Three-Dimensional Analysis of Bone Remodeling After Closed Treatment for Mandibular Condylar Head Fracture

Closed treatment of mandibular condylar fractures has been used for its indications based on the fracture site, fracture status, and patient age. Posttreatment mandibular condyle size is associated with mandibular function; however, a few studies have reported bone remodeling patterns and volume changes in the condyle and glenoid fossa after mandibular condylar head fractures (CHFs). Therefore, volumetric changes in the mandibular condyle and glenoid fossa were analyzed in the present study, and bone remodeling patterns were evaluated after mandibular CHFs. The present study included 16 condyles from 12 patients who received closed treatment for CHF. After reconstruction of a 3-dimensional skull model, including the mandible, using computed tomography data taken immediately after injury and 6 months after treatment, volume changes in the mandibular condyle and glenoid fossa were analyzed. The condylar volume increased by 0.32±0.66 cm3 during the 6-month healing period without statistical significance (P=0.093). Regarding the glenoid fossa, the fossa showed a statistically significant volume increase of 0.41±0.59 cm3 (P=0.021), and 12 glenoid fossae (75%) showed downward bone apposition; however, no change or only mild bone resorption was observed in 4 glenoid fossae (25%). The results of this study indicated that the volume changes in the mandibular condyle after closed treatment of a mandibular CHF are not significant, and the glenoid fossa adapts to the displaced mandibular condyle through downward growth accompanied by volume increase.

Transoral Endoscopy-Assisted Tongue-Lip Adhesion With Modified Tongue Base Suspension in a Pierre-Robin Sequence: A Safe and Effective Technique

Life-threatening airway obstruction is a major concern in patients with Pierre-Robin sequence. Tongue-lip adhesion (TLA) has been used to manage airway obstruction. The authors present the case of a female neonate with Pierre-Robin sequence who presented with airway obstruction and a cleft palate. She underwent a TLA procedure with modified tongue base suspension (TBS). Endoscopy was used to check and control the traction of the tongue base to enable unobstructed self-ventilation. Positive outcomes including improved O2 saturation and weight gain were noted. The effectiveness of TLA was enhanced by using TBS with real-time endoscopy to evaluate the oropharyngeal airway space required to alleviate airway obstruction. The use of endoscopy enabled us to check and determine how much the tongue base should be tracted by manipulating the tongue anteriorly and posteriorly. The authors report transoral endoscopy-assisted TLA and modified TBS.

Condylar volume and positional changes following a bilateral sagittal split ramus osteotomy in skeletal class II and III malocclusions

BACKGROUND

Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT.

METHODS

The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23.

RESULTS

Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change.

CONCLUSIONS

The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation.

Redox-Sensitive Delivery of Doxorubicin from Nanoparticles of Poly(ethylene glycol)-Chitosan Copolymer for Treatment of Drug-Resistant Oral Cancer Cells

Reactive oxygen species (ROS)-sensitive polymer nanoparticles were synthesized for tumor targeting of an anticancer drug, doxorubicin (DOX). For this purpose, chitosan-methoxy poly(ethylene glycol) (mPEG) (ChitoPEG)-graft copolymer was synthesized and then DOX was conjugated to the backbone of chitosan using a thioketal linker. Subsequently, the chemical structure of the DOX-conjugated ChitoPEG copolymer (ChitoPEGthDOX) was confirmed via 1H nuclear magnetic resonance (NMR) spectra. Nanoparticles of the ChitoPEGthDOX conjugates have spherical shapes and a size of approximately 100 nm. Transmission electron microscopy (TEM) has shown that ChitoPEGthDOX nanoparticles disintegrate in the presence of hydrogen peroxide and the particle size distribution also changes from a monomodal/narrow distribution pattern to a multi-modal/wide distribution pattern. Furthermore, DOX is released faster in the presence of hydrogen peroxide. These results indicated that ChitoPEGthDOX nanoparticles have ROS sensitivity. The anticancer activity of the nanoparticles was evaluated using AT84 oral squamous carcinoma cells. Moreover, DOX-resistant AT84 cells were prepared in vitro. DOX and its nanoparticles showed dose-dependent cytotoxicity in both DOX-sensitive and DOX-resistant AT84 cells in vitro. However, DOX itself showed reduced cytotoxicity against DOX-resistant AT84 cells, while the nanoparticles showed almost similar cytotoxicity to DOX-sensitive and DOX-resistant AT84 cells. This result may be due to the inhibition of intracellular delivery of free DOX, while nanoparticles were efficiently internalized in DOX-resistant cells. The in vivo study of a DOX-resistant AT84 cell-bearing tumor xenograft model showed that nanoparticles have higher antitumor efficacy than those found in free DOX treatment. These results may be related to the efficient accumulation of nanoparticles in the tumor tissue, i.e., the fluorescence intensity in the tumor tissue was stronger than that of any other organs. Our findings suggest that ChitoPEGthDOX nanoparticles may be a promising candidate for ROS-sensitive anticancer delivery against DOX-resistant oral cancer cells.

Can Fracture Reduction be Attempted Through a 3D-Printed Guide Template Without Maxillomandibular Fixation?

BACKGROUND

Computer-aided design and manufacturing is widely used in clinical practice. This technology may change existing methods for mandibular fracture management.

PURPOSE

The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture is performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template.

STUDY DESIGN, SETTING, AND SAMPLE

This was an in-vitro study and had the character of a proof-of-concept study. The study was planned using the existing 20 pairs of intraoral scan and computed tomography data. The mandibular model STL file was created by merging the STL file obtained for the bimaxillary dentitions with the computed tomography DICOM file, and this was set as the original model. In the original model, STL file of fracture model of mandibular symphysis was created using computer-aided design. A template similar to a wafer or an implant guide was manufactured from restoring the own occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire, and this was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups.

PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES

Reduction techniques with MMF or without MMF using guide template for mandibular fracture model.

MAIN OUTCOME VARIABLE(S)

The 3D coordinate system error (mm).

COVARIATES

The position of landmarks.

ANALYSES

The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant.

RESULTS

The 3D error value of the control and experimental group were 1.06 ± 0.63 mm (range: 0.11 to 2.92 mm) and 0.96 ± 0.48 mm (range: 0.2 to 2.95 mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P = .001 and .000, respectively) before and after the reduction in the experimental group.

CONCLUSION AND RELEVANCE

This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.

Comparison of short-term condylar positional changes in mandibular prognathism after surgery-first approach: Symmetric setback versus asymmetric setback

The aim of this study was to compare how the displacement of the mandibular condyle changed after symmetric or asymmetric mandibular setback surgery using the surgery-first approach (SFA). Patients who underwent mandibular setback surgery using the SFA were selected and divided into a symmetry group (n = 18) with differences of less than 2 mm between the right and left setback, and an asymmetry group (n = 18) with a difference of greater than 2 mm. Cone-beam computed tomography (CBCT)-generated cephalograms were obtained after three-dimensional superimposition of CBCT images taken before surgery (T0), within one week after surgery (T1), and seven months after surgery (T2). The condylar positions were measured. Condylar positional changes according to time were compared between the two groups and correlation analysis was performed. There were significant positional changes in mandibular condyles over time in both groups. However, most of these changes returned to their initial state. In the asymmetry group, there was a greater internal rotation of the mandibular condyle on the lesser setback side. The correlation analysis results revealed that only the setback difference was associated with rotational displacement of the condyle on the lesser setback side at two time points (T1-T0, T2-T0). In the SFA, significant condylar displacement occurred immediately after both symmetric and asymmetric mandibular setback surgery, and the right/left difference in mandibular setback showed a significant positive correlation with rotational displacement. Although more significant rotational displacement of the mandibular condyle was observed after asymmetric mandibular setback surgery, the amount was not large enough to be clinically significant.

Evaluation of mandibular positional changes after orthognathic surgery in skeletal class II and class III surgery-first approach patients

PURPOSE

The aim of this study was to predict and compare postoperative changes of mandibular position between mandibular setback and advancement surgery in a surgery-first approach (SFA).

MATERIALS AND METHODS

The study population included patients who underwent mandibular setback or advancement surgery using bilateral sagittal split ramus osteotomy, those were divided into two groups: mandibular setback and advancement surgery. Surgical and postoperative mandibular positional changes were evaluated by lateral cephalograms and CTs taken within 2 months before surgery (T0), 1 week after surgery (T1), and after the debonding procedure (T2). The postoperative mandibular positional changes were predicted from the increase in vertical dimension (VD) in surgical occlusion and the counterclockwise rotation to the preoperative VD on the lateral cephalograms and CT at T1. Furthermore, resultant measurement on postoperative mandibular positional changes was performed. Finally, we compared the prediction with actual positional changes of the mandible after the debonding procedure.

RESULTS

Nine SFA patients with mandibular setback surgery and six with advancement surgery were evaluated and significant mandibular changes from T0 to T1 and from T1 to T2 were observed. Negative correlation between horizontal surgical changes and postoperative horizontal changes was present in both groups. The difference between the predicted and actual amount of postoperative mandibular movement was significant in the mandibular advancement surgery group.

CONCLUSION

Postoperative mandibular relapse appeared much larger in the mandibular advancement surgery group than in the setback group. Therefore, it is more important to consider the postoperative mandibular position change in mandibular advancement surgery in SFA.

Open versus closed treatment for extracapsular fracture of the mandibular condyle

Objectives

Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction.

Patients and Methods

Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography.

Results

A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the non-fractured sides during treatment.

Conclusion

No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

Accuracy of digital surgical guides for dental implants

Background

Recently developed imaging techniques, such as cone beam computed tomography (CBCT) and CAD/CAM technology, have facilitated reliable implant planning and implant surgical guide production by 3D printing. This study compared the accuracy of implant-guided surgery using the R2GATE^® program with CBCT before and after surgery.

Patients and methods

The study included patients who visited the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital from September 2021 to March 2022. Twenty-four implants were placed in eleven patients. Using R2GATE^® Windows (Megagen implant, Daegu, Korea) software, implant placement was planned. The difference was measured by the CBCT before and after surgery. The cervical and apical distance and angular deviation of the implants were measured. Statistical analysis was performed using an independent t-test, Pearson correlation, and multiple regression analyses.

Results

The three-dimensional linear distance difference between the planned implant and the placed implant was 0.97 ± 0.37 mm at the cervical and 1.13 ± 0.36 mm at the apical. The difference in angle deviation between the planned implant and the placed implant was 3.42 ± 2.12°. Among the variables affecting the accuracy of implant placement, a statistically significant difference was found when using a tissue-supported implant guide, implant diameter and implant length.

Conclusion

Based on these results, using the R2GATE^® program is useful to use an implant digital surgical guide, and it will be used in various clinic.

Efficacy and safety of rhBMP/β-TCP in alveolar ridge preservation: a multicenter, randomized, open-label, comparative, investigator-blinded clinical trial

Background

The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation.

Materials and methods

Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups.

Results

Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group.

Conclusions

The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction.

