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Bernaola-Paredes WE, Rodrigues ML, Carvalho HP, dos Santos Bitencourt F, Coutinho MC, D’Almeida Costa F, Vallejo-Rosero KA, Marquez-Zambrano JA, Pellizzon ACA. Reconstructive surgery and adjuvant radiotherapy for the multimodal approach in oral cancer: a single cancer centre experience. Ann Med Surg (Lond) 2023; 85:5314-5322. [PMID: 37915680 PMCID: PMC10617813 DOI: 10.1097/ms9.0000000000001357] [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: 03/28/2023] [Accepted: 09/17/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Ablative surgery for oral cancer, irrespective of the histological subtype, causes large tissue defects, functional and aesthetic damage. Microsurgical free flaps have been widely used in reconstruction after resection, with satisfactory success rates in conjunction with adjuvant radiotherapy (RT). This study aims to describe our clinical institutional experience based on the multimodal treatment performed in four cases diagnosed with oral squamous cell carcinoma with the use of different microvascular free flaps and RT. Case series presentation Four patients underwent reconstructive microsurgery after surgical resection of oral cancer, using three types of free flap: radial forearm fasciocutaneous, osteomyocutaneous fibular, and anterolateral thigh musculocutaneous flaps; RT was performed in Case 2 and Case 3. In the period of 3 years after microsurgical reconstruction and RT, flaps remain clinically stable without failure signs in full patients submitted to multimodal treatment. Clinical discussion After resection of oral carcinomas, extensive tissue defects can be successfully treated with reconstructive microsurgery using different types of microvascular free flaps. RT for locoregional control is a feasible option and did not seem to interfere with the survival of flaps. Conclusion An enhance long-term follow-up to assess overall and disease-free survival rates and quality of life must be carried out; however, cohort studies would be necessary for better understanding of the role of each treatment in the multimodal scheme.
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Affiliation(s)
| | | | | | | | | | | | | | - Jose Agustin Marquez-Zambrano
- Department of Oral Pathology, School of Dentistry and Rehabiliation Sciences, San Sebastian University, Santiago, Chile
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Camolesi GCV, Veronese HRM, Celestino MA, Blum DFC, Márquez-Zambrano JA, Carmona-Pérez FA, Jara-Venegas TA, Pellizzon ACA, Bernaola-Paredes WE. Survival of osseointegrated implants in head and neck cancer patients submitted to multimodal treatment: a systematic review and meta-analysis. Support Care Cancer 2023; 31:641. [PMID: 37851170 DOI: 10.1007/s00520-023-08088-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/16/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis. METHODS An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle-Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool. RESULTS A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20-99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56-99.48, p < 0.001). CONCLUSIONS Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.
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Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain.
| | | | | | - Davi Francisco Casa Blum
- Department of Oral and Maxillofacial Surgery, Atitus Education, Passo Fundo, Rio Grande Do Sul, Brazil
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Bernaola-Paredes WE, Filho VB, Vilela Dias EM, Sugaya NN. A case of migratory stomatitis in a young male patient: Management and differential diagnosis. J Oral Maxillofac Pathol 2022; 26:S17-S21. [PMID: 35450243 PMCID: PMC9017832 DOI: 10.4103/jomfp.jomfp_446_20] [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: 11/04/2020] [Revised: 05/31/2021] [Accepted: 07/07/2021] [Indexed: 11/22/2022] Open
Abstract
Migratory stomatitis (MS) is an uncommon inflammatory condition with unclarified etiology, which despite its benign nature, may raise concerns for patients and diagnostic difficulties for professionals. This case report aims to describe the clinical features of a patient who presented with MS in conjunction with benign migratory glossitis (BMG), and its diagnostic process and management. The patient, a 25-year-old man, sought diagnosis of an oral condition, with cyclic behavior, which had been causing him great discomfort for a year. The patient presented erythematous patches on his lower lips and right side of the buccal mucosa, surrounded by a slightly elevated halo with a concomitant classical picture of BMG. After analysis of his entire symptomatology, the diagnosis of MS associated with BMG was concluded. The patient received clear explanations and symptomatic treatment. The diagnosis of MS may be challenging, even to oral medicine practitioners, especially if it occurs alone. MS with concurrent manifestation of BMG may make the conditions easier to diagnose, but it does not exclude the need to apply a complete process of differential diagnosis to rule out other similar possibilities.
