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Osman S, Hamouda GM, Eltohami YI. Clinical Spectrum and Treatment of Odontogenic Myxoma: Analysis of 37 Cases. J Maxillofac Oral Surg 2024; 23:301-307. [PMID: 38601247 PMCID: PMC11001799 DOI: 10.1007/s12663-020-01497-7] [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: 06/12/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022] Open
Abstract
Background Odontogenic myxoma is one of the benign mesenchymal odontogenic tumours with aggressive behaviour and showed slow and asymptomatic expansion, the second until the third decade of life is the most targeted age group. With high female preponderance, about the management, surgical management is the only option concerning this odontogenic pathology with a variety of treatment options. This study aims to analyse a series of 37 patients with odontogenic myxoma treated in a single institution. Materials and method In total, 37 patients with odontogenic myxoma were treated at KTDH in Sudan and were retrospectively reviewed. With the analysis of medical records of all patients diagnosed with odontogenic myxoma and the related variables, data were analysed using the SPSS statistical program (version 23). Results Most of the cases were females (26 patients 70.27%), and males were about (11 patients 29.73%). In most of the cases maxilla was affected more than the mandible (25 cases, 67.57%) mostly in its posterior segment (32 cases, 86.49). The most age group affected was the group of cases (0-20) which were about 18 cases (48.65%). In total, 35 of the cases noticed swelling (94.59%), while 14 noticed tooth mobility (37.84%) and paraesthesia was a positive finding in just one case (2.70%). In total, 12 patients (32.43%) had a positive history of tooth extraction related to the lesion, and recurrence was positive in (64, 86%). Conclusion Odontogenic myxoma is locally aggressive. There is no gold standard protocol for surgical treatment so choosing the most suitable and reliable treatment option relay on the operator taking into consideration the characteristic of each case and the recurrence rate with the associated postoperative impairments.
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Affiliation(s)
- Shahd Osman
- Faculty of dentistry, University of Khartoum, Khartoum, Sudan
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Capucha T, Krasovsky A, Abdalla-Aslan R, Ginini JG, Noy D, Emodi O, Rachmiel A, Shilo D. Central giant cell granuloma of the jaws-long-term clinical and radiological outcomes of surgical and pharmacological management. Clin Oral Investig 2024; 28:200. [PMID: 38453790 PMCID: PMC10920455 DOI: 10.1007/s00784-024-05585-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES To compare long-term results of different treatment modalities in central giant cell granuloma of the maxillofacial-skeleton. Primary resection may result in major defects. Alternative treatments include pharmacological agents. As yet there has been no consensus on the use of the variety of treatment options, and few studies have reported clarifying long-term results. MATERIALS AND METHODS This retrospective study on 22 patients with 25 lesions evaluated clinical, radiological and histological features, treatment preformed and lesion recurrence. Success was defined as regression/calcification and failure as recurrence, progression or un-responsiveness. RESULTS Of the presenting patients, 77% were under age 40. Lesion prevalence was higher in the anterior mandible and left posterior maxilla. Most cases exhibited pain, tooth-mobility or mucosal-expansion. The appearance was predominantly unilocular in the maxilla and multilocular in the mandible, which also exhibited higher prevalence of cortical perforation. Up to 80% of lesions were classified as aggressive. Intralesional steroids/calcitonin were used in 7 cases. Mean follow-up was 39.8 months. Two cases showed recurrence. In 71% of the cases treated pharmacologically, calcification/regression were observed. CONCLUSIONS Our analysis indicates better outcomes using a combined approach, including both pharmacological and surgical treatments in large aggressive lesions. Pharmacological treatment resulted in decreased size or well-defined lesions, thus reducing the need for extensive bone resection. Dual treatment with corticosteroids and calcitonin showed no superior outcomes, but a larger cohort should be assessed. CLINICAL RELEVANCE There are several protocols for treatment of central-giant-cell-granuloma lesions, but most are not fully established. It is important to report results that contribute to the establishment of proven protocols. This report attempts to establish the relevance of the combined approach: pharmacological treatment followed by surgical resection.
