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Analysis of different therapeutic protocols for osteonecrosis of the jaw associated with oral and intravenous bisphpsphonates 口服和静脉注射双膦酸盐治疗颌骨骨坏死的不同治疗方案分析
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21477
Elena-Beatriz Bermúdez-Bejarano, M. Serrera-Figallo, A. Gutiérrez-Corrales, Manuel-María Romero-Ruiz, Raquel Castillo-de-Oyagüe, J. Gutierrez-Perez, G. Machuca-Portillo, D. Torres-Lagares
Introduction Chemotherapy-associated osteonecrosis of the jaw caused by bisphosphonates is an exposure of necrotic bone with more than eight weeks of evolution that is attributable to bisphosphonates and no prior radiation therapy. Its etiopathogenesis remains unknown, although there are two hypotheses that may explain it: the drug’s mechanism of action, and the risk factors that can lead to osteonecrosis. There is a wide range of treatment options for managing chemotherapy-associated osteonecrosis of the jaw, from conservative treatments to surgical procedures of varying levels of invasiveness, which are sometimes supplemented with adjuvant therapies. Objectives The objective of this article is to group the therapeutic options for osteonecrosis of the jaw (ONJ) into seven different protocols and to evaluate their effectiveness in relation to stage of ONJ. Material and Methods A literature review was carried out in PubMed following the PRISMA criteria. A total of 47 were collected after compiling a series of variables that define ONJ, applied treatments, and the clinical results obtained. Results and Discussion The 47 articles selected have a low to average estimated risk of bias and are of moderate to good quality. According to the data obtained, Protocol 3 (conservative treatment, clinical and radiological follow-up, minimally invasive surgical treatment, and adjuvant therapies) is the most favorable approach for ONJ lesions caused by oral bisphosphonates. For lesions caused by intravenous bisphosphonates, Protocol 2 (conservative treatment, clinical and radiological follow-up, minimally invasive surgical treatment, and no adjuvant therapies) is the best approach. When comparing the different stages of ONJ, Protocol 1 (conservative treatment, clinical and radiological follow-up) promotes better healing of Stage 1 ONJ lesions caused by orally administered bisphosphonates, and Protocol 3 is recommended for Stage II. For ONJ lesions attributable to intravenous bisphosphonates, Protocol 7 (conservative treatment, clinical and radiological follow-up, and adjuvant therapies) provides the best results in Stage 0; in Stages I, II, and III, Protocol 1 gives better results. Key words:Bisphosphonates, bronj, therapeutic protocol, clinical result.
双膦酸盐引起的化疗相关性颌骨骨坏死是指坏死骨暴露超过8周,可归因于双膦酸盐且先前未接受放射治疗。其发病机制尚不清楚,但有两种假说可以解释:药物的作用机制和导致骨坏死的危险因素。治疗化疗相关的颌骨骨坏死有多种治疗选择,从保守治疗到不同程度侵入性的外科手术,有时还辅以辅助治疗。目的本文的目的是将颌骨骨坏死(ONJ)的治疗方案分为七种不同的方案,并根据ONJ的分期评估其有效性。材料和方法按照PRISMA标准在PubMed上进行文献综述。在编制了一系列定义ONJ的变量、应用的治疗方法和获得的临床结果后,共收集了47例。结果和讨论入选的47篇文章估计偏倚风险从低到平均,质量从中等到良好。根据所获得的资料,方案3(保守治疗、临床及影像学随访、微创手术治疗、辅助治疗)是口服双膦酸盐引起的ONJ病变最有利的方法。对于静脉注射双膦酸盐引起的病变,方案2(保守治疗,临床和放射随访,微创手术治疗,无辅助治疗)是最好的方法。在比较不同阶段的ONJ时,方案1(保守治疗,临床和放射随访)促进了口服双磷酸盐引起的1期ONJ病变的更好愈合,方案3推荐用于II期。对于静脉注射双膦酸盐引起的ONJ病变,方案7(保守治疗、临床和放射随访以及辅助治疗)在0期提供最佳效果;在第一阶段、第二阶段和第三阶段,方案一的效果更好。关键词:双膦酸盐;支气管;治疗方案;
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引用次数: 16
Knowledge of bisphosphonate-related osteonecrosis of the Jaws among Mexican dentists 墨西哥牙医对双磷酸盐相关颌骨骨坏死的了解
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21433
Ilan Vinitzky-Brener, N. Ibáñez-Mancera, Ana-Martha Aguilar-Rojas, Ana-Pilar Álvarez-Jardón
Background Bisphosphonate-related osteonecrosis is an infrequent but potentially serious complication. Its treatment remains complex, and in some cases can be mutilating. Prevention, a correct diagnosis and opportune management are crucial. Material and Methods A cross-sectional study was made, interviewing 410 dentists with the aim of assessing their knowledge of the subject. Results Practically all of the dental professionals (99.7%) were found to lack sufficient knowledge of the prevention, diagnosis and management of bisphosphonate-related osteonecrosis. Conclusions Actions including increased diffusion in the professional media and inclusion of the subject in training programs are needed in order to enhance the knowledge of bisphosphonate-related osteonecrosis among dentists and thus prevent complications in this group of patients. Key words:Knowledge, mexico, osteonecrosis, bisphosphonates.
