Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

2012-03-01

“Strength in Numbers”

Paul C. Edwards — 2012-03-01

“Strength in numbers”: a common cliché that admittedly is used all too often. But, excluding our oral and maxillofacial surgery colleagues, who number more than 9000 practitioners in the United States alone, those of us in the remaining 3 disciplines that fall under the umbrella of this journal's focus (oral and maxillofacial pathology, oral and maxillofacial radiology, and oral medicine) may be well-advised to ponder the potential implications of this phrase.

Clinicopathologic conference: Multiquadrant expansile fibro-osseous lesion in a juvenile

Vinay V. Kumar, Supriya Ebenezer, T.V. Narayan, Wilfried Wagner — 2012-03-01

This paper intends to present clinical, radiologic, and histopathologic features of a case of gigantiform cementoma manifesting in a 14-year-old boy, without any familial involvement. He has been followed for 3 years. Further cases from the literature have been reviewed that confirm a similar clinicopathologic picture. This is the first case report that describes “non-familial gigantiform cementoma” after the World Health Organisation's classification of 2005.

A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation

Göksel Şimşek Kaya, Günay Yapıcı Yavuz, Muhammed A. Sümbüllü, Ertunç Dayı — 2011-06-13

Objectives: This study compared the use of diode and Er:YAG lasers in treating gingival melanin pigmentation (GMP) in terms of gingival depigmentation, local anesthesia requirements, postoperative pain/discomfort, depigmentation effectiveness, and total treatment duration. Study Design: Twenty patients (13 female, 7 male) referred with GMP were enrolled in the study. Patients were randomly divided into 2 groups. Group 1 was treated with a gallium aluminum arsenide diode laser with a continuous wavelength of 808 nm, and group 2 was treated with an Er:YAG laser with a continuous wavelength of 2,940 nm. Gingival depigmentation was performed by applying the laser at 1 W. Treatment was administered on a weekly basis until a normal pink gingival color was observable in clinical examination and photographs. In addition, patients were asked to evaluate the procedure by using a self-administered questionnaire. Results: Procedures were carried out without the need for any topical or local anesthetic, and no unpleasant events occurred during the actual procedure or the healing period. The total length of treatment was significantly shorter with the diode laser (group 1) than with the Er:YAG laser (group 2; P < .05). No melanin recurrence was detected during any follow-up session. Conclusions: Diode and Er:YAG lasers administered at 1 W both result in satisfactory depigmentation of GMP.

A preliminary study on the hard-soft tissue relationships among unoperated secondary unilateral cleft nose deformities

Jingtao Li, Bing Shi, Kun Liu, Qian Zheng — 2011-06-13

Objective: The aim of this study was to explore the bone–soft tissue relationships around the nasolabial area in uncorrected secondary unilateral cleft nose deformities. Study Design: Measurements taken from photographs and cone-beam computerized tomography (CBCT) results were derived and paired up to represent the deformity features of bone and soft tissue, respectively. Results: All soft tissue measurements were significantly smaller than the corresponding bone measurements. Various bone–soft tissue correlation patterns were observed in different measurement pairs. Conclusions: The adopted photography-CBCT combined measurement method appeared to be reliable in evaluating the hard-soft tissue relationships in the nasolabial area. In unoperated unilateral cleft nose deformities, bony deformities would decide the soft tissue contours, and soft tissue in turn could camouflage the underlying bone deformities in various patterns and scale, making the external configuration less deformed than its bone basis.

Evaluation in vitro of the tensile strength of crimpable hooks used for stabilization in orthognathic surgery

2011-06-13

Objective: The aim of this study was to evaluate the tensile strength of crimpable hooks used for arch stabilization in orthognatic surgery. Study Design: Ninety stainless steel wire (0.019“ × 0.026”) segments, each measuring 6 cm long, were used and attached to crimpable hooks of different commercial brands. Six groups were formed (n = 10) denominated as follows: control, in which the wire segments were perpendicularly welded by spot welding machine; and the hooks groups M (Morelli), MS (Morelli with weld), TP (TP Ortho), TPS (TP with weld), TPTg (TP-tungsten), TPTgS (TP-tungsten with weld), AO (American Orthodontics), and AOS (American Orthodontics with weld). The test specimen topography was evaluated by scanning electron microscopy before and after the tensile strength tests. After obtaining the results, the analysis of variance and Kruskal-Wallis multiple-comparison tests were applied. Results: Compared with the control group, the AOS ball hooks and those from TPS required a greater amount of force to be displaced along the rectangular arch. The hooks in group M were significantly easier to displace, followed by those from AO. Conclusions: The best ball hooks for clinical application are those from AOS and TPS.

Osteoblast response to porous titanium surfaces coated with zinc-substituted hydroxyapatite

Fan Yang, Wen-jing Dong, Fu-ming He, Xiao-xiang Wang, Shi-fang Zhao, Guo-li Yang — 2011-06-13

Background: The aims of this study were to deposit a zinc-hydroxyapatite (Zn-HA) coating on titanium surfaces by using the electrochemical process and investigate the cell response to the Zn-HA–coated titanium surface. Study Design: Surface characteristics were evaluated by scanning electron microscopy (SEM) and inductively coupled plasma atomic emission spectroscopy (ICP-AES). Murine preosteoblast cell (MC3T3-E1) proliferation, alkaline phosphatase (ALP) activity, and osteocalcin release on Zn-HA–coated surfaces were compared with HA-coated surfaces. Results: Field-emission SEM observation showed rod-like HA crystals with a hexagonal cross-section on the HA-coated surface, although the hexagon of the cross-section of Zn-HA crystals became irregular. ICP-AES analysis showed that Zn was present in the Zn-HA coatings at a Zn/(Ca+Zn) molar ratio of 1.04%. Significant increases in cell proliferation, ALP activity on day 7, and osteocalcin produnction on day 14 (P < .05) were observed for Zn2+-containing HA-coated surfaces. Conclusions: The present study showed that a Zn-HA coating deposited by using the electrochemical process enhances proliferation and differentiation of osteoblasts, which has the potential benefit to enhance implant osseointegration.

Morphofunctional analysis of sciatic nerve and motor performance of rats after cryotherapy with liquid nitrogen

2011-06-20

Objective: This work evaluated sciatic nerve regeneration after cryotherapy. Study design: Rats underwent surgical access of the sciatic nerve and subsequent cryotherapy, crush lesion, or no manipulation. Walking-track, electroneuromyographic, and histomorphometric analyses were performed at 15, 30, and 70 postoperative days. Results: At 15 days, the crush and cryotherapy groups showed significant morphofunctional impairment. At 30 days, functional loss was significant in the walking-track, but at 70 days, there were no significant differences between the groups. Amplitude was near zero for the crush group at 15 and 30 days and zero for the cryotherapy group. Measurement of latency was not possible in the latter group. Crush and cryotherapy groups showed greater amounts of myelinated fibers (by 30 days), with axonal diameter and width of the myelin sheath being less than in control group. Conclusions: Sciatic nerve lesion by application of liquid nitrogen is classified as axonotmesis, which is reversible.

Repair of calvarial defects in rabbits with platelet-rich plasma as the scaffold for carrying bone marrow stromal cells

Zhi-qing Jiang, Huan-ye Liu, Li-ping Zhang, Zhi-qiang Wu, De-zhi Shang — 2011-06-20

Objective: Platelet-rich plasma (PRP) is becoming a new application in tissue engineering and a developing area for clinicians and researchers because it is a natural source of growth factors, many of which can accelerate and promote bone regeneration. However, few studies have reported the potentiality of using PRP as a scaffold in bone tissue engineering. The present study investigated the feasibility of using PRP as a scaffold to carry bone marrow stromal cells (BMSCs) to repair calvarial defects in a rabbit model. Study Design: The primary cultured BMSCs were divided into 2 groups. One group was induced with dexamethasone and the other was not induced. Full-thickness bone defects of 5-mm diameter (4 defects per calvarium) were created on the calvaria of 10 New Zealand white rabbits. PRP or whole blood was used, respectively to incorporate the induced or uninduced BMSCs. Then, the composites were activated and applied to repair the defects. The samples were harvested 8 weeks later and bone regeneration was assessed grossly and analyzed by radiographic or histologic examination. Results: Eight weeks after the implantation of the materials, substantial bone regeneration was observed at the calvarial defect restored with PRP incorporating the induced BMSCs. Less new bone formation was observed at the defect implanted with PRP incorporating the uninduced BMSCs. In contrast, no bone regeneration was detected at the defects implanted with the whole blood incorporating BMSCs, whether the BMSCs were induced or not. Conclusions: PRP can be used as a scaffold to carry in vitro expanded BMSCs to repair a rabbit's calvarial defect, but its inductive ability to BMSCs was limited.

Sihler-stain study of buccal nerve distribution and its clinical implications

Hun-Mu Yang, Sung-Yoon Won, Jae-Gi Lee, Seung-Ho Han, Hee-Jin Kim, Kyung-Seok Hu — 2011-06-20

Objective: The aim of this study was to elucidate the precise distribution of the buccal nerve (BN) and its anatomic relationship with the infraorbital nerve (ION) and mental nerve (MN). Study Design: Eight human specimens were subjected to Sihler staining, which is a highly accurate method for visualizing the distribution of nerve fibers without alteration of the nerve. Results: It was found that the BN mainly proceeded medially from its point of entrance near the parotid duct opening to the angular area of mouth, giving off tiny branches along its trajectory. Some of these branches were distributed in upper angular area, over the cheilion, intermingling with branches of the ION. Intermingling of the BN and the MN was also observed in the premolar area of the lower lip. Conclusions: This new information regarding the distribution of BN should be taken into consideration when evaluating the possible effects of BN damage.

Local treatment of chronic osteomyelitis with surgical debridement and tigecycline-impregnated calcium hydroxyapatite: an experimental study

2011-06-20

Objective: The aim of this study was to determine the efficacy of tigecycline-impregnated hydroxyapatite in the local treatment of chronic osteomyelitis experimentally induced in rat tibias with methicillin-resistant Staphylococcus aureus. Study Design: Monocortical defects were established in the left tibias of 32 adult Wistar albino rats. Five rats were randomly selected and injected intramedullarly with saline solution (group 1), whereas chronic osteomyelitis was induced in other rats by intramedullary injection of S. aureus. Infected rats were then randomized and divided into 4 groups: group 2, no further treatment; group 3, debridement only; group 4, debridement followed by implantation of calcium hydroxyapatite; and group 5, debridement followed by implantation of tigecycline-impregnated calcium hydroxyapatite. On day 21 after induction, all rats in groups 2-5 showed signs of osteomyelitis. Rats in groups 1 and 2 were killed on day 21 after induction, whereas rats in groups 3, 4, and 5 underwent debridement surgery on day 21 after induction and were killed 21 days after debridement surgery. Tibias were analyzed histopathologically and cultured for S. aureus. Results: Compared with group 2, histopathologic disease severity scores in groups 3, 4, and 5 were 37%, 44%, and 83% lower, respectively. Nontreated infected rats had the highest bacteria count (mean 5 × 105 colony-forming units/g bone), and bacterial count was 26%, 29%, and 79% lower in groups 3, 4, and 5, respectively, compared with group 2. Conclusions: Tigecycline-impregnated hydroxyapatite can have a potential in the treatment of chronic osteomyelitis of methicillin-resistant S. aureus origin, which may be considered as a therapeutic alternative by surgeons dealing with osteomyelitis.

Comparative study of hydroxyapatite from eggshells and synthetic hydroxyapatite for bone regeneration

Sang-Woon Lee, Seong-Gon Kim, Csaba Balázsi, Weon-Sik Chae, Hee-Ok Lee — 2011-06-22

Objectives: The objective of this study was to evaluate the physical properties of synthetic hydroxyapatite (sHA) and hydroxyapatite from eggshells (eHA) by Fourier-transform infrared (FT-IR) and x-ray diffraction (XRD) and to compare the regenerative ability of the bone using sHA and eHA in a rabbit calvarial defect model. Study Design: FT-IR and XRD were used to compare the physical properties of sHA and eHA. sHA was purchased from Sigma, and eHA was kindly donated from the Hungarian academy of science. Sixteen New Zealand white rabbits were used for the animal study. After the formation of a bilateral parietal bony defect (diameter 8.0 mm), either sHA or eHA was grafted into the defect. The defect in the control was left unfilled. Bone regeneration was evaluated by histomorphometry at 4 and 8 weeks after the operation. Results: The peak broadening of the XRD experiments were in agreement with scanning electron microscope observation; the sHA had a smaller granule size than the eHA. The eHA had impurities phases of CaO (International Center for Diffraction Data (ICDD) 075-0264) and Ca(OH)2 (ICDD 072-0156). Total new bone was 17.11 ± 10.24% in the control group, 28.81 ± 12.63% in sHA group, and 25.68 ± 10.89% in eHA group at 4 weeks after the operation. The difference was not statistically significant (P > .05). Total new bone at 8 weeks after the operation was 27.50 ± 10.89% in the control group, 38.62 ± 17.42% in sHA group, and 41.99 ± 8.44% in the eHA group. When comparing the sHA group to the control group, the difference was not statistically significant (P > .05). However, the eHA group was significantly different from the control group (P = .038). When comparing the eHA group to the sHA group, the difference was not statistically significant (P > .05). Conclusions: Both types of HA showed higher bone formation than the unfilled control. However, eHA had significantly higher bone formation than the unfilled control at 8 weeks after operation.

CAD/CAM and rapid prototyped titanium for reconstruction of ramus defect and condylar fracture caused by mandibular reduction

Guosong Wang, Jihua Li, Ashish Khadka, Yuchun Hsu, Wenyang Li, Jing Hu — 2011-06-20

Fracture or defect of the mandible is a serious complication of mandibular angleplasty, and precise reconstruction for such defect is still a huge challenge. This case report provides a new method based on CAD/CAM and rapid prototyped titanium for individual design, fabrication, and implantation of a mandibular ramus and angle. A 25-year-old woman with a square-shaped face, who had undergone mandibular outer cortex split ostectomy (MOCSO) 3 months earlier, was afflicted by a series of symptoms: asymmetric face, collapse of the right face, masticatory problems, deviation during mouth opening, malocclusion, and TMJ clicks. These symptoms were caused by unintentional removal of the fractured ramus during MOCSO. By means of CT scan data, rapid prototyping, reverse engineering, 3D display, and CAD/CAM, the individualized titanium implant was designed and fabricated. The 3D demo system of operative scheme demonstrated the operative procedure, and determined the position of the implant so as to obtain a perfect fit. Postoperatively, the patient regained satisfactory morphologic symmetry, facial appearance, occlusion, and TMJ functions.

Sunitinib related osteonecrosis of jaw: a case report

Yoram Fleissig, Eran Regev, Hadas Lehman — 2012-01-04

A 58-year-old woman presented to the Oral and Maxillofacial Surgery Clinic experiencing severe limited mouth opening and exposed bone in the socket of the right mandibular third molar 8 months following the extraction of the tooth. The patient had been treated during the year before her presentation with sunitinib, an antiangiogenic drug, for renal cell carcinoma. The clinical, radiographic, and histologic picture of a chronic nonhealing extraction socket was consistent with osteonecrosis of the jaw (ONJ), although she had never been treated with bisphosphonates or corticosteroids. The treatment with sunitinib was discontinued and the patient was treated with antibiotics and physiotherapy for 12 weeks with complete recovery. Sunitinib may cause osteonecrosis of the jaw after oral surgical interventions with no previous exposure to bisphosphonates. The pathogenesis may be related to its antiangiogenic mechanism and impaired wound healing. Full recovery may require long-term cessation of the insulting drug combined with prolonged antibiotic treatment.

A new submerged split-thickness skin graft technique to rebuild peri-implant keratinized soft tissue in composite flap reconstructed mandible or maxilla

Wei Fang, Wei Ma, Wei-guang Ma, De-hua Li, Bao-lin Liu — 2012-01-04

Objective: The objective of this study was to introduce our preliminary experience on a submerged split-thickness skin graft (STSG) technique combined with secondary vestibuloplasty to rebuild keratinized peri-implant soft tissue and oral vestibule for patients with large oromandibular defects reconstructed by composite flaps. Patients and Methods: Five patients were enrolled in this study. Stage 1 was submerged STSG and simultaneous implant placement. Stage 2 was the uncovering of the STSG and vestibuloplasty. The implant-borne fixed denture was inserted after this 2-stage treatment. All patients were followed for at least 12 months (average 18 months). Result: Eighteen implants were placed. The rebuilt peri-implant keratinized soft tissue was healthy clinically. The STSG graft had firm adherence to the underlying periosteum. The vestibule had adequate depth to maintain local hygiene. All implants were osseointegrated and all implant-borne prostheses were functioning well. Conclusion: Submerged STSG technique combined with secondary vestibuloplasty may become a feasible and effective solution to rebuild keratinized soft tissue before dental implant restoration.

Lingual nerve deficit following mandibular third molar removal: Review of the literature and medicolegal considerations

Paolo Boffano, Fabio Roccia, Cesare Gallesio — 2012-03-01

The removal of mandibular third molars is probably the most frequently performed procedure in oral and maxillofacial surgery, and it is the most common surgical procedure associated with lingual nerve deficit. Lingual sensory impairment remains a clinical problem in oral and maxillofacial surgery and has serious medical and legal implications. In fact, damage to the lingual nerve is a common cause of litigation in dentistry. The purpose of this article was to review the literature about lingual nerve deficit following mandibular third molar removal and discuss the associated medicolegal aspects.

A new approach for atraumatic implant explantation and immediate implant installation

Eduardo Anitua, Gorka Orive — 2012-03-01

Objective: This study reports a new approach for implant extraction in a convenient, fast, and atraumatic way and allowing a new implant placement at same surgical time. Study Design: The Biotechnology Institute extraction kit consists of a wrench that allows a 200 N-cm countertorque force, an internal connection extractor, an extractor for external connection, and a set of ratchet handle extension pieces. In this study, a total of 91 implants installed in 42 patients were explanted. Results: Extraction torques ranged from 80 to 200 N-cm. In those cases in which implant removal torques exceeded 200 N-cm, a 2–3-mm depth incision was done using a set of atraumatic trephines to avoid too high countertorque forces. Conclusions: The possibility of extracting osseointegrated implants opens new doors in oral implantology. The extraction kit allows dentists to re-treat cases and improve the final results, achieving the best outcomes for patients.

Recombinant human nerve growth factor (rhNGF-β) gene transfer promotes regeneration of crush-injured mental nerve in rats

2012-03-01

Objective: The aim of this study was to evaluate whether the recombinant human nerve growth factor (rhNGF-β) gene transfer at a crush-injured sensory nerve can enhance nerve regeneration. Study Design: A 4-mm crush injury was made on the mental nerve of mandible in rats, and rhNGF-β adenovirus (6 μL, concentration = 1.0 × 1011 pfu/μL) was injected at the crushed site for the experimental group (NGF-Ad group, n = 15) and the same volume of PBS for the controls (PBS group, n = 15). A sham group of uninjured nerve was also used for the normal control (Sham group, n = 15). The effect of rhNGF-β adenovirus injection was evaluated by real-time reverse trascriptase polymerase chain reaction for the quantification of nerve growth factor (NGF), low-affinity NGF receptor (p75NTR), and its tyrosine receptor kinase A (trkA) mRNA expression at the trigeminal ganglion (TG) 5 days after injection. Nerve regeneration was evaluated with sensory test, retrograde axonal transport in the TG, and histomorphometric study for 4 weeks. Results: NGF, p75NTR, and trkA mRNA expression was significantly increased at the TG 5 days after injection of rhNGF-β adenovirus (P < .05). The NGF-Ad group showed improved sensory recovery (P < .05), and the number of retrograde-labeled sensory neurons and soma size of TG were larger compared with the PBS groups (P < .05). Histomorphometrically, the myelinated axon number, myelin thickness, and G-ratio in the NGF-Ad group was also significantly higher than the PBS groups (P < .05). Conclusions: Recombinant human nerve growth factor gene transfer promoted regeneration of crush-injured mental nerve.

Clinical study of the relationship between implant stability measurements using Periotest and Osstell mentor and bone quality assessment

Ji-Su Oh, Su-Gwan Kim — 2012-03-01

Objectives: The purpose of this study was to evaluate the relationship between subjective bone quality assessments and objective implant stability values using Periotest and Osstell Mentor, which are widely used clinically, to assess the correlation between these 2 measurements. Study Design: A total of 211 dental implants (114 in the maxilla and 97 in the mandible) were placed in 162 patients (89 males and 73 females). Bone quality type was classified according to the Lekholm and Zarb classification. After implant placement, implant stability was measured using Periotest and Osstell Mentor. Implant stability was represented by the implant stability quotient (ISQ) values and periotest values (PTVs). All of the procedures were performed by 1 operator to reduce potential errors. Results: The ISQ values were higher in the mandible (72.77 ± 8.77) than in the maxilla (65.72 ± 8.65), whereas PTVs were lower in the mandible (−3.02 ± 2.63) than in the maxilla (−0.17 ± 2.82). A statistically significant correlation was found between bone quality type and both ISQ values and PTVs. A significant negative correlation was found between the ISQ values and PTVs (P < .01). Conclusion: Both measurements seem to be useful in predicting implant placement prognosis and in determining loading protocols.

Osteochondroma of the temporomandibular joint: report of 2 cases emphasizing the importance of personalizing the surgical treatment

2012-03-01

Background: Osteochondromas (OCs) are rare in the craneofacial area (0.6%). We present 2 cases of OC of the mandibular condyle, emphasizing the surgical decision of each case. Case 1: In a 48-year-old woman with facial asymmetry, left cross-bite, and mandible deviation to the left, a computerized tomographic (CT) scan confirmed the presence of a bony expansion of the right condyle. The clinical diagnosis was osteochondroma. The patient underwent condylectomy with costochondral reconstruction. Case 2: In a 76-year-old woman with a 1-month history of right preauricular pain, CT showed a deformed right condyle with a bony mass at the base of the temporal bone and the articular fossa. OC of the skull base was diagnosed, with possibly a concurrent lesion of the condyle. The patient underwent condylectomy with the removal of the skull base mass and an inmediate TMJ reconstruction by means of an appropriately sized stock total TMJ prosthesis. Conclusions: It is necessary to personalize the temporomandibular joint reconstructive options.

Effect of thin nano-hydroxyapatite coating on implant osseointegration in ovariectomized rats

Zhipeng Cheng, Caihong Guo, Wenjing Dong, Fu-ming He, Shi-fang Zhao, Gui-li Yang — 2012-03-01

Purpose: The purpose of this study was to investigate the effect of the thin nano-hydroxyapatite (nano-HA) coating on implant osseointegration in an ovariectomized rat model. Materials and Methods: Implants were divided into a control group and a test group (nano-HA–coated group). Surface morphology was examined using field-emission scanning electron microscopy (FSEM). Surface roughness of both groups was performed. Sixteen ovariectomized rats randomly received 2 implants in both tibiae. After 12 weeks of implantation, tibias were retrieved and prepared for histomorphometric evaluation and removal torque tests (RTQ). Results: Rodlike crystals uniformly covered the porous surfaces and the surface morphology of the implant was still clear. No significant differences were found in surface roughness between the 2 groups (P > .05). More bone tissue was formed around test implants compared with control implants. Test implants showed a significantly greater BIC, bone area within all threads, and RTQ values compared with control implants (P < .05). Conclusions: These results indicate the thin nano-HA coating by an electrochemical process has potential benefits to enhance implant osseointegration in ovariectomized rats.

Increased risk of mortality and loss to follow-up among HIV-positive patients with oropharyngeal candidiasis and malnutrition before antiretroviral therapy initiation: a retrospective analysis from a large urban cohort in Johannesburg, South Africa

Denise Evans, Mhairi Maskew, Ian Sanne — 2012-03-01

Objective: We investigated the effect of oropharyngeal candidiasis (OC) and body mass index (BMI) before antiretroviral therapy (ART) initiation on treatment outcomes of human immunodeficiency virus (HIV)–positive patients. Study Design: Treatment outcomes included failure to increase CD4 count by ≥50 or ≥100 cells/μL or failure to suppress viral load (<400 copies/mL) at 6 or 12 months in addition to loss to follow-up (LTFU) and mortality by 12 months. Risk and hazard ratios (HRs) were estimated with the use of log-binomial regression and Cox proportional hazards models, respectively. Results: Baseline CD4 <100 cells/μL, low BMI (<18.5 kg/m2), low hemoglobin, and elevated aspartate transaminase were associated with OC at ART initiation. Patients with low BMI with and without, respectively, OC were at risk of mortality (HR 2.42, 95% CI 1.88-3.12; HR 1.87, 95% CI 1.54-2.28) and LTFU (HR 1.36, 95% CI 1.02-1.82; HR 1.55, 95% CI 1.30-1.85). Conclusions: Low BMI (with/without OC) at ART initiation was associated with poor treatment outcomes. Conversely, normal BMI with OC was associated with adequate CD4 response and reduced LTFU compared with without OC.

