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Garajei A, Modarresi A, Arabkheradmand A, Shirkhoda M. Functional and esthetic outcomes of virtual surgical planning versus the conventional technique in mandibular reconstruction with a free fibula flap: A retrospective study of 24 cases. J Craniomaxillofac Surg 2024; 52:454-463. [PMID: 38448334 DOI: 10.1016/j.jcms.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 03/08/2024] Open
Abstract
This study aimed to compare the functional and esthetic results in patients following mandibular reconstruction with a free fibula flap (FFF) by virtual surgical planning (VSP) versus the conventional technique. Patients who had undergone mandibular reconstruction with a FFF by VSP or the conventional technique were retrospectively assessed. The two groups were compared regarding functional and esthetic variables with appropriate scales preoperatively, intraoperatively, and postoperatively. Twenty-four patients were evaluated in two groups: conventional (n = 8) and VSP (n = 16). The mean amount of mandibular asymmetry was 2.62 mm (SD = 1.59) in the conventional group and 1.19 mm (SD = 1.32) in the VSP group. Of the patients who underwent conventional surgery, 12.5% had mandibular asymmetry of <2 mm and 87.5% had asymmetry of 2-5 mm. Of the VSP patients, 61.5% had mandibular asymmetry of <2 mm and 38.5% had mandibular asymmetry of 2-5 mm (p = 0.03). The mean difference in size of mandibular angle on the surgical and control sides was not significantly different between the two groups (p = 0.62). The difference in mean length of the mandibular body on the surgical side relative to the control side was not significant between the two groups (p = 0.75). Differences in functional variables between the two groups were not significant. Within the limitation of the study, it seems that the VSP technique resulted in better facial symmetry and superior esthetic outcomes compared with the conventional technique.
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Affiliation(s)
- Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Modarresi
- Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Dental Branch, Tehran, Iran.
| | - Ali Arabkheradmand
- Department of Surgery, Cancer Institute of Iran, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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Jalaeefar A, Saffar H, Shirkhoda M, Garajei A, Sharifi A. Reconstruction with facial artery musculo-mucosal flap (FAMM.F) after resection of upper lip pleomorphic adenoma: Case report. Int J Surg Case Rep 2023; 111:108822. [PMID: 37741079 PMCID: PMC10520520 DOI: 10.1016/j.ijscr.2023.108822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023] Open
Abstract
INTRODUCTION Although pleomorphic adenoma (PA) is the most common neoplasm of both minor and major salivary glands, its presence in the buccal surface of upper lip is rare. PRESENTATION OF CASE A 70-year-old male presented with a chief complaint of recent rapid growth of a mass in the buccal aspect of the upper lip. A well-circumscribed mass measuring 3 × 2 cm with intact overlying mucosa without regional lymphadenopathy was evident. Core needle biopsy report was suggestive of PA. Complete excision of the tumor was performed. The defect was large and primary closure was not possible. Reconstruction with FAMM flap was planned. After 4 weeks, the flap was covered with epithelia and created a satisfactory result. DISCUSSION The definite diagnosis of PA is based on histopathological examination. The following features help to differentiate PA from other tumors; tubuloalveolar and gland-like structures, islands of cuboidal or polygonal cells in a chondroid, hyalinized, fibroadipose or mucinous hypocellular stroma which are stained positively for periodic acid-Schiff and Alcian. Despite these characteristics, differentiation of PA from dermal mixed tumor may be challenging especially when the specimen is from the upper lip. The main advantages of FAMM.F are being thin and pliable flap, having wide arc of rotation; being suitable for reconstruction of mucosal defects; resistance against postoperative radiotherapy and easy harvesting. CONCLUSION The FAMM flap is a reliable reconstruction technique for medium-sized intraoral defects with limited morbidity to the donor site. It provides functional reconstruction of the oral cavity with a low risk of post-operative complications.
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Affiliation(s)
- Amirmohsen Jalaeefar
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hana Saffar
- Department of Anatomical and Clinical Pathology, Cancer Institute, Imam Khomeni Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Department of Oran and Maxillofacial Surgery, School of Dentistry, Iran; Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirsina Sharifi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Mohammadi H, Roochi MM, Heidar H, Garajei A, Dallband M, Sadeghi M, Fatahian R, Tadakamadla SK. A meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies among children and adolescents. Dent Traumatol 2023; 39:403-417. [PMID: 37073864 DOI: 10.1111/edt.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 04/20/2023]
Abstract
AIMS Children and adolescents who are affected by trauma may have complications that are more serious and dangerous. Herein, a meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies according to the geographic regions of the world among children and adolescents was conducted. MATERIALS AND METHODS A comprehensive search was performed in four databases of PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2006 until July 7, 2021. To evaluate the quality of included articles, an adapted version of the Newcastle-Ottawa scale was used. The prevalence of maxillofacial trauma was estimated by event rates and 95% confidence intervals in relation to etiology and geographic region of study population. RESULTS Through search in the databases and the electronic sources, 3071 records were identified, and 58 studies were eligible for inclusion in the meta-analysis. A total of 264,433 maxillofacial trauma cases were reported by all included studies. Globally, the overall prevalence of maxillofacial trauma was highest due to Road Traffic Crashes (RTC) (33.8%) followed by falls (20.7%), violence (9.9%), and sports (8.1%) in children/adolescents. The highest prevalence of maxillofacial trauma were observed in African population (48.3%) while trauma due to falls was most prevalent in Asian population (44.1%). Maxillofacial trauma due to violence (27.6%) and sports (13.3%) were highest in North Americans. CONCLUSION The findings demonstrate that RTC was the most prevalent etiology of maxillofacial trauma in the world. The prevalent causes of maxillofacial trauma differed between the regions of study population.
