases (4.1%) lasting 2–3 weeks, and herpetic reactivation in one case (2.0%). Conclusions: The study demonstrates the therapeutic efficacy of the combined needling-peeling treatment in different types of wrinkles. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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8 pages, 2932 KiB

Open AccessArticle

Botulinum Toxin Type A Reconstituted with Lidocaine: A Report of 1000 Consecutive Cases

by Pierfrancesco Bove, Vincenzo Santillo, Giuseppe Colella, Rita Vitagliano, Romolo Fragola, Giorgio Lo Giudice, Nicola Zerbinati, Ivo Ferrieri and Raffaele Rauso

Appl. Sci. 2021, 11(10), 4491; https://doi.org/10.3390/app11104491 - 14 May 2021

Cited by 1 | Viewed by 5217

Abstract

(1) Background: There is an increasing demand for a reversal of the aging process and, nowadays, more patients are seeking minimally invasive methods instead of surgery to meet this goal. The purpose of this paper is to evaluate the predictability of the off-label aesthetic use of botulinum toxin type A (BoNTA) reconstituted with lidocaine. (2) Methods: One thousand treatments, between January 2010 and January 2020, with BoNTA reconstituted with lidocaine for the rejuvenation of the upper third of the face, were performed and retrospectively evaluated. (3) Results: A few seconds after the BoNTA injections, the effect of muscle paralysis was seen in all cases; this allowed providing an optimal symmetric result with no need for a touch-up procedure at the control after three weeks. A burning sensation during the injections was claimed by almost all patients. Major complications were not registered. No touch-up procedures were required. (4) Conclusions: The results of this study show how the reconstitution of BoNTA with lidocaine may avoid imperfect results after the injections; the immediate feedback on the extent of paralysis to be expected from the chemodenervation action of BoNTA allows the physician to have immediate control of the final result. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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13 pages, 3495 KiB

Open AccessArticle

Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience

by Fabrizio Chirico, Giuseppe Mario Rauso, Romolo Fragola, Giorgio Lo Giudice, Ludovico Pinto, Nadia De Falco, Angelo Cosenza, Luigi Rugge, Nicola Sgaramella and Gianpaolo Tartaro

Appl. Sci. 2021, 11(9), 4059; https://doi.org/10.3390/app11094059 - 29 Apr 2021

Cited by 3 | Viewed by 2940

Abstract

Since the advent of HIV antiretroviral therapies at the end of the 20th century, the morbidity and mortality rates associated with HIV infection have decreased dramatically. Unfortunately, these benefits are associated with substantial morphologic changes in the body, such as abnormal fat distribution with peripheral lipohypertrophy and facial lipoatrophy. Facial wasting is considered the major stigma for HIV–infected people and may result in reduced antiretroviral adherence. Patients suffering from the stigmata of HIV infection can benefit from non-surgical aesthetic treatments performed with fillers or lipolytic agents that provide a quick and reliable service for facial rejuvenation, with high patient satisfaction and a low risk of complications. In the present paper, a retrospective analysis of complications following non-surgical aesthetic treatments (calcium hydroxyapatite-based filler, hyaluronic acid filler, polyacrylamide hydrogel filler and dehoxycholic acid injections), in a cohort of 116 consecutive HIV+ patients, treated over a period of 12 years, was performed. With the exception of the tardive swelling reported after calcium hydroxyapatite injections, complications were recorded just after polyacrylamide hydrogel treatment as small, palpable, nonvisible nodules or aseptic abscess. Our experience is consistent with those already published in the literature and the complication rate seems to be comparable to non-infected patients. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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Review

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13 pages, 1051 KiB

Open AccessReview

Adverse Events Following COVID-19 Vaccine in Patients Previously Injected with Facial Filler: Scoping Review and Case Report

by Raffaele Rauso, Giorgio Lo Giudice, Nicola Zerbinati, Giovanni Francesco Nicoletti, Romolo Fragola and Gianpaolo Tartaro

Appl. Sci. 2021, 11(22), 10888; https://doi.org/10.3390/app112210888 - 18 Nov 2021

