Showing papers in "Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology in 2013"

Management and recurrence of keratocystic odontogenic tumor: a systematic review

Abstract: Objectives The objective of this study was to evaluate the most up-to-date treatment modalities and respective recurrence rates for keratocystic odontogenic tumor (KCOT). Study Design A systematic review of the literature from 1999 to 2010 was undertaken examining treatment and recurrence rates for KCOT. Four inclusion criteria were defined for articles to then be analyzed against 8 standards. Results Of the 2736 published articles, 8 met the inclusion criteria. When merging the data, enucleation and enucleation with adjunctive measures (other than Carnoy's solution) had recurrence rates of 25.6% and 30.3%, respectively. Marsupialization with adjunctive measures produced a recurrence rate of 15.8%, whereas enucleation with Carnoy's solution presented a recurrence rate of 7.9%. Only one resection case had recurrence (6.3%). Conclusions The enucleation technique with the use of adjunctive procedures (other than Carnoy's solution) provides a higher recurrence rate than any other treatment modality.

Prospects and challenges of rendering tissue density in Hounsfield units for cone beam computed tomography.

Abstract: Objectives Limitations in rendering of tissue density in Hounsfield units (HUs) for cone beam computed tomography (CBCT) are described and illustrated using a phantom and two CBCT systems to demonstrate grayscale measurement variability. Materials and methods The basis of the HU scale, its correlation with measured computed tomography (CT) numbers, and the limitations in the accuracy of such correlation due to artifacts are discussed. Rendering of tissue densities based on HU values of two CBCT systems [NewTom VGi and Hyperion X9, respectively large and small field of view (FOV)] are measured using a phantom. Results Data produced from small FOV CBCT acquisition are generally less affected by artifacts compared with large FOV CBCT. Conclusions Artifacts challenge the accurate conversion of density values into HUs. Care should be taken when interpreting quantitative density measurements obtained with CBCT. With more advanced software and methods, it may be possible to improve the consistency and accuracy of density measurements.

Recent advances of ultrasound imaging in dentistry--a review of the literature.

Abstract: Ultrasonography as an imaging modality in dentistry has been extensively explored in recent years due to several advantages that diagnostic ultrasound provides. It is a non-invasive, inexpensive, painless method and unlike X-ray, it does not cause harmful ionizing radiation. Ultrasound has a promising future as a diagnostic imaging tool in all specialties in dentistry, for both hard and soft tissue detection. The aim of this review is to provide the scientific community and clinicians with an overview of the most recent advances of ultrasound imaging in dentistry. The use of ultrasound is described and discussed in the fields of dental scanning, caries detection, dental fractures, soft tissue and periapical lesions, maxillofacial fractures, periodontal bony defects, gingival and muscle thickness, temporomandibular disorders, and implant dentistry.

Management recommendations for invasive dental treatment in patients using oral antithrombotic medication, including novel oral anticoagulants

Abstract: Objective The aims were (1) to search the scientific literature from 2007 to 2012 for guidelines and new studies on the dental management of patients using oral antithrombotic medication; (2) to summarize the articles' evidence and recommendations; and (3) to propose an updated clinical practice guideline for general dentists. Study Design A systematic literature search in MEDLINE, Embase, and the Guideline websites, from October 2007 to October 2012, produced articles that were critically evaluated. Results The systematic literature search for guidelines yielded 74 citations (MEDLINE, 45; Embase, 22; and the Guideline websites, 7). Of these, only 2 guideline publications and 2 systematic reviews met the inclusion criteria. They yielded 32 recommendations. Conclusions The evidence and subsequent recommendations from published guidelines all point in the same direction: do not interrupt oral antithrombotic medication, not even dual antiplatelet therapy, in simple dental procedures.

The effect of computed tomographic scanner parameters and 3-dimensional volume rendering techniques on the accuracy of linear, angular, and volumetric measurements of the mandible

Abstract: Objectives. This study investigates the effect of scanning parameters on the accuracy of measurements from three-dimensional (3D), multi-detector computed tomography (MDCT) mandible renderings. A broader range of acceptable parameters can increase the availability of computed tomographic (CT) studies for retrospective analysis. Study Design. Three human mandibles and a phantom object were scanned using 18 combinations of slice thickness, field of view (FOV), and reconstruction algorithm and 3 different threshold-based segmentations. Measurements of 3D computed tomography (3DCT) models and specimens were compared. Results. Linear and angular measurements were accurate, irrespective of scanner parameters or rendering technique. Volume measurements were accurate with a slice thickness of 1.25 mm, but not 2.5 mm. Surface area measurements were consistently inflated.

