Field Of Maxillofacial Surgery Research Articles

An overview on the art of piezosurgery in the maxillofacial practice

Introduction: Piezosurgery is an emerging boom in the field of maxillofacial surgery for precise, safe and effective osteotomies sparing the adjacent vital structures compared to conventional surgery. Corpus: It works on the principle of piezoelectric effect in which crystals in the piezoelectric substances get deformed on the application of an electric field. Various studies gave the evidence of improved wound healing and bone formation compared to conventional approaches. The soft tissue sparing capability with improved patient comfort and decreased blood loss gave the utmost importance for this surgical technique in the present as well as future world of surgery. Conclusion: Piezosurgery has emerging as a promising surgical modality with a wide range of clinical applications throughout the whole field of surgery.

Is Artificial Intelligence Transforming Dentistry Today?

Since the birth of science, the most fascinating structure of the human body is the human brain. Over the past centuries’ researchers have been developing the latest technologies to imitate and explore how the human brain functions. However, to develop a machine that thinks like a human brain is still a dream for researchers. Aristotle’s early efforts to devise logical thinking via his syllogisms (a three-part deductive reasoning) were a source of inspiration for modern computers and technologies1. In the1950, Alan Turing designed a machine to decode encrypted messages, which was a breakthrough of super computers in the days of yore. He designed the “Turing Test” which was coined to assess whether a computer could exhibit intelligence better known as “artificial intelligence” (AI) today2. AI is “a field of science and engineering concerned with the computational understanding of what is commonly called intelligent behavior, and with the creation of artifacts that exhibit such behaviour”3.
 Since 1980, AI has come a long way, virtual reality is being used in dental education these days to create real life situations and promote clinical work on simulators to eliminate risk factors associated with training on live patients. Recently artificial intelligence has been integrated with tutoring systems like “Unified Medical Language System” (UMLS), which have resulted in a better quality of feedback, which the preclinical virtual patients provide to the students4,5. This interactive phase helps students to evaluate their clinical skills and compare their skills with the standard ones, thus creating an ideal and high-quality training environment. Studies have been carried out regarding the efficacy of AI systems, which have stipulated that preclinical students build higher competencies than with the use of traditional simulator units6-8.
 Currently AI inbuilt virtual dental assistants are present in the market. They can execute various chair side tasks with greater accuracy and less manpower ensuring minimum error during the procedures. In the world of implantology and maxillofacial surgery AI helps plan and prepare surgeries with smallest details forgoing actual surgery. Some exceptional uses of AI include robotic surgeries in the field of maxillofacial surgery and bioprinting (where tissues and organs can be reconstructed in thin layers)9. The field of AI has flourished to great extent in the past decade; AI systems are an aid to the field of dentistry and dental education. 
 This narrative attempts to explain possible AI-based applications in the future, it can be used for dental diagnosis, planning out treatments, conducting image analysis, and record keeping. AI-based technologies streamline and reduce laborious workforce to routine tasks, it ensures dental procedures are possible at a lower cost and ultimately makes predictive, preventive, and participatory dentistry possible. The use of AI in dental procedures needs to be guaranteed; its application with human oversight and evidence-based dentistry shall be expected. Dental education needs to be introduced to clinical AI solutions by promoting digital literacy in the future dental liveware.

One-stage reconstruction of bone defects with fibula perforator flap

At the current stage of reconstructive surgery development, perforator flaps have confidently taken a priority place when choosing a method for wound defects cover. However, wounds with significant volume defects of both soft tissues and the bone skeleton remain especially difficult challenges for the surgeon. The desired result of such defects repair could be a technique that allows surgeons to carry out an effective reconstruction in one step.The paper describes in detail the surgical and vascular anatomy, design, preoperative preparation and surgical technique for the mobilization of the free vascularized fibula perforator flap containing a fragment of the bone di-aphysis. Clinical examples of orthoplastic reconstruction in different locations are presented.The authors conclude that free fibula flap allows effective one-stage reconstruction of extensive wounds after trauma or oncological resections, including extensive defects of the skeleton, without significant loss of support function in the donor area. A chimera-style composite flap, which contains soft tissues and a fragment of the fibula, can already be called as a “workhorse" for orthoplastic reconstruction on the lower extremities and in the field of maxillofacial surgery.