Trial registration

Clinicaltrials.gov, NCT02714829, Registered 22 March 2016

Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach

The purposes of this study were to investigate the influence of the orthodontics-first approach (OFA) and surgery-first approach (SFA) on changes in the signs and symptoms of temporomandibular joint disorders (TMDs) and to compare pre- and postoperative orthodontic treatment duration and total treatment duration between the two approaches. This retrospective study recruited 182 adult patients with malocclusions treated with OFA and SFA and recorded variables such as age, gender, skeletal classification, and signs and symptoms of TMD (clicking and pain disorders) before the start of the surgical-orthodontic treatment and after surgery. Changes in the signs and symptoms of TMD and treatment duration were evaluated within each approach and compared between two approaches. A binary logistic regression was performed to assess the influence of the variables on the postoperative signs and symptoms of TMD. There were no significant postoperative changes in temporomandibular joint (TMJ) pain for OFA and SFA, whereas a significant reduction was found in TMJ clicking after surgery for both approaches. According to binary logistic regression, the type of surgical-orthodontic treatment (OFA or SFA) was not a significant risk factor for postoperative TMJ clicking and pain, and the risk of postoperative TMJ clicking and pain was significant only when TMJ clicking (OR = 10.774, p < 0.001) and pain (OR = 26.876, p = 0.008) existed before the start of the entire treatment, respectively. With regard to the treatment duration, SFA (21.1 ± 10.3 months) exhibited significantly shorter total treatment duration than OFA (34.4 ± 11.9 months) (p < 0.001). The results of this study suggest that surgical-orthodontic treatment using SFA can be a feasible option of treatment for dentofacial deformities based on the equivalent effect on TMD and shorter overall treatment period compared to conventional surgical-orthodontic treatment using OFA.

Comparative Effectiveness of Surface Functionalized Poly-ε-Caprolactone Scaffold and β-TCP Mixed PCL Scaffold for Bone Regeneration

Physio-chemical surface properties to biomaterial has been attention in tissue engineering due to their properties on cell adhesion, proliferation, and differentiation. The object of this study is to evaluate the preosteoblast biological response on physio-chemical surface-layered 3D PCL scaffold and 3D PCL/β-TCP scaffold. 3D scaffolds were fabricated by FDM 3D printing. Physio-chemical surface of 3D scaffolds were prepared by oxygen plasma and amine plasma-polymerization, respectively. The results of this study demonstrated that amine plasma-treated 3D scaffold on adhesion, proliferation, and osteogenic differentiation of the MC3T3-E1 was significantly increased compared to the other scaffolds.

Evaluation of Bone Remodeling After Simultaneous Sagittal Split Ramus Osteotomy and Mandibular Angle Ostectomy in Patients With Mandibular Prognathism

PURPOSE

The present study assessed the postoperative bone remodeling after simultaneous sagittal split ramus osteotomy (SSRO) and mandibular angle ostectomy using a 3-dimensional analysis of computed tomography (CT) data.

MATERIALS AND METHODS

We designed and implemented a retrospective study that included patients who had undergone SSRO with (study group) or without (control group) mandibular angle ostectomy. Using CT data taken immediately after (T1) and 6 months (T2) after surgery, the vertical and horizontal morphologic changes of the mandibular angle were evaluated and compared between the 2 groups. In the study group, the volumetric changes of the mandibular angle were assessed, and the bone regeneration rate was calculated.

RESULTS

A total of 58 mandibular angles were evaluated (32 in the study group and 26 in the control group). The study group exhibited significantly greater vertical bone regrowth at the middle and posterior regions of the mandibular angle ostectomy line compared with that in the control group (middle, P < .001; posterior, P < .001). Both groups showed significant horizontal bone regrowth at 6 months postoperatively (P < .01). In the study group, the postoperative vertical bone regrowth was significantly associated with the extent of exposed bone below the angle ostectomy line at T1 for all regions (P < .001). The percentage of postoperative regenerated bone volume relative to the volume of bone removed intraoperatively was 41.8%.

CONCLUSIONS

The present findings suggest that significant bone regrowth could occur after mandibular angle ostectomy with simultaneous SSRO. Therefore, it is necessary to consider bone remodeling patterns in the treatment planning stage for better and more predictable surgical outcomes.

Comparison of postoperative condylar changes after unilateral sagittal split ramus osteotomy and bilateral sagittal split ramus osteotomy using 3-dimensional analysis

OBJECTIVE

This study aimed to evaluate postoperative changes in the condyle after unilateral sagittal split ramus osteotomy (USSRO) and to compare them with changes occurring after bilateral sagittal split ramus osteotomy (BSSRO).

STUDY DESIGN

For 50 condyles from 25 patients, positional and volumetric changes of condyle were analyzed by using computed tomography images taken before, immediately after, and 6 months after surgery and compared between the USRRO and BSSRO groups.

RESULTS

The condyle showed lateral and inferior displacement immediately after surgery and medial and superior movement at 6 months after surgery in the USSRO and BSSRO groups. No statistically significant difference was found between the 2 groups in the time-course positional change and rotation of the condyle. In the comparison of bodily shift and rotation between operated and nonoperated sides in USSRO group, there were no significant differences between the 2 sides, except for the perioperative rotation pattern on the coronal plane. At 6 months after surgery, the changed volume relative to preoperative condylar volume was only 5.2% in the USSRO group and 2.7% in the BSSRO group.

CONCLUSIONS

The findings from this study suggest that USSRO can be used effectively in appropriately selected patients; however, temporomandibular joint (TMJ) problems may arise when condylar displacement is excessive enough to exceed physiologic tolerances.

