Facial soft tissue course for trainees in oral and maxillofacial surgery

Abstract Background: The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. We will use these results in order to improve the diagnosis and the establishment of correct treatment of this pathology. Methods: A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Statistical analysis was performed with the MedCalc Statistical Software version 19.2 (MedCalc Software bvba, Ostend, Belgium;53 https://www.medcalc.org; 2020). Nominal data were expressed as frequency and percentage. The comparisons of the frequencies of a nominal variable among the categories of another nominal variable were made using the chi-square test. Multivariate logistic regressions were used in order to establish the independent association between variables and lacerations/excoriations. After using the Bonferroni correction for multiple comparisons, a value of p<0.025 was considered statistically significant.Results: The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n=179 (73.9%), closed n=179 (73.9%) and complete n=219 (90.5%). Hematoma was the most frequent associated soft tissue lesion n=102 (42.1%) regardless of the fracture pattern (p=1.000). Complete zygomatic fracture (OR – 2.68; p=0.035) and fractures with displacement (OR – 3.66; p=0.012) were independently associated with the presence of laceration. Fractures with displacement (OR – 7.1; p=0.003) were independently associated with the presence of excoriation. The most frequent type of treatment applied was Gillies reduction (61.9%), followed by ORIF (30.9%). The most frequent postoperative complication was malunion secondary to Gillies treatment (4,6%). Conclusions: Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. In the case of displaced, open or comminuted fractures we achieved the best results secondary to ORIF treatment method, while in the case of non-displaced and closed fractures, the best results achieved were secondary to conservative treatment.

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True grit? Learning points from a facial soft tissue wound

Faculty Dental Journal ◽

10.1308/rcsfdj.2020.120 ◽

2020 ◽

Vol 11 (4) ◽

pp. 196-197

Author(s):

Zachary Cole-Healy ◽

Damian Broderick ◽

Richard M Graham

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

Maxillofacial Surgery ◽

High Index ◽

Oral And Maxillofacial Surgery ◽

Facial Soft Tissue ◽

Junior Staff ◽

High Index Of Suspicion ◽

Learning Points ◽

Foreign Body Implantation

We write this short piece regarding a recently referred case to our oral and maxillofacial surgery (OMFS) unit, which highlights several important learning points for OMFS junior staff. We describe a pertinent case in which the importance of history, examination and relevant investigations during the workup of soft tissue facial injuries is illustrated. Fundamentally, all facial traumatic wounds require a thorough assessment that is performed with a high index of suspicion of foreign body implantation. This case report highlights that all facial traumatic wounds require a thorough assessment performed with a high index of suspicion for foreign body implantation.

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Interrelation between facial soft tissue lessions, underlying fracture patterns and treatment of zygomatic bone trauma: a 10 year retrospective study

Head & Face Medicine ◽

10.1186/s13005-020-00246-y ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Raluca Iulia Juncar ◽

Paul Andrei Tent ◽

Mihai Juncar ◽

Ioan Anton Arghir ◽

Oana Cristina Arghir ◽

...

Keyword(s):

Soft Tissue ◽

Bone Fractures ◽

Maxillofacial Surgery ◽

Fracture Pattern ◽

Oral And Maxillofacial Surgery ◽

Facial Soft Tissue ◽

Nominal Data ◽

Correct Treatment ◽

Zygomatic Bone ◽

Zygomatic Fracture

Abstract Background The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. We will use these results in order to improve the diagnosis and the establishment of correct treatment of this pathology. Methods A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Statistical analysis was performed with the MedCalc Statistical Software version 19.2 (MedCalc Software bvba, Ostend, Belgium; 53 https://www.medcalc.org; 2020). Nominal data were expressed as frequency and percentage. The comparisons of the frequencies of a nominal variable among the categories of another nominal variable were made using the chi-square test. Multivariate logistic regressions were used in order to establish the independent association between variables and lacerations/excoriations. After using the Bonferroni correction for multiple comparisons, a value of p < 0.025 was considered statistically significant. Results The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n = 179 (73.9%), closed n = 179 (73.9%) and complete n = 219 (90.5%). Hematoma was the most frequent associated soft tissue lesion n = 102 (42.1%) regardless of the fracture pattern (p = 1.000). Complete zygomatic fracture (OR – 2.68; p = 0.035) and fractures with displacement (OR – 3.66; p = 0.012) were independently associated with the presence of laceration. Fractures with displacement (OR – 7.1; p = 0.003) were independently associated with the presence of excoriation. The most frequent type of treatment applied was Gillies reduction (61.9%), followed by ORIF (30.9%). The most frequent postoperative complication was malunion secondary to Gillies treatment (4,6%). Conclusions Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. In the case of displaced, open or comminuted fractures we achieved the best results secondary to ORIF treatment method, while in the case of non-displaced and closed fractures, the best results achieved were secondary to conservative treatment.

