Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

2012-05-01

Welcome newly graduated oral and maxillofacial surgeons

David S. Precious — 2012-03-19

This month we enter the annual season of convocations, during which many oral and maxillofacial surgery (OMFS) residents will complete their graduate education. I am told that the shortest convocation address ever delivered was by Winston Churchill at Harrow College in the 1940s, and that the address consisted of only 7 words. I greatly admire brevity, but I am simply not eloquent enough, in 7 words, to convey to you my profound sense of celebration and accomplishment during this special time of the academic year.

White lesion on the dorsum of tongue

Junu Ojha, Anish Gupta, Ayman Madawi, Zenon Kossak — 2012-03-05

A 57-year-old African American man presented to the oral and maxillofacial clinic at the University of Detroit Mercy School of Dentistry for evaluation of a white lesion of the tongue. The patient reported that the lesion first presented 2 years earlier with slight pain and had become asymptomatic over time. The patient also reported that he picked at the lesion several times and had previously removed portions of it. The lesion then grew back over a period of weeks. The patient's medical history was unremarkable. He denied history of infectious or sexually transmitted diseases, allergies, medications, or trauma. The patient's social history was positive for 40 pack-years of tobacco smoking. He also presented with significant history of marijuana and intravenous drug abuse. Extraoral examination did not reveal any abnormalities. There was no evidence of lymphadenopathy. There was no history of previous similar lesions elsewhere or any systemic complaints. Intraoral examination revealed a thickened, large, painless, white plaque measuring approximately 4 × 4 cm on the dorsum of the tongue. The lesion appeared to exhibit slightly tan to brownish discoloration most likely owing to extrinsic staining related to the patient history of cigarette smoking. The central portion of the lesion appeared to be markedly elevated, displaying a verrucous, nodulelike appearance. A small area in the center of the lesion appeared to be slightly erythematous. The bulk of the lesion was centered on the middle third of the dorsal tongue with slight extension anteriorly and bilaterally to the posterolateral tongue. The lesion had irregular but well-delineated borders (). On palpation, the lesion was nontender and nonindurated. The lesion could not be wiped off.

New oral anticoagulants: will they replace warfarin?

James W. Little — 2012-03-02

Vitamin K antagonists, such as warfarin, are considered to be the treatment of choice to prevent thromboembolic events, but problems, such as the need for frequent dose adjustment and monitoring of coagulation status, as well as multiple drug and food interactions, make their use difficult for both physician and patient. Two new anticoagulants are now being considered as possible replacements of vitamin K antagonists. Dabigatran, an oral direct thrombin inhibitor has already been approved in the USA for prevention of stroke in patients with atrial fibrillation. Rivaroxaban, a factor Xa inhibitor, and dabigatran are licensed in Europe and Canada for short-term thromboprophylaxis after elective hip or knee replacement surgery. The advantages of these drugs are that they are safe and effective, require no monitoring, have a direct mode of action against only one clotting factor (thrombin or factor Xa), have limited drug interactions, and have rapid peak blood levels. Based on the fact that dabigatran has already been approved for use in the USA, it would appear that it has an advantage over rivaroxaban in becoming the replacement drug for vitamin K antagonists.

Inadvertent injection of formalin mistaken for local anesthetic agent: report of a case

Gururaj Arakeri, Peter A. Brennan — 2011-08-12

Chemical facial cellulitis, while commonly seen in domestic accidents or attempted suicide, is uncommon in the dental office and hence rarely addressed in the dental literature. We present an unusual case of chemical facial cellulitis caused by inadvertent injection of formalin into the soft tissues of the oral cavity, which was mistaken for local anesthesia solution. This report comprises the immediate symptoms, possible root cause, and management of the difficult situation. We also provide some guidelines to avoid such unfortunate events.