Cited by 7 | Viewed by 4125

Abstract

The “Vaccines and Related Biological Products Advisory Committee 17 December 2020 Meeting Briefing Document”, formulated by the FDA, reported three cases of swelling in areas previously injected with HA filler, introducing the possible relationship between a COVID-19 vaccine and adverse events in areas previously injected with HA fillers. The aim of this research is to report a case of an adverse event following a COVID-19 vaccine in a patient previously injected with facial filler. Furthermore, a scoping review on the same topic was performed. The research was carried out on the electronic databases PubMed, Cochrane Library, Web of Science, Google Scholar and Scopus. The selection process identified four articles as eligible for inclusion in the review. Nineteen patients, including the described case report, who experienced an adverse event following a COVID-19 vaccine in areas previously injected with facial filler were identified. Adverse events following a COVID-19 vaccine in patients previously injected with facial filler appear to be rare. A high BDDE cross-linking rate and/or a low-molecular-weight hyaluronic acid filler may have a higher tardive adverse event rate when triggered. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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Other

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15 pages, 1523 KiB

Open AccessSystematic Review

Is the Treatment of the Tear Trough Deformity with Hyaluronic Acid Injections a Safe Procedure? A Systematic Review

by Salvatore D’Amato, Romolo Fragola, Pierfrancesco Bove, Giorgio Lo Giudice, Paolo Gennaro, Rita Vitagliano and Samuel Staglianò

Appl. Sci. 2021, 11(23), 11489; https://doi.org/10.3390/app112311489 - 3 Dec 2021

Cited by 3 | Viewed by 3368

Abstract

Among the various therapeutic options for the treatment of tear trough deformities, the use of hyaluronic acid-based fillers has constantly been increasing. The aim of this research is to conduct a systematic review of the published literature related to the use of hyaluronic acid-based dermal fillers for the treatment of tear trough deformities and possible related complications. A search of the published literature was conducted following the PRISMA guidelines, including PubMed, Cochrane Library, and Ovid databases. Text words and Medical Search Headings (MeSH terms) were used to identify nine articles included in our analysis. The most used filler was Restylane (Galderma). The injection technique was performed through the use of a cannula or, more frequently, with a needle, through the execution of boluses or retrograde release. The injection plane was predominantly the supra-periosteal layer. The most observed side effects were mild and included redness, edema, contour irregularities, bruising, and blue-gray dyschromia. The degree of patient satisfaction was high, with an optimal aesthetic result that was maintained for 6 to 12 months. Although the duration of treatment of tear trough deformities with HA fillers is not comparable to surgical treatment, this is a minimally invasive, safe procedure, quick to perform, and with a high degree of patient satisfaction. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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11 pages, 3094 KiB

Open AccessSystematic Review

Polyacrylamide Injection vs. Polylactic Acid in HIV Related Lipodystrophy: A RCT Systematic Review

by Gianpaolo Tartaro, Ludovico Pinto, Giorgio Lo Giudice, Romolo Fragola, Pierfrancesco Bove, Giuseppe Mario Rauso, Nicola Zerbinati and Giuseppe Colella

Appl. Sci. 2021, 11(17), 8195; https://doi.org/10.3390/app11178195 - 3 Sep 2021

Cited by 1 | Viewed by 1972

Abstract

Lipodystrophy is an alteration of fat metabolism that commonly affects HIV-1 positive patients treated with antiretroviral therapy (ART). The facial area is most commonly affected by peripheral lipoatrophy, thus becoming a social stigma related to chronic HIV. Several treatments have been proposed, such as modification of diet, lifestyle and both surgical and nonsurgical procedures. The goal of our systematic review is to examine published clinical studies involving the use of polyacrylamide filler for the treatment of HIV FLA, and to provide evidence-based recommendations based on published efficacy and safety data. Our research was performed on published literature until April 2021. Polyacrylamide gel is a volumetric gel that has been proven stable, nontoxic, nonallergenic, nonembryotoxic and nonabsorbable. Poly-l-lactic acid (PLA) is a biocompatible, biodegradable, synthetic polymer derived from lactic acid. We believe it is essential to draft a pre- and post-injection and operative protocol to define an even setting for the clinical condition. It is desirable that such specifications are included in a large randomized controlled trial and the follow up is longer than the studies that we found, because as we have seen in the literature there are reported adverse events even 3 or 5 years after the injections. Full article

(This article belongs to the Special Issue Applied Biomaterials, Medical Devices and Drugs Delivery in Oral and Maxillo-Facial Surgery)

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