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Medicina Oral, Patologia Oral Y Cirugia... Jul 2015Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare... (Comparative Study)
Comparative Study Review
BACKGROUND
Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability.
MATERIAL AND METHODS
An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed.
RESULTS
Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials.
CONCLUSIONS
There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fractures.
Topics: Bone Wires; Fracture Fixation, Intramedullary; Humans; Mandibular Fractures
PubMed: 26034929
DOI: 10.4317/medoral.20448 -
Journal of Oral & Maxillofacial Research 2015This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of... (Review)
Review
OBJECTIVES
This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of this article is to review the scientific literature and clinical reports in order to analyse the neurosensory complications, risks and disadvantages of lateralization/transposition of the inferior alveolar nerve followed by implant placement in an edentulous atrophic posterior mandible.
MATERIAL AND METHODS
A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC databases, as well as academic sites and books. The articles were searched from January 1997 to July 2014. Articles in English language, which included adult patients between 18 - 80 years of age who had minimal residual bone above the mandibular canal and had undergone inferior alveolar nerve (IAN) repositioning, with minimum 6 months of follow-up, were included.
RESULTS
A total of 21 studies were included in this review. Ten were related to IAN transposition, 7 to IAN lateralization and 4 to both transposition and lateralization. The IAN neurosensory disturbance function was present in most patients (99.47% [376/378]) for 1 to 6 months. In total, 0.53% (2/378) of procedures the disturbances were permanent.
CONCLUSIONS
Inferior alveolar nerve repositioning is related to initial transient change in sensation in the majority of cases. The most popular causes of nerve damage are spatula-caused traction in the mucoperiosteal flap, pressure due to severe inflammation or retention of fluid around the nerve and subsequent development of transient ischemia, and mandibular body fracture.
PubMed: 25937874
DOI: 10.5037/jomr.2014.6103 -
Scientific Reports Jul 2023Our study aims to estimate the prevalence of surgical site infections (SSI) following open reduction and internal fixation (ORIF) for mandibular fractures and to... (Meta-Analysis)
Meta-Analysis
Our study aims to estimate the prevalence of surgical site infections (SSI) following open reduction and internal fixation (ORIF) for mandibular fractures and to determine the effect of potential moderators on it. A systematic literature search (Medline and Scopus databases) was conducted independently by two reviewers. The pooled prevalence with 95% confidence intervals was estimated. Quality assessment as well as outlier and influential analysis were performed. Additionally, subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. In total, seventy-five eligible studies (comprising a sum of 5825 participants) were included in this meta-analysis. The overall prevalence of SSI following ORIF for mandibular fractures was estimated as high as 4.2% (95% CI 3.0-5.6%) with significant heterogeneity between studies. One study was identified to be critically influential. In the subgroup analysis, the prevalence was 4.2% (95% CI 2.2-6.6%) among studies conducted in Europe, 4.3% (95% CI 3.1-5.6%) among studies conducted in Asia and higher among those conducted in America (7.3%) (95% CI 4.7-10.3%). It is important for healthcare professionals to be aware of the etiology of these infections, despite the relatively low rate of SSI in these procedures. However, further, well-designed prospective and retrospective studies need to be conducted in order this issue to be fully clarified.
Topics: Humans; Mandibular Fractures; Surgical Wound Infection; Prevalence; Prospective Studies; Retrospective Studies
PubMed: 37430033
DOI: 10.1038/s41598-023-37652-6 -
Journal of Oral Rehabilitation Jan 2020To evaluate the biological and mechanical complications of angulated abutments on full-arch and partial jaw rehabilitations with a follow-up for at least 1 year. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the biological and mechanical complications of angulated abutments on full-arch and partial jaw rehabilitations with a follow-up for at least 1 year.
METHODS
Electronic search was carried out in MEDLINE, EMBASE and Web of Science. Studies published between January 2000 and January 2019 were included. The quality of the included studies was assessed. The data extraction was focused on implant loss, marginal bone loss and mechanical complications, and meta-analyses were performed for marginal bone loss, mechanical complications and implant failure.
RESULTS
Nine studies, three prospective and six retrospective cohort studies were included. They reported on 797 patients that received 4127 implants. The total number of abutments was 4079 of which 1673 were angulated, and 2406 were straight. All abutments were prefabricated. Angulated abutments were associated with increased implant failure rates (two studies; RR = 7.30; 95% CI = 2.79-19.08) and an effect that was both statistically significant (P < .001) and clinically relevant. Three studies reported differentiated data for mechanical and technical complications at 1 year of follow-up, being mostly related to the retention screw while screw fracture. Angulated abutments were associated with a statistically significant increase in MBL 1 year after insertion compared to straight abutments (three studies; MD = 0.08 mm; 95% CI = 0.01-0.14 mm; P = .02), which might be, however, clinically negligible.
CONCLUSIONS
The prosthetic complications such as screw loosening and abutment loosening were frequent. After 1 year of follow-up, implants supporting angulated abutments yielded significantly more marginal bone loss than those supporting straight abutments.
