Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology - Articles in Press

Seroprevalence of anti-HCV among patients with oral lichen planus in Southern Taiwan - Corrected Proof

Liang-Ho Lin, Shin-Yu Lu, Sheng-Nan Lu — 2010-01-25

A possible association between oral lichen planus (OLP) and hepatitis C virus (HCV) infection has been documented in certain populations such as Japan and Southern Europe; however, the issue remains controversial. The aim of this study was to investigate the prevalence of HCV antibodies among patients with OLP in Southern Taiwan, and to assess the possible association between OLP and HCV infection. All patients enrolled in the study sought care at a hospital dental clinic. Serum samples of 104 patients with OLP and 100 controls with healthy oral mucosa, whose age and gender were matched, were respectively screened for anti-HCV antibodies by the microparticle enzyme immunoassay (AxSYM HCV version 3.0). The prevalence of HCV infection was 22.1% in the study group (23 of 104 OLP patients) and 2% in the control group (2 of 100 control subjects) respectively (P < .001). Eleven of 23 HCV-infected OLP patients (47.8%) were unaware of their HCV infection status in the study. A positive association between OLP and HCV in Southern Taiwan exists, suggesting that routine HCV infection testing of patients with OLP in Southern Taiwan should be considered.

Clinical and radiologic findings of synovial chondromatosis affecting the temporomandibular joint - Corrected Proof

Juanhong Meng, Chuanbin Guo, Biao Yi, Yanping Zhao, Haiyan Luo, Xuchen Ma — 2010-01-25

Objectives: Our aim was to study the clinical and radiologic findings of synovial chondromatosis (SC) affecting the temporomandibular joint (TMJ) and provide references for diagnosis and treatment.Study design: Twenty patients confirmed as SC histopathologically were included in the investigation. Nineteen cases were treated with arthrotomy and 1 case with arthroscopy. The clinical manifestations, radiographic findings, histopathologic features, surgical treatment, and differential diagnosis were combined to study this disease. The SC features of TMJ on magnetic resonance (MR) images were summarized on proton density–weighted (PD) and T2-weighted images.Results: Synovial chondromatosis of TMJ occurred more often in women and on the right. Symptoms included preauricular pain, swelling, limitation of mouth opening, crepitations, and deviation on opening. The detection rate of calcified loose bodies was 30% on conventional radiographs and 53.3% on computerized tomography. Multiple small ring-like or tubular signals could be seen on PD and T2-weighted MR images. SC mainly affected the superior joint space; it could involve the inferior space when a perforated or deformed disc was present. SC could extend into intracranial fossa, infratemporal fossa, and lateral pytergoid muscle.Conclusions: The characteristic ring-like signals could be found on MR images of the patients with SC of TMJ. This lesion should be differentially diagnosed with TMJ disorders and preauricular masses. Considering its recurrence and the different behavior of SC in different patients, various treatment strategies should be considered.

A comparison of stresses in implantation for grafted and plate-and-screw mandible reconstruction - Corrected Proof

Tomohisa Nagasao, Junpei Miyamoto, Tamotsu Tamaki, Hiromasa Kawana — 2010-01-25

Objective: During oral rehabilitation by dental implantation for mandibles reconstructed with plate and screws, intensified stresses can develop at the implant-bone interfaces and fixation screw–bone interfaces that might cause complications at these interfaces. The present study aims to evaluate the stresses occurring at these sites using the finite element method.Study design: Ten computer-aided design models simulating 10 mandibles were produced and were termed normal models. Simulation surgery was performed on these normal models, where parts of the models were removed and replaced by fibula or reconstruction plates plus screws. Depending on the replaced part (body [B] or body and symphysis [BS]) and the reconstruction materials (fibula [Fib] or reconstruction plate [Plate]), the modified models were termed B-Fib, B-Plate, BS-Fib, and BS-Plate models, respectively. For each model, an implant was embedded in the first molar region. Stresses occurring at the implant-bone interfaces and fixation screw–bone interfaces on mastication were calculated using the finite element method and compared among the model groups.Results: The stresses at the implant-bone interfaces showed no statistically significant differences among the 5 model groups. With the B-Plate and BS-Plate models, stresses at the fixation screw–bone interfaces were nearly twice as intense as those at the implant-bone interfaces.Conclusion: If it is allowed that complication risks correlate with stresses, fixation screws are more subject to failure than implants in performing implantation for mandibles reconstructed with a plate and fixation screws. Therefore, the fixation screws deserve special attention in performing oral rehabilitation for such patients.

