Description

This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices.

Publisher details

Elsevier

Publications in this journal

• Logistic regression analysis of risk factors for the development of alveolar osteitis.

  Authors: Diego Halabí, José Escobar, Carlos Muñoz, Sergio Uribe

  Journal of Oral and Maxillofacial Surgery. 70(5):1040-4.

  PURPOSE: To assess risk factors for alveolar osteitis. MATERIALS AND METHODS: A prospective nested case-control study was conducted in an urban community dental clinic in Valdivia, Chile. A cohort ofPURPOSE: To assess risk factors for alveolar osteitis. MATERIALS AND METHODS: A prospective nested case-control study was conducted in an urban community dental clinic in Valdivia, Chile. A cohort of 1,355 patients who underwent dental extractions was included. Eight predictor variables (risk factors), namely patient gender, hygiene, tooth location, previous surgical site infection, traumatic extraction, systemic diseases, alcohol consumption, and tobacco use, were considered in a risk factor model. A binary regression logistic analysis was performed to determine significant associations. RESULTS: In total 1,302 participants completed the follow-up. Eighty incident case patients with alveolar osteitis and 80 matched control patients were included. A statistically significant association was found between traumatic extraction (odds ratio [OR], 13.1; 95% confidence interval [CI], 5.4 to 31.7), tobacco smoking after extraction (OR, 3.5; 95% CI, 1.3 to 9.0), previous surgical site infection (OR, 3.3; 95% CI, 1.4 to 7.7), and the development of alveolar osteitis. CONCLUSIONS: Previous surgical site infection, traumatic extraction, and tobacco smoking are associated with an increased risk of alveolar osteitis.

• Incidence of oral cancer among south Asiansand those of other ethnic groups by sex in West Yorkshire and England

  Authors: Csikar J, Aravani A, Godson J, Day M, Wilkinson J

  Journal of Oral and Maxillofacial Surgery.

• Aksu M, Sağlam-Aydınatay B, Akcan C, El H, Taner T Kocadereli İ, Tunçbilek G, Mavili E : Skeletal and dental stability following distraction with rigid external device (RED) in adult cleft lip and palate patients, Journal of Oral and Maxil

  Authors: Aksu M, Sağlam-Aydınatay B, Akcan C, El H, Taner T Kocadereli İ, Tunçbilek G, Mavili E

  Journal of Oral and Maxillofacial Surgery.

• Are you a politician? The oral and maxillofacial surgeon leader.

  Authors: Leon A Assael

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2135.

• Torsion strength of biodegradable and titanium screws: a comparison.

  Authors: Gerrit J Buijs, Eduard B van der Houwen, Boudewijn Stegenga, Rudulf R M Bos, Gijsbertus J Verkerke

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2142-7.

  PURPOSE: To determine 1) the differences in maximum torque between 7 biodegradable and 2 titanium screw systems, and 2) the differences of maximum torque between "hand tight" and break of thePURPOSE: To determine 1) the differences in maximum torque between 7 biodegradable and 2 titanium screw systems, and 2) the differences of maximum torque between "hand tight" and break of the biodegradable and the titanium osteofixation screw systems. MATERIALS AND METHODS: Four oral and maxillofacial surgeons inserted 8 specimens of all 9 screw systems in polymethylmethacrylate plates. The surgeons were instructed to insert the screws as they would do in the clinic (hand tight). The data were recorded by a torque measurement meter. A PhD resident inserted 8 specimens of the same set of 9 screw systems until fracture occurred. Likewise, the maximum applied torque was recorded. RESULTS: 1) The mean maximum torque of the 2 titanium screw systems was significantly higher than that of the 7 biodegradable screw systems, and 2) the mean maximum torque for hand tight was significantly lower than for break in 2 biodegradable, and both titanium screw systems. CONCLUSIONS: Based on the results, we conclude that the 1.5 mm and 2.0 mm titanium screw systems still present the highest torque strength compared with the biodegradable screw systems. When there is an intention to use biodegradable screws, we recommend the use of 2.0 mm BioSorb FX (Linvatec Biomaterials Ltd, Tampere, Finland), 2.0 mm LactoSorb (Walter Lorenz Surgical Inc, Jacksonville, FL), or the larger 2.5 mm Inion (Inion Ltd, Tampere, Finland) screws.

