OBJECTIVES: This study aimed to analyze the application value of a modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction. METHODS: Condyle reconstruction was performed in 16 patients (9 females and 7 males) with modified tragus edge incision and transmasseteric anteroparotid approach. After regular follow-up, the function of condyle reconstruction was evaluated by clinical indicators, such as parotid salivary fistula, facial nerve function, mouth opening, occlusal relationship, and facial scar. The morphology of rib graft rib cartilage was evaluated by imaging indicators, such as panoramic radiography, CT, and three-dimensional CT image reconstruction. RESULTS: At 6-36 months postoperative follow-up, all patients had good recovery of facial appearance, concealed incisional scar, no parotid salivary fistula, good mouth opening, and occlusion. One case had temporary facial paralysis and recovered after treatment. Radiographic evaluation further showed that costochondral graft survived in normal anatomic locations. CONCLUSIONS The modified tragus edge incision and transmasseteric anteroparotid approach can effectively reduce parotid salivary fistula and facial nerve injury in condylar reconstruction. The surgical field was clearly exposed, and the incision scar was concealed without increasing the incidence of other complications. Thus, this approach is worthy of clinical promotion.
Male ; Female ; Humans ; Mandibular Condyle/surgery* ; Cicatrix/surgery* ; Fracture Fixation, Internal/methods* ; Mandibular Fractures/surgery* ; Oral Surgical Procedures/methods* ; Treatment Outcome

OBJECTIVE: To evaluate the changes of periodontal phenotype (width of keratinized gingiva, thickness and height of alveolar bone) of lower anterior teeth in patients with skeletal class Ⅲ malocclusion before and after the periodontal-orthodontic-orthognathic combined treatment. METHODS: In the study, 20 patients with skeletal class Ⅲ malocclusion (6 males and 14 females) completed the periodontal-orthodontic-orthognathic combined treatment were included from March 2017 to June 2022, with 39 central incisors, 40 lateral incisors and 40 canines. The mean age was (25.40±4.27) years (20-34 years). The mean follow-up time was (3.70±1.05) years from the beginning of periodontal corticotomy regenerative surgery (PCRS) to the end of the combined treatment. Cone-beam computed tomography (CBCT) was used to measure the thickness, area and height of alveolar bone by the same researcher, taken before the PCRS (T0), 6 months after the PCRS (T1), 12 months after the PCRS (T2), before the orthognathic surgery (T3), and after the periodontal-orthodontic-orthognathic combined treatment (T4). The periodontal clinical parameters were used to evaluate changes in the soft tissue by another researcher, measured before the PCRS (T0) and after the combined treatment (T4). Changes of soft and hard tissue were evaluated by the periodontal phenotype. RESULTS: The width of keratinized gingiva increased significantly (all P < 0.001) in lower anterior teeth, the central incisors, lateral incisors and canines increased by (1.82±1.57) mm, (2.03±1.48) mm and (2.05±1.27) mm, respectively. The proportion of thick periodontal biotype in the central and lateral incisors increased significantly (all P < 0.001), while the changes of periodontal biotypes in the lower canines were not obvious. The thickness of labial alveolar bone of lower anterior teeth all increased significantly after periodontal corticotomy regenerative surgery and the combined treatment (all P < 0.001). The area of labial alveolar bone of lower anterior teeth also increased significantly after the combined treatment (all P < 0.001). The whole area of labial and lingual alveolar bone of central and lateral incisors increased (P < 0.001), while the whole area of canines remained the same. All The height of the alveolar bone increased (all P < 0.001) on the labial side after the treatment. CONCLUSION The periodontal phenotypes of lower anterior teeth were significantly improved after the periodontal-orthodontic-orthognathic combined treatment in patients with skeletal Angle class Ⅲ malocclusion. The improvement was long-termly stable, and the periodontal risk was reduced.
Male ; Female ; Humans ; Malocclusion, Angle Class III/surgery* ; Oral Surgical Procedures ; Incisor ; Cone-Beam Computed Tomography/methods*

Objective To compare the impacts of different nostril on nasotracheal intubation with video laryngoscopy.Methods Totally 120 ASA grade I maxillofacial surgery patients were equally randomized into two groups:group A(left nostril)and group B(right nostril).After rapid induction of anesthesia,the nasal intubation was completed by Tosight video laryngoscope,and the success rate of the first attempt of the tube passing through the nasal cavity was recorded and compared between these two groups.In addition,time of tube through nasal cavity,time of glottis exposure,total intubation time,intubation success rate,and nasal bleeding were recorded.Results The success rate of the first attempt of tube passing through the nasal cavity was not significantly different between groups A and B(84.7% . 81.7%;=0.202,=0.653).The time of tube passing through nasal cavity [(7.3±4.6)s .(7.5±4.1)s;=-0.223,=0.824] and the time of glottic exposure [(6.6±1.4)s .(6.7±1.4)s;=-0.348,=0.728] had no significant differences between two groups.The success rates of first intubation attempt were 100% in both groups.The total intubation time was(35.1±9.2)s in group A and(34.0±7.8)s in group B(=0.663,=0.509).Intubation-related epistaxis was found in 16 cases(27.1%)in group A and in 17 cases(28.3%)in group B( =0.022,=0.882).Conclusion Different nasal approaches have no effect on nasal intubation.
Glottis ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopes ; Laryngoscopy ; Nasal Cavity ; Oral Surgical Procedures

