Michael Mezitis

The normal range of mouth opening

The maximal mouth opening of 1,160 healthy Greek adults, 18 to 70 years old, was measured. The results were similar to those reported by investigators in other countries.

Changing trends in the treatment of zygomaticomaxillary complex fractures: A 12-year evaluation of methods used

PURPOSE The efficacy of the current methods for the treatment of fractures of the zygomaticomaxillary complex was evaluated. PATIENTS AND METHODS One thousand two hundred seventy-seven patients with fracture of the zygomaticomaxillary complex and 196 patients with fractures of the zygomatic arch that were admitted between 1984 and 1995 were evaluated. One thousand one hundred fifty surgical procedures were performed, and in 401 cases, no operative treatment was considered necessary. The Gillies approach was used in 514 cases, intraosseous wiring in 89 cases, bone plate osteosynthesis in 322 cases, Roger-Anderson pins in 180 cases, antral packing in 17 cases, and elevation with a hook in 28 cases. RESULTS The best results were achieved with the use of semirigid fixation with miniplates applied at one or more sites of the fractured complex, occasionally used in combination with other methods such as Roger-Anderson pins. CONCLUSIONS Semirigid fixation with miniplates offers the most reliable method available today for the treatment of zygomatico-orbital complex fractures and has practically replaced every other method in our institution. The increased cost and occasionally the necessity to remove the hardware are the main disadvantages of the method.

An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries

OBJECTIVE The aim of this study was to evaluate the incidence and etiology of maxillofacial fractures in the Greek population over the past 5 years. A comparison of findings with 2 earlier studies from the same department was also performed. STUDY DESIGN Seven hundred twenty-seven patients treated for a total of 1,142 facial fractures in the period from 2005 to 2009 were included in a retrospective, clinical, and epidemiologic study. Cause, type, site of injury, gender, age, and nationality of the patient were the parameters evaluated. RESULTS Road traffic accidents remained the most common cause of injury (50.8%) followed by assaults (26.3%), falls (13.8%), work-related injuries (3.2%), and sport injuries (3%). CONCLUSIONS Road traffic accidents remain the most frequent etiology of maxillofacial fractures. Fractures of the facial skeleton caused by assault increased significantly in the period assessed. Concomitant injuries were most frequently associated with motorcycle accidents.

The superior orbital fissure syndrome

The superior orbital fissure syndrome is a very rare condition, characterized by a fixed dilated pupil, ptosis and proptosis of the eye and ophthalmoplegia. We have had the opportunity to observe a number of such cases, and now report four of them.

Ossifying fibroma of the jaws. Review of the literature and report of 16 cases

Ossifying fibroma is a fibro-osseous lesion rarely occurring in the jaws, although more often than in other bones of the skeleton. It is not clear whether it represents a distinct entity or a certain stage of the fibro-osseous condition. We are presenting our experience with 16 cases of ossifying fibroma treated with local excision or resection and bone graft. Their radiographic picture varied significantly from one case to another. One case was peripheral and one recurred.

Benign neurogenic tumors of the oral cavity

Neurogenic tumors are rare in the oral cavity, particularly so when malignant. Traumatic neuroma, although usually included with neurogenic tumors, is a reactive process rather than a true neoplasm. Neurofibroma and schwannoma derive from nerve fibers, the perineurium, the endoneurium and the neurolemmomal cells. They present histological differences. The neurofibroma may present in solitary and generalized types; the latter also known as neurofibromatosis or von Recklinghausens disease of the skin. We here report typical cases of benign neurogenic tumors of the oral cavity.

Fractures of the facial skeleton in the edentulous patient

An evaluation was made of 112 fractures that occurred in 66 edentulous patients in a 10 year period. There was an average of 1.7 fractures per person. 104 fractures occurred in the mandible and 75% of these were treated without intermaxillary fixation or were not treated at all. In 28.5% of the cases no treatment was provided other than soft or liquid diet and appropriate instructions. As a group, the condylar fractures were those that were left with no treatment to a greater extent than any other group, apart from the Le Fort type of fracture; the latter being very few in absolute numbers. The age group associated with the edentulous state quite often suffers from conditions that may prohibit aggressive treatment. These conditions may be aggravated by the accident and, by the time the patient is ready for maxillofacial surgery, one has to contemplate (and discuss with the patient) the advantages and disadvantages of a procedure. It appears that aesthetics are of minor importance (to a certain degree) for elderly patients and small deviations from the normal (both in appearance and function) are acceptable to them, considering the prospect of an operation or of the prolonged discomfort, such as that associated with intermaxillary fixation. The advisability of the latter should be assessed carefully in view of the respiratory impairment that it may cause in patients whose airway may already be compromised.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma cell myeloma of the jaws

Solitary myeloma may be the first manifestation of the disseminated form, known as multiple myeloma, and characterized by multiple skeletal lesions, general metabolic alterations, impairment of renal function and eventually death. Involvement of the jaws is not unusual, although infrequently reported. We present 2 cases, where oral involvement was the first indication of the disease.

Orbital apex syndrome

The orbital apex syndrome is a very rare complication of fractures of the facial skeleton, as well as other conditions and is characterized by blindness, fixed dilated pupils, proptosis, ptosis of the eye and ophthalmoplegia. We are reporting such a case we had the opportunity of treating.

Aneurysmal bone cyst of the jaws: Review of the literature and report of 2 cases

Strictly speaking, the aneurysmal bone cyst is not a true cyst. It is a lesion characterized by replacement of bone by fibro-osseous tissue containing blood-filled cavernous spaces. It is usually treated by surgical curettage, and access within the jaws may sometimes be difficult. We reviewed the world literature and found 63 cases of aneurysmal bone cysts involving the face, 22 reported in the maxilla, and 63 in the mandible. One was found in the zygomatic arch. Of the patients reported, 88% were younger than 30 years old; there was an equal sex distribution. Included in this report, are two cases of our own, one involving the maxilla and one the mandible.