Often in medicine, what seems simple is actually very complex. That is the case with chronic rhinosinusitis (CRS). CRS is a common chronic illness in the United States and worldwide, affecting all age groups. In the United States, its prevalence is 146 per 1000 population; 12.3% of adults are diagnosed with CRS, according to Centers for Disease Control and Prevention data. In Europe, the incidence is 10.9%, as per GA2LEN data. In China, it may be as high as 13%. Self-diagnosis and treatment complicate our ability to understand the actual prevalence of this disorder.
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Τετάρτη 23 Νοεμβρίου 2016
Chronic Rhinosinusitis: A “Simple” Complex Condition
Aspirin-Exacerbated Respiratory Disease
Aspirin-exacerbated respiratory disease (AERD) is characterized by the triad of asthma, sinonasal polyposis, and aspirin intolerance. The hallmark of the disease is baseline overproduction of cysteinyl leukotrienes via the 5-lipoxygenase pathway, exacerbated by ingestion of aspirin. Patients with AERD have high rates of recidivistic polyposis following sinus surgery, although the improvement in quality of life following surgery is similar to aspirin-tolerant patients. The diagnosis is secured by a positive aspirin provocation test, usually administered by a medical allergist. Aspirin therapy is a unique treatment consideration for patients with AERD.
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A Practical Approach to Refractory Chronic Rhinosinusitis
Patients with refractory chronic rhinosinusitis, by definition, have persistent, poorly controlled symptoms and objective inflammatory findings despite prior medical and surgical therapy. These patients represent a diagnostic and treatment challenge given the complexity of the underlying disease factors and the limitations in available management options. This article presents a practical framework for clinical evaluation and treatment. Germane to discussion are emerging concepts in refractory chronic rhinosinusitis that will likely have important implications in the near future.
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Biofilm and Osteitis in Refractory Chronic Rhinosinusitis
Our understanding of chronic rhinosinusitis (CRS) show biofilm and osteitis play a role in the disease's pathogenesis and refractory. Studies point to its role in pathogenesis and poor prognosis. Outside the research laboratory, biofilm detection remains difficult and specific treatment remains elusive. It is believed that osteitis is a nidus of inflammation and occurs more commonly in patients with refractory CRS. However, osteitis may be exacerbated by surgery and a marker of refractory disease, not a causative agent. Surgery remains the mainstay treatment for biofilm and osteitis with mechanical disruption and removal of disease load providing the most effective treatment.
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Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis
This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described. Extended open sinus surgical procedures, such as the Caldwell-Luc approach, frontal sinus trephine procedure, external frontoethmoidectomy, frontal sinus osteoplastic flap with or without obliteration, and cranialization, are discussed.
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Comparison of implant versus tooth-supported zirconia-based single crowns in a split-mouth design: a 4-year clinical follow-up study
Abstract
Objectives
This study aims to evaluate the 4-year clinical performance of tooth versus implant-supported single-unit zirconia crowns (LAVA™) placed on posterior region.
Materials and methods
Twenty-four patients (10 men and 14 women) who had received 48 single crowns (24 implant-supported and 24 tooth-supported) from January 2007 to December 2009, were included. California Dental Association (CDA) quality assessment system, plaque and gingival index scores were used to evaluate the performance of the crowns at baseline and at all follow-up examinations.
Results
During the follow-up period, no fracture of zirconia coping has occurred. Major complication was chipping in three patients that required a new crown fabrication. Except for the failure ones, all crowns in both groups were rated as satisfactory at the follow-up examinations based on the CDA quality assessment criteria. There were no statistically significant differences between tooth and implant-supported crowns in terms of periodontal parameters.
Conclusions
The present 4-year follow-up clinical study demonstrates that single-unit tooth- and implant-supported zirconia crowns have similar prosthetic and periodontal outcomes.
Clinical relevance
Single-unit implant or tooth-supported zirconia crowns may be considered acceptable treatment modalities for restoration of either missing or compromised posterior teeth
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Transmission of light in the visible spectrum (400–700 nm) and blue spectrum (360–540 nm) through CAD/CAM polymers
Abstract
Objectives
CAD/CAM-fabricated long-term temporary restorations from high-density polymers can be applied for a wide range of indications. Milled from monolithic, mono-colored polymer blocks, the translucency of the material plays an important role for an esthetically acceptable result. The aim of this study was to compare the transmittance through visible light and blue light of CAD CAM polymers to a glass-ceramic material of the same color.
Materials and methods
Ambarino High-Class (AM), Telio-CAD (TC), Zenotec PMMA (ZT), Cercon base PMMA (CB), CAD Temp (CT), Artbloc Temp (AT), Polycon ae (PS), New Outline CAD (NC), QUATTRO DISK Eco PMMA (GQ), Lava Ultimate (LU), and Paradigm MZ 100 (PA) were employed in this study using the feldspathic glass-ceramic Vita Mark II (MK) as control group. Using a spectrophotometer, the overall light transmittance was measured for each material (n = 40) and was calculated as the integration (t c (λ) dλ [10-5]) of all t c values for the wavelengths of blue light (360–540 nm). Results were compared to previous data of the authors for visible light (400 to 700 nm).
Results
Wilcoxon test showed significant differences between the light transmittance of visible and blue light for all materials.
Conclusion
CAD/CAM polymers showed different translucency for blue and visible light. This means clinicians may not conclude from the visible translucency of a material to its permeability for blue light. This influences considerations regarding light curing.
Clinical relevance
CAD/CAM polymers need to be luted adhesively; therefore, clinicians should be aware about the amount of blue light passing through a restoration.
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Long-term success of dental implant-supported dentures in postirradiated patients treated for neoplasms of the maxillofacial skeleton: a retrospective study
Abstract
Objectives
The reconstruction of oral function in irradiated patients with craniofacial tumors is a significant challenge. The aim of this study was to detect long-term success of dental implant-supported dentures in postirradiated patients treated for neoplasms of the maxillofacial skeleton.
Materials and methods
From 2004 to 2011, 36 irradiated patients underwent oral function reconstruction using implant-supported prostheses. Bone augmentation was completed using vascularized bone grafts in 22 patients. Fourteen patients were treated by hyperbaric oxygen therapy (HBO). A total of 198 dental implants were used in jaw rehabilitation. After loading, implant success rates, biological and prosthetic complications, patient satisfaction, and psychological changes were recorded.
Results
Bone augmentation of the jaw was successful and vascularized grafts provided an additional vascular supply in compromised irradiated tissue. Rehabilitation was successful in all of the patients after loading. Thirty-eight dental implants failed, and 35 implants were removed. The success rate of the implants was 93.6 % for 10 years after loading. It was not a significant difference in implant success rate between the HBO group and the other groups. The prosthodontic maintenance results and complication rates showed that patients required intervention 0.19 times per year. All patients were satisfied with the oral restoration results.
Conclusion
The restoration of oral function in radiotherapy patients with tumor resection using implant-supported prostheses is a viable treatment option.
Clinical relevance
Either alone or in combination with HBO, dental implant-supported prostheses can be used an effective therapeutic approach for irradiated patients with oral function reconstruction.
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Comparison of red autofluorescing plaque and disclosed plaque—a cross-sectional study
Abstract
Objectives
The aim of this cross-sectional study was to assess the correlation between dental plaque scores determined by the measurement of red autofluorescence or by visualization with a two-tone solution. Clinical photographs were used for this study.
Materials and methods
Overnight plaque from the anterior teeth of 48 participants was assessed for red fluorescence on photographs (taken with a QLF-camera) using a modified Quigley & Hein (mQH) index. A two-tone disclosing solution was applied. Total disclosed plaque was clinically assessed using the mQH index. In addition, total and blue disclosed plaque was scored on clinical photographs using the mQH index.
Results
A strong correlation was observed between the total disclosed plaque scored on photographs and the clinical scores (r = 0.70 at site level; r = 0.88 at subject level). The correlation between red fluorescent plaque and total plaque, as assessed on the photographs, was moderate to strong and significant (r = 0.50 at the site level; r = 0.70 at the subject level), with the total plaque scores consistently higher than the red fluorescent plaque scores. The correlation between red fluorescent plaque and blue disclosed plaque was weak to moderate and significant (r = 0.30 at the site level; r = 0.50 at the subject level).
Conclusions
Plaque, as scored on white-light photographs, corresponds well with clinically assessed plaque. A weak to moderate correlation between red fluorescing plaque and total disclosed plaque or blue disclosed plaque was found.
Clinical relevance
What at present is considered to be matured dental plaque, which appears blue following the application of a two-tone disclosing solution, is not in agreement with red fluorescent dental plaque assessment.
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Botulinum toxin treatment for essential palatal tremors presenting with nasal clicks instead of pulsatile tinnitus: a case report
In this study, we report a rare case of an adult patient with essential palatal tremors (EPT) presenting as nasal clicks, instead of otic clicks or objective pulsatile tinnitus in common EPT.
