Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

2012-02-01

Impact versus impact factor and Eigenfactor

Craig S. Miller — 2012-02-01

At this year's editors' meeting, we discussed the Journal's most recent impact factor calculated by Journal Citation Reports. The Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology's (OOOO's) impact factor (1.5) is relatively similar to the prior 2 years. We all agreed that this score is worth improving for many reasons, including the obvious- that better articles are theoretically submitted to journals with higher impact factors. In fact, the editors mentioned that authors often relate that they would like to submit their findings to OOOO, but they need to submit their research findings to a journal with a higher impact factor. This interpretation of the impact factor has the potential for misplaced value, however, as the impact factor is only one measure of the standing of a title. Another important value is clinical utility.

Evaluation of anatomy of impacted third molars: is 3-dimensional imaging always a necessity?

Sunil Mutalik, Anindita Saha, Keerthilatha M. Pai — 2011-08-29

We keenly assessed this interesting article by Heinz-Theo Lübbers et al. on the indication of 3-dimensional imaging in the evaluation of anatomy of impacted third molars. We greatly appreciate the efforts of the authors in publishing this extensive study. However, in the methodology the authors have not provided any direct comparison between the anatomy of the impacted third molars as visualized in the panoramic radiographs and the computed tomography (CT) sections. Because of this, the benefit of 3-dimensional imaging cannot be clearly appreciated by the readers. Moreover, the article fails to elucidate whether dental CT software was used for assessing medical CT scans. As it is important to highlight that although axial CT scans and reformatted coronal scans permit reasonable evaluation of the anatomy of impacted teeth, they do not clearly demonstrate the craniocaudal and bucco-lingual distances, nor the possible contact with the inferior alveolar nerve or resorption of the adjacent teeth in an exact proportion.

Bleed or die? A bloody simple decision

Michael J. Wahl — 2011-10-19

Thank you for an interesting article in the December 2010 issue. But Dr. Balevi makes a fatal error when he asserts that those who recommend continuing warfarin for dental extractions do so “despite the fact that there has been no reported case of a dental extraction causing a cardiovascular accident (CVA) in a patient whose warfarin was temporarily discontinued.”

Evidence does not support the discontinuation of warfarin before a dental extraction

Craig S. Miller — 2011-08-29

In the December 2010 issue of OOOOE, Dr. Balevi is to be commended for addressing the issue of whether warfarin should be discontinued before a dental extraction using decision-tree analyses (DTA). However, in my opinion, the data are inherently flawed, and the conclusion and recommendations are therefore not justified. Let's consider the errors.

Should warfarin be discontinued before a dental extraction?

Rajesh V. Lalla, Douglas E. Peterson, Doron J. Aframian — 2011-10-28

We read with interest the article by Dr. Balevi titled “Should warfarin be discontinued before a dental extraction? A decision-tree analysis.” We appreciate the author's application of this quantitative approach to a common clinical dilemma; however, we would like to address selected issues noted in the article in the context of World Workshop on Oral Medicine (WWOM) IV guidelines that we authored and that were cited in the article by Dr. Balevi.

Should warfarin be discontinued before a dental extraction?

Ben Balevi — 2011-10-28

I appreciate the interest in my article and Dr Miller's thoughtful comments. For the sake of concision and clarity, I am responding to all of them in one letter. Decision tree analysis (DTA) is a systematic and quantitative approach to making clinical decisions in a world of uncertainty and choices. Its probabilistic model is typically judged on 2 aspects: if the structure of the decision tree accurately describes the clinical scenario, and if the sensitivity analysis accurately reflects the consequences of the decision in a world of imperfect information. DTA is meant to guide patient care, not direct it; thus, my analysis does not call for a dogmatic recommendation to withhold warfarin before all dental extractions. It merely represents a best estimate of the possible outcomes of different courses of action.

