1.Establishing cleft services in developing countries: Complications of cleft lip and palate surgery in rural areas of Indonesia
Muhammad RUSLIN ; Lawrence DOM ; Andi TAJRIN ; Andi Sitti HAJRAH YUSUF ; Syafri Kamsul ARIF ; Andi Husni TANRA ; Keng Liang OU ; Tymour FOROUZANFAR ; Sri Astuti THAMRIN
Archives of Plastic Surgery 2019;46(6):511-517
BACKGROUND:
Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery.
METHODS:
This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene.
RESULTS:
In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ²=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ²=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ²=0.031; P<0.05).
CONCLUSIONS
Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.
2.Impacted mandibular third molars: a comparison of orthopantomography and cone-beam computed tomography imaging in predicting surgical difficulty
Husni MUBARAK ; Andi TAJRIN ; Mohammad GAZALI ; Nurwahida NURWAHIDA ; Fadhlil Ulum A. RAHMAN
Archives of Craniofacial Surgery 2024;25(5):217-223
Background:
This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT).
Methods:
In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05.
Results:
The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05).
Conclusion
CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.
3.Impacted mandibular third molars: a comparison of orthopantomography and cone-beam computed tomography imaging in predicting surgical difficulty
Husni MUBARAK ; Andi TAJRIN ; Mohammad GAZALI ; Nurwahida NURWAHIDA ; Fadhlil Ulum A. RAHMAN
Archives of Craniofacial Surgery 2024;25(5):217-223
Background:
This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT).
Methods:
In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05.
Results:
The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05).
Conclusion
CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.
4.Impacted mandibular third molars: a comparison of orthopantomography and cone-beam computed tomography imaging in predicting surgical difficulty
Husni MUBARAK ; Andi TAJRIN ; Mohammad GAZALI ; Nurwahida NURWAHIDA ; Fadhlil Ulum A. RAHMAN
Archives of Craniofacial Surgery 2024;25(5):217-223
Background:
This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT).
Methods:
In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05.
Results:
The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05).
Conclusion
CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.
5.Impacted mandibular third molars: a comparison of orthopantomography and cone-beam computed tomography imaging in predicting surgical difficulty
Husni MUBARAK ; Andi TAJRIN ; Mohammad GAZALI ; Nurwahida NURWAHIDA ; Fadhlil Ulum A. RAHMAN
Archives of Craniofacial Surgery 2024;25(5):217-223
Background:
This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT).
Methods:
In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05.
Results:
The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05).
Conclusion
CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.
6.Distribution of maternal risk factors for orofacial cleft in infants in Indonesia: a multicenter prospective study
Andi TAJRIN ; M. RUSLIN ; Muh. Irfan RASUL ; Nurwahida ; Hadira ; Husni MUBARAK ; Katharina OGINAWATI ; Nurul FAHIMAH ; Ikeu TANZIHA ; Annisa Dwi DAMAYANTI ; Utriweni MUKHAIYAR ; Asri ARUMSARI ; Ida Ayu ASTUTI ; Farah Asnely PUTRI ; Shinta SILVIA
Archives of Craniofacial Surgery 2024;25(1):11-16
Background:
The pathogenesis of orofacial cleft (OFC) is multifactorial, involving both genetic and non-genetic factors, the latter of which play a key role in the development of these anomalies. This paper addresses the incidence of OFC in Indonesia, with a focus on identifying and examining the distribution of contributory factors, including parental medical history, pregnancy history, and environmental influences.
Methods:
The study was conducted through the collection of primary data. An interdisciplinary research team from Indonesia administered a standardized questionnaire to parents who had children with OFC and who had provided informed consent. The case group comprised 133 children born with cleft lip and/or palate, and the control was 133 noncleft children born full-term. The risk factors associated with OFC anomalies were analyzed using the chi-square test and logistic regression. All statistical analyses were performed using SPSS version 25. A p-value of 0.05 or less was considered to indicate statistical significance.
Results:
The study comprised 138 children, of whom 82 were boys (59.4%) and 56 were girls (40.6%). Among them, 45 patients (32.6%) presented with both cleft lip and cleft palate, 25 individuals (18.1%) had a cleft palate only, and 28 patients (20.3%) had a cleft lip only. OFC was found to be significantly associated with a maternal family history of congenital birth defects (p< 0.05), complications during the first trimester (p< 0.05), consumption of local fish (p< 0.05), caffeine intake (p< 0.05), prolonged medication use (p< 0.05), immunization history (p< 0.05), passive smoking (p< 0.05), and X-ray exposure during pregnancy (p< 0.05).
Conclusion
The findings indicate close relationships between the incidence of OFC and maternal medical history, prenatal factors, and environmental influences.