Journal of Oral & Maxillofacial Research最新文献

Objectives: Acinic cell carcinoma of salivary gland harbours recurrent and specific chromosomal rearrangement [t(4;9)(q13;q31)], resulting in the translocation of secretory calcium-binding phosphoprotein gene cluster at 4q13 to nuclear receptor subfamily 4 group a member 3 at 9q31. This upregulates the transcription factor nuclear receptor subfamily 4 group A member 3, which can be detected by immunohistochemistry. The purpose of this pilot study is to evaluate the performance of nuclear receptor subfamily 4 group A member 3 immunostaining on whole-slide acinic cell carcinoma tissue, in comparison with discovered on GIST-1 immunostaining.

Material and methods: We retrieved 6 cases of acinic cell carcinoma (AciCC), including 5 conventional low-grade and 1 dedifferentiated high-grade. Immunohistochemistry (IHC) for nuclear receptor subfamily 4 group A member 3 (NR4A3) and discovered on GIST-1 (DOG1) were performed at the University of Pittsburgh Medical Centre in Pittsburgh, Pennsylvania on all retrieved cases.

Results: The result shows that NR4A3 IHC shows better performance than DOG1 IHC: 5 of the 6 (83.3%) AciCC cases (including the dedifferentiated high-grade) demonstrated strong diffuse nuclear staining for NR4A3, also five AciCC cases (including the dedifferentiated high-grade) demonstrated weak to moderate membranous staining with variable distribution for DOG1. Moreover, only 3 (50%) cases showed complete membranous staining with DOG1.

Conclusions: This pilot study showed that nuclear receptor subfamily 4 group A member 3 immunostaining is a sensitive marker for acinic cell carcinoma and of better utility than discovered on GIST-1 immunostaining in making a diagnosis of acinic cell carcinoma.

Background: Oral leucoplakia is clinical term used to describe white plaques, and that is part of the group of oral potentially malignant disorders. Leucoplakia may show epithelial dysplasia, mainly in harder smoking patient. This case report discusses a small leucoplakia with dysplasia on the tongue's lateral border in a woman, diagnosed early after a routine clinical consultation.

Methods: A 57-year-old female patient consulted to the Oral Diagnosis and Surgery Service of the State University of Ponta Grossa, Brazil. First, the patient was referred for the extraction of her lower incisors due to periodontal disease. During clinical examination, was identified a sessile white plaque, of small size, and located on the tongue's left lateral border. Thus, the lesion's diagnostic hypothesis was oral leucoplakia due to patient be chronic smoker for 40 years. The incisional biopsy was performed, with the epithelial tissue and part of the connective tissue removed.

Results: The histopathological examination revealed a stratified and keratinized pavement epithelium, with cellular atypia, and presence of hyperchromatism and nuclear pleomorphism. However, the alterations were restricted to the epithelium's basal, characterizing a mild dysplasia. The proposed treatment was surgical removal of the lesion, and the patient was also instructed to quit smoking, as well as she continues to follow-up.

Conclusions: The presented case emphasizes the importance of early diagnosis and the orientation of risk factors to smoking patients, even in small lesions that can clinically appear harmless.

Objectives: Test the hypothesis of no difference in the volumetric stability of the grafting material following maxillary sinus floor augmentation with autogenous bone graft compared with composite grafting material or bone substitute alone applying the lateral window technique.

Material and methods: MEDLINE (PubMed), Embase, Cochrane library and hand-search of relevant journals were conducted. Human studies published in English until the 9^th of October 2020 were included. Outcome measures included three-dimensional volumetric changes of the grafting material and potential predictive parameters. Volumetric changes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval.

Results: Electronic search and hand-searching resulted in 102 entries. Four randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. The volumetric stability of the grafting material was significantly improved by mixing autogenous bone graft with a non-resorbable xenograft compared with autogenous bone graft. Meta-analyses assessing absolute and relative volumetric changes demonstrated no significant differences between autogenous bone graft compared with allogeneic bone graft, synthetic biomaterials combined with autogenous bone graft or used alone. Association between volumetric changes of the grafting material and potential predictive parameters were not assessed in the included studies.

Conclusions: Volumetric reduction of the augmented area seems inevitable following maxillary sinus floor augmentation regardless of the grafting material. The volumetric stability of autogenous bone graft is improved with addition of xenograft compared with autogenous bone graft. However, conclusions drawn from this systematic review should be interpreted with caution since only four studies using three-dimensional radiographic measurements were included.

