Squamous cell carcinoma of the oral cavity ranks as the twelfth most common cancer in the world and the eighth most frequent in males. In USA, cancers of oral cavity comprises approximately 3% of all cancers, the most common sub site for oral cavity carcinomas being the tongue followed by floor of mouth among all Head and Neck squamous cell carcinoma (HNSCC). Buccal mucosa is the most common oral cancer in men and the third most common oral cancer in women in India; and accounts for up to one-third of all tobacco-related cancers.
http://ift.tt/2iRG3gU
Σάββατο 31 Δεκεμβρίου 2016
Carcinoma of buccal mucosa with metastasis to thigh
Rejection versus escape: the tumor MHC dilemma
Abstract
Most tumor cells derive from MHC-I-positive normal counterparts and remain positive at early stages of tumor development. T lymphocytes can infiltrate tumor tissue, recognize and destroy MHC class I (MHC-I)-positive cancer cells ("permissive" phase I). Later, MHC-I-negative tumor cell variants resistant to T-cell killing emerge. During this process, tumors first acquire a heterogeneous MHC-I expression pattern and finally become uniformly MHC-I-negative. This stage (phase II) represents a "non-permissive" encapsulated structure with tumor nodes surrounded by fibrous tissue containing different elements including leukocytes, macrophages, fibroblasts, etc. Molecular mechanisms responsible for total or partial MHC-I downregulation play a crucial role in determining and predicting the antigen-presenting capacity of cancer cells. MHC-I downregulation caused by reversible ("soft") lesions can be upregulated by TH1-type cytokines released into the tumor microenvironment in response to different types of immunotherapy. In contrast, when the molecular mechanism of the tumor MHC-I loss is irreversible ("hard") due to a genetic defect in the gene/s coding for MHC-I heavy chains (chromosome 6) or beta-2-microglobulin (B2M) (chromosome 15), malignant cells are unable to upregulate MHC-I, remain undetectable by cytotoxic T-cells, and continue to grow and metastasize. Based on the tumor MHC-I molecular analysis, it might be possible to define MHC-I phenotypes present in cancer patients in order to distinguish between non-responders, partial/short-term responders, and likely durable responders. This highlights the need for designing strategies to enhance tumor MHC-I expression that would allow CTL-mediated tumor rejection.
http://ift.tt/2iplZ2g
TNF-alpha stimulation increases dental pulp stem cell migration in vitro through integrin alpha-6 subunit upregulation
Source:Archives of Oral Biology, Volume 75
Author(s): Lei Shi, Shanqi Fu, Sidra Fahim, Shuang Pan, He Lina, Xiaodan Mu, Yumei Niu
ObjectiveThe dissemination of stem cells into tissues requiring inflammatory and reparative response is fundamentally dependent upon their chemotactic migration. Expression of TNF-α is up regulated in inflamed pulps. Dental pulp cells are also known to express integrin α6 subunit. Expression of integrin subunit α6 has been linked to the acquisition of migratory potential in a wide variety of cell types in both pathological and physiological capacities. Therefore, in this study we examined the effects of a pleiotropic cytokine TNF-α on the migration of hDPSCs and investigated its relationship with expression of integrin α6 in hDPSCs during chemotactic migration.DesignhDPSC cultures were established. Protein expression profile of α6 integrin subunit was determined. Effect of exogenous TNF-α (50ng/mL) on hDPSCs' migration potential was evaluated by transwell inserts and in vitro scratch assay. Upregulation/downregulation of TNF-α mediated migration was assayed in presence/absence of integrin α6 respectively. To suppress integrin α6 expression, cells were transfected with integrin α6 siRNA and then cell migration and cytoskeletal changes were evaluated.ResultsOur results showed significant increase of hDPSCs' migration after stimulation with TNF-α. By knockdown of integrin α6, which is upregulated by TNF-α, we observed a decrease in the TNF-α directed chemotaxis of hDPSCs.ConclusionIn this study, we show that activation of integrin α6 brought about by TNF-α led to an increase in migratory activity in DPSCs in vitro thus describing a novel association between a cytokine TNF-α and α6 chain of an adhesion receptor integrin in regulating migration of hDPSCs.