背景:二膦酸盐相关性骨坏死是一种罕见但潜在严重的并发症。它的治疗仍然很复杂,在某些情况下可能是致残的。预防、正确诊断和及时管理至关重要。材料与方法本研究采用横断面研究方法,访问了410名牙医,目的是评估他们对该学科的知识。结果99.7%的牙科专业人员对二膦酸盐相关性骨坏死的预防、诊断和处理缺乏足够的知识。结论:为了提高牙医对双膦酸盐相关骨坏死的认识,预防这类患者的并发症,需要采取包括在专业媒体上增加传播和将主题纳入培训计划等措施。关键词:知识,墨西哥,骨坏死,双磷酸盐。
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引用次数: 18
How could multimedia information about dental implant surgery effects patients’ anxiety level? 种植牙手术的多媒体信息如何影响患者的焦虑水平?
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21254
H. Kazancıoğlu, Ameer-Shani Dahhan, A. Acar
Background To evaluate the effects of different patient education techniques on patients’ anxiety levels before and after dental implant surgery. Material and Methods Sixty patients were randomized into three groups; each contained 20 patients; [group 1, basic information given verbally, with details of operation and recovery; group 2 (study group), basic information given verbally with details of operative procedures and recovery, and by watching a movie on single implant surgery]; and a control group [basic information given verbally “but it was devoid of the details of the operative procedures and recovery”]. Anxiety levels were assessed using the Spielberger’s State-Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS). Pain was assessed with a visual analog scale (VAS). Results The most significant changes were observed in the movie group (P < 0.05). Patients who were more anxious also used more analgesic medication. Linear regression analysis showed that female patients had higher levels of anxiety (P < 0.05). Conclusions Preoperative multimedia information increases anxiety level. Key words:Implant, anxiety, pain, dental, video and patient knowledge.
背景评价不同患者教育方式对种植牙术前术后患者焦虑水平的影响。材料与方法60例患者随机分为3组;每组20例;[第一组,口头给出基本信息,并详细说明操作和恢复情况;第二组(学习组),口头给出基本信息,包括手术过程和恢复的细节,并通过观看单种植体手术的电影];而对照组(口头给出基本信息,但没有手术过程和恢复的细节)。使用Spielberger状态-特质焦虑量表(STAI)和改良牙科焦虑量表(MDAS)评估焦虑水平。采用视觉模拟评分(VAS)评估疼痛。结果以电影组变化最为显著(P < 0.05)。焦虑程度越高的患者使用的镇痛药物也越多。线性回归分析显示,女性患者的焦虑水平较高(P < 0.05)。结论术前多媒体信息增加患者的焦虑水平。关键词:种植体,焦虑,疼痛,牙齿,视频,患者知识。
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引用次数: 28
Influence of bethanechol on salivary parameters in irradiated patients 乙二酚对放射患者唾液参数的影响
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21395
C. Cotomacio, L. Campos, A. Simões, G. Jaguar, E. Crosato, F. Alves
Background Some studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy. Material and Methods Forty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified. Results According to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05). Conclusions Our results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown. Key words:Radiotherapy, xerostomia, hyposalivation, saliva, biochemistry.
