Journal of Oral and Maxillofacial Surgery Medicine and Pathology最新文献

Introduction

Orthodontic root shortening is one of the complications which may cause movement of the teeth or even losing them. Many previous studies have found that accelerated orthodontic treatment using alveolar corticotomy could minimize the shortening and resorption of the roots. However, the X-ray imaging techniques used did not demonstrate the resorption on all root surfaces, and in some cases, they did not demonstrate root shortening unless it becomes aggressive. This study is to Evaluate variations in roots’ lengths of mandibular incisors during surgical-assisted orthodontic (SAO) alignment by alveolar corticotomy using cone beam computed tomography (CBCT).

Methods

In this study, we evaluated 96 mandibular incisors of 24 patients who suffered from moderate dental crowding in the anterior region of the mandible. The patients were divided into two groups: the control group which was submitted to conventional orthodontic treatment and the study group which was submitted to surgically-assisted orthodontic treatment using alveolar corticotomy. CBCT images were used to evaluate roots’ lengths at two times (T0, T1).

Results

The result of this study showed statistically significant differences in root shortening of the two groups, and the mean of this shortening was lower in the study group in comparison with the control group.

Conclusions

The (SAO) technique using alveolar corticotomy minimizes root shortening of the mandibular incisors during the initial alignment stage of orthodontic treatment.

Background

The aim of this study is to define an algorithm for the management of odontogenic keratocysts (OKCs) in order to reduce the recurrence rate (RR), morbidity and to analyse relapse risk factors.

Material and Methods

This article is a 10-years retrospective study on 67 patients treated for odontogenic keratocysts with different surgical options established on clinical and radiological evaluations. Recurrence free survival (RFS) and relapse risk factors were analysed with Kaplan-Meier method and log-rank tests, with a confidence interval set at 95 %. A literature research was performed using PubMed to find the most relevant and recent papers about the argument.

Results

Fifty-five subjects were included: 38 out of 55 patients presented the disease only once, while the others 17 patients presented at least one relapse. The total amount of histological examined lesions and relative surgical procedures was 75. More aggressive treatments showed lower recurrence rate but higher morbidity; more conservative ones had better functional and aesthetic outcomes but higher recurrence rate. Considering the literature, conservative treatments plus adjuvant procedures can reduce the RR. The recurrence rate was estimated to be 25.3 % with a median time to relapse of 24 months. Multilocularity resulted a negative prognostic factor significantly associated with recurrence free survival (p = 0.048).

Conclusion

According to our results and to the literature, we propose a management algorithm from diagnosis to treatment of the OKCs based on dimensions and internal arrangement of lesions, type (primary lesion or recurrence), presence of bony erosions, noble structure/teeth involvement. Multilocularity represented a statistically significant risk factor for relapse.

Objective

This review aimed to describe and deconstruct the pathogenesis and clinical presentations of primary and secondary Human herpesvirus (HHV), focusing on Human Herpes Gladiatorum (HHSG).

Methods

This narrative review gathers relevant, from articles published in databases as PubMed/Medline, Scopus, and articles reporting content and results specifically for this theme. The keywords used were “herpes”, “dentistry”, “gladiatorum”, “HHSG”, “HHV”, “sports”, and variations.

Results

Humans are frequently infected and carriers of Herpes viruses. There are different Human Herpes Simplex Virus (HHV). The pathogenesis, management, and treatment of HHV were reviewed. There is no reliable vaccine for prophylactic inoculation against the HHV, and antiviral medication for controlling symptoms and manifestations remains the most effective therapy (therapeutic drugs for HHSG drugs were tabled).

Conclusions

Understanding modes of transmission of HHV enables considering proper preventive protocols to reduce transmission of HHSG amongst athletes in contact sports.