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Affiliation(s)
- Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehrnoush Momeni Roochi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Heidar
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Dallband
- Department of Oral and Maxillofacial Surgery, Dental School, Taleghani Hospital, Shahid Beheshti of Medical Sciences, Tehran, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Fatahian
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Santosh Kumar Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Victoria, Bendigo, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Victoria, Bendigo, Australia
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Garajei A, Allameh A, Azadi M, Emami A, Atashbasteh M, Mostafavi M, Ghaderi B, Inchingolo F, Sadeghi M, Tadakamadla SK, Mohammadi H, Tadakamadla J. Evaluation of the Expression Levels of miR-21-5p and miR-429 Genes in Biopsy Samples from Patients with Oral Squamous Cell Carcinoma. Diagnostics (Basel) 2023; 13:diagnostics13071244. [PMID: 37046462 PMCID: PMC10093007 DOI: 10.3390/diagnostics13071244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction: MicroRNAs (miRs) are a group of endogenous, non-coding, 18-24 nucleotide length single-strand RNAs that mediate gene expression at the post-transcriptional level through mRNA degradation or translational repression. They are involved in regulating diverse cellular biological processes such as cell cycle, differentiation, and apoptosis. The deregulation of miRs affects normal biological processes, leading to malignancies, including oral squamous cell carcinoma (OSCC). This study evaluates the expression level of miR-21-5p and miR-429 genes in biopsy samples from patients with OSCC and performs a comparison with controls. Materials and Methods: In this study, tissue samples were obtained from 40 individuals (20 OSCC patients and 20 healthy controls) to determine miR-21-5p and miR-429 expression using the ΔCT method and analyzed by the Mann–Whitney test. Results: The mean age of subjects in the control and patient groups was 47.15 and 53.8 years, respectively. According to the Mann–Whitney test, significant differences were observed in miR-21-5p (p < 0.0001) and miR-429 (p = 0.0191) expression levels between the two groups (p < 0.05). Conclusions: The expression of miR-21-5p, miR-429, and combined miRNAs in the OSCC group was significantly higher compared to the control group. As a result, changes in the expression of these biomarkers in cancerous tissues could potentially be considered as a marker for the early diagnosis of OSCC.
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Tahmasebi E, Kamali Hakim L, Yazdanian M, Asadi A, Garajei A, Nezaminia S, Arabi Daredor AM, Khafaei M, Kahrizi S, Tavallaie M. Investigation of the expression levels of miR-21, miR-132, miR-29a, miR-204, and miR-138 in patient's plasma with primary OSCCs. Cell Mol Biol (Noisy-le-grand) 2022; 68:26-31. [PMID: 37130185 DOI: 10.14715/cmb/2022.68.12.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Indexed: 05/04/2023]
Abstract
This is the eighth most malignant tumor in the world, causing the highest incidence and malignancy rate of all cancers in the mouth and maxillofacial region. In cells, miRNAs regulate development, differentiation, proliferation, and differentiation, and miRNA expression is a better indicator of physiological status than DNA expression. miR-21, miR-132, miR-29a, miR-204, and miR-138 levels were measured in plasma from patients with primary OSCC and healthy controls. A Real Time-PCR technique was used to measure miR-21, miR-132, miR-29a, miR-29a, and miR-204 expression levels in plasma from 38 healthy and 38 people with primary OSCC. A standard distribution test and a CT unit were used to confirm the quantitative data on miRNA expression. Gene expression levels were compared between two groups of patients and healthy groups using a Mann-Whitney test and an unpaired t-test. MiR-21's median CT value was 29.68 in the OSCC group and 32.89 in the healthy group, and miR-29a's median CT value was 37.54 and 36.46 in the OSCC group and healthy group, respectively. Additionally, miR-132's CT values were 37.71 and 36.40, miR-138's CT value was 35.37 and 31.21, and miR-204's CT value was 36.44 and 36.17. The results showed that miR-21 expression levels increased significantly, while miR-29a, miR-132, and miR-138 (P < 0.05), and miR-204 expression levels did not differ significantly (P > 0.05). As a result of this study, the expression levels of microRNAs may be considered to diagnose OSCC at an early stage. It is essential to diagnose this disease early to improve treatment and patient health outcomes.
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Affiliation(s)
- Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | | | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Amirali Asadi
- Resident of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sayna Nezaminia
- Resident of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amir Mohammad Arabi Daredor
- Resident of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Khafaei
- Human Genetic Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran.
| | - Soheil Kahrizi
- Shahid Beheshti Talent High School, Area 1 Education, Department of Education, Kermanshah, Iran.
| | - Mahmood Tavallaie
- Human Genetic Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran.
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Garajei A, Parvin M, Mohammadi H, Allameh A, Hamidavi A, Sadeghi M, Emami A, Brand S. Evaluation of the Expression of miR-486-3p, miR-548-3p, miR-561-5p and miR-509-5p in Tumor Biopsies of Patients with Oral Squamous Cell Carcinoma. Pathogens 2022; 11:pathogens11020211. [PMID: 35215154 PMCID: PMC8875679 DOI: 10.3390/pathogens11020211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/23/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background and objective: Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy. Expression patterns of microRNAs (miRNAs) can direct us in identifying valuable biomarkers for the prognosis of different neoplasms. Inappropriate regulation of miRNAs during physiological procedures can result in malignancies including OSCC. The aim of the present study was to evaluate the expression of miR-486-3p, miR-561-5p, miR-548-3p, and miR-509-5p in tissue biopsy samples with and without OSCC. Materials and methods: This case-control study was conducted on 17 healthy and 17 OSCC tissue biopsy samples. The expression of miRNAs was assessed using quantitative real-time PCR (q-RT-PCR) after RNA extraction from normal and cancer tissues and cDNA synthesis. Results: The means of miRNA-486-3p, miR-561-5p, and miR-548-3p expression were significantly different between OSCC and control groups (p < 0.001), but there was no significant difference in means of miR-509-5p expression between OSCC and control groups (p = 0.179). Conclusions: The findings of this study revealed that the expression of miR-486-3p and miR-561-5p was significantly lower in cancer samples compared to normal tissue samples. On the other hand, miR-548-3p expression increased in the OSCC group compared to the control group.