http://ift.tt/2hDlin0
Transient receptor potential melastatin (TRPM) 8 is expressed in freshly isolated native human odontoblasts
Source:Archives of Oral Biology, Volume 75
Author(s): Kento Tazawa, Hideharu Ikeda, Nobuyuki Kawashima, Takashi Okiji
ObjectiveCold-sensitive ion channels, such as transient receptor potential melastatin (TRPM) 8 and transient receptor potential ankyrin (TRPA) 1, may play a crucial role in the nociceptive function of odontoblasts, whereas expression of these TRP channels in human native odontoblasts remains to be elucidated. This study aimed to analyze the expression of TRPM8 and TRPA1 in freshly isolated native human odontoblasts.DesignOdontoblasts were isolated from freshly extracted healthy human teeth (n=4); after removing the inner pulp tissues from the pulp chambers, odontoblasts remaining on the dentin surface were washed out with phosphate buffered saline and collected. Reverse transcription-polymerase chain reaction was employed to compare the expression levels of TRPM8, TRPA1, and dentin matrix acidic phosphoprotein 1 (DMP1) mRNAs between the isolated odontoblasts and the inner pulp tissues. The isolated cells were subjected to immunolocalization of TRPM8 and nestin. Paraformaldehyde-fixed, EDTA-demineralized frozen sections obtained from freshly extracted healthy human teeth (n=4) were also analyzed immunohistochemically using anti-nestin, TRPM8, and TRPA1 antibodies.ResultsExpression levels of TRPM8 and DMP1 in the isolated odontoblasts were significantly higher than those in the inner pulp tissues (p<0.05). Expression of TRPM8 and nestin was observed in the odontoblastic layer of the dental pulp tissue and isolated odontoblasts, while expression of TRPA1 was not detected.ConclusionsTRPM8, but not TRPA1, was detected in freshly isolated native human odontoblasts at the protein and mRNA levels, suggesting that odontoblasts play an important role in detecting external cold stimulation via TRPM8 in healthy condition.
http://ift.tt/2iAGaKj
Expression of matrix metalloproteinases-2, -9 and reversion-inducing cysteine-rich protein with Kazal motifs in gingiva in periodontal health and disease
Source:Archives of Oral Biology, Volume 75
Author(s): Nian Liu, Yingguang Cao, Guangxun Zhu
Background and objectivePeriodontitis is characterized by pathological destruction of extracellular matrix (ECM) of periodontal tissues. Matrix metalloproteinases (MMPs) promote the occurrence and development of periodontitis by degrading almost all proteins of ECM. RECK (reversion-inducing-cysteine-rich protein with kazal motifs), a novel membrane-anchored inhibitor of MMPs, could regulate the expression of MMP-2 and MMP-9 at post-transcriptional level. The study was to investigate the expression of RECK in healthy and diseased human gingival tissues and to correlate it with the production of MMP-2 and MMP-9.Material and methodsGingival biopsies were collected from chronic periodontitis patients and periodontally healthy control individuals. The protein and mRNA of RECK, MMP-2 and MMP-9 was determined by immunohistochemistry and semi-quantitative polymerase chain reaction analysis.ResultsThe expression of RECK protein was mainly confined to the gingival epithelium in inflamed and non-inflamed gingival tissues. Expression of RECK was significantly lower in tissues from chronic periodontitis patients, while the positive expression levels of MMP-2 and MMP-9 in periodontitis specimens were significantly higher. RECK protein expression was negatively correlated to the expressions of MMP-2 and MMP-9 in periodontitis. Moreover, RECK mRNA was significanly lower in diseased gingiva than in healthy samples(P<0.05), while MMP-2 and MMP-9 mRNAs were observed overexpressed in periodontal lesions, with no significant correlation between RECK and MMP-2/MMP-9 mRNA shown in periodontally diseased group.ConclusionThe expression of RECK in human healthy and diseased gingiva may contribute to periodontal physiological and pathological processes; low RECK expression may be associated with the enhanced MMP-2 and MMP-9 production in inflamed gingiva.
