Surgeries

The evolution of technology and computer graphics algorithms has had a significant impact on the healthcare sector. It is possible to find proposals using virtual reality or augmented reality devices focused on multiple areas, such as education and skills acquisition, the visualisation of results, and disease detection or surgical planning. The use of these new technologies allows the generation of flexible spaces in which the spatial visualisation of clinical data, such as medical images, is enhanced. This also promotes collaboration between different members of the healthcare community. This study aims to review and synthesise current research and the status of applications using systems within Milgram’s continuum of virtuality as tools to facilitate educational or surgical processes in the healthcare sector. We highlight recent approaches to tackling the various key challenges, as well as the limitations of these approaches, and point toward areas of future development. Full article

Background: Neocondylar formation is an uncommon finding that can result after the reconstruction of a vascularized free flap. Three case reports were presented in the current article. (1) A 64-year-old male presented with clear cell Odontogenic Carcinoma to the left mandible. (2) A 14-year-old male presented with an ameloblastoma to the right mandibular associated with tooth 48. (3) A 13-year-old female presented with an ameloblastoma to the right mandible. Methods and Results: All three cases required a surgical resection of the mandible involving the temporomandibular joint. Reconstruction was performed using a vascularized free flap, and Neocondylar formation was observed during the healing process in all three cases. Neocondylar formation after a vascularized free flap reconstruction can improve anatomical functions such as mastication and decrease post-operative complications. Knowledge of this finding can improve future surgical treatment planning and outcome. Conclusion: This report contributes to the existing literature by offering new insights into neo-condylar formation following mandibular reconstruction with vascularized free fibular flap, particularly in complex resective surgeries, and highlights its potential clinical implications. Full article

Background/Objectives: This study identifies and characterizes temporal bone fractures over a five-year period at a level one trauma center, focusing on the injury mechanism, otic capsule involvement, facial nerve involvement, fracture orientation, and the impact of the COVID-19 pandemic on skull base trauma. Methods: This retrospective cross-sectional study from a single level one trauma center reviewed skull base fractures from March 2018 to July 2023, identified with ICD-10 codes. Temporal bone fractures were categorized as otic capsule-sparing or -involving and by orientation (transverse, longitudinal, or oblique). Data were grouped into before, during, and after the COVID-19 lockdown period to address the impact of the COVID-19 pandemic. Data were also grouped into facial nerve injury and no facial nerve injury. Fisher’s exact test (5% significance) and descriptive statistics were used to compare groups. Results: A total of 364 fractures were identified. Facial nerve injuries (6.1%) were more likely in otic-capsule-involving (p < 0.001) and transverse or oblique fractures (p < 0.001). During the COVID-19 lockdown, hospital stays (p = 0.011) and ICU days (p = 0.035) were shorter. Among 22 facial nerve injury cases, half received high-dose steroids, but 6 died before evaluation. Six had complete paralysis; all received steroids, and three had surgical decompression. Only two had documented recovery. Of the 10 patients with partial paralysis, 5 received steroids, but only 2 showed improvement. All patients with incomplete eye closure received protective measures. Conclusions: Temporal bone fractures involving the otic capsule or transverse/oblique patterns are more likely to result in facial nerve injury. There are treatment discrepancies, which highlight a lack of a standard approach to treating those with facial nerve injury. An analysis of the impact of the COVID-19 pandemic revealed shorter hospital and intensive care stays during this time. Full article

Background: Some rib fractures do not heal appropriately and can cause significant pain and morbidity. Little is known about the locations likely to experience dysfunctional healing. We sought to determine the location of symptomatic non-union/malunion (NU/MU) rib fractures presenting to our Chest Wall Injury and Reconstruction Center. Methods: A single-center retrospective cohort study was conducted on all patients with NU/MU fractures presenting for evaluation at our CWIRC from 1 January 2019 to 30 July 2023. Their rib injury locations were mapped using computed tomography scans of the chest and a physical exam was used to characterize the location of their symptomatic NU/MU fractures. The location of the NU/MU injury was identified as either the anterior (A), anterior–lateral (AL), lateral (L), posterior–lateral (PL), or posterior (P) region of the chest wall. The results are presented as a mean +/− standard deviation for normally distributed data and median (minimum—maximum) for non-normally distributed data. Results: A total of 28 cases were evaluated. The average age at time of presentation was 48+/−14 years and 71% of patients were male. A total of 72 NU/MU fractures (median/pt 2(1–11)) were evaluated. Sixty-one percent of the injuries were on the right side. In most patients (25/28, 89%), the injuries were all in the same anatomic location in the rib cage. Three patients had NU/MU injuries in multiple anatomic locations. All multilevel injuries were sequential, without any normally healed ribs between NU/MU injuries. The most common locations were the L and PL regions (A–3, AL–8, L–19, PL–42, P–0). The most commonly symptomatic ribs were in ribs 6–10. Conclusions: Symptomatic NU/MU healing often occurs in the L and PL locations along the bony chest wall. Symptomatic NU/MU injuries also occur in the cartilaginous extensions of the bony ribs and along the costal margin. Symptomatic NU/MU healing is uncommon in the A and AL upper rib cage, as well as in P injuries. Full article