True or false facial artery aneurysm

Emil Dediol — 2011-09-21

I read with great interest an article by Ribeiro-Ribeiro et al about facial artery pseudoanuerysm after a stabbing incident. It is a classic example of facial artery aneurysm regarding etiology, presentation, and management, although from the presented article one cannot be sure whether it is a true or false aneurysm. Namely, the diagnosis of an aneurysm is clinical (history, bruit, pulsations), radiological (Doppler ultrasound and computed tomography [CT] angiography), and pathohistological. Doppler ultrasound and CT angiography usually show a dilated cavity with turbulent blood flow and trombothic masses inside. Neither one of these 2 methods can with 100% certainty differentiate a true from false aneurysm. Pathohistology confirms the clinical and radiologic diagnosis and distinguishes true from false aneurysm. As we all know, and as it is stated in the article itself, pseudoaneurysm is a result of a partial transection of the vessel wall and its wall consists of just perivascular fibrous tissue. True aneurysm can be of traumatic origin as well, but its wall consists of all 3 vessel wall layers (intima, media, and adventitia). This last step in the diagnostic procedure is missing in the presented case, as the aneurysm was only ligated and not extirpated and sent for pathohistologic examination. This distinction from the clinical point of view would not make a difference; management remains the same whether it was a true or false anuerysm.

True or false facial artery aneurysm—reply

André Luis Ribeiro Ribeiro, Sérgio de Melo Alves, João de Jesus Viana Pinheiro — 2011-10-28

We thank Dr. Emil Dediol for his interest in the subject and especially in our article, “Traumatic pseudoaneurysm of the facial artery: late complication and effects on local blood flow.” We agree that histopathological examination is important in the diagnostic conclusion, but when indicated. We present a case of pseudoaneurysm (PA) of the facial artery in which there was a late complication with wound dehiscence and exposure of clot. After ligature of the proximal segment of the artery, the main blood supply to the PA, the next rational step would be to remove the clot and explore the wound. At this point, the surrounding tissue that formed the aneurysmic sac was suggestive of a connective tissue that was poorly defined, with no cyst wall being identified that could be dissected and removed. Any attempt to remove part of the lesion wall for histopathological examination would lead to increased surgical trauma, without any advantage for the treatment.

Cobalt-based dental alloy, allergy to cobalt, and palmoplantar pustulosis

Paolo D. Pigatto, Gianpaolo Guzzi — 2012-02-01

Song et al., in their case report, documented the first observations of idiopathic palmoplantar pustulosis (PPP) due to cobalt allergy released from dental crowns. Because we have long been interested in skin diseases associated with dental alloy restorations, we would like to emphasize 2 points about this case study. It would have been interesting if the authors had included mercury compound allergens for screening for contact allergy to dental amalgam, because mercury has been associated with PPP. There is evidence that PPP is a chronic inflammatory disease of the skin, in which inflammation is driven by leukocyte infiltration with associated pustular lesions caused and/or exacerbated by metals. In this regard, it is well known that mercury-containing dental amalgam filling releases elemental mercury (Hg°) that may induce systemic adverse events or contact dermatitis. Furthermore, mercury dental amalgam contains trace amounts of metallic cobalt, ∼0.8 μg/g. In light of these considerations, could the authors clarify whether the patient had mercury dental amalgam fillings? Considering that PPP has been associated with active smoking history, it would also be interesting to know whether the patient was a current or a former cigarette smoker.

Cobalt-based dental alloy, allergy to cobalt, and palmoplantar pustulosis—reply

Hong Song, Qin Ma, Yin Wen — 2012-02-01

Thank you for allowing us to respond to the Letter to the Editor appearing in this journal. The writers' suggestion regarding the potential relationship between tobacco smoking and palmoplantar pustulosis (PPP) is reasonable. The patient was a cigarette smoker for >20 years. However, he could not recall any hypersensitivity reactions or symptoms of PPP during that 20-year history of smoking. He ceased smoking because it was suggested that he take some traditional Chinese medicine prescribed by his physician; however, the symptoms of PPP were not eliminated until the chromium-cobalt alloy casting crowns were removed. The patient had no mercury dental amalgam restorations in his oral cavity. Therefore, we think the findings suggest that the cobalt in the alloy casting crowns is most likely related to the PPP in this case.