Risk factors associated with injury to the inferior alveolar and lingual nerves following third molar surgery—revisited - Corrected Proof

2010-01-25

Objective: Earlier reports, including a preliminary study within our unit, have shown that the surgeon's experience is one of the most influential factors in determining the likelihood of both permanent inferior alveolar nerve (IAN) and lingual nerve (LN) paresthesia, following third molar surgery. The effect of this and other factors influencing such prevalence are assessed in this study.Study design: This prospective study involved 3236 patients who underwent surgical removal of impacted third molars. Patients' demographics and radiological parameters were recorded along with the grade of the treating surgeon. The prevalence of inferior alveolar and lingual nerves paresthesia at 1 month, 6 months, and 18 to 24 months postoperatively were also traced.Results: At 1 month postoperatively, the incidence of IAN paresthesia was 1.5% and the LN was 1.8%. These figures decreased over time and 18 to 24 months postoperatively, the incidence of permanent dysfunction of the IAN was 0.6% and LN was 1.1%. With regard to inferior alveolar nerve paresthesia, risk factors included the patient's age (26-30 years), horizontally impacted teeth, close radiographic proximity to the inferior alveolar canal (IAC), and treatment by trainee surgeons. With regard to the lingual nerve, risk factors included male patients, distoangular impactions, close radiographic proximity to the IAC, and treatment by trainee surgeons.Conclusion: One of the main risk factors of developing permanent sensory dysfunction in the distribution of these nerves is related to the surgical skills/experience of the operator. Other factors are associated with the type of impaction and the radiographic proximity of the tooth to the inferior alveolar nerve. Such long-term complications can affect the patient's quality of life; the impact on profession, education, and research is unknown.

Comparison of the modified lateral orbitotomy approach and modified hemicoronal approach in the treatment of unstable malunions of zygomatic complex fractures - Corrected Proof

Viraj R. Kharkar, B.M. Rudagi, Rajshekhar Halli, Yogesh Kini — 2010-01-25

Objective: The objective of this study was to evaluate immediate and late postoperative complications in treating zygomatic complex fractures by 2 modified approaches; namely, the modified lateral orbitotomy approach and the modified hemicoronal approach.Study design: Twenty zygomatic complex fractures were treated, with 10 being treated with the modified lateral orbitotomy approach and the other 10 by the modified hemicoronal approach. Both groups were evaluated for postoperative complications, ie, hematoma, infection, swelling, and nerve injury. The incisions were also evaluated in all patients using clinical evaluation and visual analogue scales.Results: Patients in both groups had temporary facial nerve injury that was primarily related to retraction of the nerve. There were no hematomas observed in any of the groups. As compared to the modified lateral orbitotomy approach, swelling was observed on more occasions with the modified hemicoronal approach. Infection was not observed in any of the groups. As far as the esthetics in relation to the incision was concerned, the patients accepted the modified hemicoronal approach more strongly as compared with the modified lateral orbitotomy approach.Conclusion: The modified hemicoronal approach seems to be preferred to the modified lateral orbitotomy approach with respect to treating zygomatic complex fractures.

