Showing papers in "Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology in 2014"
TL;DR: The severity of OED was not associated with risk of malignant transformation, suggesting that the current OED grading system is not useful for predicting patient outcomes or for determining management strategies.
Abstract: Objective. This study describes the predictive value of oral epithelial dysplasia (OED) grading as an indicator for malignant transformation and progression. Study Design. The records of an Australian-based pathology laboratory were searched for oral mucosal biopsies with a dysplastic or malignant diagnosis. Examination for an association with progression and malignant transformation without reinterpretation was performed. Analysis was undertaken using hazard ratios and the Fisher exact test. Results. A total of 368 patients with a diagnosis of OED were included. Twenty-six patients (7.1%) underwent progression or malignant transformation; the annual malignant transformation rate was 1%. No other characteristics were associated with a heightened risk of progression or transformation. Conclusions. The severity of OED was not associated with risk of malignant transformation, suggesting that the current OED grading system is not useful for predicting patient outcomes or for determining management strategies. Definitive treatment of all OED is recommended, until a more reliable progression/transformation system is developed. (Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117:343-352)
148 citations
TL;DR: Examining the expression of several cancer-related long non-coding RNAs in patients with tongue squamous cell carcinoma found expression of UCA1 lncRNA was enhanced in TSCCs and may play a role in tumor metastasis.
Abstract: Objective The aim of this study was to examine the expression of several cancer-related long non-coding RNAs (lncRNAs) in patients with tongue squamous cell carcinoma (TSCC) and to explore its clinical significance. Study Design A total of 94 TSCC tissue specimens and matched adjacent normal tissue specimens were collected from patients undergoing surgery for TSCC. Differences in the expression of cancer-related lncRNAs were examined via quantitative reverse transcriptase polymerase chain reaction. WST-1 assay and transwell migration assay were carried out to estimate the proliferation and migration abilities of TSCC cells with different expression levels of urothelial cancer–associated 1 (UCA1) lncRNA. Results The expression levels of lncRNA UCA1 were significantly elevated in TSCC tissues ( P P = .0371). Over-expression of UCA1 lncRNA could promote metastatic but not proliferation ability of TSCC cells. Conclusions Expression of UCA1 lncRNA was enhanced in TSCCs and may play a role in tumor metastasis.
132 citations
TL;DR: Analysis of surface structures and physicochemical characteristics of a novel autogenous tooth bone graft material currently in clinical use showed that the pattern associated with AutoBT was similar to that from autogenous cortical bones.
Abstract: Objectives This study evaluated the surface structures and physicochemical characteristics of a novel autogenous tooth bone graft material currently in clinical use. Study Design The material's surface structure was compared with a variety of other bone graft materials via scanning electron microscope (SEM). The crystalline structure of the autogenous tooth bone graft material from the crown (AutoBT crown) and root (AutoBT root), xenograft (BioOss), alloplastic material (MBCP), allograft (ICB), and autogenous mandibular cortical bone were compared using x-ray diffraction (XRD) analysis. The solubility of each material was measured with the Ca/P dissolution test. Results The results of the SEM analysis showed that the pattern associated with AutoBT was similar to that from autogenous cortical bones. In the XRD analysis, AutoBT root and allograft showed a low crystalline structure similar to that of autogenous cortical bones. In the CaP dissolution test, the amount of calcium and phosphorus dissolution in AutoBT was significant from the beginning, while displaying a pattern similar to that of autogenous cortical bones. Conclusions In conclusion, autogenous tooth bone graft materials can be considered to have physicochemical characteristics similar to those of autogenous bones.
96 citations
TL;DR: ED may be a viable option in the treatment of unilateral benign parotid tumors of the superficial lobe, sized less than 4 cm, without involvement of the facial nerve.
