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Journal of Cranio-maxillo-facial... Oct 2014Keratocystic odontogenic tumors (KCOTs) are locally aggressive benign tumors which occur in the bones of both jaws with a high recurrence rate. The aim of the present... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Keratocystic odontogenic tumors (KCOTs) are locally aggressive benign tumors which occur in the bones of both jaws with a high recurrence rate. The aim of the present study was to define and evaluate the post-treatment recurrence of KCOT lesions in non-syndromic and syndromic patients.
METHODS
A systematic review of the literature and meta-analysis was conducted according to the PRISMA statement. Seven electronic databases were searched from their start up to August 2013 for clinical studies on human patients without limitation to year, language or publication status.
RESULTS
A total of five case series studies with 323 treated KCOT lesions were included in the quantitative synthesis. The recurrence rate of KCOTs for three treatment forms ranged from 7% to 28%. Comparisons among the various treatments suggest that resection or marsupialization might be associated with fewer recurrences. However, high risk of bias and effect imprecision preclude the making of clinical recommendation. Existing evidence regarding nevoid basal cell carcinoma patients was likewise scarce.
CONCLUSIONS
The absence of studies with low risk of bias precludes the making of safe recommendations about the optimal management of KCOTs.
Topics: Basal Cell Nevus Syndrome; Bias; Combined Modality Therapy; Humans; Jaw Neoplasms; Neoplasm Recurrence, Local; Odontogenic Tumors; Syndrome
PubMed: 24815763
DOI: 10.1016/j.jcms.2014.03.020 -
Clinical and Experimental Dental... Feb 2023Antiresorptive medication has been reported to be associated with medication-related osteonecrosis of the jaw (MRONJ). This systematic review aims at investigating the... (Review)
Review
OBJECTIVES
Antiresorptive medication has been reported to be associated with medication-related osteonecrosis of the jaw (MRONJ). This systematic review aims at investigating the incidence of and risk factors for MRONJ after tooth extractions in cancer patients treated with high-dose bisphosphonate and denosumab (BP and DS). MATERIAL AND METHODS: The protocol followed the PRISMA statement list and was registered in PROSPERO. Searches were performed for literature published up to April 2021 in the electronic databases PubMed, Embase, Web of Science, and CINAHL and then supplemented by manual research.
RESULTS
The search process resulted in 771 identified articles, of which seven studies fitted the population, intervention, comparison, and outcome framework. All were observational studies and four had control groups. A total of 550 patients treated with BP and DS were identified of whom 271 had received tooth extractions after medication onset. Due to significant heterogenicity in the collected data, only a qualitative analysis was performed. The MRONJ incidence after tooth extractions varied between 11% and 50% at the patient level. MRONJ occurred up to 3 years after the tooth extraction. Teeth affected by inflammation before the extraction and additional osteotomy during the surgical procedure were identified as risk factors.
CONCLUSIONS
Reliable methods of diagnosing MRONJ and adequate follow-up periods are important factors in obtaining the actual incidence of MRONJ after tooth extractions in patients treated with high-dose BP and DS.
Topics: Humans; Bisphosphonate-Associated Osteonecrosis of the Jaw; Incidence; Diphosphonates; Tooth Extraction; Risk Factors; Neoplasms
PubMed: 36464958
DOI: 10.1002/cre2.698 -
The Journal of Prosthetic Dentistry Dec 2016Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the installation of implants in irradiated patients has been used with varying success.
PURPOSE
The purpose of this systematic review was to compare the success rate of implants placed in irradiated human bone tissue with that of implants placed in nonirradiated areas.
MATERIAL AND METHODS
Searches were performed in the EMBASE, Cochrane, and PubMed/Medline databases up to December 2013 to identify clinical trials addressing the subject. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The relative risks of implant failure and survival curves were calculated considering a confidence interval of 95%. Heterogeneity was analyzed by using a funnel chart.
RESULTS
A total of 40 studies involving 2220 participants and 9231 dental implants were selected. The survival curve of the studies indicated a survival rate of 84.3% for implants installed in irradiated bone tissue. The meta-analysis indicated statistically significant differences (P<.001) between item success rates of implants placed in irradiated areas and those of implants placed in nonirradiated areas.
