-
Oral and Maxillofacial Surgery Clinics... Aug 2024Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or... (Review)
Review
Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified histologically as epithelial, mesenchymal, or mixed tumors. This article will discuss the presentation, diagnosis, and treatment of odontogenic cysts and tumors in the pediatric population.
Topics: Humans; Odontogenic Cysts; Child; Odontogenic Tumors; Diagnosis, Differential; Jaw Neoplasms
PubMed: 38462396
DOI: 10.1016/j.coms.2024.01.006 -
The British Journal of Oral &... Apr 2024Ameloblastoma (AM) is characterised by local aggressiveness and bone resorption. To our knowledge, the proteomic profile of bone adjacent to AM has not previously been... (Comparative Study)
Comparative Study
Ameloblastoma (AM) is characterised by local aggressiveness and bone resorption. To our knowledge, the proteomic profile of bone adjacent to AM has not previously been explored. We therefore looked at the differential proteins in cancellous bone (CB) adjacent to AM and normal CB from the mandible. CB proteins were extracted, purified, quantified, and analysed by liquid chromatography-mass spectrometry (LC-MS) using samples from five patients with AM. These proteins were further investigated using gene ontology for additional functional annotation and enrichment. Proteins that met the screening requirements of expression difference ploidy > 1.5-fold (upregulation and downregulation) and p < 0.05 were subsequently deemed differential proteins. Immunohistochemical staining was performed to confirm the above findings. Compared with normal mandibular CB, 151 differential proteins were identified in CB adjacent to the mandibular AM. These were mainly linked to cellular catabolic processes, lipid metabolism, and fatty acids (FA) metabolism. LC-MS and immunohistochemistry showed that CD36 was one of the notably decreased proteins in CB bordering the AM compared with normal mandibular CB (p = 0.0066 and p = 0.0095, respectively). CD36 expression in CB correlates with bone remodelling in AM, making CD36 a viable target for therapeutic approaches.
Topics: Humans; Ameloblastoma; Bone Remodeling; Proteomics; CD36 Antigens; Mandibular Neoplasms; Chromatography, Liquid; Cancellous Bone; Lipid Metabolism; Adult; Female; Male; Mandible; Mass Spectrometry; Fatty Acids; Middle Aged; Proteome
PubMed: 38461076
DOI: 10.1016/j.bjoms.2024.01.001 -
Radiologie (Heidelberg, Germany) Apr 2024
Topics: Humans; Mandible; Jaw; Neoplasms
PubMed: 38441593
DOI: 10.1007/s00117-024-01282-4 -
Nederlands Tijdschrift Voor... Mar 2024For years, cancer has been one of the diseases that causes the greatest disease burden in the Netherlands. Cancer does not only have a huge impact on patients and their...
For years, cancer has been one of the diseases that causes the greatest disease burden in the Netherlands. Cancer does not only have a huge impact on patients and their loved ones, but also on society and healthcare. If the number of cancer patients increases further in the coming years, this impact will only aggravate. This development will also impact dental practice. It is therefore important to assess what awaits us in the coming years. Both with regard to supporting and treating (former) oncology patients. Forinstance, detecting secondary effects of cancer treatments such as oral mucositis and medication- and radiation-related jaw necrosis, as well as the early detection of oral cavity carcinomas and sun-related skin damage on the lips and face. Based on this, plans can be made to meet the demand for dental care as well as possible and to reduce the impact of cancer for both the individual patient and for society as a whole.
Topics: Humans; Lip; Mouth Neoplasms; Netherlands
PubMed: 38440819
DOI: 10.5177/ntvt.2024.03.23082 -
The Journal of Craniofacial Surgery Jun 2024The maxillary defects left unreconstructed or inadequately reconstructed often result in significant functional and esthetic impairments. Adequate reconstruction of...
BACKGROUND
The maxillary defects left unreconstructed or inadequately reconstructed often result in significant functional and esthetic impairments. Adequate reconstruction of extensive maxillary defects requires a sufficient volume of hard and soft tissues.
METHODS
A 48-year-old male presenting bilateral extensive maxillary defects underwent secondary reconstruction with a flow-through fibula free flap in combination with an anterolateral thigh free flap.
RESULTS
The use of flow-through technique allowed minimizing the problem of limited recipient vessels and the length of free flap vascular pedicle usually encountered in secondary reconstruction. The bilateral maxillary defects were successfully reconstructed, and the postoperative outcomes were uneventful. The patient was satisfied with the treatment outcomes. He is being followed up and was referred to the implantology department for the placement of osseointegrated dental implants.