Review of postoperative bleeding risk in dental patients on antiplatelet therapy

Abstract: Objective We conducted a review of the literature to assess risk for oral bleeding complications after dental procedures in patients on antiplatelet therapy. Study Design We conducted a search in Medline, Embase, and National Guideline Clearinghouse databases for studies involving patients on single and dual antiplatelet therapy that had invasive dental procedures or manipulations that induce oral bleeding. Results The literature search yielded 15 studies that met inclusion criteria. There is a trend toward increased occurrence of immediate postoperative bleeding for dual antiplatelet therapy, but there is no increase in the occurrence of intra- or late postoperative bleeding complications. Conclusions We found no clinically significant increased risk of postoperative bleeding complications from invasive dental procedures in patients on either single or dual antiplatelet therapy. These findings support the recommendation that there is no indication to alter or stop these drugs, and that local hemostatic measures are sufficient to control bleeding.

Effects of different growth factors and carriers on bone regeneration: a systematic review.

Abstract: Objective The application and subsequent investigations in the use of varied osteogenic growth factors in bone regeneration procedures have grown dramatically over the past several years. Owing to this rapid gain in popularity and documentation, a review was undertaken to evaluate the in vivo effects of growth factors on bone regeneration. Study Design Using related key words, electronic databases (Medline, Embase, and Cochrane) were searched for articles published from 1999 to April 2010 to find growth factor application in bone regeneration in human or animal models. Results A total of 63 articles were matched with the inclusion criteria of this study. Bone morphogenetic protein 2 (BMP-2) was the most studied growth factor. Carriers for the delivery, experimental sites, and methods of evaluation were different, and therefore articles did not come to a general agreement. Conclusions Within the limitations of this review, BMP-2 may be an appropriate growth factor for osteogenesis.

Cleidocranial dysplasia: a review of the dental, historical, and practical implications with an overview of the South African experience

Abstract: Cleidocranial dysplasia (CCD) is an uncommon but well-known genetic skeletal condition. Several hundred affected persons are members of a large extended family in the Cape Town Mixed Ancestry community of South Africa. The clinical manifestations are often innocuous, but hyperdontia and other developmental abnormalities of the teeth are a major feature and may require special dental management. Over the past 40 years, the authors have encountered more than 100 affected persons in Cape Town. Emphasis has been on dental management, but medical, genetic, and social problems have also been addressed. In this article, we have reviewed the manifestations of the disorder in the light of our own experience, and performed a literature search with emphasis on the various approaches to dental management and treatment options in CCD. Advances in the understanding of the biomolecular pathogenesis of CCD are outlined and the international and local history of the disorder is documented.

Update on the Use of Corticosteroids in Third Molar Surgery: Systematic Review of the Literature

Abstract: Objectives Third molar extraction produces inflammation, pain, and trismus, and different pharmacologic therapies have been evaluated for the minimization of postsurgical symptoms. The most frequently prescribed drugs are nonsteroidal anti-inflammatories, followed by steroids and opiates. Material and Methods A systematic search of the literature was carried out in PubMed, Scopus, MEDLINE, and Cochrane using steroid and third molar as key words. Results The most relevant randomized controlled trials and meta-analyses (n = 28) were selected from among 72 articles. Conclusions Administration of corticosteroids improves the postoperative experience of patients and has a significant impact on trismus and inflammation. Greater effects appear to be achieved by using the parenteral route and by administering the corticosteroid before the surgery.

Oral mucosal immunity

Abstract: Oral keratinocytes and dendritic cells of the oral mucosa, through molecular pattern recognition receptors, distinguish between commensal and pathogenic microorganisms and mediate the generation of protective immunoinflammatory responses to potentially invading pathogens or mediate immune tolerance toward commensal microorganisms. Oral immune tolerance is the result either of lack of activation of T cells in response to immunogenic presentation of antigens or of suppression of activity of effector T cells by regulatory T cells. Secretory immunoglobulin A (sIgA) antibodies at oral mucosal sites contribute to oral immunity by limiting colonization of microorganisms and their invasion of the epithelium. Ig isotype class switching to IgA is either dependent on or independent of T helper cells and is facilitated by cytokines secreted by dendritic cells and monocytes.