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Focusing on the Effectiveness of Prophylactic Antibiotics to Prevent Prosthetic Joint Infection Caused by Dental Treatment
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Arthur H. Friedlander, Dean M. DeLuke, Tina I. Chang, Lindsay L. Graves
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In Reply
Source:Journal of Oral and Maxillofacial Surgery
Author(s): John H. Campbell
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Retrospective Clinical Study of Maxillary Sagittal Fractures: Predictors of Postoperative outcome
Publication date: Available online 23 November 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Krishna Prasad Regmi, JunBo Tu, SuMeng Ge, ChengQun Hou, XiaoYi Hu, ShiXian Li, JingTing Du
PurposeBecause of less attention to sagittal component of maxillary fractures, they are often misdiagnosed and miss the reduction leading to maxillary transverse discrepancies. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures.MethodsThis study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures collected from the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xian Jiaotong University between January 2008 and December 2013. The predictor variables were age, gender, and occupation, the cause of injury, injury severity, treatment timing, treatment method, and quality of fracture reduction. The outcome variable was postoperative treatment effect index. Descriptive, bivariate, and multivariate statistics were computed. P value was set at 0.05.ResultsThe sample was composed of 40 cases. Male to female ratio was found to be 4:1; the most vulnerable age group was 20-30 years (30%); laborers (72.5%) were more prone to injury, and the main cause of injury was motor vehicle accident (62.5%). No cases of isolated sagittal fracture were found and most (35%)occurred with other maxillary fractures including Le Fort fractures. There was a statistically significant association between treatment timing and fracture reduction quality to postoperative treatment effect index (P value <0.05).ConclusionThe results of this study suggest that the earlier the treatment of the fractured bone, the better the result achieved. Anatomical repositioning of the fractured bone is the important predictor for good postoperative outcomes.
Graphical abstract
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Deterioration of Vestibular Cells in Labyrinthitis
Objective:
To quantitatively assess the effect of serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans on vestibular hair cells, dark cells, and transitional cells.
Methods:We examined human temporal bone specimens with serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans, then compared them with age-matched control groups without labyrinthitis. We evaluated the density of type I and II vestibular hair cells, dark cells, and transitional cells in the peripheral sensorial organs.
Results:The mean density of type I vestibular hair cells in the maculae of the saccule significantly differed between the serous labyrinthitis group and its control group. The loss of type I and II vestibular hair cells in all of the peripheral sensorial organs was significantly higher in the suppurative labyrinthitis group than in its control group. The mean density of dark cells in the lateral and posterior semicircular canals was significantly lower in the suppurative labyrinthitis group than in its control group. The mean density of type I and II vestibular hair cells, dark cells, and transitional cells was significantly lower in the labyrinthitis ossificans group than in its control group.
Conclusion:The loss of vestibular hair cells and degenerative changes in dark cells and transitional cells could affect vestibular function in patients with labyrinthitis.
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Morphological and functional imaging of neck paragangliomas
Publication date: Available online 23 November 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): J.-P. Guichard, N. Fakhry, J. Franc, P. Herman, C.-A. Righini, D. Taieb
ObjectiveTo review the optimal techniques for localization and characterization of neck paragangliomas (PGL).Material and methodsSystematic review of the literature from the PubMed/Medline database.ResultsNeck PGL are hypervascular tumours essentially arising from paraganglionic tissue situated at the carotid bifurcation (carotid body) and along the vagus nerve. Morphological and functional imaging are indicated to confirm the diagnosis, identify multifocal disease and for local and regional staging. MR angiography is the noninvasive technique of choice. CT scan and especially CT angiography are excellent alternatives for diagnosis and staging. Conventional arteriography remains useful preoperatively for embolization and occlusion tests. Functional imaging allows localization and characterization of PGLs. Somatostatin receptor scintigraphy (SRS) was the reference imaging technique for staging of sporadic PGLs. The indications for PET imaging have been extended over recent years in parallel with the development of new tracers such as [18F]-FDOPA PET or 68Gallium-labelled DOTA peptides. 68Gallium-labelled DOTA peptides has become the first-line imaging modality in the evaluation of cervical PGLs, regardless of the genetic background.ConclusionMorphological and functional imaging is essential for the staging of neck PGL.
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Addressing the challenges of oral health in the 21 st century through research
Hezekiah A Mosadomi
Saudi Journal of Oral Sciences 2014 1(2):55-56
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Saudi Journal of Oral Sciences 2014 1(2):55-56
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The nature of collagen in oral submucous fibrosis: A systematic review of the literature
VV Kamath
Saudi Journal of Oral Sciences 2014 1(2):57-64
Background: The nature of collagen in the oral potentially malignant disorder of oral submucous fibrosis (OSF) has always been a subject of interest to researchers studying the condition. The type, constitution, and morphology of the collagen has been studied to understand the pathogenesis of the disorder. Aim: The present review attempts to collate literature to assess the changes reported on the nature of collagen in OSF. Materials and Methods: A systematic analysis of literature based on the PRISMA protocol was carried out on studies that analyzed the nature of collagen in OSF. A total of 30 articles were found acceptable for analysis. The reported literature was categorized into histological, immuno-histochemistry (IHC), electron microscopic (EM)/scanning electron microscopic (SEM), biochemical, culture, and genetic studies. Results: Light microscopic studies revealed increased collagen with compaction and condensation as the disease advanced. Polarising microscopy revealed presence of greenish yellow (type I) thick fibers replacing the yellowish orange (type III) thin fibers in the submucosa. Fibrosis originated in the submucosa and subsequently involved the lamina propria as the disease advanced. EM/SEM investigations revealed frayed ends, degeneration of collagen cores. Increased expression of collagen antibodies and total collagen content were observed in IHC and biochemical studies, respectively. Cultured fibroblasts from OSF tend to produce more collagen in comparison to normal fibroblasts indicating a phenotypic change. Increased expression and upregulation of collagen genes were consistent in OSF cases. Conclusion: The collagen deposition in OSF is biochemically normal but quantitatively more. Fibroblast phenotypic change, upregulation of collagen genes, and selective remodeling due to decreased degradation seem to contribute to the increased fibrosis in the disorder.
http://ift.tt/238VSNk
Saudi Journal of Oral Sciences 2014 1(2):57-64
Background: The nature of collagen in the oral potentially malignant disorder of oral submucous fibrosis (OSF) has always been a subject of interest to researchers studying the condition. The type, constitution, and morphology of the collagen has been studied to understand the pathogenesis of the disorder. Aim: The present review attempts to collate literature to assess the changes reported on the nature of collagen in OSF. Materials and Methods: A systematic analysis of literature based on the PRISMA protocol was carried out on studies that analyzed the nature of collagen in OSF. A total of 30 articles were found acceptable for analysis. The reported literature was categorized into histological, immuno-histochemistry (IHC), electron microscopic (EM)/scanning electron microscopic (SEM), biochemical, culture, and genetic studies. Results: Light microscopic studies revealed increased collagen with compaction and condensation as the disease advanced. Polarising microscopy revealed presence of greenish yellow (type I) thick fibers replacing the yellowish orange (type III) thin fibers in the submucosa. Fibrosis originated in the submucosa and subsequently involved the lamina propria as the disease advanced. EM/SEM investigations revealed frayed ends, degeneration of collagen cores. Increased expression of collagen antibodies and total collagen content were observed in IHC and biochemical studies, respectively. Cultured fibroblasts from OSF tend to produce more collagen in comparison to normal fibroblasts indicating a phenotypic change. Increased expression and upregulation of collagen genes were consistent in OSF cases. Conclusion: The collagen deposition in OSF is biochemically normal but quantitatively more. Fibroblast phenotypic change, upregulation of collagen genes, and selective remodeling due to decreased degradation seem to contribute to the increased fibrosis in the disorder.
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Supramicrosurgical lymphatico-venular anastomosis (LVA) in treating lymphoedema: 36-months preliminary report
OBJECTIVE: Lymphoedema of the extremities is a widespread pathological condition that mostly occurs as a complication of cancer resections, especially in women. Conventional therapy refers to conservative and physiotherapeutic approaches. Surgical strategies have been widely reported in the literature and are still challenging. Part of this literature focuses on the supra microsurgical lymphaticovenular anastomosis (LVA) technique. LVA is characterized by a high success rate, minimal invasivity and broad indications. Furthermore, this procedure can be performed under local anesthesia.
PATIENTS AND METHODS: From October 2011 through October 2014, 69 patients affected by lymphedema underwent LVA surgery in Siena University Hospital, Italy. Preoperative and postoperative evaluations were taken.
RESULTS: Totally, 366 anastomosis have been performed. The average rate was 5.3 anastomosis per patient. All patients registered a decrease in the size of the affected side. The average volume reduction was 50%. Patients also showed a reduction of lymphangitis episodes and reduction of compression garments class. Moreover, a satisfaction index was evaluated. The majority of patients (72.5%) was extremely satisfied of the surgery.