• Risk Factors for Methicillin-Resistant Staphylococcus aureus (MRSA) and Use of a Nasal Mupirocin Ointment in Oral Cancer Inpatients.

  Authors: Minoru Miyake, Yumiko Ohbayashi, Akinori Iwasaki, Takaaki Ogawa, Shunichiro Nagahata

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2159-63.

  PURPOSE: Elimination of methicillin-resistant Staphylococcus aureus (MRSA) is of critical importance in oral and maxillofacial surgery because control is very difficult once infection of an oralPURPOSE: Elimination of methicillin-resistant Staphylococcus aureus (MRSA) is of critical importance in oral and maxillofacial surgery because control is very difficult once infection of an oral tumor or oral wound with MRSA is established. PATIENTS AND METHODS: We retrospectively investigated the risk factors for acquiring MRSA in 518 patients with oral cancer among 1,877 inpatients in our department between 1984 and 2005. RESULTS: The patients with oral cancer demonstrated a high rate of MRSA colonization and infection (77.8%) relative to the population as a whole with MRSA isolated percentage in our department after 1991. The risk factors for MRSA in oral cancer patients are also related to systemic diseases and physiological and iatrogenic conditions, including cerebrovascular diseases (77.8%), peripheral arterial catheterization (69.2%), diabetes (50.0%), tracheotomy (50.0%), renal failure (50.0%), long-term broad-spectrum antibiotic use (45.7%), and malnutrition (43.3%). However, the highest risk of MRSA seems to be related to poor hygienic care. CONCLUSIONS: Beginning in 1999, we implemented a strategy for reducing infection by MRSA that included nasal mupirocin ointment for patients at high risk of MRSA; since then, the detection rate has decreased. We suggest that the administration of nasal mupirocin ointment and provision of scrupulous hygienic care for high-risk patients are useful and effective measures for decreasing the incidence of MRSA infection.

• Histological and histomorphometric analysis of the bone-screw interface in the mandibular body after using a 2.0-mm miniplate system: an experimental study in dogs.

  Authors: Thiago Iafelice dos Santos, Paulo Tambasco de Oliveira, Adalberto Luiz Rosa, Valdemar Mallet da Rocha Barros, Vula Papalexiou, Cássio Edvard Sverzut

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2169-75.

  PURPOSE: To evaluate the bone-screw interface in a 2.0-mm miniplate system used for rigid internal fixation (RIF). MATERIALS AND METHODS: Nine adult mongrel dogs were subjected to unilateralPURPOSE: To evaluate the bone-screw interface in a 2.0-mm miniplate system used for rigid internal fixation (RIF). MATERIALS AND METHODS: Nine adult mongrel dogs were subjected to unilateral continuous defect through an osteotomy between the lower third and fourth premolars. The control contralateral side remained untreated. Two 4-hole miniplates were placed bilaterally according to the Arbeitgeimeinschaft für Osteosynthesefragen manual. Miniplates adapted to the alveolar processes were fixed monocortically with 6.0-mm-long titanium alloy screws, whereas miniplates placed near the mandible base were fixed bicortically. At 2, 6, and 12 weeks, mandible segments enclosing the RIF were removed, fixed in formalin, ground-sectioned, and stained with toluidine blue. Under conventional light microscopy, proportions of bone-to-screw contact (BSC) were determined, and data were compared by analysis of variance. RESULTS: At 2 weeks, for both groups, the area between threads exhibited necrotic bone with multiple cracks and absence of bone cells and blood vessels. At 6 and 12 weeks, new Haversian systems progressively replaced necrotic bone. At each time point, no significant differences were seen between screws placed in the same miniplate or between groups. The proportions of BSC were statistically similar at 2 and 6 weeks and lower at 12 weeks. CONCLUSION: The results suggested that in this model, osteotomy did not significantly alter bone repair adjacent to the screw surface.

• Oral malignant melanoma: the amsterdam experience.

  Authors: Marco Meleti, C René Leemans, Wolter J Mooi, Isaäc van der Waal

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2181-6.