http://ift.tt/2hDi5UL
The relationship between lateral displacement of the mandible and scoliosis
Abstract
Objectives
Idiopathic scoliosis is an orthopaedic disease of childhood, with onset and progress occurring until adolescence. Here, the relationship between lateral displacement of the mandible and scoliosis was analysed quantitatively.
Methods
Seventy-nine non-syndromic Japanese patients (18 men, 61 women), who were diagnosed with jaw deformities and underwent surgical orthognathic treatment at Kyushu University Hospital from January 2011 to August 2014, were enrolled. Their mean age at the time of radiography was 25.3 ± 8.7 years. Postero-anterior cephalometric radiographs and chest radiographs were examined. In postero-anterior cephalometric radiographs, a horizontal baseline (X-axis) was drawn as a straight line that intersects both the zygomatic bases, and a vertical line (Y-axis) was marked perpendicular to the X-axis, with an intersection at the anterior nasal spine (ANS). Point A was defined as the intersection of the X- and Y-axes, and line A was defined as the line connecting point A to the menton. The angle made by the X-axis and line A (i.e., lateral displacement of the mandible) was measured. We designated an absolute value even if the mandibular menton was located on the right or left side. In chest radiographs, Cobb's method was used to measure scoliosis curves; the direction of the curve was designated similarly.
Results
Nine (11.4%) individuals had a Cobb angle >10°. There was a positive correlation between the Cobb angle and the degree of mandibular deviation (p < 0.05).
Conclusion
Lateral displacement of the mandible and scoliosis are related.
http://ift.tt/2hBs7FZ
TNF-alpha stimulation increases dental pulp stem cell migration in vitro through integrin alpha-6 subunit upregulation
Source:Archives of Oral Biology, Volume 75
Author(s): Lei Shi, Shanqi Fu, Sidra Fahim, Shuang Pan, He Lina, Xiaodan Mu, Yumei Niu
ObjectiveThe dissemination of stem cells into tissues requiring inflammatory and reparative response is fundamentally dependent upon their chemotactic migration. Expression of TNF-α is up regulated in inflamed pulps. Dental pulp cells are also known to express integrin α6 subunit. Expression of integrin subunit α6 has been linked to the acquisition of migratory potential in a wide variety of cell types in both pathological and physiological capacities. Therefore, in this study we examined the effects of a pleiotropic cytokine TNF-α on the migration of hDPSCs and investigated its relationship with expression of integrin α6 in hDPSCs during chemotactic migration.DesignhDPSC cultures were established. Protein expression profile of α6 integrin subunit was determined. Effect of exogenous TNF-α (50ng/mL) on hDPSCs' migration potential was evaluated by transwell inserts and in vitro scratch assay. Upregulation/downregulation of TNF-α mediated migration was assayed in presence/absence of integrin α6 respectively. To suppress integrin α6 expression, cells were transfected with integrin α6 siRNA and then cell migration and cytoskeletal changes were evaluated.ResultsOur results showed significant increase of hDPSCs' migration after stimulation with TNF-α. By knockdown of integrin α6, which is upregulated by TNF-α, we observed a decrease in the TNF-α directed chemotaxis of hDPSCs.ConclusionIn this study, we show that activation of integrin α6 brought about by TNF-α led to an increase in migratory activity in DPSCs in vitro thus describing a novel association between a cytokine TNF-α and α6 chain of an adhesion receptor integrin in regulating migration of hDPSCs.
