Objectives To compare Double Flap Incision (DF), Coronally Advanced Lingual Flap (CALF), and Modified Periosteal Releasing Incision (MPRI) to Periosteal Releasing Incision (PRI) in flap advancement, postoperative complications in augmentation using titanium mesh. Material and methods Forty patients with partially edentulous posterior mandibles were randomly assigned to the four groups. We evaluated: (a) Flap advancement in mm (Primary outcome). (b) Pain using the Numerical Rating scale (NRS). (c) Swelling using the Visual Analogue Scale (VAS). (d) Exposure in mm and exposure percentage at 1 week to 6 months. Results The CALF showed the highest mean flap advancement of 19.9 (±5.0) mm while the PRI showed the lowest; 10.2 (±1.7) mm. The difference between groups was statistically significant (P value <.0001). MPRI showed the highest pain score of 5.3 (±1.3) while the DF showed the lowest; 2.39 (±1.7). Swelling did not show a significant difference between groups. MPRI showed the highest exposure mean; 18.6 mm (±26.3) while CALF showed the lowest; 2.5 mm (±4.0). PRI showed the highest exposure percentage; 7.4% (±9.3) while CALF showed the lowest; 0.4% (±0.7). The difference between groups was insignificant. Conclusions CALF reported highest advancement, least complications while PRI reported the highest complications.

Objective: To evaluate and analyze the effect of platelet-rich plasma (PRP) injection on the scar formed after unilateral complete cleft lip scar repair using a modified Millard technique. Hypothesis: An unavoidable cheiloplasty scar is a result of the wound healing process that not only influences patient self-esteem for life but also affects muscle function. Design: Blind, randomized, controlled clinical trial. Patients: From December 2016 to February 2018, 24 patients with unilateral complete cleft lip undergoing primary cheiloplasties were equally assigned to study and control groups. Intervention: All patients were treated by modified Millard cheiloplasty. In the study group, PRP was injected into the muscle and skin layers immediately after wound closure, while the control group patients were treated with no PRP injection. Outcomes Measures: Scar width was assessed after 6 months through the muscle using ultrasonography and at the skin surface via photographs. Results: Scar width showed a significant improvement in the study group. Conclusions: Injection of autologous PRP provides effective improvement of cutaneous and muscular wound healing and decreases scar tissue formation.

Background Temporal hollowing is a common complication following the rotation of the temporalis muscle that leaves the patient with a cosmetic impairment. Several alloplastic materials have been used to reconstruct the donor site; however, these implants need meticulous adaptation to conform the periphery of the defect and restore the contour of the temporal area. The aim of this study was to assess the use of patient-specific polyetheretherketone (PEEK) temporal implants to prevent temporal hollowing following the use of full temporalis muscle flap for large maxillary defects reconstruction. Methods This was a prospective study conducted on eight patients with major maxillary defects indicating the need of reconstruction with full temporalis muscle flap or any lesion indicating major maxillary resection and immediate reconstruction with total temporalis muscle flap. For each patient, a patient-specific PEEK implant was fabricated using virtual planning and milled from PEEK blocks. In the surgical theater, the temporalis muscle was exposed, elevated, and transferred to the maxilla. After the temporalis muscle transfer, PEEK implants were fixed in place to prevent temporal hollowing. Results The surgical procedures were uneventful for all patients. The esthetic result was satisfactory with no post-operative complications except in one patient where seroma occurred after 2 weeks and resolved after serial aspiration. Conclusion Patient-specific PEEK implant appears to facilitate the surgical procedures eliminate several meticulous steps that are mainly based on the surgeon’s experience. Trial registration Clinical trials registration: NCT05240963.

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