Background/Aim. Epidemiology of maxillofacial fractures (MFF) varies between populations. This study investigated the epidemiology of MFF treated at the Oral and Maxillofacial Surgery (OMFS) Unit, Hospital Universiti Sains Malaysia (USM).Methods. A retrospective review of 473 medical records of patients with MFF treated from June 2013 to December 2015 was conducted. Information on demographic characteristics of patients, aetiology of injury, types of MFF, and treatment was obtained. Descriptive analysis, Pearson's chi-squared test, and multiple logistic regression analysis were conducted. The level of significance was set at 0.05.Results. Most patients treated for MFF were males (82.2%), aged 30 and below (63.1%), and from Malay ethnic (97.4%). Road traffic accident was the most common cause of MFF (83.1%), with motorcycle accident accounting for most injuries (73.6%). Orbital wall fracture was the most frequent MFF type (51.2%). About half of MFF patients (51.4%) were treated conservatively. Patients aged more than 20 years old were at higher odds of sustaining orbital wall fracture (AOR= 1.76; 95% CI: 1.214-2.558;P= 0.003) but were at lower odds of sustaining mandibular fracture (AOR= 0.47; 95% CI: 0.315-0.695;P= 0.001) than patients who are 20 years old and younger. Helmet use among motorcyclists was significantly associated with the nasal, orbital wall, and maxillary sinus wall fractures (P=0.006, 0.010, and 0.004, respectively).Conclusion. Motorcycle accident was the most common cause of MFF in Kelantan, Malaysia. Ages of patient and helmet use were associated with the type of MFF sustained. This study provides important information to facilitate the planning of MFF prevention strategies among motorcyclists and emphasizes the importance of using a helmet when riding a motorcycle.

Diabetes mellitus is known to compromise the various aspects of homeostasis, including the immune response and the composition of oral microflora. One of the oral manifestations of diabetes mellitus is tooth loss and the survival rate of dental implants chosen as a treatment modality for its rehabilitation is controversial. The current study aims to evaluate and compare the failure rate of dental implants between well-controlled diabetic and healthy patients. A retrospective study of case-control design was conceptualized with 121 well-controlled diabetic and 136 healthy individuals. Records of subjects who had undergone oral rehabilitation with dental implants between the periods of January 2013 to January 2016 were retrieved. Post-operative evaluation was carried out for all patients for about three years to assess the immediate and long-term success of the procedure. From a total of 742 dental implants, 377 were placed in well-controlled diabetic patients (case group) and 365 in healthy subjects (control group). A comparable (9.81%), but non-significant (p = 0.422) failure rate was found in the case group in comparison to the control group (9.04%). A non-significant (p = 0.392) raised number (4.98%) of failure cases were reported among females in comparison to males (4.44%). In respect to arch, the mandibular posterior region was reported as the highest failure cases (3.09%; p = 0.411), with 2.29% of cases reported in the mandibular anterior (p = 0.430) and maxillary posterior (p = 0.983) each. The maxillary anterior region was found to have the least number (1.75%; p = 0.999) of failure cases. More (4.98%; p = 0.361) cases were reported to fail during the functional loading stage in contrast to osseointegration (4.44%; p = 0.365). A well-controlled diabetic status does not impose any additional risk for individuals undergoing dental implant therapy.

Cone beam computed tomography (CBCT) allows for the dimensional evaluation of jaw anatomic structures and the measurement of jawbone mineral density (BMD), to evaluate the relationship between the measured CBCT grayscale (GS) values and (dual X-ray absorptiometry) DXA scores among osteoporotic and normal dental implant participants. In addition, it can help to establish the CBCT GS values in different jaw regions that might indicate or associate osteoporosis. Eighty-one (81) participants (59 females and 22 males) were recruited into this clinical inquiry. Participants’ ages ranged between 36 and 75 years (mean age ± SD: 57.9 ± 9.3 years). The inclusion criteria included patients diagnosed with osteoporosis and were indicated for the dental implant-supported prosthesis.GS values were calculated for each participant using the CBCT radiograph and associated computer software. The average T values obtained from L1, L2, L3 and L4 were recorded and evaluated for one time only, and correlated with CBCT GS values at different jaw positions. Associations between age, gender, GS values, and T values were evaluated by Pearson correlation tests. The GS values at posterior maxilla were able to predict the presence of osteoporosis (P < 0.001, R square = 0.849). On the other hand, attempts to predict T value using GS at different jaw sites showed that GS values at posterior maxilla and anterior mandible were able to predict T value (P < 0.001, R square = 0.924). The CBCT GS values of BMD at different jaw bone regions are significantly related to the DXA T values in the presence of osteoporosis.

