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Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials

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A special issue of Surgeries (ISSN 2673-4095).

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 20787

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Dr. Maciej Chęciński

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Guest Editor

Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland
Interests: temporomandibular joint; mandibular condyle; osteosynthesis; osteonecrosis; arthrocentesis; intra-articular injections; pediatric maxillofacial traumatology
Special Issues, Collections and Topics in MDPI journals

Dr. Karolina Walczyńska-Dragon

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Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, 2 Traugutta sq, 41-800 Zabrze, Poland
Interests: Cannabidiol; CBD; myofascial pain; tmd; bruxism; emg; masseter muscle

Dr. Igor Tsesis

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Guest Editor

Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 61000, Israel
Interests: evidence based endodontics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The clash between experience and modernity is a particularly delicate issue in medicine. Effective and safe treatments are always a balance between the old and the new. The choice between that which has been repeatedly confirmed and what is potentially better, although burdened with a higher risk, affects the course of diagnostic and therapeutic processes. Additional factors in the degree of the difficulty of procedures, the availability of medical equipment and cost-effectiveness further complicate the choices that, in theory, should be dictated solely by medical considerations. I consider these topics worth covering in this Special Issue, which I invite you to cocreate, with the aim of presenting the best proven practices, innovative clinical management and prospects for the development of oral and maxillofacial surgery.

Potential topics include, but are not limited to:
best proven vs. the latest diagnostic methods; advances in craniofacial traumatology; predictable orthognathics in the context of digitization; innovations in the treatment of temporomandibular joints; apparent stagnation in inflammation therapy; constant and developing aspects of oncology; novelties vs. traditional methods in reconstructive surgery; dental implantology: the evidence-based race of innovation; postsurgical maxillofacial prosthetics; importance and new possibilities of postoperative observation; failures necessary to share to avoid their occurrence.

Dr. Maciej Chęciński
Dr. Karolina Walczyńska-Dragon
Prof. Dr. Igor Tsesis
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. Surgeries is an international peer-reviewed open access quarterly 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 1200 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

diagnostic techniques and procedures
maxillofacial injuries
orthognathic surgery
temporomandibular joint disorders
oral and maxillofacial pathology
reconstructive surgery
iatrogenic disease

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Published Papers (9 papers)

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Editorial

Jump to: Research, Other

4 pages, 190 KiB

Open AccessEditorial

Balancing Innovation and Proven Techniques in Oral and Maxillofacial Surgery

by Karolina Walczyńska-Dragon and Maciej Chęciński

Surgeries 2024, 5(3), 774-777; https://doi.org/10.3390/surgeries5030062 - 5 Sep 2024

Viewed by 624

Abstract

The field of oral and maxillofacial surgery is continuously evolving, with ongoing advancements in surgical techniques, materials, and pharmacological approaches that enhance patient outcomes [...] Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

Research

Jump to: Editorial, Other

12 pages, 3813 KiB

Open AccessArticle

Surgical Lip Cancer Reconstruction in the COVID-19 Era: Are Free Flaps or Loco-Regional Flaps Better?

by Samuel Staglianò, Gianpaolo Tartaro, Ciro Emiliano Boschetti, David Guida, Giuseppe Colella and Raffaele Rauso

Surgeries 2023, 4(1), 108-119; https://doi.org/10.3390/surgeries4010012 - 3 Mar 2023

Cited by 1 | Viewed by 3474

Abstract

Lip carcinoma is one of the most frequent conditions affecting the general population. It is among the ten most common neoplasms, but despite advances in research and therapy, its prognosis has not improved in a significant way in the past few years, making it a challenge in the medical research field and in surgical treatment. This study was conducted with the aim of evaluating the available reconstructive surgical options for the treatment of lip carcinomas in order to define which could be the most appropriate technique to achieve satisfying aesthetic and functional outcomes considering hospital resources in the COVID-19 era. Seventeen patients were included in this retrospective study, which took place between January 2019 and April 2021. There were two groups: seven patients who underwent a radial forearm free flap and ten who underwent locoregional flaps. The statistical analysis was performed to evaluate four different endpoints. Surgical length, ICU stay, and hospitalization time were minor for locoregional flaps. There was no statistically significant difference between the two groups when considering post-operative complications. Locoregional flaps have a more aesthetically pleasing result, but from a functional point of view, the results can be superimposable. Both techniques are associated with adequate speech, mouth opening, sealing, and symmetry. Given the impact of the COVID-19 pandemic on the healthcare system, locoregional flaps have been proven to be a good surgical option in the reconstruction of lip defects both in terms of aesthetics and functional outcome. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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Other