CONCLUSIONS
The flow-through fibula free flap, in combination with the anterolateral thigh free flap, was found reliable and feasible for this case of secondary reconstruction of bilateral maxillary defects. This technique has provided satisfactory functional and esthetic outcomes and effectively improved the patient's self-esteem.
Topics: Humans; Male; Free Tissue Flaps; Middle Aged; Fibula; Plastic Surgery Procedures; Thigh; Maxilla; Maxillary Neoplasms
PubMed: 38437499
DOI: 10.1097/SCS.0000000000010036 -
Cureus Jan 2024Mucoepidermoid carcinoma is a rare neoplasm of the salivary gland of which the intraosseous variety is commonly observed with a female predilection and the affected side...
Mucoepidermoid carcinoma is a rare neoplasm of the salivary gland of which the intraosseous variety is commonly observed with a female predilection and the affected side is more commonly in the mandible. It is usually perceived as an asymptomatic swelling that increases in volume over a few months to a year. They more frequently present as a cortical bulging and are mostly discovered as an accidental finding in a routine radiograph as a well-defined unilocular or multilocular radiolucency resembling an odontogenic cyst. The most widely accepted treatment is radical surgical resection due to its recurrence or metastatic nature. The current case is quite unusual developing in the posterior jaw as a result of an impacted third molar in a 22-year-old female patient.
PubMed: 38435903
DOI: 10.7759/cureus.53355 -
Journal of Oral and Maxillofacial... May 2024The best approach to maxillary reconstruction with negative impact on the patient's quality of life (QOL) remains the subject of debate. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The best approach to maxillary reconstruction with negative impact on the patient's quality of life (QOL) remains the subject of debate.
PURPOSE
This study was designed to evaluate the QOL outcomes following maxillary reconstruction using a scapular-free flap, with and without the computer-aided design and computer-aided manufacturing (CAD/CAM) technique.
STUDY DESIGN, SETTING, SAMPLE
A prospective randomized controlled clinical trial was performed following the CONSORT checklist. To be included, patients suffering from maxillary defects without previous surgery or lymph node involvement were selected. Patients with poor oncological prognosis, deficient performance status, preoperative chemotherapy, or radiotherapy, besides vascular contraindications, were excluded.
PREDICTOR VARIABLE
The predictor variable was the reconstruction technique, grouped into two equal categories. Patients were randomly assigned to reconstruction with a scapular-free flap, with the control group not utilizing a guide and the study group utilizing a CAD/CAM-customized guide.
MAIN OUTCOME VARIABLE
The primary outcome variable was the various domains of QOL, measured using the University of Washington Quality of Life score, 12 months after reconstruction.
COVARIATES
Age; sex; scapular flap side; and maxillary defect tumour type, histopathology, side, length, class, sagittal, and axial differential areas were considered.
ANALYSES
Shapiro-Wilk and Kolmogorov-Smirnov tests were performed for normality. For comparisons between the two groups, Student's t-test and Mann-Whitney test were used. The category variables were compared using the χ test. P ≤ .05 was considered statistically significant.
RESULTS
The sample was composed of twenty-two eligible patients, eleven in each group. The mean age of the control group was (50.09 ± 17.14) years, and 45.45% were male, while in the study group, the mean age was (48.36 ± 14.14) years, with 36.36% male. All the patients were evaluated, showing statistically significant differences between control and study groups in terms of pain, appearance, chewing, swallowing, speech, and shoulder (P ≤ .05), indicating that the scapular-free flap with a CAD/CAM osteotomy guide had improved the patient's QOL.
CONCLUSION AND RELEVANCE
The findings of this study indicate that virtual surgical planning with a CAD/CAM customized osteotomy guide using a scapular-free flap can improve QOL in maxillary reconstruction in terms of pain, appearance, chewing and swallowing food, pronouncing words, and shoulder QOL outcomes.
Topics: Humans; Quality of Life; Male; Female; Free Tissue Flaps; Scapula; Prospective Studies; Plastic Surgery Procedures; Middle Aged; Maxilla; Adult; Surgery, Computer-Assisted; Maxillary Neoplasms; Computer-Aided Design; Aged
PubMed: 38432642
DOI: 10.1016/j.joms.2024.02.006 -
Supportive Care in Cancer : Official... Mar 2024Optimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment...
Treatment of bone metastases from solid tumors with bone-modifying agents: a web survey of Italian oncologists investigating patterns of practice drug prescription and prevention of side effects.
PURPOSE
Optimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment duration and long-term therapy; the prevention and management of possible side effects, including renal toxicity, hypocalcaemia, and medication-related osteonecrosis of the jaw (MRONJ).
METHODS
Italian oncologists were invited to fulfil a 24-question web survey about prescription of BMAs for bone metastases of breast cancer, prostate cancer, and other solid tumors. Prevention and management of side effects were also investigated.