A comparative study of the effectiveness of sinus bone grafting with recombinant human bone morphogenetic protein 2–coated tricalcium phosphate and platelet-rich fibrin–mixed tricalcium phosphate in rabbits

2011-08-11

Objectives: The objective of this histologic study was to evaluate platelet-rich fibrin (PRF)–mixed tricalcium phosphate (TCP) and recombinant human bone morphogenic protein 2 (rhBMP-2)–coated TCP in their potential to enhance bone regeneration in sinus elevation in rabbits as well as in their inflammatory features. Study Design: Bilateral round-shaped defects (diameter 8.0 mm) were formed in the maxillary anterior sinus walls of 36 New Zealand white rabbits. The defects were grafted with TCP only (control group), with rhBMP-2–coated TCP (experimental group A) and with PRF-mixed TCP (experimental group B). Each group included 12 rabbits. The animals were killed at 3 days, 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks. The specimens underwent decalcification and were stained for histologic analysis. Results: There were no significant differences in inflammatory features among the groups at 3 days or the first week after operation. In a histomorphometric analysis, the new bone formation ratio showed significant differentiation between groups A and B. The TCP-only control group showed a relatively lower bone formation ratio rather than the experimental groups. The PRF-mixed TCP group showed a larger bone formation area, compared with both the control group and group A. Conclusions: In the results of the histologic evaluation (hematoxylin-eosin, Masson trichrome stain), the experimental groups A and B showed rapid bone formation, remodeling, and calcification in the second week. Moreover, there was a significant difference between those experimental groups and the control group in the new bone formation area at the fourth, sixth, and eighth weeks. The PRF-mixed TCP showed more rapid bone healing than the rhBMP-2-coated TCP or the TCP-only control.

Modified face-lift approach combined with a superficially anterior and superior-based sternocleidomastoid muscle flap in total parotidectomy

Hua Liu, Yisong Li, Xiaoming Dai — 2011-08-25

Objectives: The authors evaluate a modified total parotidectomy performed through a modified face-lift incision integrated with a superficially anterior and superior pedicled sternocleidomastoid muscle (SASSCM) flap. Study Design: Records of 86 cases of total parotidectomy were reviewed retrospectively. Clinical evaluation of cosmetic gratification, presence or absence of gustatory flushing or sweating, functional reversion of the seventh cranial nerve and great auricular nerve (GAN) were undertaken by 3 investigators independent to the operators. Results: This group presents a mean follow-up of twenty-six months. The average scale of cosmetic gratification from patients and investigators are 7.97 and 7.56, respectively. Almost total complaints about anesthesia in upper cervical part and cheek disappeared within three months postoperatively. Neither in objective test nor from subjective complaint was gustatory sweating identified in present study. Conclusions: The authors' technique is esthetically pleasing and efficacious to prevention of gustatory sweating in total parotidectomy.

Histomorphometric examination of long-term changes in temporomandibular joints after mandibular lengthening by distraction osteogenesis in rabbits

Ahmet Mihmanlı, Doğan Dolanmaz, Hakan Tüz, Alper Pampu, Hasan Hüseyin Dönmez — 2011-08-19

Objective: The purpose of this study was to evaluate long-term histomorphometric changes in temporomandibular joints (TMJs) of rabbits after mandibular distraction osteogenesis (DO). Study Design: Twenty-six rabbits were used in this study. Two of them served as control subjects, and the remaining 24 underwent DO procedures in their left mandibular bodies. After a latency period of 5 days, 5 mm lengthening was performed at a rate of 1 mm/d. The rabbits in the experimental group were randomly divided into 4 subgroups and killed after 1, 2, 4, and 6 months. TMJs from both sides were harvested and prepared with hematoxylin and eosin stain for histomorphometric examination under an optical microscope. Results: Compared with control subjects and nondistracted sides, fibrous articular, proliferative, and hypertrophic areas were significantly increased (P < .05) in the first 2 months in distracted sides. The changes were insignificant in the fourth and sixth postoperative months. Conclusion: Unilateral mandibular distraction of 5 mm was found to be well tolerated and no degenerative changes were observed histologically in the rabbit TMJs in the long-term period.

Mandible reconstruction assisted by preoperative virtual surgical simulation

2011-08-22

Objective: In this study, we evaluated the clinical efficacy of mandible reconstruction with preoperative virtual planning, which focused on esthetics and occlusion. Study Design: A series of 9 patients were enrolled prospectively to undergo mandibulectomy and simultaneous reconstruction. Preoperative spiral CT scans of the maxillofacial region and the fibula region were performed. Virtual surgery of tumor resection and fibula reconstruction was performed in the Mimics platform. The reconstructed mandible models were fabricated with CAD/CAM technique. The reconstruction plate and the positioning template were accommodated to the stereolithographic model as the surgical template. Results: Surgery was performed accurately according to the templates. All the fibula flaps survived. The appearance and occlusion of the patients were satisfactory. Conclusions: With preoperative virtual planning, the spatial relationship of the mandible and the fibula graft can be planned individually, which helps achieve optimum appearance and occlusion relationship.

Intraorally exposed anterior Stafne bone defect: a case report

Ömür Dereci, Serpil Duran — 2012-02-13

Anterior Stafne bone defect is a rare lingual bone depression mostly seen in the mandibular canine-premolar region; however, exposure of the defect into the oral cavity is quite rare. In this article, a case of anterior Stafne bone cavity, which can be seen in the intraoral examination, is presented with clinical features. Surgery is not considered for this case and after 2 years of follow-up, the defect remained stable.

Clinical outcomes after the use of complete autologous oral mucosa equivalents: preliminary cases

2012-01-27

Objective: Previously, we reported how to obtain complete autologous oral mucosa equivalents (CAOMEs) composed of an autologous plasma scaffold and fibroblasts together with immature keratinocytes able to build an oral epithelium with a structure similar to that of the oral mucosa. In this study, we present the clinical outcomes after applying our CAOMEs as grafts. Study Design: Four patients who needed a CAOME to restore a defect of oral mucosa were selected. Two of the patients suffered from ankyloglossia, and the other 2 required a restoration of the keratinized gum of the alveolar rim. To assess the outcomes, the scale designed by Ewers et al. was used. Results: Clinical and functional improvements were achieved in the patients with ankyloglossia. In cases of gum restoration, the mucosa was regenerated and a prosthetic restoration with implants was achieved. Conclusions: The results obtained points to the potential use of CAOME in intraoral lining.

Validation of the Bitestrip versus polysomnography in the diagnosis of patients with a clinical history of sleep bruxism

2012-02-13

Objective: This validation study compared an electromyography (EMG) device, Bitestrip, versus polysomnography in the diagnosis of sleep bruxism (SB). Study design: Forty-nine consecutive patients (32 women and 17 men, 41.2 ± 12.9 years old) with a clinical history of SB were included in the study from the Orofacial Pain Clinic, Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul in Brazil. Results: Initially, we compared an SB positive/negative test result for both systems (agreement 87.8%, sensitivity 84.2%, positive predictive value 100%, and crude kappa 0.71). We then compared a 4-scale test (no, light, moderate, or severe bruxism) between the 2 methods (agreement 80.27%, weighted kappa 0.51, and Kendall W coefficient 0.575). Conclusions: The Bitestrip can be considered as a moderate screening method for the diagnosis of SB, because it is more precise in detecting the presence or absence of SB but less precise in detecting its intensity.

Effectiveness of antiviral agents for the prevention of recurrent herpes labialis: a systematic review and meta-analysis

Hanieh Rahimi, Tom Mara, John Costella, Mark Speechley, Richard Bohay — 2012-05-01

Objective: The purpose of this study was to complete a systematic review and, if possible, a meta-analysis on the effectiveness of systemic and topical nucleoside antiviral agents in the prevention of recurrent herpes labialis (RHL) in immunocompetent subjects. Study Design: Multiple comprehensive electronic and manual literature searches without language restrictions identified the studies to be included. Quality assessment and data synthesis methods followed those described in the Cochrane guidelines. Results: Of 2,683 papers reviewed, 10 met the inclusion criteria. Oral acyclovir (800-1,600 mg daily) and valacyclovir (500 mg daily for 4 months) were shown to be effective in the prevention of RHL when taken prior to the appearance of any symptoms or exposure to triggers. Of the 10 papers reviewed, only 1 was determined to have a low risk of bias. Conclusions: This review found support for the use of systemic acyclovir and valacyclovir for the prevention of RHL.

Effect of salivary stimulation therapies on salivary flow and chemotherapy-induced mucositis: a preliminary study

2012-05-01

Objective: The objective of this study was to evaluate the effect of salivary stimulation therapies on the salivary flow, oral mucositis, and salivary cytokine levels in patients receiving allogeneic hematopoietic stem cell transplantation. Study Design: Thirty-five eligible patients were randomized into 4 groups: control, mechanical sialogogue, transcutaneous electrical nerve stimulation (TENS) sialogogue, and combined mechanical/electrical sialogogue. Saliva was collected from patients before transplantation and at days 3, 7, and 14 after transplantation. The volume was measured and salivary cytokines were assessed using enzyme-linked immunosorbent assay. Results: By day 14, resting and stimulated salivary flow levels were diminished. Resting salivary flow rates decreased the most in the control and mechanical groups. In contrast, TENS alone or in combination with mechanical stimulatory therapy benefited the patients. TENS-treated patients showed increase in resting salivary flow. Also, the groups treated with TENS had fewer patients affected by grades 3 and 4 mucositis, and less mucositis was associated with better patient survival (P = .027). Conclusions: TENS-associated salivary stimulation therapies minimized the reduction of salivary flow and prevented severe chemotherapy-induced oral mucositis.

Amlexanox is as effective as dexamethasone in topical treatment of erosive oral lichen planus: a short-term pilot study

2012-03-02

Objective: The objective of this study was to evaluate the efficacy and safety of short-term and topical application of amlexanox paste in the treatment of erosive oral lichen planus (EOLP). Study Design: A randomized, positive-controlled clinical trial was conducted from September 1 to December 31, 2009. Thirty-eight patients with EOLP received amlexanox paste (n = 20) or dexamethasone paste (n = 18) for 7 days. Outcome measures included size of erosive area and visual analog scale (VAS) scores. Results: After 7 days of treatment, both groups showed significant reduction in erosive area and VAS scores (P < .001). There was no difference between groups in the reduction of erosive area (P = .937) and VAS scores (P = .161). None of the patients had severe adverse reactions. Conclusions: Topical application of amlexanox appeared as effective as dexamethasone in the treatment of EOLP and no serious side effects were found in this pilot study.

Posttransplant lymphoproliferative disorder presenting as a nonhealing extraction socket: a case report and review of the literature

Holly Cole-Hawkins, Eithne Fyfe, Chris Price, Miranda Pring — 2012-03-05

Posttransplant lymphoproliferative disorder (PTLD) is a well-recognized complication of long-term immunosuppression following hematopoietic or solid organ transplantation and is associated with significant morbidity and mortality. We present a unique case of PTLD that manifested with a nonhealing dental extraction socket 17 years after renal transplantation. We summarize the existing literature and present a review of an additional 25 cases. These highlight the variable clinical presentations of PTLD within the oral cavity and clear potential for delayed presentation at this anatomical subsite.

Acute gingival bleeding as a complication of falciparum malaria: a case report

Saif Khan, Afaf Zia, N.D. Gupta, Afshan Bey — 2012-03-05

Introduction: Acute gingival bleeding can occasionally be the only sign of systemic bleeding problems. The diagnosis and management of such conditions may challenge the skills of the dentist. Case report: The present report describes a case of severe, prolonged gingival bleeding in a 54-year-old woman as a consequence of Plasmodium falciparum malaria infection. Specific highlights are focused on the management of the patient with emphasis on early diagnosis of the disease so as to improve the prognosis. This case report also stresses that medical intervention to correct the underlying aberration of hemostasis is necessary for local dental measures to successfully stop bleeding. Conclusions: Acute gingival bleeding as a complication of systemic disease can be challenging to manage unless the underlying systemic cause is diagnosed. Therefore, the dentist must be aware of various systemic conditions that can lead to gingival bleeding. The present case report describes a patient with acute gingival bleeding secondary to Plasmodium falciparum infection.

Induction of apoptosis and up-regulation of cellular proliferation in oral leukoplakia cell lines inside electric field

2012-05-01

Objective: In dentistry, metallic alloys are used for dentures, restorative materials, and orthodontic devices. Electric voltages up to 950 mV may occur between different dental alloys in the oral cavity. This study aimed to investigate physiologic reactions of oral leukoplakia cells in vitro to electric fields. Study Design: A human leukoplakia cell line (MSK-LEUK1), cultivated in keratinocyte growth medium (KGM-2) supplemented with growth factors in 5% CO2 humidified air at 37°C, was exposed to electric field strength of 1-20 V/m for 24 hours in a custom-made pulse chamber. The cells were then analyzed for proliferation with the use of BrdU assay and for apoptosis with the use of TUNEL assay. Findings were assessed with the use of fluorescent microscopy. Ultrastructural changes were studied by transmission electron microscopy. Results: Electric field strength of 1-10 V/m led to up-regulation of cell proliferation rate from 10.64% to 44.06% (P = .0001). The apoptotic index increased significantly (P = .0001) from 20.03% at 1 V/m to 46.56% at 10 V/m. Individual cell keratinization was seen in leukoplakia cells treated with 16 V/m. Conclusions: Oral galvanism induces subcellular changes in oral precancer cells in vitro that closely simulate some of the morphologic features of oral squamous cell carcinoma cells in vivo.

Salivary adenocarcinoma, not otherwise specified: a clinicopathological study of 28 cases

Runzhi Deng, Enyi Tang, Xudong Yang, Xiaofeng Huang, Qingang Hu — 2012-05-01

Objective: The objective of this study was to summarize the clinicopathologic features of salivary adenocarcinoma, not otherwise specified (ANOS) and to evaluate current treatments. Study Design: Between 1992 and 2010, 28 patients with ANOS were diagnosed and treated. Clinical data of demographic features, resection margin, neck dissection status, recurrence, and mortality were reviewed. Results: The parotid had the most frequent incidence of ANOS and the palate was second. The peak onset was between 40 and 60 years. The preferred management modality was surgical intervention in all cases. Neck dissection and postoperative radiotherapy were performed in 67.9% and 64.3%, respectively. The mean survival time was 97 months. The 5- and 10-year overall survival rates were 62.2% and 36.0%, respectively. Conclusions: The current data demonstrate that T, N, M, and Union for International Cancer Control staging, resection margin, and neck dissection status are the most powerful predictors of survival. Long-term follow-up is required to identify possible late recurrence.

Increased number of Langerhans cells in oral lichen planus and oral lichenoid lesions

2012-05-01

Objective: The aim of this study was to quantify the presence of Langerhans cells (LC) in oral lichen planus (OLP) and oral lichenoid lesions (OLL), comparing them with normal epithelium. Study Design: Thirty-six patients with biopsy-proven OLP or OLL were selected for the study, as well as 23 control subjects free of inflammatory conditions. Immunohistochemical reactions were performed using the streptavidin-biotin peroxidase complex method with CD1a and CD83 primary antibodies. Densities were compared between groups and correlated with microscopic findings. Results: Patients with lichenoid conditions (OLP + OLL) presented higher densities of CD1a+ cells than the control subjects (P = .03). Higher densities of CD1a were associated with a thinner layer of inflammatory cells (P = .02). Conclusions: This study indicates that OLP and OLL are characterized by the recruitment of LC, which may play a significant role on its pathogenesis.

Comparison of Ki-67, cyclin E, and p63 in benign and malignant human pleomorphic adenoma

Xiaojie Zhu, Jiali Zhang, Xinming Chen, Xiaojie Feng — 2012-05-01

Objective: A set of cell proliferation-related molecular markers was used to detect the differences in proliferative activity between benign pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA). Study Design: Seventy samples comprising 53 PAs, 10 noninvasive and 7 widely invasive (WI) CXPAs were selected. Immunohistochemical staining was used to detect Ki-67, cyclin E, and p63 expression. Results: The average Ki-67 labeling index of WI CXPAs was higher than that of PAs and the malignant component of noninvasive CXPAs (M–noninvasive CXPA; P < .01). An increased cyclin E–positive staning was observed in M–noninvasive CXPAs and WI CXPAs compared with PAs (P = .006). The p63 expression levels were notably decreased in M–noninvasive CXPAs and WI CXPAs compared with PAs (P = .007). Conclusions: The data support that increased or decreased expression of Ki-67, cyclin E, and p63 may indicate the proliferative differences between PA and CXPA.