背景:一些研究表明,预防性使用氯化乙二酚(BC)可能有助于预防口干症(XT)的发生和/或严重程度。然而,在放疗后的XT患者中,BC的适应症需要更好地表征。本研究旨在评估BC对既往接受头颈部放疗患者的XT、唾液流速和唾液成分的影响。材料与方法45例放疗后出现XT症状的患者,连续3个月给予50 mg/d的BC治疗,分4个阶段(治疗前、治疗后1个月、治疗后2个月、治疗后3个月)评估唾液参数。生化分析包括缓冲能力;pH值;总蛋白浓度;淀粉酶浓度(AM);过氧化氢酶(CAT)和过氧化物酶(PX)活性。此外,测定未受刺激和受刺激的唾液流速,并对XT进行分类。结果根据所采用的XT分级系统,患者在第1、2、3、4期XT均有改善。TP浓度也有一定变化(降低);AM浓度(增高);第2期刺激唾液采集后,PX和CAT活性分别降低和升高(p<0.05)。结论应用BC治疗头颈部放疗引起的唾液腺功能障碍后,XT症状有所改善,唾液成分有所改变。关键词:放疗,口干,低唾液,生化。
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引用次数: 7
Relationship between -889 C/T polymorphism in interleukin-1A gene and risk of chronic periodontitis: Evidence from a meta-analysis with new published findings 白细胞介素- 1a基因-889 C/T多态性与慢性牙周炎风险的关系:来自新发表研究结果的荟萃分析证据
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21233
F. D. da Silva, Any-Carolina-Cardoso Guimarães-Vasconcelos, Luiz-Felipe de-Carvalho-França, David di-Lenardo, Luana-Silva Rodrigues, Maria-Luísa-Lima Barreto-do-Nascimento, D. Vasconcelos
Background Periodontitis results from an inflammatory response caused by accumulative microorganisms in periodontal sites. Several factors are involved in pathogenesis of periodontitis, for example the -889 C/T polymorphism in interleukin-1A gene. This study aimed to evaluate the relationship between this polymorphism and risk of development of chronic periodontitis by a meta-analysis based in new published findings. Material and Methods Thereunto a review in literature was performed in the electronic biomedical and education databases (Cochrane Library, Google Scholar, MEDLINE and PubMed) to studies published before August 2, 2015, the abstracts were evaluated and the data extraction performed by two calibrated examiners. The calculations of the meta-analysis were obtained through statistical software Review Manager version 5.2 with calculation of Odds Ratio (OR), heterogeneity (I²) and Funnel plots with P <0.05. Results In overall, twenty-one case/control studies were selected with 2,174 patients with chronic periodontitis and 1, 756 controls. The meta-analysis showed T allele was associated with chronic periodontitis (OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004) with decreased value to heterogeneity (I² = 15%, P = 0.28). TT genotype was associated to patients with chronic periodontitis (OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01). No publication bias was found in this meta-analysis by asymmetry in Funnel plots. Conclusions This meta-analysis with 2,174 patients with chronic periodontitis and 1, 756 controls evidenced the -889 C/T polymorphism is associated to risk of development of chronic periodontitis with no significant value to heterogeneity to allelic evaluation. Key words:Alleles, odds ratio, periodontal disease, cytokines.