Introduction: Obesity affects over 650 million individuals worldwide and poses a significant public health challenge. Bariatric surgery is the most effective treatment for severe obesity, resulting in substantial weight loss and improvements in obesity-related conditions. However, the weight loss achieved through bariatric surgery is often associated with a notable decline in skeletal muscle. This association suggests an elevated risk of sarcopenia among patients following surgery. The purpose of this study was to assess the effects of obesity and bariatric surgery on indicators and diagnoses related to sarcopenia before and after surgery. Methods: A total of 17 bariatric surgery patients participated in this prospective study. The parameters for diagnosing sarcopenia were established for each participant, based on the EWGSOP2 and EASO/ESPEN consensuses. All evaluations were conducted at five time points throughout this study: before surgery and at 1, 6, 12, and 18 months post-surgery. Results: In this study, 88.2% of the subjects were female, with an average BMI of 42.9 kg/m² and a mean weight of 105.9 kg. After surgery, the average weight consistently decreased, with all differences from baseline being statistically significant (p < 0.001). Utilizing the SARC-F questionnaire for screening, the risk of sarcopenia increased post-surgery, then decreased at 12 months, ultimately reaching zero at 18 months. Muscle strength significantly decreased (p = 0.002) during the one-month post-surgery assessment, with slight variations thereafter, none of which were statistically significant. Muscle mass was normal prior to surgery but showed a significant decline post-surgery (p < 0.001). When applying the ESPEN/EASO consensus cut-off criteria for sarcopenic obesity, 35.3% of patients met the criteria preoperatively. After surgery, this figure rose to 70.6% in the first month but then decreased to 41.2% at 6 months. Conclusions: The findings reveal a distinct detrimental impact of bariatric surgery on muscle strength and mass, which are crucial indicators of sarcopenia. Additionally, this impact appears to arise very early after surgery, suggesting that the optimal timeframe for efforts to mitigate this effect may be during the prehabilitation period followed by the post-surgery timeframe. Full article

Background/Objectives: The insertion of engineered scaffolds and tissues requires precise surgical implantation with minimal interfacial scarring. Nanometric scale material polishing technologies developed for manufacturing microelectronic circuits make it possible to polish and sharpen surgical instruments at near-atomic-scale precision. We tested the hypothesis that the use of precision-sharpened scalpel blades would result in less tissue inflammation and incisional scarring. Methods: Parallel contralateral para-spinal longitudinal 4 cm long skin incisions in guinea pigs were performed, one side with a standard scalpel blade (SB) and the other with a polished nanometric scale, engineered experimental scalpel blade (EB). The side used for the polished blade was alternated and blinded from the histochemistry analysis team. The wound was excised at five time points (1, 3, 7, 16, and 60 days) with five animals per group. Histological and histochemical differences were compared. Results: The EB resulted in less bleeding, better wound adherence, relatively less macrophage density, scar volume, and granulation tissue, and significantly reduced levels of M1, M2, and TGF-β expression. Conclusions: Nanometric-scale-polished surgical scalpel blades produce significantly less tissue inflammation, scarring, and fibrosis. Full article