НЕДОСТАТКИ В ОРГАНИЗАЦИИ АМБУЛАТОРНО — ПОЛИКЛИНИЧЕСКОЙ СЛУЖБЫ ПО ПРОФИЛЮ ЧЕЛЮСТНО — ЛИЦЕВАЯ ХИРУРГИИ ВЗРОСЛОМУ И ДЕТСКОМУ НАСЕЛЕНИЮ В ГБУЗ ПЕНЗЕНСКОЙ ОБЛАСТНОЙ КЛИНИЧЕСКОЙ БОЛЬНИЦЕ ИМ. Н.Н. БУРДЕНКО ЗА ПЕРИОД 2018 -2020 ГГ.

The availability and quality of medical care is determined by the state of primary health care. Optimization and development of outpatient care is the primary task of healthcare. For the Penza region, according to the resolution of the Government of the Penza region of 02.10.2013 N 743-PP, improving the quality of outpatient care in the field of maxillofacial surgery and increasing its availability is one of the primary tasks for our region. In this regard, the assessment of the work of the outpatient office of the Department of Maxillofacial Surgery of the Consultative Polyclinic of the State Budgetary Healthcare Institution of the Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Aim: to analyze the work and effectiveness of a dentist - surgeon in the outpatient office of the consultative polyclinic GBUZ Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Materials and methods. To achieve this goal, a retrospective analysis of the primary accounting and reporting medical documentation for 2018–2020 was carried out, a questionnaire survey of patients hospitalized through an outpatient office in the Department of Maxillofacial Surgery of the N.I. N.N. Burdenko. Statistical data analysis procedures were carried out using MS Office Excel 2010 spreadsheets and PASW Statistics 18 statistical software package. Results. The analyzed accounting and reporting medical documentation for 2018–2020, the results of the questionnaire indicate the ineffective work of the doctor surgeon - dentist in the outpatient office of the consultative polyclinic GBUZ POKB im. NN Burdenko, the workload of the department with non-core hospitalizations, the increased workload on doctors - the department of maxillofacial surgery. The ways of solving the problem of replacing a dentist-surgeon with a doctor-maxillofacial surgeon are proposed; on the organization of a rehabilitation room for patients of the adult and pediatric population with pathology of the maxillofacial region; to create a single case history. Conclusion. Carrying out the above changes will reduce the burden on doctors - maxillofacial surgeons of the Department of Maxillofacial Surgery, transfer some of the manipulations from the inpatient to the outpatient service (inpatient replacement technology), thereby improving the medical care service in the field of maxillofacial surgery in the Penza region.

МЕЖДИСЦИПЛИНАРНЫЙ ПОДХОД В ОКАЗАНИИ ПОМОЩИ ПАЦИЕНТАМ С ПАТОЛОГИЕЙ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ В УСЛОВИЯХ ЦЕНТРА ЧЕЛЮСТНО-ЛИЦЕВОЙ ХИРУРГИИ

Every year there is a significant increase in combined anomalies and deformities of the maxillofacial region, congenital pathologies, malignant tumors, severe inflammatory diseases of the face and neck. Almost every patient who underwent surgery on the maxillofacial region develops secondary deformities of the maxillofacial region, adentia of the teeth of the jaws, impaired occlusion and speech, skeletal anomalies, which requires a comprehensive interdisciplinary approach of doctors of different profiles. The aim of the work was to improve the provision of specialized care to patients with pathology of the maxillofacial region through the introduction of an interdisciplinary approach in the treatment of patients in the center of maxillofacial surgery at the N.N. Burdenko Penza Regional Clinical Hospital (N.N. Burdenko ). Material and methods. The study was carried out on the basis of the Center for Maxillofacial Surgery of the State Budgetary Healthcare Institution "Penza Regional Clinical Hospital named after V.I. NN Burdenko ". A retrospective analysis of outpatient patient records, case histories, electronic databases, regulatory and legal documentation from 2010-2020 was carried out. Results and its discussion. Until November 2020, in the Penza region, medical care for patients with diseases of the maxillofacial region was provided in the department of maxillofacial surgery of the N.N. Burdenko State Budgetary Clinical Hospital. When analyzing the reporting and regulatory documents, it was concluded that it is necessary to improve the quality of specialized care in the field of maxillofacial surgery. We propose to employ the following specialists on the staff of the department: dentist-therapist for adults and children, gnathologist, dentist-orthodontist, otorhinolaryngologist, speech therapist. Conclusion. The materials presented in the article reflect the need for an integrated approach and close interaction between the doctors of the center. This stage begins during the preoperative preparation and planning of the operation. Rehabilitation of patients with pathology of the maxillofacial region is aimed at maximum aesthetic and anatomical recovery and requires an individual approach. To solve this problem, it is necessary to introduce interdisciplinary interaction of specialists in the center of maxillofacial surgery.

