An unusual case of Burkitt's lymphoma presenting as a gingival enlargement

Bone replacement grafts with guided tissue regeneration in treatment of grade II furcation defects: a systematic review and meta-analysis

AIM

The present systematic review appended with meta-analysis aimed to evaluate the efficacy of bone replacement graft (BRG) with guided tissue regeneration (GTR) over BRG or open flap debridement (OFD) alone in the treatment of grade II furcation defects.

MATERIALS AND METHODS

An electronic literature search of PubMed, Cochrane Library and Google Scholar databases accompanied with manual searching was done. Randomized controlled trials (RCTs) up to October 2019, comparing BRG+GTR with BRG or OFD in grade II furcation defects, were identified. Clinical attachment level (CAL) gain, changes in gingival marginal level (GML), vertical defect fill (VDF), horizontal defect fill (HDF) and reduction in defect volume were the outcome parameters.

RESULTS

Of a total of 12, 9 studies compared BRG+GTR vs BRG while 3 compared BRG+GTR vs OFD. Meta-analysis was carried out for CAL gain, VDF, HDF and GML changes. In the BRG+GTR vs BRG comparison group, out of 9 studies, 6 RCTs showed standardized mean difference (SMD) of 0.513 for VDF, 9 RCTs showed SMD of 0.83 for HDF and 2 RCTs showed SMD of 0.651 for CAL gain, whereas only 2 studies in the same group reported reduction in defect volume. Three studies of the BRG+GTR vs OFD group exhibited significant VDF and CAL gain with SMD of 2.002 and 1.161 respectively. However, no significant change was recorded for GML in both groups.

CONCLUSION

The present systematic review indicates supplemental benefits of combination therapy of BRG+GTR over monotherapy in resolving grade II furcation defects.

CLINICAL RELEVANCE

In our quest to achieve maximum regeneration in grade II furcation defects, combination therapies such as BRG+GTR have been accepted as treatment choices over other modalities. Clinical situations warranting near-complete regeneration of the tissues in such defects are better suited for combination therapies.

Burkitt Lymphoma in Adult With Atypical Clinical Presentation Primarily Involving the Oral Soft Tissue

Non-Hodgkin lymphoma is the second most common neoplasm of the head and neck after squamous cell carcinoma. However, it accounts for only 3.5% of all malignancies of the oral cavity. Oral lesions are often a component of disseminated disease process that may involve regional lymph nodes or may at times represent the primary extra nodal form of the disease. Although, isolated oral lymphoma in adults is extremely rare, this paper presents a patient with Burkitt lymphoma in an adult male with atypical clinical presentation primarily involving the oral soft tissue. It is believed that the prognosis of Burkitt lymphoma depends on the extent of the disease, the patient's age, and the timing of diagnosis. Therefore, the role of the dentist in the early diagnosis and prompt referral of patients with Burkitt lymphoma cannot be overemphasized.

Repair of bone defects with prefabricated vascularized bone grafts and double-labeled bone marrow-derived mesenchymal stem cells in a rat model

This study aims to investigate the repair of bone defects with prefabricated vascularized bone grafts and double-labeled bone marrow-derived mesenchymal stem cells (BMSCs) in a rat model. BMSCs were separated from rat bone marrow. LTR-CMVpro-RFP and LTR-CMVpro-GFP were transfected into the BMSCs for in vitro and in vivo tracking. BMSCs-RFP and BMSCs-GFP were induced into endothelial progenitor cells (EPCs) and osteoblasts (OBs). Rats were divided into five groups: Group A: in vitro prefabrication with EPCs-RFP + in vivo prefabrication with arteriovenous vascular bundle + secondary OBs-GFP implantation; Group B: in vitro prefabrication with EPCs-RFP + secondary OBs-GFP implantation; Group C: in vivo prefabrication with arteriovenous vascular bundle + secondary OBs-GFP implantation; Group D: implantation of EPCs-RFP + implantation of with arteriovenous vascular bundle + simultaneous OBs-GFP implantation; Group E: demineralized bone matrix (DBM) grafts (blank control). Among five groups, Group A had the fastest bone regeneration and repair, and the regenerated bone highly resembled normal bone tissues; Group D also had fast bone repair, but the repair was slightly slower than Group A. Therefore, in vitro prefabrication with EPCs-RFP plus in vivo prefabrication with arteriovenous vascular bundle and secondary OBs-GFP implantation could be the best treatment for bone defect.