Department Of Oral Surgery Research Articles

Evaluation of the relationship between TMD pain and toothache and dental anxiety

Aims: The aims of the study were to evaluate the relationship between pain experienced and dental anxiety in patients presenting to the department of oral and maxillofacial surgery with tootache and TMD pain. Methods: This retrospective, observational study was conducted on patients who applied to the oral and maxillofacial surgery clinic between January and June 2022. Patients were divided into 2 groups according to the reason for visiting the clinic. Patients in group 1 had toothache and patients in group 2 had temporomandibular disorder pain. Pain was assessed by VAS and dental anxiety by MDAS. The statistical significance level was accepted as p

Evaluation of the success of anterior iliac crest harvested bone graft in reconstruction of different jaw defects: a retrospective study

Aims: The aim of this study was to evaluate the success of bone grafts obtained from the anterior iliac crest, the recipient and donor site complications in the reconstruction of jaw defects caused by different etiologies in maxillofacial surgery. Methods: A retrospective cohort study was conducted at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Erciyes University between 2012-2022. It included patients with iliac crest harvested bone grafts due to jaw defect with full records. The primary predictive variable was the type of jaw defect. The primary outcomes were the presence of complications at donor and recipient sites. Secondary outcomes were length of hospital stay and type of complications at donor and recipient sites. The obtained data were analyzed with Kruskal Wallis Test, Pearson’s chi-square test and Fisher’s exact test. Results: This study included 104 (44 female, 60 male) patients. Complication rate was 21.15%. There was no statistically significant relationship between the type of jaw defect and the success of iliac bone grafts (p=0.257). The most common recipient site complication was resorption in alveolar atrophy groups, the dehiscence in alveolar cleft groups, infection in other reason groups. There was no statistically significant relationship between type of jaw defect and complication types (p=0.524). Conclusion: The results of the study demonstrate that general success rate was 78.85% in jaw reconstruction with anterior iliac crest harvested bone grafts. The major complication rate causing total graft loss was 13.46%. There was no statistically significant relationship between the type of jaw defect and the success of iliac bone grafts.

Assessment of the Efficacy of Orally Administered Lycopene in Improving the Mean Maximum Incisal Opening in Individuals Suffering from Oral Submucous Fibrosis

Objective: To compare the effectiveness of orally administered lycopene versus a placebo in increasing mean maximum incisal opening in patients with oral submucous fibrosis (OSF). Methodology: This randomized controlled trial, conducted at the Oral and Maxillofacial Surgery Department of Lahore Medical and Dental College from January to July 2020, enrolled 68 eligible patients. Two groups were formed: Group 1 (received oral lycopene) and Group 2 (received placebo). A block size of 4 was utilized for patient allocation, alternating between groups until the sample size was met. Both groups underwent a comprehensive 3-month treatment plan, including habit cessation and daily physiotherapy involving tongue spatula insertion between teeth (with spatula replacement). Only Group 1 received an additional 40mg oral lycopene daily. Follow-up appointments occurred monthly for 3 months, measuring maximal incisal opening with a Vernier Caliper. Results: Baseline incisal opening was 25.39 ± 2.92 mm in Group 1 and 25.23 ± 3.03 mm in Group 2. At the 3-month mark, Group 1 showed an incisal opening of 31.71 ± 2.84 mm, while Group 2 had 28.31 ± 2.98 mm. The mean change in incisal opening was 6.32 ± 0.96 mm for Group 1 and 3.08 ± 0.90 mm for Group 2. Group 1 exhibited a significantly higher mean change in incisal opening compared to Group 2 (p=<0.001). Conclusion: Lycopene administration is more effective than a placebo in improving mouth opening in OSF patients. Therefore, lycopene should be considered as a treatment option to enhance maximal incisal opening and improve the quality of life for individuals with OSF. Keywords: Maximum incisal opening, Oral submucous fibrosis, lycopene orally, Nutt eating

Minimally Invasive Extraction System Benex-Clinical Evaluation and Comparison.

