eJournal of Oral Maxillofacial Research最新文献

Background: Aplasia of the salivary glands, either partial or involving all the major and possibly the minor salivary glands, is a very rare cause of hyposalivation. The aim of this case report is to present a case of aplasia of the major and minor salivary glands and discuss the relevant literature.

Methods: A 23-year-old woman, with a non-contributory medical and family history was referred due to rampant caries, that could not be attributed to any obvious aetiology. No sicca symptoms, previous parotid gland swelling or general symptoms were reported. Clinically, oral mucosa dryness and extended dental erosions and caries were observed, while the orifices of the excretory ducts of the parotid and submandibular salivary glands were not evident. Unstimulated and stimulated saliva flow rates were severely diminished, while a diagnostic biopsy of the lower lip revealed absence of minor salivary glands. Detailed hematologic and immunological investigations to exclude systemic disorders were also within normal limits. Ultrasound and magnetic resonance imaging revealed the absence of all major salivary glands, confirming the clinical diagnosis of congenital aplasia of the salivary glands.

Results: Oral hygiene instructions and dietary advice were given while dental products with fluoride and saliva substitutes were administered and appropriate dental treatment was implemented. Regular dental follow-up was also advised.

Conclusions: Timely diagnosis of aplasia of the salivary glands is important, considering the detrimental effects of the absence of saliva on oral health. Management consists of the use of saliva substitutes, nutritional adaptation, maintenance of oral health and regular dental follow-ups.

Objectives: The purpose of this experimental study was to investigate the correlation between the frictional resistance torque of tap drilling prior to implant placement and the primary stability after implant placement.

Material and methods: Solid rigid polyurethane bone blocks of four different densities were used in this study. A computerized surgical implant motor device was utilized to measure the frictional resistance torque of tap drilling. After the tap torque was measured, the dental implants were inserted at the prepared sites. During the implantation, the insertion torque was recorded, and resonance frequency analysis was performed, the value of which was calculated as the implant stability quotient. Thereafter, the correlation between the tap torque and the primary stability of the implant was evaluated and compared with the standard drilling protocol.

Results: A significant positive correlation was found between the tap torque and insertion torque (Pearson's r = 0.88, P < 0.0001). Similarly, there was a positive correlation between the tap torque and implant stability quotient (Pearson's r = 0.69, P < 0.0001).

Conclusions: These results suggest that measurement of the frictional resistance torque of tap drilling prior to implant placement could provide helpful information for implant primary stability.

Objectives: This pilot study evaluated the relationship between inferior alveolar nerve location through computed tomography scan and intraoperative inferior alveolar nerve entrapment after bilateral sagittal split osteotomy.

Material and methods: Overall, 20 helicoidal computed tomography scans were evaluated in patients with facial deformities who underwent to bilateral sagittal split osteotomy (BSSO). The distance from the mandibular canal to the internal surface of the buccal and lingual cortical bone, mandibular thickness, bone density and proportion of medullary and cortical bone in 3 regions were evaluated. During the intraoperative period, the segment to which the nerve remained adhered after performing BSSO was analysed, and the data correlated.

Results: The distance from the mandibular canal to the buccal cortical bone showed a mean of 2.6 mm when the inferior alveolar nerve was adhered to the distal segment and mean of 0.7 mm when the nerve was adhered to the proximal segment. The thickness was 11.2 mm and 9.8 mm when the nerve was adhered the distal the proximal segments respectively. Mandibular thickness, distance from the mandibular canal to the buccal and lingual cortical were statistically related to intraoperative nerve entrapment (P < 0.05).

Conclusions: Narrow jaws and the distance from the mandibular canal to buccal cortical bone less than 2 mm increases the risk of the inferior alveolar nerve entrapment in bilateral sagittal split osteotomy.

Background: Epidermoid cysts are benign lesions that occur throughout the body. Their development in the oral cavity is extremely rare. Intraosseous epidermoid cysts of the jaw are even rarer and difficult to distinguish from other lesions. For this reason, we would like to draw the attention of practitioners to this pathology as a differential diagnosis through the presented clinical case.

Methods: This study presents an unusual case of a type of epidermoid cyst in an edentulous maxilla. A 70-year-old man was referred to the Maxillofacial Surgery Division at the University Multiprofile Hospital for Active Treatment and Emergency Medicine "N. I. Pirogov", Sofia, Bulgaria, for a single radiolucent area in his anterior maxilla. The patient underwent surgery to extract the cyst.

