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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2014. Vol. 19, no. 4
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- ANO1 as a marker of oral squamous cell carcinoma and silencing ANO1 suppresses migration of human SCC-25 cells(2014) Li, Yadong; Zhang, Jinsong; Hong, SulingObjectives: The purpose of this study is to confirm that ANO1 correlates with occurrence and metastasis of OSCC. Study Design: Immunohistochemistry was used to detect the expression of ANO1 in 160 specimens of OSCC and normal tissues. Lentiviral silencing ANO1 was used in scc-25 cell line to study the cell migration and cell detachment. Results: Immunohistochemical staining revealed that ANO1 was expressed in a large majority (132 out of 160, 82.5%) of OSCC specimens and that the rate of ANO1 expression in OSCC was significantly higher than that of normal tissue ( P <0.05); The rate of ANO1 expression was higher in metastatic tumors than in non-metastatic tumors, and the difference was significant ( P <0.05). The results of cell migration assay showed that the percent - age of cells through the membrane was 26.61 ±0.81 in assay group, and 54.26 ±3.74 in control group, respectively (t =-16.22, P <0.0001). The results of cell detachment assay showed that the percentage of cells detachment was 37.42 ±0.90 in assay group, and 87.38 ±1.59 in control group, respectively (t=-62.34, P <0.0001). The results of wound healing assay showed the assay group had a reduced migration rate compared with the control group in 32 h (F=1038.78, P <0.0001). Wound closure was no significantly different between the assay and control cells when DIDS was used in wound healing assay (F=4.61, P >0.05). Conclusions: Our study shows that abnormal expression of ANO1 correlated with the occurrence and metastasis of OSCC in clinical specimens and that silencing ANO1 greatly reduced migration ability of scc-25 cells. Calcium activated chloride channel activity of ANO1 promoted the cell migration. Thus, ANO1 could represent a new diagnostic biomarker and a potentially important therapeutic target of OSCC.
- Alternative treatments for oral bisphosphonate-related osteonecrosis of the jaws: a pilot study comparing fibrin rich in growth factors and teriparatide(2014) Pelaz, A.; Junquera Gutiérrez, Luis Manuel; Gallego, Lorena; García-Consuegra, L.; Junquera, Sonsoles; Gómez Alonso, CarlosObjectives: The aim of this study is to describe and compare the evolution of recurrent bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients treated with plasma rich in growth factors or teriparatide. Material and Methods: Two different types of treatments were applied in patients diagnosed of recurrent BRONJ in a referral hospital for 1.100.000 inhabitants. In the group A, plasma rich in growth factors was applied dur - ing the surgery. In the group B, the treatment consisted in the subcutaneous administration of teriparatide. All the cases of BRONJ should meet the following conditions: recurrent BRONJ, impossibility of surgery in stage 3 Ruggiero classification and absence of diagnosed neoplastic disease. Clinical and radiographic evolution of the patients from both groups was observed. Results: Nine patients were included, 5 in group A and 4 in group B. All the patients were women on oral bis- phosphonate therapy for primary osteoporosis (5 patients) or osteoporosis-related to the use of corticosteroids (4 patients). Alendronate was the most common oral bisphosphonate associated with BRONJ in our study (four patients in group A and two in group B). The mean age was 72,8 years in the group A and 73,5 years in the group B. All the patients from group A showed a complete resolution of their BRONJ. Only one patient in the group B showed the same evolution. Conclusions: In our series, the plasma rich in growth factors showed better results than the teriparatide in the treatment of recurrent BRONJ.
- Surgical management of Squamous Cell Carcinoma of the lower lip: an experience of 109 cases(2014) Rena, Wenhao; Lia, Yin; Liua, Changyang; Qianga, Cui; Zhang, Linmei; Gaoa, Ling; Wangb, Zhi; Zhia, KeqianObjectives: We are presenting our experience collected from a series of 109 cases with SCC of the lower lip focus - ing on clinical features of patients and surgical approach. Study D esign: We retrospectively analyzed medical records of patients diagnosed with Squamous Cell Carcinoma (SCC) of the lower lip at the Oral and Maxillofacial surgery at Xi'an Jiaotong University during a period between 1999 and 2008. Results: A total of 109 patients with lip cancer were included in the study. When no frozen-section test was per - formed, the neoplasia was removed with a margin of at least 6 mm. Different surgical techniques were used for lip reconstruction after tumor excision. Neck dissection was performed in all patients with clinically palpable lymph nodes. Median follow-up was 38 months. During follow-up, recurrence occurred in 5 patients, 3 patients devel - oped neck metastases, distant metastases developed in 1 patient. Five patients died during observation period. Conclusions: The patient-related and defect-related issues must be taken into consideration during reconstruction for surgical defect. For N0 patients, we recommend wait-and-see policy. Early detection, careful follow-up and prompt neck is essential for the successful treatment.