Abstract: Objective This study compared extracapsular dissection (ED) vs superficial parotidectomy (SP) in the treatment of pleomorphic adenoma and benign parotid tumors Study Design The research covered the years 1950-2011 in PubMed, Ovid MEDLINE, the Cochrane Database of Systematic Reviews, and Scopus Of 1152 articles screened, 123 studies met the inclusion criteria A review of the nomenclature of the different parotid surgery techniques was done Recurrence rate, permanent facial nerve paralysis, and Frey syndrome of patients who underwent ED vs those who underwent SP were compared by meta-analysis Results Our meta-analysis data comparing ED and SP found that: (1) the recurrence rate is higher in patients treated with SP; (2) SP has a higher incidence of cranial nerve VII paralysis; and (3) Frey syndrome is more common after SP Conclusions ED may be a viable option in the treatment of unilateral benign parotid tumors of the superficial lobe, sized less than 4 cm, without involvement of the facial nerve
96 citations
TL;DR: Nonexposed osteonecrosis of the jaws (NE-ONJ) does not fit into the current definition of oste onecrosis, which requires exposed bone, and is different from ONJ stage 0, which may be otherwise classified as ONJ stages 1, 2, or 3.
Abstract: Objective. Nonexposed osteonecrosis of the jaws (NE-ONJ) does not fit into the current definition of osteonecrosis, which requires exposed bone. A modification of the classification of bisphosphonate-induced osteonecrosis of the jaws (ONJ) is proposed. This study aimed to test proposed criteria for NE-ONJ and compare NE-ONJ with exposed ONJ (E-ONJ) in a retrospective analysis. Study Design. In 102 patients with E-ONJ diagnosed according to Ruggiero et al. (2006, 2009), criteria for NE-ONJ were developed. Subgroups of NE-ONJ and E-ONJ were tested against each other using nonparametric and parametric statistics. Results. Among 102 patients with ONJ, 14 had NE-ONJ and 88 had E-ONJ. NE-ONJ and E-ONJ were similar in all important data (P > .05) except bone exposure. Conclusions. NE-ONJ belongs to the same disease condition as E-ONJ. NE-ONJ may be otherwise classified as ONJ stage 1, 2, or 3 and is different from ONJ stage 0. We propose to include the criteria for NE-ONJ into the classification. (Oral Surg Oral
85 citations
TL;DR: Six practical steps are provided that underline the principle that one size does not fit all, especially when it comes to using radiography during pediatric dental procedures, and increase awareness of the opportunities to improve radiation protection when imaging children in dental practices.
Abstract: Author(s): White, Stuart C; Scarfe, William C; Schulze, Ralf KW; Lurie, Alan G; Douglass, Joanna M; Farman, Allan G; Law, Clarice S; Levin, Martin D; Sauer, Robert A; Valachovic, Richard W; Zeller, Gregory G; Goske, Marilyn J
79 citations
TL;DR: In this paper, a review aims to update the reader as to the current issues surrounding the delay in treatment of oral cancer, with an average delay of 3.5 to 5.4 months.
Abstract: Objective This review aims to update the reader as to the current issues surrounding the delay in treatment of oral cancer. Study Design We searched Medline/PubMed and the Cochrane database. English-language publications were included. Paired reviewers selected articles for inclusion and extracted data. The strength of the evidence was graded as high, moderate, or low. Results Eighteen studies met our inclusion criteria. The majority of the studies were retrospective case-control studies (55%). Conclusions Patient delay continues to be the greatest contributor to overall delay in treatment of head and neck cancers, with an average delay of 3.5 to 5.4 months. In addition, the average professional delay is approximately 14 to 21 weeks. Cumulatively, the amount of delay may be causative for the late stage at which head and neck cancers are diagnosed and subsequently treated.
76 citations
TL;DR: The high success rate of the described surgical procedures imply dentoalveolar surgery with low risk of development of BRONJ is possible for patients taking bisphosphonates.
Abstract: Objectives Principles and workflow are described to prevent bisphosphonate-related osteonecrosis of the jaw (BRONJ) when oral surgery is necessary in patients taking bisphosphonates. Material and Method A total of 117 surgical procedures were performed on 68 patients taking bisphosphonates. The basis of the treatment was (1) use of perioperative antibiotics; (2) after dentoalveolar surgical procedures, bone edges were smoothed and mucoperiosteal flaps were prepared to ensure tension-free wound closure; (3) sutures were not removed until 14 days postsurgery; (4) long-term results were evaluated. Results Ninety-seven percent of all procedures were simple and showed no complications. Only 3 patients with a long history of intravenous bisphosphonate medication developed BRONJ within 4 weeks after surgery. No patient receiving oral bisphosphonates developed BRONJ. No long-term failure was observed when primary wound healing was successful. Conclusions The high success rate of the described surgical procedures imply dentoalveolar surgery with low risk of development of BRONJ is possible for patients taking bisphosphonates.