Transport dentoalveolar distraction osteogenesis–assisted rapid orthodontic canine retraction - Corrected Proof

Viraj R. Kharkar, S.M. Kotrashetti — 2010-01-25

Objective: A recent innovative use of distraction osteogenesis technique in the field of orthodontic tooth movement is the application of the principle of distraction to move individual tooth segments rapidly, thus reducing orthodontic treatment time.Study design: Twelve maxillary canine teeth were rapidly retracted using the concept of dentoalveolar distraction osteogenesis. They were evaluated for the time required to complete the retraction, canine tipping, anchorage loss, and root resorption using intraoral radiographs and lateral cephalograms. The vitality of the canine was also evaluated using an electric pulp tester.Results: Canines can be rapidly retracted by dentoalveolar distraction, and subsequently the total orthodontic treatment time can be reduced as described in this technique. The time taken is 12.5 ± 0.50 days with a minimal amount of tipping and acceptable amount of anchorage loss. All the teeth were vital with no evidence of root resorption.Conclusion: The concept of distraction osteogenesis for rapid orthodontic tooth movement is thought to be promising and feasible for clinical practice.

Assessment of the anterior maxilla in orthodontic patients using upper anterior occlusal radiographs and dental panoramic tomography: A comparison - Corrected Proof

Thomas Peter Witcher, Stephen Brand, James Robert Gwilliam, Fraser McDonald — 2010-01-25

Objective: The aim of this study was to establish if dental panoramic tomographic (DPT) radiographs provide a reliable means of assessing the anterior maxilla in new orthodontic patients.Study design: Two hundred fifty pairs of upper anterior occlusal (UAO) and DPT radiographs were randomly selected from the records of new orthodontic patients. Ten observers each rated 50 pairs of radiographs for specific risk factors as well as for a measure of adequacy. Correlations between the 2 radiograph types and inter/intraobserver reliability were computed using Cohen kappa test.Results: Intraobserver reliability was good for detection of impacted teeth/supernumeraries/periapical pathology (κ = 0.711-1.0). Reliability was more variable for the specific root morphologies, with blunt and bent roots being reassessed as such most reliably (κ = 0.259-0.533). There was low interobserver reliability (κ = 0.327 for UAO and κ = 0.223 for DPT) for “normal” or “not normal” root morphology. For every variable, however, the interexaminer agreement was higher when using UAO radiographs rather than DPTs. Observers were best able to agree on the diagnosis of eroded/resorbed roots on the UAO (κ = 0.402) and blunt roots (κ = 0.303) on the DPT radiographs. With UAO as the gold (reference) standard for grading root morphology, DPT had a sensitivity of 45.6% and a specificity of 71.4% for detecting abnormal root form. Risk factors were more likely to be detected on the UAO radiographs than the DPTs. DPTs had a poor ability to detect abnormal root form. DPTs were more likely to be rated as “inadequate” than UAO radiographs. On 6 occasions, supernumerary teeth that were observed on the UAO were missed on the DPT.Conclusion: The DPT is not an accurate means of screening the anterior maxilla prior to orthodontic treatment.

Resection and immediate reconstruction of a pediatric vascular malformation in the mandible: Case report - Corrected Proof

Jonathan W. Shum, Lewis Clayman — 2010-01-25

Arteriovenous malformations (AVMs) within the mandible are rare and potentially life-threatening conditions that can pose a therapeutic dilemma. We present the case of a child with significant spontaneous gingival bleeding, radiographic evidence of a space-occupying lesion of the mandible, and delayed diagnosis and treatment because of parental reluctance to accept invasive treatment. Imaging studies and intravascular embolization with coils limited, but did not stop blood flow to this lesion. Resection of the mandible was the definitive treatment. The AVM was removed from the resected segment and the bone was replaced as a free graft, thereby avoiding a second site morbidity. Two years after surgery the replaced segment was well consolidated with moderate vertical resorption-remodeling.