- Cytotoxic effect of silorane and methacrylate based composites on the human dental pulp stem cells and fibroblasts(2014) Shafiei, Fereshteh; Tavangar, Maryam-Sadat; Razmkhah, Mahboobeh; Attar, Armin; Alavi, Ali-AsgharObjectives: The aim of this study was to compare the cytotoxic effect of a methacrylate-based and a silorane- based composite on the human dental pulp stem cells (DPSCs) versus human dental pulp fibroblasts (DPFs). Study Design: Samples of the Filtek Z250 and P90 were polymerized and immersed in the culture medium to obtain extracts after incubation for one, seven and 14 days. Magnetic cell sorting based on the CD146 expression was performed to purify DPSCs and DPFs. After incubation of both cells with the extracts, cytotoxicity was de - termined using the MTT test. Results: For the extracts of first and seventh day, both composites showed significantly lower cytotoxicity on DPSCs than DPFs ( p =0.003). In addition, there was a significant difference in the time-group interaction of both materials indicating different cytotoxic behaviours ( p =0.014). In contrast to Z250, exposure to the 14th day extract of P90 resulted in higher cell viability compared to that of day seven. Conclusions: DPSCs are less susceptible to the cytotoxic effect of the composites than DPFs. Compared to Z250, the cytotoxic effect of silorane-based composite decreases as the time passes on. This difference should be con - sidered, particularly in deep cavities, in order to preserve the regenerative capacity of the pulp.
- Influence of state anxiety and trate anxiety in postoperative in oral surgery(2014) Torres Lagares, Daniel; Recio Lora, C.; Castillo Dalí, Gabriel; Ruiz de León, Gonzalo; Hita Iglesias, Pilar; Serrera Figallo, María Angeles; Segura-Egea, Juan J.; Gutiérrez Pérez, José LuisIntroduction: The aim of this article was to study the influence of anxiety (both state and trait) in postoperative recovery after extraction of third molar together, to establish the role of each of the aspects of anxiety in the results you obtained in an independent and complementary way. Material and Methods: We performed a prospective study of a consecutive series of 88 patients who underwent lower third molar extractions. Before being provided with any information about the operation, patients were asked to complete the Spielberger State-Trait Anxiety Inventory-Trait and State. We have evaluated postoperative swelling and pain, patients completed a 10-point visual analog scale (VAS) at home each day (at approximately the same time of day as the operation) until day 8 after surgery, when the sutures were removed. Results: Regarding postoperative variables between positive and negative trait anxiety groups, consumption of analgesic drugs was higher in positive trait anxiety group in a statistically significant way, while these differences were detected only on specific occasions regarding pain and swelling. Discussion: In the present study, anxiety was taken into account and showed a significant effect in explaining postoperative pain and taking analgesics.
- Histopathologic risk factors in oral and oropharyngeal squamous cell carcinoma variants: an update with special reference to HPV-related carcinomas(2014) El Mofty, Samir KAccurate identification of the microscopic risk factors of oral and oropharyngeal (OP) squamous cell carcinomas (SCC) and their morphologic variants is of at most importance, as these generally determine treatment modalities, prognosis and overall patient outcome. The great majority of oral and oropharyngeal squamous cell carcinomas are microscopically described as kerartinizing squamous cell carcinoma (KSCC). They bear certain resemblance to keratinizing stratified squamous epithelium. Tobacco habits and excessive consumption of alcoholic beverages have been considered to be the main etiologic agents in these carcinomas. The tumors occurred in older patients more commonly affected the oral tongue and floor of the mouth with well established morphologic risk factors including tumor grade, pattern of invasion and perineural involvement. Within the last 30 years however, the advent and expanding prevalence of high risk human papillomavirus (HPV) as an important etiologic agent for head and neck squamous cell carcinoma, particularly in the OP, has resulted in a significant change in the established morphologic criteria for risk assessment. The majority of HPV relate carcinomas of the OP are nonkeratinizing squamous cell carcinoma (NKSCC). These tumors are found to be more responsive to treatment with a favorable patient outcome and good prognosis. Consequently, alterations in treat - ment protocols aimed at de-escalation are currently being evaluated. More recently, other morphologic variants that are HPV positive are reported with increasing frequency in the OP and other head and neck sites. As a result, several clinical and pathologic questions have emerged. Importantly, whether the virus is biologically active in these tumors and involved in their pathogenesis, and second, what are the clinical implications with regard to patient management and outcome in the HPV-related variants. Examples of HPV-related squamous cell carcinoma variants that will be addressed here are: basaloid squamous cell carcinoma (BSCC), undifferentiated carcinoma (UCa), papillary squamous carcinoma (PSCC) and small cell carcinoma. Some studies have suggested favorable prognosis in some variants, analogous to that of the (NKSCC), while others showed poorer outcome. So far the number of studies on this subject is limited and the number of cases evaluated in each investigation is few. Because of that, it is prudent at this stage, not to alter management protocols as a result of identification of HPV in these variants and to await additional information.