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Affiliation(s)
- Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran 1416753955, Iran;
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran 1416753955, Iran
| | - Milad Parvin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran;
| | - Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran;
| | - Abdolamir Allameh
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 1416753955, Iran; (A.A.); (A.H.)
| | - Azin Hamidavi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 1416753955, Iran; (A.A.); (A.H.)
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1416753955, Iran;
| | - Azadeh Emami
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran 1416753955, Iran;
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Correspondence:
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Mohammadi H, Momeni Roochi M, Rezaei F, Garajei A, Heidar H, Ghaderi B, Sadeghi M. Association between the CYP1A1 MspI polymorphism and risk of head and neck cancer: a meta-analysis. Sci Rep 2022; 12:1527. [PMID: 35087125 PMCID: PMC8795428 DOI: 10.1038/s41598-022-05274-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/10/2022] [Indexed: 12/24/2022] Open
Abstract
The studies recommended the relationship between lots of polymorphisms with the head and neck cancers (HNCs) risk. Herein, we reported the association between the CYP1A1 MspI polymorphism and the risk of HNC in an updated meta-analysis. The PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus databases were searched until March 31, 2021, without any restrictions. Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to assess a relationship between CYP1A1 MspI polymorphism and the HNC risk based on five applied genetic models by RevMan 5.3 software. Other analyses (sensitivity analysis, meta-regression, and bias analysis) were performed by CMA 2.0 software. Trial sequential analysis (TSA) was done by TSA software (version 0.9.5.10 beta). Among the databases and other sources, 501 recorded were identified that at last, 29 studies were obtained for the analysis. The pooled ORs were 1.28 (95%CI 1.09, 1.51; P = 0.003), 1.68 (95%CI 1.16, 2.45; P = 0.007), 1.24 (95%CI 1.03, 1.50; P = 0.02), 1.26 (95%CI 1.07, 1.48; P = 0.005), and 1.66 (95%CI 1.27, 2.16; P = 0.0002) for allelic, homozygous, heterozygous, recessive, and dominant models, respectively. Therefore, the m2 allele and m1/m2 and m2/m2 genotypes had significantly increased risks in HNC patients. With regards to stable results and enough samples, the findings of the present meta-analysis recommended that there was an association between CYP1A1 MspI polymorphism and the HNC risk.
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Affiliation(s)
- Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj, 6617713446, Iran
| | - Mehrnoush Momeni Roochi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, 1439955991, Iran
| | - Farzad Rezaei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Ata Garajei
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, Scholl of Medicine, Tehran University of Medical Sciences, Tehran, 1439955991, Iran
| | - Hosein Heidar
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, 1439955991, Iran
| | - Bayazid Ghaderi
- Department of Internal Medicine, Cancer and Immunology Research Center, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, 6617913446, Iran
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, 1477893855, Iran.
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Kargarnejad S, Ghalichi F, Pourgol-Mohammad M, Garajei A. Mandibular reconstruction system reliability analysis using probabilistic finite element method. Comput Methods Biomech Biomed Engin 2021; 24:1437-1449. [PMID: 34657530 DOI: 10.1080/10255842.2021.1892660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this study was to design for mandibular reconstruction of large lateral defect with minimum target reliability with designated confidence interval under bite force range of 300 ± 102 N. The performance of the models has been evaluated by numerical analysis considering the uncertainty of input parameters. Computer-Aided design was used to develop the models of three designs according to the patient's anatomy and to achieve to near symmetry of the mandible. Stress-strength modeling was utilized for the probabilistic physics of failure analysis under assumption of a quasi-static load. Monte-Carlo simulation was also applied for probabilistic finite element analysis and reliability assessment. The sensitivity analysis of the models was developed to reflect the significance of the variables in the models. The deterministic stress analysis shows that the highest stress and the second maximum stress are 110 MPa and 85 MPa for cortical bone around the screws, respectively. Also, it is determined that the maximum plate stress of the titanium conventional plate model is 580 MPa. The reconstruction system success rate was improved in all models by observing the anatomy of the patient's mandible in the plate designs by computer-aided design and additive manufacturing techniques. Based on the results, the reliability of plate strength and pull-out screws strength are 99.99% and 96.71% for the fibula free flap model, respectively, and 99.99% and 94.17%, respectively, for the customized prosthesis model. Probability sensitivity factors showed that uncertainty in the elastic modulus of the cortical bone has the greatest effect on the probability of screws loosening.
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Affiliation(s)
- S Kargarnejad
- Faculty of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran
| | - F Ghalichi
- Faculty of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran
| | - M Pourgol-Mohammad
- Mechanical Engineering Department, Sahand University of Technology, Tabriz, Iran
| | - A Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Tehran University of Medical Sciences, Tehran, Iran
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Mohammadi H, Roochi MM, Sadeghi M, Garajei A, Heidar H, Ghaderi B, Tadakamadla J, Meybodi AA, Dallband M, Mostafavi S, Mostafavi M, Salehi M, Sadeghi-Bahmani D, Brand S. Association of N-acetyltransferases 1 and 2 Polymorphisms with Susceptibility to Head and Neck Cancers-A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis. Medicina (Kaunas) 2021; 57:medicina57101095. [PMID: 34684132 PMCID: PMC8541135 DOI: 10.3390/medicina57101095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/01/2021] [Accepted: 10/09/2021] [Indexed: 11/23/2022]
Abstract
Background and objective:N-acetyltransferases 1 and 2 (NAT1 and NAT2) genes have polymorphisms in accordance with slow and rapid acetylator phenotypes with a role in the development of head and neck cancers (HNCs). Herein, we aimed to evaluate the association of NAT1 and NAT2 polymorphisms with susceptibility to HNCs in an updated meta-analysis. Materials and methods: A search was comprehensively performed in four databases (Web of Science, Scopus, PubMed/Medline, and Cochrane Library until 8 July 2021). The effect sizes, odds ratio (OR) along with 95% confidence interval (CI) were computed. Trial sequential analysis (TSA), publication bias and sensitivity analysis were conducted. Results: Twenty-eight articles including eight studies reporting NAT1 polymorphism and twenty-five studies reporting NAT2 polymorphism were involved in the meta-analysis. The results showed that individuals with slow acetylators of NAT2 polymorphism are at higher risk for HNC OR: 1.22 (95% CI: 1.02, 1.46; p = 0.03). On subgroup analysis, ethnicity, control source, and genotyping methods were found to be significant factors in the association of NAT2 polymorphism with the HNC risk. TSA identified that the amount of information was not large enough and that more studies are needed to establish associations. Conclusions: Slow acetylators in NAT2 polymorphism were related to a high risk of HNC. However, there was no relationship between NAT1 polymorphism and the risk of HNC.
