No abstract

A 21-year-old female patient underwent wide excision of the buccal mucosa and tongue as well as selective neck dissection due to squamous cell carcinoma on the left side of the tongue. She had a severe limitation in opening her mouth, owing to fibrosis of the mucosa and scar contracture after adjuvant radiation therapy. Reconstruction of the oral mucosa and tongue defect was performed after removal of the scar to improve mouth opening. An anterolateral thigh (ALT) flap was used, trimmed to an adipofascial flap for the reconstruction of the thin and pliable oral mucosa and tongue. The maximum mouth opening improved to 40 mm intraoperatively and was 30 mm after surgery. The adipofascial ALT flap had excellent viability and presented neomucosa after secondary healing. An adipofascial flap obtained by trimming an ALT flap could be a reliable option for the reconstruction of thin and pliable oral mucosa after wide excision of oral cancer.

Background: Orthodontic anchorage is a technique used to avoid undesired tooth movement. The miniature screw (mini-screw) implant is an orthodontic innovation that was introduced to circumvent the limitations of conventional anchorage systems. Mini-screws, known as temporary anchorage devices (TADs), give clinicians good control over tooth movement in 3 dimensions and can assist orthodontists in anchorage-demanding cases.Methods: A questionnaire was distributed by online survey using SurveyMonkey and on paper during orthodontic meetings in Saudi Arabia. Collected data were analyzed using SPSS statistical software (version 23, IBM). A 2-way cross-tabulation and Fisher’s exact or Pearson chi-square tests were used to evaluate statistically significant differences. A P-value < 0.05 was considered to be statistically significant.Results: Of 133 respondents, 72 (54.1%) of practitioners worked in the governmental sector and 61 (45.9%) worked in the private sector. A total of (87.3%) of practitioners in the governmental sector and (80%) of practitioners in the private sector reported using mini-screws in clinical practice. Practitioners who reported that they did not use mini-screws in clinical practice listed the following reasons: “I don’t have enough information” (33.3%), “It’s a surgeon’s job” (11.1%), “Not available in the hospital” (29.6%), and “Other” (25.9%). A total of 60.2% of practitioners loaded mini-screws immediately, 8.3% loaded them 1 week after implantation, 11.3% loaded them 2-3 weeks after implantation, and 3.8% loaded them >3 weeks after implantation. Regarding the method of placement, 63.2% of practitioners used radiography for placement guidance/confirmation, 9.8% used a self-made guide, and 8.3% did not use a guide.Conclusions: Lack of education and training are major reasons that practitioners do not use orthodontic mini-screws in Saudi Arabia. Increased efforts to organize seminars and workshops may motivate practitioners to incorporate mini-screw usage into routine practice.