60 citations
TL;DR: This analysis indicated that cholinergic agonists were more effective in treating radiation-induced hyposalivation compared with salivary substitutes, hyperbaric oxygen, and acupuncture, however, other treatment modalities were also found to subjectively improve patients' perception of xerostomia.
Abstract: Objective To analyze the efficacy of various treatment options for radiation-induced hyposalivation in patients with head and neck cancer. Study Design A literature review and meta-analysis was performed on all appropriate literature identified via MEDLINE/PubMed. Results Fourteen articles were identified that met inclusion criteria for review, and 8 articles qualified for inclusion in the meta-analysis. The available literature addressed both objective and subjective responses of hyposalivation, xerostomia, or both to cholinergic agonists (such as pilocarpine and cevimeline), salivary substitutes, hyperbaric oxygen, and acupuncture. Conclusions This analysis indicated that cholinergic agonists were more effective in treating radiation-induced hyposalivation compared with salivary substitutes, hyperbaric oxygen, and acupuncture. However, other treatment modalities, such as salivary substitutes and hyperbaric oxygen, were also found to subjectively improve patients' perception of xerostomia.
60 citations
TL;DR: Results indicated that daily oral consumption of tablets containing probiotic lactobacilli could help to control oral malodor and malodor-related factors.
Abstract: Objective This study evaluated the effect of probiotic intervention using lactobacilli on oral malodor. Study Design We conducted a 14-day, double-blind, placebo-controlled, randomized crossover trial of tablets containing Lactobacillus salivarius WB21 (2.0 × 10 9 colony-forming units per day) or placebo taken orally by patients with oral malodor. Results Organoleptic test scores significantly decreased in both the probiotic and placebo periods compared with the respective baseline scores ( P P = .002), and no difference was detected between periods. In contrast, the concentration of volatile sulfur compounds (VSCs) ( P = .019) and the average probing pocket depth ( P = .001) decreased significantly in the probiotic period compared with the placebo period. Bacterial quantitative analysis found significantly lower levels of ubiquitous bacteria ( P = .003) and Fusobacterium nucleatum ( P = .020) in the probiotic period. Conclusions These results indicated that daily oral consumption of tablets containing probiotic lactobacilli could help to control oral malodor and malodor-related factors.
60 citations
TL;DR: No superiority of CBCT compared with conventional radiography was found for VRF detection and adequate choice of voxel size seems to be important when diagnosing VRFs.
Abstract: Objective The aim of this review was to compare the efficiency of cone beam computed tomography (CBCT) and conventional intraoral radiography for the detection of vertical root fractures (VRFs). Study Design Data from comparative and noncomparative studies investigating CBCT, conventional radiography, or both for the diagnosis of VRFs were searched. The main outcome variables were sensitivity, specificity, and accuracy of the techniques. Data were separated into 4 groups: in vivo, ex vivo/untreated teeth, ex vivo/treated teeth, and ex vivo with post. The weighted mean of each parameter was estimated. Results Twelve articles were considered for the analysis. There was a large heterogeneity of the characteristics of the studies and a wide variability in outcome variables. No significant differences were found between radiographic techniques. Conclusions No superiority of CBCT compared with conventional radiography was found for VRF detection. Adequate choice of voxel size seems to be important when diagnosing VRFs.
TL;DR: The BCP and DBA materials showed similar osteoconductive patterns and mineralized bone, although signs of more active bone formation and remodeling were observed in BCP- than in DBA-grafted biopsies.