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Affiliation(s)
- Tal Capucha
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Andrei Krasovsky
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | | | | | - Dani Noy
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Omri Emodi
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Adi Rachmiel
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dekel Shilo
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel.
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Kirschnick LB, Schuch LF, Gondak R, Rivero ERC, Gomes APN, Etges A, Tarquinio SBC, Mesquita RA, Caldeira PC, da Costa AAS, Mendonça EF, Dos Santos JN, Smit C, Robinson L, Tager EMJR, Mosqueda-Taylor A, Pontes HAR, de Andrade BAB, Fonseca TC, Abrahão AC, Agostini M, Romañach MJ, Alves FA, Jaguar GC, de Mendonça NF, Pinto MBR, da Silva LC, Lopes MA, Vargas PA, van Heerden W, Abreu LG, Martins MD, Vasconcelos ACU. Clinicopathological Features of Metastasis to the Oral and Maxillofacial Region-Multicenter Study. Head Neck Pathol 2023; 17:910-920. [PMID: 37902929 PMCID: PMC10739623 DOI: 10.1007/s12105-023-01588-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND This study aimed to investigate the clinicopathological features of metastases in the oral and maxillofacial regions. METHODS In this retrospective study, biopsy records were obtained from referral centers for oral and maxillofacial diagnosis in Brazil, Guatemala, Mexico, and South Africa. RESULTS A total of 120 cases were evaluated. Of these, 53.78% affected female patients, with a mean age of 57.64 years. Intraosseous lesions were more frequent, particularly in the posterior region of the mandible (49.58%). Clinically, most cases presented with symptomatic swelling, with an average evolution time of 25 months. The clinical diagnostic hypothesis in most instances was that of a malignant lesion. Breast cancer was the most common primary tumor location in females, while lung origin was most common in males. In most cases, the primary cancer was an adenocarcinoma (44.73%). The follow-up period was available for 29 cases, and out of these, 20 had died due to the disease. CONCLUSION Although this is a rare condition, clinicians should be aware that any oral lesions have the possibility of being metastatic, particularly in individuals with a previous history of cancer. The findings from this study could assist clinicians in prompt diagnosing these lesions and subsequent conducting oncologic assessments and treatment.
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Affiliation(s)
- Laura Borges Kirschnick
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Lauren Frenzel Schuch
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Rogério Gondak
- Department of Pathology, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | - Ana Paula Neutzling Gomes
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Adriana Etges
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Jean Nunes Dos Santos
- Department of Oral Pathology, Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Chané Smit
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Elena María José Román Tager
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
- Pathology Section, Clinical Center of Head and Neck/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | | | | | | | - Thamyres Campos Fonseca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Fábio Abreu Alves
- Stomatology Department, A. C. Camargo Hospital, São Paulo, SP, Brazil
| | | | | | | | - Luan César da Silva
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Willie van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Manoela Domingues Martins
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ana Carolina Uchoa Vasconcelos
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
- Centro de Diagnóstico das Doenças da Boca - CDDB, Faculdade de Odontologia, Universidade Federal de Pelotas, Rua Gonçalves Chaves, 457, sala 607 , Pelotas, RS, Brazil.
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Powers AK, Hyacinthe C, Riddle MR, Kim YK, Amaismeier A, Thiel K, Martineau B, Ferrante E, Moran RL, McGaugh SE, Boggs TE, Gross JB, Tabin CJ. Genetic mapping of craniofacial traits in the Mexican tetra reveals loci associated with bite differences between cave and surface fish. BMC Ecol Evol 2023; 23:41. [PMID: 37626324 PMCID: PMC10463419 DOI: 10.1186/s12862-023-02149-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The Mexican tetra, Astyanax mexicanus, includes interfertile surface-dwelling and cave-dwelling morphs, enabling powerful studies aimed at uncovering genes involved in the evolution of cave-associated traits. Compared to surface fish, cavefish harbor several extreme traits within their skull, such as a protruding lower jaw, a wider gape, and an increase in tooth number. These features are highly variable between individual cavefish and even across different cavefish populations. RESULTS To investigate these traits, we created a novel feeding behavior assay wherein bite impressions could be obtained. We determined that fish with an underbite leave larger bite impressions with an increase in the number of tooth marks. Capitalizing on the ability to produce hybrids from surface and cavefish crosses, we investigated genes underlying these segregating orofacial traits by performing Quantitative Trait Loci (QTL) analysis with F2 hybrids. We discovered significant QTL for bite (underbite vs. overbite) that mapped to a single region of the Astyanax genome. Within this genomic region, multiple genes exhibit coding region mutations, some with known roles in bone development. Further, we determined that there is evidence that this genomic region is under natural selection. CONCLUSIONS This work highlights cavefish as a valuable genetic model for orofacial patterning and will provide insight into the genetic regulators of jaw and tooth development.