Osteoplastic ameloblastoma: a case report and literature review

Yuko Itoh, Hirokazu Nakahara, Ryota Itoh, Akihiko Ito, Takao Satou — 2011-08-22

Ameloblastoma with bone formation is rare. We report a case of a 55-year-old woman with ameloblastoma accompanied by prominent osteoplasia. Histopathological examination exhibited an abundant stromal component between tumor nests. Therefore, she was diagnosed as the desmoplastic variant, except for the numerous bone trabeculae. The distinction between new bone formation and invasion of the bone marrow poses a problem. A thin rim of fibrous bone that can be accentuated by Masson-trichrome staining suggests the former.

Bilateral maxillary duplication: case report and literature review

2011-09-20

Accessory maxillary jaws are extremely rare occurrences. Currently, there is only 1 report of bilateral accessory maxillary jaws in the English-language literature. We present a case of a 7-year-old girl with bilateral bony exostoses extending from the maxillary tuberosities. The patient also had restricted protrusive and lateral excursive movements of the mandible. The histologic report revealed teeth in various developmental stages within the bony exostoses. We concluded that these structures were an isolated form of bilateral accessory maxillary jaws.

Computer-assisted orthognathic surgery: feasibility study using multiple CAD/CAM surgical splints

Max J. Zinser, Robert A. Mischkowski, Hermann F. Sailer, Joachim E. Zöller — 2012-05-01

Objective: We present a virtual planning protocol incorporating a patented 3–surgical splint technique for orthognathic surgery. The purpose of this investigation was to demonstrate the feasibility and validity of the method in vivo. Materials and Methods: The protocol consisted of (1) computed tomography (CT) or cone-beam computed tomography (CBCT) maxillofacial imaging, optical scan of articulated dental study models, segmentation, and fusion; (2) diagnosis and virtual treatment planning; (3) computed-assisted design and manufacture (CAD/CAM) of the surgical splints; and (4) intraoperative surgical transfer. Validation of the accuracy of the technique was investigated by applying the protocol to 8 adult class III patients treated with bimaxillary osteotomies. The virtual plan was compared with the postoperative surgical result using image fusion of CT/CBCT dataset by analysis of measurements between hard and soft tissue landmarks relative to reference planes. Results: The virtual planning approach showed clinically acceptable precision for the position of the maxilla (<0.23 mm) and condyle (<0.19 mm), marginal precision for the mandible (<0.33 mm), and low precision for the soft tissue (<2.52 mm). Conclusions: Virtual diagnosis, planning, and use of a patented CAD/CAM surgical splint technique provides a reliable method that may offer an alternate approach to the use of arbitrary splints and 2-dimensional planning.

Multidetector computerized tomographic fistulography in the evaluation of congenital branchial cleft fistulae and sinuses

Zhipeng Sun, Kaiyuan Fu, Zuyan Zhang, Yanping Zhao, Xuchen Ma — 2012-05-01

Objective: The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. Study Design: Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. Results: Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. Conclusions: CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail.

Mandibular cortical bone evaluation on cone beam computed tomography images of patients with bisphosphonate-related osteonecrosis of the jaw

2012-05-01

Objectives: The objective of this study was to develop a technique for detecting cortical bone dimensional changes in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Study Design: Subjects with BRONJ who had cone-beam computed tomography imaging were selected, with age- and gender-matched controls. Mandibular cortical bone measurements to detect bisphosphonate-related cortical bone changes were made inferior to mental foramen, in 3 different ways: within a fixed sized rectangle, in a rectangle varying with the cortical height, and a ratio between area and height. Results: Twelve BRONJ cases and 66 controls were evaluated. The cortical bone measurements were significantly higher in cases than controls for all 3 techniques. The bone measurements were strongly associated with BRONJ case status (odds ratio 3.36-7.84). The inter-rater reliability coefficients were high for all techniques (0.71-0.90). Conclusions: Mandibular cortical bone measurement is a potentially useful tool in the detection of bone dimensional changes caused by bisphosphonates.

