This study evaluated the impact of class III correction by elastic traction on four miniplates and the failure rate of bone-anchored miniplates in nonsyndromic patients. A total of 218 patients (112 males and 106 females; average 11.4 years), treated by 38 orthodontists, received four miniplates (total 872 miniplates) from 2008 to 2016 at three maxillofacial centers in two countries. Factors affecting the success and failure of the miniplates were retrospectively examined and skeletal changes on cephalometric radiographs examined for 52 patients. Elastic traction was performed for 22.9 months, on average. The miniplate survival rate was 93.6%; 25.7% of the patients suffered failure of one of the miniplates. Postoperative antibiotics and placement of the neck of the miniplate in the attached gingiva significantly improved the success rate. Miniplate failure was six times higher in the maxilla and occurred more in younger patients. Self-drilling screws were significantly better than self-tapping screws for fixing the miniplate. Small cephalometric changes were seen: SNA (+1.9°), SNB (+0.4°), ANB (+1.4°), Wits analysis (+1.3 mm). In conclusion, bone-anchored maxillary protraction on four miniplates is an effective method for correcting a class III relationship, but has less skeletal effect than previously reported in the literature.
A clinicopathological review of parotid tumours treated surgically in two oral and maxillofacial surgery departments was conducted. The performance of fine needle aspiration cytology (FNAC) was also assessed. This retrospective study included 250 consecutive patients treated surgically for parotid gland-related tumours. Benign tumours (n = 211, 84.4%) were more prevalent than malignancies (n = 39, 15.6%). A predominance of pleomorphic adenoma (48.8%) was identified, and epithelial-myoepithelial carcinoma (3.6%) was the most common malignant tumour. Overall, the sensitivity and specificity of FNAC were 64% and 99%, respectively. Subgrouping resulted in sensitivity and specificity of 50% and 100% for clinically assisted FNAC versus, 72% and 99% for ultrasound guidance. Surgically, 31.6% underwent complete superficial parotidectomy and 28.4% underwent extracapsular dissection. Overall, facial nerve palsy was the most prevalent postoperative complication, affecting 29.2% (70/240); loss of function was transient in 21.2% (51/240) and permanent in 7.9% (19/240). Extracapsular dissection and superficial parotidectomy with facial nerve preservation were the treatments of choice when a benign tumour was suspected. Facial nerve palsy was quite frequent; treatment options however are scarce. Preoperative diagnostic workup using imaging and ultrasound-guided FNAC was essential in identifying malignancy so that surgical planning could be adapted.
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