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Affiliation(s)
- Amanda K Powers
- Department of Genetics, Blavatnik Institute at Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA
| | - Carole Hyacinthe
- Department of Genetics, Blavatnik Institute at Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA
| | - Misty R Riddle
- Department of Biology, University of Nevada, Reno, 1664 N. Virginia St., Reno, NV, 89557, USA
| | - Young Kwang Kim
- Harvard School of Dental Medicine, 188 Longwood Ave., Boston, MA, 02115, USA
| | - Alleigh Amaismeier
- Department of Biology, Xavier University, 3800 Victory Pkwy., Cincinnati, OH, 45207, USA
| | - Kathryn Thiel
- Department of Biology, Xavier University, 3800 Victory Pkwy., Cincinnati, OH, 45207, USA
| | - Brian Martineau
- Department of Genetics, Blavatnik Institute at Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA
| | - Emma Ferrante
- Department of Genetics, Blavatnik Institute at Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA
| | - Rachel L Moran
- Department of Biology, Texas A & M University, 100 Butler Hall, College Station, TX, 77843, USA
| | - Suzanne E McGaugh
- Department of Ecology, Evolution and Behavior, University of Minnesota, 1500 Gortner Ave., Saint Paul, MN, 55108, USA
| | - Tyler E Boggs
- Department of Biological Sciences, University of Cincinnati, 312 College Dr., Cincinnati, OH, 45221, USA
| | - Joshua B Gross
- Department of Biological Sciences, University of Cincinnati, 312 College Dr., Cincinnati, OH, 45221, USA
| | - Clifford J Tabin
- Department of Genetics, Blavatnik Institute at Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA.
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Gallagher KPD, Roza ALOC, Tager EMJR, Mariz BALA, Soares CD, Rocha AC, Abrahão AC, Romañach MJ, Carlos R, Hunter KD, Lopes MA, Vargas PA, Santos-Silva AR. Rhabdomyosarcoma with TFCP2 Rearrangement or Typical Co-expression of AE1/AE3 and ALK: Report of Three New Cases in the Head and Neck Region and Literature Review. Head Neck Pathol 2023; 17:546-561. [PMID: 36374445 PMCID: PMC10293535 DOI: 10.1007/s12105-022-01507-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 09/19/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) harboring EWSR1/FUS-TFCP2 fusions has been recently described as a distinct form of RMS with an aggressive course and predilection for the craniofacial bones, especially the jaws. METHODS We report three new cases of this rare entity, two from Brazil and one from Guatemala, with detailed clinicopathologic, immunohistochemical, and molecular descriptions. Additionally, we explored the English-language literature searching RMS with TFCP2 rearrangement or typical immunophenotype with co-expression of AE1/AE3 and ALK in the head and neck region. RESULTS Case 1 is a 58-year-old male with a 3-month history of painful swelling in the anterior maxilla. Case 2 is a 22-year-old male presenting with right facial swelling and proptosis. Case 3 is a 43-year-old female with a rapidly growing tumor located in the zygomatic region. Imaging examinations revealed highly destructive intraosseous masses in the first two cases, and a soft tissue tumor with bone invasion in case 3. Microscopically, all cases showed a hybrid spindle and epithelioid phenotype of tumor cells which expressed desmin, myogenin and/or Myo-D1, AE1/AE3, and ALK. FISH confirmed molecular alterations related to TFCP2 rearrangement in Cases 1-2. In case 3, there was no available material for molecular analysis. The patients were subsequently referred to oncologic treatment. Additionally, we summarized the clinicopathologic, immunohistochemical, and molecular features of 27 cases of this rare RMS variant in the head and neck region reported in the English-language literature. CONCLUSION RMS with TFCP2 rearrangement is a rare and aggressive tumor with a particular predilection for craniofacial bones, especially the jaws. Knowing its clinicopathologic and immunohistochemical profile can avoid misdiagnosis.