Effect of Gellan Gum/Tuna Skin Film in Guided Bone Regeneration in Artificial Bone Defect in Rabbit Calvaria

It is necessary to prevent the invasion of soft tissue into bone defects for successful outcomes in guided bone regeneration (GBR). For this reason, many materials are used as protective barriers to bone defects. In this study, a gellan gum/tuna skin gelatin (GEL/TSG) film was prepared, and its effectiveness in bone regeneration was evaluated. The film exhibited average cell viability in vitro. Experimental bone defects were prepared in rabbit calvaria, and a bone graft procedure with beta-tricalcium phosphate was done. The film was used as a membrane of GBR and compared with results using a commercial collagen membrane. Grafted material did not show dispersion outside of bone defects and the film did not collapse into the bone defect. New bone formation was comparable to that using the collagen membrane. These results suggest that the GEL/TSG film could be used as a membrane for GBR.

Orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty in a patient with a transverse facial cleft

Background

Transverse facial clefts are Tessier’s number 7 facial cleft among numbers 1–15 in Tessier’s classification of craniofacial malformations, which varies from a simple widening oral commissure to a complete fissure extending towards the external ear.

Case presentation

In a patient with a transverse facial cleft, to functionally arrange the orbicularis oris muscle and form the oral commissure naturally, we performed a surgical procedure including orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty.

Conclusion

We achieved good results functionally and esthetically by orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

A retrospective clinical investigation for the effectiveness of closed reduction on nasal bone fracture

Background

The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture.

Patients and methods

A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient’s records, and radiographic images of nasal bone fractures were evaluated.

Results

Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture.

Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications.

Conclusion

Closed reduction could be performed successfully within 2 weeks after injury.

Reconstruction of the orbital wall using superior orbital rim osteotomy in a patient with a superior orbital wall fracture

BACKGROUND

Fractures of the orbital wall are mainly caused by traffic accidents, assaults, and falls and generally occur in men aged between 20 and 40 years. Complications that may occur after an orbital fracture include diplopia and decreased visual acuity due to changes in orbital volume, ocular depression due to changes in orbital floor height, and exophthalmos. If surgery is delayed too long, tissue adhesion will occur, making it difficult to improve ophthalmologic symptoms. Thus, early diagnosis and treatment are important. Fractures of the superior orbital wall are often accompanied by skull fractures. Most of these patients are unable to perform an early ocular evaluation due to neurosurgery and treatment. These patients are more likely to show tissue adhesion, making it difficult to properly dissect the tissue for wall reconstruction during surgery.

CASE PRESENTATION

This report details a case of superior orbital wall reconstruction using superior orbital rim osteotomy in a patient with a superior orbital wall fracture involving severe tissue adhesion. Three months after reconstruction, there were no significant complications.

CONCLUSION

In a patient with a superior orbital wall fracture, our procedure is helpful in securing the visual field and in delamination of the surrounding tissue.

Evaluation of Postoperative Mandibular Positional Changes After Mandibular Setback Surgery in a Surgery-First Approach: Isolated Mandibular Surgery Versus Bimaxillary Surgery

PURPOSE

The aim of this study was to compare postoperative positional changes in the mandible after isolated mandibular surgery (IMS) or bimaxillary surgery (BMS) in a surgery-first approach (SFA).

MATERIALS AND METHODS

The authors designed and implemented a retrospective cohort study composed of patients who underwent mandibular setback surgery using the SFA. Surgical and postoperative changes were evaluated using lateral cephalograms taken 1 month before surgery (T0), 1 week after surgery (T1), and immediately after debonding of orthodontic appliances (T2; 16.6 ± 8.7 months after surgery). To predict postoperative mandibular positional changes from the increase in vertical dimension (VD) in surgical occlusion, the mandible was rotated counterclockwise to the preoperative VD on the lateral cephalogram at T1, and resultant mandibular positional changes were measured. To evaluate actual postoperative mandibular positional changes between each time point and compare them between the 2 groups, independent t test, paired t test, and repeated-measures analysis of variance were performed.

RESULTS

Thirty patients were evaluated (16 in IMS group and 14 in BMS group). The 2 groups showed significant time-course mandibular positional changes from T0 to T1 and from T1 to T2 within each group (point B, P < .001), although no statistically significant differences were observed between groups. There was no statistically relevant difference between groups in the predicted and actual postoperative rotational movements. In addition to the mandibular forward movement that resulted from postoperative mandibular counterclockwise rotation, additional horizontal relapse occurred.

CONCLUSION

The present findings suggest that the mandible exhibits notable postoperative forward movement during postoperative orthodontic treatment, regardless of the extent of the orthognathic surgery in the SFA, and it is necessary to consider mandibular forward movement from the VD increase in surgical occlusion and additional relapse during the treatment planning stage.

Corrective outcome and transverse stability after orthognathic surgery using a surgery-first approach in mandibular prognathism with and without facial asymmetry

OBJECTIVES

The aim of this study was to evaluate corrective outcome and transverse stability after orthognathic surgery via a surgery-first approach (SFA) in mandibular prognathism with and without facial asymmetry using 3-dimensional analysis.

STUDY DESIGN

Twenty-nine patients who received mandibular setback surgery using SFA were divided into 2 groups according to the menton deviation (4 mm): symmetry group (n = 17) and asymmetry group (n = 12). Using computed tomography images obtained before (T0), immediately after (T1), and 6 months after (T2) surgery, time-dependent changes in variables related to facial asymmetry, including maxillary height, ramal length, frontal and lateral ramal inclination, mandibular body length, and mandibular body height, were evaluated.

RESULTS

Immediately after surgery, the asymmetry group showed significantly decreased discrepancies between the longer and non-longer sides for all variables (P < .05); there were no significant differences in discrepancies between the 2 groups. During the postoperative period, no significant changes in discrepancies were found in any variable in either group. Compared with T0, the asymmetry group showed significantly decreased discrepancies in ramal length, frontal and lateral ramal inclination, and mandibular body length at T2.