Results: Based on the clinical and radiographic evaluation, a preliminary diagnosis of dentigerous residual cyst was made. The histopathological examination of the hematoxylin and eosin stained sections revealed an epidermoid cyst based on the observed thick keratin layer resembling epidermis together with the stratified squamous epithelium lining with many layers of sheaves of orthokeratin.

Conclusions: This report presents an uncommon case of an intraosseous epidermoid cyst occurring without a history of maxillary trauma. Although intraosseous epidermoid cysts are extremely rare in jaws, they should be considered in the differential diagnosis of radiolucent lesions.

Objectives: The presented case-control study was developed to characterize the clinical, histopathological and immunological profile of patients with traumatic injuries, benign neoplasms, potentially malignant oral disorders and malignant neoplasms of the oral cavity, in order to identify biomarkers of malignancy.

Material and methods: Clinical information was collected from dental records and several techniques were performed, including histopathological evaluation in sections stained with haematoxylin and eosin, immunohistochemistry for programmed death ligand-1 and measurement of serum levels of interferon-gamma, interleukin-6, -10 and -12. Statistical analysis was performed using IBM SPSS^® Statistics software.

Results: This study included 8 patients with traumatic injuries, 8 with benign neoplasms, 6 with potentially malignant oral disorders and 11 with malignant neoplasms. An association was observed between the classification of the lesion and smoking (P < 0.05), the size of the lesion (P < 0.05), the density of the inflammatory infiltrate (P < 0.001), the degree of dysplasia (P < 0.01) and programmed death ligand-1 expression (P < 0.01).

Conclusions: Therefore, it is suggested that smoking, the size of the lesion, the inflammatory infiltrate and the programmed death ligand-1 expression can be considered potential biomarkers of oral malignancy.

Objectives: Porous titanium is used for the reconstruction of large bone defects due to its excellent mechanical strength. The quality of osseointegration of implants placed in bone reconstructed with porous titanium is unknown. The purpose of this in vivo study was to evaluate the osseointegration of implants at sites reconstructed using porous titanium.

Material and methods: Hollow porous titanium (Ti) (outer-diameter 6 mm, inner-diameter 2 mm, length 4 mm, 85% porosity) and similar-sized porous hydroxyapatite (porous HA: 75% porosity) samples were prepared and implanted in 6 New Zealand white rabbit femurs. Four weeks later, an implant bed was created to receive a Ti implant (diameter 2 mm, length 4 mm). An implant placed at a pristine bone site served as the control. Four weeks later, histological and histomorphometric evaluations of the test and control sites were conducted.

Results: Osseointegration was observed in all groups. There was no significant difference in the bone formation ratio and bone-implant contact (BIC) ratio across all groups for the whole area. At the cancellous bone area of the bone defect, superior bone formation ratio and BIC ratio were observed with porous Ti and porous HA compared to the control (bone formation ratio: control 1.8 [SD 3]%, HA 23 [SD 3]%, Ti 23.6 [SD 5]%; BIC ratio: control 5.4 [SD 5.3]%, HA 28.9 [SD 10.7]%, Ti 41.6 [SD 14]%). Porous Ti demonstrated good osteoconduction and osseointegration abilities, similar to porous HA.

Conclusions: To our knowledge, this is the first report of implant treatment after preliminary bone reconstruction using a titanium biomaterial. Porous titanium is a suitable material for bone reconstruction before implant treatment in load-bearing areas that allow subsequent prosthetic treatment.

Objectives: The aim of this cross sectional study was to analyze the method error and reliability in acoustic pharyngometry and rhinometry and to analyze the difference between standing and sitting position in acoustic pharyngometry and rhinometry.

Material and methods: The sample comprised 38 healthy subjects (11 men and 27 women) as part of a control group in another study. The subjects underwent repeated measures of acoustic pharyngometry and rhinometry in standing and sitting position. Upper airway dimensions in terms of volume, minimum cross-sectional areas (MCA) and distances were evaluated using the Eccovision^® Acoustic Pharyngometer and Rhinometer. Method error and reliability were analyzed using paired t-test, Dahlberg's formula and the Houston reliability coefficient, and differences between body positions were analyzed using paired t-test.

