ISSN : 0376-4672
Alveolar cleft is a congenital anomaly with a frequency of 0.18-2.50 per 1,000 births, which invades the bone of maxil lary arch. Iliac crestal bone graft, considered as the gold standard for treatment of alveolar cleft, is a commonly used material due to its abundant mass, ease of harvesting, and the advantages of simultaneous operation with alveolar cleft reconstruction surgery. Despite many advantages of Iliac crestal bone graft, many studies have been conducted on alternative and additional materials for secondary alveolar bone graft in consideration of the disadvantages of iliac crest bone graft. Autogenous bone grafts from other donor sites, such as cranium, mandible and tibia can be used as an alternative with lower morbidity and lower bone resorption. Bone-tissue engineering strategies such as scaffolds, growth factors have also shown promising results in treatment of alveolar cleft. In addition, the use of Platelet-Rich-Fibrin/Plasma with abundant growth factors and osteoinducibility can increase bone maintenance and achieve better results. Therefore, here we review the various bone graft methods used in reconstruction of alveolar cleft.
Purpose. The purpose of this study was to evaluate the quality of popular videos available on YouTube related to the all-on-four implant concept. Materials and Methods. Videos containing information relevant to all-on-four implant were searched on YouTube on July 7, 2020. The videos were listed using the advanced search option ‘sort by view-count’ and the top 60 videos, which met the criteria and with duplications removed, were analyzed. The DISCERN instrument and JAMA benchmarks were used to evaluate selected videos. Statistical analysis was performed to evaluate the DISCERN scores ac cording to the producer groups. Results. Based on DISCERN score, 39 videos were rated as poor and very poor, while only one video rated as good. Videos produced by dentists showed statistically significantly higher DISCERN score than videos produced for commercial use or by unknown. All videos met the criteria for authorship and currency of JAMA benchmark. However, the number of videos with reference and copyright displayed was very small at 16%. Also, the disclosure percent age related to sponsorship and financial support was 53.33%. Conclusion. Within the limitation of this study, YouTube was an inappropriate information source about all-on-four concept. Patients need to be careful not to completely trust dental information that they search on YouTube, and dentists will have to upload relevant and reliable information using evaluation criteria such as DISCERN and JAMA benchmark.
Purpose: The purpose of this study is to evaluate the efficacy of oral appliance therapy for the treatment of obstructive sleep apnea (OSA) according to distinct polysomnographic phenotypes. Material and Methods: Forty four patients with OSA were evaluated before and after oral appliance therapy through polysomnography along with clinical and radiological examination. Treatment efficacy and change in respiratory parameters were evaluated according to polysomnographic phenotypes based on OSA severity, sleep position dependency and REM sleep relatedness. Results: Mean age of the patients was 49.8±11.3 years. The apnea-hypopnea index (AHI) value at baseline was 29.0±21.8/h. After a mean treatment duration of 56.6±42.0 months using an oral appliance, the overall AHI had reduced by 44.3±35.4%. Treatment efficacy of oral appliance for OSA was 47.7% with AHI < 10 and 40.9% for AHI >50% reduc tion. Results were similar regardless of OSA severity. The reduction of AHI and increase of oxygen saturation level was significantly greater in patients with positional OSA than in those with nonpositional OSA. Not-REM-related OSA patients showed significantly greater reduction of AHI and increase in oxygen saturation compared to those with REM-related OSA. Conclusion: Oral appliance therapy was effective in approximately half of the patients with OSA during a long-term follow-up period. Positional and not-REM-related OSA patients showed higher treatment efficacy and improvement with oral appliance therapy.
The purpose of this study is to compare and evaluate the methods through computer-assisted simulation surgery and surgical guide production in mandibular reconstruction using the fibula and the existing traditional method. From February 2021 to July 2022, 10 patients who underwent segmental mandibulectomy at our hos pital for two years were evaluated for operation time and reconstruction time. 10 patients underwent segmental mandibulectomy and reconstruction using a surgical guide prepared in advance through 3D analysis. In addi tion, we compared and analyzed 5 patients who had undergone surgery by the conventional method. In segmen tal mandibulectomy using a surgical guide, the average operating time was 443.50 minutes with the standard deviation (SD): 88.696, and the average reconstruction time was 64.90 minutes with the standard deviation: 11.377. The average operation time using the conventional method was 517.00 minutes with the standard devia tion (SD): 83.86, the average reconstruction time 77.80 minutes with the standard deviation (SD): 8.075. When the average operation time was compared, the p-value was 0.148, which was not statistically significant. In the comparison of the average reconstruction times, the p-value was 0.0425, which was statistically significant. In conclusion, it was found that in the case of mandibular reconstruction using the fibula, the operation time was shortened along with the decrease of the time in the reconstruction. The operation time in the conventional method was longer than that of the surgical guide method.
The aim of this study is to review the surgical application of virtual reality(VR) and augmented reality(AR) and report the cases by using virtual reality simulation and augmented reality navigation surgery. Virtual reality can provide an intuitive simulation that anyone can use easily and even if the understanding of the software is low. Virtual reality performs the operation in advance by reproducing the actual operation situation, and make the pre-operative plan. Virtual reality that makes this simulation possible, and this virtual reality-based simula tion can also be used for surgical education. Additionally, from the virtual planning can be applied for making 3D printing surgical guide using exporting the pre-operative planning data. Augmented reality could be highly useful for navigation in real operation.
Maxilla is a complex three-dimensional structure at midface. When wide defect occurred by oral cancer re section, it leaves a great challenge to oral and maxillofacial surgeons for the reconstruction of surgical defects. The wide maxilla defects usually include oral mucosa, skin, fascia and muscle as well as hard tissue such as dentition, bone structure. Consequently, great care should be given with the approach of composite 3D recon struction. A Microvascular free flap has been mainstay for maxilla reconstruction of multiple tissue defect. Fibula free flap, deep circumflex iliac artery free flap come as first choice. The composite 3D reconstruction is assisted by three dimensional image processing, 3D printing technology, polymer based fixation materials and concomitant soft tissue harvesting. The advanced treatment strategy for wide maxilla defect would be presented with three case reports in this article.