- Determination of cytokeratins 1, 13 and 14 in oral lichen planus(2014) Rivarola de Gutierrez, Emilce; Innocenti, Alicia-Carolina; Cippitelli, María-José; Salomón, Susana; Vargas-Roig, Laura-MaríaIntroduccion: Cytokeratins (CK) are molecules of the cytoskeleton that contribute to the cellular differenciation. We studied the expression of CK1, CK13 and CK14 in thirty-three patients with OLP. The biopsied lesions were located in the dorsal surface of the tongue, the palatal keratinized mucosa and the nonkeratinized buccal mucosa. Objectives: This study aimed to determine the expression of CK1, CK13 and CK14 in oral lichen planus (OLP) and its relations with: clinical patterns, prognosis, drugs and tobacco intake and histopathological features. Study Design: Immunohistochemical analysis, retrospective, descriptive, observational and no randomized study. Results: No significant difference was observed in the expression of CK1 in patients with or without drug treat - ment. No association was found with the amount of drugs intake or smoking nor with the histopathological fea - tures examined. Samples immunostained with CK13 were all positive in the suprabasal layers, and 13 of them in the basal layer. In these last ones, statistical analysis showed significance in the grade of vacuolization of the basal layer ( p =0.023) and in the degree of exocytosis ( p =0.0025), this, making the degree of affection higher for both parameters. Thirty-two tissue sections were immunostained with CK14. CK14 was expressed in the basal layer in 97% of samples and in the suprabasal layer in 94% of samples. Conclusions: The three CK were altered in OLP. CK1 does not have a direct connection with the presence of or - thokeratosis. The finding of the CK13 in the basal layer is related to the agression of the lymphocytic infiltration in the epithelium, due to the basal stratum vacuolization and the increase in lymphocytic exocitosis. The presence of CK14 in the suprabasal stratums is not a parameter to predict malignancy. The CK in OLP do not follow the normal pattern of keratinized or non-keratinized mucosa.
- Demographic profile of oral nonodontogenic cysts in a Brazilian population(2014) Uchoa Vasconcelos, Ana Carolina; Oliveira, Daniel José Filizola de Oliveira; Roman Martelli, Stephanie Joana; Etges, Adriana; Neutzling Gomes, Ana Paula; Chaves Tarquínio, Sandra BeatrizObjectives: The purpose of this study was to determine the clinical and demographic characteristics of oral non- odontogenic cysts (ONOC) in a Brazilian population over a 53-year period and to compare this data with the literature. Study D esign: A total of 20.391 biopsies records were evaluated, from April/1959 to August/2012. Cases of oral developmental cysts were selected. Data regarding age, gender, time of evolution, and anatomic site of all cases were collected. The data were analyzed by descriptive statistics. Results: Among 20.391 oral biopsies, 71 (0.35%) met the criteria of ONOC. Females accounted for 50.70% of all cases. The mean age observed was 38.14 years (range: 5-88 years). Nasopalatine duct cysts, oral lymphoepithelial cysts and epidermoid cysts were the most common ONOC, accounting for 63 cases (88.73%). Nasopalatine duct cysts occurred in 31 cases (43.66%), followed by 22 patients with oral lymphoepithelial cysts (30.99%) and 10 cases of epidermoid cysts (14.08%). Nasopalatine duct cysts revealed predominance among males (58.06). Oral lymphoepithelial cysts were more commonly observed in tongue (50%). Epidermoid cysts were most frequently found in the buccal mucosa (40.00%). Conclusions: The differential diagnosis of ONOC is based on the clinical, radiological, and histological findings. It is difficult to establish an epidemiological profile of ONOCs, considering the low frequency of these lesions and the divergences in the demographic and clinical presentation data among different populations.