  PURPOSE: The purpose of this study was to evaluate the clinical, pathological, and therapeutic experience of a group of patients with primary oral malignant melanoma (OMM) in Amsterdam, ThePURPOSE: The purpose of this study was to evaluate the clinical, pathological, and therapeutic experience of a group of patients with primary oral malignant melanoma (OMM) in Amsterdam, The Netherlands. PATIENTS AND METHODS: Fourteen patients (5 males, 9 females, mean age 57.9 years) with histopathologic diagnosis of OMM were treated at the Department of Oral and Maxillofacial Surgery/Oral Pathology of the Vrije University Medical Center in Amsterdam between 1978 and 2005. A pigmented, flat or swollen, irregularly bordered lesion of oral mucosa was detected in most patients during the first clinical examination. Pain was the most commonly referred symptom; the palate was the most frequently affected subsite. Following the mucosal melanoma microstaging system, all patients staged as stage I (T any N0M0) could be subclassified as microstage II (invasion up to the lamina propria), except for 1 patient microstaged as stage III (deep skeletal tissue invasion into skeletal muscle, bone, or cartilage). Where possible, surgery was the treatment of choice. Postoperative radiotherapy, using fractions of 6 Gy twice a week for a total dose of 30 Gy, was given to 3 patients. Three patients were treated primarily with radiotherapy alone. RESULTS: Five patients developed local recurrence within 4 to 72 months, and 10 patients developed distant metastases within 6 to 78 months. Ten patients died of their disease within an average interval of 40 months, with a range of 12 to 80 months. Of the 10 patients who qualified for evaluation of the 5-year-survival rate, 1 was alive with disease and 2 were alive without evidence of disease, resulting in a 5-year survival rate of 30%. However, all patients died of their disease before the end of the 10-year follow-up period. CONCLUSION: Our study confirms that OMM is a rare and aggressive malignancy with a low 5-year survival rate. An evidence-based protocol for the best therapeutic approach is not yet available.

• Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature.

  Authors: John E Griffin, Chris Jo

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2227-34.

  PURPOSE: It is well-recognized that postoperative hematoma is the most common complication of cervicofacial rhytidectomy (facelift surgery), and several strategies aimed at reducing the incidence ofPURPOSE: It is well-recognized that postoperative hematoma is the most common complication of cervicofacial rhytidectomy (facelift surgery), and several strategies aimed at reducing the incidence of hematoma have been developed and studied. Other common complications include skin necrosis, seroma, motor and sensory nerve injury, alopecia, auricular deformity/displacement, and dyspigmentation. The purpose of this study was to retrospectively analyze the incidence of complications after superficial cervicofacial rhytidectomy performed by a single surgeon and his fellows and to compare our findings with those reported in the literature. MATERIALS AND METHODS: Based on a retrospective chart review of patients who underwent cervicofacial rhytidectomy, 178 consecutive patients were enrolled in this study. The charts were reviewed for any notable complications after facelift surgery, especially postoperative hematoma. The charts of those patients with complications were reviewed to identify the presence of perioperative anomalies that may have increased the risk of such complications. Our findings were then compared with those reported in the literature. RESULTS: Of 178 patients who underwent cervicofacial rhytidectomy, 11 (6.2%) had a postoperative complications. These 11 complications included 5 cases (2.8%) of a major postoperative hematoma requiring surgical intervention, 3 cases (1.7%) of minor hematomas ("microhematomas"), and 1 case each of hypertrophic scarring necessitating surgical excision and steroid injection, superficial skin necrosis, and dehiscence. There were no cases of seroma, parotid pseudocyst, or permanent motor nerve injury. CONCLUSION: The incidence of postoperative complications associated with superficial plane rhytidectomy is very low, with hematoma the most common complication.

• Congenital neck masses: a descriptive retrospective study of 252 cases.

  Authors: Taiseer Hussain Al-Khateeb, Firas Al Zoubi

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2242-7.

  PURPOSE: This retrospective study was conducted to analyze congenital neck masses in Jordanians compared with international findings. PATIENTS AND METHODS: The records of patients with congenitalPURPOSE: This retrospective study was conducted to analyze congenital neck masses in Jordanians compared with international findings. PATIENTS AND METHODS: The records of patients with congenital neck masses between 1991 and 2002 were retrieved from the Department of Pathology, Jordan University of Science and Technology, and analyzed for age, gender, location, clinical features, and treatment. RESULTS: Within the 12-year period of the study, a total of 2,063 neck mass lesions were found; of these, 252 (12%) were congenital masses. These cases were distributed into 166 (66%) midline, 55 (22%) lateral, and 31 (12%) entire neck masses. The most frequent mass was thyroglossal duct cyst (fistulas) (53%), followed by cysts (fistulas) of the branchial apparatus (22%), dermoid cysts (11%), hemangiomas (7%), and 1ymphangiomas (6%). The majority of branchial arch anomalies (85%) were of the second arch. The mean age of patients was 16 years, with the greatest number of cases (38%) in the first decade. The male-to-female ratio was 1:1.2, with most lesions affecting females. The majority of lesions presented with painless neck swelling, and all lesions were surgically excised. CONCLUSIONS: The overall frequency and age distribution of congenital neck masses in northern Jordanians are similar to international findings. However, the gender distribution and relative frequency of individual types of neck masses are somewhat different from those in other countries. These differences may be attributed to genetic and geographic differences.

