Application of machine learning in oral and maxillofacial surgery

Oral and maxillofacial anatomy is extremely complex,and medical imaging is critical in the diagnosis and treatment of soft and bone tissue lesions.Hence,there exists accumulating imaging data without being properly utilized over the last decades.As a result,problems are emerging regarding how to integrate and interpret a large amount of medical data and alleviate clinicians’workload.Recently,artificial intelligence has been developing rapidly to analyze complex medical data,and machine learning is one of the specific methods of achieving this goal,which is based on a set of algorithms and previous results.Machine learning has been considered useful in assisting early diagnosis,treatment planning,and prognostic estimation through extracting key features and building mathematical models by computers.Over the past decade,machine learning techniques have been applied to the field of oral and maxillofacial surgery and increasingly achieved expert-level performance.Thus,we hold a positive attitude towards developing machine learning for reducing the number of medical errors,improving the quality of patient care,and optimizing clinical decision-making in oral and maxillofacial surgery.In this review,we explore the clinical application of machine learning in maxillofacial cysts and tumors,maxillofacial defect reconstruction,orthognathic surgery,and dental implant and discuss its current problems and solutions.

Nd:YAG water mist laser treatment for giant gestational gingival tumor: A case report

BACKGROUND This case of gestational gingival tumor is huge and extremely rare in clinical practice.As the growth location of this gingival tumor is in the upper anterior tooth area,it seriously affects the pregnant woman's speech and food,causing great pain to the patient.The use of Nd:YGA water mist laser to remove the gingival tumor resulted in minimal intraoperative bleeding,minimal adverse reactions,and good postoperative healing,which is worthy of clinical promotion and application.CASE SUMMARY The patient,a pregnant woman,reported a large lump in her mouth on the first day of postpartum treatment.Based on medical history and clinical examination,the diagnosis was diagnosed as gestational gingival tumor.Postoperative pathological biopsy also confirmed this diagnosis.The use of Nd:YAG water mist laser to remove the tumor resulted in minimal intraoperative bleeding,clear surgical field of view,short surgical time,and good postoperative healing.CONCLUSION In comparison to traditional surgery,Nd:YAG water mist laser surgery is minimally invasive,minimizes cell damage,reduces bleeding,ensures a clear field of vision,and virtually eliminates postoperative edema,carbonization,and the risk of cross infection.It has unique advantages in oral soft tissue surgery for pregnant patients.Therefore,the clinical application of Nd:YAG water mist laser for the treatment of gestational gingival tumors is an ideal choice.

The WhatsApp Application as a Teledentistry Tool in Oral and Maxillofacial Surgery in Cameroon

Introduction: Technological advances have greatly influenced the healthcare sector. The ability to transmit information and deliver services using telecommunication tools continues to transform the way healthcare is delivered around the world. The aim of this study was to highlight the epidemiological, clinical and therapeutic profile of oral and maxillofacial surgery patients consulted using the WhatsApp application. Methodology: This was a three-year descriptive study with a retrospective data collection, from 2021 to 2023, of WhatsApp communications between our team and oral and maxillofacial surgeons in Cameroon. In this study, the type/content of messages received, the epidemiological data of practitioners and patients, the various pathologies diagnosed and the procedures performed were evaluated. Results: 319 communications were received for a total of 146 cases. Written messages associated with images (photographs and/or X-rays) were the most frequently received, at 85.62%. Hospitals in urban areas were the most represented at 93.84%. Oral health professionals in the private sector sent more messages (65.75%). In terms of diagnoses, tumour and cystic pathologies were the most common (28.08%), followed by impacted/retained teeth (22.6%). Patients were referred to our hospital for treatment in 62.33% of cases. Conclusion: The WhatsApp application is an easy-to-use telecommunications tool. It facilitates exchanges between practitioners and improves patient care in oral and maxillofacial surgery.

Impacted Lower Third Molar Fused with a Supernumerary Tooth—Diagnosis and Treatment Planning Using Cone-Beam Computed Tomography

This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan＇s radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography--which provides precise three- dimensional information--was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomo- graphy.

Acellular Mineralized Exoskeleton Shrimp (MES): A Natural Source of Bioactive Factors for Tissue Regeneration—Preliminary Results

