Vedran Uglešić

School of Dental Medicine Zagreb, Maxillofacial, Faculty Member

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David Seamon

Kansas State University

Anil Sukumaran

Hamad Medical Corporation

David Vago

Vanderbilt University

DR.ABHITOSH DEBATA

Rajiv Gandhi University of Health Sciences

Nelson Mauro Maldonato

Università degli Studi di Napoli "Federico II"

Mirza Firnanda

Universitas Airlangga

Dellery Melsman

Universitas baiturahmah

CLEMENT C AZODO

University of Benin

Ammar siddiqui

University of Hail

Ioannis Koutroubakis

University of Crete

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Papers by Vedran Uglešić

Altered light-touch sensation after bilateral sagittal-split osteotomy

by Drazen Jokic, Jasna Spicek-Macan, and Vedran Uglešić

The Angle Orthodontist, 2012

Objective: To prospectively evaluate the incidence of change in light-touch sensation in the inne... more 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 6 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 6 1.2 with a range from 4 to 9 months. The average duration of hypoesthesia for women was 6.27 6 1.0 months, and men had hypoesthesia for 7.1 6 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. (Angle Orthod. 2012;82:1029-1032

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Maxillofacial war injuries in civilians and servicemen during the aggression against Croatia

by Jasna Spicek-Macan, P. Kobler, and Vedran Uglešić

Military medicine

Although civilian populations have been heavily involved in most of the recent wars and conflicts... more Although civilian populations have been heavily involved in most of the recent wars and conflicts throughout the world, most reports analyzed casualty data of military personnel, often leaving civilian casualties excluded or underestimated. A comparison of epidemiologic and medical data for maxillofacial injuries between civilians and servicemen (policemen, soldiers, and United Nations Protection Forces) during the aggression against Croatia is attempted. Of the 220 casualties admitted to the Department of Maxillofacial Surgery in Zagreb between August 1991 and December 1992, almost one-fourth were civilians. A significant difference between civilians and servicemen was noted in age and sex distribution. The incidence and severity of maxillofacial and associated injuries is almost equal, and the pattern of injuries is of the same type for civilian and military personnel.

Altered light-touch sensation after bilateral sagittal-split osteotomy

by Davor Jokić, Jasna Spicek-Macan, and Vedran Uglešić

The Angle Orthodontist, 2012

To prospectively evaluate the incidence of change in light-touch sensation in the innervated area... more 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. 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. 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. 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.

Advanced atherosclerosis of the vascular pedicle of radial forearm free flap in head and neck diabetic patient

by Vedran Uglešić and Emil Dediol

Journal of Plastic Surgery and Hand Surgery, 2013

This study reports a case of severe atherosclerosis of the radial artery encountered during raisi... more

European Maxillofacial Trauma (EURMAT) in children: A multicenter and prospective study

Oral surgery, oral medicine, oral pathology and oral radiology, Jan 24, 2014

The aim of this study is to present and discuss the results of a European multicentre prospective... more The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years. The most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures. Falls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after...

Assault-related maxillofacial injuries: the results from the European Maxillofacial Trauma (EURMAT) multicenter and prospective collaboration

by Vedran Uglešić, Emil Dediol, and Vitomir Konstantinović

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2014

The aim of this study is to present and discuss the demographic characteristics and patterns of a... more The aim of this study is to present and discuss the demographic characteristics and patterns of assault-related maxillofacial fractures as reported by a European multicenter prospective study. Demographic and injury data were recorded for each patient who was a victim of an assault. Assaults represented the most frequent etiology of maxillofacial trauma with an overall rate of 39% and the values ranging between 60.8% (Kiev, Ukraine) and 15.4% (Bergen, Norway). The most frequent mechanisms of assault-related maxillofacial fractures were fists in 730 cases, followed by kicks and fists. The most frequently observed fracture involved the mandible (814 fractures), followed by orbito-zygomatic-maxillary complex fractures and orbital fractures. Our data confirmed the strong possibility that patients with maxillofacial fractures may be victims of physical aggression. The crucial role of alcohol in assault-related fractures was also confirmed by our study.

European Maxillofacial Trauma (EURMAT) project: A multicentre and prospective study

by Vedran Uglešić and Emil Dediol

Journal of Cranio-Maxillofacial Surgery, 2015

The purpose of this study was to analyse the demographics, causes and characteristics of maxillof... more The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres.

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Maxillary Fragment Stabilization After Le Fort I Fracture With 1 Screw Pair per Plate

Journal of Oral and Maxillofacial Surgery, 2011

The aim of the present study was to determine whether plates with only 1 screw pair can be used f... more The aim of the present study was to determine whether plates with only 1 screw pair can be used for Le Fort I fracture management. Good postoperative results motivated the direct application of mandible fixation principles to the fractured midface region without additional experimental research. However, the amount and distribution of the forces in the midface region is different from those on the mandible. Testing was conducted on plastic anatomic models. The validity of the experimental model was tested before the fixation techniques were compared. Standard miniplates and miniscrews were used for fixation of the maxilla. The model surface strain analysis was conducted using the noncontact object grating method, which enabled the surface strain measurement without direct influence on the measured model. In 2 screw pair fixation, the outer screw pair has little effect on the local strain distribution, but it lowers the contact forces along the crack. One screw pair fixation is stable enough for fixation, but it has a greater strain peak at the crack edges. Our results showed that 1 screw pair per plate was enough for stable fixation, and 2 or more screw pairs should only be used when the bone fragment at the fracture site cannot sufficiently transmit forces along the crack.