Hereditary diseases such as chronic mucocutaneous candidiasis (CMC), autoimmune diseases such as systemic lupus erythematosus (SLE), and chronic secondary diseases such as pure red cell aplasia (PRCA) can make oral/dental surgery for some patients complicated and difficult. Because various comorbidities can increase the risk of complications and reaggravation associated with surgery, there are complexity concerns, challenges, and technical constraints. The comorbid conditions of these intractable diseases can be considered significant risk factors for postoperative complications. Dental disease in a patient with a rare genetic disease with an autoimmune disease and a subsequent refractory disease is an extremely rare case in oral and dental surgery. To our knowledge, few reports have investigated appropriate peri- and preoperative management strategies to minimize risk for postoperative complications. Therefore, informed contemplation is required to perform safe and effective surgical therapy for such patients. This case report aimed to present the experience of managing a 24-year-old woman having multiple dental caries comorbid with rare diseases, including CMC, PRCA, and SLE, and a brief overview of the symptoms and possible complications of the patient's comorbidities. In this case, local antifungal drugs, blood transfusion, and antibiotic treatment were administered before surgery to improve the oral environment and reduce the risk of infection and delayed wound healing. Furthermore, general anesthesia was applied to surgically remove caries. The patient was treated with intensive medication and wound management and recovered without postoperative complications after 1 year of follow-up. (237words)

Objective

Facial blast injuries in gold panning are rarely reported in the literature. The aim of this paper is to describe the epidemiological and clinical presentations of facial blast injuries in gold panning in Burkina Faso.

Methods

The medical records of patients suffering from facial blast injuries in gold panning sites between January 2017 and December 2020 were analyzed retrospectively. Data recording and analysis were performed with Epi Info 7 software.

Results

Facial blast injuries in gold panning represented 3.1 % of all facial trauma. The patients were all male with a mean age of 26.8 years. Soft tissue injuries accounted for 44.2 % of facial injuries. Two-thirds of the wounds were skin screening. Facial fractures accounted for 23 % of injuries. They were a multiple fracture in 4 patients. Monocular and binocular blindness were observed with equal frequency, each in 7 patients. Associated injuries were hand dislocations in 31 patients, thoracic limbs fractures in 5 patients, lower limbs fractures in 6 patients and perforation of the eardrum in 1 patient.

Conclusion

These results call for a strengthening of the laws governing the use of explosives, and a rigorous supervision of artisanal gold panning in Burkina Faso.

Plasmablastic lymphoma (PBL) is an uncommon but aggressive subtype of diffuse, large, B-cell lymphoma characterized by plasmablastic differentiation. It is a rare tumor and is known to occur most often in individuals with an immunocompromised state due to human immunodeficiency virus (HIV) or Epstein–Barr virus (EBV).

Here we report a case of PBL with no evidence of HIV or EBV infection in a 76-year-old survivor of the Nagasaki atomic bombings who was exposed at the age of 3 years. The patient presented to our hospital with a complaint of an oral mass. He was diagnosed with PBL and treated with EPOCH chemotherapy (etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin). No recurrence was observed after 3 years. The possibility of an effect of atomic bomb radiation exposure on the development of PBL cannot be ruled out in this case. However, epidemiological studies cannot prove this hypothesis because only a limited number of individuals are survivors of atomic bombings. To the best of our knowledge, this is the first report of PBL in an atomic bomb survivor with no evidence of an immunocompromised state.

Objective

Fibroblast growth factor receptor 3 (FGFR3) is a member of the fibroblast growth factor receptor tyrosine kinase family. The prognosis and management stratification of oral squamous cell carcinoma (OSCC) are based on histology and other factors; however, immunohistochemical (IHC) markers that can detect OSCC that are more malignant and with a worse prognosis have not been adequately investigated. OSCC expresses activated FGFR3 signaling, which is not associated with prognosis. Currently, we explored the association between FGFR3 overexpression or the proliferation and histopathological hierarchy and stratum of risk.