Oncolytic viruses: a new paradigm for treatment of head and neck cancer

John Bryan Lott — 2011-08-22

Head and neck squamous cell carcinoma (HNSCC) continues to be the sixth leading cause of cancer. Tumor recurrences affect 40%-50% of HNSCC patients owing to field cancerization. Many new molecular markers have been studied to reveal the true extent of oral cancer, and the molecular mechanisms that trigger development of primary and secondary recurrences are being uncovered. Clinically, however, little has changed in the past decades to improve survival and quality of life. Targeted oncolytic viruses may be a treatment that can improve morbidity and mortality of HNSCC. Viruses, such as adenovirus, are engineered to take advantage of the loss of p53 function and/or regulation that is common in most tumors. Furthermore, these oncolytic viruses can produce cytokines that assist in destroying malignant tissue. HNSCC may be the inaugural target of this new treatment modality.

Slow-growing gingival mass

2012-02-01

Objectives: A 33-year-old woman presented with a slow growing palatal gingival mass. The clinical differential diagnosis included benign tumors and tumor-like lesions, including the pyogenic granuloma, peripheral giant cell granuloma, peripheral ossifying fibroma, giant cell fibroma, peripheral odontogenic tumors, and oral focal mucinosis. Study design: The lesion was excised and histopathological examination followed by immunohistochemical staining was carried out. Results: The microscopic findings and the immunohistochemical reactivity was diagnostic for a nerve sheath myxoma. Conclusions: The clinical features, microscopic findings, immunohistochemistry, and the differential diagnosis including the relationship to the neurothekeoma are discussed.

Retrospective analysis of 314 orbital fractures

Pablo Rosado, Juan C. de Vicente — 2011-04-20

Objective: The aim of this study was to retrospectively review the orbital fractures treated at our institution, especially epidemiologic aspects, treatment options, and postoperative sequelae. Study Design: Three hundred fourteen patients with orbital fractures treated at the Department of Oral and Maxillofacial Surgery of the Central University Hospital in Asturias (Spain) between 2000 and 2006 were retrospectively reviewed. The patients were evaluated by age, gender, etiology, diagnostic tools, fracture pattern, treatment, and complications. Results: The most common causes of injury were motor vehicle accidents (29.6%), followed by falls (27.4%). Men in the sixth decade were most affected. One hundred forty-four patients (46%) underwent internal fixation with titanium miniplates, and 17 (5.4%) required orbit floor implants. The most frequent sequelae were infraorbital nerve hypoesthesia (24.5%), enophthalmos (3.8%), and diplopia (2.2%). Conclusions: In our area of 1 million inhabitants, falls are the second cause of orbital fractures, which can be attributed to the large aged population. Postoperative complications cannot be definitely evaluated until a few months after the surgery.

Sympathetic ophthalmia: a review of literature

2011-04-18

Sympathetic ophthalmia (SO), also known assympathetic uveitis, is a rare bilateral granulomatous panuveitis that occurs after a penetrating injury to an eye. After injuryfrom either surgery or accident, a variable period of time passes before a sight-threatening inflammation develops in both the eyes. The disease usually responds rapidly to corticosteroid therapy, but recalcitrant cases may require the addition of other immunosuppressive agents. A severely injured eye with no prognosis for vision should be enucleated within 2 weeks of injury to prevent SO. The purpose of this article is to highlight the risks of SO associated with the orbital fractures involving soft tissue components of the orbit. Though unusual, a maxillofacial surgeon, while operating on the orbital walls involving the soft tissue disruption, has to be aware of this condition so that the postoperative complications related to vision can be avoided.

A new coronal scalp technique to treat craniofacial fracture: The supratemporalis approach

Wen Luo, Li Wang, Wei Jing, Xiaohui Zheng, Jie Long, Weidong Tian, Lei Liu — 2011-04-20

Objective: A new coronal scalp approach, denoted as the supratemporalis approach, was designed to address facial nerve injury induced by the traditional coronal scalp approach. Study Design: First, the complication rate among 38 cases operated upon with the traditional coronal scalp approach was analyzed retrospectively. Then 40 cases were operated upon using the supratemporalis approach. The rate of complications was recorded. The follow-up periods were 3-17 months. Results: The facial contours and functions recovered well after the operation in all 78 cases. Seven cases of facial nerve injury, 1 of which was permanent, were observed in the group treated with the traditional coronal scalp approach. No case of facial nerve injury was observed in the group treated with the supratemporalis approach. Conclusions: The supratemporalis approach prevented facial nerve injury and did not increase the frequency of other complications. It is therefore worthy of application in the clinical setting.