Robust and Accurate Mandible Segmentation on Dental CBCT Scans Affected by Metal Artifacts Using a Prior Shape Model.

Accurate mandible segmentation is significant in the field of maxillofacial surgery to guide clinical diagnosis and treatment and develop appropriate surgical plans. In particular, cone-beam computed tomography (CBCT) images with metal parts, such as those used in oral and maxillofacial surgery (OMFS), often have susceptibilities when metal artifacts are present such as weak and blurred boundaries caused by a high-attenuation material and a low radiation dose in image acquisition. To overcome this problem, this paper proposes a novel deep learning-based approach (SASeg) for automated mandible segmentation that perceives overall mandible anatomical knowledge. SASeg utilizes a prior shape feature extractor (PSFE) module based on a mean mandible shape, and recurrent connections maintain the continuity structure of the mandible. The effectiveness of the proposed network is substantiated on a dental CBCT dataset from orthodontic treatment containing 59 patients. The experiments show that the proposed SASeg can be easily used to improve the prediction accuracy in a dental CBCT dataset corrupted by metal artifacts. In addition, the experimental results on the PDDCA dataset demonstrate that, compared with the state-of-the-art mandible segmentation models, our proposed SASeg can achieve better segmentation performance.

Various Therapeutic Methods for the Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) and Their Limitations: A Narrative Review on New Molecular and Cellular Therapeutic Approaches.

Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.

Virtual Surgical Planning and the “In-House” Rapid Prototyping Technique in Maxillofacial Surgery: The Current Situation and Future Perspectives

Background: The first applications of computer-aided design/computer-aided manufacturing (CAD/CAM) in maxillofacial surgery date back to the 1980s. Since then, virtual surgical planning (VSP) has undergone significant development and is now routinely used in daily practice. Indeed, in an extraordinary period, such as that of the current COVID-19 pandemic, it offers a valuable tool in relation to the protection of healthcare workers. In this paper we provide a comprehensive summary of the clinical applications reported in the literature and review our experience using an in-house rapid prototyping technique in the field of maxillofacial surgery. methods: Our research was focused on reconstructive surgery, traumatology (especially in relation to orbital floor and zygomatic arch fractures), and COVID-19 masks. The first step was a radiographic study. Next, computed tomography (CT) scans were segmented in order to obtain a three-dimensional (3D) model. Finally, in the editing phase, through the use of specific software, a customized device for each patient was designed and printed. results: Four reconstructive procedures were performed with a perfect fitting of the surgical device produced by means of VSP. In nine orbital floor fracture cases a good overlapping of the mesh on the orbital floor was obtained. In sixteen zygomatic arch cases the post-operative CT scan showed an excellent fitting of the device and a correct fracture reduction. Regarding the COVID-19 period, six masks and shields produced proved to provide effective protection. conclusions: The timescale and costs required for the production of our “home-made” virtual design are low, which makes this method applicable to a large number of cases, for both ordinary and extraordinary activities.

The Role of Ultrasonography in The Diagnosis of Oral and Maxillofacial Disease

Objective: Ultrasonography, as a diagnostic tool, constitutes a non-invasive, cost-effective, readily-availableand repeatable imaging technique. Ultrasonography has been used as a means of diagnosing various medicalconditions for many years. However, in the field of maxillofacial surgery it represents a relatively new aidin the diagnosis of various diseases affecting the oral and maxillofacial regions. These include: infection,soft-tissue related diseases and vascular anomalies which can be detected using Doppler ultrasonography.This article presents four cases, in which ultrasonography was employed to confirm diagnoses and act as aguide to treatment. Methods: Four cases of soft tissue swelling and enlargement were diagnosed with theaid of ultrasonography, namely: a submasseteric abscess, a nasolabial cyst, a dermoid cyst and a left buccalspace abscess caused by a foreign body (i.e. a fish bone). Result: In the case of a submasseteric abscess,ultrasonography was used in confirming the diagnosis and therapy, while determining the maximal point ofthe abscess. In the cases of both cysts, ultrasonography highlighted well-defined cystic lesions with internalecho showing fluid accumulation, while in the buccal space abscess, an ultrasonogram confirmed the exactlocation of the fish bone. Conclusion: Ultrasonography is a quick, widely-available, relatively inexpensive,painless procedure which can be repeated as often as necessary without risk to the patient. Thus, ultrasonographyis a valuable diagnostic aid to the oral and maxillofacial surgeon in achieving early and accurate diagnosis.

