-Davide Sozzi - Academia.edu (original) (raw)

Papers by -Davide Sozzi

Hellenic Archives of Oral & Maxillofacial Surgery

Journal of Cutaneous and Aesthetic Surgery

Operative Techniques and Recent Advances in Acute Care and Emergency Surgery, 2019

Maxillofacial involvement in patients with multiple trauma injuries is usually frequent and notic... more Maxillofacial involvement in patients with multiple trauma injuries is usually frequent and noticeable, but it is mainly dangerous for ATLS priorities, meaning that it can compromise airway protection (A) and circulation (C) and it can often be associated with brain and cervical spine injuries. Facial hemorrhages are rarely one of the main causes of hemodynamic instability, but their early detection and prompt local control must be supported by each emergency surgeon. In very few, selected and complex cases, when local measures fail, endovascular treatment is today the best option available to achieve definitive control of refractory bleeding.

Journal of Craniofacial Surgery, 2018

Purpose: Autogenous bone represents the best material in pediatric reconstructive cranioplasty be... more Purpose: Autogenous bone represents the best material in pediatric reconstructive cranioplasty because of its compatibility with growth; however, its availability is limited. Alternative use of alloplastic materials would have the advantage of unlimited amount, but shows an increased risk of complications and incompatibility with growth. Fresh frozen banked cadaveric bones could be ideal for the reconstruction of large cranial defects in growing patients, because it offers unlimited amount of structural grafts with biomechanics properties quite similar to the autologous bones. Results: The authors report 2 cases of growing patients (13 months female and 9 years old male) undergoing the reconstruction of large (about 70 cm2 and 50 cm2 respectively) cranial vault defects, by using structural homologous banked bone grafts. Analytic main reconstruction materials risks/benefits evaluation, literature review of few previously reported pediatric cranioplasty with homologous bone, and both ...

International Journal of Oral and Maxillofacial Surgery, 2013

Purpose: This study aimed at evaluating the accuracy of computer guided mandibular fracture reduc... more Purpose: This study aimed at evaluating the accuracy of computer guided mandibular fracture reduction. Patients and method: Ten patients were included in this study. A preoperative radiographic assessment cone beam computed tomography (CBCT) scan was performed to all patients. The digital imaging and communications in medicine (DICOM) files of the CBCT were imported by the MIMICS software then a 3D construction and virtual reduction of the fracture segments was performed. A virtual bone borne surgical guide was designed exported by the software as a standard tessellation language STL file. The STL file was imported by a 3D printing machine and a physical guide was constructed. ORIF was done for all patients and the fracture segments were anatomically reduced by the aid of the computer surgical guide. A post operative CBCT was obtained 7 days post operatively. Results: There was no statistically significant difference between the virtual reduction and the actual reduction. Conclusion: The usage of the computer based surgical guide was found to be beneficial for the edentulous patients, and partially edentulous patients with insufficient teeth to act as an occlusal guide.

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2014

Head and neck squamous cell carcinoma of the (HNSCC) represents approximately 5% of malignant tum... more Head and neck squamous cell carcinoma of the (HNSCC) represents approximately 5% of malignant tumours in Italy. HNSCC are commonly treated with surgery or radiotherapy, or a combination of such therapies. The objectives of treatment are maximum cure rate balanced with organ preservation, restoration of form and function, reduction of morbidities and improvement or maintenance of the patient's quality of life. Immediate reconstructive surgery: local, regional or free flaps are now widely advised in the treatment of these patients. Microsurgical transfer requires expertise, is time and resource consuming, and as a whole requires substantial costs. These considerations introduce some concerns about the wide or indiscriminate use of free flap reconstructive surgery. When considering cost-benefit outcomes of such treatment, the main objective is undoubtedly, survival. This data is underreported in the current literature, whereas functional outcomes of free flaps have been largely dif...