Distraction osteogenesis in the dog mandible under 60-Gy irradiation

Yuxiao Liu, Guicai Liu, Jianli Xu, Guoxiong Zhu, Zhaoling Wang, Yanpu Liu — 2011-04-20

Objective: The objective of this study was to explore the probability of distraction osteogenesis (DO) in the irradiated dog mandible after 60-Gy irradiation. Study Design: Fourteen Chinese dogs were randomly divided into 2 groups. Twelve dogs received a preoperative unilateral irradiation from 60Co (group R) in the mandible with a total dose of 24.8 Gy in four 6.2-Gy fractions (biologically equivalent to 60 Gy/25 fractions). The other 2 dogs without irradiation served as the control (group C). Bilateral corticotomies were made 6 months after completion of irradiation. Bone distraction was activated at a rate of 0.5 mm twice daily for 10 days after a 1-week latency period, followed by a consolidation phase of 8 weeks. The inferior alveolar nerve (IAN) underwent electrophysiologic analysis. Dog mandibles were subsequently subjected to histologic and radiographic analysis. Results: All the animals had successful distractions. After 8 weeks of consolidation, no difference was found between the percentage area of new bone in both groups. New bone was more mature and organized in group C than in group R. The action potential of IAN showed corresponding alternation during the irradiation and distraction process. Conclusions: Based on this study it seems that DO may be feasible in dog mandible under 60-Gy irradiation. Further research is indicated.

Improved sedation for dental extraction by using video eyewear in conjunction with nitrous oxide: a randomized, controlled, cross-over clinical trial

2011-04-20

Objective: The purpose of this study was to investigate the effect of a portable video eyewear entertainment system used in conjunction with nitrous oxide/oxygen sedation during the removal of impacted lower third molars. Study Design: Thirty-eight patients had their bilateral third molars removed under local anesthesia and nitrous oxide/oxygen inhalation sedation in 2 visits. On one side, video eyewear was used (group NE). On the other side, the tooth was removed without the use of video eyewear (group N). Vital signs were monitored. Overall behavior and the outcome of treatment were assessed. Results: All 38 patients completed the study. The mean scores on behavior rating in group NE were significantly higher than those in group N (P < .05). The majority of patients (92.1%) preferred nitrous oxide with video eyewear. Conclusions: The use of video eyewear appeared to augment the effectiveness of nitrous oxide sedation in dental extraction patients.

Virtual model surgery and wafer fabrication using 2-dimensional cephalograms, 3-dimensional virtual dental models, and stereolithographic technology

Jin-Young Choi, Jong-Min Hwang, Seung-Hak Baek — 2011-04-18

Although several 3-dimensional virtual model surgery (3D- VMS) programs have been introduced to reduce time-consuming manual laboratory steps and potential errors, these programs still require 3D-computed tomography (3D-CT) data and involve complex computerized maneuvers. Because it is difficult to take 3D-CTs for all cases, a new VMS program using 2D lateral and posteroanterior cephalograms and 3D virtual dental models (2.5D-VMS program; 3Txer version 2.5, Orapix, Seoul, Korea) has recently been introduced. The purposes of this article were to present the methodology of the 2.5D-VMS program and to verify the accuracy of intermediate surgical wafers fabricated with the stereolithographic technique. Two cases successfully treated using the 2.5D-VMS program are presented. There was no significant difference in the position of upper dentition after surgical movement between 2.5D-VMS and 3D-VMS in 18 samples (less than 0.10 mm, P > .05, Wilcoxon-signed rank test). The 2.5D-VMS can be regarded as an effective alternative for 3D-VMS for cases in which 3D-CT data are not available.

Complications in endoscopic-assisted open reduction and internal fixation of mandibular condyle fractures

Sang-Hoon Kang, Eun-Joo Choi, Hyun-Woo Kim, Hyung-Jun Kim, In-Ho Cha, Woong Nam — 2011-05-05

Endoscopic-assisted open reduction and internal fixation (EAORIF) of subcondylar fractures is minimally invasive, provides excellent visibility without a large incision, and reduces surgical scarring and the risk of facial nerve injury. This study evaluated the complications associated with EAORIF. Twenty-six patients underwent EAORIF for mandibular condyle fractures. The postoperative follow-up period was longer than 6 months. We analyzed associations between the complication incidence and the number of fixation plates, accompanying mandibular fractures, and age. Eighteen (69.2%) and 6 (23.1%) patients had temporary (<3 months after surgery) and long-term (>6 months after surgery) complications, respectively. Patients older than 30 years had complications more frequently than those younger than 30 years. Complication rates were similar for different numbers of fixation plates and among patients with and without accompanying mandibular fractures. EAORIF is a reliable technique for treating condylar fractures, regardless of patient age, number of fixation plates, or accompanying mandibular fractures. However, improvements are needed to reduce long-term complications.