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Affiliation(s)
- Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran;
| | - Mehrnoush Momeni Roochi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran;
| | - Ata Garajei
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran 1439955991, Iran;
| | - Hosein Heidar
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Bayazid Ghaderi
- Cancer and Immunology Research Center, Department of Internal Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj 6617913446, Iran;
| | - Jyothi Tadakamadla
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia;
| | - Ali Aghaie Meybodi
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran 1439955991, Iran;
| | - Mohsen Dallband
- Department of Oral and Maxillofacial Surgery, Dental School, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran;
| | - Sarton Mostafavi
- English Department, Baneh Branch, Islamic Azad University, Baneh 6691133845, Iran;
| | - Melina Mostafavi
- Tehran Medical Branch, Islamic Azad University, Tehran 1419733171, Iran;
| | - Mojtaba Salehi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Correspondence:
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10
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Bolandparva F, Hashemi Nasab MS, Mohamadnia A, Garajei A, Farhadi Nasab A, Bahrami N. Early Diagnosis of Oral Squamous Cell Carcinoma (OSCC) by miR-138 and miR-424-5p Expression as a Cancer Marker. Asian Pac J Cancer Prev 2021; 22:2185-2189. [PMID: 34319042 PMCID: PMC8607090 DOI: 10.31557/apjcp.2021.22.7.2185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION MicroRNAs (miRs) are a group of endogenous, non-coding, 18-24 nucleotide length single-strand RNAs. These molecules mediate the gene expression and are involved in regulating diverse cellular biological processes, i.e. cell cycle, differentiation, and apoptosis. Aberrant miR expression has been shown to be an important event in the pathologies of various types of cancer, including oral squamous cell carcinoma (OSCC). METHODS Blood samples were obtained from 30 patients (15 cases and 15 controls), to determine miR-138 and miR-424-5p expression by using real-time PCR and ΔΔCT. RESULTS The median CT values of miR-138 were 27.60 and 28.70, while those of miR 424-5p were 29.40 and 30.0 in the case and control groups, respectively. Mann-Whitney test indicated no significant difference in miR-138 and miR-424-5p between the two groups (P > 0.05). However, results obtained by ΔΔCT method showed that miR-424-5p expression was 1.96 times higher in the case group, but miR-138 expression was 3.05 times lower in the plasma of OSCC patients. CONCLUSION Our findings suggest that the evaluation of miR-138 and miR-424-5p expression in serum can be used as potent markers for carcinoma detection and also may be a potentially therapeutic approach in the future. Further longitudinal studies with larger samples are required to verify these findings.<br />.
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Affiliation(s)
- Farzaneh Bolandparva
- Craniomaxillofacial Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abdolreza Mohamadnia
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Biotechnology, School of Advanced Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Craniomaxillofacial Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Farhadi Nasab
- Behavioral Sciences Research Center,Shahid Beheshti University of Medical Sciences,Tehran, Iran
| | - Naghmeh Bahrami
- Craniomaxillofacial Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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11
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Garajei A, Kheradmand AA, Miri SR, Emami A. A retrospective study on mandibular reconstruction using iliac crest free flap. Ann Med Surg (Lond) 2021; 66:102354. [PMID: 34026108 PMCID: PMC8121997 DOI: 10.1016/j.amsu.2021.102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To assess the availability, success rate and complications of microvascular iliac crest free flap for reconstruction of mandibular segmental defects. METHODS In this retrospective-descriptive study, we report patients who had undergone segmental mandibular resection for pathologic lesions and received reconstruction with iliac crest microvascular free flap between 2016 and 2019. Clinical and demographic data of all the cases were collected. Success was regarded as complete consolidation of the bone graft in panoramic radiograph. Postoperative complications were defined as major or minor based on the need for intervention. T-test, Kolomogorov_Smirnov, and multivariate analysis were used and the p-value<0.05 was considered to be statistically significant. RESULTS Of all 30 patients, 16 were women and 14 were men with an average age of 27.2 years (range 14-40). Patients were followed for 12-60 month (mean: 38.4). One flap was lost due to unsalvageable venous thrombosis. Six other cases had post-op complications while smoking and diabetes were associated with more complications (P = 0.036). Twenty-three patients received primary reconstruction which was more successful than secondary ones (P = 0.003). Osteogenic sarcoma was associated with greater risk of complications (P < 0.01). CONCLUSIONS The results of this study suggest that iliac crest microvascular free flap serves as a promising option for the reconstruction of mandibular defects, providing excellent contour and acceptable success rate with low donor site morbidity. Future studies will focus on the role of systemic diseases in post-op complications and flap failures.
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Affiliation(s)
- Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali A. Kheradmand
- The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Roohollah Miri
- The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Emami
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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12
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Shojaeian S, Moazeni-Roodi A, Allameh A, Garajei A, Kazemnejad A, Kabir K, Zarnani AH. Methylation of TGM-3 Promoter and Its Association with Oral Squamous Cell Carcinoma (OSCC). Avicenna J Med Biotechnol 2021; 13:65-73. [PMID: 34012521 PMCID: PMC8112137 DOI: 10.18502/ajmb.v13i2.5523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Oral Squamous Cell Carcinoma (OSCC) is among the ten most common cancers worldwide. Hypermethylation of CpG sites in the promoter region and subsequent down-regulation of a tumor suppressor gene, TGM-3 has been proposed to be linked to different types of human cancers including OSCC. In this study, methylation status of CpG sites in the promoter region of TGM-3 has been evaluated in a cohort of patients with OSCC compared to normal controls. Methods: Forty fresh tissue samples were obtained from newly diagnosed OSCC patients and normal individuals referred to dentistry clinic for tooth extraction. DNA was extracted, bisulfite conversion was performed and it was subjected to PCR using bisulfite-sequencing PCR (BSP) primers. Prepared samples were sequenced on a DNA analyzer with both forward and reverse primers of the region of interest. The peak height values of cytosine and thymine were calculated and methylation levels for each CpG site within the DNA sequence was quantified. Results: Quantitative DNA methylation analyses in CpG islands revealed that it was significantly higher in OSCC patients compared to controls. DNA methylation at CpG1/CpG3/CpG5 (p=0.004–0.01) and CpG1/CpG3 (p=0.001–0.019) sites was associated with tumor stage and grade, respectively. Male OSCC patients had higher methylation rate at CpG3 (p=0.032), while smoker patients showed higher methylation rate at CpG6 (p=0.045). Conclusion: These results manifested the contribution of DNA methylation of TGM-3 in OSCC and its potential association with clinico-pathologic parameters in OSCC.
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Affiliation(s)
- Sorour Shojaeian
- Department of Biochemistry, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Abdolamir Allameh
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ata Garajei
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Bio-statistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Kabir
- Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir-Hassan Zarnani
- Department of Immunology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
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13
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Davudov MM, Harirchi I, Arabkheradmand A, Garajei A, Mirzajani Z, Amiraliyev K, Rustamli N, Zebardast J, Montazeri A. Quality of life in patients with oral cancer treated by different reconstruction methods as measured by the EORTC QLQ-H&N43. Br J Oral Maxillofac Surg 2020; 58:e67-e74. [PMID: 32646789 DOI: 10.1016/j.bjoms.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 06/17/2020] [Indexed: 11/12/2022]
Abstract
This was a prospective clinical study and the purpose was to assess the quality of life (QoL) as the primary endpoint for patients given prospective treatment for cancer of the oral cavity that required reconstruction using various reconstruction methods in Azerbaijan. All patients who were operated on during the year 2017 to 2018 were entered into the study. Quality of life was assessed six months postoperatively using the European Organization for Research and Cancer Treatment Core Cancer Quality of Life (EORTC QLQ-C30) and the Head and Neck Specific Quality of Life (QLQ-H&NN43) questionnaires. A total of 96 patients completed the questionnaires. There were 36 patients who did not receive a flap, 31 patients received a local flap, and 29 patients had distant-regional flaps. QoL assessed by the EORTC QLQ-C30, and the QLQ-H&N43 was lower in patients who received a local flap. In general, the results showed that the reconstruction with a distant-regional flap compared with no flap and local flap leads to improved quality of life of patients with oral cancer.
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Affiliation(s)
- M M Davudov
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - I Harirchi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Arabkheradmand
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Garajei
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Z Mirzajani
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - K Amiraliyev
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - N Rustamli
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - J Zebardast
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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14
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Mahdavi N, Yasaman K, Garajei A, Nouri NN. Bisphosphonate-related spindle cell carcinoma and osteonecrosis. J Oral Maxillofac Pathol 2020; 24:168-171. [PMID: 32508468 PMCID: PMC7269287 DOI: 10.4103/jomfp.jomfp_346_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/16/2020] [Indexed: 11/07/2022] Open
Abstract
A 48-year-old female with a complaint of persistent pain referred to the Imam Khomeini (Tehran, Iran) in 2018. Based on the radiographic findings, radiolucent lesion found in the right mandible and she had alendronate administration approximately for 10 years. Since the past 6 months, the lesion detected in the right mandible. According to the computed tomography scan, a large lytic destructive lesion with a soft-tissue component was seen at the right mandibular ramus. Microscopic examinations revealed the proliferation of anaplastic spindle-shaped cells arranged in interlacing bundles and whorled patterns. Nuclear polymorphism, scattered cells with hyperchromatic nuclei and increased mitotic activity were notable. Immunohistochemistry findings for tissue section composed of spindle cell proliferation revealed Ki67 (20% positive in hotspots), scattered positive right side incisional biopsy was done. The observation revealed hyperplastic and disorganized squamous epithelial lesion, suggestive of spindle squamous cell carcinoma and osteonecrosis in this patient.
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Affiliation(s)
- Nazanin Mahdavi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran, Iran
| | - Kheirandish Yasaman
- Department Oral and Maxillofacial Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - A Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Head and Neck Surgical Oncology and Reconstructive Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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15
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Shoohanizad E, Garajei A, Enamzadeh A, Yari A. Nonsurgical management of temporomandibular joint autoimmune disorders. AIMS Public Health 2019; 6:554-567. [PMID: 31909075 PMCID: PMC6940567 DOI: 10.3934/publichealth.2019.4.554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/24/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction Temporomandibular disorders (TMD) are observed in a number of autoimmune diseases but limited studies have assessed the effect of autoimmune diseases on TMD. Therefore, the present review article was conducted to determine the effect of autoimmune diseases on TMD. Methods International databases, including Web of Sciences, PubMed and Scopus, were searched in order to find related articles. The search key words were; temporomandibular joint (TMJ) autoimmune disorders, TMJ, TMD, medical therapy and non-invasive, local and systemic management. Published articles from June, 2010 to June, 2019 were included in the review. Results A total of 11 related articles including rheumatoid arthritis (RA), lupus erythematosus and systemic sclerosis were found. All articles noted that TMJ has unique features that distinguishes it from other human body joints. Cases of TMJ injury and TMD require specific treatments. Therefore, early diagnosis of TMD is essential. It was also mentioned in the articles that the collagen-induced arthritis (CIA) method is a suitable method for investigating TMD and its relationship with RA. Treatment methods included oral steroids, Disease-modifying antirheumatic drugs, nonsteroidal anti-inflammatory drugs, methotrexate 75 mg, and combination therapy with methotrexate. Conclusion Based on the results of this study, TMD exists in some autoimmune diseases, including RA, lupus erythematosus and systemic sclerosis. Therefore, there should be an interdisciplinary collaboration between physicians and dentists in order to choose the best conservative treatment and medication therapy for TMD to reduce the progression and pain associated with this type of disorder.
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Affiliation(s)
- Ehsan Shoohanizad
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ata Garajei
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Enamzadeh
- DMD, Private Practice, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Yari
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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16
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Davudov MM, Harirchi I, Arabkheradmand A, Garajei A, Mahmudzadeh H, Shirkhoda M, Motiee-Langroudi M, Mirzajani Z, Zebardast J, Montazeri A. Evaluation of quality of life in patients with oral cancer after mandibular resection: Comparing no reconstruction, reconstruction with plate, and reconstruction with flap. Medicine (Baltimore) 2019; 98:e17431. [PMID: 31593097 PMCID: PMC6799791 DOI: 10.1097/md.0000000000017431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This cross-sectional study aimed to assess and compare quality of life in patients with advanced oral cavity tumors after mandibular resection in 3 groups (no reconstruction, reconstruction with plate, and reconstruction with flap) at the Cancer Institute, affiliated to Tehran University of Medical Sciences. Quality of life was measured using the European Organization for Research and Treatment of Cancer core quality of life questionnaire and European Organization for Research and Treatment of Cancer head and neck cancer-specific quality of life questionnaire-35 items. The comparison was tested using Kurskal-Wallis analysis. All 120 patients were entered into the study. The mean age of patients was 48.5 (standard deviation = 18.1) years. Patients presented with advanced stage of the disease and underwent mandibular resection with no reconstruction (n = 40), reconstruction with plate (n = 41), and reconstruction with flap (n = 39). The findings showed that in general, there were no statistically significant differences in quality of life among 3 groups except for speech problem (P = .4), dry mouth (P = .03), and feeling ill (P = .04). Although there were no significant differences in quality of life among patients in 3 groups, overall patients who received reconstruction with flap reported better functioning and fewer symptoms. Those who did not receive any reconstruction reported the worse conditions.
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Affiliation(s)
- Mahammad M. Davudov
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan
| | - Iraj Harirchi
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Arabkheradmand
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Mahmudzadeh
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Motiee-Langroudi
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zoheir Mirzajani
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan
| | - Jayran Zebardast
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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17
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Allameh A, Moazeni-Roodi A, Harirchi I, Ravanshad M, Motiee-Langroudi M, Garajei A, Hamidavi A, Mesbah-Namin SA. Promoter DNA Methylation and mRNA Expression Level of p16 Gene in Oral Squamous Cell Carcinoma: Correlation with Clinicopathological Characteristics. Pathol Oncol Res 2018; 25:1535-1543. [PMID: 30511108 DOI: 10.1007/s12253-018-0542-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 11/14/2018] [Indexed: 12/20/2022]
Abstract
The aim of this study was to investigate the relationship between p16 methylation and its expression in oral squamous cell carcinoma (OSCC). Also the contribution of clinicopathological factors, HPV infection and smoking in p16 expression and promoter methylation has been investigated. In this study 67 consecutive OSCC patients and 59 normal individuals were enrolled. All patients were candidates for surgery of oral cavity and fresh tumor biopsies were collected and processed for DNA and RNA extraction. Normal gingival tissues were collected from individuals referred to dentistry clinic and considered as controls. All the cases and controls were checked for HPV infection and then promoter methylation and expression of p16 gene were determined using Methylation-specific PCR (MSP) and real-time PCR (QPCR), respectively. Methylation of p16 in tumors and normal tissues were 59.7 and 38.9%, respectively. Most of hypermethylated samples (>82%) were in high grades. P16 methylation was comparable in HPV+ and HPV- patients or smokers. P16 was overexpressed (~3 fold; p = 0.044) in HPV+ tumors, but it was significantly down-regulated in smoker patients (40% of all tumors). Comparison of P16 expression in OSCC tumors with different degrees of promoter methylation further suggest the relationship of methylation rate and down-regulation of P16 expression. The p16 methylation and expression was differentially affected in patients with HPV infection and the smoker cases. Regardless of the influence of environmental factors, it appears that P16 status is useful for classifying patients with OSCC and for influencing treatment strategies in accordance with this classification. Moreover, targeting the upregulation of p16 could be a promising therapeutic option.
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Affiliation(s)
- Abdolamir Allameh
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran.