- Low-level laser effect in patients with neurosensory impairment of mandibular nerve after sagittal split ramus osteotomy.Randomized clinical trial, controlled by placebo(2014) Führer Valdivia, Alberto; Noguera Pantoja, Alfredo; Ramírez Lobos, Valeria; Solé Ventura, PedroObjectives: Evaluate the effect on the application of low level laser therapy, in patients that have been previously intervened with a sagittal ramus split osteotomy and present neurosensory impairment due to this surgery, com - pared with placebo. Study D esign: This preliminary study is a randomized clinical trial, with an experimental group (n=17) which received laser light and a control group (n=14), placebo. All participants received laser applications, divided after surgery in days 1, 2, 3, 5, 10, 14, 21 and 28. Neurosensory impairment was evaluated clinically with 5 tests; visual analog scale (VAS) for pain and sensitivity, directional and 2 point discrimination, thermal discrimination, each one of them performed before and after surgery on day 1, and 1, 2 and 6 months. Participants and results evalu - ator were blinded to intervention. Variables were described with absolute frequencies, percentages and medians. Ordinal and dichotomous variables were compared with Mann Whitney's and Fisher's test respectively. Results: Results demonstrate clinical improvement in time, as well as in magnitude of neurosensory return for laser group; VAS for sensitivity reached 5 (normal), 10 participants recovered initial values for 2 point discrimina - tion (62,5%) and 87,5% recovered directional discrimination at 6 months after surgery. General VAS for sensitiv - ity showed 68,75% for laser group, compared with placebo 21,43% ( p -value = (0.0095). Left side sensitivity (VAS) showed 3.25 and 4 medians for placebo and laser at 2 months, respectively ( p -value = (0.004). Conclusions: Low-level laser therapy was beneficial for this group of patients on recovery of neurosensory impair - ment of mandibula r nerve, compared to a placebo.
- Diagnostic criteria in proliferative verrucous leukoplakia: evaluation(2014) García Chías, Begoña; Casado De La Cruz, Laura; Esparza Gómez, Germán Carlos; Cerero Lapiedra, RocíoObjectives: to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia. Study Design: retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid. Results: the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion's site and histopathology, and minor criteria b and c, concerning sex and smoking habit. Conclusions: diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease.
- Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial(2014) Montserrat Bosch, Marta; Figueiredo, Rui; Nogueira Magalhaes, P.; Arnabat Domínguez, Josep; Valmaseda Castellón, E.; Gay Escoda, CosmeObjectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study D esign: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, perform - ing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.
- A c.1244G>A (p.Arg415Gln) mutation in SH3BP2 gene causes cherubism in a Turkish family: report of a family with review of the literature(2014) Sekerci, Ahmet Ercan; Balta, Burhan; Dundar, Munis; Hu, Ying; Reichenberger, Ernst-J.; Etoz, Osman-A.; Nazlim, Sinan; Bayrakdar, Ibrahim-SevkiObjectives: The present study was aimed at advancing the understanding of the pathogenesis of cherubism by presenting a case study based on history, physical examination, typical radiological features, molecular and histo - pathological laboratory tests and a review of the literature. Study Design: This study began with a 7-year-old boy who was referred due to mandibular overgrowth. A pan - oramic radiograph revealed multilocular radiolucent lesions of the upper/lower jaws suggestive of cherubism. Overall, a total of four family members were tested for SH3BP2 mutations, namely two siblings and their parents. Both siblings had been clinically diagnosed with cherubism; however, the parents were clinically normal. Periph - eral blood was collected from all participants and genomic DNA sequencing was carried out. Results: A missense mutation was found in the two affected siblings and their asymptomatic mother. The mu - tation was a 1244 G>A transversion which resulted in an amino acid substitution from arginine to glutamine (p.Arg415Gln) in exon 9. Conclusions: The present study emphasized the importance of further clinical and molecular investigation even when only a single case of cherubism is identified within a family. Genotype-phenotype association studies in individuals with cherubism are necessary to provide important insights into the molecular mechanisms associated with this disease.
