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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 20130

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Special Issue Editors

Dr. Fabio Maglitto

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Guest Editor

Maxillofaciarl Surgery Operative Unit, Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70120 Bari, Italy
Interests: oral and maxillofacial surgery; plastic surgery; otolaryngology
Special Issues, Collections and Topics in MDPI journals

Dr. Giovanni Salzano

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Guest Editor

Department of Reproductive and Odontostomatological Neurosciences, University of Naples “Federico II”, Naples, Italy
Interests: oral and maxillofacial surgery; plastic surgery; otolaryngology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, with the rapid development of medical equipment, surgical techniques, and biomaterials, the field of oral and maxillofacial surgery is switching to digital and personalized treatments. This includes digital imaging, digital impressions, jaw modeling, 3D planning of complex oral prosthetics, osteophytes and implant placement, and minimally invasive surgery, such as endoscopic and functional surgery.

This Special Issue, entitled "New Updates in Oral and Maxillofacial Surgery", aims to discuss personalized treatment and future trends in oral and maxillofacial surgery. Therefore, we encourage researchers (clinicians and scientists) in the fields of plastic surgery, oral and maxillofacial surgery, otolaryngology–head and neck surgery, and neurosurgery to submit original articles or reviews to this Special Issue of Journal of Personalized Medicine.

Topics may include (but are not limited to):

Orthognathic surgery, surgical treatment/correction of dental and maxillofacial malformations;
Head and neck cosmetic surgery;
Oral cancer;
Reconstructive surgery;
Management of oral diseases;
New methods and techniques in oral and maxillofacial surgery;
Oral and maxillofacial soft and hard tissue trauma and reconstruction techniques;
Drug-related osteonecrosis of the jaw;
New diagnostic and therapeutic tools for the management of potentially malignant diseases of the oral cavity;
Temporomandibular joint (TMJ) disorders.

Dr. Fabio Maglitto
Dr. Giovanni Salzano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

oral and maxillofacial surgery
digital planning
head and neck surgery
reconstructive surgery
implant–prosthetic rehabilitation
oral diseases
regenerative dentistry

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Published Papers (10 papers)

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Editorial

Jump to: Research

5 pages, 185 KiB

Open AccessEditorial

Special Issue “New Updates in Oral and Maxillofacial Surgery”

by Fabio Maglitto, Chiara Copelli, Alfonso Manfuso, Stefan Cocis and Giovanni Salzano

J. Pers. Med. 2024, 14(7), 705; https://doi.org/10.3390/jpm14070705 - 1 Jul 2024

Viewed by 989

Abstract

In the ever-evolving landscape of medical science, few fields have witnessed as profound a transformation as oral and maxillofacial surgery [...] Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

Research

Jump to: Editorial

25 pages, 9989 KiB

Open AccessArticle

Characterization of Tissue Immunity Defense Factors of the Lip in Primary Dentition Children with Bilateral Cleft Lip Palate

by Laura Ozola and Mara Pilmane

J. Pers. Med. 2024, 14(9), 965; https://doi.org/10.3390/jpm14090965 - 11 Sep 2024

Viewed by 3221

Abstract

Background: Bilateral cleft lip palate is a severe congenital birth defect of the mouth and face. Immunity factors modulate immune response, inflammation, and healing; therefore, they are vital in the assessment of the immunological status of the patient. The aim of this study is to assess the distribution of Gal-10, CD-163, IL-4, IL-6, IL-10, HBD-2, HBD-3, and HBD-4 in tissue of the bilateral cleft lip palate in primary dentition children. Methods: Five patients underwent cheiloplasty surgery, where five tissue samples of lip were obtained. Immunohistochemical staining, semi-quantitative evaluation, and non-parametric statistical analysis were used. Results: A statistically significant increase in HBD-2, HBD-3, and HBD-4 was found in skin and mucosal epithelium, hair follicles, and blood vessels. A notable increase was also noted in IL-4, IL-6, and IL-10 in the mucosal epithelium and CD163 in blood vessels. The connective tissue of patients presented with a statistically significant decrease in Gal-10, IL-10, and HBD-3. Spearman’s rank correlation revealed multiple significant positive and negative correlations between the factors. Conclusions: Upregulation of CD163 points to increased angiogenesis but the increase in IL-4 and IL-10 as well as the decrease in Gal-10 points to suppression of excessive inflammatory damage. Decreased connective tissue healing and excessive scarring are suggested by the decrease in HBD-3 and IL-10 and the increase in IL-6. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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13 pages, 3416 KiB