PURPOSE: Analyzing different patterns of maxillary sinus septa in cone-beam computed tomography (CBCT) images and predicting maxillary sinus membrane perforations. MATERIALS AND METHODS: In this cross-sectional study, CBCT images of 222 patients ranging from 20 to 81 years old were evaluated. One hundred fifty-two patients (93 females and 59 males) who had maxillary sinus septa in axial views were included in this study. Cross-sectional images were used to determine classifications of sinus septa and the risk of membrane perforation using a method modified from Al-Faraje et al. Variables of sex, age, and dental status were considered. Chi-squared and Kruskal-Wallis tests were used for data analysis (P < .05). RESULTS: In this study, 265 maxillary sinus septal patterns were found. The mean age of the patients was 44.1±14.7 years old. The Class I and VII-div II patterns had the greatest and least prevalence, respectively. Furthermore, there was a significant relationship between the location of septa and the frequency of membrane perforation risk (P < .05). In this study, the relationship of different patterns of septa with dental status did not differ significantly (P>0.05). CONCLUSION: A higher prevalence of moderate risk of membrane perforation in the molar region relative to the premolar region was observed. Furthermore, maxillary sinus septa occur most frequently in the molar region, demonstrating the importance of paying attention to this region during sinus lift surgery. This study did not show any relationship between tooth loss and the presence of septa.
Bicuspid ; Classification ; Cone-Beam Computed Tomography* ; Cross-Sectional Studies ; Female ; Humans ; Lifting* ; Maxillary Sinus* ; Membranes* ; Methods ; Molar ; Oral Surgical Procedures ; Prevalence ; Statistics as Topic ; Tooth Loss

A new method using the ideal mid-facial line as the navigating reference was introduced to improve the outcome of cleft lip repair. Using the verticle coordinate crossing the middle point of the intercanthus line, surgeons could observe and correct the distortion of the fine structures in labial-nasal area. This laser projecting mid-facial-line navigation was repeatable, while not interfere the operating. In conclusion, generalizing laser navigation is a valuable supplementary for cleft lip repair.
Cleft Lip ; surgery ; Face ; Lasers ; Nose ; Oral Surgical Procedures ; methods ; Surgical Flaps ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Oroantral fistula is an epithelialized communication between the oral cavity and the maxillary sinus. The aim of this study is to investigate the clinical characteristics and treatment of oroantral fistula. SUBJECTS AND METHOD: Patients who have undergone treatment for oroantral fistula between May 1995 and December 2015 were enrolled in this study. The demographic data of these patients and characteristics of oroantral fistula were analyzed. Patients with oroantral fistula were initially administered oral antibiotics for 3 weeks. If fistula persists in spite of the medication, surgery (soft tissue flap with or without bone graft) was performed. The surgical results according to the presence of bone graft were compared. RESULTS: Twenty-two patients were in accordance with the inclusion criteria. The male to female ratio of patients was 12:10, with the mean age of 47.9±13.4 years. The main complaint of patients was pus discharge from the fistula. Two patients were successfully treated with antibiotics whereas 20 patients underwent surgery. Recurrence occurred in 3 patients, who were treated with soft tissue flap, but no recurrence developed in the patients treated with soft tissue flap and bone graft. Although dehiscence of soft tissue flap occurred in one patient treated with bone graft, it was successfully treated by secondary intention without an additional surgery. CONCLUSION: Bone graft bears the negative pressure of the oral cavity and the weight of secretions including the blood. In addition, it induces secondary intention for the dehiscence of the flap. In this regard, bone graft seems to contribute to the surgical success of oroantral fistula.
Anti-Bacterial Agents ; Bone Transplantation ; Female ; Fistula ; Humans ; Intention ; Male ; Maxillary Sinus ; Methods ; Mouth ; Oral Surgical Procedures ; Oroantral Fistula* ; Recurrence ; Suppuration ; Surgical Flaps ; Transplants

Dental Implantation ; methods ; Humans ; Maxillary Sinus ; Oral Surgical Procedures, Preprosthetic ; Pressure ; Sinus Floor Augmentation ; methods

OBJECTIVETo examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects.

METHODSPatients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1,185 patients, 1,212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed.

RESULTSAmong the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=-0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05).

CONCLUSIONAnterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.

Free Tissue Flaps ; Humans ; Maxillofacial Abnormalities ; surgery ; Myocutaneous Flap ; Necrosis ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; statistics & numerical data ; Surgery, Oral ; Thigh ; Wound Healing

Adenoma, Pleomorphic ; diagnosis ; diagnostic imaging ; surgery ; Adolescent ; Adult ; Aged ; Angiography, Digital Subtraction ; Carcinoma, Adenoid Cystic ; diagnosis ; diagnostic imaging ; surgery ; Chemotherapy, Adjuvant ; Child ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; diagnostic imaging ; surgery ; Oral Surgical Procedures ; methods ; Postoperative Complications ; Radiotherapy, Adjuvant ; Tomography, X-Ray Computed ; Young Adult

This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry, by implementing surgical planning with SimPlant OMS. Using this method, we conducted LF1 osteotomy, intraoral vertical ramus osteotomy (IVRO), sagittal split ramus osteotomy (SSRO), mandibular constriction and mandibular border genioplasty. Not only did we obtain a class I occlusal relationship, but the complicated surgery also improved the asymmetry of the frontal view, as well as of the profile view, of the patient. The virtual operation using three-dimensional computed tomography (3D-CT) could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.
Adult ; Facial Asymmetry ; complications ; diagnostic imaging ; surgery ; Genioplasty ; Humans ; Imaging, Three-Dimensional ; Jaw Abnormalities ; complications ; diagnostic imaging ; surgery ; Male ; Mandible ; abnormalities ; diagnostic imaging ; surgery ; Occlusal Splints ; Oral Surgical Procedures ; methods ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus ; Patient Care Planning ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed