Journal of Maxillofacial & Oral Surgery最新文献

Objectives: Due to the importance of clinical impression in accurate final diagnosis of oral pathologic lesions, this study evaluated the agreement rate between clinical and histopathological diagnosis in of oral premalignant (PML) and malignant lesions, over a period of 22 years.

Materials and methods: In this retrospective and cross-sectional study, 861 cases were reviewed. Patients' clinical data, type of biopsy, clinical appearance of the lesion, as well as clinical impression and histopathological diagnosis were noted using the archived medical files. Descriptive statistics and Chi-square test were used for analyzing the data.

Results: Overall, the agreement rate between histopathological and clinical diagnoses was 71.9%. This rate was 71.8% in PML and 75.7% in malignant lesions. The highest agreement among all lesions was found in OLP, in the mouth floor and by oral medicine specialists.

Conclusion: The results showed a relatively high agreement rate between clinical and histopathologic diagnosis of PML and malignant lesions. Clinical presentation, site and type of biopsy, as well as clinicians' specialty were associated with this rate. More education, careful clinical examination, and more cooperation between the surgeon and pathologist are necessary for accurate diagnosis and management.

Background: Venous thromboembolism (VTE) is a major factor responsible for death in patients suffering from prolonged immobilisation due to various causes like old age, pregnancy, stroke, and prolonged surgical procedures to mention a few. Long-duration surgeries as in fixation and reconstruction in panfacial fractures and facial orthognathic surgeries can be potential cases predisposed for VTE in maxillofacial surgery.

Method: A fifty-eight-year-old patient suffered from pulmonary thromboembolism following long-duration surgery for panfacial fracture fixation and reconstruction under general anaesthesia. He was promptly managed via medical management and recovered well.

Discussion: Pulmonary thromboembolism is a severe complication that can lead to severe morbidity or even death. Owing to the characteristics of venous thrombosis, all collaborating healthcare team members should be trained to assess risk factors for efficient diagnosis which can facilitate specialised intervention that can result in better patient outcomes.

Conclusion: Maxillofacial surgeons need to evaluate the risk of thromboembolism in patients and institute efficient diagnosis whenever required to deliver optimised and better patient care. Although thromboembolism is a preventable disease state, the key is to keep a close eye on the patient's clinical features to identify and treat them at the right time for better patient care and survival.

Aim: To assess effect of therapeutic nutrition on serum albumin levels, nutritional indices and on recovery of patients who have undergone open reduction and internal fixation for maxillofacial fractures.

Methods: A total of 82 patients were included in this prospective study with 41 patients each in therapeutic and non-therapeutic nutrition group. Pre-operative serum albumin, prognostic nutritional index (PNI) and nutritional risk index (NRI) were calculated. Early wound healing index (EHI) was taken along with serum albumin on day 0 and follow-up day 10 and were compared.

Results: There was statistically significant difference (p < 0.001) between pre- and post-mean serum albumin levels and mean EHI score in both groups. In non-therapeutic group, there was decrease in serum albumin whereas increase in therapeutic group. There was increase in EHI score on follow-up day 10 which indicated improvement in healing in both the groups.

Conclusion: Addition of protein supplement increased post-operative serum albumin level. Regardless of type of nutrition, an improvement in healing was seen in both the groups. Special nutrition counselling and care must be given for maxillofacial fracture patients who have additional injuries as this may benefit overall post-operative recovery of the patients.

Aim: This study examines the levels of CD24 and CD44 expression in premalignant oral lesions (PMOL) and locally advanced oral squamous cell carcinoma (OSCC) in order to improve the early detection of the disease. We utilized RT-PCR techniques to examine the expression of two cell membrane proteins, CD24 and CD44, in blood and tissue samples.

Methods: A quantitative real-time polymerase chain reaction was performed to evaluate the expression patterns of CD24 and CD44 in blood and tissue samples obtained from individuals with PMOL (n = 20), OSCC (n = 20), and control subjects (n = 10). An independent t-test was utilized, revealing that CD24 demonstrated statistical significance with a p-value < 0.05. Fold change analysis had been performed to quantify the differences in expression between the two groups.