Abstract: Objective The gain of mineralized bone was compared between deproteinized bovine bone allograft (DBA) and biphasic calcium phosphate (BCP) for dental implant placement. Study Design Five patients with atrophic maxillae underwent bilateral sinus elevation with DBA (Bio-Oss) and BCP (Straumann BoneCeramic). After 3 to 8 months, 32 Camlog implants were placed, and biopsies were retrieved. Bone and graft volume, degree of bone mineralization, and graft degradation gradient were determined using micro–computed tomography, and bone formation and resorption parameters were measured using histomorphometry. Implant functioning and peri-implant mucosa were evaluated up to 4 years. Results Patients were prosthetically successfully restored. All but one of the implants survived, and peri-implant mucosa showed healthy appearance and stability. Bone volume, graft volume, degree of bone mineralization, and osteoclast and osteocyte numbers were similar, but BCP-grafted biopsies had relatively more osteoid than DBA-grafted biopsies. Conclusions The BCP and DBA materials showed similar osteoconductive patterns and mineralized bone, although signs of more active bone formation and remodeling were observed in BCP- than in DBA-grafted biopsies.
TL;DR: LLLT reduced the pain and the inconvenience of eating, drinking, and brushing teeth for patients with RAS, compared with placebo.
Abstract: Objective The aim of the study was to determine whether low-level laser therapy (LLLT) has an analgesic effect in patients with recurrent aphthous stomatitis (RAS). Study Design A randomized single-blinded placebo-controlled trial was conducted with LLLT (wavelength, 809 nm; power, 60 mW; pulse frequency, 1800 Hz; duration, 80 seconds per treatment; dose, 6.3 J/cm2) in 40 patients with RAS. The intervention group was treated with LLLT on 3 occasions, with a 1-day interval. The control group was treated similarly, without any laser power. Pain perception (visual analog scale [VAS] rating) and patients' experience of eating, drinking, and brushing teeth was registered. Results VAS rating decreased (day 0 until day 2) from 84.7 to 31.5 (LLLT) and from 81.7 to 76.1 (placebo) (P Conclusions LLLT reduced the pain and the inconvenience of eating, drinking, and brushing teeth for patients with RAS, compared with placebo.
TL;DR: The results indicated that a combination of immunologic testing for circulating autoantibodies is useful for the diagnosis of MMP.
Abstract: Objective. Mucous membrane pemphigoid (MMP) is a rare autoimmune bullous disease caused by various autoantibodies. This study aimed to evaluate the diagnostic value of MMP-specific autoantibodies in patient sera. Study Design. We analyzed sera from 30 MMP-suspected patients with intractable oral mucosal lesions using a combination of indirect immunofluorescence with 1M NaClesplit skin, immunoblot analysis, and ELISAs. We also analyzed clinical features among different types of MMP. Results. Seventeen, 4, and 3 patients were diagnosed with anti-BP180-type MMP, anti-laminin-332-type MMP, and combined anti-BP180/anti-laminin-332-type MMP, respectively. Conclusions. Our results indicated that a combination of immunologic testing for circulating autoantibodies is useful for the diagnosis of MMP. (Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117:483-496) Autoimmune bullous diseases (ABDs) are a group of heterogeneous blistering disorders that may involve the oral cavity. 1,2 ABDs are divided into the pemphigus group and subepidermal bullous disease group. Current classification of ABDs with their autoantigens is summarized in Table I. Major diseases of the pemphigus group are pemphigus vulgaris (PV), pemphigus foliaceus (PF), and paraneoplastic pemphigus (PNP). The subepidermal bullous disease group includes bullous pemphigoid (BP), mucous membrane pemphigoid (MMP), and epidermolysis bullosa acquisita (EBA). ABDs show autoantibodies to various epithelial adhesion molecules or extracellular matrices. Pemphigus diseases are characterized by the presence of autoantibodies against components of cell-cell adhesion, whereas pemphigoid diseases have autoantibodies against components at the dermoepidermal junction (Figure 1). Recently developed assays for autoantibodies and autoantigens enable serologic diagnosis in 90% of ABD cases. 3-9
TL;DR: Owing to the limited number of studies, it is concluded that more randomized, adequately powered clinical trials are needed to validate the potential beneficial effect of MSCs on salivary gland dysfunction and xerostomia.