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17 pages, 766 KiB

Open AccessSystematic Review

Mechanisms of Degradation of Collagen or Gelatin Materials (Hemostatic Sponges) in Oral Surgery: A Systematic Review

by Maria Catarino, Filipe Castro, José Paulo Macedo, Otília Lopes, Jorge Pereira, Pedro Lopes and Gustavo Vicentis Oliveira Fernandes

Surgeries 2024, 5(3), 532-548; https://doi.org/10.3390/surgeries5030043 - 15 Jul 2024

Cited by 1 | Viewed by 1650

Abstract

Objective: The goal of this systematic review was to identify the mechanisms associated with the enzymatic degradation of collagen and gelatin biomaterials and the possible associated flaws. Methods: Four databases (PubMed, B-On, Cochrane Library, and ResearchGate) were used for the bibliographic search of articles. The research question was formulated using the PCC method, (P): collagen or gelatin sponges, hydrogels, and scaffolds; concept (C): enzymatic degradation of collagen or gelatin sponges, hydrogels, and scaffolds; and context (C): effect of enzymatic action on degradation time of collagen or gelatin sponges, hydrogels, and scaffolds. The search was contextualized according to PRISMA recommendations. The identification and exclusion of evidence followed the PRISMA criteria, with specific inclusion and exclusion factors being stipulated for the selection of articles. The risk of bias assessment was performed using the QUIN Scale. Results: The initial search was composed of 13,830 articles after removing duplicates; 56 articles followed for the full-text reading; 45 were excluded; then, 11 articles were obtained, constituting the results of this systematic review. All studies evaluated the materials using gravimetric analysis, and collagenases were the proteases used for the degradation solution. The materials tested were as follows: human-like collagen (HLC) hydrogel with microbial transglutaminase (MTGase), gelatin sponges subjected to different types of crosslinking, and collagen scaffolds with different types of crosslinking. The period of analysis varied between 0.25 h and 35 days. It was possible to highlight the lack of uniformity in the protocols used, which varied largely, thus influencing the degradation times. The risk of bias was low in nine studies and medium in two studies. Conclusions: This systematic review identified a gap in the literature, highlighting the absence of in vitro studies using human saliva and a collagenase concentration close to the physiological levels to simulate oral dynamics. However, based on existing literature, the mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials were comprehensively understood, answering the first research question postulated. In response to the second research question, the main shortcomings identified in the laboratory evaluation of mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials included the lack of standardization in degradation test protocols; this limited inter-study comparisons, which increased heterogeneity. Additionally, variations in collagenase concentrations and types influenced collagen degradation rates, and inappropriate evaluation intervals hindered the identification of total degradation time. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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17 pages, 681 KiB

Open AccessSystematic Review

Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review

by Miriam Alves de Oliveira, Alexandra Arcanjo, Filipe Castro, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes

Surgeries 2024, 5(2), 350-366; https://doi.org/10.3390/surgeries5020029 - 8 May 2024

Cited by 2 | Viewed by 1899

Abstract

Objective: This systematic review was carried out with the primary objective of verifying which suture (polyamide or silk) of two non-resorbable suture materials with different structures had better/greater tensile strength/resistance to tension, thereby presenting better mechanical behavior. The secondary objective was to verify which one had better performance. The null hypothesis was that both types of sutures had the same behavior. Methods: This systematic study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The focused clinical question was: “In patients that underwent oral surgery treatment (P), is there significantly higher tensile strength/resistance for silk sutures (I) or for polyamide sutures (C) when comparing the outcomes (O)?”. The bibliographic search was conducted on ScienceDirect, B-On, and PubMed/MedLine between March and May 2023. The following MeSH terms were defined: sutures, breaking strength, tensile strength, oral surgery, and dentistry, which were articulated and combined using Boolean operators. There were restrictions, such as articles published in Portuguese, Spanish, or English between 1 January 2018 and 3 April 2023. The quality assessment involved the use of the Joanna Briggs Institute (JBI) checklist for RCTs and the QUIN tool (Quality Assessment Tool For In Vitro Studies) for in vitro assays. Results: Ten articles were included in this review (eight in vitro studies and two RCTs). For the RCTs, there were moderate and high levels of bias, whereas in the in vitro studies, three were classified as having a high risk of bias and five as moderate risk. The results proved that suture thread with a monofilament polyamide physical structure causes a less inflammatory reaction owing to less bacterial retention and capillarity, while multifilament sutures, such as silk, have superior mechanical characteristics. Regarding hydration, the evidence demonstrated that the preservation and stability of mechanical properties lacked uniformity. Otherwise, hyaluronic acid (HA) presents a promising solution with the same characteristics and antibacterial capabilities. Conclusion: It was possible to reject the null hypothesis that both types of sutures had the same behavior and result. It was proven by the results above that sutures with a monofilament polyamide physical structure cause a less inflammatory reaction owing to less bacterial retention and capillarity. In contrast, multifilament sutures (silk) have superior mechanical characteristics. Regarding hydration using chlorohexidine in surgical sites, the evidence demonstrated in the preservation and stability of mechanical properties lacks uniformity and congruence. However, HA seems to present a promising option with the same characteristics and antibacterial capabilities. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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45 pages, 22119 KiB