Mandibular Condylar Fracture in a Professional Soccer Goalkeeper: How to Achieve Early Return-to-Play—A Case Report

Sport-related mandibular fracture is a common injury in the field of maxillofacial surgery. However, the treatment of mandibular condylar fractures in professional soccer goalkeepers is rarely reported. A 32-year-old male professional soccer goalkeeper was referred for malocclusion after collision with an opponent player during a game. The patient’s mandible was displaced between the left lower lateral incisor and left lower canine. Computed tomography showed right condylar base fracture with medial displacement and left para-symphysis fracture. Internal fixation using retromandibular anterior trans-parotid approach via 25-mm skin incision immediately below the earlobe and intraoral vestibular approach were performed under general anesthesia 2 days after the injury. The patient was discharged without complications 3 days after surgery, with mandibular protrusion and diduction exercises with limitation of mouth opening. Soft diet and limitation of mouth opening was performed for 4 weeks after surgery. To achieve early return-to-play, rehabilitation based on Fowell and Earls’ return-to-play guidelines following facial fractures was started, with moderate exercise 5 days after surgery, and progressively full exercise without contact 8 days after surgery. He started normal team training with individualized jaw-guard 4 weeks after surgery. His body weight decreased by 2.2 Kg 1 week after surgery, gradually recovered, and became normal 4 weeks after surgery. The patient returned to a game 2 months after surgery. This case report can be a reference case in condylar fractures of professional soccer players, as the available scientific literature is limited with regard to return-to-play after maxillofacial fracture in professional athletes.

Professor tatianag. Robustova: scientist, physician, teacher and person

The purpose of the study is in connection with the 90th anniversary of the outstanding scientist and clinician of the Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor Tatyana Grigorievna Robustova to highlight her scientific, medical, pedagogical and social activities, to consider the formation of T.G. Robustova as a professional of the first magnitude in Russia, to present the main scientific areas of research in the field of maxillofacial surgery and dentistry, to note its personality characteristics.

Three-Dimensional Technology Applications in Maxillofacial Reconstructive Surgery: Current Surgical Implications.

Defects in the oral and maxillofacial (OMF) complex may lead to functional and esthetic impairment, aspiration, speech difficulty, and reduced quality of life. Reconstruction of such defects is considered one of the most challenging procedures in head and neck surgery. Transfer of different auto-grafts is still considered as the “gold standard” of regenerative and reconstructive procedures for OMF defects. However, harvesting of these grafts can lead to many complications including donor-site morbidity, extending of surgical time, incomplete healing of the donor site and others. Three-dimensional (3D) printing technology is an innovative technique that allows the fabrication of personalized implants and scaffolds that fit the precise anatomy of an individual’s defect and, therefore, has attracted significant attention during the last few decades, especially among head and neck surgeons. Here we discuss the most relevant applications of the 3D printing technology in the oral and maxillofacial surgery field. We further show different clinical examples of patients who were treated at our institute using the 3D technology and discuss the indications, different technologies, complications, and their clinical outcomes. We demonstrate that 3D technology may provide a powerful tool used for reconstruction of various OMF defects, enabling optimal clinical results in the suitable cases.

Impact of Wound Closure on the Corrosion Rate of Biodegradable Mg-Ca-Zn Alloys in the Oral Environment.