Diagnostic accuracy of proximal caries by digital radiographs: An in vivo and in vitro comparative study - Corrected Proof

Gang Li, Xin-min Qu, Yan Chen, Jie Zhang, Zu-yan Zhang, Xu-chen Ma — 2010-01-25

Objectives: The aim of this study was to evaluate if the diagnostic accuracy of proximal dental caries in digital radiographs was similar when obtained in in vivo and in vitro conditions.Study design: Thirty-nine noncavitated teeth were collected from 11 subjects who had part of upper or lower jaws excised owing to cyst or neoplasm. Before operation, radiographs of the teeth involved were taken with the digital imaging system Digora Optime (Soredex, Helsinki, Finland), and after operation, the same extracted teeth were mounted in plaster blocks and exposed with the same digital imaging system. The teeth were subsequently sectioned for histologic validation of the lesions. Six observers evaluated all of the radiographs according to a 5-category scale. Receiver operating characteristic analysis was performed. Repeated-measure analysis of variance was used for the statistical analysis.Results: There were no significant differences between digital radiographs taken in in vivo and in vitro conditions for diagnosis of proximal dental caries (P = .286).Conclusion: Detection accuracy of proximal dental caries obtained from an in vitro study can be considered to be representative of diagnostic accuracy of proximal dental caries obtained in the real clinical situation.

Radiographic quantification of chronic dental infection and its relationship to the atherosclerotic process in the carotid arteries - Corrected Proof

Arthur H. Friedlander, Eric C. Sung, Evelyn M. Chung, Neal R. Garrett — 2010-01-25

Background: Atherosclerosis may be initiated/accelerated by chronic dental infection (CDI). Noninvasively visualizing the carotid arteries is an accepted surrogate marker for determining coronary artery atherosclerosis (CAA). We hypothesized that 36 individuals with radiographic carotid atheromas would have more radiographic CDI than risk-matched individuals without atheromas.Methods: We determined the arithmetic sum of individuals' periapical and furcal lesions, pericoronitis sites, carious roots, teeth with pulpal caries, and vertical bony defects (>4 mm).Results: Individuals with atheromas had a significantly (P < .01) greater mean score of 15.5 ± 10.4 compared with control subjects (7.9 ± 8.1). Similarly significant (P < .05) was the difference in the mean numbers of mesial and distal vertical bony defects in the atheroma group (4.1 ± 3.9 and 4.8 ± 3.8, respectively) compared with control subjects (1.6 ± 2.4 and 1.8 ± 2.7, respectively).Conclusions: Individuals with atheromas on their radiographs (and high probability of CAA) had significantly greater amounts of CDI than individuals without atheromas.

Parathyroid hormone–related peptide (PTHrP), parathyroid hormone/parathyroid hormone–related peptide receptor 1 (PTHR1), and MSX1 protein are expressed in central and peripheral giant cell granulomas of the jaws - Corrected Proof

2010-01-11

Objective: Parathyroid hormone–related peptide (PTHrP) binds to the parathyroid hormone receptor type 1 (PTHR1), which results in the activation of pathways in osteoblasts that promote osteoclastogenesis through the RANK/RANKL system. RANK/RANKL expression has been shown in central giant cell granuloma of the jaws but PTHrP/PTHR1 has not. MSX1 protein is a classical transcription regulator which promotes cell proliferation and inhibits cell differentiation by inhibiting master genes in tissues such as bone and muscle. It has been implicated in the pathogenesis of cherubism, and its expression has been reported in a single central giant cell granuloma (CGCG) case. We aimed, therefore, to study the expression of those proteins by the different cellular populations of central and peripheral giant cell granulomas (PGCGs) of the jaws.Study design: Twenty cases of CGCG and 20 cases of PGCG of the jaws were retrospectively examined by immunohistochemistry for the percentage of positively staining cells to antibodies for PTHrP, PTHR1, and MSX1, using a semiquantitative method.Results: In both CGCG and PGCG of the jaws, PTHrP and PTHR1 were abundantly expressed by type I multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) with vesicular nuclei, whereas type II MGC and MSC with pyknotic nuclei expressed those proteins to a lesser extent. In both CGCG and PGCG of the jaws, MSX1 was abundantly expressed by type I MGC and MSC but type II MGC did not express it. A statistically significant difference (P < .05) was observed between CGCG and PGCG in the expression of PTHrP in type II MGC and MSC with pyknotic nuclei and in the expression of PTHR1 in type II MGC.Conclusions: We suggest that in CGCG and PGCG of the jaws, PTHrP-positive immature osteoblasts activate PTHR1-positive mature osteoblasts to produce RANKL which interacts with RANK on the PTHrP/PTHR1-positive osteoclast-precursor cells found in abundance in the stroma of giant cell lesions and induces osteoclastogenesis through the classic pathway. Cells of the jawbones, the periodontal ligament, or the dental follicle, originating from the neural crest, may be involved in the pathogenesis of giant cell lesions of the jaws. Further study is required for these suggestions to be proved.

Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis - Corrected Proof

2010-01-11

Objective: In vivo studies of antimicrobial PDT in animal models of oral candidosis are scarce and the association of porphyrin and LED light has not been evaluated for in vivo photoinactivation of Candida. In this study the effectiveness of photodynamic therapy (PDT) on the inactivation of Candida albicans in vivo was evaluated. Study design. Seventy-one 6-week-old female Swiss mice were immunosuppressed, provided tetracycline to their drinking water, then orally swabbed with a suspension of C. albicans (107 CFU/mL). Four days after oral inoculation, PDT was performed on the dorsum of the tongue after topical administration of Photogem at 400, 500, or 1000 mg/L and followed 30 minutes later by illumination with LED light (305 J/cm2) at 455 or 630 nm (n = 5 each). After swabbing to recover yeast from the tongue, the number of surviving yeast cells was determined (CFU/mL) and analyzed by ANOVA and Holm-Sidak tests (P < .05). Animals were humanely killed, and the tongues surgically removed and processed for histological evaluation of presence of yeast and inflammatory reaction. Results. PDT resulted in a significant reduction in C. albicans recovered from the tongue (P < .001) when compared with mice from the positive control group. There was no difference between the concentrations of Photogem and LED light wavelengths used. Histological evaluation of the tongue revealed that PDT causes no significant adverse effects to the local mucosa. Conclusion. PDT promoted significant reduction in the viability of C. albicans biofilm without harming the tongue tissue.

An evaluation of microbiologic contamination on a phosphor plate system: is weekly gas sterilization enough? - Corrected Proof

2010-01-11

Objective: This study was performed to determine: 1) the rate and source of microbiologic contamination of photostimulable phosphor plates (PSP) in a predoctoral clinic; and 2) whether a combination of weekly gas sterilization and barrier protocols can prevent contamination of PSP plates.Methods: Fifty plates in clinical use and 25 gas-sterilized control plates were selected for examination. The PSP plates were pressed onto blood agar medium and incubated at 37°C. The number, size, distribution, and variety of resulting colonies were noted. To test whether these bacteria could have come from oral sources, 17 colonies were selected for culture on Mitis-Salivarius (M-S) agar. Those colonies that grew on the M-S agar were Gram stained.Results: Twenty-eight test plates (56%) exhibited growth of bacterial colonies on blood agar. Seventeen of those bacterial colonies were selected for growth on M-S agar, and 13 (76.47%) showed growth, 69% of them gram positive.Conclusion: Our results indicate reinforcing standard precautions of infection control for intraoral radiography, and that gas sterilization of plates after each day's clinical use is a potential solution.