牙周炎是由牙周部位微生物积聚引起的炎症反应引起的。牙周炎的发病与多种因素有关,如白细胞介素- 1a基因的-889 C/T多态性。本研究旨在通过一项基于新发表的研究结果的荟萃分析来评估这种多态性与慢性牙周炎发展风险之间的关系。材料与方法在2015年8月2日之前,在电子生物医学和教育数据库(Cochrane Library, Google Scholar, MEDLINE和PubMed)中对发表的研究进行文献综述,由两位校准的审查员对摘要进行评估并进行数据提取。meta分析的计算采用统计软件Review Manager version 5.2进行,计算优势比(OR)、异质性(I²)和漏斗图,P <0.05。结果共纳入21个病例/对照研究,2174例慢性牙周炎患者和1756例对照组。meta分析显示,T等位基因与慢性牙周炎相关(OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004),但异质性降低(I²= 15%,P = 0.28)。TT基因型与慢性牙周炎患者相关(OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01)。本荟萃分析未发现漏斗图不对称的发表偏倚。结论对2174名慢性牙周炎患者和1756名对照者进行的荟萃分析表明,-889 C/T多态性与慢性牙周炎的发生风险相关,但对等位基因评估的异质性没有显著价值。关键词:等位基因,优势比,牙周病,细胞因子
{"title":"Relationship between -889 C/T polymorphism in interleukin-1A gene and risk of chronic periodontitis: Evidence from a meta-analysis with new published findings","authors":"F. D. da Silva, Any-Carolina-Cardoso Guimarães-Vasconcelos, Luiz-Felipe de-Carvalho-França, David di-Lenardo, Luana-Silva Rodrigues, Maria-Luísa-Lima Barreto-do-Nascimento, D. Vasconcelos","doi":"10.4317/medoral.21233","DOIUrl":"https://doi.org/10.4317/medoral.21233","url":null,"abstract":"Background Periodontitis results from an inflammatory response caused by accumulative microorganisms in periodontal sites. Several factors are involved in pathogenesis of periodontitis, for example the -889 C/T polymorphism in interleukin-1A gene. This study aimed to evaluate the relationship between this polymorphism and risk of development of chronic periodontitis by a meta-analysis based in new published findings. Material and Methods Thereunto a review in literature was performed in the electronic biomedical and education databases (Cochrane Library, Google Scholar, MEDLINE and PubMed) to studies published before August 2, 2015, the abstracts were evaluated and the data extraction performed by two calibrated examiners. The calculations of the meta-analysis were obtained through statistical software Review Manager version 5.2 with calculation of Odds Ratio (OR), heterogeneity (I²) and Funnel plots with P <0.05. Results In overall, twenty-one case/control studies were selected with 2,174 patients with chronic periodontitis and 1, 756 controls. The meta-analysis showed T allele was associated with chronic periodontitis (OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004) with decreased value to heterogeneity (I² = 15%, P = 0.28). TT genotype was associated to patients with chronic periodontitis (OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01). No publication bias was found in this meta-analysis by asymmetry in Funnel plots. Conclusions This meta-analysis with 2,174 patients with chronic periodontitis and 1, 756 controls evidenced the -889 C/T polymorphism is associated to risk of development of chronic periodontitis with no significant value to heterogeneity to allelic evaluation. Key words:Alleles, odds ratio, periodontal disease, cytokines.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"28 1","pages":"e7 - e14"},"PeriodicalIF":0.0,"publicationDate":"2016-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89605634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Predictive factors of difficulty in lower third molar extraction: A prospective cohort study 下第三磨牙拔除困难的预测因素:一项前瞻性队列研究
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21348
J. Alvira-González, R. Figueiredo, E. Valmaseda-Castellón, Carmen Quesada-Gómez, C. Gay-Escoda
Background Several publications have measured the difficulty of third molar removal, trying to establish the main risk factors, however several important preoperative and intraoperative variables are overlooked. Material and Methods A prospective cohort study comprising a total of 130 consecutive lower third molar extractions was performed. The outcome variables used to measure the difficulty of the extraction were operation time and a 100mm visual analogue scale filled by the surgeon at the end of the surgical procedure. The predictors were divided into 4 different groups (demographic, anatomic, radiographic and operative variables). A descriptive, bivariate and multivariate analysis of the data was performed. Results Patients’ weight, the presence of bulbous roots, the need to perform crown and root sectioning of the lower third molar and Pell and Gregory 123 classification significantly influenced both outcome variables (p< 0.05). Conclusions Certain anatomical, radiological and operative variables appear to be important factors in the assessment of surgical difficulty in the extraction of lower third molars. Key words:Third molar, surgical extraction, surgical difficulty.