CONCLUSIONS: LVA has demonstrated to be an effective surgical strategy to treat lymphoedema, especially in secondary cases in early stages. Although LVA is widely discussed in the literature, the majority of works relates to Japanese authors and few reports exist outside Japan. This paper represents the very first retrospective analysis of the adoption of LVA technique in Italy and one of the few outside Japan.
L'articolo Supramicrosurgical lymphatico-venular anastomosis (LVA) in treating lymphoedema: 36-months preliminary report sembra essere il primo su European Review.
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The "True Triangle" in cleft lip repair: A novel technique
Abdullah I Al Atel
Saudi Journal of Oral Sciences 2014 1(2):114-116
The aim of this short communication is to describe the True Triangle (TT) technique for the repair of unilateral cleft lip (CL). A total of 309 patients were operated using the TT technique. The final cleft lip repair results showed positive outcomes. Conclusion: This technique may overcome some of the drawbacks of the previously described surgical techniques used for CL repair.
http://ift.tt/238UquC
Saudi Journal of Oral Sciences 2014 1(2):114-116
The aim of this short communication is to describe the True Triangle (TT) technique for the repair of unilateral cleft lip (CL). A total of 309 patients were operated using the TT technique. The final cleft lip repair results showed positive outcomes. Conclusion: This technique may overcome some of the drawbacks of the previously described surgical techniques used for CL repair.
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Physical and mechanical properties of pressure-molded and injection-molded denture base acrylics in different conditions
Yousef A Shibat Al Hamd, Veerendra B Dhuru
Saudi Journal of Oral Sciences 2014 1(2):65-70
Background and Aim: The aim of the study was to compare the physical (processing shrinkage) and mechanical properties (bending deflection, flexure strength, and flexure modulus) of pressure-molded (Lucitone 199 and ProBase Hot) and injection-molded (SR-Ivocap) denture base materials in different conditions. Materials and Methods: Two denture base materials for pressure molding, Lucitone 199 and ProBase Hot, and one for injection molding (SR-Ivocap) were tested. Polymerization shrinkage (PS) was determined by measuring the linear distances between the reference points on the wax patterns (65 mm × 55 mm × 6 mm) and the corresponding cured acrylic plates and calculating the difference. Rectangular specimens (50 mm × 10 mm × 2.5 mm) were machined from these acrylic plates and used to measure bending deflection (BD) at various load levels, flexure strength (FS), and modulus of elasticity using a three-point bend test on an Instron Universal Testing Machine. A minimum of seven specimens were tested for each variable category. For each material, the percentage of specimens that failed within the load range of 9-10 kg was noted. Statistical analysis involved calculation of mean and standard deviations followed by group comparison of properties of different materials by using analysis of variance (ANOVA) and Tukey's multiple range tests. Level of significance was set at P < 0.05. Result: There was no significant difference between the PS values. ProBase Hot exhibited significantly less BD and greater FS values than the other two materials (P < 0.05). Within the load range of 9-10 kg., 5% of the lucitone specimens, 25% of the SR-Ivocap specimens, and all of the ProBase Hot specimens fractured. Conclusion: The three tested denture base acrylics did not show any significant differences in processing shrinkage. However, ProBase Hot showed significantly lower bending deflection values than Lucitone 199 and SR-Ivocap. Compared to Lucitone 199 and SR-Ivocap, ProBase Hot is a tougher and a stiffer material. Hence, it is more likely to fracture readily if subjected to extreme loading conditions due to the accidental fall of the denture on a hard surface or if the denture wearer inadvertently bites on a particularly hard particle.
http://ift.tt/25WSbj5
Saudi Journal of Oral Sciences 2014 1(2):65-70
Background and Aim: The aim of the study was to compare the physical (processing shrinkage) and mechanical properties (bending deflection, flexure strength, and flexure modulus) of pressure-molded (Lucitone 199 and ProBase Hot) and injection-molded (SR-Ivocap) denture base materials in different conditions. Materials and Methods: Two denture base materials for pressure molding, Lucitone 199 and ProBase Hot, and one for injection molding (SR-Ivocap) were tested. Polymerization shrinkage (PS) was determined by measuring the linear distances between the reference points on the wax patterns (65 mm × 55 mm × 6 mm) and the corresponding cured acrylic plates and calculating the difference. Rectangular specimens (50 mm × 10 mm × 2.5 mm) were machined from these acrylic plates and used to measure bending deflection (BD) at various load levels, flexure strength (FS), and modulus of elasticity using a three-point bend test on an Instron Universal Testing Machine. A minimum of seven specimens were tested for each variable category. For each material, the percentage of specimens that failed within the load range of 9-10 kg was noted. Statistical analysis involved calculation of mean and standard deviations followed by group comparison of properties of different materials by using analysis of variance (ANOVA) and Tukey's multiple range tests. Level of significance was set at P < 0.05. Result: There was no significant difference between the PS values. ProBase Hot exhibited significantly less BD and greater FS values than the other two materials (P < 0.05). Within the load range of 9-10 kg., 5% of the lucitone specimens, 25% of the SR-Ivocap specimens, and all of the ProBase Hot specimens fractured. Conclusion: The three tested denture base acrylics did not show any significant differences in processing shrinkage. However, ProBase Hot showed significantly lower bending deflection values than Lucitone 199 and SR-Ivocap. Compared to Lucitone 199 and SR-Ivocap, ProBase Hot is a tougher and a stiffer material. Hence, it is more likely to fracture readily if subjected to extreme loading conditions due to the accidental fall of the denture on a hard surface or if the denture wearer inadvertently bites on a particularly hard particle.
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The effect of different types of oral mouth rinses on the hardness of Silorane-based and Nano-hybrid composites
Rohit Ashok Antony Fernandez, Marwan El Araby, Mohamed Siblini, Ayed Al-Shehri
Saudi Journal of Oral Sciences 2014 1(2):105-109
Background: The restorative materials used in dentistry are required to have long-term durability in the oral cavity. Effect of various fluids in the oral environment can affect the hardness of these restorations. This study was carried out to evaluate the effect of different mouth rinses on the hardness of Silorane and Nano-hybrid resin composites. Materials and Methods: Thirty specimens were prepared from each type of composite and stored in artificial saliva for 24 h at 37°C. They were then divided into six experimental groups based on the test solution and were immersed and stored for 24 h at 37°C. Thereafter, the specimens were washed, dried and the hardness was measured for each specimen by Vickers microhardness tester. Results: Nano-hybrid resin composite showed higher Vickers hardness number (VHN) than Silorane composite in any test solution. There was only a mildly significant difference in the mean VHN of Silorane composite immersed in alcohol-containing mouthwash compared with artificial saliva. However, there was a significant difference in the mean VHN of Nano-hybrid composite when immersed in different mouthwashes. Conclusion: The microhardness values of Silorane-based and Nano-hybrid resin composites were decreased after immersion in the mouthwashes. The hardness of Nano-hybrid composite immersed in artificial saliva showed the highest VHN and was significantly affected when immersed in other test solutions. Silorane-based composite is more resistant to alcohol-containing mouthwash than Nano-hybrid composite.
http://ift.tt/238UA5a
Saudi Journal of Oral Sciences 2014 1(2):105-109
Background: The restorative materials used in dentistry are required to have long-term durability in the oral cavity. Effect of various fluids in the oral environment can affect the hardness of these restorations. This study was carried out to evaluate the effect of different mouth rinses on the hardness of Silorane and Nano-hybrid resin composites. Materials and Methods: Thirty specimens were prepared from each type of composite and stored in artificial saliva for 24 h at 37°C. They were then divided into six experimental groups based on the test solution and were immersed and stored for 24 h at 37°C. Thereafter, the specimens were washed, dried and the hardness was measured for each specimen by Vickers microhardness tester. Results: Nano-hybrid resin composite showed higher Vickers hardness number (VHN) than Silorane composite in any test solution. There was only a mildly significant difference in the mean VHN of Silorane composite immersed in alcohol-containing mouthwash compared with artificial saliva. However, there was a significant difference in the mean VHN of Nano-hybrid composite when immersed in different mouthwashes. Conclusion: The microhardness values of Silorane-based and Nano-hybrid resin composites were decreased after immersion in the mouthwashes. The hardness of Nano-hybrid composite immersed in artificial saliva showed the highest VHN and was significantly affected when immersed in other test solutions. Silorane-based composite is more resistant to alcohol-containing mouthwash than Nano-hybrid composite.