Journal of Cranio-Maxillofacial Surgery, 2008

s, EACMFS XIX Congress subcondylar fractures has been described to minimize the risk of facial ne... more s, EACMFS XIX Congress subcondylar fractures has been described to minimize the risk of facial nerve injury without visible scars. The aim of the present study is to evaluate outcomes of a series of subcondylar fractures repaired with endoscopic reduction and fixation. Methods: Nine subcondylar fractures were treated endoscopically by means of limited transoral incision, using 30-degree angled endoscope. Intermaxillary fixation was used intraoperatively to aid in fracture reduction. Fracture fixation was achieved with 4-hole trapezoidal plates in 5 cases, two 4-hole miniplates in 2 cases and one 4-hole miniplate in 2 cases. Good visibility of the fracture site was obtained, which allowed for precise anatomical reduction in all patients. The mean operating time was 2 hours. Results: All patients demonstrated a stable occlusion in the postoperative period and anatomic alignment of the condyle radiographically. Normal temporomandibular joint function was noted 6 months after surgery in all patients. Conclusions: Transoral endoscopic assisted treatment of subcondylar fractures is the method of choice for management of this type of fractures. The technique allows good visualization of the fracture site. Reduction achieved allows reconstruction of anatomic ramus height in combination with excellent functional and aesthetic results. Facial nerve injury and visible scars are avoided.

Journal of Cranio-Maxillofacial Surgery, 2008

Journal of Cranio-Maxillofacial Surgery, 2008

Objectives: Because of the complexity of skull reconstructive surgery, pre-operative planning is ... more Objectives: Because of the complexity of skull reconstructive surgery, pre-operative planning is often unavoidable (Mommaerts et al., 2001). Virtual surgery simulation is still highly timeconsuming and labor-intensive when dealing with complex operations. Therefore, automated osteotomy simulation software was developed to lower this barrier for complex congenital cranial anomalies. Methods: An extensive number of typical surgical approaches are incorporated in the program and classified according to the craniosynostosis type. After interactive selection of the preferred approach, all osteotomies are automatically applied to the CTbased neurocranium model. The cutting paths are based on the location of the sutures-interactively retrieved from the neurocranium − , anatomical and geometrical landmarks and symmetry planes. Manual post-processing is provided by traditional virtual bone osteotomy tools. Results: In a retrospective study the clinical feasibility of the automated osteotomy algorithm is validated by comparison to the manually similarly performed planning of seven clinical craniosynostosis reconstruction cases. Therefore, the remodeled cranial vaults of both approaches are registered to each other. Comparisons show the automated methodology provides optimal cutting of all bone segments. This suggests automated case-specific cranial reconstruction implicates considerable preoperative time-saving in the order of hours to even days with complex approaches. Conclusions: The presented automated osteotomy methodology provides the user with a considerable planning time reduction compared to manual similar computer-aided simulation. Moreover, the planning simplification and associated time reduction allows for a trial of different relevant clinical approaches in less the amount of time normally spent to manually simulate one approach.

Journal of Craniofacial Surgery, 2012

An essential step in the navigation procedure is the recording of markers required for the triang... more An essential step in the navigation procedure is the recording of markers required for the triangulation of the intraoperative navigation system. The aim of this study was to describe the procedure and preliminary results of a simple methodology for the application of dental markers to achieve good triangulation of the navigation system in maxillofacial surgery, highlighting the indications, contraindications, and possible limitations. We analyzed results from a sample of 7 patients with orbital or orbitozygomatic fractures, who were subjected to surgical intervention for the reduction and synthesis of the zygomatic fracture and from 1 case of untreated orbital fracture with enophthalmos and diplopia. We used 2 different types of dental markers: in 3 patients, we used 4 or 5 ordinary orthodontic brackets, which we placed on their upper maxillary teeth, and in 1 patient, the hexagonal-headed screws used in osteosynthesis. The accuracy of the recording was assessed during surgery by checking healthy anatomic structures against computed tomographic images. By analyzing our clinical results in light of the most recent literature, we highlighted that the application of dental markers is comparable with the best recording systems requiring a discrepancy of less than 1 mm. From the preliminary clinical analysis of the results, we confirm that the introduction of this new and simple procedure enables the successful triangulation of the navigation system, which can be used whenever the use of a navigator is required.

Acta cytologica, Jan 18, 2016

This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) whi... more This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) which provide diagnostic information that cytopathologists approaching orbital lesions for the first time can find useful and underlines the importance of teamwork. The investigators retrospectively obtained data from 24 consecutive orbital FNAs. For all patients, a complete clinicoradiological database was created. FNAs were performed under US guidance with 25-gauge needles and an aspiration biopsy syringe gun, and sent to the Department of Pathology for examination and data management. The mean age of the patients was 54 years. Imaging studies included US, magnetic resonance imaging and computed tomography scans; 9 lesions involved the right orbit and 15 the left orbit. The mean lesion size was 23.6 ± 7.2 mm. After microscopic examination, 7 smears were labeled as 'nondiagnostic', while in 17 cases a definitive diagnosis was proposed, which always proved to be correct (70.8%, spec...