Tooth extraction is one of the oldest and most well-known surgical procedures in dental medicine. It is still routinely performed by general practitioners and dental undergraduates. The Benex extraction system allows for the extraction of teeth in a vertical direction, which avoids most trauma against surrounding alveolar bone and soft tissues. The study included 56 patients who were recruited from the Department of Oral Surgery, Medical University-Plovdiv. The patients were split into two groups of 28 patients-Group I (control group) and Group II (study group). For each group, the success of the extraction, buccal cortical plate preservation, pain experience and early wound healing were assessed. There was no statistical significance between the success of the extractions in both groups. The Benex extractions preserved the buccal cortical plate in 95% of the cases, whereas the forceps extractions preserved it in only 71.8%, which is statistically significant. On the seventh day, patients in Group II reported less pain, without a significant difference. There was a significantly bigger number of completely healed extraction wounds on the 10th day. Atraumatic extractions allow for more hard and soft tissues to be preserved in the extraction site. This is essential for a successful outcome and the aesthetically pleasing results of the following dental restoration.

Efficacy of Submucosal versus Pterygomandibular Dexamethasone Injection in Surgical Extraction of the Impacted Lower Third Molar

Objectives: This study aimed to evaluate the efficacy and postoperative complications of preoperative submucosal dexamethasone injection compared to preoperative dexamethasone injection into the pterygomandibular space for surgical extraction of the impacted lower third molar. Study design and setting: This was a quasi-experimental, cross-sectional study conducted at the Department of Oral and Maxillofacial Surgery, Dow International Dental College, Dow University of Health Sciences, Karachi, from April to July 2021. Methodology: The study sample consisted of 72 patients who reported surgical extraction of their lower wisdom teeth and consented to participate in this study. The patients were randomly divided into the submucosal injection group (SM) and the pterygomandibular space (PM) group. The injection time was recorded on the second and seventh postoperative days. Results: No significant differences in the duration of the intervention were observed between the two groups (23.08 min in PM, 23.07 min in SM). The postoperative facial swelling was significantly reduced transversely (ear lobe to the angle of the mouth) in both groups compared to their respective baselines on the first postoperative day. On the secondpostoperative day, significant changes were observed in the submucosal group in postoperative swelling. Conclusions: Using intraoral dexamethasone injections in third molar surgery significantly reduces conventional complications of surgery while avoiding the systemic side effects of steroids. Dexamethasone should be used regardless of the administration site when warranted, with less apprehension than is common in dentistry

Effect of residual dental follicle after removal of impacted mandibular third molar on the periodontal health of adjacent second molar

Objective: To investigate whether residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars affect the periodontal health of adjacent mandibular second molars, in order to provide clinical reference for the management of residual dental follicles after third molar extraction. Methods: A total of 82 patients who underwent bilateral impacted mandibular third molar extraction at the Department of Oral Surgery, School and Hospital of Stomatology Wuhan University, from November 1, 2020, to November 30, 2022, were included in the study. Using a self-controlled method, each patient's bilateral mandibular third molars were randomly divided into two groups: Group A underwent third molar extraction with thorough removal of residual dental follicle tissue, while Group B underwent third molar extraction without any treatment of the remaining dental follicle tissue. Operation time and adverse reactions were recorded. Clinical and radiographic examinations were performed at 6-month follow-up to evaluate the periodontal parameters and alveolar bone height of the bilateral mandibular second molars, and differences between the two groups were compared. Results: All patients had successful bilateral mandibular third molar extractions, and no serious complications occurred intraoperatively or postoperatively. There were no statistically significant differences in surgical time, postoperative pain, or facial swelling between the two groups (P>0.05). At the 6-month follow-up, the probing depth on the distal aspect of the mandibular second molars in Group A [2.67 (2.00, 3.67) mm] was significantly less than that in Group B [4.00 (3.00, 5.00) mm] (Z=-6.55, P<0.001). The clinical attachment loss on the distal aspect of the mandibular second molars in Group A [1.00 (0.00, 3.00) mm] was less than that in Group B [3.00 (2.00, 5.00) mm] (Z=-5.99, P<0.001). The distance from the alveolar crest to the cementoenamel junction on the distal aspect of the mandibular second molars in Group A [(1.86±1.34) mm] was less than that in Group B [(3.04±1.89) mm] (t=6.87,P<0.001). In patients aged≥20 years, the probability of recovery of alveolar bone height to normal level on the distal aspect of the mandibular second molars in Group A [42.3% (11/26)] was significantly higher than that in Group B [0 (0/26)] (P<0.01), while there was no statistically significant difference between Group A [63.3% (19/30)] and Group B [46.7% (14/20)] in patients aged<20 years (P>0.05). Conclusions: Residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars adversely affect the periodontal health of adjacent teeth. Thorough removal of residual dental follicles during impacted mandibular third molar extraction is beneficial for the postoperative recovery of alveolar bone height of the distal aspect of the mandibular second molars, especially in patients aged≥20 years.