Effect of an herbal compound for treatment of burning mouth syndrome: randomized, controlled, double-blind clinical trial

2012-03-01

Objective: This randomized, double-blind, placebo-controlled clinical study aimed at evaluating the effect of the systemic use of an herbal compound (Catuama) on the symptoms of burning mouth syndrome (BMS). Study Design: Seventy-two patients with BMS were randomly allocated into test (n = 38) and control (n = 34) groups. Patients were instructed to take 2 capsules each day for 8 weeks. They were reassessed at 4, 8, and 12 weeks after treatment onset using a faces scale (FS) and a visual numeric scale (VNS). Results: Although both groups demonstrated a reduction in symptoms, the improvement observed in the test group was significantly greater than in the control group after 4 (FS: P = .010) and 8 (VNS: P = .03; FS: P < .001) weeks of treatment. This significant reduction was maintained 12 weeks after treatment onset (FS, VNS: P = .001). Conclusions: The systemic administration of Catuama reduces the symptoms of BMS and may be a novel therapeutic strategy for the treatment of this disease.

Differential collagenolytic activity of Candida albicans isolated from oral mucosa and dentinal carious lesions of HIV-infected children

2012-03-01

Objective: The aim of this study was to compare type I collagen degradation by Candida albicans isolated from oral mucosa (M) and cavitated active dentinal caries (CAD) of HIV-infected children. Study Design: To verify the proteolytic activity, the specimens were cultivated in brain-heart infusion medium and the supernatants were incubated in the presence or absence of type I collagen at 37°C for 12 hours and analyzed using 10% sodium dodecyl sulfate–polyacrylamide gel electrophoresis. Intensity of the bands on the gels was assessed by densitometric analysis using a scanner and images analyzed with software from Kodak Digital Science EDAS 120. Results: Supernatants of all the C. albicans degraded type I collagen: that from M, on average, by 38.3% (SD 21.67) and that from CAD by 54% (SD 25.94; Wilcoxon test: P < .05). Predisposing factors had no association with the percentage of type I collagen degradation (Mann-Whitney test: P > .05). Conclusions: Candida albicans from different sites of the oral cavity of HIV-infected children has proteolytic activity for type I collagen.

Localized mandibular enlargement in end-stage renal disease: two case reports and a review of the literature

2011-08-17

Enlargement of the jaws is an infrequently reported complication of chronic kidney disease mineral and bone disorder (CKD-MBD). Two cases of localized mandibular swellings in young patients with histories of end-stage renal disease are discussed with a review of the literature. Although 17 of the first 19 cases that were reported exhibited diffuse enlargement, these reports increase the number of localized swellings to 8 and support the contention that localized expansion of the jaws as a manifestation of CKD-MBD is more common than originally recognized.

A comparative study of microvessel density in squamous cell carcinoma of the oral cavity and lip

2012-03-01

Objectives: The objective of this study was to comparatively evaluate the density of lymphatic vessels (LVD) and neoformed microvessels (NMVD) in squamous cell carcinoma of the oral cavity (OCSCC) and lip (LSCC). Association between LVD/NMVD and vascular endothelial growth factor (VEGF)-A/-C was also assessed. Study Design: OCSCC and LSCC were compared with regard to immunoexpression of LVD, NMVD, and vascular endothelial growth factor-A (VEGF)-A/-C. Association between VEGF-A/-C with vascularity was also assessed. Statistical analyses were performed using t test, Pearson χ2, and Mann-Whitney tests. Statistical significance was accepted at P less than .05. Results: The NMVD and VEGF-C expressions were significantly higher in OCSCC compared with LSCC. NMVD was associated with VEGF-C in OCSCC, but not in LSCC. Conclusions: Differences in NMVD and VEGF-C were found between OCSCC and LSCC. Positive association between VEGF-C and NMVD was observed in OCSCC, but not in LSCC, which may be one of the contributing factors that account for the distinctive clinical-biological behavior of these lesions.