Magnesium alloys have exhibited a rapid rate of corrosion and thus early implant failure, so this study was designed to investigate the longer-term effects and in particular on wound closure. The aim of the study is to evaluate Mg-Ca-Zn Alloys as promising biodegradable implants in the field of maxillofacial surgery, which have so far never been evaluated for the changing conditions from a saliva to a serum-like environment after wound closure. Magnesium-0.6/calcium-0.8 wt.% zinc alloys were either immersed for 10 days in artificial saliva or 10 days in Hank’s salt solution as control groups. The test group was transferred from artificial saliva to Hank’s salt solution after 5 days in order to simulate wound closure. Corrosion rates were determined by immersion testing. Additional electron microscopy and energy dispersive X-ray spectroscopy (EDX) were performed. Prior artificial saliva exposure led to significantly decreased (p = 0.0272) corrosion rates after transfer to Hank’s solution in comparison to sole Hank’s solution exposure (0.1703 vs. 0.6675 mg/(cm2·day)) and sole artificial saliva exposure (0.3180 mg/(cm2·day)), which both exhibit a strong increase after 5 days. The results were in accordance with the scanning electron microscopy and EDX pictures. Prior saliva exposure could protect from increasing corrosion rates after wound closure. Thus Mg-Ca-Zn Alloys are promising future implant alloys in oral surgery, whereas other surgical fields without saliva exposure have to deal with accelerated corrosion rates after 5 days.

Virtual Reality Simulation and Augmented Reality-Guided Surgery for Total Maxillectomy: A Case Report

With the improvement in computer graphics and sensors, technologies like virtual reality (VR) and augmented reality (AR) have created new possibilities for developing diagnostic and surgical techniques in the field of surgery. VR and AR are the latest technological modalities that have been integrated into clinical practice and medical education, and are rapidly emerging as powerful tools in the field of maxillofacial surgery. In this report, we describe a case of total maxillectomy and orbital floor reconstruction in a patient with malignant fibrous histiocytoma of the maxilla, with preoperative planning via VR simulation and AR-guided surgery. Future developments in VR and AR technologies will increase their utility and effectiveness in the field of surgery.

Tissue Integration and Biological Cellular Response of SLM-Manufactured Titanium Scaffolds

Background: SLM (Selective Laser Melting)–manufactured Titanium (Ti) scaffolds have a significant value for bone reconstructions in the oral and maxillofacial surgery field. While their mechanical properties and biocompatibility have been analysed, there is still no adequate information regarding tissue integration. Therefore, the aim of this study is a comprehensive systematic assessment of the essential parameters (porosity, pore dimension, surface treatment, shape) required to provide the long-term performance of Ti SLM medical implants. Materials and methods: A systematic literature search was conducted via electronic databases PubMed, Medline and Cochrane, using a selection of relevant search MeSH terms. The literature review was conducted using the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Results: Within the total of 11 in vitro design studies, 9 in vivo studies, and 4 that had both in vitro and in vivo designs, the results indicated that SLM-generated Ti scaffolds presented no cytotoxicity, their tissue integration being assured by pore dimensions of 400 to 600 µm, high porosity (75–88%), hydroxyapatite or SiO2–TiO2 coating, and bioactive treatment. The shape of the scaffold did not seem to have significant importance. Conclusions: The SLM technique used to fabricate the implants offers exceptional control over the structure of the base. It is anticipated that with this technique, and a better understanding of the physical interaction between the scaffold and bone tissue, porous bases can be tailored to optimize the graft’s integrative and mechanical properties in order to obtain structures able to sustain osseous tissue on Ti.

The use of muscle extracellular matrix (MEM) and SCPC bioceramic for bone augmentation

Background: Bone augmentation is a challenging problem in the field of maxillofacial surgery. Objective: In this study, we prepared and evaluated muscle extracellular matrix (MEM) after adding silica calcium phosphate composite (SCPC) seeded with human bone marrow mesenchymal cells (hBMSCs). We then investigated bone augmentation in vivo using the prepared MEM-SCPC. Materials and Methods: hBMSCs were seeded on MEM-SCPC, and MEM was characterized. Calvarial bone grafts were prepared using nude mice (n = 12) and grafted separately in two experimental groups: grafts with MEM (control, n = 4) and grafts with MEM-SCPC-hBMSCs (experimental group, n = 8) for 8 weeks. Micro-computed tomography (micro-CT) and histological analysis were then performed. Results: Micro-CT analysis demonstrated a thinner trabeculae in grafted defects than normal native bone, with a high degree of anisotropy. Quantitative histomorphometric assessment showed a higher median bone percentage surface area of 80.2% ± 6.0% in the experimental group. Conclusion: The enhanced bone formation and maturation of bone grafted with MEM-SCPC-hBMSCs suggested the potential use of this material for bone augmentation.

