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

Response teams, via the rapid response system (RRS), are activated when a patient's condition deteriorates; respiratory, neurological, or cardiac diseases are precursors to unexpected in-hospital cardiac arrest or death. In December 2019, our hospital introduced the RRS to reduce serious adverse events. Herein, we report a case where RRS was initiated twice for a patient who developed septic shock due to cervical necrotizing fasciitis and non-occlusive mesenteric ischemia (NOMI) after the septic shock. In August 2021, a male in his 70 s developed facial swelling, difficulty opening his mouth, and difficulty with oral intake. We observed necrotic skin on the face, soft tissue swelling in the neck, and hypotension. The RRS was initiated, and the patient was immediately admitted to the intensive care unit (ICU) where he was diagnosed with septic shock and necrotizing fasciitis of the neck. The patient underwent surgical necrotic lesion debridement and incisional drainage under general anesthesia. After weaning from shock, owing to his hypotensive and hemorrhagic status, the RRS was requested again. The patient was re-admitted to the ICU and diagnosed with NOMI. His general condition improved, and he was discharged on day 47.

Background

Periodontal therapy aims to slow the progression of periodontal disease and encourage regeneration. Clinically, a number of periodontal therapies are used to treat periodontitis. Stem cell-based tissue regeneration is currently thought to be a promising therapeutic approach for periodontal tissue regeneration.

Objective

The systemic review's objective is to assess and compare the efficacy of periodontal ligament derived stem cells and bone marrow-derived stem cells in periodontal regeneration.

Methods

The Preferred Reporting Items for Systematic Review recommendations will be followed while conducting a systematic review. The efficiency of bone marrowderived stem cells (BMSCs) and stem cells produced from periodontal ligaments (PDLSCs) in regenerating periodontal tissue will be assessed. From 2013 to 2023, search engines will be utilized to identify appropriate information from databases like PubMed, Web of Science, and Scopus in order to locate research studies on PDLSCs and BMSCs in periodontal regeneration. The newly created periodontal ligament (NPDL), newly formed cementum (NC), and newly produced alveolar bone (NB) will be the main outcomes.

Results

The research evaluating bone marrow-derived stem cells-based therapies and periodontal ligament-derived stem cell-based therapies for the regeneration of periodontal tissue will be identified, and their efficacy in terms of histologic markers will be compared.

Conclusion

The most popular and efficient stem cell types for regenerating periodontal tissue are those produced from bone marrow and periodontal ligaments. The research will aid in the eventual clinical application of stem cell research.

Osteoma is a benign neoplasm composed of mature bone and is limited almost exclusively to the craniofacial bones. Osteoma of the coronoid process is very rare. We encountered a 35-year-old woman who noticed right cheek pain when opening her mouth. She was referred to our hospital in August 2021 for the further evaluation and treatment of radio-opacity of the right mandibular coronoid process. She had no relevant medical history, family history, or history of oral parafunction. Initial extra- and intraoral clinical examinations revealed no definite swelling and no limitation of joint motion. However, the maximum unassisted mouth opening was 37 mm, and she experienced pain in the medial mandibular ramus at mouth opening. After this discomfort she had been pain-free for 15 years. Panoramic radiography revealed mushroom-shaped radiopacity on the right-side mandibular coronoid process which had increased in size compared to 15 years earlier. Computed tomography showed a bone-like lesion on the right mandibular coronoid process measuring 28 × 18 × 15 mm, with lesion-shaped right skull base bone resorption. The clinical diagnosis was a benign osseous neoplasm of the coronoid process (right side). The lesion was excised intraorally under general anesthesia; the pathological diagnosis was compact bone osteoma. The postoperative course was uneventful. The patient was then able to open her mouth to 40 mm and her right cheek pain at mouth-opening had disappeared. There has been no recurrence as of 2 years post-surgery.

Objectives

This study aimed to investigate the role of Actinomyces on the development of MRONJ in an immunocompromised mouse model with periapical disease.

Methods

Thirty ovariectomized C57BL/6 N female mice were treated with zoledronic acid (ZA) and dexamethasone (DX) for 12 weeks. At the eighth week of drug administration, pulpal exposure operation was performed on the lower right first molar in Group B and C, meanwhile Actinomyces inoculation was performed at the pulpal entrance of Group C. Group A received no operation as control. After 4 weeks, loads of total bacteria and Actinomyces in the oral cavity were assessed by real-time polymerase chain reaction (PCR). Mandibles were harvested for micro-computed tomography (CT) and histological analysis.

Results

Real-time PCR revealed positive detection of Actinomyces in 30% samples in Group C and negative detection in all samples in Group B and control group. Micro-CT examination demonstrated that in ZA treated mice, pulpal exposure significantly increased periapical bone loss, which was significantly aggravated by Actinomyces inoculation. Histological assessment showed vasodilation, acute exudative changes and pulp necrosis in Group B and C.

Conclusions

The present study revealed that inoculation of Actinomyces compromises the bone quality but does not further aggravate bone necrosis significantly.

Objective

Allogeneic hematopoietic stem cell transplants are associated with a greater susceptibility to secondary malignancies. The present study examines the prevalence and risk factors of developing secondary oral and oropharyngeal cancer.

Material and methods

This was a chart review of 286 allogeneic stem cell transplant recipients treated at a large Health Center, with a mean follow-up time of 5 years. The eligibility included adults who underwent allogeneic hematopoietic stem cell transplants between October 2016 and June 2021.