Abdominal fat harvest technique and its uses in maxillofacial surgery - Corrected Proof

Dennis J. Kantanen, James J. Closmann, Henry H. Rowshan — 2010-01-11

Abdominal fat harvest and augmentation to the maxillofacial region is a relatively inexpensive, safe, and readily available procedure. The use of abdominal fat free transfer has been well documented for cosmetic, trauma, and temporomandibular joint reconstruction. Fat is the closest we have to an ideal filler, it is readily available and inexpensive, it is autologous and therefore lacks a host immune response, it is safe and noncarcinogenic, and it is easily acquired with a minimally invasive procedure. Abdominal fat donor site is the most commonly used owing to ease of access and availability of fat stores. Complications are rare and easily managed in the office. Free abdominal fat harvest is a predictable surgical technique that allows the maxillofacial surgeon access to autologous graft material that is ideal for multiple facial procedures.

Bone healing with an in situ–formed bioresorbable polyethylene glycol hydrogel membrane in rabbit calvarial defects - Corrected Proof

2010-01-11

Objectives: The aims of this study were to test whether or not the application of an in situ–formed synthetic polyethylene glycol hydrogel (PEG) used as a biodegradable membrane for guided bone regeneration with a variety of graft materials and ambient oxygen or hyperbaric oxygen (HBO) environments would result in enhanced bone regeneration, and to observe the histologic and histomorphometric aspects of bone healing of the calvarial defects with and without a PEG membrane.Study design: Thirty adult, skeletally mature, male New Zealand white rabbits were randomly divided into 3 groups of 10 animals each. Bilateral 15-mm-diameter critical-size defects were created in the parietal bones of each animal. Group 1 served as a control with unfilled bilateral calvarial defects, group 2 had bilateral calvarial defects filled with morcelized autogenous calvarial bone, and group 3 had bilateral calvarial defects filled with a biphasic calcium phosphate ceramic. One of the calvarial defects was randomly protected with a PEG resorbable liquid membrane in each animal. Five animals from each group underwent a course of HBO treatment (2.4 ATA 100% oxygen for 90 minutes 5 days a week for 4 weeks) and the other 5 served as control and did not receive any supplemental oxygen (normobaric). The animals were killed 6 weeks after their surgery, and their parietal bones were harvested. The specimens were analyzed with microscopic computerized tomography (microCT) scans and histomorphometrics.Results: The unfilled normobaric control bony defects did not heal, proving the critical-size nature of these defects. The presence of autogenous bone or bone ceramic in the defects increased the bone volume fraction and bone mineral density of the defects (P < .001). The presence of a membrane in the ungrafted and autogenous bone grafted defects resulted in a decrease in the corrected bone volume fraction (P = .002) but not in the bone ceramic grafted defects (P = .580). Bony healing of defects where the membrane was unsupported was compromised; the membrane did not maintain the desired bone regeneration volume with the unfilled and autogenous bone grafted groups. The PEG resorbable liquid membrane worked best with the bone ceramic material. HBO did not ameliorate the healing of the autogenous bone graft or ceramic filled defects in the 6-week time period of this study.Conclusions: Although the PEG resorbable liquid membrane is easy to use and forms an occlusive layer, caution is recommended when using the membrane over an unsupported defect. HBO did not ameliorate bony healing with the membrane at the early 6-week time point. The authors recommend future assessment with HBO at the 12-week time point.

Jaw bone changes in rats after treatment with zoledronate and pamidronate - Corrected Proof

2010-01-11

Objective: The aim of this study was to histopathologically evaluate the effects of pamidronate and zoledronate on the mandible in an animal model.Study design: Sixty female Sprague-Dawley rats were used in this study. Animals were divided into 6 groups (10 per group): control-1 (C1), injected with saline solution for 6 weeks; zoledronate-1 (ZA1), injected with zoledronate for 6 weeks; pamidronate-1 (PA1), injected with pamidronate for 6 weeks; control-2 (C2), injected with saline solution for 8 weeks; zoledronate-2 (ZA2), injected with zoledronate for 8 weeks; and pamidronate-2 (PA2), injected with pamidronate for 8 weeks. No dental procedures were performed on the animals. Rats were killed 2 days after the end of drug therapy, and the posterior and anterior mandible and femur of each rat were evaluated histopathologically.Results: Histological examination revealed inflammation limited to the posterior mandible of the ZA2 and PA2 groups; the anterior mandible and femur were not affected. Soft tissue necrosis was evident in one rat in the ZA2 group.Conclusion: Specific, bisphosphonate-asociated inflammatory bony and soft tissue changes were observed in the mandible, suggesting that these drugs may set the stage for altered healing associated with the development of bisphosphonate-related osteonecrosis of the jaw.