| | - Abdolkarim Moazeni-Roodi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran.,Department of Clinical Biochemistry, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Iraj Harirchi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mehrdad Ravanshad
- Department of Medical Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Maziar Motiee-Langroudi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ata Garajei
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Hamidavi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Seyed Alireza Mesbah-Namin
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
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Baghai F, Yazdani F, Etebarian A, Garajei A, Skalova A. Clinicopathologic and molecular characterization of mammary analogue secretory carcinoma of salivary gland origin. Pathol Res Pract 2017; 213:1112-1118. [PMID: 28781197 DOI: 10.1016/j.prp.2017.07.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/19/2017] [Accepted: 07/19/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Mammary analogue secretory carcinoma (MASC) is a newly recognized salivary gland tumor that harbors a characteristic balanced chromosomal translocation t (12; 15) (p13; q25) resulting in an ETV6-NTRK3 fusion gene. METHODS Retrospective study of 111 salivary gland carcinomas revealed 37 cases with secretory features and growth patterns resembling secretory carcinoma of breast. These 37 cases were originally diagnosed as acinic cell carcinoma, adenocarcinoma not otherwise specified and cystadenocarcinoma. Positive immunostaining for S-100 protein and mammaglobin, followed by detection of ETV6 gene rearrangement by FISH and/or ETV6-NTRK3 fusion transcript by RT-PCR were used to identify MASCs. RESULTS In the cohort of 37 salivary carcinomas with secretory features we have identified 10 cases of MASC. All 10 MASCs were positive for mammaglobin, S-100 protein and SOX10, while staining for DOG1 and p63 protein were mostly absent. In 7/10 cases, both FISH and RT-PCR were positive while three remaining cases showed break of ETV6 gene by FISH analysis and the RT-PCR was negative. Clinical follow-up data were obtained in 6 out of 10 patients with MASC. In 3 patients cervical lymph node metastases developed, one patient with high grade transformed MASC died with multiple distant bone metastases, and local recurrence was observed in three patients. CONCLUSION Our clinicopathological data are in keeping with previous studies; in most cases, MASC is a low-grade malignancy with overall favorable prognosis. In rare cases, however, MASC with high-grade transformation may behave aggressively, and these patients could benefit from targeted biological treatment using tyrosine kinase inhibitors.
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Affiliation(s)
- F Baghai
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - F Yazdani
- Department of Pathology, Amir Alam Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Etebarian
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran.
| | - A Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
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19
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Garajei A. Autologous platelet-rich plasma's role in enhancing the healing phase after surgical removal of teeth. Dent Res J (Isfahan) 2017; 14:223-224. [PMID: 28702066 PMCID: PMC5504877 DOI: 10.4103/1735-3327.208770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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20
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Bayat M, Garajei A, Afshari Pour E, Hasheminasab M, Ghorbani Y, Kalantar Motamedi MH, Bahrami N. The Effect of Locally Administered Pamidronate on Autogenous Bone Graft in Maxillofacial Reconstruction: A Randomized Clinical Trial. Int J Organ Transplant Med 2017; 8:43-47. [PMID: 28299027 PMCID: PMC5347405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although bone grafts are commonly used in reconstructive surgeries, they are sensitive to local perfusion and are thus prone to severe resorption. Biphosphonates can inactivate osteoclasts and can be used to control the undesirable bone resorption. OBJECTIVE To assess the effect of administration of biphosphonates on bone resorption. METHODS 20 patients with bony defects who were candidates for free autogenous grafts were randomized into "pamidronate" and "control" groups. Bone segments were soaked in either pamidronate solution or normal saline and were inserted into the area of the surgery. Bone densities were measured post-surgery and in 6-month follow-up. Data were obtained via Digora software and analyzed. RESULTS The mean±SD bone density in pamidronate group changed from 93.4±14.6 to 93.6±17.5 (p<0.05); in the control group the density decreased from 89.7±13.2 to 78.9±11.4 (p<0.05). The mean difference of bone density in anterior areas of the jaws showed higher DXA in comparison to posterior regions (p=0.002). CONCLUSION Locally administered pamidronate affects reduction in bone resorption.
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Affiliation(s)
- M. Bayat
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Garajei
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - E. Afshari Pour
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Hasheminasab
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Y. Ghorbani
- Department of Physiology, Islamic Azad University, Tehran, Iran
| | - M. H. Kalantar Motamedi
- Oral and Maxillofacial Surgery, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,Attending Faculty, Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Dental College, Tehran, Iran
| | - N. Bahrami
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Dr. Naghmeh Bahrami, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran, E-mail:
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Moazeni-Roodi A, Allameh A, Harirchi I, Motiee-Langroudi M, Garajei A. Studies on the Contribution of Cox-2 Expression in the Progression of Oral Squamous Cell Carcinoma and H-Ras Activation. Pathol Oncol Res 2016; 23:355-360. [PMID: 27628320 DOI: 10.1007/s12253-016-0114-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/07/2016] [Indexed: 02/07/2023]
Abstract
The aim of this study was to investigate the relationship between the H-ras and Cox-2 gene expression in tumors from Iranian Oral Squamous Cell Carcinoma (OSCC) patients. Fresh tumor biopsies removed from oral cavity were collected from 67 new cases. Total RNA was extracted from biopsies and processed for quantification of H-ras and Cox-2 specific RNA expression using real-time PCR (QPCR). In addition, 59 gingival biopsies from apparently normal individuals were processed for QPCR assays. The results showed that Cox-2 expression at mRNA levels was at minimal levels in normal gingival biopsies. However, there was a surge in Cox-2 expression in tumor tissues (11.5 fold, p < 0.0001). Cox-2 expression was elevated depending on the tumor grade and there was a 1.7 fold increase (p = 0.003) in tumors diagnosed as MD/PD compared to that pathologically diagnosed as WD. This inflammatory marker was increased more significantly in smoker patients compared to non-smoker matching group. The H-ras expression at mRNA levels was significantly higher in OSCC samples compared to normal gingival (3 fold; p = 0.044). This expression was significantly higher in tumors diagnosed as MD/PD compared to WD (1.59 fold, p = 0.033). In conclusion, we found a correlation between H-ras expression and Cox-2 induction in OSCC tissue, suggesting that together these genes are contributing to cancer progression. Cox-2 is an early event in cancers of mucosal epithelial cells and a surge in Cox-2 expression in OSCC could be partly due to pro-inflammatory factors such as smoking.