http://ift.tt/2hDlin0
Transient receptor potential melastatin (TRPM) 8 is expressed in freshly isolated native human odontoblasts
Source:Archives of Oral Biology, Volume 75
Author(s): Kento Tazawa, Hideharu Ikeda, Nobuyuki Kawashima, Takashi Okiji
ObjectiveCold-sensitive ion channels, such as transient receptor potential melastatin (TRPM) 8 and transient receptor potential ankyrin (TRPA) 1, may play a crucial role in the nociceptive function of odontoblasts, whereas expression of these TRP channels in human native odontoblasts remains to be elucidated. This study aimed to analyze the expression of TRPM8 and TRPA1 in freshly isolated native human odontoblasts.DesignOdontoblasts were isolated from freshly extracted healthy human teeth (n=4); after removing the inner pulp tissues from the pulp chambers, odontoblasts remaining on the dentin surface were washed out with phosphate buffered saline and collected. Reverse transcription-polymerase chain reaction was employed to compare the expression levels of TRPM8, TRPA1, and dentin matrix acidic phosphoprotein 1 (DMP1) mRNAs between the isolated odontoblasts and the inner pulp tissues. The isolated cells were subjected to immunolocalization of TRPM8 and nestin. Paraformaldehyde-fixed, EDTA-demineralized frozen sections obtained from freshly extracted healthy human teeth (n=4) were also analyzed immunohistochemically using anti-nestin, TRPM8, and TRPA1 antibodies.ResultsExpression levels of TRPM8 and DMP1 in the isolated odontoblasts were significantly higher than those in the inner pulp tissues (p<0.05). Expression of TRPM8 and nestin was observed in the odontoblastic layer of the dental pulp tissue and isolated odontoblasts, while expression of TRPA1 was not detected.ConclusionsTRPM8, but not TRPA1, was detected in freshly isolated native human odontoblasts at the protein and mRNA levels, suggesting that odontoblasts play an important role in detecting external cold stimulation via TRPM8 in healthy condition.
http://ift.tt/2iAGaKj
Expression of matrix metalloproteinases-2, -9 and reversion-inducing cysteine-rich protein with Kazal motifs in gingiva in periodontal health and disease
Source:Archives of Oral Biology, Volume 75
Author(s): Nian Liu, Yingguang Cao, Guangxun Zhu
Background and objectivePeriodontitis is characterized by pathological destruction of extracellular matrix (ECM) of periodontal tissues. Matrix metalloproteinases (MMPs) promote the occurrence and development of periodontitis by degrading almost all proteins of ECM. RECK (reversion-inducing-cysteine-rich protein with kazal motifs), a novel membrane-anchored inhibitor of MMPs, could regulate the expression of MMP-2 and MMP-9 at post-transcriptional level. The study was to investigate the expression of RECK in healthy and diseased human gingival tissues and to correlate it with the production of MMP-2 and MMP-9.Material and methodsGingival biopsies were collected from chronic periodontitis patients and periodontally healthy control individuals. The protein and mRNA of RECK, MMP-2 and MMP-9 was determined by immunohistochemistry and semi-quantitative polymerase chain reaction analysis.ResultsThe expression of RECK protein was mainly confined to the gingival epithelium in inflamed and non-inflamed gingival tissues. Expression of RECK was significantly lower in tissues from chronic periodontitis patients, while the positive expression levels of MMP-2 and MMP-9 in periodontitis specimens were significantly higher. RECK protein expression was negatively correlated to the expressions of MMP-2 and MMP-9 in periodontitis. Moreover, RECK mRNA was significanly lower in diseased gingiva than in healthy samples(P<0.05), while MMP-2 and MMP-9 mRNAs were observed overexpressed in periodontal lesions, with no significant correlation between RECK and MMP-2/MMP-9 mRNA shown in periodontally diseased group.ConclusionThe expression of RECK in human healthy and diseased gingiva may contribute to periodontal physiological and pathological processes; low RECK expression may be associated with the enhanced MMP-2 and MMP-9 production in inflamed gingiva.
