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The artificial generation of tissues, organs, or even more complex living organisms was throughout the history of mankind a matter of myth and dream. During the last decades this vision became feasible and has been recently introduced in clinical medicine. The interest and attention that this rapidly developing area has received are based on the vision that the growing understanding of tissue healing and the achievements of biotechnology will be of profound therapeutic relevance. Clinically, reconstructive surgery has arrived at a standard of care that allows for repair and restoration of the vast majority of tissues/organs with established techniques. The real challenge of tissue engineering in clinical treatment is the reduction of surgical morbidity by the application of biological signals or bio-artificial components cultivated from the patient's own cells, that can replace the lost body part or accomplish its repair without the need for autogenous tissue transfer. Initially, activities in this area were mainly focused on cell-based approaches aiming at the generation of tissue-like constructs by combining ex vivo expanded cell populations with various types of scaffolds. Today, the field of tissue engineering has expanded tremendously, in that not only cells and scaffolds but also growth factors, controlled release carriers, engineering of biomaterials and many other areas of basic and applied research are considered to be part of the field of tissue engineering.

Purpose: Mandibular angle fractures remain among the most difficult and unpredictable fractures to treat compared with those of other areas of the mandible. This study was done to clinically and radiographically evaluate the use of three-dimensional (3D) Threadlock plate for the treatment of mandibular angle fractures. Materials and methods: Ten patients were selected from those admitted to the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, suffering from isolated mandibular angle fracture. Management was accomplished after careful case history, clinical examination and radiographic examination. Reduction of the fracture was accomplished through an extraoral approach followed by fixation with 3D Threadlock plates. The patients were then followed up for 6 months postoperatively and the collected clinical and radiographic data was statistically analyzed. Results: The following clinical parameters were used: pain intensity, postsurgical edema, maximal mouth opening, sensory function, surgical wound, and occlusion. All the results showed that the clinical findings were within reasonable limits and returned to normal values during the follow up period. Radiographically, the increase in mean bone density was statistically significant from preoperative to 6 weeks postoperative, from 6 weeks to 3 months and from 3 months to 6 months postoperatively, consistent with the progress of fracture bone healing. Conclusion: Considering the results of the current study, it is concluded that the 3-D plate has all the advantages of 2 miniplate fixation i.e. 1) High fracture fragment stability, 2) Harmonius occlusion, 3) Early return of the patient to his/her normal social life and function. 4) At the same time, it overcomes all the shortcomings of single miniplate, and satisfies the biomechanical requirements for occlusal loading. According to this study, the 3D Threadlock plating system through an extraoral/transbuccal approach is a suitable method for fixation of mandibular angle fractures, providing adequate stability especially in severely displaced mandibular angle fractures.

BackgroundWhile the psychosocial morbidity of orofacial pain (OFP) is widely recognized, the differential impact of musculoskeletal, neuropathic and neurovascular symptoms on pain and psychosocial function in individuals with and without coexisting OFP conditions is unclear.Materials and methodsThis was a comparative cross‐sectional study of 350 consecutive patients attending an OFP clinic; 244 completed standardized self‐report measures of pain experience, mood, and generic and oral health‐related quality of life (HRQoL). The impact of musculoskeletal, neuropathic and neurovascular symptoms on measures was assessed using linear and logistic generalized linear models.ResultsTwo hundred patients were diagnosed with a neuropathic condition: 125 with musculoskeletal pain and 101 with (neurovascular) headache disorders. 23% of patients presented with multiple OFP conditions; this was more common in patients with neurovascular (62%) than neuropathic (21%) and/or musculoskeletal orofacial symptoms (28%). Patients with neurovascular symptoms experienced significantly higher levels of pain, evidenced less pain self‐efficacy and had poorer overall health. Neuropathic OFP was significantly associated with greater psychological and social oral health disability. Multiple OFP symptoms were not linked to pain severity or psychosocial function, although health scores were worse for patients with neurovascular pain and neuropathic/musculoskeletal symptoms compared with patients with only neurovascular symptoms.ConclusionsThe profile and degree of psychosocial morbidity in patients with OFP is significantly related to the types of presenting orofacial symptoms. Patients with neurovascular pain present with higher pain levels and have poorer health while those with neuropathic pain have higher oral functional morbidity; both may require more complex multidisciplinary management.