Management of 112 Hospitalized Patients with Spreading Odontogenic Infections: Correlation with DMFT and Oral Health Impact Profile 14 Indexes

2011-05-03

Objective: The aim of this study was to report our experience in treating patients affected by spreading odontogenic infections and to discuss their management and outcome. Study Design: Demographic and clinical information was collected from hospitalized patient records. Decayed, missing, and filled teeth (DMFT) index was calculated for 45 randomly selected patients. Statistical analysis was used to search for associations among multiple variables. Results: Statistical analysis of the variance by univariate test found significant associations between a longer hospital stay and patients >30 years old (P < .05) and patients with the presenting symptoms of dysphagia and/or dyspnea (P < .05). Statistical analysis using Fisher exact test found significant associations between patients with a DMFT index >10 and female patients (P < .05), patients >30 years old (P < .005), and a hospital stay >4 days (P < .0005). Conclusions: Rapid resolution of the infection was appreciated when removal of the cause, drainage of the infection, and intravenous antibiotics were performed.

Intraoperative Biopsy of the Major Cranial Nerves in the Surgical Strategy for Adenoid Cystic Carcinoma Close to the Skull Base

2011-05-09

Objective: Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base. Study Design: During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection. Results: The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve–negative and without infiltration of the skull base (P = .001). Conclusions: Our study shows that local control of disease for patients who are named nerve–positive with skull base infiltration is significantly more complex compared with patients who are named nerve–negative without infiltration of the skull base.

The impacted maxillary canine: a proposed classification for surgical exposure

Andrew R. Chapokas, Khalid Almas, Gian-Pietro Schincaglia — 2011-05-23

Objective: One of the treatment options for the impacted maxillary canine is surgical exposure followed by orthodontic forced eruption. Several surgical techniques have been introduced in the literature for the exposure of the impacted canine. The aim of this study was to review the current literature and to introduce a classification for maxillary canine impactions that includes guidelines for selecting the proper surgical approach. Methods: Epidemiology of canine impaction, diagnosis, and surgical options for the exposure of an impacted maxillary canine are discussed based on the current literature. Results: Careful clinical examination and proper diagnostic imaging should be used to define the anatomical position of the impacted canine. The surgical approach for exposure of impacted maxillary canines should consider the anatomical position of the tooth in relation to the alveolar ridge and the amount of keratinized mucosa/gingiva. Conclusions: The proposed clinical classification provides a structured approach to treatment based on impacted tooth location and anatomical factors.

Facial necrotizing fasciitis from an odontogenic infection

Sunil Yadav, Ajay Verma, Akash Sachdeva — 2012-02-01

Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. It is a rare but life-threatening infection characterized by a progressive, usually rapid, necrotizing process of the subcutaneous tissues and fascial planes. The condition is commonly described in the extremities, abdominal wall, and perineum but rarely seen in the head and neck. The diagnosis of NF depends mainly on clinical features, which are not always observable, so that the disease is often diagnosed late in its course, resulting in high mortality. Broad-spectrum antibiotics, aggressive surgical treatment and supportive therapy are the most widely accepted modalities of successful treatment. We describe a case of necrotizing fasciitis of the head and neck, arising from odontogenic origin.

Cracks in dentin and enamel after cryopreservation

2012-02-01

Objective: The objective of this study was to investigate if cryopreservation of teeth for long-term storage leads to cracks in enamel and dentin. Study Design: Three teeth, which were extracted for orthodontic reasons, were cryopreserved in liquid nitrogen (temperature –196°C) and thawed according to standard protocols after 4 months. Micro computed tomography using synchrotron radiation was performed to detect cracks in the tooth hard tissues. Results: Cracks were found in the enamel of all teeth, which are associated with forceps application during extraction. Cracks with a width larger than 0.8 μm were not identified in dentin and cementum. Conclusion: Although cryopreservation of teeth according to the standard protocol does not generate cracks more than 0.8 μm wide, the use of forceps can result in prominent cracks.