CONCLUSIONS

Variables related to facial asymmetry showed significant improvement after surgical-orthodontic treatment using SFA, and corrected outcomes showed good postoperative stability in both the symmetry and asymmetry groups.

Oxygen and Acrylic Acid Plasma Treatment on Titanium Mesh for Improving the Hydroxyapatite Formation

Customized titanium (Ti) meshes were treated with O2 plasma and acrylic acid plasmapolymerization (PPAAc). The optimum conditions for PPAAc were as follows: 20 W, 15 mTorr, and 5 min. Hydroxyapatite formation increased in Ti meshes treated with O2 and PPAAc compared with that in untreated Ti meshes. Moreover, MC3T3-E1 cells exhibited improved cell spreading, attachment, proliferation in PPAAc treated Ti mesh than in untreated Ti mesh. This result revealed that O2 and PPAAc surface treatment on Ti mesh was potential tool for improving the bone formation on the Ti mesh clinically application.

Treatment of dental implant displacement into the maxillary sinus

Background

Displacement of dental implants into the maxillary sinus is rare, but it primarily occurs in patients with severe pneumatization of the maxillary sinus and/or deficiency of the alveolar process. Some complications such as the infection of the paranasal sinuses and formation of the oroantral fistula can be followed by the displacement of a dental implant. Therefore, the displaced implant has to be removed immediately with surgical intervention show and another plan for rehabilitation should be considered.

Main body

The conventional procedure for the removal of a displaced implant from the maxillary sinus involves sinus bone grafting and new implant placement performed in two or more steps with a significant time gap in between. Simplification of these surgical procedures can decrease the treatment duration and patient discomfort.

Conclusions

In this review, we discuss the anatomical characteristics of the maxillary sinus and the complications associated with implant displacement into the sinus.

Surgical excision of osteochondroma on mandibular condyle via preauricular approach with zygomatic arch osteotomy

Background

Osteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses.

Case presentation

This study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period.

Conclusions

In local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.

Horizontal changes of the proximal mandibular segment after mandibular setback surgery using 3-dimensional computed tomography data

OBJECTIVES

To evaluate horizontal changes of the proximal mandibular segment after mandibular setback surgery using 3-dimensional computed tomography (3-D CT).

STUDY DESIGN

This study included 66 patients who underwent bilateral sagittal split ramus osteotomy for correction of mandibular prognathism. With the use of 3-D CT data obtained preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3), horizontal changes of the proximal mandibular segment, including the intercondylar width, the intergonial width, and the frontal-ramal inclination were evaluated.

RESULTS

The value of the right frontal-ramal inclination was 11.43 ± 1.36° at T1, 11.91 ± 1.96° at T2, and 10.7 ± 1.5° at T3. The values of the left frontal-ramal inclination were 6.10 ± 1.03° at T1, 8.17 ± 1.66° at T2, and 7.66 ± 1.65° at T3. The values of the intergonial width were 99.67 ± 1.67 mm at T1, 98.24 ± 1.72 mm at T2, and 97.08 ± 1.71 mm at T3. The intergonial width was significantly decreased at T3 compared with T1 (P < .001). The values of the intercondylar width were 123.51 ± 1.66 mm at T1, 123.9 ± 1.66 mm at T2, and 122.88 ± 1.58 mm at T3.

CONCLUSIONS

Lower facial width at mandibular angle region decreased immediately after mandibular setback surgery and showed further decreases during the postoperative period.

Abstract P6-05-05: The expression of lysyl oxidase and fibrotic focus is related to inflammation in breast cancer

Background: Lysyl oxidase (LOX) is an extracellular matrix enzyme that catalyzes the

cross-linking of collagens or elastin. Our hypothesis is that LOX contributes to the formation

of a fibrotic focus (FF), which is related to inflammation in breast carcinogenesis.

In this study, we analyzed the association between the expression LOXs and FF, and

investigated prognostic significance in breast cancer.

Methods: Tissue microarrarys were constructed from the specimens of 444 patients

with primary invasive breast cancer. Immunohistochemical staining for LOX, LOXlike

(LOXL)-, LOXL-2 and LOXL-3 was performed. The status of FF within the tumor

was assessed. The number of CD4+ T cells, CD8+ T cells, CD68+ macrophages was

counted, and intratumoral and peritumoral lymphocyte infiltration were evaluated.

The clinicopathologic characteristics of the patients were analyzed.

Result: The percentage of positive FF was 39.2% and positive rate of LOX expression

was 50% in primary breast cancer tissues. FF was found to be significantly associated

with intratumoral and peritumoral inflammation, lymph node metastasis, high histologic

grade, larger tumor size. LOX was associated with intratumoral and peritumoral

inflammation, CD8+ T cells and menopausal status. LOXL-3 was significantly associated

with positive expression of ER and PR, and molecular subtype.

Conclusions: FF and the expression of LOX were associated with inflammation in

breast cancer in this study. Our results suggest that LOXs may contribute to the formation

of a FF indirectly in relation with inflammation in breast cancer. Further studies

are needed to clarify the role of LOXs, FF and inflammation in tumorigenesis and

prognostic value of them in breast cancer.

Citation Format: Park SH, Jeong YJ, Bong JG, Oh HK. The expression of lysyl oxidase and fibrotic focus is related to inflammation in breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-05-05.

Changes in condylar position after BSSRO with and without Le Fort I osteotomy via surgery-first approach in mandibular prognathism with facial asymmetry

OBJECTIVES

This study aimed to evaluate changes in condylar position after bilateral sagittal split ramus osteotomy (BSSRO) with and without Le Fort I osteotomy via the surgery-first approach (SFA) in patients with facial asymmetry.