Tetraploidy with double t(11;18) of recurrent MALT lymphoma in buccal mucosa: a case report

Toshiaki Tanaka, Kenichirou Kitabatake, Mituyoshi Iino, Kaoru Goto — 2012-03-01

Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of an extranodal marginal zone B-cell lymphoma that accounts for about 5% to 8% of all B-cell lymphomas. It is rare for a recurrent oral MALT lymphoma to have tetraploidy with a double t(11;18) chromosomal abnormality, however. A 66-year-old Japanese woman with a swelling of the right buccal mucosa was referred to our hospital. A tumor was excised, and a pathologic diagnosis of MALT lymphoma with a t(11;18) (q21; q21) chromosome translocation was made. Two years later, swelling of the right buccal mucosa recurred, which was then excised and pathologically diagnosed as MALT lymphoma. This tumor did not have a t(11;18) (q21; q21) chromosome translocation, but exhibited tetraploidy with double t(11;18). FISH analysis revealed that the recurrent MALT lymphoma of the buccal mucosa had tetraploidy with double t(11;18). This is the first reported case of a recurrent MALT lymphoma showing tetraploidy with double t(11;18).

Unusually severe limitation of the jaw attributable to fibrodysplasia ossificans progressiva: a case report with cone-beam computed tomography findings

Kaan Orhan, Lokman Onur Uyanık, Erkan Erkmen, Yeliz Kilinc — 2011-06-13

Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary connective tissue disease characterized by the progressive ectopic ossification of ligaments, tendons, and facial and skeletal muscles throughout life. Symptoms begin in childhood as localized soft tissue swellings. Immobility and articular dysfunction appear with involvement of the spine and proximal extremities. The temporomandibular joint (TMJ) is a critical component involved in the maxillofacial region, resulting in severe limitation of masticatory function, although TMJ involvement is rare. We report a case of FOP presenting as severely limited TMJ movements owing to ectopic calcification of the left coronoid process. In addition to the clinical examination, panoramic radiography and cone-beam computed tomography images were obtained. The case is presented and the clinical and imaging findings, differential diagnosis, and treatment modalities are discussed.

Unusual cone-beam computerized tomography presentation of traumatic (simple) bone cyst: case report and radiographic analysis

Reji Mathew, Galal Omami, Dennis Gianoli, Alan Lurie — 2011-08-29

Traumatic (simple) bone cyst (TBC) is an empty nonepithelial-lined cavity of the jaws. The majority of TBCs are located in the body or symphysis of the mandible. Clinically, the lesion is asymptomatic and often discovered incidentally on routine radiographic examination as a noncorticated sharply defined radiolucent area with undulating borders. Because tissues for histologic examination may be scant or nonexistent, the definite diagnosis is invariably achieved during surgery when the lesion is empty. In this report, we present a case of unusual bilateral synchronous TBCs of the mandible with possible traumatic etiology, featuring significant buccolingual expansion of the mandibular ramus and body, presence of septa, and probable displacement of the inferior alveolar canal.

Calcifying cystic odontogenic tumor associated with other lesions: case report with cone-beam computed tomography findings

Jira Chindasombatjaroen, Sopee Poomsawat, Boworn Klongnoi — 2012-03-01

The calcifying cystic odontogenic tumor (CCOT) simultaneously occurring with other lesions at different locations in the same patient is rare. We report a patient with CCOT associated with an odontoma, a supernumerary tooth, and a dentigerous cyst simultaneously occurring in the maxilla. Cone-beam computed tomography (CBCT) images showed a well-defined expansile lesion with internal calcification, high-density masses surrounded by low-density area, and a supernumerary tooth at the anterior maxilla. Posterolaterally to these lesions, an embedded canine with pericoronal radiolucency was detected. Histopathologic examination revealed a CCOT associated with an odontoma, a supernumerary tooth, and a dentigerous cyst of the embedded canine. Enucleation was performed, and a 2-year postoperative follow-up was uneventful. CBCT was useful in giving the differential diagnosis by depicting internal calcification of CCOT, and in revealing the extent and complex relationship of these lesions.

No plane is the best one—the volume is!

2011-08-29

We thank you for your contribution and your interesting thoughts. We certainly agree that our article does not provide a comparison between panoramic radiographs and computerized tomography; however, this was not our intention. The intent was “to describe and estimate the frequencies of anatomic variations of lower third molars in patients with panoramic findings at high risk for IAN injury after surgical removal of the tooth,” as was stated in the introduction section. We obviously agree that we did not state the type of planes used for data analysis. This is because we strongly believe that fixed planes of whatever orientation are no longer state-of-the-art for 3-dimensional (3D) image analysis. The person judging the situation should always have full access to the volume dataset itself and should interactively reconstruct planes as he or she needs for optimal visualization. This, of course, includes transaxial/dental scan planes, if needed. Anything less than that is unacceptable. However, if one has to choose a single reconstruction plane, e.g., for methodical reasons, we have had our best experience with an oblique orientation, as recently described in a more technical paper.

Comment on surgical management of solitary venous malformation in the midcheek region

Jia Wei Zheng — 2012-03-01

I read the article “Surgical management of solitary venous malformation in the midcheek region” published in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics on August 18, 2011, with great interest. I agree that surgical excision is a good treatment option for venous malformations in the head and neck; however, surgical management is not the treatment of choice, especially for the so-called “solitary venous malformation” and for young patients who care much for their appearance.

