Background The quality of the healing response after oral and maxillofacial surgery (OMS) is influenced by the nature of the tissue disruption and the circumstances surrounding wound closure. The use of wound healing scales may help the surgeon anticipate and, when possible, intervene so that wound repair can progress favorably. Materials and Methods Studies reported in the OMS literature of the last 20 years that applied scales/indexes to monitor the wound healing process were reviewed. Results We identified eight scales/indexes that were developed for use in OMS, including three that are modifications of a previously reported scale. Most were applied in split‐mouth trials of wound healing modifiers. Conclusion Wound healing scales are infrequently used in OMS. Those that are available do not allow for an association of the outcome parameters, modifiers used, or effectiveness of the modifiers with the different phases of the wound healing process (inflammatory, proliferative, and remodeling). Moreover, there is no consensus regarding the time frames that should be evaluated or the preferred scale. On the basis of these findings, we suggest a novel scale that distinguishes among the wound healing phases and yields three subscale scores and a total score.
Background Electric bikes (E-bikes) and powered scooters (P-scooters) have become increasingly popular modes of public transportation, but they have been associated with injuries of all kinds, including dental trauma. Helmet use is promoted as a means of reducing injuries in accidents involving motorized and unmotorized vehicles. The aim of the study was to evaluate the impact of helmet use on the number and severity of oral and maxillofacial injuries caused by E-bikes and P-scooters. Methods A retrospective cross-sectional study design was used. The cohort included all patients referred to the emergency department of a tertiary medical center in 2014–2020 with oral and maxillofacial injuries involving E-bikes or P-scooters. Data were collected from the medical files on demographics, types of injuries, circumstances of occurrence, work-up, treatment, and outcome. Use of a helmet was recorded in each case. Results Of the total 1417 patients referred to the emergency department for E-bike and P-scooter-related trauma, 62 had oral and maxillofacial injuries, including 57 riders and 5 pedestrians. All had hard- or soft-tissue injuries; 20 (32.2%) had head injuries and 22 (35.5%) had dentoalveolar injuries. Eleven riders had worn a helmet at the time of injury (17.7%). Helmet use was associated with time of injury (weekday/weekend, daytime/night-time), type of motorized vehicle (E-bike or P-scooter), head injury, and number of bone fractures. Head injuries occurred more often on the weekend (57.9%) than during the week (20.9%) and were more likely to occur in riders who were not protected by a helmet (37.3% vs 18.2%). Patients who used helmets also had a lower rate of fractured bones (18.2%) and dentoalveolar injuries (23.7%) than patients who did not (68.8 and 37.3%, respectively). Interestingly, helmet use had no protective effect on soft-tissue injuries. Conclusions Helmet use by E-bike and P-scooter riders decreased the probability of head injury and of hard tissue and dentoalveolar injuries. These results may provide guidance for effective legislation and regulation of helmet use and improved treatment protocols for general and dental physicians.
Background and purpose: Immediate implants placement (IIP) are considered a reliable procedure, with survival rates of 94.9% to 98.4%. Nevertheless, in the posterior mandible it poses high risk of damage to anatomical structures. The aim of this study was to determine the risk of anatomical structures injury associated with IIP in the posterior mandible based on apical primary stability, respecting a safe distance from inferior alveolar nerve (IAN) and lingual plate. Moreover, to evaluate the influence of different factors on those risks. Materials and methods: Pre-extraction cone beam computed tomography (CBCT) scans of 100 patients were retrospectively analyzed. Measurements were taken from tooth apices to lingual plate and to mandibular canal. Values of <4mm of the former and <6mm of the later categorized as considerable risk. Values of <2mm at both measurements considered as high risk. Two-sided p values <0.05 were considered statistically significant. Results: Mean root-to-alveolar canal (RAC) distance was 7.6±2.7mm in the first molar, 6.5±3mm in second premolar and 5.4±3 mm in the second molar ( p <0.005). Mean distance to the outer lingual cortex (DLC) was 3.9±2.1mm in the first molar and 3.2±0.1mm in the second molar. Thus, second molars were at the higher risk of inferior alveolar nerve injury and lingual plate perforation during IIP. Background factors associated with higher IIP risk were female sex and age <40 years. Conclusions: In the mandible, the anatomic risk posed by IIP is greatest for second molars and lowest for first molars. Several background factors affect the distances between root apices and the mandibular canal.
Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.
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