Deciphering the fate of granulation tissue in the human inflammatory alveolar microenvironment using single-cell RNA sequencing

Objective: To investigate the cellular composition and heterogeneity of granulation tissue in human alveolar sockets and construct single-cell transcriptomic maps to elucidate the potential outcomes of natural resolution in the inflammatory microenvironment. Methods: Granulation tissues from 12 alveolar sockets undergoing tooth extraction due to periodontitis and scheduled for delayed site preservation or autologous tooth transplantation were collected in the Department of Oral and Maxillofacial Surgery, School of stomatology Fourth Military Medical University from September 2022 to August 2023. This study used HE staining and single-cell RNA sequencing (scRNA-seq) to observe the cellular composition and morphological changes of different types of granulation tissues. This approach enabled us to identify cellular sequence variations in the inflammatory dental alveolar granulation tissue within specific microenvironments, construct single-cell atlases for different types of human dental alveolar granulation tissues, and explore the spatiotemporal patterns of cell type distribution and key gene changes during the resolution process of inflammatory granulation tissue. Results: HE staining revealed extensive infiltration of inflammatory cells in the dental alveolar inflammatory granulation tissue. After allowing the inflammatory granulation tissue to naturally resolve for three weeks, its histological morphology was essentially consistent with that of reparative granulation tissue. ScRNA-seq captured a total of 20 448 cells from granulation tissues, and the gene expression quantification analysis revealed total gene counts of 33 835 for inflammatory granulation tissue, 36 058 for naturally resolved granulation tissue, and 34 719 for reparative granulation tissue. At the single-cell level, granulation tissue was annotated into ten cell subgroups, including vascular endothelial cells, mesenchymal stem cells, and fibroblasts. Differences were observed in the proportion of cell compositions between inflammatory and naturally resolved granulation tissues. Pseudo-temporal analysis illustrated two main outcomes in tissue resolution and healing, involving immune responses and angiogenesis. Among these, genes associated with inflammation regulation and immune response, such as Igbp5, Zfp36, and Hspa1b, as well as genes involved in extracellular matrix secretion and the formation of vessels and fibers such as Timp3, Postn, and Rgs5, showed significant differences in expression between the two types of granulation tissues. Conclusions: Inflammatory granulation tissue exhibits heterogeneity in cell composition, gene expression, and biological functions compared to naturally resolved granulation tissue. When the inflammatory granulation tissue in the alveolar socket is left undisturbed to undergo natural resolution, it displays a cellular composition similar to that of reparative granulation tissue at both the histological and single-cell levels. Moreover, it modulates the inflammatory response and the healing process through immune reactions and tissue remodeling.

Effect of mandibular third molar tooth germ extraction on mandibular development: a retrospective study

Objective: To investigatethe effect of extraction of mandibular third molar (M3) tooth germon the development of the mandible in orthodontic patients, with a view to providing a reference for clinical M3 tooth germ extraction. Methods: One hundred and twenty-nine Angel class Ⅰ patients aged 10-16 years who attended the Department of Orthodontics Division 1, School & Hospital of Stomatology, Wuhan University from 1 January 2013 to 30 December 2021 and fulfilled the criteria for nativity were included. Those who had their M3 extracted in the Department of Oral and Maxillofacial Surgery were included in the study group, with a total of 66 cases; and those who did not have their M3 extracted were included in the control group, with a total of 63 cases. The average annual growth was calculated by tracing point measurements on cephalometric films before and after orthodontic treatment according to the Jarabak and McNamara methods, with measurements of the mandibular ramus height (Ar-Go'), mandibular body length (Go'-Me), and overall mandibular length (Co-Gn) values, respectively. The average annual growth of Ar-Go', Go'-Me, and Co-Gn were compared between the two groups for the overall sample of patients, patients of the same sex (male/female), patients of the same age group (A, B, and C), and patients of the same cervical vertebral maturation stage (stages Ⅱ, Ⅲ, and Ⅳ), respectively, to see if there was any difference in the average annual growth of Ar-Go', Go'-Me, and Co-Gn. Results: There was no statistically significant difference in the average annual growth of Ar-Go', Go'-Me, and Co-Gn between the study group [0.88 (0.40, 1.80), 0.67 (0.15, 1.18), and 0.86 (0.40, 1.90) mm, respectively] and the control group [1.08 (0.45, 1.60), 0.53 (0.25, 1.13), and 1.20 (0.46, 2.28) mm, respectively] (P>0.05). In addition, there was no significant difference in the average annual growth in the Ar-Go', Go'-Me, and Co-Gn between the groups for patients of the same sex group (male/female), patients of the same age group (A, B, and C), and patients of the same cervical vertebral maturation stage group (stages Ⅱ, Ⅲ, and Ⅳ) (P>0.05). Conclusions: Extraction of the mandibular third molar tooth germ has no significant effect on the development of the mandible in Angle class Ⅰ orthodontic patients.