Methods

A total of 62 patients who had been diagnosed with OSCC at our department between January 2008 and December 2013 were included. The IHC expression of FGFR3 and Ki67 was analyzed in 45 (n = 37 tongue, 7 floor of mouth, 3 buccal mucosa) cases of OSCC. JMP14.2 was used for statistical analysis.

Results

A combined analysis of FGFR3^high/Ki67^high positivity resulted in a reduced mean overall survival (OS) of 67.3 months when comparing with all other combinations. In the multivariate analysis (MVA), high clinical stage (p = 0.036) and FGFR3^high/Ki67^high (p = 0.031) were significant independent risk factors for OS.

Conclusions

We identified FGFR3^high/Ki67^high OSCC as a subgroup that has a weak prognosis and OS. OSCC grading should probably be augmented by IHC staining, and tumors classified as having a worse prognosis require appropriate clinical surveillance.

Basal cell adenoma (BCA) is a benign salivary gland tumor that usually arises in the parotid gland. It was classified as an independent tumor for the first time by the World Health Organization in 1991. BCA appears as a hard, mobile, slow-growing mass. A BCA situated within the palatal minor salivary glands is rare. As far as we could wade through the literature, only 9 cases of BCA occurring in the palatal minor salivary glands have been reported. We present a case of BCA arising in the palatal minor salivary glands. A 70-year-old woman was referred to our department for evaluation of a painless swelling in the left palate region. Based on the clinical findings, an excisional biopsy was planned with the tentative diagnosis of a benign tumor of the palate. Under general anesthesia, the tumor was resected with healthy peripheral tissue. The tumor was well-differentiated and did not invade the surrounding tissues. Immunohistochemically, tumor cells reacted positively to cytokeratin (AE1/AE3), S-100 protein, p 63, and α-smooth muscle actin (α-SMA). The Ki-67 labeling index, a marker of cell proliferation, was low. Thus, the final diagnosis was a BCA. No recurrences or postoperative complications have been noted 42 months postoperatively.

Adenocarcinoma, not otherwise specified (NOS) exhibits ductal differentiation without the diagnostic histomorphological features of other defined salivary carcinomas. Adenocarcinoma, NOS rarely occurs in the lip, and when adenocarcinomas occurs in more than one organ, it is often difficult to identify the primary site. We report a case of adenocarcinoma of the left-upper lip occurring in a 67-year-old woman, which need to clearly identify the type of tumor required collaboration with Department of Respiratory Surgery to identify the primary origin site. The woman was referred to our department because of a painless mass in the upper lip. The clinical diagnosis was a benign tumor or mucous cyst and we performed a biopsy. The histopathological diagnosis was adenocarcinoma, NOS. Chest computed tomography demonstrated a mass in the lower-right-lung lobe. We suspected lung metastases and histopathologically attempted to identify the primary lesion. Immunohistochemical analysis showed positive staining for cytokeratin 7 and negative staining for thyroid transcription factor 1 and napsin A. The analysis identified the primary lesion as a salivary adenocarcinoma, NOS. We performed a full-thickness resection of the left-upper lip and reconstructive surgery of the upper lip. Postoperative computed tomography at the 3-month follow-up showed no mass in the lower-right-lung lobe. Follow-up examinations have shown no evidence of recurrence for 4 years after the surgery.

Castleman’s disease（CD）usually occurs in the mediastinum and rarely occurs in the head and neck region. Almost all CD in the head and neck region is hyaline vascular (HV) type, and plasma cell (PC) type of CD is relatively rare. An 82-year-old woman with a well-defined, elastic, hard, and palpable painless tumor in the left submandibular area was referred to our division. Magnetic resonance imaging of the tumor revealed low signal intensity on T1-weighted images, moderate to high signal intensity on T2-weighed images. Fine needle aspiration was performed, and no dysplasia was detected. Tumorectomy was performed under general anesthesia. The histopathological diagnosis was PC type of CD. There was no recurrence at follow-up 10 months after surgery. Herein, we present the first female and the oldest case of PC type of CD in the submandibular.