Intravenous bisphosphonate-related osteonecrosis of the jaw: long-term follow-up of 109 patients.

Abstract: Objective We report long-term follow-up of patients with intravenous bisphosphonate–related osteonecrosis of the jaw (BRONJ). Study Design Medical and dental histories, including type and duration of bisphosphonate treatment and comorbidities, were analyzed and compared with clinical course of 109 patients with BRONJ at Memorial Sloan-Kettering Cancer Center Dental Service. Results Median onset of BRONJ in months was 21 (zoledronic acid), 30 (pamidronate), and 36 (pamidronate plus zoledronic acid), with a significant difference between the pamidronate plus zoledronic acid and zoledronic acid groups (P = .01; Kruskal-Wallis). The median number of doses for BRONJ onset was significantly less with zoledronic acid (n = 18) than pamidronte plus zoledronic acid (n = 36; P = .001), but not pamidronate alone (n = 29). An association between diabetes (P = .05), decayed-missing-filled teeth (P = .02), and smoking (P = .03) and progression of BRONJ was identified through χ2 test. Conclusions This long-term follow-up of BRONJ cases enhances the literature and contributes to the knowledge of BRONJ clinical course.

Benign fibro-osseous lesions: clinicopathologic features from 143 cases diagnosed in an oral diagnosis setting.

Abstract: Objective The aim of this study was to report the clinicopathologic and radiologic features of 143 benign fibro-osseous lesions (BFOLs). Study Design Clinical and radiologic information were retrieved from the patients files, and histologic features were reviewed from hematoxylin and eosin–stained histologic slides. Results There were 22 ossifying fibromas (OFs), 21 fibrous dysplasias (FDs) and 100 osseous dysplasias (ODs; 65 florid, 18 focal, and 17 periapical). The mean age of the FD/OF patients was a decade lower than those with OD. The mandible was more affected than the maxilla, except in FDs. All FDs and OFs presented local swelling, whereas this was observed in Conclusions Florid OD, OF, and FD were the most common diagnoses, and the clinicopathologic and radiologic features were somewhat distinct from the characteristics of other populations.

Osteonecrosis of the mandible associated with bevacizumab therapy.

Abstract: Bevacizumab is a humanized antibody that blocks vascular endothelial growth factor and is of great value for the treatment of advanced cancer. Several adverse effects following its administration have been reported. To date, only 8 cases of osteonecrosis of the jaws associated with bevacizumab (without any association with bisphosphonates) have been reported. The aim of this article was to describe an original case of bevacizumab-related osteonecrosis of the jaw. A 61-year-old man diagnosed with advanced renal cell carcinoma was undergoing treatment with intravenous bevacizumab and temsirolimus when he spontaneously developed mandible osteonecrosis, which resolved after 3 months of conservative management. The present case reinforces recent speculation that the anti-angiogenic properties of bevacizumab may represent a potential new source of osteonecrosis of the jaws in patients undergoing cancer treatment. Multidisciplinary teams in cancer care should be aware of the possible association between osteonecrosis of the jaw and bevacizumab therapy.

Retromolar canals as observed on cone-beam computed tomography: their incidence, course, and characteristics

Abstract: Objective The study aims at assessing the incidence, course, and characteristics of retromolar canals. Study design The cone-beam computed tomography images of 171 subjects were evaluated for the presence, course, and pattern of occurrence of retromolar canals. Results Three types of retromolar canals namely A, B, & C were detected in 129 subjects. Type A branched off the mandibular canal distal to third molar to open into retomolar fossa, type B coursed between retromolar fossa and radicular portion of third molar, type C coursed from mandibular foramen anteroinferiorly to exit into retromolar fossa. The type B retromolar canal presented features distinguishing it from other types. Conclusions Considerable number of individuals presented with retromolar canals emphasizing their significance in surgeries involving the retromolar area. The type B pattern, to the best of our knowledge, hasn't been reported by most researchers and hence, could be considered as an additional type of retromolar canal.

A retrospective analysis of clinical features of oral malignant and potentially malignant disorders with and without oral epithelial dysplasia.