Concomitant Extraction of Wisdom Teeth with Bilateral Sagittal Split Osteotomy (BSSO): A Case Series

Aim: Aim:To investigate the incidence of postoperative complications (including pain, nerve damage, swelling and infection) associated with the concomit an textraction of wisdom teeth at the time of bilateral sagittal split osteotomy procedures. Materials and Methods: A retrospective evaluation of eight patients who underwent concomitant removal of their lower wisdom teeth (either fully erupted, partially or fully bone impacted) at the time of their surgical procedure (Bilateral sagittal split osteotomy with/without LeFort 1 procedure/genioplasty). All patients presented to the Oral and Maxillofacial Surgery Department at Case Western Reserve University. Postoperative complications (including pain, nerve dysfunction, swelling and infection) were examined at regular follow-up appointments after their surgical procedure. Results: A total of eight patients were examined for post operative complications. All patients confirmed the presence of mild pain/discomfort/swelling in the short-term postoperatively.

Oral infections - a retrospective study of patients treated in the Oral and Maxillofacial Surgery clinic of the Emergency County Clinical Hospital in Sibiu.

The present study was carried out in the Department of Oral and Maxillo-Facial Surgery of the Sibiu County Emergency Clinical Hospital and aimed to evaluate the oral health status of patients who refer to this medical unit, identifying the presence and frequency of dental infections among these patients. The study also aimed to identify and characterize the comorbidities present in patients with these oral conditions. Finally, the study aims to highlight the degree of concern regarding the oral health status of patients and provide relevant information for dental health services and for the development of appropriate prevention and intervention strategies. The study was conducted retrospectively and descriptively, using the hospital's electronic medical records. The total sample consisted of 1246 people, the inclusion criteria were: (a) patients admitted to the OMF Surgery Department; (b) outpatients who required hospitalization; (c) patients hospitalized under continuous hospitalization regime; (d) patients over 16 years of age; (e) patients diagnosed with infectious pathologies.After data registration, information on sex, background, distribution of diagnoses, associated pathologies of the patients and the existence of combined pathologies of the patients included in the study were taken into account. The duration of hospitalization of patients, the need and duration of antibiotic therapy, the frequency of use of combinations of antibiotics, and the number of antibiotics used in correlation with the duration of hospitalization were also analyzed.The data are presented as frequency and percentages. The combination of the most frequent associated pathologies was analyzed using an algorithm based on association rules and chord diagram was used for their visual representation. Statistical analyses were performed using IBM SPSS® (Statistical Package for the Social Science) version 20 and R software. The total sample consisted of a total of 1246 people. From the preliminary analysis, the majority of people in the sample, 68.5%, did not suffer from infectious conditions, while 31.5% were affected. Most of the patients came from the urban environment (61.73%) and were male (54.34%). Frequent comorbidities included cardiac pathologies (11.99%) and diabetes (4.08%).These data indicate the poor state of oral health among patients who call on the OMF Surgery services. It is not an isolated case, but it reflects a pattern observed globally. Based on the results of the study, the hypothesis is validated that there is a poor state of oral health among the population, manifested by the increased incidence of dental infections. International studies confirm that dental infections are often complicated by the presence of comorbidities. The study concludes that patients hospitalized in the department of Oral and Maxillofacial Surgery face a poor oral health state, characterized by a high prevalence of dental infections. The presence of comorbidities and seasonal factors contribute to the aggravation of these infections. These results emphasize the need for preventive and educational interventions to improve the oral health of the population in this region, as well as the development of personalized treatment strategies.