一些出版物测量了第三磨牙拔除的难度,试图确定主要的危险因素,然而一些重要的术前和术中变量被忽视了。材料和方法进行了一项前瞻性队列研究,共包括130个连续的下第三磨牙拔出。衡量拔牙难度的结果变量为手术时间和外科医生在手术结束时填写的100mm视觉模拟量表。预测因素被分为4个不同的组(人口统计学、解剖学、放射学和手术变量)。对数据进行描述性、双变量和多变量分析。结果患者体重、是否存在球根、是否需要进行下第三磨牙冠根切开术以及Pell和Gregory 123分类对两项结果均有显著影响(p< 0.05)。结论下三磨牙拔除手术中解剖学、影像学和手术方面的因素是判断手术难度的重要因素。关键词:第三磨牙,手术拔牙,手术难度。
{"title":"Predictive factors of difficulty in lower third molar extraction: A prospective cohort study","authors":"J. Alvira-González, R. Figueiredo, E. Valmaseda-Castellón, Carmen Quesada-Gómez, C. Gay-Escoda","doi":"10.4317/medoral.21348","DOIUrl":"https://doi.org/10.4317/medoral.21348","url":null,"abstract":"Background Several publications have measured the difficulty of third molar removal, trying to establish the main risk factors, however several important preoperative and intraoperative variables are overlooked. Material and Methods A prospective cohort study comprising a total of 130 consecutive lower third molar extractions was performed. The outcome variables used to measure the difficulty of the extraction were operation time and a 100mm visual analogue scale filled by the surgeon at the end of the surgical procedure. The predictors were divided into 4 different groups (demographic, anatomic, radiographic and operative variables). A descriptive, bivariate and multivariate analysis of the data was performed. Results Patients’ weight, the presence of bulbous roots, the need to perform crown and root sectioning of the lower third molar and Pell and Gregory 123 classification significantly influenced both outcome variables (p< 0.05). Conclusions Certain anatomical, radiological and operative variables appear to be important factors in the assessment of surgical difficulty in the extraction of lower third molars. Key words:Third molar, surgical extraction, surgical difficulty.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"14 1","pages":"e108 - e114"},"PeriodicalIF":0.0,"publicationDate":"2016-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85145677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 39
Simple and aneurysmal bone cyst: Aspects of jaw pseudocysts based on an experience of Brazilian pathology service during 53 years 单纯性和动脉瘤性骨囊肿:基于53年巴西病理服务经验的颌假性囊肿的各个方面
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21551
I. Flores, Marian E Hamilton, Elaine-de-Fátima Zanchin-Baldissera, Ana C. Uchoa-Vasconcelos, S. Chaves-Tarquínio, Ana P. Neutzling-Gomes
Background Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. Material and Methods A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. Results Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. Conclusions The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws. Key words:Simple bone cyst, aneurysmal bone cyst, pseudocysts, jaws.
背景:下颌假性囊肿是一种病因不明的良性骨性病变。其中单纯性骨囊肿(SBC)和动脉瘤性骨囊肿(ABC)是目前研究较少的两种骨病理。本回顾性研究旨在介绍颌骨假性囊肿患者的临床、影像学和手术方面的长期病例系列。材料与方法对SBC和ABC患者进行回顾性分析。本文回顾了1959-2012年间20,469例假性囊肿的临床、影像学和手术方面的资料。对所有描述性数据进行汇总。结果骨病理354例(15.25%),颌骨假性囊肿54例,其中SBC 42例(11.86%),ABC 12例(3.39%)。对于这两种病变,大多数样本是年轻的白人女性,无症状的后下颌病变,进化时间不确定,无创伤史。在这两种情况下,也观察到一种独特的放射透明的扇形病变,呈现空腔。然而,SBC的一些不典型表现包括:骨皮质扩张、牙齿吸收、下颌管移位和复发。部分ABC病例无疼痛症状,无典型的充血腔。结论SBC和ABC是一种骨病理,回顾性研究较少,没有关于这两种情况的研究,命名不同,在某些情况下不典型。因此,了解这类假性囊肿的临床、影像学和手术特征,作为颌骨透光病变的诊断假设,具有临床价值。关键词:单纯性骨囊肿,动脉瘤性骨囊肿,假性囊肿,颌骨。
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引用次数: 17
Venous thromboembolism after oral and maxillofacial oncologic surgery: Report and analysis of 14 cases in Chinese population 口腔颌面部肿瘤手术后静脉血栓栓塞:14例报告与分析
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21399