http://ift.tt/2hDi5UL
Osteoblastoma of the temporal articular tubercle misdiagnosed as a temporomandibular joint disorder
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): J. Emanuelsson, C.M. Allen, K. Rydin, M. Sjöström
The case of a 17-year-old female with a benign osteoblastoma in the temporomandibular joint (TMJ) is reported. The patient had a 2.5-year history of reduced mouth opening accompanied by tenderness and swelling in the left TMJ. Initial treatment included stabilization of the occlusion with a splint, jaw exercises, and analgesics. At first the patient's symptoms decreased, but they then increased 18 months later, prompting a cone beam computed tomography (CBCT) evaluation of the joint. The radiographic findings showed a somewhat ill-defined, radiolucent, expansile lesion containing small scattered calcifications located in the temporal articular tubercle. The lesion was removed under general anaesthesia and sent for histopathological examination. At the 12-month follow-up, the patient had normal TMJ function without clinical symptoms. CBCT examination showed a small recurrence of 3mm. Another 12 months later, CBCT showed a 1-mm increase in the recurrence. Her function was normal, with slight tenderness lateral to the left TMJ. The decision from a multidisciplinary meeting was further annual follow-up. The present case illustrates the importance of initial radiographic examination together with clinical examination in patients with TMJ dysfunction.
http://ift.tt/2ioiAkm
Can a surgery-first orthognathic approach reduce the total treatment time?
Publication date: Available online 30 December 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): W.S. Jeong, J.W. Choi, D.Y. Kim, J.Y. Lee, S.M. Kwon
Although pre-surgical orthodontic treatment has been accepted as a necessary process for stable orthognathic correction in the traditional orthognathic approach, recent advances in the application of miniscrews and in the pre-surgical simulation of orthodontic management using dental models have shown that it is possible to perform a surgery-first orthognathic approach without pre-surgical orthodontic treatment. This prospective study investigated the surgical outcomes of patients with diagnosed skeletal class III dentofacial deformities who underwent orthognathic surgery between December 2007 and December 2014. Cephalometric landmark data for patients undergoing the surgery-first approach were analyzed in terms of postoperative changes in vertical and horizontal skeletal pattern, dental pattern, and soft tissue profile. Forty-five consecutive Asian patients with skeletal class III dentofacial deformities who underwent surgery-first orthognathic surgery and 52 patients who underwent conventional two-jaw orthognathic surgery were included. The analysis revealed that the total treatment period for the surgery-first approach averaged 14.6 months, compared with 22.0 months for the orthodontics-first approach. Comparisons between the immediate postoperative and preoperative and between the postoperative and immediate postoperative cephalometric data revealed factors that correlated with the total treatment duration. The surgery-first orthognathic approach can dramatically reduce the total treatment time, with no major complications.
http://ift.tt/2isqxHJ
The efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible
Publication date: Available online 30 December 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): F.J. Dieleman, T.T.T. Phan, F.J.A. van den Hoogen, J.H.A.M. Kaanders, M.A.W. Merkx
This study aimed to evaluate the success of hyperbaric oxygen therapy (HBOT) and surgery in the treatment of mandibular osteoradionecrosis (ORN) in relation to the extent of the ORN. Twenty-seven patients with ORN were identified from a total of 509 patients with a history of primary oral or base of the tongue cancer; these patients had been treated with radiation therapy with curative intent between 1992 and 2006, with a radiation dose to the mandible of ≥50Gy. The ORN was staged according to the classification of Notani et al. The time from completion of radiation therapy to the development of ORN varied (median 3 years). Forty HBOT sessions were offered. After HBOT alone, 3 of 11 stage I lesions, 0 of 8 stage II lesions, and 0 of 8 stage III lesions had healed (P=0.0018). An absolute incidence of 5.3% ORN was found in this population. Of all sites irradiated in this study, the floor of the mouth was most associated with ORN (8.6%), whereas the cheek was least associated (0%). Based on the results of this study, HBOT can be recommended for stage I and II ORN and for selected cases of stage III ORN.