Retromolar intubation for the general anesthesia of maxillofacial fracture patients

BackgroundEvaluate the possibility of retromolar intubation for general anesthesia in patients with maxillofacial fractures.MethodsThe medical records of 54 patients with maxillofacial fractures who visited the Oral and Maxillofacial Surgery Department of Nantong First People’s Hospital from January 2020 to August 2022 were collected. The retromolar areas of each patient were measured from the coronal CT images, and correlated with the patient’s age, sex, type of fracture (i.e., maxillary fracture, mandibular fracture, or complex fracture of multiple maxillofacial bones), and the presence of the third molar (verified from 3D CT). The dimensions of the retromolar areas were finally compared with the outer diameter (OD) of standard endotracheal tubes (ETTs), most importantly the size 7.5 ETT (OD 10.3 mm) for male and the size 7.0 ETT (OD 9.8 mm) for female.ResultsThe survey included 38 male and 16 female patients, with an average age of 44.1 and 54.3 years, respectively. The dimensions of the retromolar area (height × width) were as follows: male, (9.39 ± 1.77) mm × (12.08 ± 0.98) mm on the left and (9.81 ± 2.23) mm × (11.77 ± 1.08) mm on the right; female, (8.82 ± 1.53) mm × (10.51 ± 1.00) mm on the left and (9.73 ± 1.60) mm × (10.63 ± 1.58) mm on the right. The width was always larger than the OD of the routinely used ETT, but the height could be smaller by less than 1 mm. However, the oral mucosa can be compressed to allow the ETT to fit in the retromolar area.ConclusionsThe retromolar area provided appropriate space to place a reinforced ETT for patients with maxillofacial fractures needing general anesthesia that must not interfere with intermaxillary ligation. Retromolar intubation can help maxillofacial fracture surgeries that focus on occlusal restoration.

Demographic and Radiographic Characteristics Associated with the Occurrence of Impacted Third Molars in Indonesian Patients: A Retrospective Study.

An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based on their radiographic features as well as their association with demographic characteristics. Outpatient dental records of the oral and maxillofacial surgery department of Hasan Sadikin Hospital, Bandung, Indonesia, from 1 January 2018 to 31 December 2019, were sorted, and relevant clinical and demographic data and panoramic radiographic examination results were extracted from these records. All data were then tabulated and analyzed by using SPSS version 29. As many as 3019 impacted third molars were identified. Our findings suggested the association between age to the occurrence of impacted third molars where patients aged between 17 and 29 years old showed high occurrences of impacted third molars. Male patients with impacted third molars are more likely to have multiple impacted third molars, while this risk decreases in females. Radiographic examination showed that the mesioangular position is the most common position for mandibular third molars. The variation in high occurrences of the impacted third molar is associated with several demographic factors.

Dental Notation System Used in Dental Teaching in Different Dental Collages

The aim of this study was to find the most commonly used Tooth Numbering System to teach and learn in dental collages in various universities (Benghazi University, Omar Mukhtar University and Libyan International Medical University) by both academic staff and fourth year dental students, to identify the most commonly taught TNS in different dental colleges, to understand the reason why dental staff prefer to use a specific TNS, and the consequences of using more than one TNS. This cross-sectional study was conducted within the dental collages of various Medical Universities. The questionnaire containing 11 questions was randomly distributed to 120 individuals (60 deans of academic staff and 50 fourth year dental students). The palmer notation system was the most commonly used to teach and learn by academic staff and dental students in teaching and practiced in dental collages, while the universal notation system was the least used to teach and learn by academic staff and dental students. As well as the most TNS preferred to use by academic staff and dental students in operative, oral surgery departments and orthodontic department in academic teaching was the palmer notation system while the least TNS use was universal notation system. The Palmer TNS proved to be the most taught TNS in dental colleges in different University. It is advised that the Palmer TNS be implemented as a unified system in my country, due to the advantages of this particular TNS and the benefits of using one single TNS.