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Diode laser in the surgical treatment of inflammatory fibrous hyperplasia: Case report and literature review

Revista Odonto Ciência ◽

10.15448/1980-6523.2017.3.28054 ◽

2018 ◽

Vol 32 (3) ◽

pp. 154

Author(s):

Fernando De Oliveira Andriola ◽

Leonardo Matos Santolim Zanettini ◽

Ricardo Giacomini De Marco ◽

Camila Kunz ◽

Cássia Dos Santos Machado Vaz ◽

...

Keyword(s):

Soft Tissue ◽

Diode Laser ◽

Oral Surgery ◽

Maxillofacial Surgery ◽

Complete Healing ◽

Oral And Maxillofacial Surgery ◽

Surgical Removal ◽

Tissue Mass ◽

Patient Reported ◽

School Of Dentistry

OBJECTIVE: This article presents a case of inflammatory fibrous hyperplasia (IFH) treated by diode laser surgery, as well as a review of the literature about this pathology.CASE DESCRIPTION: A 55-year-old woman was referred to the Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul, School of Dentistry, complaining of a discomfort on swallowing due to a soft-tissue mass in the oral cavity that had been developing for approximately 3 years. Intraoral examination revealed multiple exophytic, pedunculated lesions with a smooth surface and pinkish in color, affecting almost the entire right cheek mucosa. The lesion turned out to be a IFH by histopatology. Surgical removal of IFH of the oral mucosa using a diode laser was performed. The lesion was removed in 3 sessions. The patient reported no local symptoms after each irradiation. The clinical appearance 10 months after the last irradiation session demonstrated complete healing and no signals of recurrence.CONCLUSION: Based on the results obtained, we can conclude that diode laser radiation contributes significantly to the advancement of oral surgery and should be considered a valuable resource for the treatment of soft-tissue lesions in the field of oral and maxillofacial surgery.

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In the emergency department

10.1093/med/9780198767817.003.0004 ◽

2018 ◽

Author(s):

Luke Cascarini ◽

Clare Schilling ◽

Ben Gurney ◽

Peter Brennan

Keyword(s):

Soft Tissue ◽

Bone Fractures ◽

Maxillofacial Surgery ◽

Soft Tissue Injuries ◽

Oral And Maxillofacial Surgery ◽

Mandibular Fractures ◽

Soft Tissue Infections ◽

Penetrating Injuries ◽

Orbital Floor Fractures ◽

Zygomatic Fractures

This chapter discusses oral and maxillofacial surgery in the A&E department, including, The paediatric OMFS patient, Overview of maxillofacial trauma, Mandibular fractures, Zygomatic fractures, Orbital floor fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Penetrating injuries to the neck, Intra-oral injuries, Dento-alveolar trauma, Dento-alveolar infections, Post-extraction complications, Head and neck soft tissue infections, Salivary gland diseases, and Miscellaneous conditions

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COMPARISON OF POST EXTRACTION SOCKET HEALING WITH AND WITHOUT USING PLATELET RICH FIBRIN (PRF) – A CLINICAL AND RADIOGRAPHIC STUDY

10.36106/ijsr/0702367 ◽

2021 ◽

pp. 62-65

Author(s):

S.P. Indra Kumar ◽

Kavin T ◽

Narendar R ◽

E. Gayathri Priyadharshini ◽

Akshaya murugan ◽

...

Keyword(s):

Soft Tissue ◽

Maxillofacial Surgery ◽

Test Group ◽

Control Group ◽

Oral And Maxillofacial Surgery ◽

Soft Tissue Healing ◽

Extraction Socket ◽

Platelet Rich Fibrin ◽

Tissue Healing ◽

Socket Healing

AIM: The aim of this study is to comparatively evaluate the post extraction socket healing clinically and radiographically with and without using Platelet Rich Fibrin (PRF). MATERIALS AND METHODS: Fifty, otherwise healthy individuals undergoing dental treatment in the department of Oral and Maxillofacial surgery, Vivekananda Dental College for women, Thiruchengode, were randomly selected and the participants were divided into two groups – test group(PRF, n=25) and control group (Blood clot, n=25). Blood was freshly obtained from the participants of the test group and PRF was prepared. PRF was placed in the sockets of the test group and followed by the pressure application and suturing. Control group were allowed to heal naturally. Clinically, soft tissue healing and socket closure were assessed. Radiographic analysis of socket healing done by comparison of pre- and post-operative radiographs. The clinical follow-up assessments were done at an interval of 3 days, 1 week and 4 weeks and the data obtained were assessed. The patients were aged above 18 years, i RESULT: ncluding 33 females and 17 males. The soft tissue and socket healing were higher in the test group when compared with the control group clinically and the mean proportion of radiographic bone ll was signicantly higher in the test group in all the time intervals of 3 days, 1 week and 4 weeks, respectively. Outcome of the study CONCLUSION: demonstrate that the PRF placement in the extraction socket accelerates soft tissue healing and socket healing and increases the bone ll and reduces the bone resorption using clinical and radiographic methods.