Abstract: The most severe forms of xerostomia and salivary gland dysfunction, as well as a severely reduced quality of life, are seen in Sjogren syndrome (SS) and after radiotherapy for head and neck cancer. For both conditions, no effective regenerative therapies yet exist. Thus, the aim of this article was to assess, through systematic review, the potential benefit of mesenchymal stem cell (MSC) therapy in radiation-induced and SS-related salivary gland dysfunction and xerostomia. We searched PubMed/MEDLINE, Embase, Web of Science, the Cochrane Database of Systematic Reviews, the World Health Organization Clinical Trials Registry Platform, and Google Scholar. We identified 6 separate study comparisons eligible for inclusion. Owing to the limited number of studies, we conclude that more randomized, adequately powered clinical trials are needed to validate the potential beneficial effect of MSCs on salivary gland dysfunction and xerostomia. Nonetheless, the preliminary studies identified in the present review were encouraging for further research.
TL;DR: PGCG is a well-defined pathologic entity among reactive gingival lesions and was more likely to contain calcifications than other pathologic entities.
Abstract: Objective This study investigated the demographic, clinicopathologic, and histopathologic findings of lesions diagnosed as peripheral giant cell granuloma (PGCG) by the Louisiana State University Oral Pathology Biopsy Service from 1974 to 2011. Study Design Clinical, demographic, and histopathologic evaluation was completed for 279 cases. A follow-up questionnaire was mailed to all surgeons who performed these biopsies from 1990 to 2011. Results Of the 279 lesions, 58% occurred in the mandible, 44% occurred in the anterior portion of the arches, 83% were adjacent to teeth, 14% occurred in edentulous areas, and 2% were adjacent to implants. Average duration was 10.5 months, and the average size was 12.7 mm. The recurrence rate was 17.5%. Histopathologically, 78% of lesions extended to the base of the specimen, 50% exhibited ulceration, 41% contained calcifications, and 6% exhibited features overlapping with another pathologic entity. Conclusions PGCG is a well-defined pathologic entity among reactive gingival lesions. Recurrent lesions were more likely to contain calcifications.
TL;DR: Reactive keratoses were the most common white lesions followed by lichen planus and may represent the very earliest dysplasia phenotype and clinical findings may be helpful in differentiating the two.
Abstract: Objective The objectives were to (1) determine the frequency of specific diagnoses in a series of white lesions, and (2) describe the nature of keratotic lesions that are neither reactive nor dysplastic. Study Design White lesions were analyzed and diagnosed as reactive keratoses, dysplastic/malignant, or keratoses of unknown significance (KUS). Results Of the 1251 specimens that were evaluated, 703 met criteria for inclusion, and approximately 75% were reactive, 10% dysplastic/malignant, and 14% KUS. Excluding reactive keratoses, 43% were dysplastic/malignant and 57% were KUS. Conclusions Reactive keratoses were the most common white lesions followed by lichen planus. Dysplastic/malignant lesions constituted almost 50% of all true leukoplakias. KUS constituted the remaining cases and do not show typical reactive histopathology as well as clear dysplasia. They may represent evolving or devolving reactive keratoses but may also represent the very earliest dysplasia phenotype. Clinical findings may be helpful in differentiating the two.
TL;DR: The authors' data provide important information for coping with bleeding or hematoma occurring during surgical procedures in the mandibular region and demonstrate that the arterial supply to an incisor tooth is often from the submental artery.
Abstract: Objective The purpose of this research was to contribute to minimizing arterial disruption during mandibular surgical procedures by clarifying the course of the arteries supplying the sublingual and submental regions. Study Design Heads of 75 human cadavers were dissected to identify the arterial supply of the sublingual and submental regions. Computed tomography scans were performed to visualize the lateral lingual foramina of the mandibles. Results The facial artery was found to contribute to the composition of almost half of the sublingual arteries studied. Furthermore, it was demonstrated that the arterial supply to an incisor tooth is often from the submental artery. Conclusions Our data provide important information for coping with bleeding or hematoma occurring during surgical procedures in the mandibular region.
TL;DR: Cutaneous injections of CHA and PLA fillers may induce granulomatous reactions presenting as intraoral nodules distant from the injection sites, suggestive of filler migration.