Evaluating a Methodical Approach to Lingual Nerve Protection during Third Molar Surgery Using a Standardized Step-by-Step Procedure: A Retrospective Analysis

The aim of this study was to assess the methodical protection of the lingual nerve via the use of a standardized step-by-step procedure in the surgical extraction of the lower third molar. A 5-year retrospective analysis of surgical third molar surgery conducted by third-year oral surgery specialty program students was performed in the oral surgery department of Policlinico Umberto I in Rome, from 2017 to 2022. All surgeries were carried out using a standardized step-by-step procedure to protect the lingual flap during the surgery. Every patient underwent a review on the initial postoperative day, and subsequently, one week after the surgery, coinciding with the removal of the sutures. During each postoperative visit, thorough examinations were conducted to assess any sensory nerve impairment of the inferior alveolar, lingual, or mylohyoid nerves. None of the cases reported postsurgical lingual nerve injury; there was zero incidence of lingual nerve paresthesia or dysesthesia. The systematic application of lingual flap protection proved to be an effective and reproducible approach for the surgical removal of lower third molars without raising the risk of lingual nerve sensory impairment, regardless of the operator’s experience.

Sports-related Mandibular Fractures in the Center of Italy: A Retrospective Study.

The main causes of injuries to the lower and middle third of the facial skeleton are traffic accidents, accidental falls, assaults, and sport. Regarding sports-related maxillofacial trauma, an 8-year retrospective study was conducted at the Department of Oral and Maxillofacial Surgery of the Policlinico Umberto I in Rome, Italy. In all, 329 patients were included, of which we analyzed 35 patients with sports-related mandibular fractures. Specifically, we assessed the type of mandibular fracture reported, age, gender, number of fracture lines, association with other maxillofacial fractures, and treatment options. The causes of sports-related injuries are often multifactorial. Therefore, the aim of our study was to understand the correlation between the type of sport practiced and the most frequently reported pattern of mandibular fracture, highlighting how, depending on the sport, the mechanism of action is different and may correlate with a specific type of mandibular fracture.

The Effect of a Horizontal Apical Mattress Suturing Technique on the Width and Thickness of the Keratinized Mucosa After Dental Implant Surgery: A Cohort Study.

Introduction There is general agreement that a thick zone of the keratinized tissues around implants promotes accurate prosthetic procedures, permits oral hygiene maintenance, resists recession, and enables esthetic blending with surrounding tissues. A new procedure called Choukroun's technique has been suggested, and it consists of a combination of horizontal apical mattress suture with regular suture to increase the keratinized tissue in the mandibular arch during the first stage after implantation. The proposed procedure has not been evaluated yet in a cohort of patients. Therefore, this prospective study aimed to evaluate the impact of Choukroun's technique on the width and thickness of the keratinized gingiva after oral surgery. Materials and methods A one-group prospective cohort study was conducted on patients referred to the Department of Oral and Maxillofacial Surgery at the Dental College of Al-Wataniya Private University who had been referred to undergo dental implant surgery.The inclusion criteria for the study group were as follows: patients with mandibular missing teeth, good oral health, good general health, 18-70 years old, at least 1 mm thickness of keratinized gingiva, and at least 1 mm width of the attached gingiva. A total of 14 patients aged 27-67 years were included in the study. After inserting the dental implants, the suturing was accomplished according to Choukroun's method. The width and thickness of the keratinized gingiva were assessed before surgery and at one and two months post-surgery. Repeated measures analysis of variance (ANOVA) was applied to detect significant differences between assessment times. Results The study sample comprised 14 patients, of which four were females (28.6%) and 10 were males (71.4%). Patients' ages ranged from 27 to 67 years, with a mean age of 54.86 ± 11.73 years. The surgical procedure was performed in three different regions: the upper posterior teeth with four patients (28.6%), the upper anterior teeth with three patients (21.4%), and the lower posterior teeth with seven patients (50%). The mean gingival width before surgery was 5.78 mm, whereas the mean gingival thickness was 2.82 mm. There was no significant difference between the three evaluation times in the mean gingival width (P=0.222), and there was a significant difference between the three evaluation times in the mean gingival thickness (P<0.001). The mean mean gingival thickness one month after surgery was significantly greater than its mean value before surgery (mean difference: 0.749 mm). Additionally, the mean gingival thickness two months after surgery was significantly greater than its mean value before(mean differences: 0.636 mm). Conclusions Using horizontal apical mattress sutures (Choukroun's technique) does not provide any advantage in increasing the width of the keratinized gingiva. However, it does lead to an increase in the thickness of keratinized gingiva in the surgical area. Therefore, the use of horizontal apical mattress sutures is recommended.

Motivational Drivers in Implant Therapy: A Novel Treatment Motivation Scale.