Pseudotumor of hemophilia in the mandible of a patient with hemophilia A

Roger R. Throndson, David Baker, Patrick Kennedy, Keith McDaniel — 2011-11-30

Hemophilic pseudotumor is a rare lesion that is essentially a progressive, slowly expanding, encapsulated hematoma. It is estimated to affect 1% to 2% of severe hemophiliacs. The majority of hemophilic pseudotumors occur within soft tissues (intramuscular) and long bones of adult males. Fewer than 20 cases have been reported in the maxillofacial region. We report a rare case occurring in the mandible of a 14-year-old boy who presented with considerable expansion and displacement of teeth.

Gingival bleeding and jaw bone necrosis in patients with metastatic renal cell carcinoma receiving sunitinib: Report of 2 cases with clinical implications

2012-02-01

There is emerging evidence that oral mucositis/stomatitis is a common adverse effect of sunitininb antiangiogenic therapy in patients with metastatic renal cell carcinoma (mRCC). In addition, a case of sunitinib-related jaw osteonecrosis was recently described. We report on 2 patients with mRCC treated with sunitinib. The first patient, a 19-year-old woman, treated with cisplatin and sunitinib, presented with oral pain, malodor, spontaneous and continuous gingival bleeding, and painful necrotic ulcerations clinically resembling necrotizing ulcerative gingivitis (NUG). Suntinib-related stomatitis and bleeding were considered cumulative to NUG symptoms. The second patient, a 64-year-old woman, treated with sunitinib only, complained of mandibular pain. Sunitinib-related jaw osteonecrosis was diagnosed. Gingival bleeding and soft tissue necrosis, as well as jaw osteonecrosis may develop as adverse events of sunitinib use. Antiangiogenic therapies are increasingly used in the treatment of cancers. The presented cases are aimed to alert health care professionals on adverse oral events.

Adhesion molecule L1 is down-regulated in malignant peripheral nerve sheath tumors versus benign neurofibromatosis type 1–associated tumors

2011-08-12

Type 1 neurofibromatosis (NF-1), also known as von Recklinghausen disease, is caused by a disorder of a single gene on chromosome 17 that usually restrains cell division. A sequence that is frequently associated with NF-1 is tumor progression from neurofibromas to malignant peripheral nerve sheath tumors (MPNSTs). The aim of this study was to determine the expression of the neural L1 cell adhesion molecule in dermal-diffuse neurofibromas, plexiform neurofibromas, and MPNSTs of NF-1. We retrospectively analyzed surgically resected primary tumors, including 20 dermal neurofibromas, 23 plexiform neurofibromas, and 17 MPNSTs, by immunohistochemistry in paraffin sections of NF-1 tumors with the use of the L1-specific monoclonal antibody UJ127, which does not cross-react with other members of the L1 family. Immunostainings for CD34 and S100 were included to distinguish and allocate L1-expressing Schwann cells and perineural (specialized) fibroblasts. Our data showed that L1 is highly expressed in all benign NF-1 tumors and in some but not all MPNSTs. Furthermore, we demonstrated a correlation between L1 expression and differentiation grade of MPNSTs. There was a significant trend toward lower or nondetectable expression in the poorly differentiated MPNSTs, in contrast to all other tumor entities so far investigated, in which L1 expression correlated positive with malignancy, except for juvenile but not adult-derived neuroblastomas. Future studies are warranted to elucidate the molecular basis of the varying effects of the degree of L1 expression, receptor, and signal transduction mechanisms in different tumors.