Open AccessSystematic Review

The Effect of Antihypertensive Agents on Dental Implant Stability, Osseointegration and Survival Outcomes: A Systematic Review

by Dary Jones, Rabia S. Khan, John D. Thompson, Cemal Ucer and Simon Wright

Surgeries 2024, 5(2), 297-341; https://doi.org/10.3390/surgeries5020027 - 29 Apr 2024

Cited by 1 | Viewed by 1298

Abstract

Antihypertensive agents are commonly prescribed to manage hypertension and are known to be beneficial for bone formation and remodeling. The aim of this systematic review was to assess the impact that antihypertensive agents have on dental implant stability, osseointegration, and survival outcomes. A review of the literature was conducted using articles from 11 data sources. PRISMA guidelines were followed, and a PICO question was constructed. The search string “Antihypertensive* AND dental implant* AND (osseointegration OR stability OR survival OR success OR failure)” was used for all data sources where possible. The Critical Appraisal Skills Programme (CASP) was used for study appraisal, including the risk of bias. The search resulted in 7726 articles. After selection according to eligibility criteria, seven articles were obtained (one randomized control trial, two prospective cohort studies, three retrospective cohort studies, and a case control study). Five papers investigated the effects of antihypertensive agents on primary stability, but there were discrepancies in the method of assessment. Inhibition of the renin–angiotensin–aldosterone system was linked to higher primary stability. Secondary stability was usually higher than primary stability, but it is unknown if antihypertensive agents caused this. Survival outcomes were increased with certain antihypertensive agents. It is possible that inhibition of the renin–angiotensin–aldosterone system may lead to greater bone mineral density, improved primary stability, and improved survival outcomes although the effects on osseointegration are unknown. However, more research is needed to confirm this theory. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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12 pages, 1934 KiB

Open AccessCase Report

Dermal Cosmetic Migration after Lip Augmentation Procedure: Clinical Management and Histological Analysis in a Case Report with Review of the Literature

by Antonio Scarano, Francesco Inchingolo, Maristella Di Carmine, Marco Marchetti, Felice Lorusso, Roberto Amore and Domenico Amuso

Surgeries 2023, 4(2), 223-234; https://doi.org/10.3390/surgeries4020023 - 15 May 2023

Cited by 5 | Viewed by 3230

Abstract

Lip augmentation procedures have become gradually more popular and common due to cultural tendencies and an increasing association of the appearance of the lips with both beauty and youth. Different dermal fillers have been proposed for lip augmentation—such as collagen, calcium hydroxylapatite, hyaluronic acid, and polylactic acid—which are used as temporary fillers. The present case report describes the histopathologic and clinical management of one case of HA filler migrating into the intraoral cheek, which caused discomfort by intraoral swelling. There is also a review of the relevant literature. A female patient, V.A., 34 years old, smoker, no allergies to drug and food substances, came to our attention. The patient was referred to the Department of Innovative Technology in Medicine and Dentistry of the University “G. D’Annunzio” of Chieti-Pescara in Italy by her dentist for the removal of a mass present in the right cheek. The clinical examination of the patient revealed a single mobile mass mimicking a soft tissue tumor in the right anterior cheek. The mass was palpable and approximately 2 cm long and was causing pain and swelling. The mucosa appeared healthy without ulcers. The filler, which had migrated into the cheek, was removed by reaching it with a scalped blade. The material was stored immediately in 10% buffered formalin and processed for histological analysis. The literature search was carried out in accordance with the criteria of the PICO guidelines. Observed histologically, the filler was surrounded by fibroblasts and a few inflammatory cells and giant cells without granuloma formation. The clinical diagnosis was swelling and discomfort caused by chewing trauma, while the histological examination excluded discomfort due to a foreign body reaction caused by the HA used for a lip augmentation procedure. In conclusion, the high-pressure and high-volume filler injections probably caused a detachment of the tissues, with the orbicularis oris muscle concurrently acting as a pump and moving the HA implant, causing migration to the area with low-density tissue such as the cheek. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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8 pages, 2442 KiB

