Purpose The recent coronavirus disease (COVID-19) pandemic mainly affects the respiratory system; however, several oral and maxillofacial post-COVID-19 complications have also been observed. This series reports the growing number of osteonecrosis cases associated with post-COVID-19 patients. Materials and methods This is a retrospective, multi-center case series that reports cases with maxillary osteonecrosis after various periods of SARS-CoV-2 infection in the period between January and August 2021 based on the PROCESS guidelines. Results Twelve cases were reported with post-COVID-19 manifestation of spontaneous osteonecrosis of the maxillary jaw. Five patients were hospitalized during COVID-19 management and all of the twelve cases had at least one systematic Co-morbidity, and undertake corticosteroids prescription based on the COVID-19 disease treatment protocol. The mean onset of osteonecrosis symptoms appearance was 5.5 ± 2.43 weeks calculated from the day of the negative PCR test. The management was successfully done through surgical debridement and pre and post-operative antibiotics. No anti-fungal medications were prescribed as the fungal culture and the histopathological report were negative. Conclusion Post-COVID-related osteonecrosis of the jaw (PC-RONJ) could be now considered as one of the potential post-COVID-19 oral and maxillofacial complications that occurs unprovokedly and mainly in the maxilla.

INTRODUCTION: Maxillofacial injuries, such as soft-tissue injuries, dental injuries, or maxillary, mandibular, and zygomatic fractures; are the most common injuries treated by oral and maxillofacial surgeons. In the last few years polyetheretherketone (PEEK) material was recognized as a material for maxillo-facial and cranial reconstructions. OBJECTIVES: The aim of this study is to evaluate the use of custom made polyetheretherketone (PEEK) plate in the treatment of mandibular fracture. MATERIALS AND METHODS: 10 patients having non-comminuted recent mandibular fracture will be treated using custom made PEEK plates. Clinical follow up will be conducted after 24-hours, one week, 1 month, 3 months and 6 months. Also, a radiographic investigation will be performed after 6 months to estimate the mean bone density across the fracture line. RESULTS: Data will be collected, summarized and statistically analyzed using the suitable methods. CONCLUSIONS: Fixation of mandibular fracture with custom made PEEK plate provides satisfying clinical and radiographic results after 6 months follow up.

INTRODUCTION:Scars widen when the underlying musculature (frontalis muscles, procerus, and corrugator supercilii muscles) pulls apart suture lines, and scars oriented against relaxed skin tension lines (RSTL) are especially susceptible to these distraction forces. Because botulinum toxin A (BTA) induces complete muscle paralysis, the purpose of the current study was to evaluate the effects of BTA using both observer dependent qualitative assessments and quantitative measurements to verify its beneficial effects on facial scarring. OBJECTIVE: To evaluate the efficacy and safety of Botulinum Toxin type A injection on improving vertical or oblique facial scars when injected in early postoperative days. MATERIALS AND METHODS: Twelve individuals with vertical or oblique recent forehead lacerations were randomly selected. The sample was chosen based on a set of inclusion and exclusion criteria and was then randomized to one of two groups:The BTA injection was given to one group (n = 6) within five days of primary closure, while the other group (n = 6) received no further treatment. Assessment included measurement of wound width and Vancouver scar scale, along with clinical photographs. RESULTS: In comparison to the control group, patients treated with BTA injections had a significant improvement in VSS and a less gain in wound width. At the 3-and 6-month examinations, all significant changes were found, but not at the 1-month appointment. All cases showed uneventful healing. CONCLUSION: This study showed that when BTA injections are administrated during the early postoperative days it shows great improvement in the scar quality.

OBJECTIVE:The purpose of this study was to assess the functional and aesthetical performance of transcervical submandibular incision for various procedures in the submandibular area. MATERIALS AND METHODS:The study is a prospective case series for the introduction of the patient and observer scar assessment scale in the postoperative assessment of linear surgical scars in the neck region. Primary outcome variable was the functional and aesthetical outcome performance of transcervical submandibular incision. Statistical significance was set at the 5% level. RESULTS: Twenty-one patients with various procedures in the submandibular area were enrolled in this study. Only three patients reported a transient mild dysfunction in the first week, which dissipated in the subsequent follow up period. The patient side of the scar assessment scale ranged from 7 to 19, with a mean record of 10.2 ± 3.45 and a total satisfaction rate of 85.7% was reported by the patients. The observer side of the scar assessment scale ranged from 19 to 25, with a mean record of 21.9 ± 1.42. Furthermore, an extreme degree of reliability was reported when evaluating the outcomes of both different observers (P<0.001). CONCLUSION:The transcervical approach granted the patients a safer approach, regarding the safety of the marginal mandibular nerve, and a more aesthetically pleasing outcome with superb patient satisfaction. Furthermore, the utilization of the Patient and Observer Scar Assessment Scale in linear facial scars assessment offers a reliable and consistent tool with easy to implement tool.

Objective:The purpose of this study was to to outline the performance of low profile 2.4-mm reconstruction plate in bridging segmental mandibular defects. Materials and methods:The study is a randomized clinical trial with a one-year follow up period. Patients requiring segmental resection was divided into Group I, managed with a low-profile 2.4-mm reconstruction plate, and Group II, managed with a regular 2.7-mm reconstruction plate. A long-term follow-up session was performed to outline plate related complications. Results: Twelve patients were included in this study and divided into two groups, and at the end of the follow up period one patient failed to recall. None of the cases in the study group suffered from plate related complications, while two cases reported major and minor Plate related complications in the control group. Conclusion: a 2.4-mm reconstruction plate utilized in the fixation and reconstruction of a segmental mandibular defect offers a more convenient fixation device with a comparable favorable clinical and radiographic outcomes as the conventional reconstruction plate.