Non-Hodgkin lymphoma involving the mandible: imaging findings

2012-03-02

Objective: The aim of this study was to investigate the imaging findings of non-Hodgkin lymphoma (NHL) involving the mandible. Study Design: The imaging studies of 4 patients with NHL involving the mandible were retrospectively reviewed. Panoramic and computerized tomographic (CT) images were available for all patients. Magnetic resonance imaging (MRI) was available for 3 patients. Results: On panoramic images, an apparent radiolucent lesion was found in only 2 of 4 cases. However, in all cases careful observation demonstrated imaging findings suggesting malignancy. On CT and MRI, tumor replaced the bone marrow in all cases and spread to the surrounding soft tissue in 3 cases. Cortical bone destruction tended to be mild for the extent of tumor involvement. Conclusions: NHL involving the mandible tended to show slight or mild cortical bone destruction relative to the extent of the tumor involvement. Careful observation was considered to be necessary when interpreting conventional images, because they might not clearly demonstrate bone destruction.

Evaluation of interproximal caries using the IPad 2 and a liquid crystal display monitor

Werner H. Shintaku, Mark Scarbecz, Jaqueline S. Venturin — 2012-03-05

Objective: The objective of this study was to compare the detection of interproximal caries in digital intraoral images presented in a 24-inch liquid crystal display (LCD) monitor and the IPad 2. Study Design: Twenty-seven digital bitewing radiographs of 102 adult teeth were generated by a charge-coupled device sensor and presented to 4 dentists in 2 sessions. The dentists were asked to rate the presence or absence of carious lesions using a 5-point scale. Differences in sensitivity, specificity, and accuracy were weighted using the Wilcoxon test, and the z test for the receiver operating characteristic curves. Results: For the IPad 2 and LCD monitor, Az values were 0.87 and 0.86, respectively. For the tablet, the mean values of sensitivity, specificity, and accuracy were 0.75, 0.86, and 0.83, respectively. For the LCD monitor, these values were 0.77, 0.82, and 0.80, respectively.

Drug-related osteonecrosis of the jaws: “Exposure, or not exposure: that is the question”

Michele D. Mignogna, Gennaro Sadile, Stefania Leuci — 2012-03-05

We would like to raise an important issue regarding the 2009 update of the American Association of Oral and Maxillofacial Surgeons (AAOMS) position paper, “Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ),” which has to date incorporated 2 additional modifications. We would like to propose a new modification that we think would be extremely useful for the next AAOMS update, which is likely to be released very soon given the rapidly evolving state of this topic.

Clopidogrel-induced ageusia: a possible overlooked etiology by dentists?

Rama Krsna Rajandram — 2012-03-05

Cardiovascular disease remains the number one cause of death globally, and antiplatelet therapy is currently the cornerstone treatment modality for prevention of coronary artery disease. Clopidogrel bisulfate (Plavix), a platelet-aggregation inhibitor from the thienopyridine group, has proven to be the most successful supplementary antiplatelet therapy. The increased usage of antiplatelet therapy translates to the fact that dentists are more likely to see an increased number of patients on this drug who seek dental treatment. Ageusia is a rare adverse reaction to clopidogrel that has not been reported on in the dental literature. The condition is often associated with an olfactory deficit, advancing age, and cerebrovascular disease; can reduce appetite for food, resulting in weight loss; and has been shown to increase anxiety and depression. Proper clinical investigation by a neurologist, dentist, and otorhinolaryngologist is therefore of particular importance when dealing with patients with taste disorders.

Cervicofacial actinomycosis: most common or second most common type of actinomycosis?