Abstract: Objective We report intraoral granulomatous foreign body reactions in patients treated with calcium hydroxylapatite (CHA) or poly- l -lactic acid (PLA). Study Design Clinical and histopathologic data were obtained from 25 patients who developed orofacial nodules or swelling after dermal filler injections. Results All 25 patients were women aged 35 to78 years (median, 55 years). All had a history of injection of CHA (n = 13) or PLA (n = 12) to the lips, nasolabial area, or mental area. Two patients developed cutaneous nodules at the sites of injections; all others presented with intraoral nodules (labial/buccal or vestibular mucosa) distant from the site of injections, suggestive of filler migration. Five of 21 cases presented with pain. Histopathologically, CHA presented as a diffuse mass of mauve-gray or beige, nonrefractile spherules, and PLA as rice- or spindle-shaped, geometric, refractile bodies within circumscribed nodules. Conclusions Cutaneous injections of CHA and PLA fillers may induce granulomatous reactions presenting as intraoral nodules distant from the injection sites.
TL;DR: It was found that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL among older Japanese people.
Abstract: Objective Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health–related quality of life (OHRQoL) among elderly Japanese people. Study Design A total of 99 community-dwelling, independently living individuals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Results Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Conclusions Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people.
TL;DR: It is demonstrated that psammomatoid and trabecular juvenile ossifying fibromas exhibit unique radiologic features that allow for distinction between the two variants on CT studies.
Abstract: Objective Evaluate and compare the radiologic features of psammomatoid versus trabecular variants of juvenile ossifying fibromas. Study Design Twelve of fifteen cases of juvenile ossifying fibroma of the craniofacial bones, retrieved from our pathology archives for the period between 2002 and 2013, had available preoperative computed tomography (CT) scans. The radiologic features of each case were analyzed and compared by two neuroradiologists and one oral and maxillofacial radiologist, each blinded to the histopathologic diagnosis. Results Juvenile psammomatoid ossifying fibroma (JPOF) exhibited a ground-glass pattern, as an outer mantle with central radiolucency, a single mural nodule, or a solid homogeneous mass. The trabecular variant presented as a radiolucent lesion with irregular, scattered calcifications. Both variants displayed a well-defined border. Conclusion This study demonstrates that psammomatoid and trabecular juvenile ossifying fibromas exhibit unique radiologic features that allow for distinction between the two variants on CT studies.
TL;DR: Tumor thickness of greater than 7 mm is predictive of a higher incidence of lymph node metastasis, and a TT > 10 mm is predicted of worse disease-free survival in squamous cell carcinoma of the oral tongue.
Abstract: Objective The aim of the study was to compare the thickness of primary tumors with the frequency of nodal metastases and survival in patients surgically treated for T1/T2N0 oral tongue squamous cell carcinoma. Study Design This is a retrospective longitudinal study with 74 patients. Results None of the patients with a tumor thickness (TT) ≤ 7 mm presented with nodal metastasis, whereas 25 of the patients with a TT > 7 mm (51.0%) developed metastases (P 7 mm was a risk factor for occult nodal metastasis (odds ratio = 8.7; P = .002) with 81.9% accuracy. TT > 10 mm was also a predictive factor of worse disease-free survival in these patients (hazard ratio = 12.2; P = .003). Conclusions Tumor thickness of greater than 7 mm is predictive of a higher incidence of lymph node metastasis, and a TT > 10 mm is predictive of worse disease-free survival in squamous cell carcinoma of the oral tongue.
TL;DR: Demineralized freeze-dried allogeneic bone transplants can stimulate new bone formation and are a viable alternative to bone autograft material, however, the well-tolerated use of allografted material in regard to the findings should be further investigated.
Abstract: Objectives Allograft material for alveolar ridge reconstruction is quite promising and appears to be as equally successful as bone autograft material. The aim of the present study was to compare four different allogeneic bone grafts in terms of their histologic structure and DNA content before grafting. Study Design Four allograft specimens from different suppliers were analyzed histologically, and the DNA content was analyzed before clinical use of the allografts. Results Organic tissue remnants were detected in all of the evaluated samples. In the present samples adipocytes, fibroblasts, osteocytes, and chondrocytes were identified and DNA isolation and purification was possible. Conclusion Demineralized freeze-dried allogeneic bone transplants can stimulate new bone formation and are a viable alternative to bone autograft material. However, the well-tolerated use of allograft material in regard to our findings should be further investigated.