Open AccessArticle

Long-Term Clinical Outcomes of 3D-Printed Subperiosteal Titanium Implants: A 6-Year Follow-Up

by Neculai Onică, Dana Gabriela Budală, Elena-Raluca Baciu, Cezara Andreea Onică, Gabriela Luminița Gelețu, Alice Murariu, Mihail Balan, Mihaela Pertea and Carmen Stelea

J. Pers. Med. 2024, 14(5), 541; https://doi.org/10.3390/jpm14050541 - 18 May 2024

Cited by 5 | Viewed by 1976

Abstract

As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4–6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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13 pages, 3022 KiB

Open AccessArticle

Comparison of Nasal Dimensions According to the Facial and Nasal Indices Using Cone-Beam Computed Tomography

by Jeong-Hyun Lee, Hey-Suk Kim and Jong-Tae Park

J. Pers. Med. 2024, 14(4), 415; https://doi.org/10.3390/jpm14040415 - 14 Apr 2024

Cited by 2 | Viewed by 1393

Abstract

The nasal cavity constitutes the foremost portion of the respiratory system, composed of the anterior nasal aperture, nostrils, and choanae. It has an intricate anatomical structure since it has various functions, such as heat exchange, humidification, and filtration. Accordingly, clinical symptoms related to the nose, such as nasal congestion, snoring, and nasal septal deviation, are closely linked to the complex anatomical structure of the nasal cavity. Thus, the nasal cavity stands as a paramount structure in both forensic and clinical contexts. The majority of relevant studies have performed comparisons between sexes, with studies making comparisons according to the FI and NI only and examining relative percentages. Furthermore, the nasal cavity was measured in 2D, and not 3D, in most cases. In this study, we conducted a 3D modeling and anthropometric assessment of the nasal cavity using a 3D analysis software. Furthermore, we aimed to investigate whether the size of the nasal cavity differs according to sex, facial index (FI), and nasal index (NI). We retrospectively reviewed the cone-beam computed tomography (CBCT) data of 100 participants (50 males, 50 females) aged 20–29 years who visited the dental hospital of Dankook University (IRB approval no. DKUDH IRB 2020-01-007). Our findings showed that nasal cavity sizes generally differed according to sex, FI, and NI. These findings provide implications for performing patient-tailored surgeries in clinical practice and conducting further research on the nasal cavity. Therefore, we believe that our study makes a significant contribution to the literature. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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14 pages, 3260 KiB

Open AccessArticle

Assessment of a New Medical Device (Pirifix^TM) for Positioning and Maintaining the Upper Dental Arch during Le Fort I Osteotomy

by Pierre-Etienne Serree, Eugénie Bertin, Camille Coussens, Eleonore Brumpt, Jean-François Devoti and Aurélien Louvrier

J. Pers. Med. 2024, 14(3), 324; https://doi.org/10.3390/jpm14030324 - 20 Mar 2024

Cited by 1 | Viewed by 1162

Abstract

Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (Pirifix^TM) coupling these two functions during LFIO on 3D-printed models. Materials and Methods: DICOM data were selected from patients who underwent surgical planning for LFIO between 27 July 2020 and 1 December 2022. Their anatomy was reproduced after segmentation, planning, and stereolithography in two models. Each model was assigned to one of two surgical groups: the control group (positioning by occlusal splint) and the Pirifix^TM group. Each patient’s model was planned with the objective of horizontalizing and recentering the UDA. After positioning, models were digitalized using Einscan Pro 2X and compared to the planned model with CloudCompare. The statistical analysis was performed using the Wilcoxon Mann–Whitney test. The result was considered significant if the p-value was less than 0.05. Results: Twenty-one patients were selected. Forty-two anatomical models were 3D-printed. The mean difference compared to the planned and corrected positions was 0.69 mm for the control group and 0.84 mm for the Pirifix^TM group (p = 0.036). Conclusion: Pirifix^TM may be a new alternative to available MDs. Further investigations are needed to describe the relationship between the device and facial soft tissues. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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11 pages, 1671 KiB

Open AccessArticle

Guided Genioplasty: Comparison between Conventional Technique and Customized Guided Surgery

by Raúl Antúnez-Conde Hidalgo, José Luis Silva Canal, Carlos Navarro Cuéllar, Celia Sánchez Gallego-Albertos, Javier Arias Gallo, Ignacio Navarro Cuéllar, Antonio López Davis, Gastón Demaria Martínez, Néstor Naranjo Aspas, José Zamorano León and Manuel Chamorro Pons