Results: There was no systematic error in the repeated measures except for the distance to MCA in the left nostril in sitting position (P = 0.041). The method error for the pharyngometry ranged between 0.001 to 0.164 cm/cm²/cm³ and the reliabity was 0.99. The method error for rhinometry ranged between 0.001 to 0.37 cm/cm²/cm³ and the reliability between 0.99 to 1. Difference between standing and sitting position was found only in the pharyngeal airway in terms of volume (P = 0.025) and mean area (P = 0.009) with smaller airway in sitting position.

Conclusions: The results indicate that acoustic pharyngometry and rhinometry are reliable methods to perform repeated measures of the upper airway dimensions especially in the standing mirror position. It may be essential to perform the measures with the patient positioned in the same body position each time.

Objectives: This study was to investigate suitable surface treatment methods for porous titanium by ex vivo study of material properties and calcium phosphate deposition in simulated body fluid.

Material and methods: Porous titanium with acid (H₂SO₄ and HCl mixed acid) or alkali (NaOH) treatment was prepared. The surfaces were observed, and the weight change ratio (after and before surface treatment) and compression strength were measured. To investigate the apatite formation ability, each sample was immersed in simulated body fluid (SBF). Surface observations were performed, and the weight change ratio (before/after immersing SBF) and calcification (by alizarin red staining) were measured.

Results: The acid group showed a martensitic micro-scale rough structure and the weight and mechanical strength greatly decreased compared to the other groups. The alkali group exhibited a nano-scale roughness structure with similar weight and mechanical strength. Following immersion in SBF, an apatite-like crystal layer in the alkali group was observed. The weight of all samples increased. The change in weight of the samples in the alkali, acid, and control groups were significantly different, showing the following trend: alkali group (1.6%) > acid group (1.2%) > control group (0.8%). Calcium precipitation values were higher in the samples from alkali group than in those from the acid and control groups.

Conclusions: Alkali treatment was found to be a suitable surface modification method for porous titanium, resulting in good mechanical strength and apatite formation ability in simulated body fluid.

Objectives: The purpose of this article is to systematically review the use, efficacy, differences between botulinum toxin type A doses and side effects of botulinum toxin type A therapy in patients with trigeminal neuralgia.

Material and methods: The search for the performed reviews was done in PubMed and Cochrane library in English language from January 2010 up to February 2020. Inclusion criteria: full-text studies in English language, in which visual assessment scale (VAS) was present, in which patients with trigeminal neuralgia (TN) were participated and the comparison between botulinum toxin type A (BT-A) and saline was done.

Results: The review included 4 randomized, double-blind, placebo-controlled trials with 8 to 12 weeks follow-up to observe changes in VAS and in frequency of TN attacks, differences between dosages of BT-A in therapy and side effects. Mean VAS of BT-A group decreased by approximately 68% and of palcebo group decreased by approximately 21.6% after the therapy. Mean frequency of TN attacks in 3 studies of BT-A group decreased by 85%, while in palcebo by only 15.9%.

Conclusions: Botulinum toxin type A injection therapy is a safe and effective method in management of trigeminal neuralgia. No differences between dosages of botulinum toxin type A were found. Maximum efficacy was noticed between 6 weeks and 3 months after the procedure. Side effects were mostly facial asymmetry after injection, headaches, haematoma, which disappeared in one week.

Objectives: The present manuscript aims to critically detail the physiologic process of socket healing, in the absence or presence of grafting materials or platelet concentrates, addressing the associated molecular and cellular events that culminate in the restoration of the lost tissue architecture and functionality.

Material and methods: An electronic search in the National Library of Medicine database MEDLINE through its online site PubMed and Web of Science from inception until May 2019 was conducted to identify articles concerning physiologic process of socket healing, in the absence or presence of grafting materials or platelet concentrates. The search was restricted to English language articles without time restriction. Additionally, a hand search was carried out in oral surgery, periodontology and dental implants related journals.

Results: In total, 122 literature sources were obtained and reviewed. The detailed biological events, at the molecular and cellular level, that occur in the alveolus after tooth extraction and socket healing process modulated by grafting materials or autologous platelet concentrates were presented as two entities.

Conclusions: Tooth extraction initiates a convoluted set of orderly biological events in the alveolus, aiming wound closure and socket healing. The healing process comprises a wide range of events, regulated by the interplay of cytokines, chemokines and growth factors that determine cellular recruitment, proliferation and differentiation in the healing milieu, in a space- and time-dependent choreographic interplay. Additionally, the healing process may further be modulated by the implantation of grafting materials or autologous platelet concentrates within the tooth socket, aiming to enhance the regenerative outcome.