Notes

Remission involving persistent methamphetamine-induced psychosis right after cariprazine remedy: display of an situation record.
Microvascular reconstruction of defects in the head and neck has always been a challenge in patients who have undergone previous neck dissection, owing to the prior resection of potential recipient blood vessels used for free flap perfusion.

The objective of the study is to evaluate the reliability and safety of free flap reconstruction in patients who have had previous neck dissection.

Twenty-four free flaps were performed in 22 patients with a previous history of neck dissection for head-and-neck squamous cell carcinoma. These included patients who underwent salvage surgery for recurrent cancer as well as patients undergoing secondary reconstruction following previous oncological resections. Selleck Ionomycin Flap includes 12 radial forearm free flaps, 5 fibula flaps, 1 rectus abdominis flap, and 6 anterolateral thigh flaps.

In cases with the previous history of selective neck dissection, recipient vessels on the ipsilateral/same side of the previously operated neck were used, while contralateral vessels were used ineful planning and relying on flaps with a long vascular pedicle obviates the need to perform a suitable vein graft. In our present series, careful planning and the right choice of a free flap with a long vascular pedicle contributes to the absence of free flap failure. In our experience, previous neck dissection should not be considered as a contraindication to microvascular reconstruction of previously operated oncologic defects.
A retrospective clinical study was performed regarding the minimally invasive-guided genioplasty technique (MIGG technique) described in a previous clinical note. The aims of this clinical study were to study the incidence of immediate complications with this technique compared with a control group using a nonminimally genioplasty technique, to validate the accuracy of the three-dimensional (3D) printed cutting guide, and to evaluate the duration of the surgery and the satisfaction of the surgeons with this technique.

One controlled group, including 56 patients, operated with a classical genioplasty and one group, including 24 patients operated with the MIGG technique. The inclusion criteria were patients from 18 years old benefiting from orthognathic surgery for dysmorphic maxillofacial disorders, sleep apneas, or posttraumatic malocclusion; operated by the three same surgeons. A database was retrospectively made, including the demographics parameters, the indication, the type and the duration of surgeryt combines the latest technologies in piezosurgery and in 3D-guided surgery by the creation of a validated-accurate 3D-printed cutting guide. This technique is affordable by the use of open-source program and a desktop fused deposit Modeling 3D-printer. Finally, the comfort of the surgeon is improved, and the operating time is decreased.
Postoperative pain is an important concern for patients who need dental implants. This study aims to compare the experience of pain in patients who undergo tooth removal and dental implant surgery.

This is a crossover study. Patients who underwent a simple tooth extraction and dental implant surgery were studied. The pain severity was assessed using a visual analog scale at 12, 24, 48, and 72 h after procedures. The repeated measure test was used to compare pain severity between two treatment sessions.

Forty patients were studied. Patients reported higher pain levels in a tooth extraction at study times than implant surgery (
= 0.001).

It seems patients who had experience of tooth extraction and a dental implant placement reported significantly lower pain in implant surgery.
It seems patients who had experience of tooth extraction and a dental implant placement reported significantly lower pain in implant surgery.
Implant-supported prosthetic rehabilitation of a severely atrophic posterior mandibular alveolar ridge is a real challenge. Implant placement in such situations is very difficult and implies the risk of inferior alveolar nerve (IAN) damage.

The purpose of this study is to evaluate the incidence of neurosensory disturbance and the cumulative survival of dental implants placed after the IAN transposition (IANT) procedures followed by dental implants placement.

Twenty International Team for Implantology implants were placed in eight patients following unilateral IANT. In two patients, nerve transposition was performed bilaterally, and hence, a total of 10 IAN transposition surgeries were performed. Neurosensory dysfunction was objectively evaluated by using light touch test (LT), pain test (PT), and 2-point discrimination test (2-DT). In addition, patients were asked to answer a short questionnaire to investigate the individual feeling of discomfort and advantages related to this surgical technique. The mean follow-up periods were 47.1 months (range 12-78 months).

Neurosensory disturbance (i.e., disturbance registered by the LT, PT, and 2-DT tests) was experienced in 2 of 10 cases. The cumulative implant survival was 100%. However, at the time of data analysis (12-79 months after surgery), all patients indicated that they would go through the surgery again.

IANT can permit the placement of implants with adequate length and good initial stabilization as used in routine sites, with the same favorable prognosis. All patients felt that they had received benefits from their new prostheses in terms of improved comfort, chewing efficiency, and esthetics.
IANT can permit the placement of implants with adequate length and good initial stabilization as used in routine sites, with the same favorable prognosis. All patients felt that they had received benefits from their new prostheses in terms of improved comfort, chewing efficiency, and esthetics.
Alloplastic temporomandibular joint (TMJ) replacement is a treatment strategy for segmental mandibular defects with occlusal abnormalities.