The pectoralis major flap in head and neck reconstruction: First 500 patients

by Vedran Uglešić and Aleksandar Milenović

Journal of Cranio-Maxillofacial Surgery, 2006

Patients: In the period from 1981 through 1999 a total of 506 pectoralis major flaps were used fo... more Patients: In the period from 1981 through 1999 a total of 506 pectoralis major flaps were used for head and neck reconstruction in 500 patients. In all cases the flap was used after surgical resection of an advanced malignant tumour of the head and neck. Results: The tumours were intraoral in 387 cases (77%), pharyngeal in 78 cases (15%) and on the skin in 10 cases (5%). The defect was located in the mucosal lining in 407 (81%), skin in 43 (8%), both intra-and extraoral in 53 (10%) patients. Bone defects took place in 65 patients. In 31 patients (6 %) the pectoralis major flap was used in combination with other flaps (deltopectoral, tongue, trapezius and free flaps). Complications occurred with 168 flaps (33 %), but total flap necrosis was seen in only 10 patients (2%). Surgical treatment of complications was necessary in 87 patients (17 %). Conclusion: Despite the increasing application of microvascular reconstruction, the pectoralis major myocutaneous flap continues to be the most universal flap in head and neck reconstruction.

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$Research paper thumbnail of Evaluation of mandibular fracture treatment$

Evaluation of mandibular fracture treatment

by Vedran Uglešić and Jasna Spicek-Macan

Journal of Cranio-Maxillofacial Surgery, 1993

A total of 124 patients treated for mandibular fractures were analyzed. Patients were divided int... more A total of 124 patients treated for mandibular fractures were analyzed. Patients were divided into three groups according to treatment: intermaxillary fixation, wire fixation and mini-plate fixation. For each method, the success of treatment was evaluated with respect to surgical approach, fracture site and injury to treatment interval. Five basic parameters were used for evaluation of the outcome: occlusion, appearance, mastication, duration of IMF and complications. The treatment was surveyed based on both the surgeon&#39;s and patient&#39;s-evaluation. All parameters were scored and average values for every parameter calculated. The most successful treatment was achieved with mini-plate fixation in symphyseal and angle fractures. Intermaxillary fixation is indicated for mandibular body fractures with or without minimal displacement and a sufficient number of teeth. However, mini-plate fixation should be used for fractures with displacement. Wire fixation has been shown to be the poorest choice for all sites. Results showed that the intraoral approach has advantages over the extraoral one. The optimal time for treatment of mandibular fractures is within 72 h from time of injury. Even in fractures older than 7 days we recommended mini-plate fixation.

Chondromyxoid fibroma of the mandible

by Jasna Spicek-Macan, Tomislav Ćabov, and Vedran Uglešić

$Fig. 3 Photomicrograph of the tumour showing scattered multinucleated giant cells (haematoxylin and eosin, original magnification x 200) The patient was given general nasoendotracheal anaes- thesia and a local anaesthetic and a mucoperiosteal flap was raised; the lesion was removed by curettage. The lower right second premolar was also removed, and it was necessary to remove the apices of teeth 43, 42, 41, and 31 to remove the tumour properly. During the operation we noticed a pathological fracture of the inferior mandibular On a review of papers in the English language we found 21 previous examples of chondromyxoid fibromas of the jaws.$

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Underestimated Value of Communicating Vein Between Deep and Superficial Venous System of Radial Forearm Free Flap

by Vedran Uglešić, Aleksandar Milenović, and Emil Dediol

Annals of Plastic Surgery, 2011

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$Research paper thumbnail of Evaluation of sensitivity of teeth after mandibular fractures$

Evaluation of sensitivity of teeth after mandibular fractures

by Jasna Spicek-Macan, Davor Brajdić, and Vedran Uglešić

International Journal of Oral and Maxillofacial Surgery, 2011

The sensitivity of teeth anterior to a fracture between the mental and mandibular foramina has be... more The sensitivity of teeth anterior to a fracture between the mental and mandibular foramina has been tested and followed up until reinnervation or 3 years has passed. This study assessed the reinnervation period, the number of denervated teeth, and their clinical importance. Fifty patients and 459 teeth were examined. Two hundred and seventy-three teeth were affected and had potentially impaired innervation. Tests after injury showed non-responsive teeth in 81% of affected teeth. Six weeks after injury, 19% of teeth were reinnervated; by 1 year after injury, 92% of initially non-responsive teeth were reinnervated. Most teeth (34%) were reinnervated from 6 weeks to 3 months. All 23/186 initially non-responsive, unaffected, contralateral corresponding teeth were reinnervated within 6 weeks. A year after injury, 95% of incisors, 91% of canines, 94% of premolars, and 82% of molars were reinnervated. Three years after injury, 8% of teeth remain denervated. During the second and third years, no reinnervation occurred, but clinical signs of pulp devitalisation of denervated teeth occurred in 18% or 1% of the initially non-responsive affected teeth. The results revealed the stability of pulp 1 year after injury. Denervated teeth should not be treated if no clinical or radiological signs of devitalisation exist.

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Altered light-touch sensation after bilateral sagittal-split osteotomy

by Drazen Jokic, Jasna Spicek-Macan, and Vedran Uglešić

The Angle Orthodontist, 2012

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Maxillofacial war injuries in civilians and servicemen during the aggression against Croatia

by Jasna Spicek-Macan, P. Kobler, and Vedran Uglešić

Military medicine