Yang Wang, Jiannan Liu, Xuelai Yin, Jingzhou Hu, Evagelos F. Kalfarentzos, Chenping Zhang, Liqun Xu
Background Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is a leading cause of death in cancer patients. The aim of this study was to explore the potential risk factor of VTE in oral and maxillofacial oncological surgery. Material and Methods The data of patients who received operation in our institution were gathered in this retrospective study. A diagnosis of VTE was screened and confirmed by computer tomography angiography (CTA) of pulmonary artery or ultrasonography examination of lower extremity. Medical history and all perioperative details were analyzed. Results 14 patients were diagnosed as VTE, including 6 cases of PE, 7 cases of DVT, 1case of DVT and PE. The mean age of these patients was 62.07 years. Reconstruction was performed in 12 patients of these cases, most of which were diagnosed as malignance. Mean length of surgery was 8.74 hours, and lower extremity deep venous cannula (DVC) was performed in all these patients. Conclusions We analyzed several characters of oral and maxillofacial surgery and suggested pay attention to lower extremity DVC which had a high correlation with DVT according to our data. Key words:Venous thromboembolism, pulmonary embolism, deep vein thrombosis, oral and maxillofacial surgery.
背景静脉血栓栓塞(VTE)包括深静脉血栓形成(DVT)和肺栓塞(PE)是癌症患者死亡的主要原因。本研究旨在探讨口腔颌面肿瘤手术中静脉血栓栓塞的潜在危险因素。材料与方法回顾性分析本院手术患者的资料。通过肺动脉计算机断层血管造影(CTA)或下肢超声检查筛查并确诊静脉血栓栓塞。分析病史及所有围手术期细节。结果14例患者诊断为静脉血栓栓塞,其中PE 6例,DVT 7例,DVT合并PE 1例。患者平均年龄62.07岁。这些病例中有12例进行了重建,其中大多数被诊断为恶性肿瘤。手术时间平均8.74小时,均行下肢深静脉插管(DVC)。结论我们分析了口腔颌面外科的几个特点,根据我们的资料,建议注意与DVT高度相关的下肢DVC。关键词:静脉血栓栓塞,肺栓塞,深静脉血栓形成,口腔颌面外科
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引用次数: 7
Efficacy of naproxen with or without esomeprazole for pain and inflammation in patients after bilateral third molar extractions: A double blinded crossover study 萘普生联合或不联合埃索美拉唑治疗双侧第三磨牙拔牙后疼痛和炎症的疗效:一项双盲交叉研究
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21514
G. M. Weckwerth, L. F. Simoneti, P. Zupelari-Gonçalves, A. M. Calvo, D. T. Brozoski, T. Dionísio, E. A. Torres, J. Lauris, F. A. Faria, C. Santos
Background Using a double-blinded randomized crossover design, this study aimed to evaluate acute postoperative pain management, swelling and trismus in 46 volunteers undergoing extractions of the two lower third molars, in similar positions, at two different appointments who consumed a tablet of either NE (naproxen 500 mg + esomepraz ole 20 mg) or only naproxen (500 mg) every 12 hours for 4 days. Material and Methods Parameters were analyzed: self-reported pain intensity using a visual analog scale (VAS) pre- and postoperative mouth opening; incidence, type and severity of adverse reactions; total quantity consumed of rescue medication; and pre- and postoperative swelling. Results Female volunteers reported significantly more postoperative pain at 1, 1.5, 2, 3 and 4hrs after surgery while also taking their first rescue medication at a time significantly earlier when consuming NE when compared to naproxen (3.7hrs and 6.7hrs). Conversely, no differences were found between each drug group in males. Conclusions In conclusion, throughout the entire study, pain was mild after using either drug in both men and women with pain scores on average well below 40mm (VAS), although in women naproxen improved acute postoperative pain management when compared to NE. Key words:Oral surgery, third molar, pain, naproxen, esomeprazole, NSAIDs.