http://ift.tt/2isw40Q
Management of a complex pancreaticoduodenal lesion following a suicidal attempt with a crossbow
Traumatic pancreaticoduodenal lesions are rare, often involve a challenging management, and have high rates of morbidity and mortality. A 43-year-old male patient committed a suicidal attempt by shooting an arrow with a crossbow into his upper abdomen. He was successfully treated with cautious multidisciplinary approach. Crossbow lesions demonstrate low kinetics. Sharp tips of arrows result in localized damage, likely to involve several organs. Pancreatic lesions are of particular interest because of their difficult surgery. Surgical exploration and drainage can allow an efficient management of pancreatic penetrating lesions, even in the presence of a complete pancreatic duct disruption.
http://ift.tt/2hztqSi
Corrigendum to ‘Effect of HPV on head and neck cancer patient survival, by region and tumor site: A comparison of 1362 cases across three continents’ [Oral Oncol. 62 (2016) 20–27]
The authors regret that the affiliation and author order for Gabriella Cadoni was incorrect. The correct order and affiliations of the authors can be seen above.
http://ift.tt/2hEdYJJ
Time to onset of bisphosphonate-related osteonecrosis of the jaws: a multicentre retrospective cohort study
Abstract
Objectives
Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of bisphosphonates (BP). Although the risk of ONJ increases with increasing duration of BP treatment, there are currently no reliable estimates of the ONJ time to onset (TTO). The objective of this study was to estimate the TTO and associated risk factors in BP-treated patients.
Subjects and methods
Retrospective analysis of data from 22 secondary care centres in 7 countries relevant to 349 patients who developed BP-related ONJ between 2004 and 2012.
Results
The median (95%CI) TTO was 6.0 years in patients treated with alendronate (n = 88) and 2.2 years in those treated with zoledronate (n = 218). Multivariable Cox regression showed that dentoalveolar surgery was inversely associated, and the use of antiangiogenics directly associated, with the TTO in cancer patients treated with zoledronate.
Conclusions
The incidence of ONJ increases with the duration of BP therapy, with notable differences observed with respect to BP type and potency, route of administration and underlying disease. When data are stratified by BP type, a time of 6.0 and 2.2 years of oral alendronate of intravenous zoledronate therapy, respectively, is required for 50% of patients to develop ONJ. After stratification by disease, a time of 5.3 and 2.2 years of BP therapy is required for 50% of patients with osteoporosis and cancer, respectively, to develop ONJ. These findings have significant implications for the design of future clinical studies and the development of risk reduction strategies aimed at either assessing or modulating the risk of ONJ associated with BP.
This article is protected by copyright. All rights reserved.
http://ift.tt/2hEs8ug
Virtual reconstruction of midface defects using statistical shape models
Publication date: Available online 30 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Marc Anton Fuessinger, Stefan Schlager, Steffen Schwarz, Edward Ellis, Carl-Peter Cornelius, Florian Probst, Marc Christian Metzger, Wiebke Semper-Hogg
PurposeThis study evaluates the accuracy of a statistical shape model (SSM) for virtual fracture reconstruction of the lateral midface.Materials and MethodsA uniform bony defect of the right zygoma was created. A virtual reconstruction was performed by using the standard procedure of mirroring the unaffected to the affected side (Group I) and by using the statistical model based on 178 pathologically unaffected CT scans (Group II). The accuracy of the statistical shape model was evaluated in comparison to the present mirroring protocol. The reconstructed region was compared with the original bone evaluating the mean deviation of both surfaces.ResultsAll zygomas could be reconstructed with all methods. On the affected side the mean deviation was 1.10mm +/-0.23mm in group I and 0.85mm +/-0.26mm in group II. The differences between the groups were significant.ConclusionSSM offers a more precise reconstruction of midface defects than mirroring procedures. As an additional element SSM could automatize the CAS workflow in many respects.