Increased expression of CK8 and CK18 in leukoplakia, oral submucous fibrosis, and oral squamous cell carcinoma: An immunohistochemistry study

Kanwar Deep Singh Nanda, Kanan Ranganathan, Uma Devi, Elizabeth Joshua — 2011-08-29

Objective: Oral squamous cell carcinoma (OSCC) may be preceded by potentially malignant disorders such as leukoplakia and oral submucous fibrosis (OSF) and has a greater than normal risk of malignant transformation. Very little is known of cytokeratin (CK) alterations in OSF, leukoplakia, and OSCC. The aim of this study was to evaluate and compare the expression of CK8 and CK18 in normal oral mucosa, oral epithelial dysplasia, OSF, and OSCC by immunohistochemistry. Study Design: Paraffin-embedded normal (n = 10), dysplasia (n = 10), OSF (n = 10), and OSCC (n = 10) tissues were stained with CK8 and CK18 by immunohistochemistry. Results: Increased expression of CK8 and CK18 was seen in dysplasia, OSF, and OSCC. Staining pattern and intensity showed variations, with intensity of staining in basal and suprabasal layers for CK8 and CK18. Conclusions: Intensity of staining in the basal layer for CK18 was statistical significant, suggesting CK8 and CK18 as surrogate markers of malignant transformation.

Mucocutaneous dyskeratosis with periodontal destruction and premature tooth loss

2012-02-01

We report the case of a 16-month-old boy who presented an exuberant erythematous gingival swelling and severe tooth mobility. Radiographic examination confirmed alveolar bone loss, and gingival biopsy showed epithelium containing numerous dyskeratotic cells. Because of feeding difficulties, the enlarged gingival tissue and involved teeth were removed. One year later, similar problems were encountered during the eruption of the deciduous second molars. The patient also exhibited papular skin lesions. Histopathologic features on biopsies of the skin and oral lesions were similar. The oral and cutaneous lesions presented by this patient were similar to those described by From et al. in 1978 in a father and son, reported as dyskeratosis benigna intraepithelialis mucosae et cutis hereditaria—the sole report in the English language. To avoid confusion with hereditary benign intraepithelial dyskeratosis (Witkop–von Sallmann syndrome) we have renamed the condition as mucocutaneous dyskeratosis with periodontal destruction and tooth loss.

Three-dimensional assessment of impacted canines and root resorption using cone beam computed tomography

Snehlata Oberoi, Stephanie Knueppel — 2011-06-27

Objective: The objective of this study was to localize impacted canines in 3 dimensions and determine the most common location of impaction using cone beam computed tomography (CBCT). We also assessed root resorption of adjacent teeth. The cusp tip of each impacted canine was located and digitized using Dolphin 3D imaging, after viewing sagittal, coronal, and axial views. The position on the occlusal plane where the normally erupted canine cusp tip should be located was used as a control reference point. The degree of impaction was defined by the difference between the impacted canine cusp tip and reference cusp tip positions. Materials and Methods: CBCT scans of 29 consecutive individuals with impacted canines undergoing orthodontic treatment at the UCSF Orthodontic Clinic were included in this study. Results: The average degree of mesial impactions was 10.1 mm, of distal impactions was 4.2 mm, of facial impactions was 4.16 mm, of palatal impactions was 1.8 mm, and of gingival impactions was 10 mm; 40.4% had no root resorption, 35.7% showed slight root resorption, 14.2% showed moderate resorption, and 4% showed severe root resorption of the adjacent lateral incisor. Conclusion: We reliably assessed the position of impacted canines in 3 dimensions using CBCT, thereby improving accuracy of location and facilitating precise surgical and orthodontic management. In our study 40.4% had no root resorption, 35.7% showed slight root resorption, 14.2% showed moderate resorption, and 4% showed severe root resorption of the adjacent lateral incisor. The most frequent location of impacted canines was palatal, mesial, and gingival.

Clinical and radiological presentation of hemimaxillofacial dysplasia/segmental odontomaxillary dysplasia: critical analysis and report of a case

Silvina Friedlander-Barenboim, Kıvanç Kamburoğlu, Israel Kaffe — 2011-07-29

Objectives: The purpose of the present study was to critically evaluate the literature, describe the clinical and radiographic features of HD-SOD (hemimaxillofacial dysplasia/segmental odontomaxillary dysplasia), and describe one new case, involving a 12-year-old boy, with detailed radiological, clinical, and histologic characteristics. Methods: Thirty-six cases published between 1987 and 2010, together with the present case, were evaluated according to criteria that included gender, age, location of the lesion, findings, and symptoms. Results: We found that the lesion is discovered mainly in the first decade of life (71%), and has a male predilection (64%, 23/64). The maxillary alveolar process was affected unilaterally in all cases, with gingival and bone enlargement and facial asymmetry being constant findings. Missing premolars and skin manifestations were found to be common features. Conclusions: New case reports should include clinical, radiographic, and histologic findings; follow-up reports; and treatment protocols to improve dentist and parent information regarding HD.