• The impact of dental surgery on HSV-1 reactivation in the oral mucosa of seropositive patients.

  Authors: Luciano Marques-Silva, Wagner Henriques Castro, Eliane Lustosa Cabral Gomez, André Luiz Sena Guimarães, Marina Sena Lopes Silva, Ricardo Santiago Gomez

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2269-72.

  PURPOSE: Herpes simplex virus type 1 (HSV-1) is a member of the human herpes virus family. Most of the population (90%) has antibodies to HSV-1, and as many as 40% of these individuals may developPURPOSE: Herpes simplex virus type 1 (HSV-1) is a member of the human herpes virus family. Most of the population (90%) has antibodies to HSV-1, and as many as 40% of these individuals may develop secondary herpes. Shedding of HSV-1 in the oral mucosa can be induced by many factors, including stress, sunlight, menstruation, and physical trauma. The aim of the present study was to evaluate the impact of dental surgical procedures on HSV-1 shedding in the oral mucosa. PATIENTS AND METHODS: The case group comprised 48 patients undergoing third molar extraction (case group) and 48 patients undergoing conventional restorative procedures (control group). All of the patients were IgG-positive for HSV-1. Oral swabs were performed before and 1 week after the procedures to investigate HSV-1 reactivation by nested polymerase chain reaction. RESULTS: The frequency of positive oral swabs to HSV-1 in the group that underwent surgery (4.2%) was not statistically different from that in the control group (2.1%). CONCLUSIONS: The results indicate that oral surgical trauma does not have a significant impact on HSV-1 shedding in the oral mucosa.

• Using ultrasound to visualize the lingual nerve.

  Authors: James Olsen, Maria Papadaki, Maria Troulis, Leonard B Kaban, Mary J O'Neill, Bruce Donoff

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2295-300.

  PURPOSE: The purpose of this study was to assess the effectiveness of ultrasonography in visualizing the lingual nerve, calculating its distance from the lingual cortex at the area of the thirdPURPOSE: The purpose of this study was to assess the effectiveness of ultrasonography in visualizing the lingual nerve, calculating its distance from the lingual cortex at the area of the third molar, and in detecting injuries. MATERIALS AND METHODS: Using a standardized protocol, lingual nerve dissections were performed in Yorkshire pig cadaver heads. After nerve isolation was confirmed, the nerve was left intact, fully transected, or partially transected. The dissection flap was repositioned and the pig heads were given to 3 blinded evaluators. Using a handheld ultrasound device, the evaluators were asked to determine the status of the nerve and categorize their finding as intact, fully transected, or partially transected. The recorded ultrasound images from the 9 study specimens were then analyzed and the distances of the lingual nerves from the alveolus were measured. RESULTS: After becoming familiar with the ultrasonographic appearance of the lingual nerve, all of the evaluators were able to visualize and identify the nerve using the ultrasound machine. Lingual nerve injuries were accurately categorized in 17 out of the 27 total attempts (success rate, 63%). The average distance of the nerve from the alveolar cortex was measured to be an average distance of 1 mm. CONCLUSION: The results of this study indicate that ultrasonography can be effectively used to visualize the lingual nerve.

• Retrospective analysis of 736 implants inserted without antibiotic therapy.

  Authors: Alberto Mazzocchi, Luca Passi, Roberto Moretti

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2321-3.