Annali di stomatologia, 2017

Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and ... more Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a welldesigned mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the Annali di Stomatologia 2017;VIII (2):45-52 45 tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar area.

Asian Journal of Oral and Maxillofacial Surgery, 2010

Abstract Epithelial–myoepithelial carcinoma (EMC) is characterized by a biphasic cytomorphology c... more Abstract Epithelial–myoepithelial carcinoma (EMC) is characterized by a biphasic cytomorphology comprising inner duct-forming epithelium and outer, prominently clear, enveloping myoepithelial cells. EMC typically occurs in major salivary glands, but also in the minor glands of the oral mucosa. We report herein a rare case of EMC arising from the intrabuccal mucosa in a 28-year-old man, with no recurrence after surgical excision and postoperative radiotherapy despite of partially positive surgical margin for tumor. The clinical and pathological features of this tumor are discussed.

Asian Journal of Oral and Maxillofacial Surgery, 2008

ABSTRACT Primary intraosseous squamous cell carcinoma derived from odontogenic cyst is an uncommo... more ABSTRACT Primary intraosseous squamous cell carcinoma derived from odontogenic cyst is an uncommon lesion and was designated as odontogenic carcinoma by the World Health Organization. About 60 welldocumented cases of this disease have been reported between 1938 and 2001. This report is of a patient with squamous cell carcinoma arising in a dentigerous cyst in the body of the left mandible. The patient presented with a bony hard swelling with slight pain. Panoramic radiography exhibited a well-defined unilocular radiolucent area with an embedded left lower second premolar. Treatment included wide excision, radical neck dissection, and radiotherapy. Histopathologically, a transitional zone from the cystic epithelial lining to the well-differentiated squamous cell carcinoma was demonstrated. A review of 56 cases of intraosseous squamous cell carcinomas from previous reports is also included.

Cancers

Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally... more Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, w...

Journal of Clinical Medicine, Apr 6, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Annals of Maxillofacial Surgery, 2021

Motorcycle accidents represent, in many countries, one of the main causes of trauma submitted to ... more Motorcycle accidents represent, in many countries, one of the main causes of trauma submitted to the attention of maxillofacial surgeons: [1,2] Bikers are exposed to 30 times greater risk of suffering trauma compared to car drivers. [3] Safety devices are able to influence the severity of injuries: [4] there are many helmet types available on the market with variable protection profiles [Figure 1]. Aim of this study is to evaluate the effectiveness of different safety devices in motorcycle-related road accidents, focusing on the prevention of craniofacial injuries, measured using comprehensive facial injury (CFI) score [5,6] and abbreviated injury score (AIS-Head) for head injuries. Methods This retrospective observational study enrolled 440 patients with motorcycle-related trauma evaluated between January 2002 and February 2019 by a team of five surgeons experienced in maxillofacial injuries and shared between two Level I Trauma Centers in Northern Italy. Patients of

Craniomaxillofacial Trauma & Reconstruction, 2021

Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following... more Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following orbital fractures depends on the accurate restoration of the orbital volume. Computer-Assisted procedures and Patient Specific Implants represent modern solutions, but they require additional resources. A more reproducible option is the use of standard preformed titanium meshes, widely available and cheaper; with their use quality of results is proportional to the accuracy with which they are positioned. This work identifies 6 reproducible and constant anatomical landmarks, as an intraoperative guide for the precise positioning of titanium preformed meshes. Methods: 90 patients treated at the Maxillofacial Surgery Department, Niguarda Trauma Center, Milan, for unilateral orbital reconstruction (January 2012 to December 2018), were studied. In all cases reconstruction was performed respecting the 6 proposed anatomical landmarks. The outcomes analyzed are: post-operative CT adherence to t...

Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ ... more Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ has traditionally been accomplished using vascularized free fibula flaps (FFF). But not all patients are candidates for FFF. A two-staged protocol (SPR) was developed taking into account the challenges of the surgical site and comorbidities of the patient utilizing custom prosthetics. Methods: This study retrospectively analyzed 16 patients (13 males, 3 females) who developed stage III ORNJ subsequent to radiation and molar extraction (FFF n=4, SPR n=12). Postoperative surgical complications, maximal incisal opening (MIO), Pain Visual Analog Scale (VAS) at the different end points for the SPR and FFF group were analyzed. Results: All patients demonstrated decrease in pain and increased mouth opening. Comparing Stage 1 SPR and FFF patients, there was a significant difference in pain, but not in function (1.89 ± 1.05 vs 0.25 ± 0.5, p<0.01 and 28.44 ± 8.10 vs 24.75 ± 1.26 p>0.20). Aft...

Journal of Cranio-Maxillofacial Surgery, 2021

The study aims to assess the influence on mortality of motorcycle road accidents, caused by injur... more The study aims to assess the influence on mortality of motorcycle road accidents, caused by injuries to the head, chest, abdomen, face, skin, pelvis and extremities. Road motorcycle accidents consecutively admitted to Level I Trauma Center were retrospectively analyzed. Each body site involvement was classified through Abbreviated Injury Score (AIS-98), and Comprehensive Facial Injury (CFI) score; Injury Severity Score (ISS) was also calculated. The data collected were subjected to a descriptive analysis and inferential statistic, with uni- and multivariate analysis; mortality was the main outcome examined. 1862 patients were studied. Limbs (53.9%) and Head (53.8%) are the most involved body site, facial trauma regards 19.4% of the sample. Only 4.4% of Facial injuries occurred as isolated, 71.6% were associated to Head involvement. The overall mortality was 4.6% and 80.0% of dead patients were affected by Head injury. Multivariate analysis shows that head (OR=3.06, p <0.0001), thoracic (OR=1.82, p <0.0001) and abdominal trauma (OR=1.41, p =0.019) are predicting the risk of death. Facial trauma does not directly influence mortality and, however severe and distracting it may be, becomes secondary to the management of frequently associated brain injuries. Severity scores targeted to the risk of death, such as AIS and AIS-derived, are ineffective in describing the true characteristics of facial injuries. The CFI score has been shown to predict the weight of surgical treatment and the outcome of the hospital stay, therefore its use is recommended.

Hellenic Archives of Oral & Maxillofacial Surgery

Journal of Cutaneous and Aesthetic Surgery

Operative Techniques and Recent Advances in Acute Care and Emergency Surgery, 2019

Maxillofacial involvement in patients with multiple trauma injuries is usually frequent and notic... more Maxillofacial involvement in patients with multiple trauma injuries is usually frequent and noticeable, but it is mainly dangerous for ATLS priorities, meaning that it can compromise airway protection (A) and circulation (C) and it can often be associated with brain and cervical spine injuries. Facial hemorrhages are rarely one of the main causes of hemodynamic instability, but their early detection and prompt local control must be supported by each emergency surgeon. In very few, selected and complex cases, when local measures fail, endovascular treatment is today the best option available to achieve definitive control of refractory bleeding.

Journal of Craniofacial Surgery, 2018

Purpose: Autogenous bone represents the best material in pediatric reconstructive cranioplasty be... more Purpose: Autogenous bone represents the best material in pediatric reconstructive cranioplasty because of its compatibility with growth; however, its availability is limited. Alternative use of alloplastic materials would have the advantage of unlimited amount, but shows an increased risk of complications and incompatibility with growth. Fresh frozen banked cadaveric bones could be ideal for the reconstruction of large cranial defects in growing patients, because it offers unlimited amount of structural grafts with biomechanics properties quite similar to the autologous bones. Results: The authors report 2 cases of growing patients (13 months female and 9 years old male) undergoing the reconstruction of large (about 70 cm2 and 50 cm2 respectively) cranial vault defects, by using structural homologous banked bone grafts. Analytic main reconstruction materials risks/benefits evaluation, literature review of few previously reported pediatric cranioplasty with homologous bone, and both ...