Results: CD24 was found to be increased in both tissue and blood groups. CD44 expression was higher in the tissue group in contrast to the blood group. The results for CD24 were statistically significant, with a p-value < 0.05. The findings affirm the use of CD24 as a dependable biomarker for early detection and diagnosis of OSCC in both tissue and blood specimens.

Conclusion: In conjunction with histological characteristics and clinicopathological factors, CD24 serves as a dependable biomarker for the early diagnosis of OSCC.

Background: Oral and maxillofacial lesions (OMFL) consist of a various malignant and benign lesions of the oral cavity. The aim of this study was to report the details of OMFL that had been diagnosed histologically at Oral Pathology Unit of a Dental Institute of eastern UP region.

Materials and methods: Oral cavity biopsied submitted to the Oral Pathology Unit during the period from 2016 to 2021 was evaluated. Information on age, gender, and histopathologic diagnosis was analyzed.

Results: A total of 1128 biopsies were examined and analyzed. Reactive lesions were the most common type (n = 267; 23.7%) of lesions diagnosed, and epithelial malignancies (n = 250; 22.2%) were second most common type of lesion followed by cystic lesions (n = 202; 17.92%), epithelial lesions (n = 141; 12.5%), and odontogenic tumors (n = 122; 10.82%).

Conclusion: The results provide important information on the prevalence and distribution of OMFL in eastern UP region of India. Reactive lesions were the most common type of OMFL diagnosed. Most of the lesions were soft tissue lesions, inflammatory in origin, and benign in nature. Multicentric studies involving larger sample should be carried out to assess the pattern of oral diseases in our community leading to the overall betterment of our society.

Objective: To study the prognostic predictive value of the platelet lymphocyte ratio as a clinical parameter of the outcome of the Sudanese OSCC patients.

Method: Forty two oral cancer patients were selected for the study. The patients surgically managed in the period December 2018 to June 2020. The PLR was recorded and correlated with :the status of surgical margins, the lymphovascular invasion, the extranodal extension, the microscopic depth and the patient's survival (dead/ alive).

Result: A ratio of 170 was considered to be a cut off point of the PLR; as patients with a ratio higher than 170 were found to have a bad prognosis. Twenty-four patients (59.5%) had a PLR higher than 170. Patients with PLR equal to 170 or less have 45% decrease in the odds of survival and 57% decrease in the odds of having positive lymph nodes. Thirty-three percent passed away.

Conclusion: The PLR is an affordable, practical and efficient way to predict an OSCC patient's overall survival.

Purpose: Treating vascular anomalies (VAs) in the head and neck is challenging for resident physicians due to evolving educational approaches. This survey assessed oral and maxillofacial surgery (OMFS) residents' exposure, education, and comfort in managing patients with VAs.

Methods: The Boston Children's Hospital Vascular Anomalies Center distributed a 15-question survey to 108 program/fellowship directors and 633 OMFS residents in the U.S. The survey included questions on demographics, education, exposure, VA management, and the role of oral health professionals. It was sent on 5/10/2022, with a reminder on 5/17/2022. Statistical significance set at p < 0.05.

Results: Of 633 residents contacted, 98 (15.5%) responded, with 91 (14.4%) completing the survey. Among them, 57.1% were in dual degree programs, and 42.9% in single degree programs. Over half (56%) had no experience with VA care teams, and 35.2% lacked specific VA education. Only 23.1% trained at facilities with interdisciplinary VA clinics. While 67% had VA case exposure, 33% felt unconfident in treating head and neck vascular lesions or managing oral health for VA patients.

Conclusion: The study highlights limited exposure and education on VAs among OMFS residents, underscoring the need to include VAs in the OMFS curriculum and expand interdisciplinary VA clinics in OMFS programs.