1.Use of stem cells in bone regeneration in cleft palate patients:review and recommendations
Mohammad Amin AMIRI ; Fatemeh LAVAEE ; Hossein DANESTEH
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2022;48(2):71-78
This study was conducted to review the efficacy of different sources of stem cells in bone regeneration of cleft palate patients. The majority of previous studies focused on the transplantation of bone marrow mesenchymal stem cells. However, other sources of stem cells have also gained considerable attention, and dental stem cells have shown especially favorable outcomes. Additionally, approaches that apply the co-culture and co-transplantation of stem cells have shown promising results. The use of different types of stem cells, based on their accessibility and efficacy in bone regeneration, is a promising method in cleft palate bone regeneration. In this regard, dental stem cells may be an ideal choice due to their efficacy and accessibility. In conclusion, stem cells, despite the lengthy procedures required for culture and preparation, are a suitable alternative to conventional bone grafting techniques.
2.The effects of orthognathic surgery on auditory function
Farhad GHORBANI ; Hossein DANESTEH ; Afshin KHORAMNIA ; Saeid TAVANAFAR
Maxillofacial Plastic and Reconstructive Surgery 2021;43(1):11-
Background:
Orthognathic surgery is widely used in treating functional and skeletal problems. Any surgical procedure could cause side effects.
Objectives:
This study aimed to evaluate the potential changes in orthognathic surgery on the hearing function of patients.
Materials and methods:
Thirty-one orthognathic surgery candidates were recruited in this study. Patients underwent either single or double jaw surgery. Pure tone audiometry (PTA), tympanometry, and Eustachian Tube Dysfunction Test (ETFT) were performed postoperatively at 24 h, 6 weeks, and 6 months after surgery. Patients were tabulated based on the type of maxilla and mandibular surgical movements (vertical and horizontal).
Results:
PTA evaluation, based on horizontal or vertical movements, did not show significant differences, although vertical movements resulted in less change in hearing threshold. In other words, no significant changes occurred in patients’ hearing threshold after surgery. No significant difference was also observed between horizontal and vertical movements in the results of tympanometry. Negative changes were found in the results of ETFT in vertical movements, which returned to pre-surgery values in the final test.
Conclusions
The risk of minor changes in hearing function is probable during the first week after orthognathic surgery, but these negative changes will either totally fade or remain negligible. Patients gave informed consent preoperatively, and reassurance postoperatively is prudent.
3.Changes in the pharyngeal airway after different orthognathic procedures for correction of class III dysplasia
Mohammad Saleh KHAGHANINEJAD ; Leila KHOJASTEHPOUR ; Hossein DANESTEH ; Mehdi CHANGIZI ; Farzaneh AHRARI
Maxillofacial Plastic and Reconstructive Surgery 2022;44(1):23-
Objective:
This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity.
Methods:
The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images.
Results:
In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P < 0.05). In subjects who underwent maxillary advancement, the airway dimensions were significantly greater at T2 than the T0 time point (P < 0.05), whereas in the mandibular setback and bimaxillary surgery groups, the T2 values were lower than the baseline examination (P < 0.05). The alterations in airway variables were significantly different between the study groups (P < 0.05).
Conclusions
The mandibular setback procedure caused the greatest reduction in the pharyngeal airway, followed by the bimaxillary surgery and maxillary advancement groups, with the latter exhibiting an actual increase in the pharyngeal airway dimensions. It is recommended to prefer a two-jaw operation instead of a mandibular setback alone for correction of the prognathic mandible in subjects with predisposing factors to the development of sleep-disordered breathing.