Aim This study aims to assess patient motivation during implant therapy using the newly developed implant treatment motivation scale. Materials and methods A questionnaire study was conducted, consisting of 15 questions designed to explore the motivating factors behind patients' decision to undergo implant therapy. A total of 50 patients about to undergo implant treatment at the Departments of Periodontology, Oral and Maxillofacial Surgery, and Prosthodontics participated in the study. Results Analysis revealed a consistently high level of motivation (intrinsic and extrinsic) among all patients undergoing implant therapy. Conclusions The findings highlight the crucial role of motivation in treatment-seeking behavior, emphasizing the importance of dentists in motivating and guiding patients through the process of implant therapy.

Comparison of Different Genioplasty Techniques in Terms of Neurosensory Deficit and Haematoma Formation.

To compare different types of genioplasty techniques (chin advancement, rotation and advancement, setback, and reduction) in terms of neurosensory deficit and haematoma formation. Comparative analytical study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January 2022 to April 2023. Patients requiring genioplasty and fulfilling the inclusion criteria i.e. both genders aged 16-60 years were included and divided into 4 groups according to the type of genioplasty performed. Genioplasty was planned as per the ortho treatment plan and performed under general anaesthesia. Setback genioplasty was performed on 8 patients, advancement genioplasty on 11 patients, reduction genioplasty on 3, and advancement with rotation genioplasty on 16 patients. Postoperatively neurosensory deficit was recorded on follow-up after 1 month by subjective and objective assessments, and haematoma formation was assessed clinically on the 7th day after the procedure. Advancement with rotation genioplasty showed the highest frequency of neurosensory deficit (almost 50%) and reduction type genioplasty showed the least frequency of neurosensory deficit (<1%, p = 0.49). The frequency of haematoma formation was maximum in the advancement with rotation genioplasty (62.5%) and minimum in equal setback genioplasty (25%, p = 0.61). Advancement with rotation genioplasty had the highest rate of postoperative neurosensory deficit and haematoma formation when compared with other techniques of genioplasty. Genioplasty, Neurosensory deficit, Haematoma, Advancement with rotation genioplasty, Setback genioplasty.

Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznań University of Medical Sciences, Poznań, Poland

Introduction and aim. Anomalies in dental characteristics such as size, shape, number, structure, and eruption are commonly observed in clinical conditions. One such anomaly is the presence of supernumerary teeth found in various regions of the dental arch. Although frequently asymptomatic, supernumerary teeth are routinely identified during radiographic evaluations. Among the most common causes of impacted maxillary incisors is the presence of supernumerary teeth. Description of the case. Herein, we present a rare case of lower left canine impaction subsequent to a supernumerary fusion to the mandibular left incisor in a 10-year-old Caucasian female. Conclusion. This case contributes to the current knowledge regarding supernumerary fused teeth, emphasizing the importance of early intervention and multidisciplinary collaboration in effectively managing such developmental dental irregularities.

Frequency of Zygomatic Complex Fracture in Patients Presenting to Ayub Teaching Hospital

Zygomatic complex fractures are a prevalent type of facial injury. It often results from road traffic accidents (RTA). It poses significant clinical challenges. Objective: To find out the frequency of zygomatic complex fractures among patients introduced at the Ayub Teaching Hospital. Methods: This cross-sectional study was carried out in the Department of Oral and Maxillofacial Surgery at Ayub Teaching Hospital, Abbottabad, Pakistan after approval from IRB (Institutional Review Board) of the Ayub Teaching Hospital Abbottabad, (IRB-F5/Dent/AMC&amp;ATH) from September 1, 2019, to March 1, 2020. A total of 146 patients, including both genders and revealing oral and maxillofacial injury, were essential parts of the research. Before performing meticulous intra and extra-oral clinical examinations and computed tomography (CT) scans in the Department of Radiology to diagnose zygomatic complex fractures. Results: Out of the total number of 146 patients, 33.6% had ZMC fractures. The study involved patients aged 18-60 years. This is consistent with an average age of 31.993 ± 8.00 years and a mean weight of 74.664 ± 9.26 kg. Male patients represented 74.7% of cases and female comprised 25.3%. The primary causes of fractures were road traffic accidents, falls, and sports injuries. Conclusions: The research concluded that zygomatic complex fractures occurred due to road traffic accidents (RTA), which are more common in this region. Thus, the examination highlights the basic requirement for procedures to alleviate street mishaps to abridge such terrible facial injuries.