J. Pers. Med. 2023, 13(12), 1702; https://doi.org/10.3390/jpm13121702 - 12 Dec 2023

Cited by 1 | Viewed by 1723

Abstract

Background: Genioplasty as an isolated surgical technique is a highly demanded procedure in the maxillofacial surgery area. Advances in facial reconstructive surgery have been associated with less morbidity and more predictable results. In this paper, “conventional” genioplasty and genioplasty by means of virtual surgical planning (VSP), CAD-CAM cutting guides, and patient custom-made plates are compared. Methods: A descriptive observational study was designed and implemented, and 43 patients were treated, differentiating two groups according to the technique: 18 patients were treated by conventional surgery, and 25 patients were treated through virtual surgical planning (VSP), CAD-CAM cutting guides, STL models, and titanium patient-specific plates. Results: The operation time ranged from 35 to 107 min. The mean operative time in the conventional group was 60.06 + 3.74 min.; in the custom treatment group it was 42.24 + 1.29 min (p < 0.001). The difference between planned and obtained chin changes in cases of advancement or retrusion was not statistically significant (p = 0.125; p = 0.216). In cases of chin rotation due to asymmetry, guided and personalized surgery was superior to conventional surgery (p < 0.01). The mean hospital stay was equal in both groups. A decrease in surgical complications was observed in the group undergoing VSP and customized treatment. Conclusions: Multi-stage implementation of VSP with CAD-CAM cutting guides, STL models, and patient-specific plates increased the accuracy of the genioplasty surgery, particularly in cases of chin asymmetry, reducing operation time and potential complications. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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13 pages, 1855 KiB

Open AccessArticle

Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis

by Jean-Pierre T. F. Ho, Ning Zhou, Tom C. T. van Riet, Ruud Schreurs, Alfred G. Becking and Jan de Lange

J. Pers. Med. 2023, 13(10), 1517; https://doi.org/10.3390/jpm13101517 - 22 Oct 2023

Cited by 3 | Viewed by 2057

Abstract

This retrospective study aimed to: (1) investigate the surgical accuracy of maxillomandibular advancement (MMA) in obstructive sleep apnea (OSA) patients, with a specific focus on maxillary and mandibular advancement and counter-clockwise rotation and (2) investigate the correlation between the amount of achieved advancement and the reduction in the relative apnea hypopnea index (AHI). Sixteen patients, for whom a three-dimensional virtual surgical plan was generated preoperatively and a computed tomography scan (CT) or cone-beam computer tomography (CBCT) was acquired postoperatively, were included. The postoperative CT or CBCT was compared to the virtual surgical plan, and differences in the mandibular and maxillary advancement and counter-clockwise rotation were assessed. Maxillary and mandibular advancement (median 3.1 mm, p = 0.002 and 2.3 mm, p = 0.03, respectively) and counter-clockwise rotation (median 3.7°, p = 0.006 and 4.7°, p = 0.001, respectively) were notably less than intended. A significant correlation was found between the planned maxillary advancement and the difference between the planned and actual maxillary advancement (p = 0.048; adjusted R² = 0.1979) and also between the planned counter-clockwise rotation and the difference between the planned and actual counter-clockwise rotation for the mandible (p = 0.012; adjusted R² = 0.3261). Neither the maxilla-first nor the mandible-first surgical sequence proved to be superior in terms of the ability to achieve the intended movements (p > 0.45). Despite a significant reduction (p = 0.001) in the apnea hypopnea index (AHI) from a median of 62.6 events/h to 19.4 events/h following MMA, no relationship was found between the extent of maxillary or mandibular advancement and AHI improvement in this small cohort (p = 0.389 and p = 0.387, respectively). This study underlines the necessity for surgeons and future research projects to be aware of surgical inaccuracies in MMA procedures for OSA patients. Additionally, further research is required to investigate if sufficient advancement is an important factor associated with MMA treatment outcome. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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10 pages, 4649 KiB

Open AccessArticle

Safety and Aesthetics of Autologous Dermis-Fat Graft after Parotidectomy: A Multidisciplinary Retrospective Study

by Ciro Emiliano Boschetti, Rita Vitagliano, Nicola Cornacchini, Mario Santagata, Valentina Caliendo, Maria Paola Belfiore, Giuseppe Colella, Gianpaolo Tartaro and Salvatore Cappabianca