Current challenges in the development of scaffolds for bone regeneration include the engineering of biomaterials that can withstand a natural dynamic physiology on the bone that provides a matrix capable of supporting cell migration and tissue ingrowth. The objective of the present work was to develop and characterize a new biomembrane—Mineralized Exoskeleton Shrimp (MES) developed from the exoskeleton of paleomonetes. The integration of MES as a biomaterial for tissue regeneration relies on the growing evidence that the shrimp is characterized by a hierarchically arranged chitin fiber structure, mineralized predominately by calcium carbonate and/or calcium phosphate, bringing beneficial effects in bone regeneration. Additionally, the tridimensional MES structure, can act as a “tent” for Guided Bone Regeneration (GBR). Recently, our team has characterized the MES biomaterial by in vitro (human osteoblastic cellular cultures and immersion of the membrane in modified synthetic plasma) and in vivo (soft tissue in lab mice and hard tissue in rabbit model). The cellular growth in the MES membrane was very exuberant in cellular culture with osteoblastic colonization on its surface (histophilic and biocompatible). After the immersion in modified synthetic plasma for one week, a mass mineralization occurred throughout the membrane’s surface (bioactive). The analysis of histological samples from experimental surgery in lab mice showed that the MES membrane wasn’t toxic to soft tissues and that it caused a moderate inflammatory response (first reabsorption signs at 8 weeks). The MES could act as a cell-guiding template that contains the necessary cues and adequate three-dimensional set to facilitate cell adhesion and promote tissue regeneration upon implantation and subsequent biodegradation.

Mandibular cementoblastoma:Case report

Cementoblastoma is a rare benign lesion that represents less than 1% of all odontogenic tumours. It’s characterized by proliferation of cementum-like tissue and in almost all cases tends to be associated with an erupted permanent tooth, most often the first mo- lar. We present an unusual case of a large cemento-blastoma that affected the right mandibular body, extending from the first premolar to the second molar, of a 19-years-old male. In this case an initial surgery was attempted under local anaesthesia, resulting in incomplete tumor removal. A second surgical procedure was performed under general anaesthesia, ensuring the complete excision of the lesion. The patient was monitored for 1 year after surgery and did not show any signs of recurrence.

Adenomatoid odontogenic tumour displacing multiple teeth in an adolescent

Adenomatoid odontogenic tumor is an unusual benign neoplasm which shares clinical and radiographic characteristics with odontogenic cystic lesions denoting a distinct behavior. This paper reports a case of a 12-year-old boy with a bony consistence tumefaction involving the area from teeth 12 to 17. Radiographically, the lesion was characterized by a well-circum- scribed unilocular radiolucent area displacing maxillary canine, first and second premolars. The final diagnosis was adenomatoid odontogenic tumour. The lesion was enucleated concomitantly with the removal of the canine tooth under general anesthesia. The patient was submitted to orthodontic treatment and has been followed-up for four years. Clinical and radiographic features are discussed in this report.

中国口腔颌面外科专科医师培训和教育指南

中华口腔医学会口腔颌面外科专业委员会(Chinese Society of Oral and Maxillofacial Surgery,简称CSOMS)是国际口腔颌面外科医师协会(IAOMS)和亚洲口腔颌面外科医师协会(AsianAOMS)成员。本培训和教育指南的制定,是为了提高患者在接受口腔颌面部疾病诊治过程中的医疗水平和条件。对于直接参与这些医疗工作的口腔颌面外科医师来讲,他们的专业水平和所接受的专业培训教育水平是其所提供医疗服务水平高低的决定性因素。

Exposed endoscopic full-thickness resection for duodenal submucosal tumors: Current status and future perspectives

Exposed endoscopic full-thickness resection(EFTR),with or without laparoscopic assistance,is an emergent natural orifice transluminal endoscopic surgery technique with promising safety and efficacy for the management of gastrointestinal submucosal tumors(SMTs)arising from the muscularis propria(MP),especially of the gastric wall.To date,evidence concerning duodenal exposed EFTR is lacking,mainly due to both the technical difficulty involved because of the special duodenal anatomy and concerns about safety and effectiveness of transmural wall defect closure.However,given the non-negligible morbidity and mortality associated with duodenal surgery,the recent availability of dedicated endoscopic tools for tissue-approximation capable to realize full-thickness defect closure could help in promoting the adoption of this endosurgical technique among referral centers.The aim of our study was to review the current evidence concerning exposed EFTR with or without laparoscopic assistance for the treatment of MP-arising duodenal SMTs.

The infrahyoid myocutaneous flap for reconstruction after oral cancer resection: A retrospective single-surgeon study

Objective:To review our experience with infrahyoid myocutaneous flap in reconstruction after oral cancer resection.Methods:Chart reviews were completed for all patients who underwent oral reconstruction with an infrahyoid myocutaneous flap by a single surgeon in the Department of Otolaryngology at Chonburi Cancer Hospital from 2011 to 2017.Characteristics of the patients and postoperative complications were analyzed.Results:Of the 34 patients in the study,10(29.4%)developed partial flap loss and 1(2.9%)developed total flap loss.All cases of partial flap loss resolved with conservative treatment.Apparent cancer involvement of a cervical lymph node was significantly associated with flap failure(odds ratio:5.0,95%CI:1.03e24.28).Conclusions:The infrahyoid myocutaneous flap is a fairly reliable reconstruction method.The flap should be performed with caution in cases with gross lymph node involvement.