Prevention of Frey’s Syndrome with the Use of Porcine Dermal Collagen Graft: Retrospective Analysis of 76 “Formal” Parotidectomies for Benign Pathologies

Background: Frey’s syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. Methods: We conducted a 20-year retrospective study including the patients who had undergone “formal” (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. Results: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey’s syndrome was found after the use of dermal collagen interpositional barrier ( P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor’s test was positive at an incidence of 59.09% in Group A and 21.87% in Group B ( P = .004, 95% CI). Severe Frey’s syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B ( P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey’s syndrome in the compared groups, Conclusion: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey’s syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.

Synthesis of polymethyl methacrylate– ollagen graft copolymer using a photocatalyst - complex oxide RbTe1.5W0.5O6

The synthesis of polymethyl methacrylate – collagen graft copolymer was carried out upon initiation of the process by radicals formed upon irradiation of the complex oxide RbTe1.5W0.5O6 with visible light (λ = 400-700 nm) at a temperature of 250C. The characteristics of the new polymer material were obtained by the methods of elemental and physicochemical analyzes.

Effect of collagen matrix on postoperative palatal fistula in cleft palate repair

Palatal fistula is a challenging complication following cleft palate repair. We investigated the usefulness of collagen matrix in the prevention of postoperative fistula. We performed a retrospective cohort study of patients with cleft palate who underwent primary palatoplasty (Furlow’s double opposing z-plasty) in Seoul National University Children’s Hospital. Collagen Graft and Collagen Membrane (Genoss, Suwon, Republic of Korea) were selectively used in patients who failed complete two-layer closure. The effect of collagen matrix on fistula formation was evaluated according to palatal ratio (cleft width to total palatal width) and cleft width. A total of 244 patients (male, 92 and female, 152; median age, 18 months) were analyzed. The average cleft width was 7.0 mm, and the average palatal ratio was 0.21. The overall fistula rate was 3.6% (9/244). Palatal ratio (p = 0.014) and cleft width (p = 0.004) were independent factors impacting the incidence of postoperative fistula. Receiver operating characteristic curve analysis showed that the cutoff values in terms of screening for developing postoperative fistula were a palatal ratio of 0.285 and a cleft width of 9.25 mm. Among nonsyndromic patients with values above those cutoffs, the rates of fistula development were 0/5, 1/6 (16.7%), and 4/22 (18.2%) for those who received Collagen Graft, Collagen Membrane, and no collagen, respectively. Collagen matrix may serve as an effective tool for the prevention of palatal fistula when complete two-layer closure fails, especially in wide palatal clefts. The benefit was most evident in Collagen Graft with thick and porous structure.

Prevention of Bone Resorption by HA/β-TCP + Collagen Composite after Tooth Extraction: A Case Series

After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.

AUTOTRANSPLANTASI GIGI-GIGI IMPAKSI INSISIVUS MAKSILA KANAN DISERTAI KISTA DENTIGEROUS DENGAN PENAMBAHAN GRAFT KOLAGEN KARBONAT APATIT

Background: Autotransplantation is a surgical movement to reposition teeththat have been erupted, partially erupted or not yet erupted from one place to another in the same individual, either on post-extraction sockets or artifcial sockets made by surgery. Dental folicle from impacted teeth may develope dentigerous cysts that will result in destruction of the jaw bone. There are many factors that influence the success of autotransplantation, one of which is adequate bone support.The purpose of this poster is to present the successful autotransplantation treatment of impacted right maxillary incisor teeth associated with dentigerous cyst and bone support replacement after cyst enucleation using a carbonate apatite collagen graft, GAMACHA®, at RSUP Dr. Sardjito.Case management: A 9-year-old girl, referred to the Oral and MaxillofacialSurgery Department of RSUP Dr. Sardjito with the complaint of right deciduous maxillary incisor persistence. Radiological examination showing persistent of 51 and 52 radices and impaction of teeth 11 and 12 in a horizontal position above radix 53. Also visible radiolucent image with a frm limit around the crown of 11 that supports the image of cyst. This patient performed cyst enucleation under general anesthesia, removal of impacted 11 and 21, followed by an artifcial socket drilling at the alveolar bone that could support all aspects of the root wall although only on the apical part of the tooth root for teeth 11 and 12 placement. Autotransplantation of teeth11 and 12 followed by the application of GAMACHA® and wire fxation, strengthen with acrylic splint.Conclusion: Two years follow up after surgery, patient have no complaintseither from aesthetic or functional and the result of clinical and radiologicalexamination did not found existence of any pathological abnormalities around teeth 11 and 12.