Background: Emphysema is a chronic lung disease characterized by alveolar wall destruction, leading to impaired gas exchange. Giant bullous emphysema (GBE) is a severe form of emphysema, often requiring surgical intervention. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for various thoracic pathologies, including lung volume reduction surgery (LVRS) and bullectomy for emphysematous bullae. Uniportal VATS (U–VATS), a further refinement, offers benefits such as reduced postoperative pain and faster recovery. Methods: This retrospective study analyzed data from two high-volume European Thoracic Surgery centers between August 2016 to January 2024. A total of 29 patients underwent U–VATS bullectomy for GBE. Results: Nineteen patients were males (65.5%) with a mean age of 44.7 ± 8.8 years. Ten (34.5%) were active smokers. Eighteen patients (62.1%) presented with a single giant bulla, while the remaining cases were in the context of pulmonary emphysema. Four patients (13.8%) presented with pneumothorax, with one requiring preoperative chest drainage. Twenty-eight patients (96.6%) underwent only U–VATS bullectomy, with additional chemical pleurodesis in eleven cases (37.9%). One patient (3.4%) underwent a left upper lobectomy for a giant bulla and NSCLC. In cases of severe lung emphysema and fragile pulmonary tissue, the stapler line was buttressed with Gore^® Seamguard^®. No conversions to thoracotomy, postoperative air-leaks, or major complications were recorded. At a mean follow-up time of 22.0 ± 14.0 months, no pneumothorax recurrence was documented. At about six months after surgery, pulmonary function significantly improved. Conclusions: U–VATS bullectomy appears to be a safe and feasible technique for the treatment of bullae in GBE, offering promising postoperative outcomes. Full article

Odontogenic myxoma (OM) is a rare, benign intraosseous tumor that arises from the dental follicle, dental papilla, or periodontal ligament. It typically affects the mandible, maxilla, and sinuses, more frequently in women than men. The histopathology of OM is characterized by a myxoid stroma with varying degrees of collagenization and spindle cells. Treatment is surgical, but there are no standardized guidelines. Available options include enucleation and curettage, with conservative approaches offering better aesthetics and functionality but a higher recurrence risk. This case report aims to discuss a rare presentation of OM in the anterior part of the mandible of a 22-year-old female patient with Hashimoto’s thyroiditis and idiopathic thrombocytopenic purpura. The patient presented with painless swelling and tooth mobility in the symphysis region. Radiographic evaluation revealed a unilocular lesion extending from the left second incisor to the right first incisor, with no root resorption. Histopathological analysis confirmed the OM diagnosis. Due to the patient’s young age and the size of the lesion, a conservative treatment approach was chosen, with the potential for future implant-prosthodontics rehabilitation. The case underscores the importance of thorough clinical, radiological, and histopathological assessment to ensure accurate diagnosis and management of OM. Long-term follow-up is essential due to the increased risk of recurrence in younger patients. Full article

Objective: To evaluate the impact of a prosthetic and native aorta proximal landing zone (PLZ) for hybrid thoracic aorta repair with a stent graft deployed in the Zone 0 ascending aorta. Methods: Retrospective analysis of 100 patients who underwent Zone 0 hybrid thoracic aorta repair between 2005 and 2022, at a single institution. Fifty-eight (58%) had a Dacron PLZ (ascending aorta replacement with debranching), and forty-two (42%) had a native ascending aorta PLZ (off-pump aortic arch debranching). All the surviving patients had at least one radiological follow-up. Results: Patients with a native aorta PLZ were older (p = 0.01) and had higher rates of pulmonary disease (p = 0.01) and chronic kidney disease (p = 0.01) and a higher Logistic EUROscore (p = 0.02). In-hospital mortality was similar between the two groups (2.3% vs. 1.7%; p = 0.68). Retrograde aortic dissection was observed in four (9.2%) of the native PLZ group. The mean follow-up was 37 ± 22 months in the Dacron PLZ group and 42 ± 20 months in the native PLZ group (p = 0.05). At 1,3, and 5 years, freedom from Type Ia endoleak was significantly higher in patients with a Dacron PLZ: 100% vs. 96 ± 0.3%, 100% vs. 85 ± 1%, and 100% vs. 66 ± 1.3% (p = 0.03). Despite this, the 1-, 3-, and 5-year survival was similar between groups: 100% vs. 96 ± 0.4%, 90 ± 1% vs. 89 ± 0.6%, and 66 ± 1% vs. 64 ± 2%. (p = 0.96). Conclusions: Endograft deployment in a prosthetic ascending aorta is a safe and durable option for aortic repair. A Dacron PLZ is associated with a lower rate of Type Ia endoleak and can prevent retrograde aortic dissection when compared with native aorta. Full article

