Occurrence of a ‘bad’ split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients

Publication date: Available online 26 May 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): J.C. Posnick, E. Choi, S. Liu
The purpose of this study was to assess the prevalence of a 'bad' split after sagittal ramus osteotomies (SRO) and report the results of initial mandibular healing. A retrospective cohort study derived from patients treated by a single surgeon at one institution between 2004 and 2013 was performed. An index group consisting of a series of subjects with a spectrum of bimaxillary dentofacial deformities also involving the chin and symptomatic chronic obstructive nasal breathing was identified. The SRO design, bicortical screw fixation technique, and perioperative management were consistent. Outcome variables included the occurrence of a 'bad' split and the success of initial SRO healing. Two hundred sixty-two subjects undergoing 524 SROs met the inclusion criteria. Their average age was 25 years (range 13–63 years) and 134 were female (51%). Simultaneous removal of a third molar was performed during 209 of the SROs (40%). There were no 'bad' splits. All subjects achieved successful bone union, the planned occlusion, and return to a chewing diet and physical activities by 5 weeks after surgery. The presence of a third molar removed during SRO was not associated with an increased frequency of a 'bad' split or delayed mandibular healing.



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Significance of oral cancer-associated fibroblasts in angiogenesis, lymphangiogenesis, and tumor invasion in oral squamous cell carcinoma

Background

Cancer-associated fibroblasts (CAFs) are recognized as a pivotal promoter in cancer initiation and development. However, the role of CAFs in the progression and metastasis of oral squamous cell carcinoma (OSCC) has not been fully elucidated.

Materials and Methods

Lymphatic vessel density (LVD) and microvessel density (MVD) and the expression of α-smooth muscle actin (α-SMA) and matrix metalloproteinase-9 (MMP-9) were evaluated by immunohistochemistry in 86 cases of OSCC. The correlations between α-SMA expression and MMP-9 expression, LVD, MVD, and other clinicopathological parameters were analyzed. In vitro invasion assay was performed to assess the effect of CAFs on the invasion of OSCC cells. We also investigated the effect of CAFs on the angiogenesis and lymphangiogenesis by inoculating CAFs with OSCC cells into nude mice subcutaneously.

Results

Positive expression of α-SMA protein was detected in 69.8% of the tumors. Increased α-SMA expression was correlated strongly with enhanced tumor invasion, higher tumor grade, increased risk of recurrence, lymph node involvement, and higher peritumoral lymphatic vessel density and microvessel density (P < 0.05). CAFs induced more cancer cells to invade relative to normal fibroblasts (NFs) (P < 0.05). Compared with co-injection of OSCC cells and NFs or injection of tumor cells alone, co-injection of OSCC cells and CAFs resulted in earlier tumor formation and bigger tumor volume accompanied with increased angiogenesis and lymphangiogenesis (P < 0.05).

Conclusion

CAFs may play critical roles in OSCC progression as an inducer of tumor invasion, angiogenesis, and lymphangiogenesis. Therapeutic strategies targeting CAFs against OSCC is promising and need further exploration.

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The potential role of in vivo reflectance confocal microscopy for evaluating oral cavity lesions: a systematic review

Background

Since the early 2000s, several studies have examined the application of reflectance confocal microscopy (RCM) to the oral cavity. This review gives an overview of the literature on reflectance confocal microscopy analysis of the oral cavity in vivo and identifies flaws in the studies, providing guidance to improve reflectance confocal microscopy applications and inform the design of future studies.

Methods

The PubMed, ISI, Scopus, and Cochrane Library databases were searched for publications on RCM using the terms 'reflectance confocal microscopy' in combination with 'mouth' and other terms related to the topic of interest.

Results

The search gave 617 results. Seventeen studies were included in our final analysis. We decided to organize the selected articles according to four topics: healthy mucosa, autoimmune diseases, cancer and precancerous lesions, and hard dental tissues.

Conclusion

Although reflectance confocal microscopy is promising for diagnosing and monitoring oral pathology, it has shortcomings and there are still too few publications on this topic. Further studies are needed to increase the quantity and quality of the results, to translate research into clinical practice.

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Current management of the neck in salivary gland carcinomas

Salivary gland cancers include a diverse group of tumours with many histological subtypes which occur in both major and minor salivary glands. As a result of this heterogeneity and different sites of presentation, there have been no randomised controlled trials to evaluate the indications and efficacy of neck treatments by either surgery or radiotherapy for occult or apparent neck node metastases. Neck dissection is an important treatment strategy for neck metastases arising from major and minor salivary gland malignancy as well as being useful for disease staging. However, there is considerable controversy in how to manage the neck in these patients. In this review, we discuss the management of neck metastases relating to malignant salivary gland tumours.

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Effect of repetitive transcranial magnetic stimulation on auditory function following acoustic trauma

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is one form of non-invasive brain stimulation and increasingly shows neuroprotection in multiple neurological disorders. However, the potential of rTMS for protective action on auditory function following acoustic trauma has not been investigated. Here, we examined effect of TMS on hearing conservation, neurons survival and brain-derived neurotrophin factor (BDNF) expression in the cochlea and auditory cortex following acoustic trauma in rats. Wistar rats were exposed to intense pure tone noise (10 kHz, 120 dB SPL for 2 h) followed by rTMS treatment or sham treatment (handling control) daily for 14 days. Auditory brainstem response revealed there was no significant difference in hearing threshold shifts between rTMS- and sham-treated rats, although rTMS-treated rats showed less neuron loss in the auditory cortex in comparison with sham rats. Additionally, acoustic trauma increased BDNF expression in the cochlea and auditory cortex, and this elevation could be attenuated by rTMS treatment. Our results suggest present regiment of rTMS does not protect hearing against acoustic trauma, but maybe have implications for tinnitus treatment.

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A retrospective study on the effectiveness of curettage and electrodesiccation for clinically suspected primary nodular basal cell carcinoma

Abstract

An easy, cheap, and practical therapy for nodular basal cell carcinoma (nBCC) is curettage combined with electrodessication (C&ED).^1,2 Recurrence rates for BCC after C&ED range from 1-27%, influenced by anatomic location, histopathologic growth pattern, and size.^2-7 Therefore, most guidelines solely recommend C&ED as treatment in low-risk BCC, typically defined as: primary and small BCC (≤5 mm) with no clinical suspicion of infiltrative growth in low-risk areas (outside of the H-zone).

This article is protected by copyright. All rights reserved.

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Association of non-melanoma skin cancer with second non-cutaneous malignancy in the Women's Health Initiative

Abstract

Non-melanoma skin cancer (NMSC), the most prevalent cancer in the US,¹ has been associated with increased risk of non-cutaneous malignancies, including breast cancer, lung cancer, and lymphoma. ^2-7 In the Women's Health Initiative (WHI) Observational Study (OS), women with NMSC history at baseline were more likely to report history of another cancer (Odds ratio [OR] = 2.3, 95% CI = 2.18 –2.44.⁶ Subsequently, Nurses Health Study (NHS) prospective analyses found increased risk of developing breast cancer, lung cancer, and melanoma in women with NMSC.⁷ We sought to replicate these prospective findings in the large WHI cohort, for which important potential confounders, e.g. smoking and body mass index, and rich phenotypic data are available.

This article is protected by copyright. All rights reserved.

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Annals of Neurology: Volume 79, Number 6, June 2016

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Issue Information – Masthead

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Issue Information – Copyright

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