Topics: Bone Screws; Dental Abutments; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Prospective Studies; Retrospective Studies
PubMed: 31441527
DOI: 10.1111/joor.12877 -
BMC Geriatrics Jun 2020Prescribing trends suggest that pharmacologic alternatives to antipsychotics are gaining in popularity, but randomized trial (RCT) data of their comparative safety is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Prescribing trends suggest that pharmacologic alternatives to antipsychotics are gaining in popularity, but randomized trial (RCT) data of their comparative safety is scarce. Our objective was to describe the comparative safety of pharmacologic interventions for treating neuropsychiatric symptoms in dementia.
METHODS
We searched MEDLINE, EMBASE, CENTRAL, CINAHL, and PsycINFO, from inception to May 28, 2019, for studies of pharmacologic interventions used to treat neuropsychiatric symptoms in dementia. Dementia care partners selected fracture risk as our primary outcome. Pairs of reviewers, working independently, conducted all study screening, data abstraction, and risk of bias appraisal. We conducted Bayesian random-effects network meta-analyses (NMAs) using data from RCTs to derive odds ratios (ORs). In secondary analyses, we conducted frequentist random-effects NMAs using data from RCTs and Bayesian three-level hierarchical random-effects NMAs incorporating data from RCTs and non-randomized studies.
RESULTS
Our systematic review included 209 randomized and non-randomized studies (889,378 persons with dementia). In NMAs of data from randomized trials, there were no increased odds of fracture associated with any intervention in primary analyses; however, data were sparse. We found increased odds of cerebrovascular events associated with antipsychotics (odds ratio [OR] 2.12, 95% credible interval [CrI] 1.29 to 3.62; number needed to harm [NNH] = 99) and increased odds of falls associated with dextromethorphan-quinidine (OR 4.16, 95% CrI 1.47 to 14.22; NNH = 55) compared to placebo in persons with dementia. In a subgroup of persons with Alzheimer disease, antipsychotics were associated with increased odds of fracture compared to anticonvulsants (OR 54.1, 95% CrI 1.15 to 38,300; NNH = 18). In older persons (mean age ≥ 80 years) with dementia, anticonvulsants were associated with increased odds of death compared to placebo (OR 8.36, 95% CrI 1.17 to 203.4; NNH = 35) and antipsychotics were associated with increased odds of death compared to antidepressants (OR 5.28, 95% CrI 1.06 to 3.51; NNH = 47).
CONCLUSION
Although antipsychotics were associated with greater harm than antidepressants and anticonvulsants in subgroups of persons with dementia, medications used in lieu of antipsychotics for treating neuropsychiatric symptoms in dementia, such as anticonvulsants and dextromethorphan-quinidine, were also associated with harm. Decision-making concerning treatments prescribed in lieu of antipsychotics should include potential harms.
PROSPERO REGISTRATION
CRD42017050130.
Topics: Aged; Aged, 80 and over; Antidepressive Agents; Antipsychotic Agents; Bayes Theorem; Dementia; Humans; Network Meta-Analysis
PubMed: 32546202
DOI: 10.1186/s12877-020-01607-7 -
Current Oncology (Toronto, Ont.) Mar 2021The role of denosumab in patients with resectable giant cell tumour of bone remains unclear. We asked the following research question: for patients (aged ≥ 12 years)...
The role of denosumab in patients with resectable giant cell tumour of bone remains unclear. We asked the following research question: for patients (aged ≥ 12 years) with resectable giant cell tumour of bone, what are the benefits and harms of denosumab compared with no denosumab in terms of (1) facilitation of surgery (operative time, blood loss), (2) disease recurrence, (3) pain control, (4) disease stability, and (5) adverse effects (e.g., malignant transformation, osteonecrosis of jaw, atypical femur fracture)? One previous systematic review addressed only one outcome-disease recurrence. Therefore, we undertook this new systematic review to address the above five outcomes. MEDLINE, EMBASE, PubMed, and Cochrane Database of Systematic Reviews databases were searched on June 30, 2020. This systematic review included one previous systematic review and five comparative studies. Due to poor quality, non-randomized studies fraught with selection bias, it is difficult to determine if a significant difference exists in the outcomes for surgical giant cell tumour of bone with perioperative denosumab. There were no reported cases of adverse effects from denosumab. To date, there is insufficient evidence to understand the value of denosumab in the perioperative setting in patients with giant cell tumour of bone.