Development of a novel bone grafting material using autogenous teeth - Corrected Proof

2010-01-11

We developed a novel bone grafting material that incorporates autogenous teeth (AutoBT), and provided the basis for its clinical application. AutoBT contains organic and inorganic mineral components and is prepared from autogenous grafting material, thus eliminating the risk of an immune reaction that may lead to rejection. AutoBT was used at the time of implant placement, simultaneously with osteoinduction surgery, and excellent bony healing by osteoinduction and osteoconduction was confirmed.

Presence of oral lesions in leprosy patients does not imply involvement by Mycobacterium leprae - Corrected Proof

2010-01-07

Leprosy is still an important public health problem in many countries. The spectrum of clinical manifestations is extremely broad and depends on different degrees of cell-mediated immunity to the bacillus. The frequency of leprotic oral mucosal involvement is a controversial topic in the literature, varying from the complete absence of lesions to 57.5%. Many lesions frequently observed in the oral mucosa of normal individuals or with other illnesses can also involve the oral mucosa of leprosy patients. In such a case, a biopsy is essential of any lesion whose diagnosis is doubtful, because none is pathognomic of leprosy. We decided to conduct a cross-sectional study in patients with varied clinical forms of leprosy, with the objective of verifying the frequency of lesions of the oral mucosa through clinical and histopathologic examinations.

Clinical analysis of Castleman disease (hyaline vascular type) in parotid and neck region - Corrected Proof

2009-12-07

Objective: The aim of this study was to analyze a single institution's experience in clinical diagnosis, treatment, and prognosis of Castleman disease (hyaline vascular type) in the parotid and neck region.Study design: From 2004 to 2008, a total of 10 consecutive patients with Castleman disease (hyaline vascular type) in the parotid and neck region underwent surgery were included in this retrospective study. The preoperative examinations, clinical diagnosis, surgical treatment, and prognosis were recorded and analyzed.Results: Of the 10 patients, 4 were males and 6 female; their age ranged from 13 to 54 years with a mean of 26.6 years. The lesion occurred in the parotid region in 3 patients, in the neck region in 5 patients, and in both the parotid and neck regions in 2 patients. Their course of disease ranged from 3 months to 48 months with a mean of 12.5 months; 70% of the patients (7 out of 10) had a course of disease of <12 months. The patients always had no obvious complaint, and the laboratory examinations were almost within the normal limits. Magnetic resonance imaging/angiography were valuable on clinical diagnosis and differential diagnosis. All patients underwent surgical removal of the masses completely. During the follow-up period, which ranged from 9 months to 60 months with a mean of 38.9 months, no recurrence of the lesion occurred, and the quality of life of each patient was good.Conclusions: Castleman disease (hyaline vascular type) in the parotid and neck region is rare, with clinical manifestation and physical examination the same as benign lesions. There is no specific indication in the laboratory tests and imaging examinations; however, magnetic resonance imaging/angiography has potential value on clinical diagnosis and differential diagnosis. Surgical resection is the choice of treatment with good prognosis.