Abstract: Objective Clinical identification of underlying histopathology of oral mucosal lesions (OMLs) remains difficult. The study aims to identify clinical indicators of underlying histopathology of oral malignant and potentially malignant disorders. Study Design All clinical patient records of an oral medicine and pathology clinic over a 12-year period were manually searched. Cases of OMLs with a histopathologic diagnosis of dysplasia (n = 124) and malignancy (n = 27) and a sample of nondysplastic OMLs (n = 109) were analyzed using both univariate and multivariate analysis and odds ratios for an association with clinical characteristics. Results A nonhomogeneous clinical appearance was strongly associated with underlying dysplasia in both univariate and multivariate analysis ( P P = .005; odds ratio, 2.6) and smoking history ( P = .04). Conclusions These findings suggest that a nonhomogeneous mucosal lesion is a significant independent indicator for underlying oral epithelial dysplasia, with location, size, and color as additional contributing factors.

Validation of the cone beam computed tomography–based stereolithographic surgical guide aiding autotransplantation of teeth: clinical case–control study

Abstract: Objective To compare the outcome of cone beam computed tomography (CBCT)–based surgical planning and transfer technique for tooth autotransplantation versus conventional autotransplantation. Study Design The study material comprised 40 pediatric subjects in whom 48 teeth were transplanted following a case–control design. While the study group (mean age 11 years) underwent CBCT imaging for surgical planning and transfer via stereolithographic tooth replica fabrication, the historical control group (mean age 12 years) was subjected to conventional autotransplantation. Results The CBCT-based preoperative planning and the use of a tooth replica decreased the extra-alveolar time and reduced the number of positioning trials with the donor tooth. In the control group, 6 patients showed 1 or more complications, while this was noticed for only 2 study patients. Conclusion CBCT-based surgical planning of tooth autotransplantation may benefit from a shorter surgical time, while being a less invasive technique, causing fewer failures than a conventional approach.

Evaluation of postoperative discomfort following third molar surgery using submucosal dexamethasone – a randomized observer blind prospective study

Abstract: Background Surgical removal of impacted lower third molar is still the most frequent procedure done by Oral and Maxillofacial surgeons and is often associated with pain, swelling and trismus. These postoperative sequelae can cause distress to the patient as a result of tissue trauma and affect the patient's quality of life after surgery. Use of antiseptic mouthwashes, drains, muscle relaxants, cryotherapy, antibiotics, corticosteroids and physiotherapy seems to decrease postoperative discomfort. Among them corticosteroids are well-known adjuncts to surgery for suppressing tissue mediators of inflammation, thereby reducing transudation of fluids and lessening edema. The rationale of this study is to determine the effectiveness of submucosal injection of dexamethasone in reducing postoperative discomfort after third molar surgery. Patients and Methods 100 patients requiring surgical removal of third molar under local anesthesia were randomly divided into 2 groups, group I receiving 4 mg dexamethasone as submucosal injection and the control group II received no steroid administration. Facial swelling was quantified by anatomical facial landmarks. Furthermore, pain and patient satisfaction, as well as neurological score and the degree of mouth opening were observed from each patient. Results Patients receiving dexamethasone showed significant reduction in pain, swelling, trismus, a tendency to less neurological complaints and improved quality of life compared with the control group. Conclusions Submucosal injection of dexamethasone is more efficient to manage postoperative discomfort after removal of third molars compared to no steroid administration.

The binary oral dysplasia grading system: validity testing and suggested improvement.

Abstract: Objectives A binary system is reputed to be superior to the World Health Organization (WHO) system in grading oral dysplasia. We aimed to validate its reproducibility and prognostic ability and examine whether it could be improved. Study Design Three pathologists graded 141 oral epithelial dysplasia biopsies with the use of both systems. Observer variability and prognostic ability were assessed with the use of kappa and logistic regression models. Results The binary system showed superior agreement to the WHO system (multirater kappa 0.59 vs. 0.49, respectively) but similar prognostic ability (odds ratio [OR] 4.59 [ P = .014] vs. OR 2.25 [ P = .02], respectively). Adding smoking and alcohol slightly improved the prognostic ability of both systems (OR 5.10 vs. OR 2.42, respectively). Our new binary system with a refined diagnostic threshold demonstrated a slightly greater prognostic ability and improved ability to differentiate between high- and low-risk moderate dysplasia cases. Conclusions The binary system has similar prognostic ability but superior reproducibility compared with the WHO system. Prognostication is improved still further by using a new threshold.

