This study developed a zygomaticomaxillary complex (ZMC) patient-specific repairing thin (PSRT) implant based on the buttress theory by integrating topology optimization and finite element (FE) analysis. An intact facial skeletal (IFS) model was constructed to perform topology optimization to obtain a hollow skeleton (HS) model with the structure and volume optimized. The PSRT implant was designed based on the HS contour which represented similar trends as vertical buttress pillars. A biomechanical analysis was performed on a ZMC fracture fixation with the PSRT implant and two traditional mini-plates under uniform axial loads applied on posterior teeth with 250 N. Results indicated that the variation in maximum bone stress and model volume between the IFS and HS models was 15.4% and 75.1%, respectively. Small stress variations between the IFS model and repairing with a PSRT implant (2.75–26.78%) were found for compressive stress at frontal process and tensile stress at the zygomatic process. Comparatively, large stress variations (30.67–96.26%) with different distributions between the IFS model and mini-plate models were found at the corresponding areas. This study concluded that the main structure/contour design of the ZMC repair implant according to the buttress position and orientation can obtain a favorable mechanical behavior.

Background/Objective: This study aimed to evaluate nasal changes in maxillary advancement in patients undergoing to prevent nasal base widening after modified Le Fort I osteotomy. Methods: A retrospective cohort study of 26 subjects undergoing modified Le Fort I osteotomy for Class III malocclusion was implemented. Patients undergoing Lefort I advancement and bilateral sagittal split osteotomy receive a Cinch suture before wound closure. Facial soft tissue landmarks of the nose including nasal height, nasal length, nasal tip projection, alar width, alar base width, Philtrum length, nasolabial angle, nasofrontal angle, and columella inclination before and at 12 months after surgery were obtained by a 3D stereophotogrammetry. Results: No significant changes in nasal height, length, columellar length, or vertical height after maxillary advancement with modified Le Fort I osteotomy. Nasal tip projection increased but not significantly. Modified Le Fort I osteotomy did not change alar basal width after maxillary advancement. However, alar width widening was significantly different ( P <0.001). The majority of nasal angles showed preoperative and postoperative nasolabial angle differences (Preop: 98.38 postop: 99.96) without statistical significance. Conclusion: This study suggests that the modified Le Fort I osteotomy is effective in preventing significant nasal changes in case of maxillary advancement with promising results in addressing mid-face retrusion.

Adipose-derived stem cells (ADSCs) have become an accepted source of cells in bone tissue engineering. This study aimed to investigate whether platelet-rich plasma (PRP) lysate can replace traditional fetal bovine serum as a culture medium with the enhanced proliferation and osteogenic potential of ADSCs. We divided the experiment into 5 groups where the ADSCs were cultured in an osteogenic medium containing 2.5%, 5%, 7.5%, and 10% PRP lysate with 10% fetal bovine serum as the control group. The cell proliferation, alkaline phosphatase (ALP) activity, ALP stain, alizarin red stain, osteocalcin (OCN) protein expression, and osteogenic-specific gene expression were analyzed and compared among these groups. The outcome showed that all PRP lysate–treated groups had good ALP stain and ALP activity performance. Better alizarin red stains were found in the 2.5%, 5%, and 7.5% PRP lysate groups. The 2.5% and 5% PRP lysate groups showed superior results in OCN quantitative polymerase chain reaction, whereas the 5% and 7.5% PRP lysate groups showed higher OCN protein expressions. Early RUNX2 (Runt-related transcription factor 2 () genes were the most expressed in the 5% PRP lysate group, followed by the 2.5% PRP lysate group, and then the 7.5% PRP lysate group. Thus, we concluded that 5% PRP lysate seemed to provide the optimal effect on enhancing the osteogenic potential of ADSCs. Platelet-rich plasma lysate–treated ADSCs were considered to be a good cell source for application in treating nonunion or bone defects in the future.