Maxillofacial Fractures: From Diagnosis to Treatment

Oral and maxillofacial fractures are common injuries among multiple trauma patients. Mid-face fractures are considered serious medical problems rather than all other maxillofacial injuries due to their complexity of management. An appropriate treatment plan is essential to reconstruct the mid-face aperture esthetically and functionally. Favorable results are provided by interdisciplinary approaches and appropriate surgical treatments. The authors believe in that a complete and universal book about trauma surgery should contain a chapter about this issue which includes all aspects of mid-face fractures. So we aim to provide a comprehensive chapter about diagnosis and treatment of mid-face fractures which may be a complete and useful guideline for trauma surgeons

Mandibular angle fracture following closed extraction of lower third molar: A case report and systematic review

Objectives Mandibular third molar extraction is among the most commonly performed dental procedures. Fracture of the angle of mandible after third molar extraction is a rare complication of this procedure.Case Herein, we report fracture of the right angle of mandible immediately after extraction of mandibular right third molar in a 38-year old healthy female patient, which was surgically managed. A review of the relevant literature is also presented. Thirty four cases of mandibular fracture following third molar extraction are reported in the literature. Most of these cases were removed surgically.Conclusion Systematic review of papers showed that angulation of impacted third molar is one of the most related factors in following fractures of mandibular angle

Surgical Approaches to the Temporomandibular Joint

The temporomandibular joint (TMJ) acts as a sliding hinge between mandible and temporal bone. Disorders of temporomandibular joint are intolerable for the patients in severe cases. Furthermore, surgical treatment of temporomandibular joint problems is a challenge for surgeons in some cases. In that order, it is critical for the surgeon to choose the best surgical approach in treating the temporomandibular joint diseases. There are several surgical approaches in the management of temporomandibular joint problems including some pros and cons. So, in this chapter, we aim to present a comprehensive review of surgical approaches to the temporomandibular joint

Facelift: Current Concepts, Techniques, and Principles

The effects of aging on skin, including thinning and loss of muscle tone, result in a flabby or drooping appearance of the face. The demands of an attractive appearance and smooth skin are wanted all around the world. There are a lot of factors which influence the choice of rejuvenation techniques, including anatomy of the facial skeleton, the severity of aging changes, social and economic status of the patient, and structure of the skin. Facelifting is a facial rejuvenation procedure in which by dissection of subcutaneous layers and different suturing techniques we are able to stretch the skin and make the patient look younger. This chapter presents the technique, current concepts, complications, and indications of facelift surgery

Maxillary advancement using external distraction device internally: A case report and review of the literature

Introduction: Advancing the dysplastic maxilla in cleft palate patients is a challenging issue. This study aimed to report a case of maxillary advancement in a cleft palate patient by distraction osteogenesis technique.Materials and methods: A 21 year old woman with the chief complaint of retruded maxilla was planned to be treated by distraction method. An external craniofacial distraction device was used in a total different way to advance the hypoplastic maxilla. In the second section of the study a review table of advancing techniques in such cases was designed and presented.Results: The amount of maxillary advancement was 10 mm horizontally and 5 mm inferiorly. The distraction procedure gave the ability of moving the maxilla in two directions. The tooth show was improved and paranasal area and A point were advanced to help in gaining a straight profile. The remained discrepancy was corrected by mandibular setback procedure.Conclusions: Distraction osteogenesis may be a reliable treatment plan in advancing hypoplastic midface in cleft palate patients. The results of this method may be more sufficient than routine orthognathic surgery

Evaluation of neo-adjuvant, concurrent and adjuvant chemotherapy in the treatment of head and neck squamous cell carcinoma: a meta-analysis.

Squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity. This study aims to evaluate different treatment procedures including neo-adjuvant, concurrent and adjuvant therapy in treating squamous cell carcinoma of the head and neck by a meta-analysis.The authors searched all electronic databases (Medline, Embase and Cochrane) for all the articles published from 1970 to January 2011. Data of the evaluated treatment procedures (chemotherapy or radiotherapy), number of patients, publishing date and the authors' names have all been extracted from the articles and have been categorized in a table.Forty-six researches are included in this study. All three ways show that using chemotherapy after or with radiotherapy improves the vitality rate significantly (p-value< 0.01).It is concluded that after deciding not to perform a surgery for treating SCC, the recommended treatment plan is chemotherapy and radiotherapy simultaneously

Maxillary Sinusitis due to Dental Infection: A Case Series Study: Odontogenic maxillary sinusitis

Introduction: Odontogenic infection is one of the most common causes of maxillary sinusitis which can lead to severe complications like cerebral abscess and orbital cellulitis. This study aims to evaluate the frequency of acute and chronic maxillary sinusitis by odontogenic source in 120 patients. Materials and Methods: One hundred and twenty patients (240 sinuses) were examined by clinical examinations and their sinuses were assessed for the extent of fluid or mucosal thickening in computed tomography (CT) images and water's views. A dental examination has been performed to detect dental involvement and priapical radiography has been obtained to confirm the findings. Combination treatments were performed on five patients with refractory odontogenic sinusitis. Chi-square analysis has been used to identify the correlation between the prevalence of odontogenic sinusitis, age, and gender. Results: Sinus involvement caused by dental origin has been found in 11.2% of the cases. Periapical involvement of maxillary first molar has been the most common cause of sinusitis with dental source (68%). The incidence of chronic apical periodontitis has been significantly higher than the other periapical infections (75% versus 25%). The signs and symptoms of sinusitis in all five cases were eliminated after the combination treatment after four months. Conclusions: Odontogenic sources especially chronic apical periodontitis may lead to inflammation of the maxillary sinus membrane which usually is ignored because of its silent progression

Effects of Different Growth Factors on New Bone Formation: A Systematic Review

Background and Aim: Using different osteogenic growth factors, which is still under investigation, is a favorable method for bone regeneration. This systematic review is aimed at evaluating the effects of different growth factors and their carriers on osteogenesis .   Materials and Methods: Electronic databases (Medline, EMBase and Cochrane) were studied by the authors for articles published from 1999 to October 2010. Clinical and animal studies evaluating bone formation by applying a specific growth factor and the related carrier were included in this investigation. Obtained data were organized in a table and evaluated through a qualitative analysis .   Results: Sixty-nine studies most of which evaluated the effects of BMP-2 osteogenesis in different models were included in this study. Totally, twenty-five carriers were applied with different growth factors in the experiments. Among these carriers, poly lactic– co glycolic acid (PLGA), hydroxy apatite/tricalcium phosphate/absorbable collagen sponge (HA/TCP/ACS) and BioOss were the most frequently used carriers with the growth factors in bone regeneration studies.   Conclusion: The current evidence, although not strong enough, confirms that BMP-2 has more favorable results in osteogenesis compared with other factors. The carrier scaffold, methods of measurement (histologic or radiographic), type of animal, defect diameter and the length of follow-up are the variables that should be matched before reaching definite results for the effect of growth factors in bone regeneration