STUDY DESIGN

Eighteen patients (36 condyles) who received surgical-orthodontic treatment using the SFA were included and divided into 2 groups depending on the extent of surgery: BSSRO-only group (n = 12) and BSSRO with Le Fort I osteotomy group (n = 6). Using computed tomography images taken preoperatively, immediately postoperatively, and 6 months postoperatively, surgical and postoperative changes of the condylar position were analyzed 3-dimensionally.

RESULTS

Both groups showed mainly inferolateral displacement with inward rotation immediately after surgery, and superomedial returning movement with outward rotation 6 months after surgery. There was no statistical difference in time-course changes of the condylar position between the 2 groups. In comparing the deviated and nondeviated sides, the deviated side showed significantly greater amount of bodily shift and rotational movement after surgery compared with the nondeviated side in both groups.

CONCLUSIONS

These results suggest that BSSRO via the SFA, either with or without Le Fort I osteotomy, may cause condylar displacement after surgery and that the displaced condyles return to their original position on both the deviated and the nondeviated sides.

Evaluation of clinical outcomes of implants placed into the maxillary sinus with a perforated sinus membrane: a retrospective study

Background

The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach.

Methods

We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was 57.2 ± 7.2 years at the time of operation (range, 20–76 years). The mean follow-up duration was 2.1 years (range, 0.5–5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study.

Results

Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was 3.4 ± 2.0 mm in cases of simultaneous implant placement and 0.6 ± 0.9 mm in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%.

Conclusions

In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

Retrospective clinical study of an implant with a sandblasted, large-grit, acid-etched surface and internal connection: analysis of short-term success rate and marginal bone loss

Background

The purpose of this retrospective study was to evaluate the clinical utility of an implant with a sandblasted, large-grit, acid-etched (SLA) surface and internal connection.

Methods

Six patients who received dental implants in the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, were analyzed by factors influencing the success rate and marginal bone loss. Factors included patient’s age, sex, implant installation site, whether bone graft was done, type of bone graft materials, approaching method if sinus lift was done, and the size of the fixture. In addition, the marginal bone loss was analyzed by using a radiograph.

Results

All implants were successful, and the cumulative survival rate was 100 %. Average marginal bone loss of 6 months after the installation was 0.52 mm and 20 months after the functional loading was 1.06 mm. Total marginal bone resorption was 1.58 mm on average. There was no statistically significant difference in mesial and distal marginal bone loss.

Conclusions

The short-term clinical success rate of the implant with an SLA surface and internal connection was satisfactory. Moreover, the marginal bone loss was also consistent with the implant success criteria.

Postoperative changes in mandibular position after mandibular setback surgery via the surgery-first approach in relation to the increase of vertical dimension and the amount of mandibular setback

OBJECTIVES

This study aimed to compare preoperatively predicted rotational relapse with actual post-treatment mandibular position after mandibular setback surgery via the surgery-first approach and to evaluate the effect of the increase of vertical dimension (VD) on surgical occlusion and the amount of mandibular setback on postoperative mandibular positional changes.

STUDY DESIGN

Twenty-nine patients who underwent bilateral sagittal split ramus osteotomy for mandibular prognathism were evaluated by using lateral cephalograms, which had been obtained preoperatively, immediately postoperatively, and immediately after debonding. Increase of VD on surgical occlusion was measured preoperatively. We estimated the mandibular forward movement resulting from the postoperative mandibular anticlockwise rotation during postoperative orthodontic treatment and compared it with the actual post-treatment mandibular position.

RESULTS

The actual postoperative mandibular forward movement (2.1 mm) was significantly greater compared with the forward movement (1 mm) predicted preoperatively (P < .01). The postoperative mandibular forward movement was greater in the groups with greater VD increase (>1.5 mm) or greater mandibular setback (>10 mm), even though there was no statistically significant difference.

CONCLUSIONS

These results suggest that additional postoperative relapse may occur with mandibular rotational relapse, and VD increase and the amount of mandibular setback may affect post-treatment mandibular position in surgery-first orthodontic treatment.

Retrospective study on factors affecting the prognosis in oral cancer patients who underwent surgical treatment only

Background

This study was performed to evaluate their 5-year survival rates and identify the factors affecting the prognosis of oral cancer patients who had undergone surgical treatment only.

Methods

Among 130 patients who were diagnosed with malignant tumor of oral, maxillofacial, and surgical treated in the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital within a period from January 2000 to December 2010, for 11 years, 84 patients were investigated who were followed up for more than 5 years after radical surgery; oral cancer is primary and received only surgical treatment. The survival rate according to gender, age, type and site of cancer, TNM stage, cervical lymph node metastasis and its stage, recurrence or metastasis, time of recurrence and metastasis, and differentiation were investigated and analyzed.

Results

Overall, 5-year survival rate in patients who received only surgical treatment was 81.2 %, and disease-specific 5-year survival rate was 83.1 %. The disease-specific 5-year survival rate based on TNM stage, metastasis of cervical lymph node, N stage, and presence of recurrence/metastasis was a significant difference (p < 0.05). The disease-specific 5-year survival rate based on sex, age, type of tumor, primary site, and differentiation was not a significant difference (p > 0.05).

Conclusions

These results suggest that good survival rate can be obtained with surgical treatment only, and stage of oral cancer, cervical lymph node metastasis and stage, recurrence or metastasis, time of recurrence, and metastasis have a significant effect on survival rate in oral cancer patients.