TL;DR: Shammh use is a major risk factor for oral cancer in Yemen and the association of shammah use alone with OSCC exceeded that of shamsah use in combination with qat chewing, smoking, or both.
Abstract: Objective The role of qat chewing, tobacco (shammah) dipping, smoking, alcohol drinking, and oral viral infection as risk factors for oral squamous cell carcinoma (OSCC) in Yemen was assessed. Study Design A total of 60 cases of OSCC and 120 age- and gender-matched controls were analyzed with respect to demographic data, history of oral habits, and the presence of human papillomavirus (HPV)-16, HPV-18, or Epstein-Barr virus (EBV) as determined by Taqman quantitative polymerase chain reaction. Logistic regression analysis was used to identify independent predictors of the disease. Results Shammah use was the only risk factor for OSCC, with an odds ratio of 12.6 (CI, 3.3-48.2) and 39 (CI, 14-105) for the ex-users and current users, respectively. The association of shammah use alone with OSCC exceeded that of shammah use in combination with qat chewing, smoking, or both. EBV infection, smoking, and qat chewing showed no association with OSCC, while neither HPV-16 nor HPV-18 were detected in any sample. Conclusions Shammah use is a major risk factor for oral cancer in Yemen.
TL;DR: A stent was effective in decreasing doses to healthy structures and delaying the emergence of mucositis as well as decreasing radiation dose to health tissues during intensity-modulated radiotherapy (IMRT).
Abstract: Objective To determine whether an intraoral stent may decrease radiation dose to health tissues during intensity-modulated radiotherapy (IMRT) and to evaluate the effect on mucositis. Study Design A total of 33 patients with tongue or floor of the mouth cancer were retrospectively evaluated and divided into 2 groups: group 1 (with stent, n = 19) and group 2 (without stent, n = 14). Data were collected on dosimetric and mucositis outcomes. Results The mean dose to the maxilla was significantly lower in group 1 (20.9 Gy) than in group 2 (35.8 Gy) ( P = .05). The mean dose to the ipsilateral parotid was 35.0 Gy in group 1 vs 41.8 Gy in group 2 ( P = .05). No difference was seen in the severity of mucositis between groups ( P = .82). However, grade III mucositis was present in group 1 at 4 weeks after IMRT, 1 week after its occurrence in group 2. Conclusions A stent was effective in decreasing doses to healthy structures and delaying the emergence of mucositis.
TL;DR: The diffuse nuclear staining pattern of SOX2 is suggestive of a high-grade process in ameloblastic neoplasms, and numerous aggregates of cells harboring dense nuclear stain should raise concern for a malignancy.
Abstract: Objective Ameloblastic carcinoma often poses diagnostic challenges in its separation from benign ameloblastoma with atypical cytologic features or an unusual clinical course. This study aimed to determine whether SOX2 (sex determining region-Y-related high mobility group box 2), a protein expressed in the epithelial basal proliferative zone in dentigerous cysts, is a marker for ameloblastic carcinoma as well as for high-grade transformation in ameloblastic neoplasms. Study Design Immunoperoxidase stains were performed according to a standard protocol. Immunostains were interpreted independently by 3 pathologists, and scores were recorded based on the percentage of staining and intensity of staining in the cells of interest. Results The diffuse strong nuclear staining pattern has 86.4% specificity (19 of 22) to indicate the presence of high-grade features and has 76.9% sensitivity (10 of 13) in comparison with benign counterparts ( P = .0021). Although previously shown as a marker for ameloblastic neoplasms, calretinin is weakly positive in a few cells in 50% (5 of 10) of ameloblastic carcinoma and 43% (3 of 7) of benign ameloblastic neoplasms, with little value in highlighting the high-grade change ( P = .36). Conclusions The diffuse nuclear staining pattern of SOX2 is suggestive of a high-grade process in ameloblastic neoplasms. Numerous aggregates of cells harboring dense nuclear stain should raise concern for a malignancy.