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Affiliation(s)
- Abdolkarim Moazeni-Roodi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, I.R., Iran
| | - Abdolamir Allameh
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, I.R., Iran.
| | - Iraj Harirchi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R., Iran
| | - Maziar Motiee-Langroudi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R., Iran
| | - Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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22
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Tabrizi R, Garajei A, Shafie E, Jamshidi S. Outcome of Neoadjuvant Chemotherapy on Local Recurrence and Distant Metastasis of Oral Squamous Cell Carcinoma: A Retrospective Study. J Dent (Shiraz) 2016; 17:207-12. [PMID: 27602396 PMCID: PMC5006830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STATEMENT OF THE PROBLEM Neoadjuvant chemotherapy (NCH) is controversial in the treatment of oral squamous cell carcinoma (OSCC). PURPOSE The aim of this study was to evaluate the efficacy of NCH on OSCC prognosis. MATERIALS AND METHOD In this retrospective cohort study, 94 patients were studied in two groups. The patients in group 1 received NCH before the surgery, and those in group 2 underwent resection without any chemotherapy prior to surgery. The employed NCH agents consisted of cisplatin in combination with 5-fluorouracil in two treatment courses. Tumor size, lymph node involvement, age, and follow-up time were considered as variable factors of the study. Local recurrence (LR) and distant metastasis (DM) were outcomes of the study. RESULTS Comparison of LR and DM in various tumor sizes demonstrated no significant difference between the two groups (p> 0.05). Analysis of the data did not show any statistically significant difference between the groups for LR in subjects with N0, N1 and N2. Each one-year increase in age was associated with 10% increase in the hazard ratio (HR) (HR distance metastasis Y/N = 1.10, p= 0.05). In the same analysis, when considering LR as a dependent factor, LR risk in N2 was 3 times more than in N1 (p= 0.02). LR risk in N3 was 5 times more than in N1 [HR local recurrence (p= 0.006). CONCLUSION Based on our results, neoadjuvant chemotherapy with combination of cisplatin and 5-fluorouracil may not improve prognosis of OSCC. However, further studies are suggested to assess other neoadjuvant chemotherapy protocols in OSCC patients.
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Affiliation(s)
- Reza Tabrizi
- Dept. of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ata Garajei
- Dept. of Oral and Maxillofacial Surgery and Research Director, Craniomaxillofacial Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ehsan Shafie
- Postgraduate Student, Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Samira Jamshidi
- Postgraduate Student, Dept. of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Sadighi S, Keyhani A, Harirchi I, Garajei A, Aghili M, Kazemian A, Motiee Langroudi M, Zendehdel K, Nikparto N. Neoadjuvant Chemotherapy for Locally Advanced Squamous Carcinoma of Oral Cavity: a Pilot Study. Acta Med Iran 2015; 53:380-386. [PMID: 26069178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 11/24/2014] [Accepted: 11/26/2014] [Indexed: 06/04/2023] Open
Abstract
To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF) induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SPSS version 17 was used for data analysis. Median follow-up was 16 months. The median age of the patients was 62 years old (23-75 years). Man/woman ratio was 1.13. The primary site of the tumor was the tongue in most patients (48%). No significant difference was observed between pathologic characteristics of the two groups. Chemotherapy group showed 16% complete pathologic response to TPF. No significant difference in organ preservation surgery or overall survival was detected. However, the patients in the chemotherapy group had longer progression-free-survival (P=0.014). Surgery followed by chemoradiotherapy with or without TPF induction results in similar survival time. However, progression-free-survival improves with the TPF induction chemotherapy. Studies with more patents and new strategies are recommended to evaluate organ preservation improvement and long-term outcomes.
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Affiliation(s)
- Sanambar Sadighi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amanolah Keyhani
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Iraj Harirchi
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ata Garajei
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdi Aghili
- Radiotherapy Oncology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Kazemian
- Radiotherapy Oncology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Maziar Motiee Langroudi
- Department of Ear, Nose and Trout, Valiasr Hospital, Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nariman Nikparto
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
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Bayat M, Badri A, Momen-Heravi F, Garajei A, Asgarian A. Transverse Displacement and Angulation of the Proximal Segment After Mandibular Setback by Means of Bilateral Intraoral Vertico-Sagittal Ramus Osteotomy. J Oral Maxillofac Surg 2011; 69:906-10. [DOI: 10.1016/j.joms.2010.06.213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Accepted: 06/24/2010] [Indexed: 10/18/2022]
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Kheradmand AA, Garajei A, Motamedi MHK. Nasal reconstruction: experience using tissue expansion and forehead flap. J Oral Maxillofac Surg 2010; 69:1478-84. [PMID: 21185640 DOI: 10.1016/j.joms.2010.07.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Accepted: 07/01/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The forehead is acknowledged to be one of the best, if not the best, donor sites for reconstruction of postoperative nasal defects after ablation in cancer patients. The versatility, color match, and texture are among the benefits of this flap. However, it has 2 major disadvantages: 1) it is stiff, flat, and thicker than normal nasal skin, and thus molding from a 2-dimensional to a 3-dimensional shape is difficult, and 2) there is a donor-site defect that requires coverage using a split-thickness skin graft. PATIENTS AND METHODS In this 5-year study (2004-2009), we modified the 2-stage technique and added an operation before tissue transfer and pedicle division in 48 patients with nasal defects. During the first stage, the tumor was completely excised, and a tissue expander was inserted in the subgaleal plane. After 3 weeks, expansion was initiated. The second operation was performed 12 weeks later. A full-thickness forehead flap was elevated and transposed with primary closure of the donor site. In a third or final stage 3 weeks later, the pedicle was divided. Patient satisfaction and donor site scar was evaluated. RESULTS Over the past 5 years, 48 reconstructions for nasal defects were performed using this technique. Nasal defects of the dorsum, alar, tip, columella, and septum were successfully treated. Graft take was successful in all patients. CONCLUSIONS The forehead flap technique, in conjunction with tissue expander for nasal repair, has both advantages and disadvantages. The esthetic benefits of this technique must be weighed against the disadvantages.
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Affiliation(s)
- Ali A Kheradmand
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Garajei A. Poster 28: Nasal Reconstruction With Preoperative Tissue Expander and Forehead Flap—Our 5 Years' Experience. J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.joms.2009.05.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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