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3D Soft-Tissue Prediction Methodologies for Orthognathic Surgery—A Literature Review

Applied Sciences ◽

10.3390/app9214550 ◽

2019 ◽

Vol 9 (21) ◽

pp. 4550 ◽

Cited By ~ 5

Author(s):

Elena Carlotta Olivetti ◽

Sara Nicotera ◽

Federica Marcolin ◽

Enrico Vezzetti ◽

Jacqueline P. A. Sotong ◽

...

Keyword(s):

Soft Tissue ◽

Literature Review ◽

Surgical Planning ◽

Maxillofacial Surgery ◽

Three Dimensional ◽

Facial Soft Tissue ◽

Unknown Variable ◽

Common Planning ◽

The Face ◽

Soft Tissue Changes

Three-dimensional technologies have had a wide diffusion in several fields of application throughout the last decades; medicine is no exception and the interest in their introduction in clinical applications has grown with the refinement of such technologies. We focus on the application of 3D methodologies in maxillofacial surgery, where they can give concrete support in surgical planning and in the prediction of involuntary facial soft-tissue changes after planned bony repositioning. The purpose of this literature review is to offer a panorama of the existing prediction methods and software with a comparison of their reliability and to propose a series of still pending issues. Various software are available for surgical planning and for the prediction of tissue displacements, but their reliability is still an unknown variable in respect of the accuracy needed by surgeons. Maxilim, Dolphin and other common planning software provide a realistic result, but with some inaccuracies in specific areas of the face; it also is not totally clear how the prediction is obtained by the software and what is the theoretical model they are based on.

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Evaluation Of Clinical Features And Treatment Of Zygomatic Bone Fractures: A 10-Year Retrospective Study

10.21203/rs.3.rs-44138/v1 ◽

2020 ◽

Author(s):

Juncar Raluca Iulia ◽

Paul Andrei Tent ◽

Juncar Mihai ◽

Arghir Ioan Anton ◽

Arghir Cristina Oana ◽

...

Keyword(s):

Soft Tissue ◽

Clinical Features ◽

Bone Fractures ◽

Maxillofacial Surgery ◽

Treatment Method ◽

Fracture Pattern ◽

Oral And Maxillofacial Surgery ◽

Correct Treatment ◽

Zygomatic Bone ◽

Soft Tissue Lesions

Abstract Background The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions, which make clinical diagnosis and therapeutic indications difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue lesions, in order to improve the diagnosis and the establishment of the correct treatment. We also aimed to assess the type of treatment methods applied depending on the fracture pattern of the zygomatic bone, as well as their effectiveness depending on the incidence rate of postoperative complications. Methods A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Results The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n = 179 (73.90%), closed n = 179 (73.90%) and complete n = 219 (90.50%). Hematoma was the most frequent associated soft tissue lesion n = 102 (42.15%) regardless of the fracture pattern (p = 1.000). The incidence of lacerations and excoriations was statistically higher in the case of complete (laceration p = 0.0028/ excoriation p = 0.037), displaced and comminuted zygomatic fractures (laceration p = 0.015/ excoriation p = 0.001). The most frequent type of treatment applied was Gillies reduction (61.98%), followed by ORIF (30.99%). The most frequent postoperative complication was malunion secondary to Gillies treatment (p = 002). Conclusions Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. The most effective treatment method in the case of displaced, open or comminuted fractures was ORIF, while in the case of non-displaced and closed fractures, conservative treatment was the most effective.

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USE OF PLATELET-RICH FIBRIN IN MAXILLOFACIAL SURGERY

Contemporary Materials ◽

10.7251/comen1601045t ◽

2016 ◽

Vol 7 (1) ◽

Author(s):

Nenad Tanasković

Keyword(s):

Soft Tissue ◽

Second Generation ◽

Maxillofacial Surgery ◽

Biological Properties ◽

Platelet Concentrate ◽

Oral And Maxillofacial Surgery ◽

Platelet Rich Fibrin ◽

Ridge Augmentation ◽

Wide Range ◽

Autologous Platelet Concentrate

Platelet Rich Fibrin (PRF) is autologous biomaterial which is the second-generation platelet concentrate. It has a favorable biological properties that accelerate healing of soft tissue, and bone, giveing a wide range of applications found in oral and maxillofacial surgery and other surgical fields. PRF technique was developed by Choukroun et al in 2001 and it represents a second generation of autologous platelet concentrate, which is used to accelerate the healing of soft and hard tissue. In contrast to the PRP, the PRF is composed of autologous fibrin matrix in which a large amount of platelets and their growth factors are embedded. PRF-graft is used in augmentative techniques residual bone defects, alone or in combination with biomaterials. When the alveolar ridge augmentation technique GBR, the PRF membranes can be used for protection and stabilization of bone compensation. PRF accelerates the healing of soft tissue and reduces the possibility of dehiscence and exposure of the membrane.

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