Results

Two hundred eighty-six charts were reviewed of them: leukemia (65%), aplastic anemia (10%), and lymphoma (9%). 57 (20%) developed secondary cancers Five cases of the secondary cancers (8.8%) were oral squamous cell carcinoma, and three were human papillomavirus-related. Graft versus host disease occurred in 77.1% and 100% of oral/oropharyngeal cancers. About 50% across the groups had a history of smoking. graft versus host disease, immunosuppression, and smoking. The risk factors for secondary oral/oropharyngeal cancer; chronic graft versus host disease, immunosuppression, and smoking were not statistically significant.

Conclusions

These findings support the recommendation for increased follow-up time and close monitoring of hematopoietic stem cell transplant recipients for secondary oral/oropharyngeal malignancies. The involvement of the human papillomavirus in these cases should be further investigated.

Congenital infiltrating lipomatosis of the face (CILF) is a benign non-epithelial tumor that was initially reported in 1983. Although lipomas are generally encased in fibrous tissue, CILF lacks a fibrous capsule and is characterized by intramuscular invasion. We herein report a case of CILF diagnosed based on the early eruption of permanent teeth and reviewed the English literature. The patient was a 5-year-old male with diffuse swelling of the left upper canine gingiva. He had undergone surgery at 3 years old to debulk left buccal lipoma. At presentation, facial asymmetry and diffuse swelling of the left cheek were noted. Radiographic examinations revealed the early eruption of and accelerated root formation by the left upper permanent teeth, bony hyperplasia of the left maxilla and zygomatic bone, and adipose hyperplasia of the left cheek region. Hormone examinations revealed no abnormalities. A histopathological specimen obtained from surgery to reduce buccal lipoma was re-evaluated and diagnosed as infiltrative lipoma. Based on histopathological and clinical features, the patient was diagnosed with congenial infiltrative lipoma was established. Conservative therapy was performed in consideration of future surgical interventions after adolescence.

Orbital cellulitis is an infection of the soft tissues around the eye. It can cause ischemic optic neuropathy and central retinal artery occlusion due to compression of the optic nerve by swelling in the orbit. It requires emergency treatment due to the high risk of blindness. The majority of cases are caused by infection from festering lesions in adjacent tissues, such as sinusitis, and blood-borne infection from a remote site is rare. In this report, we present a rare case of orbital cellulitis with bacteremia caused by oral Streptococcus pyogenes in a patient with 8┘ periapical edentulism.

Eosinophilic gastroenteritis (EGE) is an inflammatory disease that causes symptoms related to dysfunction owing to the high infiltration of eosinophils into the gastrointestinal tissue. We report a case of EGE that developed after severe eosinophilia induced by nivolumab administration. A 53-year-old woman was diagnosed with recurrent neck lymph node metastasis of right tongue cancer and was referred to our hospital for chemotherapy. After the administration of 12 courses of nivolumab, grade 2 diarrhea was observed, and contrast-enhanced computed tomography (CT) revealed intestinal wall edema and stenosis of the small intestine. Symptoms improved with fasting, discontinuation of nivolumab, and administration of a proton pump inhibitor. Biopsy performed using a colon fiberscope revealed EGE. After resuming nivolumab and administering three courses, positron emission tomography/CT confirmed a complete response to the metastatic lesion, and nivolumab was discontinued. After discontinuation, mild eosinophilia persisted, but abdominal symptoms, such as diarrhea, did not recur. No signs of recurrence or metastasis were observed after two years.

Objective

Oral appliances (OA) are effective in reducing apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). However, residual excessive sleepiness (RES) may occur despite successful OA treatment, and there is limited evidence on the cause of this. Furthermore, few studies have examined the association between changes in sleepiness after OA treatment and polysomnography (PSG) parameters. The purpose of this study was to evaluate the prevalence of RES after OA treatment and examine the effects of changes in sleepiness on PSG parameters.

Methods

The study sample included 121 participants who were diagnosed with OSA and had evaluated RES after OA treatment outcomes using PSG. All patients were scored using the Epworth sleepiness scale (ESS) at baseline and after OA treatment, and the association between changes in ESS and PSG parameters were examined statistically.

Results

Approximately 20.5% of OA responders (n = 73) exhibited RES. The ESS change better group (n = 24, ESS decreased by ≥2 points after treatment) exhibited significantly lower baseline lowest SpO₂ values (82.0 ± 7.9 vs. 87.5 ± 4.2; p-value <0.01) and higher baseline CT90 value (2.4 ± 4.0 vs. 0.5 ± 0.9; p-value <.05) compared to the ESS change worse group (n = 19, ESS increased by ≥2 points after treatment). Moreover, the CT90 change rate after OA treatment was also significantly higher in the former group.

Conclusion

OSA patients can exhibit RES despite improvements in AHI after OA treatment. Furthermore, improvements in ESS can potentially help predict hypoxia parameters in PSG.

The tongue is a vital and complex organ responsible for various functions, with sensory and motor properties in oral cavity. Different etiological factors, such as oncological resections, trauma, or lacerations can result in significant tissue loss. Currently, lingual reconstruction is a challenge for surgeons, as it aims to restore speech and swallowing while maintaining its role between the maxillary arches, aesthetic appearance, airway patency, and taste. Therefore, achieving ideal surgical outcomes is essential. A 56-year-old male patient consulted an emergency health center due to an accidental partial glossectomy of the anterior two-thirds of the tongue caused by a traumatic bite. The patient underwent surgical lingual plasty under general anesthesia using a modification of the technique described by Harada et al. Here, we present a case of a patient who underwent a traumatic partial glossectomy of the anterior two-thirds of the tongue, which was successfully reconstructed using a modification of the Harada technique.