Topics: Bone Density Conservation Agents; Bone Neoplasms; Denosumab; Giant Cell Tumor of Bone; Humans; Neoplasm Recurrence, Local; Systematic Reviews as Topic; Treatment Outcome
PubMed: 33809979
DOI: 10.3390/curroncol28020124 -
F1000Research 2023Our study aims to estimate the prevalence of Frey syndrome following open reduction and internal fixation (ORIF) for mandibular fractures. Two reviewers independently... (Meta-Analysis)
Meta-Analysis
Our study aims to estimate the prevalence of Frey syndrome following open reduction and internal fixation (ORIF) for mandibular fractures. Two reviewers independently conducted a systematic literature search in the Medline and Scopus databases. The pooled prevalence with 95% confidence intervals (CI) was estimated, and quality assessment, outlier analysis, and influential analysis were performed. In total, fifteen eligible studies were included in this meta-analysis. One study was identified as critically influential. The overall prevalence of Frey syndrome following extraoral surgical treatment for mandibular fractures was estimated as 0.01% (95%CI 0%-0.7%) with moderate heterogeneity observed between studies. In the meta-regression analysis with continuous variables, no statistically significant association was observed. Despite the relatively low prevalence, the impact of Frey syndrome on affected individuals should not be underestimated. Additional research will provide a more comprehensive understanding of the underlying factors contributing to Frey syndrome, leading to improved preventive measures and treatment strategies. A better grasp of the prevalence and associated risk factors will aid in the development of guidelines to minimize the occurrence of this syndrome.
Topics: Humans; Fracture Fixation, Internal; Mandibular Fractures; Sweating, Gustatory; Prevalence; Risk Factors
PubMed: 38106653
DOI: 10.12688/f1000research.140994.2 -
Journal of Indian Prosthodontic Society 2021The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept.
AIM
The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept.
SETTING AND DESIGN
Systematic Review.
MATERIALS AND METHODS
A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment.
STATISTICAL ANALYSIS USED
Qualitative analysis.
RESULTS
The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible.
CONCLUSION
All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.
Topics: Humans; Jaw, Edentulous; Mandible; Prostheses and Implants; Quality of Life; Survival Rate
PubMed: 33835063
DOI: 10.4103/jips.jips_100_20 -
Dental and Medical Problems 2018The removal of the upper third molar is a procedure commonly performed in oral and maxillofacial surgery. Maxillary third molars are generally less difficult to extract...
The removal of the upper third molar is a procedure commonly performed in oral and maxillofacial surgery. Maxillary third molars are generally less difficult to extract than mandibular third molars. The surgical removal of maxillary third molars is usually associated with low complication rates and low morbidity. This procedure involves the risk of developing complications such as oroantral communication, displacement into adjacent anatomic spaces, fracture of the maxillary tuberosity, and root fracture. Orthopantomograms are the standard preoperative imaging modality, but there is no proven tool for predicting oroantral communication. New possibilities have been offered by cone-beam computed tomography, which is increasingly used in dentistry and is an innovative technique that provides more information as it eliminates the superimposition of surrounding structures and allows the acquisition of 3-dimensional images and their qualitative assessment. The aim of this systematic review was to assess risk factors during the extraction of the upper third molar using orthopantomograms and cone-beam computed tomography.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Fractures; Maxillary Sinus; Molar, Third; Oroantral Fistula; Radiography, Panoramic; Risk Factors; Tooth Extraction; Tooth Fractures; Tooth Root
PubMed: 30152638
DOI: 10.17219/dmp/80944 -
European Review For Medical and... Feb 2022Retromandibular approaches have been known to reduce the risk of facial nerve palsy and improve the management of condylar fractures. As such, it is necessary to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Retromandibular approaches have been known to reduce the risk of facial nerve palsy and improve the management of condylar fractures. As such, it is necessary to identify the best approach with the least complications. This review was conducted to obtain a comprehensive estimate for the risk of complications following both the transparotid and the anteroparotid approach for patients with mandibular condylar fractures.
MATERIALS AND METHODS
A comprehensive search was conducted using PubMed Central, EMBASE, MEDLINE, and Cochrane library, ScienceDirect and Google Scholar from January 1964 until October 2021. The Newcastle Ottawa scale and Cochrane risk of bias tool were used to assess the quality of the included studies. A meta-analysis was carried out using a random-effects model and reported pooled incidence with 95% confidence intervals (CIs). A funnel plot was used to assess possible publication biases.
RESULTS
In total, 40 studies with 2,096 participants were assessed and the majority of the included studies (29 out of 40 studies) had a high risk of bias. The pooled incidence of facial nerve palsy following the transparotid approach was 13% (95% CI: 10%-17%; I2=66.8%), and 2% (95% CI: 1%-5%; I2=57.8%) following the anteroparotid approach. The pooled incidence of sialocele following the transparotid approach was 2% (95% CI: 0%-4%; I2=45.8%), and 2% (95% CI: 1%-5%; I2=67.2%) following the anteroparotid approach. The pooled incidence of postoperative infection following the transparotid approach was 1% (95% CI: 0%-4%; I2=63.1%), and 1% (95% CI: 0%-3%; I2=0%) following the anteroparotid approach.
CONCLUSIONS
The incidence of facial nerve palsy was higher among patients undergoing the transparotid approach when compared to patients undergoing the anteroparotid approach. Further trials comparing both of these approaches are required to identify the best methodology with the lowest complication rate.
Topics: Facial Nerve Injuries; Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Postoperative Complications
PubMed: 35179746
DOI: 10.26355/eurrev_202202_27988