The metaplastic variant of Warthin tumor of the parotid gland: Dynamic multislice computerized tomography and magnetic resonance imaging findings with histopathologic correlation in a case - Corrected Proof

Hasan Yerli, Suat Avcı, Erdinc Aydin, Ünser Arıkan — 2009-12-07

Metaplastic Warthin tumor is a rarely seen subtype of Warthin tumor. It can resemble squamous carcinomas histopathologically, because it contains atypical squamous cells on the necrotic surface. Making a diagnosis can become easier by knowing this entity of Warthin tumor well and by correlating the radiologic findings with pathology. In this case presentation, imaging features of a metaplastic Warthin tumor are presented together with its histopathologic findings. When a solid mass with peripheral enhancing cystic-necrotic component and well defined contour and capsule that shows early enhancement and washout is identified with imaging methods in parotid gland, metaplastic Warthin tumor should be indicated in the differential diagnosis before the histopathologic evaluation.

Effects of soft tissue punch size on the healing of peri-implant tissue in flapless implant surgery - Corrected Proof

2009-11-19

Objective: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effects of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model.Study design: Bilateral, edentulous, flat alveolar ridges were created in the mandibles of 6 mongrel dogs. After a 3-month healing period, 3 fixtures (diameter 4.0 mm) were placed on each side of the mandible using 3-mm, 4-mm, or 5-mm soft tissue punches. After subsequent healing periods of 3 weeks and 3 months, the peri-implant mucosa was evaluated using clinical, radiologic, and histometric parameters, which included gingival index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues.Results: The results obtained showed significant differences (P < .05) between the 3-mm, 4-mm, and 5-mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss at both 3 weeks and 3 months after implant placement. When the mucosa was punched with a 3-mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter ≥4 mm.Conclusions: The results show that the size of the soft tissue punch plays an important role in achieving optimal healing. The findings support the use of a tissue punch slightly narrower than the implant itself to obtain better peri-implant tissue healing around flapless implants.

Pilot study on recurrent aphthous stomatitis (RAS): A randomized placebo-controlled trial for the comparative therapeutic effects of systemic prednisone and systemic montelukast in subjects unresponsive to topical therapy - Corrected Proof

F. Femiano, C. Buonaiuto, F. Gombos, A. Lanza, N. Cirillo — 2009-11-19

Background: Recurrent aphthous stomatitis (RAS) is characterized by recurrent painful oral ulcers whose etiology remains largely unknown. Numerous therapeutic protocols have been tried so far, but effectiveness remains an issue.Objective: To test a new drug for patients with recurrent oral aphthae nonresponsive to local corticosteroid therapy, we compared the therapeutic effectiveness and adverse effects of systemic prednisone and systemic montelukast in a placebo-controlled trial.Study design: Sixty patients suffering from minor RAS for ≥6 months were studied and randomly assigned to 3 groups of 20 each in a double-blind study. Patients of group A took 25 mg prednisone orally daily for 15 days, 12.5 mg daily for 15 days, 6.25 mg daily for 15 days, then 6.25 mg on alternate days for 15 days. Patients of group B took 10 mg montelukast orally every evening and then on alternate days for the second month. Patients of group C took 100 mg cellulose (placebo) by mouth daily for the first month and on alternate days for the second month. Outcomes assessed were days til pain cessation, days to ulcer healing, and number of aphthae occurring during the follow-up period.Results: Both prednisone and montelukast were effective in reducing the number of lesions and improving pain relief and ulcer healing when compared with placebo. Prednisone was more effective than montelukast in pain cessation (P < .0001) and in accelerating ulcer healing (P < .0001). However, adverse drug reactions recorded during the entire trial were more common in the prednisone group compared with montelukast (10%) and placebo (10%).Conclusions: These data suggest that the effectiveness of systemic montelukast is similar to that of systemic prednisone in patients with RAS. The lack of serious side effects makes montelukast a candidate drug to use in cases of RAS where pharmacologic therapy for long periods is needed.

WITHDRAWN: Power Doppler sonography in the diagnosis of buccal space masses - Corrected Proof

Ichiro Ogura — 2006-09-26

This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.