Factors influencing attractiveness of soft tissue profile

Abstract: Background and Aim The factors affecting the attractiveness of the soft tissue profile are assessed in only very few nonmatched and controversial studies. We aimed to evaluate these factors in a matched comprehensive study. Methods Profile photographs of 100 students with good occlusion were sorted according to facial beauty by 20 judges. After excluding 40 unmatched subjects or those with marginal scores, 12 soft tissue variables were compared among profiles of 30 attractive and 30 unattractive matched participants (t test, α = 0.05). Results and Conclusion As the most important factor, excessive mandibular retrusion made both men and women unattractive. Both attractive men and women tended to have less prominent noses with higher nose tips, protruded upper lips compared with the position of lower lips, and deeper lower faces. Closeness of lips to the middle of vertical chin-nose distance enhanced female beauty only. Straight profiles and more protruded maxillae merely made men more attractive.

Atraumatic vertical tooth extraction: a proof of principle clinical study of a novel system

Abstract: Objective The aim of this study was to evaluate the applicability and limitations of a novel atraumatic extraction system Study Design Seventy-two patients with severely decayed teeth or root remnants not suitable for forceps extraction were consecutively recruited and had 111 teeth extracted with the use of a novel atraumatic vertical extraction system (Benex) Various patient, tooth, and procedure data were recorded and analyzed Results Overall, 92 out of 111 teeth (83%) were successfully extracted The success rate was higher in single-rooted teeth (89%) and lower in multirooted teeth (43%), with a risk ratio for failure of multirooted versus single-rooted teeth of 52 (95% confidence interval 25-107) The majority of failures were characterized by insufficient retention of the screw and/or root fracture, which mainly occurred as a result of caries in the root canal, misplacement/misalignment of the screw by the surgeon, or a fracture of the root in response to drilling and/or moderate input of traction force Conclusions The Benex extractor system may be successfully used for atraumatic tooth extraction The system has a higher success rate with single-rooted teeth compared with multirooted teeth Extraction failure is mostly associated with insufficient retention or misplacement of the screw and root fracture

Detection of periimplant fenestration and dehiscence with the use of two scan modes and the smallest voxel sizes of a cone-beam computed tomography device.

Abstract: Objective To assess the accuracy of cone-beam computed tomography (CBCT) in periimplant fenestration and dehiscence detection, and to determine the effects of 2 voxel sizes and scan modes. Study Design One hundred titanium implants were placed in bovine ribs in which periimplant fenestration and dehiscence were simulated. CBCT images were acquired with the use of 3 protocols of the i-CAT NG unit: A) 0.2 mm voxel size half-scan (180°); B) 0.2 mm voxel size full-scan (360°); and C) 0.12 mm voxel size full scan (360°). Receiver operating characteristic curves and diagnostic values were obtained. The Az values were compared with the use of analysis of variance. Results The Az value for dehiscence in protocol A was significantly lower than those of B or C ( P P > .05). Conclusions Protocol B yielded the highest values. The voxel sizes did not affect fenestration and dehiscence detection, and for dehiscence full-scan performed better than half-scan.

Cleft lip, nose, and palate: the nasal septum as the pacemaker for midfacial growth

Abstract: The need to be aware of the dynamics of cartilage development and growth is encountered by surgeons whenever they attempt to correct craniofacial defects such as unilateral or bilateral cleft lip/cleft palate or midfacial injuries after trauma. Within the craniofacial region, the nasal septal cartilage and the sphenoethmoidal and sphenooccipital cranial synchondroses are distinguished from other craniofacial cartilages in possessing intrinsic growth potential. Indeed, growth of the nasal septal cartilage outstrips the growth of other skeletal and soft tissues in the midface to such an extent that it is the pacemaker for growth of the face and anterior portion of the skull. We revisit and reinforce the importance of the nasal septum as pacemaker with analysis of 3 classes of evidence: in vivo growth of the nasal septum in nonhuman mammalian models; composition and in vitro growth of nasal septal cartilage or chondrocytes; and experience from the surgical repair of unilateral or bilateral facial clefts.

Bone regeneration with a combination of nanocrystalline hydroxyapatite silica gel, platelet-rich growth factor, and mesenchymal stem cells: a histologic study in rabbit calvaria.