Screening and development of DNA aptamers specific to several oral pathogens

Aptamers are composed of single-stranded oilgonucleotides that can selectively bind desired molecules. It has been reported that RNA or DNA could act as not only a genetic messenger but also a catalyst in metabolic pathways. RNA aptamers (average sizes 40-50 bp) are smaller than antibodies and have strong binding capacities to target molecules, similar to antigen-antibody interactions. Once an aptamer was selected, it can be readily produced in large quantities at low cost. The objectives of this study are to screen and develop aptamers specific to oral pathogens such as Porphyromonas gingivalis, Treponema denticola, and Streptococcus mutans. The bacterial cell pellet was fixed with formaldehyde as a target molecule for the screening of aptamers. The SELEX method was used for the screening of aptamers and a modified western blot analysis was used to verify their specificities. Through SELEX, 40 kinds of aptamers were selected and the specificity of the aptamers to the bacterial cells was confirmed by modified western blot analysis. Through the SELEX method, 40 aptamers that specifically bind to oral pathogens were screened and isolated. The aptamers showed possibility as effective candidates for the detection agents of oral infections.

Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism

BACKGROUND

This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism.

METHODS

This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo 5™ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively.

RESULTS

In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant.

CONCLUSIONS

The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

Aplastic anemia and dental implant rehabilitation: a clinical trial

The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

Humoral immune responses to periodontal pathogens in the elderly

PURPOSE

Elderly people are thought to be more susceptible to periodontal disease due to reduced immune function associated with aging. However, little information is available on the nature of immune responses against putative periodontal pathogens in geriatric patients. The purpose of this study was to evaluate the serum IgG antibody responses to six periodontal pathogens in geriatric subjects.

METHODS

The study population consisted of 85 geriatric patients and was divided into three groups: 29 mild (MCP), 27 moderate (MoCP) and 29 severe (SCP) chronic periodontitis patients. Serum levels of IgG antibody to Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum and Prevotella intermedia were measured by enzyme-linked immunosorbent assay (ELISA) and compared among the groups.

RESULTS

All three groups showed levels of serum IgG in response to P. gingivalis, A. actinomycetemcomitans, and P. intermedia that were three to four times higher than levels of IgG to T. forsythia, T. denticola, and F. nucleatum. There were no significant differences among all three groups in IgG response to P. gingivalis (P=0.065), T. forsythia (P=0.057), T. denticola (P=0.1), and P. intermedia (P=0.167), although the IgG levels tended to be higher in patients with SCP than in those with MCP or MoCP (with the exception of those for P. intermedia). In contrast, there were significant differences among the groups in IgG levels in response to F. nucleatum (P=0.001) and A. actinomycetemcomitans (P=0.003). IgG levels to A. actinomycetemcomitans were higher in patients with MCP than in those with MoCP or SCP.

CONCLUSIONS

When IgG levels were compared among three periodontal disease groups, only IgG levels to F. nucleatum significantly increased with the severity of disease. On the contrary, IgG levels to A. actinomycetemcomitans decreased significantly in patients with SCP compared to those with MCP. There were no significant differences in the IgG levels for P. gingivalis, T. forsythia, T. denticola, and P. intermedia among geriatric patients with chronic periodontitis.

The submuscular sliding plate technique for acetabular posterior wall fractures extending to the acetabular roof

There is extension of the Kocher-Langenbeck approach using trochanteric osteotomy for posterior wall fracture extending to acetabular roof, but it exposes to complications such as nonunion, breakage, and heterotopic ossification. The current study introduces a submuscular sliding plate technique. We retrospectively analyzed 13 patients treated with this technique. It is based on conventional method for posterior wall fracture. After reduction of roof fragment with direct visualization, a pre-contoured plate was passed through a submuscular tunnel under the gluteus medius and minimus. A small split incision was performed on the muscles, and screws were inserted with a triple trocar complex safely under fluoroscopic imaging. All patients had fracture union without complications. X-rays results showed anatomical reduction in 10 cases and imperfect reduction in 3 cases. Our results were satisfactory, particularly without heterotopic ossifications despite no prophylactic regimen of NSAID was applied and no neurological complications, so we believe that this technique is a good option for posterior wall fractures extending to the acetabular roof.

A comparison study between periosteum and resorbable collagen membrane on iliac block bone graft resorption in the rabbit calvarium

BACKGROUND

To compare the different resorption patterns between resorbable membrane barrier and periosteum after iliac block bone grafting radiographically and histologically.

METHODS

Eighteen mature male rabbits weighing from 2.0 to 2.5 kg were used. The recipient site was the rabbit skull, and autogenous iliac bone was used as the grafting material. The harvested iliac block bones were divided in the following groups: autogenous iliac block bone with preservation of the periosteum (the periosteum group), autogenous iliac block bone covered with a resorbable collagen membrane (Biomesh®, Samyang Co, Korea) after removing the periosteum (the collagen membrane group), and autogenous iliac block bones with removal of the periosteum (the control group). In each experimental group, periosteum or resorbable collagen membrane of the donor site was fixed directed to the periosteum of the recipient site. The specimens were examined macroscopically, radiographically, histologically, and histomorphometrically at every 2, 4, and 8 weeks.

RESULTS

All groups presented excellent bone graft healing state without inflammation, dehiscence, or displacement. The radiolucency increased from mild to moderate in all groups over the experiment. The mean thickness of the upper end of the cortical iliac bone graft was statistically significantly different between the control group and the periosteum group, between the four-week and eight-week control group, and between the four- week and eight-week periosteum group (p & 0.05).

CONCLUSION

This study suggests that both the periosteum and the resorbable collagen membrane may help to prevent soft tissue infiltration into the bone graft and to reduce bone graft resorption compared to block graft alone.