Preoperative predictive model of cervical lymph node metastasis combining fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography findings and clinical factors in patients with oral or oropharyngeal squamous cell carcinoma

2012-02-01

Objective: This study aimed to construct a preoperative predictive model of cervical lymph node metastasis using fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography (18F-FDG PET/CT) findings in patients with oral or oropharyngeal squamous cell carcinoma (SCC). Study Design: Forty-nine such patients undergoing preoperative 18F-FDG PET/CT and neck dissection or lymph node biopsy were enrolled. Retrospective comparisons with spatial correlation between PET/CT and the anatomical sites based on histopathological examinations of surgical specimens were performed. We calculated a logistic regression model, including the SUVmax-related variable. Results: When using the optimal cutoff point criterion of probabilities calculated from the model that included either clinical factors and delayed-phase SUVmax ≥0.087 or clinical factors and maximum standardized uptake (SUV) increasing rate (SUV-IR) ≥ 0.100, it significantly increased the sensitivity, specificity, and accuracy (87.5%, 65.7%, and 75.2%, respectively). Conclusions: The use of predictive models that include clinical factors and delayed-phase SUVmax and SUV-IR improve preoperative nodal diagnosis.

2012-02-01

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2012-02-01

Information for Readers

2012-02-01

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

Editorial Board

Impact versus impact factor and Eigenfactor

Evaluation of anatomy of impacted third molars: is 3-dimensional imaging always a necessity?

Bleed or die? A bloody simple decision

Evidence does not support the discontinuation of warfarin before a dental extraction

Should warfarin be discontinued before a dental extraction?

Should warfarin be discontinued before a dental extraction?

True or false facial artery aneurysm

True or false facial artery aneurysm—reply

Cobalt-based dental alloy, allergy to cobalt, and palmoplantar pustulosis

Cobalt-based dental alloy, allergy to cobalt, and palmoplantar pustulosis—reply

Oncolytic viruses: a new paradigm for treatment of head and neck cancer

Slow-growing gingival mass

Retrospective analysis of 314 orbital fractures

Sympathetic ophthalmia: a review of literature

A new coronal scalp technique to treat craniofacial fracture: The supratemporalis approach

Distraction osteogenesis in the dog mandible under 60-Gy irradiation

Improved sedation for dental extraction by using video eyewear in conjunction with nitrous oxide: a randomized, controlled, cross-over clinical trial

Virtual model surgery and wafer fabrication using 2-dimensional cephalograms, 3-dimensional virtual dental models, and stereolithographic technology

Complications in endoscopic-assisted open reduction and internal fixation of mandibular condyle fractures

Management of 112 Hospitalized Patients with Spreading Odontogenic Infections: Correlation with DMFT and Oral Health Impact Profile 14 Indexes

Intraoperative Biopsy of the Major Cranial Nerves in the Surgical Strategy for Adenoid Cystic Carcinoma Close to the Skull Base

The impacted maxillary canine: a proposed classification for surgical exposure

Facial necrotizing fasciitis from an odontogenic infection

Cracks in dentin and enamel after cryopreservation

Pseudotumor of hemophilia in the mandible of a patient with hemophilia A

Gingival bleeding and jaw bone necrosis in patients with metastatic renal cell carcinoma receiving sunitinib: Report of 2 cases with clinical implications

Adhesion molecule L1 is down-regulated in malignant peripheral nerve sheath tumors versus benign neurofibromatosis type 1–associated tumors

Increased expression of CK8 and CK18 in leukoplakia, oral submucous fibrosis, and oral squamous cell carcinoma: An immunohistochemistry study

Mucocutaneous dyskeratosis with periodontal destruction and premature tooth loss

Three-dimensional assessment of impacted canines and root resorption using cone beam computed tomography

Clinical and radiological presentation of hemimaxillofacial dysplasia/segmental odontomaxillary dysplasia: critical analysis and report of a case

Preoperative predictive model of cervical lymph node metastasis combining fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography findings and clinical factors in patients with oral or oropharyngeal squamous cell carcinoma

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