The first metatarsal has the greatest inclination of all metatarsals and carries about 40% of body weight during the static stance. The rearfoot and the first ray (FR) are two distinct structures, but they are strongly related to the latest studies in the literature; however, their mutual involvement in the foot biomechanics appears not to be fully explored. Understanding their interdependence is essential to approaching the patient in his totality. This overview aims to analyze the current evidence from the latest studies that examine the correlation between FR insufficiency (FRI) and hindfoot valgus (HV), focusing on their biomechanical interaction, clinical implications, and treatment approaches. All analyzed studies showed that plantarflexion of the first metatarsophalangeal (MTP1) joint in correct alignment increased by 26% compared to a deviated articulation. In FRI, the “windlass” mechanism appears compromised, and FR lacks the necessary stability and plantarflexion; consequently, the medial arch collapses, and the foot moves into excessive pronation. On the other hand, in HV condition, the pulley system is significantly diminished, and peroneus longus contraction cannot stabilize the FR with resultant FRI and dorsal migration. A significant correlation was found between hindfoot alignment and first metatarsal rotation (86% of patients) and between HV and hallux valgus. Foot orthoses, physical therapy, and exercise programs, especially in the initial stages of symptomatic HV, provide satisfactory results in 67% to 90% of cases, improving foot alignment and pain relief in FRI patients. In more severe cases, surgical intervention to realign the hindfoot is indicated with a very low complication rate (1–4%), which can vary from 24% to 55% in stage 4 flatfoot. No study in the literature has been found to address both pathologies simultaneously from a treatment point of view, and, although not all HV patients are affected by FRI, most patients seem to benefit from surgical stabilization of the FR in 80% of individuals with symptomatic HV. However, despite a predominance of FRI among HV individuals, not all clinical studies have confirmed this correlation. Full article

Background/Objectives: Research is widely recognized as an essential element of medical education across all levels. This study explores the association between publishing before, during, and after general surgery residency, shedding light on research productivity trends in medical education. By examining a diverse cohort of general surgery residents, the research aims to uncover factors influencing research output at various training levels. Methods: This study analyzed graduates’ Curriculum Vitae from a single institution’s general surgery residency program from 2017–2024. Linear regression models assessed whether variables encompassing total research output (manuscripts, abstracts, posters, and podium presentations) could predict graduates’ research outcomes in the next stage of training. Results: Out of the 38 eligible graduates, 20 submitted their Curriculum Vitae and were included in the study, resulting in a response rate of 52.6%. Total research activity before residency was not found to be predictive of total research activity in residency (t(18) = 1.020, p = 0.322) but was found to be related to total research activity in fellowship (t(10) = 5.399, p < 0.005). Total research activity during residency was not found to be related to fellowship research (t(10) = 0.834, p = 0.424). No sequential correlation was found between undergraduate, medical school, residency, or fellowship publications. Additionally, there was no correlation between first authorship and publication total in the subsequent phase of medical education. Conclusions: Research productivity during medical school does not have predictive value for future research during residency but is found to be predictive of future works in fellowship. These findings suggest that the research emphasis should be strategically managed throughout medical education to sustain long-term academic engagement. Full article

Background: Posterior cruciate ligament (PCL) injuries are relatively rare, with limited consensus on the optimal treatment for isolated acute cases. Conservative management and surgical reconstruction each offer potential benefits, but their comparative efficacy remains unclear. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search of MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science was completed on 23 December 2024. Studies comparing conservative treatment and surgical reconstruction for isolated acute PCL injuries were included. Outcomes such as functional recovery, stability, and long-term complications were extracted and synthesized qualitatively. Results: Six studies were included, comprising case series, prospective, retrospective, and review designs. Conservative treatment demonstrated significant improvements in functional recovery (IKDC scores: 67–90.3/100) but showed limited improvement in stability (STSD reduction: 0–3 mm). Surgical reconstruction yielded superior stability (STSD reduction: 8.2 to 2.7 mm) and lower rates of degenerative changes but was associated with a higher risk of complications. Functional outcomes were comparable between approaches in some studies, although surgical patients showed slightly better long-term stability. Conclusions: Both conservative and surgical treatments achieve satisfactory outcomes for isolated acute PCL injuries. Treatment selection should be tailored to patient-specific factors, considering functional demands and injury severity. Full article

Standardized frameworks for interpreting medical images, such as the radiological Reporting and Data Systems (RADS), are designed to improve the consistency and accuracy of radiological assessments across different imaging modalities, anatomical locations, and disease processes. Clear communication and information sharing between radiologists and referring physicians, including surgeons, is a key goal of the RADS guidelines. Therefore, familiarity with these guidelines is crucial for all physicians involved in patient care. This review synthesizes current RADS guidelines relevant to surgical practice. Our analysis identified 28 radiological RADS with potential applications in surgical workflows, primarily in oncology. Of the RADS examined, nine were validated by the American College of Radiology (ACR), one was validated through a collaboration between the ACR and other scientific societies, and seventeen were developed by other scientific organizations. Numerous surgical specialties may encounter RADS in clinical practice, including neurosurgery, head and neck surgery, cardiovascular surgery, thoracic surgery, endocrine surgery, breast surgery, gastrointestinal surgery, hepatobiliary surgery, gynecological surgery, urological surgery, orthopedic surgery, emergency surgery, and surgical oncology. The effective utilization and validation of RADS necessitates close collaboration between radiologists and surgeons, coupled with widespread education for all healthcare professionals involved in patient care. Artificial intelligence software will play an important role in facilitating the dissemination and use of RADS in clinical practice. Full article