Abstract P2-06-05: Association of promoter methylation status of the FHIT gene and Fhit expression with HER2/neu status in breast cancer

Purpose: Aberrant DNA methylation has been recognized to contribute to breast carcinogenesis, and promoter hypermethylation of many tumor suppressor genes has been correlated with decreased gene expression. The fragile histidine triad (FHIT) gene is a putative tumor suppressor gene in breast and other cancers, and loss of Fhit expression has been observed in breast cancers. The aim of this study was to evaluate the association between methylation of the FHIT gene and its expression in breast cancer, and to investigate whether methylation and expression of the FHIT gene would correlate with clinicopathological characteristics in relation to human epidermal growth factor receptor 2 (HER2) status.

Methods: Pyrosequencing of bisulfite treated DNA was performed to study the methylation status of the FHIT gene in 60 breast cancer samples from Korean women obtained at Daegu Catholic University Hospital. We examined the expression of FHIT using tissue microarrays by immunohistochemical staining. Association between the methylation status of the FHIT gene and its expression was analyzed, and the relationship between the FHIT expression and the clinicopathological characteristics of the patients was evaluated.

Results: FHIT methylation was detected in 96.7% and positive expression rate of Fhit was 87.3% of the patients. The mean methylation level of the FHIT gene was associated with intratumoral inflammation. Methylation level of the FHIT gene had no significant differences according to molecular subtypes. Loss of Fhit expression was associated with large tumor size, basal-like subtype and positive expression of EGFR. In HER2-negative breast cancers, loss of Fhit expression was significantly associated with tumor size, estrogen receptor status and Ki-67 proliferation index. There was no significant correlation between methylation of the FHIT gene and its expression in this study.

Conslusion: Our study revealed that loss of Fhit expression in breast cancer is associated with poor prognostic features, although there is no significance association between the FHIT gene methylation and Fhit expression. We found that in HER2-negatvie breast cancers, loss of Fhit expression was associated with poor prognostic features. These results support the possibility of potential complementation between HER2 and the Fhit pathway. The clinical significance of our findings needs to be further evaluated in larger cohorts with longer follow-up.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-06-05.

Effect of magnesium and calcium phosphate coatings on osteoblastic responses to the titanium surface

PURPOSE

The aim of this study was to evaluate the surface properties and in vitro bioactivity to osteoblasts of magnesium and magnesium-hydroxyapatite coated titanium.

MATERIALS AND METHODS

Themagnesium (Mg) and magnesium-hydroxyapatite (Mg-HA) coatings on titanium (Ti) substrates were prepared by radio frequency (RF) and direct current (DC) magnetron sputtering.The samples were divided into non-coated smooth Ti (Ti-S group), Mg coatinggroup (Ti-Mg group), and Mg-HA coating group (Ti-MgHA group).The surface properties were evaluated using scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The surface roughness was evaluated by atomic force microscopy (AFM). Cell adhesion, cell proliferation and alkaline phosphatase (ALP) activity were evaluated using MC3T3-E1 cells. Reverse transcription polymerase chain reaction (RT-PCR) analysis was performed.

RESULTS

Cross-sectional SEM images showed that Mg and Mg-HA depositionson titanium substrates were performed successfully. The surface roughness appeared to be similaramong the three groups. Ti-MgHA and Ti-Mg group had improved cellular responses with regard to the proliferation, alkaline phosphatase (ALP) activity, and bone-associated markers, such as bone sialoprotein (BSP) and osteocalcin (OCN) mRNA compared to those of Ti-S group. However, the differences between Ti-Mg group and Ti-MgHA group were not significant, in spite of the tendency of higher proliferation, ALP activity and BSP expression in Ti-MgHA group.

CONCLUSION

Mg and Mg-HAcoatings could stimulate the differentiation into osteoblastic MC3T3-E1 cells, potentially contributing to rapid osseointegration.

Quantitative analysis of periodontal pathogens present in the saliva of geriatric subjects

PURPOSE

At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition.

METHODS

Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured.

RESULTS

It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples.

CONCLUSIONS

Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.

Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study

Objectives

This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection.

Materials and Methods

Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009.

Results

Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms.

Conclusion

These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy.

Dichloromethane fraction from Gardenia jasminoides: DNA topoisomerase 1 inhibition and oral cancer cell death induction

CONTEXT

A growing body of evidence shows that compounds of plant origin have the ability to prevent cancer. The fruit of gardenia, Gardenia jasminoides Ellis (Rubiaceae), has long been used as a food additive and herbal medicine, and its pharmacological actions, such as protective activity against oxidative damage, cytotoxic effect, and anti-inflammatory and anti-tumor activity, have already been reported.

OBJECTIVE

The purpose of the present study was to investigate the presence of DNA topoisomerase 1 inhibitor in various solvent fractions of Gardenia extract and examine the induction of oral cancer cell death upon treatment with Gardenia extract.

MATERIALS AND METHODS

The methanol extract of Gardenia was partitioned with n-hexane, dichloromethane, ethyl acetate, n-butanol, and water.

RESULTS

In the DNA topoisomerase 1 assay, n-hexane and dichloromethane fractions inhibited topoisomerase 1 and led to a decrease in the cell viability of KB cells. The dichloromethane fraction (0.1 mg/mL) also showed 77% inhibition of cell viability in KB cells compared with HaCaT cells. Treatment with dichloromethane fraction led to apoptotic cell death as evidenced by flow cytometric analysis and morphological changes. In addition, treatment with Gardenia extract dichloromethane fraction led to the partial increase of caspase-3, caspase-8 and caspase-9 activities and the cleavage of poly (ADP-ribose) polymerase.

CONCLUSION

Taken together, these results suggest that the dichloromethane fraction from Gardenia extract induces apoptotic cell death by DNA topoisomerase 1 inhibition in KB cells. These findings suggest the possibility that Gardenia extract could be developed as an anticancer modality.