CONCLUSIONS
Dental implants installed in the irradiated area of an oral cavity have a high survival rate, but strict monitoring is needed to prevent complications, thereby reducing possible failures.
Topics: Dental Implants; Dental Restoration Failure; Equipment Failure Analysis; Head and Neck Neoplasms; Humans; Jaw; Kaplan-Meier Estimate
PubMed: 27460315
DOI: 10.1016/j.prosdent.2016.04.025 -
Medicina Oral, Patologia Oral Y Cirugia... May 2023Osteoradionecrosis of the jaws (ORNJ) is a severe and challenging complication of head and neck radiation therapy. Despite its aggressiveness and controversy respect to...
BACKGROUND
Osteoradionecrosis of the jaws (ORNJ) is a severe and challenging complication of head and neck radiation therapy. Despite its aggressiveness and controversy respect to its efficacy, surgical intervention remains the main treatment modality. Nevertheless, due to advances in the understanding of ORNJ physiopathology, new treatment alternatives such as the combination of pentoxifylline with tocopherol (PENTO) have emerged. The aim of this systematic review was to assess the reported efficacy of PENTO for the treatment of ORNJ. Material and Methods: Studies were search using Pubmed, The Cochrane Library, Scopus, and Web of Science data bases following the PRISMA guidelines. Inclusion criteria were cohort, case series, randomized or non-randomized clinical studies published in English including human subjects who received PENTO as treatment for ORN of the jaws. Results: Eleven articles met the inclusion criteria and were included for data analysis. All studies reported patients with complete mucosal coverage with no exposed bone (considered healthy) after PENTO treatment, ranging from 16.6% to 100% of the patients, depending on the study. Clinical improvement or disease stabilization was reported between 7.6% and 66.6% of studied individuals, while disease progression was seen in only 5 studies involving 7.6 - 32% of patients.
CONCLUSIONS
PENTO treatment achieved a complete disease control in a significant number of patients in all studies. However, there is no standardized protocol for administering the therapy. It is necessary to determine the pharmacological doses and to evaluate the benefits of adding antibiotics and clodronate. Good quality clinical trials are needed to develop a successful algorithm for the management of ORN of the jaws.
Topics: Humans; Tocopherols; Pentoxifylline; Osteoradionecrosis; Head and Neck Neoplasms; Jaw
PubMed: 36641743
DOI: 10.4317/medoral.25729 -
Dento Maxillo Facial Radiology Jan 2011The aim of this review is to evaluate the principal clinical and conventional radiographic features of non-syndromic keratocystic odontogenic tumour (KCOT) by systematic... (Review)
Review
OBJECTIVES
The aim of this review is to evaluate the principal clinical and conventional radiographic features of non-syndromic keratocystic odontogenic tumour (KCOT) by systematic review (SR), and to compare the frequencies between four global groups.
METHODS
The databases searched were the PubMed interface of Medline and LILACS. Only those reports of KCOTs that occurred in a series of consecutive cases, in the reporting authors' caseload, were considered.
RESULTS
51 reports, of 49 series of cases, were included in the SR. 11 SR-included series were in languages other than English. KCOTs affected males more frequently and were three times more prevalent in the mandible. Although the mean age at first presentation was 37 years, the largest proportion of cases first presented in the third decade. The main symptom was swelling. Over a third were found incidentally. Nearly two-thirds displayed buccolingual expansion. Over a quarter of cases recurred. Only a quarter of all SR-included reported series of cases included details of at least one radiological feature. The East Asian global group presented significantly as well-defined, even corticated, multilocular radiolucencies with buccolingual expansion. The KCOTs affecting the Western global group significantly displayed an association with unerupted teeth.
CONCLUSIONS
Long-term follow-up of large series that would have revealed detailed radiographic description and long-term outcomes of non-syndromic KCOT was lacking.
Topics: Africa South of the Sahara; Chi-Square Distribution; Ethnicity; Europe; Asia, Eastern; Humans; Keratins; Latin America; Mandibular Neoplasms; Maxillary Neoplasms; Neoplasm Recurrence, Local; Odontogenic Tumors; Radiography; Sex Ratio; United States
PubMed: 21159911
DOI: 10.1259/dmfr/29949053 -
Journal of Oral and Maxillofacial... 2021Solitary plasmacytoma of bone (SPB) is a localized form of plasma cell neoplasm where jaw involvement is rare. Distinguishing SPB from other plasma cell neoplasms is...