http://ift.tt/2iQifd0
Comparison of two preoperative protocols for mandibular symphyseal distraction osteogenesis to reduce the risk of tooth damage
Transverse mandibular deficiency is a common problem in orthodontic patients. The clinical signs of mandibular transverse deficiency are a decrease in mandibular arch length, a narrow intercanine width, a crowding of the lower anterior teeth, a flattened anterior arch morphology, an increased overbite and a posterior buccal crossbite (Del Santo et al., 2000; Chung and Tae, 2007). In younger patients, transverse mandibular deficiency can be corrected by orthodontic expansion, lip bumpers, Schwarz devices, or functional appliances resulting in stable results (Bell et al., 1997).
http://ift.tt/2iQeqo7
Virtual reconstruction of midface defects using statistical shape models
This study evaluates the accuracy of a statistical shape model (SSM) for virtual fracture reconstruction of the lateral midface.
http://ift.tt/2hzmpBd
Corrigendum to ‘Effect of HPV on head and neck cancer patient survival, by region and tumor site: A comparison of 1362 cases across three continents’ [Oral Oncol. 62 (2016) 20–27]
Source:Oral Oncology
Author(s): Gypsyamber D'Souza, Devasena Anantharaman, Tarik Gheit, Behnoush Abedi-Ardekani, Daniel C. Beachler, David I. Conway, Andrew F. Olshan, Victor Wunsch-Filho, Tatiana N. Toporcov, Wolfgang Ahrens, Kathy Wisniewski, Franco Merletti, Stefania Boccia, Eloiza H. Tajara, Jose P. Zevallos, José Eduardo Levi, Mark C. Weissler, Sylvia Wright, Ghislaine Scelo, Angela L. Mazul, Massimo Tommasino, Gabriella Cadoni, Paul Brennan
http://ift.tt/2iAevsT
Cost and lack of insurance coverage are prohibitive to having dental implants after resections for benign mandibular neoplasms
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Zachary S. Peacock, Yisi D. Ji
ObjectivesTo assess how often patients receive dental implants after mandibular resections for benign neoplasms and determine barriers to completing functional reconstruction.Study DesignA retrospective cohort study of patients who underwent resection for benign mandibular neoplasms between 2005 and 2014. Demographic variables included age, gender, and race. Outcome variables include rates of implant placement, implant restoration, and reasons for not having implants. Fisher's exact test and odds ratios were calculated.Results52 subjects (47.1±19.2 years) were included. Twenty (38.6%) received dental implants. Race was associated with the likelihood of receiving implants(p=0.0302). Blacks/African Americans (1/10, 10%) compared to all other racial groups were least likely to have implants (OR=0.1158, p=0.035, 95% CI (0.013, 0.989). Caucasians (17/35, 48.6%) were 4.41 times more likely to receive implants compared to all other races (OR=4.41, 95% CI [1.073, 18.093] p=0.038). Of the 20 subjects who received implants, 10 went on to have dental prostheses. The most common reason for not having implants was cost (37.5% overall) cited by 50% of Black/African American and 16.7% of Caucasian subjects.ConclusionSubjects do not typically go on to dental reconstruction after mandibular resections with cost as a major barrier. African-Americans were least likely to complete full reconstruction.
http://ift.tt/2ise7iW
Decompression of keratocystic odontogenic tumors leads to increased fibrosis, but no change in epithelial proliferation
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): S. Awni, B. Conn
ObjectiveInvestigation into whether decompression treatment induces changes in histology or biological behaviour in KCOT.Study design17 patients with KCOT had decompression treatment alone or with enucleation. Histological evaluation and immunohistochemical expression of p53, Ki-67and Bcl-2 were analysed using conventional microscopy.ResultsKCOT showed significantly increased fibrosis (p=0.01) and a subjective reduction in mitotic activity (P=0.03) after decompression. There were no statistically significant changes in the expression of proliferation markers. An increase in daughter-cysts / epithelial rests was seen after decompression (p=0.04). Recurrence was noted in 4/16 cases, there was a strong correlation between expression of p53 with prolonged duration of treatment (p= 0.01) and intense inflammatory changes (P=0.02).ConclusionStructural changes in the KCOT epithelium/capsule following decompression facilitate the surgical removal. There was no statistical evidence that decompression influences expression of proliferation markers in the lining, indicating that the potential for recurrence may not be restricted to the cellular level. The statistically significant increase of p53 expression with increased duration of treatment and of inflammation may also indicate the possibility of higher rates of recurrence with prolonged treatment and significant inflammatory changes.