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Comparative study of marginal adaptation and mechanical properties of CAD/CAM versus dual polymerized interim fixed dental prosthesis
Marwa Eltayeb I Elagra, Yousria Shalaby, Moustafa Fakhry Khalil, Nagiub ElFawal
Saudi Journal of Oral Sciences 2014 1(2):71-78
Background: With the advent of new interim crown materials, it has become imperative to evaluate its strength in order to select the appropriate interim crown and partial fixed dental prosthesis material. Aim: The purpose of this in vitro study was to compare marginal adaptation, wear resistance, and fracture resistance of a computer-aided design/computer-aided manufacturing (CAD/CAM) versus a dual polymerized interim fixed dental prosthesis (FDP). Materials and Methods: Twenty models were randomly allocated into two equal groups (I and II). Group (I) received 10 CAD/CAM fabricated interim FDP (CAD-Temp) and Group (II) received 10 directly fabricated interim FDP using a dual polymerized material (TempSpan). All specimens were stored before testing. Marginal adaptation was tested using stereomicroscope and image analyzing software to measure the amount of marginal gap. For wear resistance test, all specimens were subjected to mechanical tooth brushing. Stereomicroscope and image analyzing software were used to measure the difference in height before and after tooth brushing. Specimens were subjected to cyclic loading; specimens intact from defects were then loaded to fracture. Data were analyzed using Student's T- test, Mann Whitney test and Fisher exact test (α = 0.05). Results: CAD-Temp (15.026 ± 4.340 μm) showed significantly higher marginal adaptation than TempSpan (145.418 ± 25.365μm)(P < 0.001). The wear resistance of CAD-Temp (7.3322 ± 0.99853 μm) was significantly higher than TempSpan (22.3165 ± 2.35459 μm) (P < 0.001). The fracture resistance of CAD-Temp (605.1 ± 31.718N) was also significantly higher than that of TempSpan (225.76 ± 32.469N) (P < 0.001). Conclusions: CAD/CAM fabricated interim restorations have better marginal adaptation, wear resistance and fracture resistance than dual polymerized interim restorations hence, might withstand longer duration in the oral cavity.
http://ift.tt/238VH4N
Saudi Journal of Oral Sciences 2014 1(2):71-78
Background: With the advent of new interim crown materials, it has become imperative to evaluate its strength in order to select the appropriate interim crown and partial fixed dental prosthesis material. Aim: The purpose of this in vitro study was to compare marginal adaptation, wear resistance, and fracture resistance of a computer-aided design/computer-aided manufacturing (CAD/CAM) versus a dual polymerized interim fixed dental prosthesis (FDP). Materials and Methods: Twenty models were randomly allocated into two equal groups (I and II). Group (I) received 10 CAD/CAM fabricated interim FDP (CAD-Temp) and Group (II) received 10 directly fabricated interim FDP using a dual polymerized material (TempSpan). All specimens were stored before testing. Marginal adaptation was tested using stereomicroscope and image analyzing software to measure the amount of marginal gap. For wear resistance test, all specimens were subjected to mechanical tooth brushing. Stereomicroscope and image analyzing software were used to measure the difference in height before and after tooth brushing. Specimens were subjected to cyclic loading; specimens intact from defects were then loaded to fracture. Data were analyzed using Student's T- test, Mann Whitney test and Fisher exact test (α = 0.05). Results: CAD-Temp (15.026 ± 4.340 μm) showed significantly higher marginal adaptation than TempSpan (145.418 ± 25.365μm)(P < 0.001). The wear resistance of CAD-Temp (7.3322 ± 0.99853 μm) was significantly higher than TempSpan (22.3165 ± 2.35459 μm) (P < 0.001). The fracture resistance of CAD-Temp (605.1 ± 31.718N) was also significantly higher than that of TempSpan (225.76 ± 32.469N) (P < 0.001). Conclusions: CAD/CAM fabricated interim restorations have better marginal adaptation, wear resistance and fracture resistance than dual polymerized interim restorations hence, might withstand longer duration in the oral cavity.
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Rare presentation of radicular cyst with sebaceous differentiation
Malay Kumar, Tapan G Modi, Manas Bajpai, Ronak Nanavati
Saudi Journal of Oral Sciences 2014 1(2):120-122
Sebaceous glands in the oral mucosa are said to be a normal variation, but the presence of the sebaceous gland in the jaw is extremely rare. Sebaceous gland differentiation in dentigerous cysts and in keratocystic odontogenic tumor (earlier odontogenic keratocysts) has been reported, but it has never been reported in any radicular cyst. We presented a case of a radicular cyst in an 18-year-old male with sebaceous gland differentiation.
http://ift.tt/238WO4g
Saudi Journal of Oral Sciences 2014 1(2):120-122
Sebaceous glands in the oral mucosa are said to be a normal variation, but the presence of the sebaceous gland in the jaw is extremely rare. Sebaceous gland differentiation in dentigerous cysts and in keratocystic odontogenic tumor (earlier odontogenic keratocysts) has been reported, but it has never been reported in any radicular cyst. We presented a case of a radicular cyst in an 18-year-old male with sebaceous gland differentiation.
http://ift.tt/238WO4g
A retrospective study of panoramic radiographs for zygomatic air cell defect in children
Srikanth H Srivathsa, Suchetha N Malleshi, Karthikeya Patil, Mahima V Guledgud
Saudi Journal of Oral Sciences 2014 1(2):79-82
Background and Aim: The aim was to determine the prevalence of zygomatic air cell defect (ZACD) among children of Indian origin and also to determine the dominant form of ZACD. Materials and Methods: One thousand six hundred and eighty-eight routine panoramic radiographs of subjects between 7 and 18 years, processed between January 2006 and January 2009 were screened, recorded and analyzed for ZACD. Results: Of the 1688 panoramic radiographs examined, 768 were of males and 920 of females. The radiographs were divided into two groups, Group I comprising of subjects in the age 7-12 years and other Group II in the age range 13-18 years. ZACD was found in 50 subjects, accounting for prevalence of 2.96%. Other occurrences found were unilateral 38 cases, bilateral 12, unilocular 20 and multilocular 42 respectively. Conclusion: This study described the prevalence and characteristics of ZACD among selected Indian children. It is essential to know and determine this variant of normal anatomy and differentiate it from pathologies.
http://ift.tt/25WSBWw
Saudi Journal of Oral Sciences 2014 1(2):79-82
Background and Aim: The aim was to determine the prevalence of zygomatic air cell defect (ZACD) among children of Indian origin and also to determine the dominant form of ZACD. Materials and Methods: One thousand six hundred and eighty-eight routine panoramic radiographs of subjects between 7 and 18 years, processed between January 2006 and January 2009 were screened, recorded and analyzed for ZACD. Results: Of the 1688 panoramic radiographs examined, 768 were of males and 920 of females. The radiographs were divided into two groups, Group I comprising of subjects in the age 7-12 years and other Group II in the age range 13-18 years. ZACD was found in 50 subjects, accounting for prevalence of 2.96%. Other occurrences found were unilateral 38 cases, bilateral 12, unilocular 20 and multilocular 42 respectively. Conclusion: This study described the prevalence and characteristics of ZACD among selected Indian children. It is essential to know and determine this variant of normal anatomy and differentiate it from pathologies.
http://ift.tt/25WSBWw
Knowledge and orientations of medical interns toward periodontal disease in Saudi Arabia
Farah Asa'ad, Nassr Al-Maflehi, Bushra Alelyan, Lama Asaad, Walaa Alrumaih, Fatimah Alassad, Sara Alshakhs, Basma Alshakhs
Saudi Journal of Oral Sciences 2014 1(2):98-104
Background and Aim: This study was conducted to assess the periodontal knowledge, orientations of Saudi medical interns and the medical curriculum. Study Population and Methodology: Questionnaires were distributed to 221 medical interns chosen randomly from two major educational institutions in Saudi Arabia. Questions were developed from literature reviews. The questionnaire had five true/false knowledge items, and eight Likert-scale questions. Data were analyzed by computerized SPSS (version 20). Level of significance was set at P < 0.05. Results: Of the 221 respondents, 66% were male and 34% were female. Most of the participants were 24 years old (48%). About 40% of the interns answered all five true/false general knowledge questions correctly, nearly half of the respondents (49.8%) reported they never asked patients if they were diagnosed with periodontal disease, 93.2% reported not receiving any training about periodontal disease in medical school, 23.5% reported they would feel absolutely uncomfortable performing a simple periodontal examination, about one-third of interns (29.4%) agreed that patients expect physicians to discuss/screen for periodontal disease, 43.9% felt that discussing/evaluating the periodontal status of their patients was peripheral to their role as physicians, nearly half of interns (48.4%) reported never screening patients for periodontal disease, and 33% stated they never referred patients to dentists. Conclusion: Medical interns were not prepared nor trained to screen patients for periodontal disease. They had limited knowledge about the association between periodontal health and general health. Oral health training as part of the medical curriculum is strongly recommended.