  PURPOSE: The routine use of antibiotics in oral implant treatment seems to be widespread. The principle of antibiotic prophylaxis before oral surgical procedures in patients at risk for endocarditisPURPOSE: The routine use of antibiotics in oral implant treatment seems to be widespread. The principle of antibiotic prophylaxis before oral surgical procedures in patients at risk for endocarditis or in those who are severely immunocompromised is well established. Antibiotic therapy in conjunction with implant surgery in fit patients and its correlation with failure and success rates remains poorly documented, however. The debate regarding overprescription of antibiotics raises the need for a critical evaluation of proper antibiotic coverage in association with implant treatment. The purpose of this study was to retrospectively show and value the outcomes of dental implant treatment without antibiotic prophylaxis. MATERIALS AND METHODS: The study included 437 consecutively treated patients, in whom a total of 736 implants were placed. The population received no prophylactic antibiotics, but received anti-inflammatory therapy (nimesulide 100 mg twice daily or Arnica montana 5C 3 times a day) for 3 days postoperatively. Healing was evaluated at second-stage surgery (4 to 6 months postoperatively). Failure was defined as removal of the implant due to either signs of infection or nonosseointegration of the implant, according to the criteria for success described by Albrektsson and Coll in 1988. RESULTS: The implant survival rate in the sample (96.2%) was no lower than the high success rates published in the literature using various antibiotic regimens. CONCLUSIONS: Our findings support the results of several recent reviews of minor use of antibiotics in oral surgery. These findings suggest that the use of antibiotics for routine oral implants may not be as beneficial as once believed and that clinicians should look forward to the reduction of their unnecessary use. The use of antibiotic prophylaxis before oral surgical procedures remains a controversial issue, poorly documented in the literature.

• Metastatic mandibular retinoblastoma in a child reconstructed with soft tissue matrix expansion grafting: a preliminary report.

  Authors: Christopher C Fenton, Iain A Nish, Robert P Carmichael, George K B Sàndor

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2329-35.

  PURPOSE: Retinoblastoma is a congenital malignant neoplasm of retinal tissue. Reports of metastasis to the mandible are rare. Successful retinoblastoma management has led to a dramatic improvement inPURPOSE: Retinoblastoma is a congenital malignant neoplasm of retinal tissue. Reports of metastasis to the mandible are rare. Successful retinoblastoma management has led to a dramatic improvement in survival rates. Increasing numbers of surviving patients require reconstruction of the defects caused by the ablation of such metastasis. PATIENT AND METHODS: This article describes the management of a pediatric mandibular defect secondary to the resection of a metastatic retinoblastoma. RESULTS: A unique application of the soft tissue matrix expansion technique, otherwise known as the "tent-pole" graft, which has been previously described in adults with severe mandibular atrophy, was utilized in the pediatric patient. CONCLUSION: The soft tissue matrix expansion grafting technique can be successfully utilized in the reconstruction of ablative defects in pediatric patients.

• Community-acquired methicillin-resistant Staphylococcus aureus infection with fatal necrotizing pneumonia from lip abscess: a case report.

  Authors: Gerard J Bruno, Joanna M Bruno, Alan A Miyake

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2350-3.

• Using botox to treat a mohs defect repair complicated by a parotid fistula.

  Authors: Gregory P Hatzis, Richard Finn

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2357-60.

• Fibula onlay reconstruction of the severely atrophic mandible in a patient with chronic lymphocytic leukemia: case report.

  Authors: Eric J Dierks, Larry M Over, Brian L Schmidt, R Bryan Bell, Mark Buehler

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2367-71.

• Treating bisphosphonate osteonecrosis of the jaws: is there a role for resection and vascularized reconstruction?

  Authors: Stephen L Engroff, Dongsoo David Kim

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2374-85.

• "Plus ça change, plus c'est la même chose".

  Authors: Roger A Meyer

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2389.

• Bone morphogenetic protein-induced repair of the premaxillary cleft.

  Authors: Alan S Herford, Philip J Boyne, Rick Rawson, Roland P Williams

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2136-41.

  PURPOSE: The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier.PURPOSE: The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier. PATIENTS AND METHODS: Twelve patients with unilateral clefted premaxillas were evaluated preoperatively and 4 months postoperatively. Ten patients were repaired with recombinant human bone morphogenetic protein type 2 while 2 others were grafted with anterior iliac crest particulate marrow cancellous bone. Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and preoperative and postoperative volume ratios. RESULTS: A preoperative and postoperative volume ratio for patients repaired with recombinant human bone morphogenetic protein type 2 ranged from 24.1% to 90.6% with a mean of 71.7%. Patients who were grafted with particulate marrow cancellous bone had similar preoperative and postoperative volume ratios ranging from 71.3% to 84.9% with a mean of 78.1%. CONCLUSIONS: Clefts of the anterior maxilla can have complete osseous regeneration induced by recombinant human bone morphogenetic protein type 2 as an effective alternative to conventional anterior iliac particulate marrow cancellous bone grafts.