Background: Irreversible pulpitis is a severe inflammation of the dental pulp. The purpose of this clinical trial was to evaluate the effectiveness of an inferior alveolar nerve block (IANB) injection followed by oral dexamethasone administration in reducing the pain associated with symptomatic irreversible pulpitis (SIP) in mandibular molars, without performing conventional pulpotomy. Methods: A sample of 80 subjects suffering from acute pain due to SIP on a mandibular molar were assigned to the dexamethasone group, who received an IANB injection followed by one oral dose of 4 mg of dexamethasone during the emergency visit followed by one dose of 4 mg after 8 h, or the control group, who received a conventional pulpotomy. Both groups received complete endodontic treatment after five to six days. The intensity of the preoperative pain and pain levels were measured in both groups at different times after each intervention. The Mann–Whitney U test was used to compare the pain scores between the groups at the same time point, while Friedman’s test was used to compare the pain scores between the four time points within the same intervention group, followed by the Bonferroni correction for multiple pairwise comparisons. Success was determined when the pain score on the visual analogue scale (VAS) was 20 or lower. Results: A survival analysis was conducted, where the event was considered as the disappearance of symptoms (or success: pain score ≤ 20). For both groups, the pain significantly decreased 8 h postoperatively (p < 0.05). The success rates at 8 and 12 h were significantly higher in the dexamethasone group compared to the control group (p = 0.05). However, the pain scores at 24 h remained comparable. Conclusions: An IANB injection followed by 8 mg of oral dexamethasone could reduce pain significantly in patients with SIP without performing conventional pulpotomy. The oral administration of dexamethasone could therefore be a valuable strategy to temporarily alleviate SIP symptoms until definitive treatment becomes feasible. Dexamethasone is a temporary pain management strategy rather than a replacement for pulpotomy. Full article

Background: The attractiveness of the central area (the so-called mid-face area or middle third) has a strong impact on the observer, and the treatment of aging in this area is therefore considered a key component in facial rejuvenation. A standardized photographic and three-dimensional analysis was conducted in this observational study to determine the outcome of volumetric restoration procedures of the mid-face area with HA injection, providing an objective, repetitive, and reliable evaluation of this facial rejuvenation technique. Methods: In total, 47 patients were treated with two types of HA-based dermal fillers, and calibrated, stereoscopic images of the face were taken with volume reconstruction and analysis software performed before (t0), 45 days after HA implantation (t1), and at the check-up after the end of follow-up (t2). Results: In total, 39 out of 47 patients completed the study, which showed an overall volume restoration of 4.46 ± 1.34 mL at 45 days (t0–t1) after HA implantation, maintaining a value of 1.23 ± 0.68 mL at the end of the 318-day follow-up (t0–t2). Conclusions: The results of this study indicate that rejuvenation of the mid-facial region through volumetric restoration with an HA filler leads to an indirect volumetric effect that is clinically more significant than the actual injected volume and equally long-lasting. Full article

Objective: The aim of this systematic review is to compare the survival rates of zirconia and titanium dental implants, by evaluating the most recent scientific evidence, in order to comprehend the behaviour of zirconia implants as an alternative to titanium, due to the latter’s biological properties. Methods: An electronic search was performed on the Pubmed/MEDLINE and Scopus databases in November 2023 to identify clinical trials that investigated zirconia and titanium implants’ behaviour with a follow-up of at least 5 years. The primary outcome was the implant survival rate—defined as the maintenance of the implant in situ during the period of study. The secondary outcome was the implant success rate, which is associated with the values of the peri-implant variables—the probing depth, marginal bone loss, gingival recession, bleeding on probing, plaque index, and aesthetics scores. Results: A total of 17 articles were selected from the search, resulting in a sample of 364 studies. A total of 15 articles fulfilled the selection criteria. Zirconia implants showed satisfactory results. Due to the lack of data available with follow-up times of more than five years, it is not possible to conclusively describe the benefits of zirconia in comparison with titanium implants. Conclusions: While zirconia implants show promise as a future alternative to metal implants, more research is needed to understand their long-term benefits and peri-implant behaviour. Full article