Abstract: Objective This study aimed to assess NanoBone as a carrier construct for mesenchymal stem cells (MSCs) and platelet-rich growth factor (PRGF). Study Design In the calvarial bone of 8 mature New Zealand White male rabbits, four 8-mm defects were created. Each defect received one of the following treatments: Group 1, 0.2 mg Nano-hydroxyapatite (HA) granule + 2 mL culture medium; Group 2, 0.2 mg Nano-HA + 1 mL autologous PRGF + 2 mL acellular culture medium; Group 3, 0.2 mg Nano-HA + 2 mL culture medium containing 100,000 autogenous MSCs; Group 4, 0.2 mg Nano-HA + 2 mL culture medium containing 100,000 autogenous MSCs + 1 mL autologous PRGF. Result Histomorphometric analysis at 6 and 12 weeks demonstrated significantly higher bone formation in group 4 (29.45% and 44.55%, respectively) (P Conclusions NanoBone with MSCs and PRGF seems to be an effective combination for bone regeneration in a rabbit calvaria model.

A prospective epidemiological study for odontogenic and non-odontogenic lesions of the maxilla and mandible in Queensland.

Abstract: Objectives Investigate the epidemiological profile for odontogenic and non-odontogenic intra-osseous lesions in the Queensland population (4.56 million) over 12 months. Study Design The following data were prospectively collected from all Queensland histopathology laboratories in 2011: gender, age at diagnosis, location of lesion, histopathological diagnosis of the lesion and the patient's postcode. Results Six-hundred and thirty-three lesions were collected, comprising 540 odontogenic cysts and 93 odontogenic tumors. Radicular cyst was the most frequently diagnosed lesion (247/540, 45.7%). The overall incidence of odontogenic tumors was 20.4/million. Keratocystic odontogenic tumor was the highest (15.1/million), followed by ameloblastoma (2.41/million) with odontoma and calcifying cystic odontogenic tumor having the same incidence (1.1/million). The 39 non-odontogenic intra-osseous lesions had an overall incidence of 8.55/million. Nasopalatine cysts had an incidence of 2.19/million, followed by fibrous dysplasia and central giant cell granuloma (1.97/million). Conclusions Odontogenic tumors are 5 times less common than cysts. Non-odontogenic lesions are rare, with benign lesions 6.8 times more common than malignant lesions.

Oromandibular dystonia—functional and clinical characteristics: a report on 21 cases

Abstract: Objectives. The objectives of this study were to describe subtypes, characteristics, and orofacial function of patients with oromandibular dystonia and report results of special dental importance. Study Design. Symptoms, signs, and function were evaluated by questionnaires, video, and clinical and physiological examinations in 21 patients with primary and secondary dystonia (13 focal, 7 segmental, 1 multifocal). Results. A mixture of 2 or more subtypes of jaw movements was most common (43%), and the dystonic electromyographic activity was frequent in the anterior digastric (62%) and temporal and lateral pterygoid (48%) muscles. The impact from the oromandibular dystonia was marked. The prevalence of problems with mastication and swallowing was high, as well as with hyposalivation, dental attrition, and other dental problems. Conclusions. Patients with oromandibular dystonia may present to dentists with involuntary jaw movements and other severe functional problems. Care must be adapted to the neurological disorder and may be complicated by the condition itself. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:e21-e26) Oromandibular dystonia (OMD) is a rare focal neurological disorder affecting the lower part of the face and jaws. The dystonic activity may look similar to idiopathic sleep bruxism but usually ceases during sleep. It is characterized by sustained or repetitive involuntary jaw and tongue movements and facial grimacing caused by involuntary spasms of the masticatory, facial, pharyngeal, lingual, and lip muscles. 1–3 OMD is typically classified as jaw opening, jaw closing, jaw deviating, or lingual dystonia or combinations of these. 2,4,5 The combination of OMD, blepharospasms, and dystonic movements of the upper face is known as Meige’s syndrome. 6 Oral function has been reported to be compromised in most cases of OMD. Such dysfunction may lead to social embarrassment, reduced quality of life, depression, and weight loss. 7–13 OMD often interferes with normal orofacial function, such as chewing and control of food bolus, swallowing, breathing, and both verbal and nonverbal communication. Electromyographic (EMG) recordings have shown deviating masticatory muscle activity, such as cocontractions of antagonists and loss of rhythmicity during chewing. 7,14 Depending on the subtype, OMD may also be accompanied by trismus, bruxism, and forceful involuntary jaw closure or temporomandibular joint dislocation, which may lead to trauma and damage of the structures of the oral cavity, dental restorations, and dentures. 2,15 Thus, jawclosing dystonia may result in excessive dental wear, dental fractures, and trauma of the lips, gums, and tongue, whereas jaw-opening dystonia may be associ

Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia.