TL;DR: The exposure of the inferior alveolar nerve or partial axonal injury together with a disruption of the bony environment of the superior alveolars nerve is a risk factor after bilateral sagittal split osteotomy.
Abstract: Objective This study assesses the incidence of neuropathic pain after orthognathic surgery at our center and briefly reports the cases found. Study Design All records of orthognathic surgical patients between 2001 and 2011 were exported from the hospital information system into a Portable Document Format platform (Adobe Acrobat) to simplify keyword searching. Records of patients that developed debilitating chronic pain were isolated and examined. Results Records included 982 bilateral sagittal split osteotomies, 536 LeFort I procedures, and 335 surgically assisted rapid palatal expansion procedures. Six records were identified that described cases in which patients developed debilitating chronic neuropathic pain after orthognathic surgery (mean age at surgery, 43 years). Conclusions The exposure of the inferior alveolar nerve or partial axonal injury together with a disruption of the bony environment of the inferior alveolar nerve is a risk factor after bilateral sagittal split osteotomy.
TL;DR: It is suggested that oral squamous cell carcinoma tissues show the Warburg effect, which stems from the combined enhancement of glucose consumption and glutaminolysis.
Abstract: Objective To characterize the metabolic system of oral squamous cell carcinoma (OSCC) by metabolome analysis. Study Design The metabolome profiles, including the Embden-Meyerhof-Parnas pathway (EMPP), the pentose phosphate pathway, the tricarboxylic acid cycle (TCAC), and amino acids, were obtained from OSCC and its surrounding normal tissues (32 patients) using capillary electrophoresis and a time-of-flight mass spectrometer. Results Enhancement of glucose consumption and lactate production (Warburg effect) was observed in OSCC tissues. The decrease of glucose along with the decrease of the downstream intermediates in the EMPP suggests that incorporated glucose is mainly consumed for biosynthesis. Glutamine consumption with the increase of the intermediates in the last half of the TCAC suggests the involvement of glutaminolysis, in which glutamine is converted to lactate via the last half of the TCAC. Conclusions It is suggested that OSCC tissues show the Warburg effect, which stems from the combined enhancement of glucose consumption and glutaminolysis.
TL;DR: Investigation of whether immunologic and psychologic parameters are associated with diagnosis of geographic tongue found they appear associated with GT and may constitute risk factors of this condition.
Abstract: Objective Several conditions have been associated with geographic tongue (GT). However, there is no consensus on the etiology of GT. The purpose of this study was to investigate whether immunologic and psychologic parameters are associated with diagnosis of GT. Study Design A case-control study was performed on 170 participants (85 with GT, 85 controls). Unstimulated whole saliva was collected, and tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) concentrations were measured. Anxiety level was measured using psychologic and physiologic testing instruments. An independent t test and a Pearson correlation analysis were performed with SPSS (α = .05). Results There was a significant difference between the 2 groups regarding the salivary concentrations of TNF-α ( P = .008) and IL-6 ( P = .001). The concentration of salivary cortisol and state and trait anxiety levels in the GT group were significantly higher than those in the control group ( P = .001). Conclusions Immunologic and psychologic parameters appear associated with GT and may constitute risk factors of this condition.
TL;DR: The majority of patients undergoing primary palatal repair do not develop palatal fistulas, and surgeons with 1-stage palatoplasty closing the hard and soft palate concurrently treat patients with cleft lip and palate concurrently.
Abstract: Objective The purpose of this retrospective study was to determine the incidence of palatal fistulas after primary cleft palate repair. Study Design The study included 136 patients who were treated at the Oulu University Hospital cleft lip and palate center between 1998 and 2011. All patients were treated by the same surgeons with 1-stage palatoplasty closing the hard and soft palate concurrently. Results The overall frequency of postoperative fistula was 9.6% of patients. Patients with cleft lip and palate (20.0%) were more likely to develop postoperative palatal fistulas than patients with cleft palate (6.6%). Surgical technique and cleft severity were not significant factors for the development of palatal fistulas. Conclusions The majority of patients undergoing primary palatal repair do not develop palatal fistulas.