RESULTS
Answers of 191 oncologists were collected. BMAs are usually prescribed at the time of diagnosis of bone metastases by 87.0% (breast cancer) and 76.1% (solid tumors except breast and prostate cancers) of oncologists; the decision is more articulated for prostate cancer (endocrine-sensitive versus castration-resistant). The creatinine level (32.3%), the availability of patient venous access (15.8%), and the type of primary neoplasm (13.6%) are the most reported factors involved in choice between bisphosphonates and denosumab. Zoledronic acid every 3 months was considered as a valid alternative to monthly administration by 94% of Italian oncologists. Oncologists reported a good confidence with measures aimed to prevent MRONJ, whereas uncertainness about prevention and management of hypocalcemia was registered.
CONCLUSION
Italian oncologists showed a high attitude in prescribing bisphosphonates or denosumab at the time of diagnosis of bone metastases, with a large application of preventive measures of side effects. Further studies are needed to investigate some controversial aspects, such as optimal drug treatment duration and long-term drug schedules.
Topics: Male; Humans; Denosumab; Bone Density Conservation Agents; Bone Neoplasms; Diphosphonates; Prostatic Neoplasms; Breast Neoplasms; Drug Prescriptions; Italy
PubMed: 38427111
DOI: 10.1007/s00520-024-08392-8 -
Head & Neck Jul 2024The pharyngeal flap (PF) is useful for reconstruction of soft palate defects, but effective arrangements of PF for various types of soft palate defects are...
BACKGROUND
The pharyngeal flap (PF) is useful for reconstruction of soft palate defects, but effective arrangements of PF for various types of soft palate defects are controversial. Here, we classify three types of soft palate defects and discuss the arrangements of PF and their functional prognosis.
METHODS
Reconstruction was performed based on the classification of the defects. Clinical details were collected, and postoperative function was analyzed.
RESULTS
Eight patients were included in the study. The defect sizes ranged from 25 (width) × 40 (depth) to 40 × 60 mm. Six patients underwent pharyngeal flap reconstruction with free-flap reconstruction, and two underwent pharyngeal flap reconstruction. The pharyngeal flap was harvested at the maximum width of the posterior pharyngeal wall, ranging from 25 to 40 mm in length. Eating and speaking functions were maintained in all patients.
CONCLUSIONS
Good postoperative function can be maintained by narrowing the velopharyngeal space with a pharyngeal flap.
Topics: Humans; Palate, Soft; Male; Middle Aged; Female; Plastic Surgery Procedures; Pharynx; Aged; Surgical Flaps; Adult; Palatal Neoplasms; Free Tissue Flaps; Retrospective Studies; Treatment Outcome
PubMed: 38426332
DOI: 10.1002/hed.27712 -
Oral Diseases Feb 2024Ameloblastoma (AM), a locally aggressive tumor with extensive growth capacity, causes significant damage to the jaw and affects facial appearance. Although the high...
OBJECTIVES
Ameloblastoma (AM), a locally aggressive tumor with extensive growth capacity, causes significant damage to the jaw and affects facial appearance. Although the high prevalence of BRAF V600E mutation in AM is known, its specific impacts on patients with AM remain unclear. Thus, the present study investigated the role of BRAF V600E mutation, thereby focusing on its impact on AM invasion and growth.
MATERIALS AND METHODS
Immunohistochemical analysis was used to compare BRAF V600E, MMP2, MMP9, and Ki-67 expressions in AM (n = 49), normal oral mucosa (NOM) (n = 10), and odontogenic keratocyst (OKC) (n = 15) tissues. AM was further classified according to the presence or absence of BRAF V600E. The relationship between BRAF V600E and invasion as well as growth was evaluated. In addition, correlation analysis was performed using immunohistochemistry and confirmed via double-labeling immunofluorescence. Finally, comparative analyses using mass spectrometry, immunohistochemistry, and immunofluorescence were performed to explore and identify underlying mechanisms.
RESULTS
AM exhibited a higher incidence of BRAF V600E mutation than NOM and OKC. BRAF V600E expression was positively correlated with the invasion-associated proteins MMP2 and MMP9 and the growth-related protein Ki-67. Proteomic data revealed that BRAF V600E primarily activates the MAPK signaling pathway in AM, particularly driving the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2).
CONCLUSIONS
In summary, the findings suggested that the BRAF V600E mutation enhances the invasion and growth abilities of AM via the MAPK/ERK signaling pathway. Thus, targeting BRAF V600E or the MAPK/ERK pathway may be a potential AM therapy.
PubMed: 38424736
DOI: 10.1111/odi.14909