International Journal of Oral and Maxillofacial Surgery, 2013

Purpose: This study aimed at evaluating the accuracy of computer guided mandibular fracture reduc... more Purpose: This study aimed at evaluating the accuracy of computer guided mandibular fracture reduction. Patients and method: Ten patients were included in this study. A preoperative radiographic assessment cone beam computed tomography (CBCT) scan was performed to all patients. The digital imaging and communications in medicine (DICOM) files of the CBCT were imported by the MIMICS software then a 3D construction and virtual reduction of the fracture segments was performed. A virtual bone borne surgical guide was designed exported by the software as a standard tessellation language STL file. The STL file was imported by a 3D printing machine and a physical guide was constructed. ORIF was done for all patients and the fracture segments were anatomically reduced by the aid of the computer surgical guide. A post operative CBCT was obtained 7 days post operatively. Results: There was no statistically significant difference between the virtual reduction and the actual reduction. Conclusion: The usage of the computer based surgical guide was found to be beneficial for the edentulous patients, and partially edentulous patients with insufficient teeth to act as an occlusal guide.

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2014

Head and neck squamous cell carcinoma of the (HNSCC) represents approximately 5% of malignant tum... more Head and neck squamous cell carcinoma of the (HNSCC) represents approximately 5% of malignant tumours in Italy. HNSCC are commonly treated with surgery or radiotherapy, or a combination of such therapies. The objectives of treatment are maximum cure rate balanced with organ preservation, restoration of form and function, reduction of morbidities and improvement or maintenance of the patient's quality of life. Immediate reconstructive surgery: local, regional or free flaps are now widely advised in the treatment of these patients. Microsurgical transfer requires expertise, is time and resource consuming, and as a whole requires substantial costs. These considerations introduce some concerns about the wide or indiscriminate use of free flap reconstructive surgery. When considering cost-benefit outcomes of such treatment, the main objective is undoubtedly, survival. This data is underreported in the current literature, whereas functional outcomes of free flaps have been largely dif...

Journal of Cranio-Maxillofacial Surgery, 2008

s, EACMFS XIX Congress subcondylar fractures has been described to minimize the risk of facial ne... more s, EACMFS XIX Congress subcondylar fractures has been described to minimize the risk of facial nerve injury without visible scars. The aim of the present study is to evaluate outcomes of a series of subcondylar fractures repaired with endoscopic reduction and fixation. Methods: Nine subcondylar fractures were treated endoscopically by means of limited transoral incision, using 30-degree angled endoscope. Intermaxillary fixation was used intraoperatively to aid in fracture reduction. Fracture fixation was achieved with 4-hole trapezoidal plates in 5 cases, two 4-hole miniplates in 2 cases and one 4-hole miniplate in 2 cases. Good visibility of the fracture site was obtained, which allowed for precise anatomical reduction in all patients. The mean operating time was 2 hours. Results: All patients demonstrated a stable occlusion in the postoperative period and anatomic alignment of the condyle radiographically. Normal temporomandibular joint function was noted 6 months after surgery in all patients. Conclusions: Transoral endoscopic assisted treatment of subcondylar fractures is the method of choice for management of this type of fractures. The technique allows good visualization of the fracture site. Reduction achieved allows reconstruction of anatomic ramus height in combination with excellent functional and aesthetic results. Facial nerve injury and visible scars are avoided.

Journal of Cranio-Maxillofacial Surgery, 2008

Journal of Cranio-Maxillofacial Surgery, 2008

Objectives: Because of the complexity of skull reconstructive surgery, pre-operative planning is ... more Objectives: Because of the complexity of skull reconstructive surgery, pre-operative planning is often unavoidable (Mommaerts et al., 2001). Virtual surgery simulation is still highly timeconsuming and labor-intensive when dealing with complex operations. Therefore, automated osteotomy simulation software was developed to lower this barrier for complex congenital cranial anomalies. Methods: An extensive number of typical surgical approaches are incorporated in the program and classified according to the craniosynostosis type. After interactive selection of the preferred approach, all osteotomies are automatically applied to the CTbased neurocranium model. The cutting paths are based on the location of the sutures-interactively retrieved from the neurocranium − , anatomical and geometrical landmarks and symmetry planes. Manual post-processing is provided by traditional virtual bone osteotomy tools. Results: In a retrospective study the clinical feasibility of the automated osteotomy algorithm is validated by comparison to the manually similarly performed planning of seven clinical craniosynostosis reconstruction cases. Therefore, the remodeled cranial vaults of both approaches are registered to each other. Comparisons show the automated methodology provides optimal cutting of all bone segments. This suggests automated case-specific cranial reconstruction implicates considerable preoperative time-saving in the order of hours to even days with complex approaches. Conclusions: The presented automated osteotomy methodology provides the user with a considerable planning time reduction compared to manual similar computer-aided simulation. Moreover, the planning simplification and associated time reduction allows for a trial of different relevant clinical approaches in less the amount of time normally spent to manually simulate one approach.