http://ift.tt/25WSfiT
Saudi Journal of Oral Sciences 2014 1(2):98-104
Background and Aim: This study was conducted to assess the periodontal knowledge, orientations of Saudi medical interns and the medical curriculum. Study Population and Methodology: Questionnaires were distributed to 221 medical interns chosen randomly from two major educational institutions in Saudi Arabia. Questions were developed from literature reviews. The questionnaire had five true/false knowledge items, and eight Likert-scale questions. Data were analyzed by computerized SPSS (version 20). Level of significance was set at P < 0.05. Results: Of the 221 respondents, 66% were male and 34% were female. Most of the participants were 24 years old (48%). About 40% of the interns answered all five true/false general knowledge questions correctly, nearly half of the respondents (49.8%) reported they never asked patients if they were diagnosed with periodontal disease, 93.2% reported not receiving any training about periodontal disease in medical school, 23.5% reported they would feel absolutely uncomfortable performing a simple periodontal examination, about one-third of interns (29.4%) agreed that patients expect physicians to discuss/screen for periodontal disease, 43.9% felt that discussing/evaluating the periodontal status of their patients was peripheral to their role as physicians, nearly half of interns (48.4%) reported never screening patients for periodontal disease, and 33% stated they never referred patients to dentists. Conclusion: Medical interns were not prepared nor trained to screen patients for periodontal disease. They had limited knowledge about the association between periodontal health and general health. Oral health training as part of the medical curriculum is strongly recommended.
http://ift.tt/25WSfiT
Detection of bacteria in endodontic samples and its association with defined clinical signs and symptoms of endodontic infection
Shaikha Al-Samahi, Mohammad A Al-Omari
Saudi Journal of Oral Sciences 2014 1(2):83-89
Introduction : The role of bacteria in pulpal and periradicular lesions is well established. However, the association of bacterial species with signs and symptoms of endodontic infection is not well elucidated. The purpose of this study was to investigate the types of bacterial species in infected root canals (using MicroSeq 500 16S ribosomal ribonucleic acid, rRNA) and the association of bacterial species with clinical signs and symptoms of different pulpal and periapical infections. Materials and Methods: Microbial samples were obtained from 92 adult patients (one tooth with single root canal for each patient). Clinical data including signs and symptoms were collected. Polymerase chain reaction (PCR) (MicroSeq 500 16S rRNA) was used to detect bacteria in the infected root canals. Results: A total of 179 bacterial species were identified. Actinomyces viscosus and Streptococcus sanguis were associated with the presence of pain. While Staphylococcus haemolyticus and Veillonella spp. were associated with pain of palpation, the pain to percussion was associated with Actinomyces spp., Actinomyces naeslundii, and Actinomyces viscosus. Also, Streptococcus mitis, Bacteroides spp., and Veillonella spp. were associated with periapical swelling. The presence of sinus tract was found to be significantly associated with Neisseria spp. and Staphylococcus haemolyticus. The wet canal was significantly associated with the presence of Propionibacterium acnes and Bacteroides spp. Conclusions: There are significant associations between the presence of some bacterial species with clinical signs and symptoms of infected root canals.
http://ift.tt/238UCtO
Saudi Journal of Oral Sciences 2014 1(2):83-89
Introduction : The role of bacteria in pulpal and periradicular lesions is well established. However, the association of bacterial species with signs and symptoms of endodontic infection is not well elucidated. The purpose of this study was to investigate the types of bacterial species in infected root canals (using MicroSeq 500 16S ribosomal ribonucleic acid, rRNA) and the association of bacterial species with clinical signs and symptoms of different pulpal and periapical infections. Materials and Methods: Microbial samples were obtained from 92 adult patients (one tooth with single root canal for each patient). Clinical data including signs and symptoms were collected. Polymerase chain reaction (PCR) (MicroSeq 500 16S rRNA) was used to detect bacteria in the infected root canals. Results: A total of 179 bacterial species were identified. Actinomyces viscosus and Streptococcus sanguis were associated with the presence of pain. While Staphylococcus haemolyticus and Veillonella spp. were associated with pain of palpation, the pain to percussion was associated with Actinomyces spp., Actinomyces naeslundii, and Actinomyces viscosus. Also, Streptococcus mitis, Bacteroides spp., and Veillonella spp. were associated with periapical swelling. The presence of sinus tract was found to be significantly associated with Neisseria spp. and Staphylococcus haemolyticus. The wet canal was significantly associated with the presence of Propionibacterium acnes and Bacteroides spp. Conclusions: There are significant associations between the presence of some bacterial species with clinical signs and symptoms of infected root canals.
http://ift.tt/238UCtO
Intra-alveolar auto-transplantation to correct a single tooth rotation: A case report with four years of follow-up
Sunil Babu Kotha
Saudi Journal of Oral Sciences 2014 1(2):110-113
It is uncommon for children or young adults to have rotated central incisors. The restorative options are to carry out an orthodontic treatment or root canal treatment followed by crown placement for their correction. Often overlooked and misunderstood, another treatment option in the intra-alveolar auto-transplantation where the tooth is rotated within the same socket to an appropriate position. This article highlights the overview of intra-alveolar auto-transplantation along with a case of rotated central incisor. A 12-year-old complaining of rotated tooth and wanted it to be corrected. On clinical examination, there was rotation of maxillary left central incisor with no history of any gingival and periodontal involvement. After obtaining the consent from the patient and his parent, intra-alveolar auto-transplantation procedure was carried out. After a four-year follow-up, the concerned tooth, had retained its vitality and showed no signs of relapse.
http://ift.tt/25WS5I8
Saudi Journal of Oral Sciences 2014 1(2):110-113
It is uncommon for children or young adults to have rotated central incisors. The restorative options are to carry out an orthodontic treatment or root canal treatment followed by crown placement for their correction. Often overlooked and misunderstood, another treatment option in the intra-alveolar auto-transplantation where the tooth is rotated within the same socket to an appropriate position. This article highlights the overview of intra-alveolar auto-transplantation along with a case of rotated central incisor. A 12-year-old complaining of rotated tooth and wanted it to be corrected. On clinical examination, there was rotation of maxillary left central incisor with no history of any gingival and periodontal involvement. After obtaining the consent from the patient and his parent, intra-alveolar auto-transplantation procedure was carried out. After a four-year follow-up, the concerned tooth, had retained its vitality and showed no signs of relapse.
http://ift.tt/25WS5I8
Dentin hypersensitivity among undergraduates in a university community
Omoigberai Bashiru Braimoh, Nzube Anthony Ilochonwu
Saudi Journal of Oral Sciences 2014 1(2):90-93
Background and Aim: There is limited data on dentin hypersensitivity (DH) among young adults in Africa. The objective of this study was to determine the prevalence and trigger factors associated with DH among young adults in a university community in Nigeria. Materials and Methods: The study population consisted of 360 young adults, 188 males and 172 females, aged 18-33 years. All individuals answered questions regarding demography, self-reported dentin sensitivity, trigger factors, action taken, and impact of DH on quality of life. Statistical analysis used descriptive statistics and the Chi-square test. Results: The prevalence of DH was 228 (63.3%) among the surveyed population and was significantly higher in females as compared to males (P = 0.03). All the participants who reported DH were right-handed. Among the participants with DH, majority 139 (61.0%) have not taken any action. The major precipitant for the DH was a cold drink 78 (34.2%). Of the 228 who experienced DH, 92 (40.3%) indicated eating as the precipitant, 76 (33.3%) indicated tooth brushing and 22 (9.6%) indicated talking as the precipitant. Approximately, 30% of the participants expressed unhappiness due to tooth sensitivity. Individuals with functional and psychological disturbance were significantly more likely to visit a dentist. Conclusion: The prevalence of DH found in this study was higher than previously reported, suggesting an increase in the levels of sensitivity within the general population. All the participants were right-handed and left side of the mouth was the most commonly affected.
http://ift.tt/25WSr1z
Saudi Journal of Oral Sciences 2014 1(2):90-93
Background and Aim: There is limited data on dentin hypersensitivity (DH) among young adults in Africa. The objective of this study was to determine the prevalence and trigger factors associated with DH among young adults in a university community in Nigeria. Materials and Methods: The study population consisted of 360 young adults, 188 males and 172 females, aged 18-33 years. All individuals answered questions regarding demography, self-reported dentin sensitivity, trigger factors, action taken, and impact of DH on quality of life. Statistical analysis used descriptive statistics and the Chi-square test. Results: The prevalence of DH was 228 (63.3%) among the surveyed population and was significantly higher in females as compared to males (P = 0.03). All the participants who reported DH were right-handed. Among the participants with DH, majority 139 (61.0%) have not taken any action. The major precipitant for the DH was a cold drink 78 (34.2%). Of the 228 who experienced DH, 92 (40.3%) indicated eating as the precipitant, 76 (33.3%) indicated tooth brushing and 22 (9.6%) indicated talking as the precipitant. Approximately, 30% of the participants expressed unhappiness due to tooth sensitivity. Individuals with functional and psychological disturbance were significantly more likely to visit a dentist. Conclusion: The prevalence of DH found in this study was higher than previously reported, suggesting an increase in the levels of sensitivity within the general population. All the participants were right-handed and left side of the mouth was the most commonly affected.