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Affiliation(s)
| | - Valdener Bella Filho
- Department of Stomatology, School of Dentistry, Federal University of Goias (UFG), Sao Paulo, Brazil
| | | | - Norberto Nobuo Sugaya
- Department of Stomatology, School of Dentistry, University of Sao Paulo (USP), Sao Paulo, Brazil
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Bernaola-Paredes WE, da Silva Conceição MB, Moreira SC, Aparecida Souza AM, Souza Pina PS, Azevedo LH. Clinical and histopathological features of congenital epulis in a newborn submitted to laser surgery. J Oral Maxillofac Pathol 2022; 26:S77-S79. [PMID: 35450244 PMCID: PMC9017822 DOI: 10.4103/jomfp.jomfp_449_20] [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: 11/06/2020] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/11/2022] Open
Abstract
Congenital epulis (CE) is a rare condition in newborns, whose histogenesis remains unclear. It mostly presents as a circumscribed mass in the maxilla alveolar ridge of female neonates and can interfere with their normal breathing and breastfeeding. This benign oral lesion usually appears as a pedunculated nodule covered with normal mucosa that extends from the anterior vestibular alveolar ridge up to the posterior region. There are some pathological conditions that show clinical and histopathological features similar to those of CE, such as granular cell tumor, gingival cyst of the newborn, vascular malformations and others. This case report aimed to describe the clinical and pathological features of a newborn patient with a clinical and histopathological diagnosis of CE on the right side of the maxillary alveolar ridge, treated with excision by laser surgery, with a follow-up of 5 months without any sign of recurrence.
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Affiliation(s)
| | | | - Suzana Cardoso Moreira
- Department of Laboratory of Lasers in Dentistry (LELO), University of Sao Paulo (USP), Brazil
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Araújo RV, Milani BA, Martins IS, Vilela Dias EM, Bernaola-Paredes WE. An Extraoral Surgical Approach to Treat Chronic Submandibular Sialolithiasis - A Case Series. Ann Maxillofac Surg 2020; 10:537-542. [PMID: 33708613 PMCID: PMC7944014 DOI: 10.4103/ams.ams_102_20] [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: 04/02/2020] [Revised: 04/25/2020] [Accepted: 06/28/2020] [Indexed: 11/04/2022] Open
Abstract
Sialolithiasis is the most common cause of sialadenitis in the submandibular gland, in which the highest incidence of this condition occurs, among the major salivary glands. This could be explained by the anatomy of Wharton's duct, and the chemical composition of the saliva produced by this gland. There are several alternatives and techniques for the treatment of sialolithiasis, including lithotripsy, sialoendoscopy, and conservative removal of the sialoliths or complete removal of the submandibular gland, through the transoral and extraoral routes for access to the gland. To determine the form of treatment, characteristics such as topography, diameter, and location of the sialolith in the duct are observed. The aim of this case series was to show our experience gained in two clinical cases of submandibular gland excision through an extraoral approach, using the submandibular access technique. In addition, we discussed the cause of sialolithiasis in these patients and after follow-up, compared the clinical results we obtained with this technique with those reported in the current literature. The submandibular approach or Risdon access continues to be a safe approach to removing the submandibular gland, as it is a commonly used technique and obtained satisfactory results, as shown in these cases. However, the major disadvantages were the less favorable esthetic results and paralysis of the marginal mandibular branch of the facial nerve.