Open AccessCase Report

Nasal Floor Elevation—An Option of Premaxilla Augmentation: A Case Report

by Ante Jordan, Marko Vuletić, Mato Sušić, Luka Stojić and Dragana Gabrić

Surgeries 2022, 3(4), 306-313; https://doi.org/10.3390/surgeries3040033 - 29 Oct 2022

Cited by 2 | Viewed by 3040

Abstract

The atrophic edentulous maxilla is demanding for dental implant placement because of extensive resorption of the alveolar ridge after teeth loss and, consequently, the proximity of the anatomical structures, nasal cavity, and maxillary sinus. Treatment options are short implants, guided bone regeneration, onlay grafts, Le Fort I osteotomy with interpositional bone grafting, distraction osteogenesis, or nasal floor elevation. Nasal floor elevation is a method of augmentation of premaxilla by raising the base of the nose. The aim of this case report is to evaluate the success of implants placed after nasal floor elevation. A 75-year-old female patient came to the Clinical Department of Oral Surgery, University Hospital Centre Zagreb, unsatisfied with her complete removable denture. Clinical and radiological examination revealed severe maxillary alveolar ridge atrophy. Nasal floor elevation was made under local anesthesia through aperture piriformis and lateral window in the distal part. After eight months, four implants were placed and, after period of osseointegration, a bar-retained implant overdenture was made. This case report shows that nasal floor augmentation can be considered among the surgical techniques to allow implant-supported rehabilitation of the atrophic anterior maxilla. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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9 pages, 11116 KiB

Open AccessCase Report

Guided Biopsy of a Radiopaque Lesion Simultaneous with Dental Implants’ Placement: A Multidisciplinary Approach

by Diana Parise, Federica Sartorato, Enrico Fabris, Andrea Scarpa, Tiziano Baesso, Luca Sbricoli, Omnia Abdelwahab, Marny Fedrigo and Christian Bacci

Surgeries 2022, 3(4), 297-305; https://doi.org/10.3390/surgeries3040032 - 11 Oct 2022

Cited by 1 | Viewed by 1878

Abstract

Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery decreases surgical risks and is less invasive. The aim of this article is to present a case of guided osteotomy for bone biopsy and implant placement. Methods: CBCT was performed for the patient’s bone examination, an optical scanner was used for intra-oral images, and surgical certified software was applied for the osteotomy planning and the surgeon’s guide realization. Case report: The patient’s question is about left maxilla prosthetic rehabilitation. During the oral cavity and X-ray examination, a radiopacity with a feathered edge was found; in order to detect the finding, a CBCT was performed, and the surgery was planned. A bone biopsy was performed simultaneously with the implant’s placement through a drill guide. The specimen sent for histological exam showed osteosclerosis. Conclusions: It is the opinion of the authors that by involving and combining close collaboration and communication, several professional specializations (clinicians and radiologists) can improve the treatments for better patient care. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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11 pages, 7540 KiB

Open AccessCase Report

by Maciej Chęciński, Krzysztof Wróbel and Maciej Sikora

Surgeries 2022, 3(2), 142-152; https://doi.org/10.3390/surgeries3020016 - 15 Jun 2022

Cited by 2 | Viewed by 2311

Abstract

The aim of this report is to present a successful combined surgical and pharmaceutical treatment in the highest stage of medicine-related osteonecrosis of the jaw (MRONJ). A 70-year-old man treated for metastatic prostate cancer concomitant with hypertension and diabetes presented due to the exposure of the jawbone. Initial imaging studies suggested MRONJ, and the biopsy did not confirm bone metastasis in the oral cavity. Marginal resection of the mandible was performed after the administration of antibiotics and anticoagulants. There was no recurrence of mandibular necrosis during the 3-year follow-up. MRONJ can develop covertly, with scanty clinical symptoms, and can be easily overlooked. Radical combined treatment may, in some cases, prevent further progression of the disease, which was successful in this case. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Balance Between Innovative and Proven Procedures, Drugs and Materials)

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