Solitary plasmacytoma of bone (SPB) is a localized form of plasma cell neoplasm where jaw involvement is rare. Distinguishing SPB from other plasma cell neoplasms is critical for treatment and survival. Here, a case of SPB of mandible in an elderly female is reported. Histopathological diagnosis of plasma cell neoplasm was confirmed immunohistochemically with MUM1 and CD138 positivity and multiple myeloma (MM) was ruled out on performing systemic workup. Prognosis of SPB worsens when it transforms into MM. A systematic review was undertaken with the objective to determine the factors affecting conversion of SPB to MM. An electronic search was undertaken with PubMed/MEDLINE, Web of Science and Science Direct. Fifty cases of SPB of jaw from 29 publications were reviewed. SPB commonly presents as a painless swelling. Radiographically, it is commonly seen as multilocular radiolucency with well-defined borders. Follow-up data showed that nine cases turned into MM in a mean duration of 1 year 9 months and 12 patients died after median disease-free survival of 6 years 9 months. Prognosis of SPB is found to be affected by tumor size (≥5 cm), anaplasia of tumor cells, Ki-67 labeling index, vascularity of the tumor, presence of clonal bone marrow plasma cells, serum immune globulin level, dose of radiotherapy and persistence of M protein after treatment. There is a need to identify prognostic subgroups in SPB based on these factors. Furthermore, studies are necessary for standardization of treatment protocol to halt or prolong the progression of SPB to MM.
PubMed: 34349446
DOI: 10.4103/jomfp.JOMFP_251_20 -
Oral Oncology May 2013The incidence of head and neck cancer (HNC) is increasing, and treatment advances have contributed to improvements in survival. However, a growing number of HNC... (Review)
Review
PURPOSE
The incidence of head and neck cancer (HNC) is increasing, and treatment advances have contributed to improvements in survival. However, a growing number of HNC survivors now live with the long-term consequences of cancer treatment, in particular, problems with eating. The combined effects of HNC cancer, intensive chemotherapy, radiotherapy and surgery have a profound impact on functional, psychological, social and physical aspects of eating. Evidence is needed to underpin new rehabilitation approaches to address these complex problems. This review aimed to identify and summarise the evidence for rehabilitation interventions aimed at alleviating eating problems after HNC treatment.
METHODS
A systematic review of studies indexed in Medline, CinAHL and PsycINFO using search terms relevant to a wide range of aspects of eating. Publications reporting empirical findings regarding physical, functional and/or psychosocial factors were included.
RESULTS
Twenty-seven studies were identified. Fifteen focussed on swallowing exercises, eight on interventions to improve jaw mobility and four on swallowing and jaw exercises. None included interventions to address the complex combination of functional, physical and psychological problems associated with eating in this patient group.
CONCLUSIONS
This review highlights that, whilst there is some evidence to support interventions aimed at improving swallowing and jaw mobility following treatment for HNC, studies are limited by their size and scope. Larger, high quality studies, which include patient-reported outcome measures, are required to underpin the development of patient-centred rehabilitation programmes. There is also a particular need to develop and evaluate interventions, which address the psychological and/or social aspects of eating.
Topics: Deglutition; Deglutition Disorders; Drinking; Eating; Feeding and Eating Disorders; Head and Neck Neoplasms; Humans; Range of Motion, Articular; Recovery of Function; Trismus
PubMed: 23291294
DOI: 10.1016/j.oraloncology.2012.12.002 -
Oral Diseases Jan 2020To evaluate the global incidence of ameloblastoma and to provide a profile of ameloblastoma patients. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the global incidence of ameloblastoma and to provide a profile of ameloblastoma patients.
MATERIAL AND METHODS
A systematic review and meta-analysis was conducted. Searches were performed in PubMed, EMBASE, SCOPUS, and Web of Science for articles published from 1969 to 2018 for the global incidence and from 1995 to 2018 for the profile of ameloblastoma patients.