To describe our experience with extended total TMJ replacement (eTMJR) by reporting operative obstacles, complications, and patient-reported outcomes, as well as to suggest a subclassification system and paradigm shift.

University hospital and private clinic; case series with retrospective follow-up.

Five patients (6 eTMJRs) were followed for more than 1 year after surgery. Patient-reported outcomes were assessed using FACE-Q™ "Satisfaction with Outcome" questionnaires (sum and corresponding transformed Rasch scores).

Descriptive analyses were performed.

Problems were related to contralateral mandibular osteotomy healing (if performed), keying the prosthetic condyle into the fossa component, intra- and postoperative prosthetic lag, and intraoperative proper establishment of the occlusion when unilateral replacement was performed. Patients reported high satisfaous osseous transplant is still available in case of implant failure. A subclassification system is proposed for eTMJR, which accounts for contour corrections, occlusal adjustments, and simultaneous contralateral mandibular osteotomy.
The association of mandibular gonial angle, facial height, and jaw relationship in masseteric hypertrophy (MH) has not been adequately described for the typical Indian population. The aim of this study was to report the gonial angle relationship with facial height parameters in cases diagnosed with bilateral MH and its possible influence on the treatment plan.

This is a retrospective study based on archival records of bilateral MH cases surgically treated over a 10-year period at the author's center. Patients' records fulfilling inclusion and exclusion criteria were considered for the study. Age, gender, upper anterior facial height (UAFH), lower anterior facial height (LAFH), upper posterior facial height (UPFH), ramus height (also a reflection of the lower posterior facial height), and gonial angle were collected along with the type of bite (open/normal/deep), surgical procedure (debulking with/without bone removal), and concomitant jaw bone corrections (yes/no). These were subjected to statistical analysis using SPSS, and
≤ 0.05 was taken as statistically significant.

Overall, 21 patients formed the study group comprising 9 females and 12 males. Gender influenced the UAFH, LAFH, UPFH, ramus height, and gonial angle significantly. Males had higher values than females. Normal bite had an obtuse gonial angle than the deep bite, and the difference was statistically significant (
= 0.036). When the gonial angle was acute or square faced, the need for other surgical procedures was high and the difference was statistically significant (
= 00.048).

The results are discussed in the light of Indian skeletal anthropometry. The relationship of the gonial angle with facial height parameters in bilateral MH cases in this part of the world is presented.
The results are discussed in the light of Indian skeletal anthropometry. The relationship of the gonial angle with facial height parameters in bilateral MH cases in this part of the world is presented.
To compare the efficacy of intravenous (IV), intramassetric (IM) submucosal (SM) routes & oral routes of dexamethasone administration post impacted third molar removal surgery.

Prospective randomized comparative clinical study.

This prospective comparative study included 60 patients with Class II and position B type of impaction (according to Pell and Gregory's classification). Patients were randomly divided into 4 groups. Group A, B, C & D patients received 8mg dexamethasone immediately post-surgical tooth removal via the IV, SM and IM route & oral respectively. Assessment of swelling, mouth opening and pain was done at intervals of 1st, 3rd and 7th post-op days.

The average age of the patients was 27 years. The mean time taken was 20 mins 40 seconds. The IV group showed minimal swelling and better pain control on the 3rd post op day (statistically significant). All 4 routes showed comparable mouth opening results.

IV administration of dexamethasone post third molar surgery has been the traditional way because of its faster onset of action and increased efficacy; IM and SM routes are also comparably effective although oral route had the best patient acceptance.
IV administration of dexamethasone post third molar surgery has been the traditional way because of its faster onset of action and increased efficacy; IM and SM routes are also comparably effective although oral route had the best patient acceptance.
Nasotracheal intubation is the most common method of airway management in oral and maxillofacial surgery patients. However, many times, it is associated with bleeding resulting from trauma to nasopharyngeal mucosa. We conducted this study to determine the effectiveness of nasopharyngeal airway (NPA) to easily facilitate the nasopharyngeal insertion and to reduce the trauma during nasotracheal intubation.

A total of 120 patients scheduled for elective oral and maxillofacial surgery requiring nasotracheal intubation were randomly divided into two groups of 60 each, after preparation with xylometazoline drops intranasally, lubrication with lignocaine jelly, and thermosoftening of the tip of the endotracheal tube (ETT). In group NPA, dilatation of the nasal cavity was done with NPA before nasotracheal intubation and in Group C, nasotracheal intubation was done without dilatation of the nasal cavity. The smoothness of insertion of ETT was graded on a 4‑point rating scale. Assessment of bleeding into nasopharynx was confirmed during laryngoscopy and was also graded with 4‑point scale.
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