- Impression of multiple implants using photogrammetry: description of technique and case presentation(2014) Peñarrocha Oltra, David; Agustín Panadero, Rubén; Bagán Debón, Leticia; Giménez, Beatriz; Peñarrocha Diago, MaríaAim: To describe a technique for registering the positions of multiple dental implants using a system based on photogrammetry. A case is presented in which a prosthetic treatment was performed using this technique. Study Design: Three Euroteknika® dental implants were placed to rehabilitate a 55-year-old male patient with right posterior maxillary edentulism. Three months later, the positions of the implants were registered using a photogrammetry-based stereo-camera (PICcamera®). After processing patient and implant data, special abut - ments (PICabutment®) were screwed onto each implant. The PICcamera® was then used to capture images of the implant positions, automatically taking 150 images in less than 60 seconds. From this information a file was obtained describing the relative positions - angles and distances - of each implant in vector form. Information regarding the soft tissues was obtained from an alginate impression that was cast in plaster and scanned. A Cr-Co structure was obtained using CAD/CAM, and its passive fit was verified in the patient's mouth using the Sheffield test and the screw resistance test. Results and Conclusions: Twelve months after loading, peri-implant tissues were healthy and no marginal bone loss was observed. The clinical application of this new system using photogrammetry to record the position of multiple dental im - plants facilitated the rehabilitation of a patient with posterior maxillary edentulism by means of a prosthesis with optimal fit. The prosthetic process was accurate, fast, simple to apply and comfortable for the patient.
- Frequency of micronucleus in oral epithelial cells after exposure to mate-tea in healthy humans(2014) Bortoluzzi, Marcelo Carlos; Campagnoli, Eduardo-Baulm; Milan, José-Ricaon; Reinheimer, Angélica; Masson, Maicon; Capella, Diogo-LenziObjectives: The aim of this study was to evaluate the possibility of technique simplification for cytology slides in order to evaluate the frequency of micronuclei (FMic) and conduct a experiment looking to know the FMic of oral epithelial cells of healthy volunteers exposed to mate tea (Ilex paraguarariensis). Material and Methods: This is a laboratorial and nonrandomized trial (quasi-experiment), where the nonusers subjects were exposed to mate-tea, consumed in the traditional way, two drinks, two times a day for a single week. Two cytology of exfoliated epithelial cells were obtained before and after the mate tea exposition. Results: The sample was composed by 10 volunteers. The age ranged from 18 to 33 years (Mean 23; SD5.5). The use of mate tea did not showed significant variation in the FMic (Wilcoxon Signed Ranks Test p = .24). Conclusions: The proposed technique simplification showed to be reliable, without losses when compared to the conventional technique and with the advantage of eliminate toxic substances, becoming simple and practical tool for research in dentistry. The acute exposure to mate tea did not induce an increase of FMic in exfoliated buccal cells of healthy nondrinkers and nonsmokers subjects and may not have genotoxic effect. More human studies are needed before a conclusion can be made on the oral carcinogenic risk of mate tea to humans.
- Oral potentially malignant disorders: is malignant transformation predictable and preventable?(2014) Van der Waal, IsaäcLeukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approxi - mately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract. The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant trans - formation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value. It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed.
- The role of a labial salivary gland biopsy in the diagnostic procedure for Sjögren's syndrome: a study of 94 cases(2014) Stein-Callenfels, Dewi van; Tan, Jonathan; Bloemena, Elisabeth; Vugt, Richard M. van; Voskuyl, Alexandre E.; Santana, Nathalie T.Y.; Van der Waal, IsaäcObjectives: The purpose of the present study is to examine the role of the outcome of the labial salivary gland biopsy (LSGB) in the diagnostic procedure of patients suspected of suffering from Sjögren's syndrome (SS). Material and Methods: In a retrospective study the result of histopathological assessment of 94 consecutively taken labial salivary gland biopsies has been examined. For the diagnosis of SS the American-European Consensus Group classification (AECG, 2002) have been used. The outcome of the assessment has been discussed in relation to a recently reported classification provided by the American College of Rheumatology (ACR, 2012). Results: In the 94 LSGBs support for a diagnosis of SS has been encountered in 24 out of 26 patients with SS. In the 68 patients with a negative diagnosis of SS only six positive LSGBs were observed. The sensitivity of the labial biopsy amounted 0.92; the specificity was 0.91, while the positive predictive value and the negative predictive value amounted 0.80 and 0.97 respectively. LSGBs taken by or on the request of the departments of Rheumatology or Internal Medicine had a significant higher yield compared to LSGBs taken in other clinical departments. Conclusion s : The LSGB may play a role in the diagnostic procedure of Sjögren's syndrome when using either the AECG classification or the ACR classification. A LSGB should preferably taken after counseling for the possible presence of SS by a department of Rheumatology or Internal Medicine since the yield of such biopsies is much higher than in patients who have not been counseled by these departments prior to the taking of a LSGB. When using the ACR classification, a positive serologic result and a positive ocular test make the taking of a LSGB redundant. Only in case of a negative serologic outcome or a negative result of the ocular test a LSGB is indicated. Since both the serologic test and the ocular test carry hardly any morbidity, these tests should, indeed, be performed first before considering to take a LSGB.