Journal of Craniofacial Surgery, 2012

An essential step in the navigation procedure is the recording of markers required for the triang... more An essential step in the navigation procedure is the recording of markers required for the triangulation of the intraoperative navigation system. The aim of this study was to describe the procedure and preliminary results of a simple methodology for the application of dental markers to achieve good triangulation of the navigation system in maxillofacial surgery, highlighting the indications, contraindications, and possible limitations. We analyzed results from a sample of 7 patients with orbital or orbitozygomatic fractures, who were subjected to surgical intervention for the reduction and synthesis of the zygomatic fracture and from 1 case of untreated orbital fracture with enophthalmos and diplopia. We used 2 different types of dental markers: in 3 patients, we used 4 or 5 ordinary orthodontic brackets, which we placed on their upper maxillary teeth, and in 1 patient, the hexagonal-headed screws used in osteosynthesis. The accuracy of the recording was assessed during surgery by checking healthy anatomic structures against computed tomographic images. By analyzing our clinical results in light of the most recent literature, we highlighted that the application of dental markers is comparable with the best recording systems requiring a discrepancy of less than 1 mm. From the preliminary clinical analysis of the results, we confirm that the introduction of this new and simple procedure enables the successful triangulation of the navigation system, which can be used whenever the use of a navigator is required.

Acta cytologica, Jan 18, 2016

This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) whi... more This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) which provide diagnostic information that cytopathologists approaching orbital lesions for the first time can find useful and underlines the importance of teamwork. The investigators retrospectively obtained data from 24 consecutive orbital FNAs. For all patients, a complete clinicoradiological database was created. FNAs were performed under US guidance with 25-gauge needles and an aspiration biopsy syringe gun, and sent to the Department of Pathology for examination and data management. The mean age of the patients was 54 years. Imaging studies included US, magnetic resonance imaging and computed tomography scans; 9 lesions involved the right orbit and 15 the left orbit. The mean lesion size was 23.6 ± 7.2 mm. After microscopic examination, 7 smears were labeled as 'nondiagnostic', while in 17 cases a definitive diagnosis was proposed, which always proved to be correct (70.8%, spec...

Annali di stomatologia, 2017

Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and ... more Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a welldesigned mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the Annali di Stomatologia 2017;VIII (2):45-52 45 tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar area.

Asian Journal of Oral and Maxillofacial Surgery, 2010

Abstract Epithelial–myoepithelial carcinoma (EMC) is characterized by a biphasic cytomorphology c... more Abstract Epithelial–myoepithelial carcinoma (EMC) is characterized by a biphasic cytomorphology comprising inner duct-forming epithelium and outer, prominently clear, enveloping myoepithelial cells. EMC typically occurs in major salivary glands, but also in the minor glands of the oral mucosa. We report herein a rare case of EMC arising from the intrabuccal mucosa in a 28-year-old man, with no recurrence after surgical excision and postoperative radiotherapy despite of partially positive surgical margin for tumor. The clinical and pathological features of this tumor are discussed.

Asian Journal of Oral and Maxillofacial Surgery, 2008

ABSTRACT Primary intraosseous squamous cell carcinoma derived from odontogenic cyst is an uncommo... more ABSTRACT Primary intraosseous squamous cell carcinoma derived from odontogenic cyst is an uncommon lesion and was designated as odontogenic carcinoma by the World Health Organization. About 60 welldocumented cases of this disease have been reported between 1938 and 2001. This report is of a patient with squamous cell carcinoma arising in a dentigerous cyst in the body of the left mandible. The patient presented with a bony hard swelling with slight pain. Panoramic radiography exhibited a well-defined unilocular radiolucent area with an embedded left lower second premolar. Treatment included wide excision, radical neck dissection, and radiotherapy. Histopathologically, a transitional zone from the cystic epithelial lining to the well-differentiated squamous cell carcinoma was demonstrated. A review of 56 cases of intraosseous squamous cell carcinomas from previous reports is also included.

Cancers

Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally... more Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, w...