Mohammad Hasan Akhavan Karbasi, Fatemeh Owlia, Mahrooz Ershadi — 2012-03-05

We read with great interest the case report by Göçmen et al., introducing a cervicofacial actinomycosis (CFA) with the extraordinary thickness sinus tract. Their excellent operation was appreciable. In the abstract it was mentioned that CFA is the second most common type of actinomycosis; however in the following text it was noted that CFA is the most common type of actinomycosis. These 2 sentences as facts are paradoxically different. As far as we know, the most common type of actinomycosis is cervicofacial.

Cervicofacial actinomycosis: most common or second most common type of actinomycosis?

Gökhan Göçmen, Altan Varol, Kamil Göker, Selçuk Basa — 2012-05-01

We thank Dr. Karbasi et al. for their careful evaluation of our article. Although cervicofacial actinomycosis is the most common type of actinomycosis, as we wrote in the introduction, that phrase was overlooked in the abstract.

Erratum to: “Kaposi sarcoma: review and medical management update” [Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:2-16]

Mahnaz Fatahzadeh — 2012-03-14

In the above-mentioned article, printer's errors were introduced into . The corrected table appears below. Also, the author has noted that Table III entitled “Spectrum of therapeutic modalities for epidemic Kaposi sarcoma” includes a few references related to non-epidemic Kaposi sarcoma.

2012-05-01

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2012-05-01

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2012-05-01

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

Welcome newly graduated oral and maxillofacial surgeons

White lesion on the dorsum of tongue

New oral anticoagulants: will they replace warfarin?

Inadvertent injection of formalin mistaken for local anesthetic agent: report of a case

A comparative study of the effectiveness of sinus bone grafting with recombinant human bone morphogenetic protein 2–coated tricalcium phosphate and platelet-rich fibrin–mixed tricalcium phosphate in rabbits

Modified face-lift approach combined with a superficially anterior and superior-based sternocleidomastoid muscle flap in total parotidectomy

Histomorphometric examination of long-term changes in temporomandibular joints after mandibular lengthening by distraction osteogenesis in rabbits

Mandible reconstruction assisted by preoperative virtual surgical simulation

Intraorally exposed anterior Stafne bone defect: a case report

Clinical outcomes after the use of complete autologous oral mucosa equivalents: preliminary cases

Validation of the Bitestrip versus polysomnography in the diagnosis of patients with a clinical history of sleep bruxism

Effectiveness of antiviral agents for the prevention of recurrent herpes labialis: a systematic review and meta-analysis

Effect of salivary stimulation therapies on salivary flow and chemotherapy-induced mucositis: a preliminary study

Amlexanox is as effective as dexamethasone in topical treatment of erosive oral lichen planus: a short-term pilot study

Posttransplant lymphoproliferative disorder presenting as a nonhealing extraction socket: a case report and review of the literature

Acute gingival bleeding as a complication of falciparum malaria: a case report

Induction of apoptosis and up-regulation of cellular proliferation in oral leukoplakia cell lines inside electric field

Salivary adenocarcinoma, not otherwise specified: a clinicopathological study of 28 cases

Increased number of Langerhans cells in oral lichen planus and oral lichenoid lesions

Comparison of Ki-67, cyclin E, and p63 in benign and malignant human pleomorphic adenoma

Osteoplastic ameloblastoma: a case report and literature review

Bilateral maxillary duplication: case report and literature review

Computer-assisted orthognathic surgery: feasibility study using multiple CAD/CAM surgical splints

Multidetector computerized tomographic fistulography in the evaluation of congenital branchial cleft fistulae and sinuses

Mandibular cortical bone evaluation on cone beam computed tomography images of patients with bisphosphonate-related osteonecrosis of the jaw

Non-Hodgkin lymphoma involving the mandible: imaging findings

Evaluation of interproximal caries using the IPad 2 and a liquid crystal display monitor

Drug-related osteonecrosis of the jaws: “Exposure, or not exposure: that is the question”

Clopidogrel-induced ageusia: a possible overlooked etiology by dentists?

Cervicofacial actinomycosis: most common or second most common type of actinomycosis?

Cervicofacial actinomycosis: most common or second most common type of actinomycosis?

Erratum to: “Kaposi sarcoma: review and medical management update” [Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:2-16]

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