• Salivary gland tumors in an Iranian population: a retrospective study of 130 cases.

  Authors: Mohammad Hussein Ansari

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2187-94.

  PURPOSE: Tumors of the salivary glands are uncommon, comprising 3% to 10% of head and neck neoplasia. In the absence of epidemiologic studies of these neoplasms in an Iranian population, we conductedPURPOSE: Tumors of the salivary glands are uncommon, comprising 3% to 10% of head and neck neoplasia. In the absence of epidemiologic studies of these neoplasms in an Iranian population, we conducted a preliminary survey of 130 cases over the last 20 years in Hamedan, Iran. PATIENTS AND METHODS: The medical records and case notes of all patients with histologically confirmed salivary gland tumors were reviewed retrospectively from February 1984 to March 2003. This review found 89 patients with benign tumors and 41 patients with malignant tumors. The collection of data included gender, age, location, and histopathology of the tumor. Other recorded data included diagnostic procedures, operative reports, complications, additional treatment, and follow-up. RESULTS: We studied 78 females and 52 males with a mean age of 44.9 years. Patients with benign and malignant tumors presented with a mean age of 41.3 and 47 years, respectively. The frequency of benign tumors was 68.4% (n = 89) and 31.6% for malignant tumors (n = 41). Tumors were localized in the parotid gland (63%; n = 82), the submandibular gland (23%; n = 30), and in the minor salivary glands (14%; n = 18). The most common benign tumor was pleomorphic adenoma (65.4%; n = 85). Among malignant tumors, mucoepidermoid carcinoma was the most frequent (11.5%; n = 15), followed by adenocarcinoma (10%; n = 13). Greater than 63% of malignant tumors were treated surgically, and the remaining with combined therapy. Seven patients died over the follow-up period (6 with persistent disease), 5 were lost to follow-up, and 23 remained cancer-free. CONCLUSION: Between benign and malignant salivary gland tumors, frequency of pleomorphic adenoma and mucoepidermoid carcinoma was in keeping with studies reported previously. In other salivary gland tumors, however, diversity was obvious and showed significant difference, requiring further studies.

• Harvesting of cancellous bone from the proximal tibia under local anesthesia: donor site morbidity and patient experience.

  Authors: Robert Kirmeier, Michael Payer, Martin Lorenzoni, Walther A Wegscheider, Franz Josef Seibert, Norbert Jakse

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2235-41.

  PURPOSE: The objective of this retrospective study was to evaluate postoperative morbidity, risk of complications, and patient discomfort after ambulatory tibial bone harvesting procedures underPURPOSE: The objective of this retrospective study was to evaluate postoperative morbidity, risk of complications, and patient discomfort after ambulatory tibial bone harvesting procedures under local anesthesia. PATIENTS AND METHODS: Between 2000 and 2005, bone was harvested from the head of the tibia for internal or external maxillary augmentation in 79 patients. A medial osteoplastic approach to the donor region was used. All patients' records were reviewed. Forty-five of the 79 patients later came in for follow-up examination. A traumatologist examined the donor region both clinically and radiologically. Subjective disorders and experiences of the patients were documented using a standardized questionnaire. RESULTS: The patient records revealed that 80% did not report significant complaints or gait disturbances after bone harvesting, and only 5% reported postoperative complaints or gait disturbances lasting longer than 2 weeks. In 1 case, a nondisplaced fracture healed without further complications. Clinical and radiologic examinations of 45 patients revealed full regeneration of the donor region in all cases. Some 91% of the patients described the outpatient bone harvesting procedure under local anesthesia as "not distressing" and would undergo such an intervention again if required. CONCLUSIONS: This study demonstrates that both complaints and risk of complications after outpatient bone harvesting from the proximal tibia under local anesthesia can be considered very low, especially as far as outpatient maxillary augmentation (eg, sinus floor elevation) is concerned.

• Ovariectomy delays alveolar wound healing after molar extractions in rats.