Journal of Clinical Medicine, Apr 6, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Annals of Maxillofacial Surgery, 2021

Motorcycle accidents represent, in many countries, one of the main causes of trauma submitted to ... more Motorcycle accidents represent, in many countries, one of the main causes of trauma submitted to the attention of maxillofacial surgeons: [1,2] Bikers are exposed to 30 times greater risk of suffering trauma compared to car drivers. [3] Safety devices are able to influence the severity of injuries: [4] there are many helmet types available on the market with variable protection profiles [Figure 1]. Aim of this study is to evaluate the effectiveness of different safety devices in motorcycle-related road accidents, focusing on the prevention of craniofacial injuries, measured using comprehensive facial injury (CFI) score [5,6] and abbreviated injury score (AIS-Head) for head injuries. Methods This retrospective observational study enrolled 440 patients with motorcycle-related trauma evaluated between January 2002 and February 2019 by a team of five surgeons experienced in maxillofacial injuries and shared between two Level I Trauma Centers in Northern Italy. Patients of

Craniomaxillofacial Trauma & Reconstruction, 2021

Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following... more Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following orbital fractures depends on the accurate restoration of the orbital volume. Computer-Assisted procedures and Patient Specific Implants represent modern solutions, but they require additional resources. A more reproducible option is the use of standard preformed titanium meshes, widely available and cheaper; with their use quality of results is proportional to the accuracy with which they are positioned. This work identifies 6 reproducible and constant anatomical landmarks, as an intraoperative guide for the precise positioning of titanium preformed meshes. Methods: 90 patients treated at the Maxillofacial Surgery Department, Niguarda Trauma Center, Milan, for unilateral orbital reconstruction (January 2012 to December 2018), were studied. In all cases reconstruction was performed respecting the 6 proposed anatomical landmarks. The outcomes analyzed are: post-operative CT adherence to t...

Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ ... more Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ has traditionally been accomplished using vascularized free fibula flaps (FFF). But not all patients are candidates for FFF. A two-staged protocol (SPR) was developed taking into account the challenges of the surgical site and comorbidities of the patient utilizing custom prosthetics. Methods: This study retrospectively analyzed 16 patients (13 males, 3 females) who developed stage III ORNJ subsequent to radiation and molar extraction (FFF n=4, SPR n=12). Postoperative surgical complications, maximal incisal opening (MIO), Pain Visual Analog Scale (VAS) at the different end points for the SPR and FFF group were analyzed. Results: All patients demonstrated decrease in pain and increased mouth opening. Comparing Stage 1 SPR and FFF patients, there was a significant difference in pain, but not in function (1.89 ± 1.05 vs 0.25 ± 0.5, p<0.01 and 28.44 ± 8.10 vs 24.75 ± 1.26 p>0.20). Aft...

Journal of Cranio-Maxillofacial Surgery, 2021

The study aims to assess the influence on mortality of motorcycle road accidents, caused by injur... more The study aims to assess the influence on mortality of motorcycle road accidents, caused by injuries to the head, chest, abdomen, face, skin, pelvis and extremities. Road motorcycle accidents consecutively admitted to Level I Trauma Center were retrospectively analyzed. Each body site involvement was classified through Abbreviated Injury Score (AIS-98), and Comprehensive Facial Injury (CFI) score; Injury Severity Score (ISS) was also calculated. The data collected were subjected to a descriptive analysis and inferential statistic, with uni- and multivariate analysis; mortality was the main outcome examined. 1862 patients were studied. Limbs (53.9%) and Head (53.8%) are the most involved body site, facial trauma regards 19.4% of the sample. Only 4.4% of Facial injuries occurred as isolated, 71.6% were associated to Head involvement. The overall mortality was 4.6% and 80.0% of dead patients were affected by Head injury. Multivariate analysis shows that head (OR=3.06, p <0.0001), thoracic (OR=1.82, p <0.0001) and abdominal trauma (OR=1.41, p =0.019) are predicting the risk of death. Facial trauma does not directly influence mortality and, however severe and distracting it may be, becomes secondary to the management of frequently associated brain injuries. Severity scores targeted to the risk of death, such as AIS and AIS-derived, are ineffective in describing the true characteristics of facial injuries. The CFI score has been shown to predict the weight of surgical treatment and the outcome of the hospital stay, therefore its use is recommended.