Objectives: To evaluate changes in bone volume induced by absorbable collagen sponge (ACS) use during maxillary sinus floor elevation and to identify associated factors. Patients and Methods: After elevating the sinus membrane through a crestal approach (CA) or lateral approach (LA), ACS (AteloPlug; Bioland) was inserted, and dental implants were placed simultaneously. Changes in bone volume at 12 months were evaluated by three-dimensional (3D) analyses of cone-beam computed tomography images. Factors including age, sex, smoking status, span, number of ACSs, and perforation were assessed for associations with changes in sinus bone volume using uni- and multivariable analyses based on the generalized estimating equation. Results: Medical records of 108 patients were collected and retrospectively evaluated, with 135 regions of interest defined (CA, 45; LA, 90). The changes in bone volume at the sinus floor were 159.38±134.52 mm 3 and 486.83±253.14 mm 3 in the CA and LA groups, respectively. Bone volume changes in the CA group were significantly affected by the number of ACSs (P<0.001) and perforation of the sinus membrane (P<0.001), whereas bone volume changes in the LA group were significantly affected by the number of ACSs (P=0.001). Conclusion Use of ACS for maxillary sinus elevation resulted in detection of new bone formation in 3D analysis. Clinicians can ensure stable amounts of bone formation by inserting an adequate number of ACSs.

Objectives: To evaluate changes in bone volume induced by absorbable collagen sponge (ACS) use during maxillary sinus floor elevation and to identify associated factors. Patients and Methods: After elevating the sinus membrane through a crestal approach (CA) or lateral approach (LA), ACS (AteloPlug; Bioland) was inserted, and dental implants were placed simultaneously. Changes in bone volume at 12 months were evaluated by three-dimensional (3D) analyses of cone-beam computed tomography images. Factors including age, sex, smoking status, span, number of ACSs, and perforation were assessed for associations with changes in sinus bone volume using uni- and multivariable analyses based on the generalized estimating equation. Results: Medical records of 108 patients were collected and retrospectively evaluated, with 135 regions of interest defined (CA, 45; LA, 90). The changes in bone volume at the sinus floor were 159.38±134.52 mm 3 and 486.83±253.14 mm 3 in the CA and LA groups, respectively. Bone volume changes in the CA group were significantly affected by the number of ACSs (P<0.001) and perforation of the sinus membrane (P<0.001), whereas bone volume changes in the LA group were significantly affected by the number of ACSs (P=0.001). Conclusion Use of ACS for maxillary sinus elevation resulted in detection of new bone formation in 3D analysis. Clinicians can ensure stable amounts of bone formation by inserting an adequate number of ACSs.

Objectives: To evaluate changes in bone volume induced by absorbable collagen sponge (ACS) use during maxillary sinus floor elevation and to identify associated factors. Patients and Methods: After elevating the sinus membrane through a crestal approach (CA) or lateral approach (LA), ACS (AteloPlug; Bioland) was inserted, and dental implants were placed simultaneously. Changes in bone volume at 12 months were evaluated by three-dimensional (3D) analyses of cone-beam computed tomography images. Factors including age, sex, smoking status, span, number of ACSs, and perforation were assessed for associations with changes in sinus bone volume using uni- and multivariable analyses based on the generalized estimating equation. Results: Medical records of 108 patients were collected and retrospectively evaluated, with 135 regions of interest defined (CA, 45; LA, 90). The changes in bone volume at the sinus floor were 159.38±134.52 mm 3 and 486.83±253.14 mm 3 in the CA and LA groups, respectively. Bone volume changes in the CA group were significantly affected by the number of ACSs (P<0.001) and perforation of the sinus membrane (P<0.001), whereas bone volume changes in the LA group were significantly affected by the number of ACSs (P=0.001). Conclusion Use of ACS for maxillary sinus elevation resulted in detection of new bone formation in 3D analysis. Clinicians can ensure stable amounts of bone formation by inserting an adequate number of ACSs.

Implant placement may be restricted by anatomical and/or financial limitations in restoring a completely edentulous arch, or the patients’ unwillingness to have extensive surgical procedures. Implant assisted removable partial dentures (IARPD) in combination with anterior fixed implant prostheses can be proposed as an alternative treatment option for the restoration of a completely edentulous arch. In this case, a 56-year-old female patient who has a fully edentulous maxilla opposed by partially edentulous mandible was treated. The treatment option for the maxilla consisted of an implant-assisted removable partial denture supported by four anterior fixed implant prostheses. The mandible was restored with 8 anterior fixed partial dentures and posterior fixed implant-supported prostheses.Long-term follow-up and supportive periodontal treatment were performed for 9years, and the patient was satisfied with the overall appearance as well as masticatory function.

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pres-sure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer’s assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had simi-lar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combinedwith RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm2 , with a mean of 33.05 cm2 . Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.

OBJECTIVES: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.MATERIALS AND METHODS: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.RESULTS: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).CONCLUSION: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.
Anticoagulants ; Electrocoagulation ; Emergency Service, Hospital ; Emergency Treatment ; Fibrinolytic Agents ; Gingiva ; Hemorrhage ; Humans ; Liver Cirrhosis ; Male ; Methods ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Surgery, Oral ; Sutures ; Tooth Extraction ; Tranexamic Acid

OBJECTIVE: This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population. METHODS: This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD. RESULTS: Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189–2.190), 1.573 (1.162–2.129) and 1.612 (1.182–2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289–2.454), 1.742 (1.265–2.400) and 1.770 (1.280–2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment. CONCLUSIONS Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

OBJECTIVES: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. MATERIALS AND METHODS: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. RESULTS: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). CONCLUSION A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

BACKGROUND: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. METHODS: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. RESULTS: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications—observed in 126 patients—had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. CONCLUSIONS: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-018-0168-y) contains supplementary material, which is available to authorized users.
Accidental Falls ; Accidents, Traffic ; Hospitalization ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Postoperative Complications ; Retrospective Studies ; Zygoma