http://ift.tt/25WSr1z
Neumann's tumor in new born: A case requiring surgical intervention
Murali Nirupama, Ganesh Pai, Anand Pai, Reshma Pai
Saudi Journal of Oral Sciences 2014 1(2):117-119
Congenital epulis (CE) also known as granular cell tumor of new born was first described by Neumann in the year 1871. Most frequent location includes maxillary alveolar ridge with a female preponderance up to 8 times more than males. These tumors are usually small and can be solitary or multiple, pedunculated or protuberant mucosa covered nodules presenting at birth. Multiple theories have been proposed for their origin. Though, it may cause panic at birth they are indolent and regress spontaneously. Rare cases require surgical intervention in the neonatal period when symptomatic, causing difficulties in respiration or deglutition. We describe a case of CE in a 2-day-old female neonate, who presented with pink protuberant mass in the anterior alveolar ridge of maxilla. The mass was symptomatic and surgery was indicated. The mass was excised and the benign nature was confirmed by histopathology.
http://ift.tt/25WRdDl
Saudi Journal of Oral Sciences 2014 1(2):117-119
Congenital epulis (CE) also known as granular cell tumor of new born was first described by Neumann in the year 1871. Most frequent location includes maxillary alveolar ridge with a female preponderance up to 8 times more than males. These tumors are usually small and can be solitary or multiple, pedunculated or protuberant mucosa covered nodules presenting at birth. Multiple theories have been proposed for their origin. Though, it may cause panic at birth they are indolent and regress spontaneously. Rare cases require surgical intervention in the neonatal period when symptomatic, causing difficulties in respiration or deglutition. We describe a case of CE in a 2-day-old female neonate, who presented with pink protuberant mass in the anterior alveolar ridge of maxilla. The mass was symptomatic and surgery was indicated. The mass was excised and the benign nature was confirmed by histopathology.
http://ift.tt/25WRdDl
Prevalence of torus palatinus and torus mandibularis in an Indian population
Santosh Patil, Sneha Maheshwari, Suneet Khandelwal Khandelwal
Saudi Journal of Oral Sciences 2014 1(2):94-97
Background and Aim: Oral tori are bony growth present in the oral cavity and are not considered as pathological lesions. Smaller tori do not cause any problems, but larger sized tori can result in significant problems. The aim of this study was to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) in the Indian population. Study Design: A total of 3087 patients were examined between August, 2010 and October, 2012 for the presence of TP and TM by inspection and palpation. The data were collected and analyzed using SPSS 12.0 (SPSS Inc., Chicago, USA). Results: A total of 36 patients (1.3%) presented with TP, while 214 patients (6.9%) presented with TM. Tori were more frequent in males and this difference was statistically significant (P < 0.05). TP was more common in 31-40 years age group (13 patients, 36.1%), whereas TM was more in the 41-50 years age group (81 patients, 37.9%). The most commonly observed type of TP was flat shaped, whereas bilateral solitary types were the most common TM. Conclusion: The results of this study showed a significantly higher prevalence of tori in males. No difference in the prevalence of TP and TM was noted regarding the age groups. Although, not pathologically significant, these bony overgrowths very often need surgical removal, especially when prosthesis are indicated.
http://ift.tt/238VEG9
Saudi Journal of Oral Sciences 2014 1(2):94-97
Background and Aim: Oral tori are bony growth present in the oral cavity and are not considered as pathological lesions. Smaller tori do not cause any problems, but larger sized tori can result in significant problems. The aim of this study was to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) in the Indian population. Study Design: A total of 3087 patients were examined between August, 2010 and October, 2012 for the presence of TP and TM by inspection and palpation. The data were collected and analyzed using SPSS 12.0 (SPSS Inc., Chicago, USA). Results: A total of 36 patients (1.3%) presented with TP, while 214 patients (6.9%) presented with TM. Tori were more frequent in males and this difference was statistically significant (P < 0.05). TP was more common in 31-40 years age group (13 patients, 36.1%), whereas TM was more in the 41-50 years age group (81 patients, 37.9%). The most commonly observed type of TP was flat shaped, whereas bilateral solitary types were the most common TM. Conclusion: The results of this study showed a significantly higher prevalence of tori in males. No difference in the prevalence of TP and TM was noted regarding the age groups. Although, not pathologically significant, these bony overgrowths very often need surgical removal, especially when prosthesis are indicated.
http://ift.tt/238VEG9
Hairy intraoral flaps: An uncommon complication of surgical therapy in oral cancer
Gaurav Sharma, Archna Nagpal
Saudi Journal of Oral Sciences 2014 1(2):123-124
http://ift.tt/25WRpT3
Saudi Journal of Oral Sciences 2014 1(2):123-124
http://ift.tt/25WRpT3
Short and long-term safety outcomes with ixekizumab from 7 clinical trials in psoriasis: Etanercept comparisons and integrated data
Safety of biologics is important when treating patients with psoriasis.
http://ift.tt/2fqbsRq
Acantholytic squamous cell carcinoma is usually associated with hair follicles, not acantholytic actinic keratosis, and is not “high risk”: Diagnosis, management, and clinical outcomes in a series of 115 cases
Acantholytic squamous cell carcinoma (aSCC) is regarded as a high-risk variant of cutaneous squamous cell carcinoma (SCC). Acantholytic actinic keratosis (aAK) has been regarded as a precursor risk factor for aSCC. However, supporting evidence is limited.
http://ift.tt/2ghIkww
Randomized, split-body, single-blinded clinical trial of topical broccoli sprout extract: Assessing the feasibility of its use in keratin-based disorders
Epidermolysis bullosa simplex is a skin-blistering disorder caused by mutations in keratin (K)14 or K5. Treatment with nuclear factor (erythroid-derived 2)-like 2 inducer sulforaphane ameliorated skin blistering in Krt14-null mice, correlating with induction of K17. To be therapeutically useful for epidermolysis bullosa simplex, topical broccoli sprout extract (BSE), enriched for sulforaphane, would ideally induce the expression of homologous keratins (eg, K6, K17, K16) in the basal layer of human epidermis without impacting expression of defective keratins (K5/K14).
http://ift.tt/2f8N1N6
The sphingosine-1-phosphate receptor: A novel therapeutic target for multiple sclerosis and other autoimmune diseases
Publication date: Available online 23 November 2016
Source:Clinical Immunology
Author(s): Yang Mao-Draayer, Jeffrey Sarazin, David Fox, Elena Schiopu
Multiple sclerosis (MS) is a prototype autoimmune disease of the central nervous system (CNS). Currently, there is no drug that provides a cure for MS. To date, all immunotherapeutic drugs target relapsing remitting MS (RR-MS); it remains a daunting medical challenge in MS to develop therapy for secondary progressive MS (SP-MS). Since the approval of the non-selectivesphingosine-1-phosphate (S1P) receptor modulator FTY720 (fingolimod [Gilenya®]).for RR-MS in 2010, there have been many emerging studies with various selective S1P receptor modulators in other autoimmune conditions. In this article, we will review how S1P receptor may be a promising therapeutic target for SP-MS and other autoimmune diseases such as psoriasis, polymyositis and lupus.
http://ift.tt/2ft87nB
Novel mutation in DOCK8-HIES with severe phenotype and successful transplantation
Publication date: Available online 23 November 2016
Source:Clinical Immunology
Author(s): Latifa Al Shekaili, Farrukh Sheikh, Sulaiman Al Gazlan, Hasan Al Dhekri, Hamoud Al Mousa, Abdulaziz Al Ghonaium, Bander Al Saud, Saleh Al Mohsen, Agha M Rehan Khaliq, Safiah Al Sumayli, Mufarreh Al Zahrani, Anas Dababo, Ammar AlKawi, Abbas Hawwari, Rand Arnaout
BackgroundHyper-IgE syndrome (HIES) due to DOCK8 deficiency is an autosomal recessive (AR) primary combined immunodeficiency which results in significant morbidity and mortality at a young age. Different mutations in the DOCK8 gene can lead to variable severity of the disease.ObjectiveWe evaluated the genetic mutations in three related patients with severe clinical manifestations suggestive of AR HIES. We also explored whether treatment with stem cell transplantation could lead to complete disease resolution.MethodWe examined the clinical manifestations and immunological workup of these patients. Their DNA was also screened for causative mutation. Post transplantation, clinical and immunological data for the transplanted patient was also collected.ResultsAll patients had a severe course of the disease with rarely reported severe complications in HIES. One patient died with lymphoma while another died with progressive multifocal leukoencephalopathy (PML) due to a slow virus. All our patients had two novel mutations in the DOCK8 gene. One of these mutations was a novel pathogenic mutation and explains the severity of the disease (homozygous splice site mutation at position 5 after the end of exon 45), while the other mutation was mostly non-pathogenic. Hematopoietic stem cell transplantation (HSCT) was performed in the youngest patient with excellent engraftment and full reversibility of the clinical manifestations.ConclusionWe report 3 patients from a consanguineous family diagnosed with AR–HIES due to a novel pathogenic mutation in DOCK8 gene leading to fatal outcome in 2 patients and complete resolution of the clinical and immunological features in the third patient by HSCT.