Background: Chronic subdural hematoma (CSDH) is a common neurosurgical condition that usually occurs in the elderly. Surgical evacuation of the hematoma with burr holes is considered the standard of care for the treatment of patients with CSDH. However, a high risk of recurrence, up to 34%, after hematoma evacuation has been reported, while the risk factors linked with recurrence have not been studied in depth. In the present study, we set out to identify risk factors of recurrence in patients surgically treated for CSDH. Methods: We retrospectively studied patients with symptomatic CSDH who were treated surgically in our institute during a five-year period. All the patients were treated by single or double burr hole drainage. The data for this study were extracted by the pre-operative and post-operative CT scan of each patient. These data include the sex, the midline shift, the width, and the presence of acute clots and subdural air collection post-operatively. A univariate analysis was performed. A receiver operating characteristic (ROC) analysis was utilized to detect the hematoma’s width more efficiently, differentiating patients that developed recurrence. Results: A total of 222 patients were included in this study. Recurrence occurred in 20 (9.0%) patients. The univariate analysis showed that the presence of acute clots post-operatively are significant factors related with recurrence (OR = 4.01, CI 95% 1.55–10.33, and p = 0.002). There was no significant relationship between the recurrence rate and the hematoma’s width, sex, the midline shifts pre-operatively or post-operatively, the subdural space, and air collection post-operatively. Conclusions: The presence of acute clots in the post-operative CT scan is a potential, previously unexplored, risk factor associated with the recurrence of CSDH. Full article

Background/Objectives: Scalp defect reconstruction often poses a challenge due to the distinct anatomy and limited skin elasticity of the region. Rotational flaps, when properly planned, offer a superior and creative solution for effectively covering most scalp defects. The aim of this study is to present the indications, and versatile use of rotational flaps in scalp reconstructive surgery, guided by an algorithmic approach and exemplified by numerous clinical applications. Methods: An observational cohort study was conducted between 2019 and 2024. The study protocol adhered to the ethical guidelines of the Declaration of Helsinki, was approved by the local ethics committee, and followed the STROBE statement for cohort studies. Results: A total of 152 rotational flaps were performed in 138 patients to reconstruct scalp defects, mostly following skin cancer excision. The defect size ranged from 30 to 96 mm in largest diameter (mean diameter, 52.8 ± 8.8 mm). Postoperative complications occurred in 13 cases (9.4%), and 5 cases (3.6%) required further surgical treatment, due to wound healing problems and/or necrosis. Based on high VAS scores (9.4 + 0.3), the cosmetic outcomes were deemed satisfactory, with excellent color and texture matching. Conclusions: This study underscores the critical role of meticulous surgical planning and technique in achieving optimal outcomes in scalp reconstruction. By combining the principles of tissue biomechanics with the versatility of rotational flaps, surgeons can effectively address a wide range of defects, achieving both functional and esthetic excellence. Full article

Purpose: The objective of this study was to determine the prevalence of exostosis in the Mississippi population. Methods: The patient archives of the UMMC School of Dentistry between January 2018 and May 2021 were examined. Patients with exostosis were included in the study based on the findings from intraoral photographs, full-moth series (FMS), panoramic radiographs, and cone-beam computerized tomography (CBCT) images of the patients. Patients were excluded from the study if they did not have maxillary or mandibular exostosis. In addition, each patient’s age, gender, and ethnic origins, such as Caucasian, African-American, or Asian, were recorded. All data regarding exostosis were evaluated and categorized according to age, gender, and ethnicity. Multiple logistic regression analysis was performed for more detailed statistical analysis. Results: A total of 1242 patients were examined for the presence of maxillary and mandibular tori. In total, 303 patients were diagnosed with maxillary and/or mandibular tori among the Mississippi population, with a prevalence rate of 24.4%. Exostosis was seen more in females (57.4%) compared to males (42.6%). The highest prevalence of exostosis was seen in Caucasians (71.3%), followed by African-Americans (23.8%) and Asians (5%). Conclusions: High prevalence of exostosis was seen in the Mississippi population. Our findings will help clinicians to be more aware of these bony protuberances and, thus, better at diagnosing them. This may specifically help oral surgeons, periodontists, and prosthodontists in pre-prosthodontic surgery and denture fabrication. Full article