Objectives: Digital radiography is an increasingly used technology in Lithuania. However, there is no published information about using cone-beam computed tomography. The aims of this cross-sectional study performed in Lithuania were (1) to obtain information about the prevalence and accessibility of digital radiography and cone-beam computed tomography usage, and (2) to estimate dental practitioners' knowledge about this diagnostic method and their need for education.

Material and methods: Questionnaires consisting of 31 questions were distributed during the 2019 International Dentist Congress in Lithuania.

Results: This study analyses the data obtained from 248 respondents. Most of the clinicians use digital radiographic methods in their practice. The institutions usually have a digital dental X-ray machine, less often a digital panoramic X-ray machine, and least often a cone-beam computed tomography (CBCT) unit. Most dental practitioners performed 1 to 10 CBCT scans per month for adult patients and the most frequent reason for its use was implantation planning. Of the practitioners, 81.7% would like to improve their CBCT knowledge and skills.

Conclusions: The number of digital X-ray machines has increased throughout the last decade. Lithuanian dental practitioners do not excessively use cone-beam computed tomography. Some concerns were raised regarding respondents' knowledge about exposure factors and this diagnostic method's performance for paediatric patients. Additional training should be provided to Lithuanian dental specialists.

Objectives: Previous studies of variation in mandibular foramen characteristics with age have involved comparison in different populations, but few data, between non-atrophic and atrophic mandibles are available. The aim of this original article was to compare the position, shape and area of the mandibular foramen between non-atrophic and atrophic mandibles.

Material and methods: Morphometric methods were used to study the mandibular foramen variation. Fifty adult dry mandibles from the laboratory of anatomy were selected. Mandibles were considered non-atrophic if the distance between the base and alveolar ridge was homogeneous and greater than 25 mm in the anterior region and 20 mm in the posterior region. Conversely, mandibles were considered atrophic if that distances were lower than those described to a minimum of 11 mm in all areas. All measurements were performed with a digital caliper. For statistical analysis, the admitted level of significance was 5%.

Results: When non-atrophic mandibles were compared to atrophic ones, the mandibular foramen shifted significantly to an anterior position (mean difference [MD]: 4.81 mm; P < 0.0001) and to an inferior position (MD: 3.04 mm; P < 0.0001) and changed from an elliptical shape to round one, with a significant decrease in its area (MD: 3.66 mm²; P < 0.05).

Conclusions: The results indicate that there are significant differences in the position, shape and area of the mandibular foramen between non-atrophic and atrophic mandibles. These data should be considered in anaesthetic techniques and surgical procedures to prevent vascular and nervous lesions.

Objectives: The aim of this retrospective multicentre cohort study was to compare clinical outcomes, soft tissues conditions and differences in marginal bone loss between implants with a laser-microgrooved collar placed in posterior maxillary extraction sockets grafted by 4 to 5 months, and in posterior maxillary pristine bone (spontaneously healed posterior maxillary extraction sockets) by means of osteotome-mediated sinus floor elevation, over a period of 5 years after functional loading.

Material and methods: Patients of Group 1 underwent extractions with sockets preservation using porcine-derived bone, covered with collagen membrane. Group 2 underwent extractions without socket preservation. Patients of Group 1 received implants in grafted sites, and Group 2 received implants in spontaneously healed bone using a maxillary sinus lift with crestal approach.

Results: Over the observation period, the overall clinical success rate in Group 1 and Group 2 was 98% and 100%, respectively, with no differences between the procedures and implants used. Cumulative radiographic marginal bone loss ranged from 0.03 to 0.39 mm after 60 months of functional loading. There were no statistically significant differences in marginal bone loss between short and standard-length implants placed in grafted extraction sockets and in pristine bone.

Conclusions: Short and standard implants with a laser-microgrooved collar, placed in posterior maxillary extraction sockets grafted by 4 to 5 months, and in posterior maxillary pristine bone (spontaneously healed posterior maxillary extraction sockets) by means of osteotome-mediated sinus floor elevation, exhibited no statistical difference in success rate, clinical parameters and marginal bone loss.

Objectives: The aim of this retrospective study was to evaluate the relation of the infraorbital canal course with the maxillary sinus using cone-beam computed tomography.

Material and methods: A total of 1000 infraorbital canals (IOC) were examined from 500 cone-beam computed tomography scans. IOCs were classified into three types based on the degree of protrusion into the sinus. The presence of Haller cells and mucosal thickening in the sinus were evaluated. The length of bony septum from the canal to the sinus wall (D1), the distance at which protrusion begins posterior to the inferior orbital rim (D2), the vertical distance from the canal to the sinus roof (D3), and the vertical distance from the canal to the sinus floor (D4) were measured.