Abstract: Objective To evaluate whether an oral nutritional supplement enriched with omega-3 fatty acids, micronutrients, and probiotics affected body weight (BW) changes, serum albumin and prealbumin levels in patients with head and neck cancer (HNC) cachexia. Study Design Sixty-eight HNC patients were randomly assigned to receive either an Ethanwell/Ethanzyme (EE) regimen enriched with omega-3 fatty acids, micronutrients, and probiotics, or control (Isocal) for a 3-month period. Analysis of covariance was used to examine the association between BW change and variables. Results Patients with body mass index (BMI) P Conclusions EE regimen improved BW as well as serum albumin and prealbumin levels in HNC patients with BMI

Correlation between articular eminence steepness measured with cone-beam computed tomography and clinical dysfunction index in patients with temporomandibular joint dysfunction

Abstract: Objective The purpose of this study was to investigate the correlation between articular eminence steepness and clinical dysfunction index (Di) in patients with temporomandibular joint dysfunction (TMD) using cone-beam computed tomography (CBCT). Study design In this study, CBCT images of 60 temporomandibular joints in 30 patients with TMD were evaluated. The eminence inclination values were measured on CBCT images. Patients were subdivided into 3 groups based on Helkimo's clinical Di. The data were analyzed using Spearman's rho correlation coefficient test. Results The results of the present study did not confirm any significant differences in the values of articular eminence inclinations among the 3 groups (P value >.05). Conclusion Based on the present study, there is no apparent relationship between the articular eminence inclination and the clinical Di in patients with TMD.

Alveolar distraction osteogenesis versus autogenous onlay bone graft for vertical augmentation of severely atrophied alveolar ridges after 12 years of long-term follow-up

Abstract: Objective The aim of this study was to evaluate alveolar distraction osteogenesis (ADO) and autogenous onlay bone graft (AOBG) procedures by comparing their long-term results and their ability to correct severe vertical alveolar defects for further rehabilitation. Study Design Fourteen patients treated with ADO and 28 patients treated with AOBG were included in this study. Radiographic measurements of alveolar bone heights over time and the implant survival and success were compared for the 2 groups. Results The vertical bone gain was 8.4 ± 2.6 mm for ADO and 6.5 ± 2.3 mm for AOBG. After a mean follow-up period of 7.1 years, there was no significant difference between the 2 groups regarding alveolar bone heights over time and implant survival and success ( P > .05). The cumulative survival and success rates were 97.3%, 92.7% in the ADO group and 94.1%, 90.2% in the AOBG group, respectively. Conclusion Both ADO and AOBG may be reliable and effective for ridge augmentation procedures of severe vertical alveolar bone defects and subsequent dental rehabilitation using implants.

Acetaldehyde production and microbial colonization in oral squamous cell carcinoma and oral lichenoid disease

Abstract: Objective. The main aim of this prospective study was to explore the ability of the oral microbiome to produce acetaldehyde in ethanol incubation. Study Design. A total of 90 patients [30 oral squamous cell carcinoma (OSCC); 30 oral lichenoid disease (OLD); 30 healthy controls (CO)] were enrolled in the study. Microbial samples were taken from the mucosa using a filter paper method. The density of microbial colonization was calculated and the spectrum analyzed. Microbial acetaldehyde production was measured by gas chromatography. Results. The majority (68%) of cultures produced carcinogenic levels of acetaldehyde (>100 mM) when incubated with ethanol (22 mM). The mean acetaldehyde production by microbes cultured from smoker samples was significantly higher (213 mM) than from non-smoker samples (141 mM) (P ¼ .0326). Conclusions. The oral microbiota from OSCC, OLD patients and healthy individuals are able to produce carcinogenic levels of acetaldehyde. The present provisional study suggests smoking may increase the production of acetaldehyde. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116:61-68)

Healing acceleration in hamsters of oral mucositis induced by 5-fluorouracil with topical Calendula officinalis.

Abstract: Objective This study assessed the potential of topical Calendula officinalis extract on the healing of oral mucositis induced by 5-fluorouracil (5-FU) in hamsters. Study Design Oral mucositis was induced in 60 male hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on days 1 and 2. On days 12-17, 5% and 10% C. officinalis gel and gel base groups were treated and then compared with a control group. Macroscopic and microscopic scores and weights were evaluated. Results Microscopic and macroscopic scores of mucositis were lower in the 5% and 10% C. officinalis gel groups than in the gel base and control groups (P Conclusions Calendula officinalis extract accelerated the healing of oral mucositis in hamsters.