Comment on surgical management of solitary venous malformation in the midcheek region: reply

Lai-ping Zhong, Li-zhen Wang — 2012-03-01

Generally, for most venous malformations, especially diffuse venous malformations, surgery is not the only choice of treatment, and we agree that sclerotherapy could be used as the first choice under most conditions, and surgery sometimes could be used to improve the result. For the solitary venous malformation in the midcheek region, however, based on our prognostic result, we suggest surgery as the choice of treatment.

Should pain be used as predictor of prognosis in oral squamous cell carcinomas?

Hitesh Shoor, Sunil Mutalik, Keerthilatha M. Pai — 2012-03-01

We read the article titled “Pain may predict poor prognosis in patients with oral squamous cell carcinoma” by Jun Sato et al. with great interest. The efforts of the authors to study such a correlation are commendable. However, there are several concerns that need clarifications from authors. Pain is a subjective symptom, and threshold of pain varies from one individual to other, as the authors highlighted in their discussion. However, in our experience, many patients who have oral squamous cell carcinoma deny the presence of pain, which makes it difficult to correlate pain with prognosis. In addition, pain due to secondary infection in malignant lesions was not addressed in the article. It is not clear in the article as to why only 42% of the patients were available for follow-up at the end of 5 years. Finally, it would be interesting to know if the sites of malignancy had any effect on prognosis.

Should pain be used as predictor of prognosis in oral squamous cell carcinomas

2012-03-01

We thank you for your interest in our paper entitled “Pain may predict prognosis in patients with oral squamous cell carcinoma” published in OOOO. So, we are answering your concerns.

2012-03-01

Society Page

2012-03-01

Information for Readers

2012-03-01

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

“Strength in Numbers”

Clinicopathologic conference: Multiquadrant expansile fibro-osseous lesion in a juvenile

A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation

A preliminary study on the hard-soft tissue relationships among unoperated secondary unilateral cleft nose deformities

Evaluation in vitro of the tensile strength of crimpable hooks used for stabilization in orthognathic surgery

Osteoblast response to porous titanium surfaces coated with zinc-substituted hydroxyapatite

Morphofunctional analysis of sciatic nerve and motor performance of rats after cryotherapy with liquid nitrogen

Repair of calvarial defects in rabbits with platelet-rich plasma as the scaffold for carrying bone marrow stromal cells

Sihler-stain study of buccal nerve distribution and its clinical implications

Local treatment of chronic osteomyelitis with surgical debridement and tigecycline-impregnated calcium hydroxyapatite: an experimental study

Comparative study of hydroxyapatite from eggshells and synthetic hydroxyapatite for bone regeneration

CAD/CAM and rapid prototyped titanium for reconstruction of ramus defect and condylar fracture caused by mandibular reduction

Sunitinib related osteonecrosis of jaw: a case report

A new submerged split-thickness skin graft technique to rebuild peri-implant keratinized soft tissue in composite flap reconstructed mandible or maxilla

Lingual nerve deficit following mandibular third molar removal: Review of the literature and medicolegal considerations

A new approach for atraumatic implant explantation and immediate implant installation

Recombinant human nerve growth factor (rhNGF-β) gene transfer promotes regeneration of crush-injured mental nerve in rats

Clinical study of the relationship between implant stability measurements using Periotest and Osstell mentor and bone quality assessment

Osteochondroma of the temporomandibular joint: report of 2 cases emphasizing the importance of personalizing the surgical treatment

Effect of thin nano-hydroxyapatite coating on implant osseointegration in ovariectomized rats

Increased risk of mortality and loss to follow-up among HIV-positive patients with oropharyngeal candidiasis and malnutrition before antiretroviral therapy initiation: a retrospective analysis from a large urban cohort in Johannesburg, South Africa

Effect of an herbal compound for treatment of burning mouth syndrome: randomized, controlled, double-blind clinical trial

Differential collagenolytic activity of Candida albicans isolated from oral mucosa and dentinal carious lesions of HIV-infected children

Localized mandibular enlargement in end-stage renal disease: two case reports and a review of the literature

A comparative study of microvessel density in squamous cell carcinoma of the oral cavity and lip

Tetraploidy with double t(11;18) of recurrent MALT lymphoma in buccal mucosa: a case report

Unusually severe limitation of the jaw attributable to fibrodysplasia ossificans progressiva: a case report with cone-beam computed tomography findings

Unusual cone-beam computerized tomography presentation of traumatic (simple) bone cyst: case report and radiographic analysis

Calcifying cystic odontogenic tumor associated with other lesions: case report with cone-beam computed tomography findings

No plane is the best one—the volume is!

Comment on surgical management of solitary venous malformation in the midcheek region

Comment on surgical management of solitary venous malformation in the midcheek region: reply

Should pain be used as predictor of prognosis in oral squamous cell carcinomas?

Should pain be used as predictor of prognosis in oral squamous cell carcinomas

Contents

Society Page

Information for Readers