Upper airway assessment is particularly important in the daily work of orthodontists, because of its close connection with the development of craniofacial structures and with other pathologies such as Obstructive Sleep Apnea Syndrome (OSAS). Three-dimensional cone-beam computed tomography images provide a more reliable and comprehensive tool for airway assessment and volumetric measurements. However, the association between upper airway dimensions and skeletal malocclusion is unclear. Therefore, the current systematic review evaluates the effects of different surgical movements on the upper airway. Materials and Methods: Medline (PubMed, OVID Medline, and EBSCO), Cochrane Library (Cochrane Review and Trails), Web of Knowledge (social science, and conference abstracts), Embase (European studies, pharmacological literature, and conference abstracts), CINAHL (nursing and allied health), PsycInfo (psychology and psychiatry), SCOPUS (conference abstracts, and scientific web pages), and ERIC (education) databases were searched. Two authors independently performed the literature search, selection, quality assessment, and data extraction. Inclusion criteria encompassed computed tomography evaluations of the upper airway spaces with retrospective, prospective, and randomised clinical trial study designs. To grade the methodological quality of the included studies a GRADE risk of bias tool was used. Results and conclusion: In total, 29 studies were included. Among these, 17 studies had a low risk of bias, whereas 10 studies had a moderate risk of bias. A meta-analysis was performed with the mean differences using a fixed-effects model. Heterogeneity was assessed with the Q-test and the I² index. The meta-analysis revealed significant (p ≤ 0.001, 95% confidence interval) increases in upper airway volume after rapid maxillary expansion and surgical advancement for the correction of Class II.

Objective: To evaluate the cephalometric norm for Saudi sample by Ricketts analysis (RA). Material and Methods: In this cross-sectional study, cephalometric radiographs were taken for 500 samples. The subjects included 250 males and 250 females. The ages of the subjects ranged from 18-30years. The criteria of selection were based on Class I incisor relationship, no skeletal abnormality and no previous orthodontic treatment. Lateral cephalometric radiographs were taken, traced and digitized by SPSS software, according to RA. An independent t-test was used to test the level of significance between genders. Results: Significant disparities found between Saudi males and females in dental and soft tissue measurements. The result showed that the distal position of the maxillary first molar to pterygoid vertical plane (U6 to Ptv) measurement was highly significantly greater (p<0.001) in Saudi males than females. Lower incisor to A-Pog (L1 to A-Pog) and lower lip to E plane was significantly longer (p<0.05) in Saudi males than females. Other measurements had no significant difference between Saudi males and females. Conclusion: The craniofacial morphology of the Saudi males was different from Saudi females using Ricketts analysis. This study will help the clinicians to diagnosis and treatment planning of orthodontic and orthognathic patients.

The aim of this study was to evaluate the changes in the peri-implant hard and soft tissues and implant stability and to assess the correlation of bone loss and peri-implant probing depth with implant stability. Twenty-one patients with implants were included in this study and implants were assessed by resonance frequency analysis (RFA). Bone levels of the implants were assessed by measuring mesial and distal bone levels from the periapical radiograph, and soft tissue was assessed from probing depth using a periodontal probe. Implants were assessed for stability and probing depth at pre-loading, at 3 months and 6 months post-loading. RFA and probing depth were statistically compared from different time points. Correlation of probing depth and marginal bone loss with implant stability was also determined. The average change in implant stability quotient (ISQ) measurements from pre-loading to 6 months post-loading was found to be statistically significant (p <0.005). The average probing depth reduced from 1.767 mm at pre-loading to 1.671 mm at post-loading 3 months, and 1.600 mm at post-loading 6 months. At 6 months of function, radiographic examination yielded 0.786 mm mesial bone loss and 0.8 mm distal bone loss. It was found to be statistically significant (p <0.005) but within an acceptable range. No significant correlation was found between implant stability and bone loss; and implant stability and probing depth. The study revealed an increasing trend in implant stability values with the time that indicates successful osseointegration. Increasing mean values for mesial and distal bone loss were also found. The success of dental implants is highly dependent on the quality of bone and implant-bone interface, i.e., osseointegration. The most important factors that influence the survival rate of an implant is initial stability. The present study found the changes in the peri-implant hard and soft tissues and implant stability. This article, while being a prospective study, may show the evidence of successful osseointegration by increasing trend in implant stability (RFA) values with time which can help to the clinician in the long-term management of implants.