An in vitro Study on the Biocompatibility of Titanium Implants Made by Selective Laser Melting

Customized medical implants obtained by selective laser melting have an important applicability due the accurate architecture which promotes the osteointegration, osteoconduction, and osteoinduction. This study assessed the in vitro effect of titanium scaffolds, both pure and covered with a layer of hydroxyapatite, on mesenchymal stem cells harvested from various oral tissues. Eight titanium implants were manufactured by selective laser melting, obtaining a porosity of 63.4% and a pore size of 600 µm. Four matrices were covered with nano-hydroxyapatite. Four lines of mesenchymal stem cells isolated from the apical papilla, the dental pulp, the inter-radicular bone, and the tuberosity bone were seeded on the implants. The cells’ proliferation, viability, and differentiation into the osteoblastic lineage were assessed after 18 days, using light microscopy and fluorescence. Our results indicated that the titanium matrices did not exert cytotoxic effect. The cells seeded on titanium matrices conditioned with nano-hydroxyapatite had a slightly higher proliferation rate. The stem cells isolated from the inter-radicular bone had the most intense proliferation and differentiation towards the osteoblastic lineage showing a nodular architecture. In conclusion, the oral mesenchymal stem cells have the potential to promote and improve bone regeneration when associated with the titanium scaffolds manufactured by selective laser melting, either non-coated or coated with hydroxyapatite. These findings open new perspectives for the bone reconstruction in the oral and maxillofacial surgery field.

Dexamethasone Injection Into Pterygomandibular Space Versus Sublingual Space on Post-Operative Sequalae of Lower Third Molar Intervention

BackgroundThe surgical removal of lower third molar is still the most common surgical procedure that is done in oral and maxillofacial surgery field and creates the predictable post-operative sequelae such as pain, swelling, stiffness and difficulty in mouth opening. The purpose of this study is to compare pre-operative dexamethasone injection into pterygomandibular space (PGS) and sublingual space (SLS) in lower third molar intervention of post-operative pain, swelling, and limited mouth opening.MethodsThis study is the split-mouth, randomized crossover clinical trial in 30 healthy patients (mean age 21 years). These patients had similar bilateral lower third molar impactions. The patients were randomly divided into two groups receiving either 8-mg dexamethasone injection into SLS or PGS with the 4-week washout period intervention. Clinical assessment of facial swelling and maximum mouth opening was performed before operation and on day 2 and day 7 after operation. The post-operative pain was also measured by patients’ response on pain visual analogue scale (VAS) on the first, second and third day after intervention.ResultsThere is no significant difference between PGS group and SLS group in pain and swelling on the second and seventh day after operation. However, PGS group showed a greater degree of limited mouth opening than SLS group on the second day after operation.ConclusionsThis study showed that 8-mg dexamethasone injection into PGS or SLS was not different in reduction of pain, swelling, and limited mouth opening. This result suggests that dexamethasone injection into PGS or SLS is similarly effective.

Treatment of Mandibular Fractures

Treatment of mandibular fractures and their sequelae are difficult to resolve in the maxillofacial surgery field, their components cause that reduction must not only be anatomic, but functional as well. The aim of this article is to present a review about actual knowledge in mandibular fracture treatment and report a case of mandibular trauma. The treatment of these fractures has been changing through the years; the new technologies achieve better reduction with the osteosynthesis systems, which results in reduced approaches and lesser morbidity. Presently, titanium plates systems like mini-plates, reconstruction plates or blocking plates offer excellent results in high energy traumas through anatomic and stable reductions. The technology of 3D reconstruction systems and intra-operatory CT accomplishes better results in trauma treatment.

Using Piezoelectric System in Oral and Maxillofacial Surgery

Motors and handpieces with the piezoelectric system have recently been used in several surgeries, following the current minimally invasive trend surgery. The system consists of crystals or ceramics undergoing deformation when exposed to electrical current, resulting in an oscillating movement with ultrasound frequency. In the Oral and Maxillofacial Surgery field activity, the piezosurgery may be used in maxillary and mandibular osteotomies in the orthognathic surgery, alveolar corticotomies, cysts tumors, facial trauma surgery, among others. This study aims to present a literary review on the piezoelectric system, which allows discussion to their use and effectiveness in oral surgery procedures.