1.A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia
Griet I.L. PARMENTIER ; Margaux NYS ; Laurence VERSTRAETE ; Constantinus POLITIS
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2022;48(3):133-148
Treatment of mandibular coronoid process hyperplasia (MCPH) has been described and explored in the literature. This systematic review aims to provide a comprehensive overview of the surgical and non-surgical treatment options for MCPH in pediatric and adult populations. Three databases were searched for treatment of MCPH patients (MEDLINE, Embase, and Web of Science). Two reviewers selected case reports and case series based on titles and abstracts. Finally, 55 studies reporting a total of 127 cases were included for qualitative synthesis and data extraction. The mean age at symptom onset was 15.6 years, while the mean age at diagnosis was 23.5 years. Of the included cases, 83.7% were male, and the condition was bilateral in more than 81% of the cases. Coronoidectomy was performed in 82.7% of the included cases, while coronoidotomy was performed in 3.9% of the cases. In 85.0% of the surgically treated cases, the approach was intraoral. The mean maximal intraoperative mouth opening was 38.1 mm compared with 16.5 mm at diagnosis. The mean maximal postoperative mouth opening was 35.3 mm, and the mean follow-up period was 16.3 months. Maximum mouth opening was achieved intraoperatively, and non-surgical treatment after surgery aims to reduce the risk of relapse. Additional research with a higher level of evidence is necessary to confirm these findings.
2.Late reconstruction of extensive orbital floor fracture with a patient-specific implant in a bombing victim
Maximiliaan SMEETS ; Robin SNEL ; Yi SUN ; Titiaan DORMAAR ; Constantinus POLITIS
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2020;46(5):353-357
Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patientspecific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.
3.Accuracy and reliability of 2-dimensional photography versus 3-dimensional soft tissue imaging
Irem AYAZ ; Eman SHAHEEN ; Medhat ALY ; Sohaib SHUJAAT ; Giulia GALLO ; Wim COUCKE ; Constantinus POLITIS ; Reinhilde JACOBS
Imaging Science in Dentistry 2020;50(1):15-22
PURPOSE:
This study was conducted to objectively and subjectively compare the accuracy and reliability of 2-dimensional (2D) photography and 3-dimensional (3D) soft tissue imaging.
MATERIALS AND METHODS:
Facial images of 50 volunteers (25 males, 25 females) were captured with a Nikon D800 2D camera (Nikon Corporation, Tokyo, Japan), 3D stereophotogrammetry (SPG), and laser scanning (LS). All subjects were imaged in a relaxed, closed-mouth position with a normal smile. The 2D images were then exported to Mirror® Software (Canfield Scientific, Inc, NJ, USA) and the 3D images into Proplan CMF® software (version 2.1, Materialise HQ, Leuven, Belgium) for further evaluation. For an objective evaluation, 2 observers identified soft tissue landmarks and performed linear measurements on subjects' faces (direct measurements) and both linear and angular measurements on all images (indirect measurements). For a qualitative analysis, 10 dental observers and an expert in facial imaging (subjective gold standard) completed a questionnaire regarding facial characteristics. The reliability of the quantitative data was evaluated using intraclass correlation coefficients, whereas the Fleiss kappa was calculated for qualitative data.
RESULTS:
Linear and angular measurements carried out on 2D and 3D images showed excellent inter-observer and intra-observer reliability. The 2D photographs displayed the highest combined total error for linear measurements. SPG performed better than LS, with borderline significance (P=0.052). The qualitative assessment showed no significant differences among the 2D and 3D imaging modalities.
CONCLUSION
SPG was found to a reliable and accurate tool for the morphological evaluation of soft tissue in comparison to 2D imaging and laser scanning.
4.In vivo quantification of mandibular bone remodeling and vascular changes in a Wistar rat model: A novel HR-MRI and micro-CT fusion technique
Dandan SONG ; Sohaib SHUJAAT ; Ruiting ZHAO ; Yan HUANG ; Eman SHAHEEN ; Jeroen Van DESSEL ; Kaan ORHAN ; Greetje Vande VELDE ; Ruxandra COROPCIUC ; Ruben PAUWELS ; Constantinus POLITIS ; Reinhilde JACOBS
Imaging Science in Dentistry 2020;50(3):199-208
Purpose:
This study was performed to introduce an in vivo hybrid multimodality technique involving the coregistration of micro-computed tomography (micro-CT) and high-resolution magnetic resonance imaging (HR-MRI) to concomitantly visualize and quantify mineralization and vascularization at follow-up in a rat model.
Materials and Methods:
Three adult female rats were randomly assigned as test subjects, with 1 rat serving as a control subject. For 20 weeks, the test rats received a weekly intravenous injection of 30 μg/kg zoledronic acid, and the control rat was administered a similar dose of normal saline. Bilateral extraction of the lower first and second molarswas performed after 10 weeks. All rats were scanned once every 4 weeks with both micro-CT and HR-MRI. Micro-CT and HR-MRI images were registered and fused in the same 3-dimensional region to quantify blood flow velocity and trabecular bone thickness at T0 (baseline), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks), T16 (16 weeks), and T20 (20 weeks). Histological assessment was the gold standard with which the findings were compared.
Results:
The histomorphometric images at T20 aligned with the HR-MRI findings, with both test and control rats demonstrating reduced trabecular bone vasculature and blood vessel density. The micro-CT findings were also consistent with the histomorphometric changes, which revealed that the test rats had thicker trabecular bone and smaller marrow spaces than the control rat.
Conclusion
The combination of micro-CT and HR-MRI may be considered a powerful non-invasive novel technique for the longitudinal quantification of localized mineralization and vascularization.