- Health-related quality of life after mandibular resection for oral cancer: reconstruction with free fibula flap(2014) Yang, Wenli; Zhao, Sanjun; Liu, Fei; Sun, MingleiObjectives: Mandibular resection for oral cancer is often necessary to achieve an adequate margin of tumor clear - ance. Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly before free fibula flap to reconstruct the defect. The aim of this study was to evaluate health-related quality of life in patients who have had mandibular resections of oral cancer and reconstruction with free fibula flap. Study D esigns: There were 115 consecutive patients between 2008 and 2011 who were treated by primary surgery for oral squamous cell carcinoma, 34 patients had a mandibular resection. HRQOL was assessed by means of the 14-item Oral Health Impact Profile (OHIP-14) and University of Washington Quality of Life (UW-QOL) question - naires after 12 months postoperatively. Results: In the UW-QOL the best-scoring domain was mood, whereas the lowest scores were for chewing and saliva. In the OHIP-14 the lowest-scoring domain was social disability, followed by handicap, and psychological disability. Conclusions: Mandible reconstruction with free fibula flap would have significantly influenced on patients' quality of life and oral functions. The socio-cultural data show a fairly low level of education for the majority of patients.
- Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment(2014) Crovetto Martínez, Rafael; Martin Arregui, Francisco Javier; Zabala López de Maturana, Aitor; Tudela Cabello, Kiara; Crovetto de la Torre, Miguel AngelObjectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid si - nuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study D esign: This is a retrospective cohort study performed on 55 patients diagnosed of odontogenic sinusitis and treated surgically by functional endoscopic sinus surgery. Results: This study showed that 52.7% of odontogenic maxillary sinusitis spreads to anterior ethmoid, causing added anterior ethmoid sinusitis. We found that 92.3% of the odontogenic maxillary sinusitis (who underwent middle meatal antrostomy) and 96.5% of the odontogenic maxillary sinusitis extended to the anterior ethmoid (treated with middle meatal antrostomy and anterior ethmoidectomy) were cured. Conclusions: Ethmoid involvement is frequent in maxillary odontogenic sinusitis. The ethmoid involvement does not worsen the results of "functional endoscopic sinus surgery" applied to the odontogenic sinusitis.
- Materials and prognostic factors of bone regeneration in periapical surgery: a systematic review(2014) Sánchez Torres, Alba; Sánchez Garcés, María Angeles; Gay Escoda, CosmeObjectives: Analyse the effectiveness of different materials and techniques used in guided tissue regeneration (GTR) applied in periapical surgery, comparing the success rate obtained in 4-wall defects and in through-and- through bone lesions as well as to establish prognostic factors. Material and Methods: A Cochrane, PubMed-MEDLINE and Scopus database search (October 2012 to March 2013) was conducted with the search terms "periapical surgery", "surgical endodontic treatment", "guided tissue regeneration", "bone regeneration", "bone grafts", "barrier membranes" and "periapical lesions" individually and next, using the Boolean operator "AND". The inclusion criteria were the use of GTR (bone graft and/or membrane barrier), clinical studies including at least 10 patients, 10 years aged articles published in English or French. The exclusion criteria were case reports and nonhuman studies. Results: 34 publications were selected from a total of 483. 9 of the 34 were excluded. Finally, the systematic review included 25 articles: 2 metaanalysis, 8 reviews, 13 prospective studies and 2 retrospective studies. They were stratified according to their level of scientific evidence using the SORT criteria. The 4-wall periapical and through-and-through lesions improve more their prognosis by combining bone grafts and barrier membranes than using these materials exclusively, respect to the control groups. The results show lower failure rates in 4-wall le - sions than in through-and-through lesions using GTR. Conclusions: The combined GTR technique (filling material and membranes) obtains a greater success rate both in 4-wall lesions and in through-and-through lesions, respect to the control groups. The use of regeneration materials seems to be more necessary in through-and-through lesions, > 5mm lesions, lower teeth and apicomarginal lesions as they have the worst healing prognosis. In function of the articles scientific quality, a type B recommendation is given in favour to the use of GTR in association of periapical surgery in case of 4-wall and through-and-through lesions.