http://ift.tt/2io7Wdi
Osteoblastoma of the temporal articular tubercle misdiagnosed as a temporomandibular joint disorder
The case of a 17-year-old female with a benign osteoblastoma in the temporomandibular joint (TMJ) is reported. The patient had a 2.5-year history of reduced mouth opening accompanied by tenderness and swelling in the left TMJ. Initial treatment included stabilization of the occlusion with a splint, jaw exercises, and analgesics. At first the patient's symptoms decreased, but they then increased 18 months later, prompting a cone beam computed tomography (CBCT) evaluation of the joint. The radiographic findings showed a somewhat ill-defined, radiolucent, expansile lesion containing small scattered calcifications located in the temporal articular tubercle.
http://ift.tt/2hEkBeW
Can a surgery-first orthognathic approach reduce the total treatment time?
Although pre-surgical orthodontic treatment has been accepted as a necessary process for stable orthognathic correction in the traditional orthognathic approach, recent advances in the application of miniscrews and in the pre-surgical simulation of orthodontic management using dental models have shown that it is possible to perform a surgery-first orthognathic approach without pre-surgical orthodontic treatment. This prospective study investigated the surgical outcomes of patients with diagnosed skeletal class III dentofacial deformities who underwent orthognathic surgery between December 2007 and December 2014.
http://ift.tt/2hW5OZ7
The efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible
This study aimed to evaluate the success of hyperbaric oxygen therapy (HBOT) and surgery in the treatment of mandibular osteoradionecrosis (ORN) in relation to the extent of the ORN. Twenty-seven patients with ORN were identified from a total of 509 patients with a history of primary oral or base of the tongue cancer; these patients had been treated with radiation therapy with curative intent between 1992 and 2006, with a radiation dose to the mandible of ≥50Gy. The ORN was staged according to the classification of Notani et al.
http://ift.tt/2hEtLIn
Complication and surgical site infection for salvage surgery in head and neck cancer after chemoradiotherapy and bioradiotherapy
We aimed to investigate the complications, surgical site infection (SSI), and survival in salvage surgery without free-flap reconstruction for patients with head and neck squamous cell carcinoma who were treated by platinum-based chemoradiotherapy (Plat-CRT) or cetuximab-based bioradiotherapy (Cet-BRT).
http://ift.tt/2iAcQUc
ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2)...
http://ift.tt/2inUCWa
A Virtual Reality Simulation Model of Spinal Ultrasound: Role in Teaching Spinal Sonoanatomy.
Background and Objectives: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model ( http://ift.tt/2hE59iM and http://ift.tt/2hVI8nU). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy. Methods: After obtaining ethics board approval and written participant consent, 14 anesthesia trainees with no prior experience with spine ultrasound imaging were included in this study. Construct validity was assessed using a pretest/posttest design to measure the knowledge acquired from self-study of the virtual spine simulation modules. Two tests (A and B) with 20 multiple-choice questions were used either for the pretest or posttest, at random in order to account for possible differences in difficulty between the 2 tests. These tests were administered immediately before and after a 1-hour training session using the spine ultrasound model. Results: Fourteen anesthesia trainees completed the study. Seven used test A as the pretest (group A), and 7 used test B as the pretest (group B). Both groups showed a statistically significant improvement (P
http://ift.tt/2hVPzvh
http://ift.tt/2hVPzvh
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