http://ift.tt/2g5zUc8
Apigenin inhibited hypoxia induced stem cell marker expression in a head and neck squamous cell carcinoma cell line
Source:Archives of Oral Biology, Volume 74
Author(s): Yuwaporn Ketkaew, Thanaphum Osathanon, Prasit Pavasant, Sireerat Sooampon
ObjectiveCancer stem cells contribute to tumor recurrence, and a hypoxic environment is critical for maintaining cancer stem cells. Apigenin is a natural product with anticancer activity. However, the effect of apigenin on cancer stem cells remains unclear. Our aim was to investigate the effect of apigenin on cancer stem cell marker expression in head and neck squamous cell carcinoma cells under hypoxia.DesignWe used three head and neck squamous cell carcinoma cell lines; HN-8, HN-30, and HSC-3. The mRNA expression of cancer stem cell markers was determined by semiquantitative RT-PCR and Real-time PCR. The cytotoxic effect of apigenin was determined by MTT colorimetric assay. Flow cytometry was used to reveal the number of cells expressing cancer stem cell surface markers.ResultsHN-30 cells, a cancer cell line from the pharynx, showed the greatest response to hypoxia by increasing their expression of CD44, CD105, NANOG, OCT-4, REX-1, and VEGF. Apigenin significantly decreased HN-30 cell viability in dose- and time-dependent manners. In addition, 40μM apigenin significantly down-regulated the mRNA expression of CD44, NANOG, and CD105. Consistent with these results, the hypoxia-induced increase in CD44+ cells, CD105+ cells, and STRO-1+ cells was significantly abolished by apigenin.ConclusionApigenin suppresses cancer stem cell marker expression and the number of cells expressing cell surface markers under hypoxia.
http://ift.tt/2ghwouD
Apigenin inhibited hypoxia induced stem cell marker expression in a head and neck squamous cell carcinoma cell line
Source:Archives of Oral Biology, Volume 74
Author(s): Yuwaporn Ketkaew, Thanaphum Osathanon, Prasit Pavasant, Sireerat Sooampon
ObjectiveCancer stem cells contribute to tumor recurrence, and a hypoxic environment is critical for maintaining cancer stem cells. Apigenin is a natural product with anticancer activity. However, the effect of apigenin on cancer stem cells remains unclear. Our aim was to investigate the effect of apigenin on cancer stem cell marker expression in head and neck squamous cell carcinoma cells under hypoxia.DesignWe used three head and neck squamous cell carcinoma cell lines; HN-8, HN-30, and HSC-3. The mRNA expression of cancer stem cell markers was determined by semiquantitative RT-PCR and Real-time PCR. The cytotoxic effect of apigenin was determined by MTT colorimetric assay. Flow cytometry was used to reveal the number of cells expressing cancer stem cell surface markers.ResultsHN-30 cells, a cancer cell line from the pharynx, showed the greatest response to hypoxia by increasing their expression of CD44, CD105, NANOG, OCT-4, REX-1, and VEGF. Apigenin significantly decreased HN-30 cell viability in dose- and time-dependent manners. In addition, 40μM apigenin significantly down-regulated the mRNA expression of CD44, NANOG, and CD105. Consistent with these results, the hypoxia-induced increase in CD44+ cells, CD105+ cells, and STRO-1+ cells was significantly abolished by apigenin.ConclusionApigenin suppresses cancer stem cell marker expression and the number of cells expressing cell surface markers under hypoxia.
http://ift.tt/2ghwouD
Otolaryngology sleep medicine curriculum objectives as determined by sleep experts
(1) Ascertain the most important concepts and topics for otolaryngology resident education in sleep medicine and surgery, as determined by faculty who teach sleep medicine to otolaryngology residents. (2) Create learning objectives within the area of otolaryngologic sleep medicine in order to design a sleep medicine curriculum for otolaryngology residents.
http://ift.tt/2fT1dsr
Corrigendum to “Methylene blue staining in the parotid surgery: Randomized trial, 144 patients” [Am J Otolaryngol 37 (2016) 22–26]
In the January/February 2016 issue of the American Journal of Otolaryngology (37/1), the article titled "Methylene blue staining in the parotid surgery: Randomized trial, 144 patients" was incorrectly described as a prospective study. Upon further clarification it is a retrospective study and should be reclassified as such.
http://ift.tt/2g5uuOr
The effect of topical 5-flurouracil application post endoscopic inferior turbinoplasty
Rationale and objectives.Adhesions are the most common complication after nasal surgery and revision. 5-Fluorouracil (5-FU) reduces various adhesions and epithelial growth related complications. The aim of this study was to evaluate the effects of 5-flurouracil application in the nasal cavity after a multi-procedure nasal surgery in term of complications frequency.Materials and methodology.Institutional ethical approval was granted and a double-blinded prospective clinical trial was conducted to study the effect of 5-fu on post-operative complications.
http://ift.tt/2fSUCOD
The financial impact of clinic no-show rates in an academic pediatric otolaryngology practice
To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code.
http://ift.tt/2g5tAkR
True abscess formation is rare in bacterial orbital cellulitis; consequences for treatment
Pre- or retroseptal bacterial orbital cellulitis (pOC/rOC) is not an uncommon orbital disease. Treatment consists of antibiotics with or without surgical drainage. Several questions regarding course, complications and outcome of treatment are unanswered and the indication for surgery is not well defined. The aim of this study is to: 1. describe the outcome of orbital cellulitis (OC) in a large cohort, 2. assess the significance of Chandler's classification, 3. assess the incidence of abscess formation in OC, and 4.
http://ift.tt/2fT19ZJ
Occult infratemporal fossa neurofibroma presenting with persistent unilateral tinnitus and middle ear effusion: More than meets the eye
Herein, we present the case of a previously healthy 54year-old female who developed several weeks of unilateral tinnitus and aural fullness. She subsequently underwent unilateral pressure equalization tube placement at an outside institution after exam demonstrated a middle ear effusion, conductive hearing loss and normal nasopharyngoscopy. Ultimately, an MRI revealed an occult mass in the infratemporal fossa (ITF), which was successfully removed via an endoscopic transnasal ITF approach. Following resection of a histopathologically confirmed benign neurofibroma, she reported complete resolution of her symptoms.
http://ift.tt/2g5vfqI
Oral foregut duplication cysts: A rare and fascinating congenital lesion. Case report and review of the literature
Oral foregut duplication cysts are extremely rare lesions with approximately 57 cases reported. They are congenital cysts, located in the anterior or ventral tongue, and occur predominantly in males. They are lined by one or more types of epithelia which is limited to gastric, intestinal or respiratory epithelium. The differential diagnosis includes lymphangioma, hemangioma, ranula, epidermoid cyst, teratoma and less likely a malignant process.
http://ift.tt/2fSZFPg
Improved smell function with increased nasal mucus sonic hedgehog in hyposmic patients after treatment with oral theophylline
We previously demonstrated the presence of sonic hedgehog (Shh) in nasal mucus in normal subjects and in patients with smell loss (hyposmia). Nasal mucus Shh levels were found significantly diminished in untreated hyposmic patients of multiple etiologies. Since treatment with oral theophylline has been previously associated with improvement in smell function we wished to study if such treatment increased nasal mucus Shh as well as improved smell function in patients with hyposmia.
http://ift.tt/2g5rku4
Clinicopathologic and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands: A clinical analysis of 130 cases
This study was to investigate clinicopathologic characteristics and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands.
http://ift.tt/2fT04ky
The efficacy and safety of sublingual immunotherapy in children and adult patients with allergic rhinitis
Clinical research had showed that sublingual immunotherapy (SLIT) is effective and safe in moderate-severe allergic rhinitis (AR) induced by house dust mite (HDM). However, the sample size in many studies is small. Meanwhile, the controversy on the efficacy and safety in the very young children <4years old is still existed.
http://ift.tt/2g5vstP
Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary
The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass.
http://ift.tt/2fSV3c4
Vitiligo and Depression: A systematic review and meta-analysis of observational studies
Abstract
Background
Vitiligo is a common depigmenting disorder with profound psychosocial impacts. Previous observational studies have suggested a link between vitiligo and psychiatric morbidity such as depression. Variability in study design, however, makes it difficult to accurately quantify the relationship between vitiligo and depression.
Objectives
This study aimed to investigate the underlying prevalence and risk of depression among vitiligo patients.
Methods
A comprehensive search of Medline, Embase, and Cochrane library databases was conducted. Cross-sectional, case-control, or cohort studies that assessed the prevalence of depression among vitiligo patients or the relationship between vitiligo and depression were included. DerSimonian and Lard random-effects models were utilized to calculate the pooled prevalence and relative risks (RRs). Publication bias was evaluated by funnel plots and Egger's tests.