Results: The prevalence of IOC protrusion into the sinus was 8.8%. There was a significant difference in the prevalence of Haller cells between IOC types (P < 0.01). However, no significant correlation was found between IOC types and the presence of mucosal thickening (P > 0.05). There was no significant difference in the mean D1, D2, and D3 between the genders (P > 0.05). The mean D4 was significantly higher in males than in females (P < 0.05).

Conclusions: The protrusion of infraorbital canals into the sinus is a common variation that must be considered to prevent accidental injury. Our findings suggest that the risk of injury to the descending canals is very low during routine dentoalveolar procedures because the protruded canal is not close to the sinus floor.

Objectives: Evidence on the clinical performance of recently introduced dental implants in titanium-zirconium alloy is sparse. The aim of the present pilot study with randomized controlled design is to compare changes in supporting structures around dental titanium-zirconium alloy implants to commercially pure titanium implants.

Material and methods: The present material includes consecutive patients referred to a specialist clinic in Sweden. Two patient groups treated with dental implants in two different materials - titanium (Ti) and titanium-zirconium (TiZr) - were defined after block randomisation for smoking. In total, 40 implants installed in 21 patients were available for one-year follow-up. Marginal bone level, soft tissue height and width of keratinised mucosa were registered at baseline and at one-year follow-up.

Results: At implant level, the test group (TiZr) yielded significant marginal bone loss (P < 0.001) after one year. Additionally, marginal bone loss after one year was significantly higher for TiZr implants (P < 0.001) as compared to traditional Ti implants. Soft tissue dimensions were stable throughout the evaluation time for both implant materials.

Conclusions: One-year results indicate more pronounced initial marginal bone loss for dental implants in titanium-zirconium alloy as compared to implants made of commercially pure titanium.

Objectives: The aim of presented cross-sectional and observational study was to determine the prevalence of late oral complications of patients with head and neck cancer who underwent radiotherapy, by clinical and laboratory analyses.

Material and methods: Fifty-five patients, 43 (78.2%) men and 12 (21.8%) women, mean age 60; range 38 to 87 years, who have completed radiotherapy for head and neck cancer for at least 6 months were enrolled. The presence of xerostomia, hyposalivation, oral candidiasis, and type of oral yeasts were correlated with post-radiotherapy period. A control group, age and gender matched, was used for comparisons. The Pearson's Chi-square or Fischer's exact test was used at a significance level of 5%.

Results: The mean post-radiotherapy period was 32 months. The oral complications found were xerostomia (45/55, [81.8%]), hyposalivation (44/55 [80%]) and oral candidiasis (15/55 [27.2%]). Xerostomia and hyposalivation was statistically higher in the study group when compared to the control group (P < 0.05). The presence of yeast occurred in 39 (70.9%) of the patients in the study group, and Candida albicans was the most prevalent etiological agent in 25 (64.1%) of those patients (P < 0.05).

Conclusions: Xerostomia and hyposalivation were the more prevalent late oral complications related to radiotherapy. Oral candidiasis was also observed, although its prevalence was lower. The need for long-term dental follow-up of patients who underwent radiotherapy of the head and neck cancer is mandatory.

Objectives: The aim of this systematic review was to test the hypothesis of no difference in complications and donor site morbidity following harvesting of autogenous bone graft from the ascending mandibular ramus compared with the chin region.

Material and methods: MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through June 26, 2020. Randomized and controlled trials were included. Outcome measures included pain, infection, mucosal dehiscence, altered sensation or vitality of adjacent tooth/teeth, neurosensory disturbances and patient-reported outcome measures. Risk of bias was assessed by Cochrane risk of bias tool and Newcastle-Ottawa Scale.

Results: Ten controlled trials of high-quality fulfilled inclusion criteria. Risk of infection and mucosal dehiscence seems to be comparable with the two treatment modalities. However, harvesting from the chin seems to be associated with increased risk of pain, altered sensation or loss of tooth vitality, and neurosensory disturbances. Willingness to undergo the same treatment again was reported with both treatment modalities, but significant higher satisfaction, lower discomfort and acceptance of the surgical procedure was reported following harvesting from the ascending mandibular ramus.

Conclusions: The hypothesis was rejected due to higher prevalence and severity of complications and donor site morbidity following harvesting of autogenous bone graft from the chin region. Dissimilar evaluation methods and various methodological confounding factors posed serious restrictions for literature review in a quantitative systematic manner. Conclusions drawn from results of this systematic review should therefore be interpreted with caution.