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Affiliation(s)
- Renan Veiga Araújo
- Department of Oral and Maxillofacial Surgery, Campo Limpo Medical Center, Sao Paulo, Brazil
| | - Basílio Almeida Milani
- Department of Oral and Maxillofacial Surgery, Campo Limpo Medical Center, Sao Paulo, Brazil
| | - Ivan Solani Martins
- Department of Oral and Maxillofacial Surgery, Hospital Sirio-Libanes, Sao Paulo, Brazil
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De Lima FF, Bezerra CP, Rocha AC, Martins IS, Bernaola-Paredes WE. Surgical Management of Palatal Pleomorphic Adenoma (PPA) Recurrence After 10 years, Treated at a Brazilian Center - A Case Report. Ann Maxillofac Surg 2020; 10:533-536. [PMID: 33708612 PMCID: PMC7944004 DOI: 10.4103/ams.ams_107_20] [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: 04/07/2020] [Revised: 08/15/2020] [Accepted: 08/27/2020] [Indexed: 11/04/2022] Open
Abstract
Pleomorphic adenoma, considered the most frequent benign mixed neoplasm of the minor salivary glands, occurs mainly in the region of the hard palate, with slight predilection in females and peak of incidence between the third and fifth decades of life. An increase in recurrence rates has been associated with the histopathological variants of the tumor, cellular characteristics, stroma, and capsule rupture during surgical removal of the lesion. The present case report aims to describe the surgical approach performed on the patient, a 45-year-old woman with a recurrent Pleomorphic Adenoma (PA) in the region of the hard palate on the right side, 10 years after initial enucleation of the lesion; her main complaint was an increase in volume in the palatal region. After extensive local surgical excision of the tumor and 2 years of follow-up, there were no signs of recurrence. Computed tomography and a correct histopathological diagnosis are essential to enable the establishment of an appropriate surgical treatment, with the purpose of achieving complete removal of the lesion, with wide surgical margins, including the lining mucosa and the underlying periosteum, as described in the present case.
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Affiliation(s)
| | - Catarina Pires Bezerra
- Department of Dentistry and Restoration, School of Dentistry, Paulist University, Sao Paulo, Brazil
| | - André Caroli Rocha
- Department of Oral and Maxillofacial Surgery, Hospital Regional Sul, Sao Paulo, Brazil
| | - Ivan Solani Martins
- Department of Oral and Maxillofacial Surgery, Hospital Sirio-Libanes, Sao Paulo, Brazil
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Teitelbaum S, Azevedo LH, Bernaola-Paredes WE. Antimicrobial Photodynamic Therapy Used as First Choice to Treat Herpes Zoster Virus Infection in Younger Patient: A Case Report. Photobiomodulation, Photomedicine, and Laser Surgery 2020; 38:232-236. [DOI: 10.1089/photob.2019.4725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Susana Teitelbaum
- Department of Onco-Hematological Pediatric, Perez Scremini Foundation, Montevideo, Uruguay
| | - Luciane Hiramatsu Azevedo
- Clinician of Special Laboratory of Laser in Dentistry (LELO), School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
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Bernaola-Paredes WE, Sugaya NN, Bergamini ML, Braz-Silva PH. A distinct fibro-osseous lesion of the jaws affecting the maxilla. J Oral Maxillofac Pathol 2020; 24:S23-S27. [PMID: 32189899 PMCID: PMC7069147 DOI: 10.4103/jomfp.jomfp_333_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: 11/22/2019] [Accepted: 01/16/2020] [Indexed: 11/04/2022] Open
Abstract
The differential diagnosis of fibro-osseous lesions (FOL) presents oral clinician stomatologists with a challenging task because of their similar clinical, radiographic and histopathological behavior that will also hinder the therapeutic planning. Presentation of case to describe the clinical, radiographic and histopathological features of an unusual case of FOL presented by the patient, a Black woman, and the results obtained with the conservative surgical treatment and 3-month follow-up. The presence of cementum in the histopathological analysis of cemento-osseous dysplasias, according to the current literature, is an important factor for the diagnosis of this lesion. Considering the characteristics presented by this particular case, we could suggest another entity that could be named a benign cemento-osseous lesion with adult onset. Some occurrences, as in the present case, do not fit properly into the current World Health Organization classification, thereby generating some doubts concerning the correct management of these patients. Conservative surgical treatment is the first choice in the management of these lesions due to their self-limiting nature, which show a behavior of clinical involution.
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Affiliation(s)
| | - Norberto Nobuo Sugaya
- Department of Oral Diagnosis, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Mariana Lobo Bergamini
- Department of Oral Pathology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of Sao Paulo, Brazil.,Department of Virology, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
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