Results
Twenty-five studies with 2,708 cases of vitiligo were included in this meta-analysis.
Based on diagnostic codes, the pooled prevalence of depression among vitiligo patients was 0.253 (95% CI: 0.161 to 0.345, p < 0.001). Using self-reported questionnaire, the pooled prevalence of depressive symptoms was 0.336 (95% CI: 0.248 to 0.424, p < 0.001). The pooled odds ratio of depression among vitiligo patients was 5.05, compared to controls (95% CI: 2.21 to 11.51, p < 0.001). Moderate to high heterogeneity was observed between the studies.
Conclusions
Vitiligo patients were significantly more likely to suffer from depression. Clinical depression or depressive symptoms can be very prevalent, with the actual prevalence differs depending on screening instruments or possibly geographical regions. Clinicians should actively evaluate vitiligo patients for signs/symptoms of depression and provide appropriate referrals to manage their psychiatric symptoms accordingly.
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Feasibility and safety of peroral endoscopic myotomy for achalasia after failed endoscopic interventions
Summary
With advances in natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) has become a novel treatment for esophageal achalasia. In this study, we investigated the feasibility and safety of POEM in patients with achalasia after failed endoscopic interventions. Data on all patients undergoing POEM treatment of achalasia were collected prospectively. We enrolled 61 patients who underwent POEM for achalasia between July 2011 and January 2014. The preoperative intervention group included patients who had undergone botulinum toxin injection or pneumatic balloon dilation before POEM. The preoperative, operative, and short-term outcome data between the groups were compared. Among preoperative intervention group, 22 patients received endoscopic therapy before being referred for operation (18 dilation only, 2 botulinum toxin only, and 2 both treatments). Procedure time in the preoperative intervention group was similar to the nonpreoperative intervention group (60.8 ± 30.9 vs. 62.0 ± 21.0 minutes, P = 0.863). Both groups demonstrated significant improvement in Eckardt scores and manometric outcomes at 1-year follow-up. There were no significant differences in pretreatment and posttreatment D-values of symptom scores and lower esophageal sphincter pressures between groups (6.2 ± 2.2 vs. 6.1 ± 1.8, P = 0.840; 27.9 ± 17.6 vs. 24.9 ± 15.2; P = 0.569). There was also no significant difference in the incidence of intraoperative complications (P = 0.958) and gastroesophageal reflux rate (23.5% vs. 20.0%, P = 0.771) between the two groups. Our study demonstrated that POEM is safe and effective, even for treating achalasia in the setting of failed endoscopic interventions.
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Survival outcomes of consolidation chemoradiotherapy in esophageal cancer patients who achieve clinical complete response but refuse surgery after neoadjuvant chemoradiotherapy
Summary
Some esophageal cancer patients may be reluctant to accept the scheduled resection after neoadjuvant chemoradiotherapy (nCRT) because of its potential negative impact on quality of life as a result of high morbidity. This study was performed to investigate the survival outcomes of these patients. Between 2000 and 2012, we identified 190 patients with resectable esophageal squamous cell carcinoma (ESCC) who did not proceed to surgery following nCRT. Subjects who had a clinical complete response (cCR) and were medically fit for surgery were deemed eligible. Survival rates, recurrence patterns, and risk factors for recurrence served as the main outcome measures. The study cohort consisted of 73 patients (67 males and 6 females; mean age: 61.3 years). The 5-year overall survival was 39.6% (median survival time: 46.77 months). Cancer recurrences were observed in 44 patients (60.2%), with locoregional recurrence (LR) being the most common failure pattern (n = 35). Endoscopic findings after nCRT were the most important independent predictor of LR identified in multivariate analysis. Compared with the 'normal findings' subgroup, the odds ratios for LR in cCR patients who refused surgery were 4.774 (P = 0.026) and 2.844 (P = 0.16) in the 'scar' and 'other findings' subgroups, respectively. Patients with 'normal findings' had the lowest rate of LR (22.2%), with no recurrences occurring within the first 6 months. Sixty percent of ESCC patients who achieve cCR following nCRT but refuse esophagectomy develop disease recurrence, with LR being the most common pattern. Post-nCRT endoscopic findings may serve as a predictor for LR.
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Venous thromboembolism in patients with esophageal or gastric cancer undergoing neoadjuvant chemotherapy
Summary
There is a well-established link between cancer and venous thromboembolism (VTE), and patients receiving chemotherapy for esophageal or gastric cancer appear at high risk of developing VTE. The incidence of VTE in the neoadjuvant setting in these patients is poorly understood, as is the role for thromboprophylaxis during neoadjuvant chemotherapy. A PubMed search was conducted using a combination of terms including; esophageal & gastric cancer, deep venous thrombosis (DVT), VTE, neoadjuvant, chemotherapy and chemoradiotherapy. One hundred and fifty-four articles were retrieved and a narrative review was conducted. For patients with esophageal and gastric cancer the incidence of VTE ranged from 4 to 19%. Gastric cancer (Odds Ratio [OR] 6.38, [95% CI: 1.96–20.80]) and Stage III/IV disease, (OR 5.16 [95% CI: 1.29–20.73]) were identified as risk factors for developing VTE. Neoadjuvant chemotherapy was identified as an independent risk factor for developing VTE. Symptomatic and asymptomatic VTE have a similar effect on mortality. Median overall survival for asymptomatic VTE was 13.9 months (95% CI: 5.0–∞) versus 12.8 months (95% CI: 4.7–30.3) if the VTE was symptomatic. Neoadjuvant chemotherapy is a significant risk factor for VTE in patients with esophageal and gastric cancer. Intervention to minimize the risk using pharmacological and mechanical thromboprophylaxis should be considered, and this should start in the neoadjuvant period.
http://ift.tt/2fqf4Wu
The role of flexible fiberoptic laryngoscopy in robin sequence: a systematic review
Publication date: Available online 22 November 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Denise Manica, Cláudia Schweiger, Leo Sekine, Simone Chaves Fagondes, Gabriel Kuhl, Marcus Vinícius Martins Collares, Paulo José Cauduro Marostica
ObjectiveSystematically search literature for flexible fiberoptic laryngoscopy (FFL) use in Robin Sequence (RS) patients, in diverse clinical scenarios.Data SourcesPubmed, LILACS and SCIELO.Review MethodsSystematic review using a sensitive search strategy focused on RS patients and FFL.ResultsThere were 48 full text articles included in this systematic review. No summary meta-analytic measurement could be calculated due to heterogeneity of interventions and outcomes. FFL approaches were grouped in five topics, as follows: Endoscopic classification: no evidence on superiority of awake over light sedation and correlation of grading scales with symptom severity. Airway abnormalities: high incidence of concomitant lesions besides glossoptosis. Swallowing evaluation: no validation against fluoroscopy (gold standard) yet. Intubation aid for mechanical ventilation: ultra-thin bronchoscopes improve success rates of intubation. Treatment outcome monitoring: no consensus on ideal parameters to be checked.ConclusionSome applications have their roles already well established in the management of RS patients, like the evaluation of glossoptosis and associated lesions and as an intubation assistance tool, while others need to be the subject of further research, like the exact method of evaluation, its association with clinical manifestations, its role in swallowing investigation and as a postoperative success predictor.
http://ift.tt/2gkJDvJ
Pharmacologic Treatment of Vitiligo in Children and Adolescents: A Systematic Review
Abstract
Background
The true pathogenic mechanism of vitiligo is still unknown. About half of the patients with this disease have onset before the age of 20 years, making it a serious dermatologic disorder in childhood.
Objectives
The objective of this study was to review the literature in a systematic way and identify the main pharmacologic treatments and outcomes in children and adolescents with vitiligo.
Methods
Four databases—the National Library of Medicine (MEDLINE-PubMed), Web of Science, Scopus, and Latin American and Caribbean Health Sciences (LILACS)—were used for the search up to January 2015. All electronic search titles, selected abstracts and full-text articles were independently reviewed by a minimum of two reviewers.
Results
There were 15 articles from 13 different countries: 3 were retrospective and 12 were prospective; the number of participants in the studies varied between 9 and 400, ages ranged from 0 to 18 years, and the duration of disease ranged from 1 to 17 years. The most commonly used drugs were tacrolimus alone (or combined with clobetasol), pimecrolimus, corticosteroids, and calcipotriol. Treatment duration ranged from 10 days to 6 months with a topical route of administration.
Conclusions
The main outcome measurements were morphometric analysis performed using a computer program, hematologic or biochemical change, and photography (predominant). It is unclear which was the most effective treatment for vitiligo, however, it was found that these therapies are all promising in the treatment of the disease. With proper care, disease control and repigmentation, even if partial, can be achieved.
http://ift.tt/2geC3Bt
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