  Authors: Michele Conceição Pereira, Karina Gottardello Zecchin, Eduardo Bauml Campagnoli, Jacks Jorge

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2248-53.

  PURPOSE: This study was conducted to investigate the morphological effects of the absence of estrogen on alveolar wound healing of young female rats after tooth extraction. MATERIALS AND METHODS: APURPOSE: This study was conducted to investigate the morphological effects of the absence of estrogen on alveolar wound healing of young female rats after tooth extraction. MATERIALS AND METHODS: A total of 60 4- to 6-week-old female rats underwent bilateral ovariectomy (OVX) or sham operations. Three weeks later, the first mandibular molars were extracted. Subsequently, the animals were killed by cervical dislocation 3, 5, 7, 14, 21, or 28 days after tooth extraction. The mandibles were removed, and serial transversal sections of mesial alveolus of the first mandibular molars were obtained for histometric analysis. RESULTS: OVX sockets showed significant increases in fibroblasts and collagen content 3 and 5 days after the extractions, followed by significant decreases in these parameters in the subsequent periods. In accordance with the decreased collagen content in the latest period of healing, new bone formation was significantly reduced in the OVX animals. CONCLUSION: These findings suggest that the initial molecular changes observed in the absence of estrogen lead to delayed alveolar wound healing.

• The usefulness of stereomodels in maxillofacial surgical management.

  Authors: Lop Keung Chow, Lim Kwong Cheung

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2260-8.

  PURPOSE: This retrospective study aimed to determine the usefulness of stereomodels in various maxillofacial surgical treatments. MATERIALS AND METHODS: A total of 45 stereomodels were evaluated inPURPOSE: This retrospective study aimed to determine the usefulness of stereomodels in various maxillofacial surgical treatments. MATERIALS AND METHODS: A total of 45 stereomodels were evaluated in terms of usefulness from questionnaires completed by 4 groups of subjects: surgeons, postgraduate students, technicians, and patients. These models were categorized into 4 treatment groups: distraction osteogenesis, reconstruction, pathology, and trauma management. The scores of each category were computed and compared among the treatment groups. RESULTS: The stereomodels in this study were used mainly for distraction osteogenesis (53.3%, 24/45 models) and reconstructive surgery (33.3%, 15/45 models). The total mean scores (with 10 being the top score) from the different subjects' assessments were 8.18 by surgeons, 7.80 by postgraduate students, 5.90 by technicians, and 7.70 by patients. CONCLUSIONS: Stereomodels were found by the group subjects to be very useful, particularly for treatment planning and patient communication, as a teaching tool for students, and for prosthesis fabrication.

• Branching patterns and intraosseous course of the mental nerve.

  Authors: Kyung-Seok Hu, Hee-Sun Yun, Mi-Sun Hur, Hyuk Jae Kwon, Shinichi Abe, Hee-Jin Kim

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 65(11):2288-94.

  PURPOSE: The purpose of this study was to clarify the branching patterns of the mental nerve (MN) and intraosseous courses of the MN branches, and to determine the clinical relevance of the variousPURPOSE: The purpose of this study was to clarify the branching patterns of the mental nerve (MN) and intraosseous courses of the MN branches, and to determine the clinical relevance of the various courses of the MN branches. MATERIALS AND METHODS: We investigated the topography of the MN by dissecting 31 hemifaces of Korean cadavers. Based on the distribution area of the MN, it was divided into angular (A), medial inferior labial (ILm), lateral inferior labial (ILl), and mental (M) branches. We classified the branching patterns of the 4 branches of the MN into 5 types. RESULTS: Type II, in which the MN divided into 3 branches (A, ILm, and M), with the ILl branch separating from the A branch, was the most common (35.4%). The MN was classified based on the shape of the anterior loop into loop, straight, and vertical patterns, which constituted 61.5%, 23.1%, and 15.4%, respectively. In the mandibular canal, the inferior alveolar nerve completely divided into the MN and the dental nerve, which supplies the teeth. In 17 cases (81%), the nerve bundles constituting the A branch were located at the superior aspect, whereas the nerve bundles of the inferior labial and mental branches were in the middle and inferior aspects within the mandibular canal, respectively, at the mental foramen region. CONCLUSION: These observations can help clinicians to predict the location or extent of paresthesia in the facial region according to the location and extent of nerve damage during dental implant surgery or genioplasty.

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