Dražen Jokić

Ambulatory oral surgery: 1-year experience with 11 680 patients from Zagreb district, Croatia

Aim To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia. Methods Sociodemographic and clinical data on 11 680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age. Results The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P < 0.001) and intraoral incisions (P < 0.001) were performed among male patients, whereas significantly more alveolectomies and apicoectomies were performed among female patients (P < 0.001). A greater prevalence of periodontal disease was found in patients residing in Zagreb than in patients residing in rural areas. Conclusion The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients’ awareness of the importance of oral health.

Soft tissue changes after mandibular setback and bimaxillary surgery in Class III patients

OBJECTIVE To evaluate the relationship between soft tissue and bone structure for Class III patients before and after bilateral sagittal split osteotomy (BSSO) and bimaxillary orthognathic surgery; to determine the impact of other factors on soft tissue change; and to evaluate correlations between thickness of tissue before surgery, SNA, SNB, and ANB angles, and soft tissue changes. MATERIALS AND METHODS The study included 78 Class III patients treated only with BSSO or with BSSO and Le Fort I osteotomy. Lateral cephalograms were taken before and 3 months to 1 year after surgery. After all points of the Zagreb82 and Legan and Burstone profile analysis were traced, the ratio of five soft tissue points before and after surgery was evaluated. RESULTS Soft tissue between points Sn and A and upper lip showed statistically significant changes for patients treated with bimaxillary surgery and BSSO. Only gender had an influence on soft tissue change. The correlation between soft tissue thickness and changes after surgery was significant. A change in SNB angle correlated with upper lip thickness for patients treated with BSSO but not for patients treated with BSSO and Le Fort I. SNA angle changes correlated with soft tissue changes between points Sn and A. CONCLUSION Results of this study show soft tissue changes after BSSO and BSSO and Le Fort I and eliminate the deficiencies that were indicated in the meta-analysis of soft tissue changes from a previous study.

Altered light-touch sensation after bilateral sagittal-split osteotomy A prospective study of 50 patients

OBJECTIVE To prospectively evaluate the incidence of change in light-touch sensation in the innervated area of the lower alveolar nerve after bilateral sagittal-split osteotomy (BSSO) with attention on the time it takes to rebuild the function of the inferior alveolar nerve. MATERIALS AND METHODS The sample consisted of 30 women and 20 men with a mean age of 22.14 ± 3.30 years. The neurosensory test was conducted with a 20-mm long monofilament of suture material Prolene (3-0) connected to a plastic holder. These tests were performed 1 day before surgery and every 2 weeks during first 2 months after surgery. After that, patients were tested once every month until the end of the first year. RESULTS All patients had a disturbance of light-touch sensation after BSSO, but none of these changes was permanent. The average duration of hypoesthesia was 6.6 ± 1.2 with a range from 4 to 9 months. The average duration of hypoesthesia for women was 6.27 ± 1.0 months, and men had hypoesthesia for 7.1 ± 1.2 months on average. This difference was statistically significant. The two oldest female patients, who were 33 and 37 years old at the time of the surgery, experienced altered sensitivity for only 4 months. CONCLUSIONS After BSSO, all patients experienced disturbed light-touch sensation in the innervated area of the lower alveolar nerve. A faster recovery in the oldest patients and a statistically significant difference between the sexes should be interpreted with caution.