RESULTS
Seven studies on the incidence rate of ameloblastoma were included in the meta-analysis. These studies only covered Europe, Africa, and Australia. The pooled incidence rate was 0.92 per million person-years (95% CI: 0.57-1.49), with significant heterogeneity between studies. Forty-two articles provided profile data of 6,446 ameloblastoma patients. Mean age was 34 years and the peak age incidence in the third decade of life. In Europe and North America, ameloblastoma mostly occurred at an older age when compared to Africa and South America. A slight male preference (53%) was found, and the mandible appeared to be the preferred site. The most common type of ameloblastoma was multicystic. The histopathologic patterns were mostly follicular and plexiform.
CONCLUSIONS
This is the first study assessing the global incidence of ameloblastoma. The pooled incidence rate was determined to be 0.92 per million person-years.
Topics: Africa; Ameloblastoma; Australia; Europe; Humans; Incidence; Jaw Neoplasms; Mandible
PubMed: 30614154
DOI: 10.1111/odi.13031 -
Journal of Racial and Ethnic Health... Feb 2024Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and... (Meta-Analysis)
Meta-Analysis Review
Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and inconclusive. The role of race and ethnicity on ameloblastoma growth characteristics, genetic mutational profile, and recurrence is also still unclear. The primary aim of this systematic review was to assess genetic, racial, and ethnic distribution of primary and recurrent ameloblastoma from published literature. The secondary aim was to assess potential correlations between ethnicity, genetic mutation, and disparities in ameloblastoma treatment outcomes in Afro-descendants and non-Afro-descendants. Twenty-three eligible articles were selected based on preferred reporting items for systematic review and meta-analysis (PRISMA), and a total of 169 ameloblastoma cases were evaluated. Data on patient demographics, ameloblastoma growth characteristics, and genetic status were collected for quantitative analysis. Among a total of 169 ameloblastoma cases, Afro-descendant patients had higher primary and recurrent ameloblastomas at 15.5% and 4.7% respectively compared to non-Afro-descendant at 10.7% and 1.8% respectively. Additionally, BRAF V600E was positively associated with 48.8% of all ameloblastomas and strong predilection for Afro-descendants. Despite the paucity of information on genetic profile of ameloblastomas in the Afro-descendant patient cohort, this ethnic group still accounted for 2.95% of all BRAF V600E-positive tumors. These suggest that Afro-descendants are understudied regarding ameloblastoma characteristics, genetic profile, and recurrence profile. Mutational analysis of ameloblastoma tumors in Afro-descendants should be promoted.
Topics: Humans; Ameloblastoma; Proto-Oncogene Proteins B-raf; Jaw Neoplasms; Treatment Outcome; Mutation
PubMed: 36596981
DOI: 10.1007/s40615-022-01500-6 -
The Journal of Craniofacial Surgery Jun 2017Intraosseous schwannomas of the mandible are rare tumors that usually arise from peripheral nerve sheaths of the main trunk or branches of the inferior alveolar nerve... (Review)
Review
Intraosseous schwannomas of the mandible are rare tumors that usually arise from peripheral nerve sheaths of the main trunk or branches of the inferior alveolar nerve (IAN).A systematic review of the English literature through PubMed was conducted from 1945 to 2016. Forty-nine patients of mandibular intraosseous schwannomas were identified. The most common location of the tumor was the posterior mandible (61.2%). There were 28 patients in whom the tumor involved the IAN (57.1%). The most commonly performed procedures included enucleation through a mucoperiosteal flap and a bone window (73%), curettage (10%), segmental mandibulectomy (10%), and sagittal split ramus osteotomy (6%). The recurrence rate was 6%: all 3 recurrent patients occurred in the posterior area. The authors report a 72-year-old female with a schwannoma of the IAN which was removed through a sagittal split of the mandible, although there was a bony defect of the external cortex after biopsy of the lesion. The nerve was reconstructed with a sural nerve graft.Due to the slow growing nature and encapsulation of schwannomas, surgical resection seems the best treatment with optimal functional outcomes and low recurrence rate even with a minimally invasive approach. Sagittal split ramus osteotomy and segmental mandibulectomy are reserved to large or posterior lesions to aid with radical resection or improve exposure and reconstruction.
Topics: Female; Humans; Male; Mandible; Mandibular Neoplasms; Mandibular Nerve; Mandibular Osteotomy; Neoplasm Recurrence, Local; Neurilemmoma; Neurosurgical Procedures; Osteotomy, Sagittal Split Ramus; Sural Nerve
PubMed: 28212127
DOI: 10.1097/SCS.0000000000003557