J. Pers. Med. 2023, 13(8), 1200; https://doi.org/10.3390/jpm13081200 - 28 Jul 2023

Cited by 3 | Viewed by 1534

Abstract

(1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative aesthetic asymmetry problems. (2) Methods: In this study, we enrolled thirty patients with parotid gland tumours in which a partial or complete parotidectomy was performed with positioning in the parotid bed of autologous dermis-fat grafts. We evaluated the satisfaction rate of the patients and the objective efficacy in solving the deformity by comparing MRI data before and after surgery. (3) Results: Twenty-six patients showed a satisfying cosmetic result with proper facial symmetry between the affected side and the healthy one. Two patients presented mild postsurgical complications such as haematomas, and two patients reported temporary weakness of the facial nerve related to the parotidectomy. (4) Conclusions: Based on the imaging data obtained via MRI before and after surgery, we can assess that the employment of fat grafts in parotidectomy surgical procedures gives good cosmetic results and does not affect the post operative management and follow up of oncologic patients. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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13 pages, 3570 KiB

Open AccessArticle

Total Joint Replacement for Immediate Reconstruction following Ablative Surgery for Primary Tumors of the Temporo-Mandibular Joint

by Luis-Miguel Gonzalez-Perez, Jose-Francisco Montes-Carmona, Eusebio Torres-Carranza and Pedro Infante-Cossio

J. Pers. Med. 2023, 13(7), 1021; https://doi.org/10.3390/jpm13071021 - 21 Jun 2023

Cited by 2 | Viewed by 2760

Abstract

Temporomandibular joint (TMJ) tumors are rare and difficult to diagnose. The purpose of this retrospective study was to evaluate the clinicopathologic characteristics of twenty-one patients with primary TMJ tumors between 2010 and 2019 and to analyze the surgical outcome and morbidity after ablative surgery and TMJ replacement. This case series confirmed the difficulty of diagnosis and reaffirmed the need for early recognition and management of TMJ tumors. There were no pathognomonic findings associated with TMJ tumors, although single or multiple radiopaque or radiolucent areas were observed on plain or panoramic radiographs. Occasionally, bone resorption or mottled densities caused by pathologic calcification and ossification were seen. Computed tomography and magnetic resonance imaging played an important role in the diagnosis. In our study, the distribution of histologic types of TMJ tumors was quite different from that of other joint tumors. The recommended treatment was surgical intervention by ablation of the joint and TMJ replacement. The results of this retrospective study support the surgical exeresis and replacement with TMJ stock and custom-made prostheses and show that the approach is efficacious and safe, reduces pain and improves mandibular movements, with few complications. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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16 pages, 1231 KiB

Open AccessArticle

Airway Management of Orofacial Infections Originating in the Mandible

by Andreas Sakkas, Christel Weiß, Wolfgang Zink, Camila Alejandra Rodriguez, Mario Scheurer, Sebastian Pietzka, Frank Wilde, Oliver Christian Thiele, Robert Andreas Mischkowski and Marcel Ebeling

J. Pers. Med. 2023, 13(6), 950; https://doi.org/10.3390/jpm13060950 - 4 Jun 2023

Cited by 1 | Viewed by 1574

Abstract

The primary aim of this study was to assess the incidence of a difficult airway and emergency tracheostomy in patients with orofacial infections originating in the mandible, and a secondary aim was to determine the potential predictors of difficult intubation. This retrospective single-center study included all patients who were referred between 2015 and 2022 with an orofacial infection originating in the mandible and who were surgically drained under intubation anesthesia. The incidence of a difficult airway regarding ventilation, laryngoscopy, and intubation was analyzed descriptively. Associations between potential influencing factors and difficult intubation were examined via multivariable analysis. A total of 361 patients (mean age: 47.7 years) were included in the analysis. A difficult airway was present in 121/361 (33.5%) patients. Difficult intubation was most common in patients with infections of the massetericomandibular space (42.6%), followed by infections of the mouth floor (40%) and pterygomandibular space (23.5%). Dyspnea and stridor were not associated with the localization of infection (p = 0.6486/p = 0.4418). Multivariable analysis revealed increased age, restricted mouth opening, higher Mallampati scores, and higher Cormack–Lehane classification grades as significant predictors of difficult intubation. Higher BMI, dysphagia, dyspnea, stridor and a non-palpable mandibular rim did not influence the airway management. Patients with a difficult airway were more likely to be admitted to the ICU after surgery than patients with regular airway were (p = 0.0001). To conclude, the incidence of a difficult airway was high in patients with orofacial infections originating in the mandible. Older age, limited mouth opening, a higher Mallampati score, and a higher Cormack–Lehane grade were reliable predictors of difficult intubation. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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