本研究采用双盲随机交叉设计,旨在评估46名志愿者的急性术后疼痛管理、肿胀和牙关,这些志愿者在两个不同的时间,在相似的位置拔除两颗下三磨牙,每12小时服用一片NE(萘普生500 mg +埃索美拉唑20 mg)或仅服用萘普生500 mg,持续4天。材料和方法对参数进行分析:采用视觉模拟量表(VAS)进行术前和术后自我报告疼痛强度;不良反应的发生率、类型和严重程度;抢救用药总消耗量;以及术前和术后肿胀。结果女性志愿者在术后1、1.5、2、3和4小时报告了更多的术后疼痛,同时与服用萘普生(3.7小时和6.7小时)相比,服用NE的女性志愿者在更早的时间服用了第一次抢救药物。相反,在男性中,每个药物组之间没有发现差异。总而言之,在整个研究中,无论男性还是女性,在使用任何一种药物后疼痛都是轻微的,疼痛评分平均远低于40mm (VAS),尽管在女性中,与NE相比,萘普生改善了急性术后疼痛管理。关键词:口腔外科,第三磨牙,疼痛,萘普生,埃索美拉唑,非甾体抗炎药。
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引用次数: 9
Could formaldehyde induce mutagenic and cytotoxic effects in buccal epithelial cells during anatomy classes? 解剖课上甲醛是否会引起口腔上皮细胞的诱变和细胞毒性作用?
Pub Date : 2016-12-06 DOI: 10.4317/medoral.21492
D. Lorenzoni, Leon-Penido Pinheiro, H. Nascimento, Cristiani-Sartorio Menegardo, R. Silva, W. Bautz, J. Henriques, K. Almeida-Coburn, Letícia-Nogueira da Gama-de-Souza
Background Due to increased formaldehyde exposure, carcinogenic to humans, several researches have been studying the potential toxicity and the safe levels for human beings. The aim of this study was to investigate mutagenicity and cytotoxicity in buccal epithelial exfoliated cells (BEC) of students subjected to formaldehyde (FA) during anatomy classes. Material and Methods BEC were collected periodically from 17 volunteers of undergraduate programs, who had participated in practical anatomy classes, before and after FA exposure. Cells were stained according to Feulgen method and then micronucleus test was applied. A total of 1,500 cells were assessed per individual in this study for the micronucleus frequency and other parameters of cytotoxicity. Results There was statistically significant increase in number of micronucleated BEC after FA exposure (after 1 month p=.034 and after 3.5 months p=.017). However, FA exposure caused no significant increase in other nuclear alterations closely related to cytotoxicity (p≥.05). Conclusions FA induced mutagenicity during anatomy classes. Cell death increased, but it was not statistically significant. Efforts have to be made to improve air quality and reduce exposures during anatomy classes. Key words:Carcinogens, formaldehyde, micronucleus tests, mutagenicity tests.
由于甲醛暴露量增加,对人类具有致癌性,一些研究一直在研究甲醛对人类的潜在毒性和安全水平。本研究旨在探讨解剖课上接触甲醛的学生口腔上皮脱落细胞(BEC)的致突变性和细胞毒性。材料与方法对17名参加过实习解剖学课程的本科生志愿者在FA暴露前后进行定期的BEC采集。采用Feulgen法对细胞进行染色,然后进行微核试验。本研究共对每个个体的1500个细胞进行了微核频率和其他细胞毒性参数的评估。结果FA暴露后微核BEC数量显著增加(1个月后p=。3.5个月后p= 0.017)。然而,FA暴露没有引起其他与细胞毒性密切相关的核改变的显著增加(p≥0.05)。结论FA在解剖课上具有诱变作用。细胞死亡增加,但无统计学意义。在解剖课上,必须努力改善空气质量,减少接触空气。关键词:致癌物甲醛微核试验致突变性试验
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引用次数: 14
期刊
Medicina Oral, Patología Oral y Cirugía Bucal
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