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Affiliation(s)
- Karen Patricia Domínguez Gallagher
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil.
- Oral Pathology, School of Dentistry, National University of Asunción, Asunción, Paraguay.
| | - Ana Luiza Oliveira Corrêa Roza
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Elena María José Roman Tager
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Bruno Augusto Linhares Almeida Mariz
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Ciro Dantas Soares
- Laboratório de Citopatologia, Division of Surgical Pathology, Private Pathology Service, Natal, Rio Grande do Norte, Brazil
| | - André Caroli Rocha
- Oral and Maxillofacial Surgery and Traumatology Service, Clinical Hospital, Medical School, University of São Paulo (FMUSP), São Paulo, São Paulo, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Roman Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Keith D Hunter
- Liverpool Head and Neck Centre, Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Areão, Piracicaba, São Paulo, 13414-903, Brazil
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Silveira HA, Coelho MC, Silva EV, Nogueira GM, Díaz KP, Oliveira-Santos C, León JE. Maxillary Parosteal Osteosarcoma: Additional case Report and Literature Review of Surface Osteosarcomas. Indian J Otolaryngol Head Neck Surg 2023; 75:1076-1080. [PMID: 37274972 PMCID: PMC10235407 DOI: 10.1007/s12070-022-03373-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction: Surface osteosarcomas represent around 3-6% of all osteosarcomas, which include the parosteal (low-grade), periosteal (intermediate-grade) and high-grade surface osteosarcomas. The classical location is the femur, followed by tibia and humerus. Parosteal osteosarcoma is the most common type of surface osteosarcoma. To date, 26 cases of parosteal osteosarcoma affecting the jaws have been reported, with most cases following an evolution time of several months to years, clinically favoring a benign osseous or fibro-osseous lesion. Methods: Here, we report a 39-year-old female who was referred presenting a maxillary tumoral mass 5 years ago, clinically diagnosed as osteoma. After clinical, imaginological and histopathological analysis, a diagnosis of parosteal osteosarcoma was made. Conclusion: Thus, parosteal osteosarcoma should also be considered in the differential diagnosis of benign-appearance, bone-forming nodular lesions affecting the jaws.
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Affiliation(s)
- Heitor Albergoni Silveira
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (FOAr/UNESP), Araraquara, São Paulo, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 SP Brazil
| | - Maria Carolina Coelho
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 SP Brazil
| | - Evânio Vilela Silva
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (FOAr/UNESP), Araraquara, São Paulo, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 SP Brazil
| | - Gustavo Milhomens Nogueira
- Department of Pathology and Forensic Medicine (FMRP/USP), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Katya Pulido Díaz
- Facultad de Ciencias de la Salud (UABC-Valle de Las Palmas), Universidad Autónoma de Baja California, Mexicali, Baja California México
| | - Christiano Oliveira-Santos
- Division of Oral Radiology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jorge Esquiche León
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 SP Brazil
- Department of Pathology and Forensic Medicine (FMRP/USP), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Anyanechi CE, Shetty SS. Ameloblastoma of the jaws in adult: A retrospective review of local recurrent lesions based on the resection margin in the adjacent apparent healthy tissues. Heliyon 2023; 9:e16243. [PMID: 37251853 PMCID: PMC10209404 DOI: 10.1016/j.heliyon.2023.e16243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/17/2022] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Background The surgical treatment of ameloblastoma of the jaws remains contentious due to the variable recurrence rate amongst its variants, the tumor's local invasive behavior, and the lack of consensus among surgeons concerning the extent of resection in the contiguous healthy tissues. Objective To determine the recurrence rate of ameloblastoma and its association with the resection margins. Materials and methods This is a retrospective cohort study of the medical records of patients who underwent surgical resection of the jaws as the primary modality of treatment for ameloblastoma. Clinical data over the 26 years were analyzed for age, gender, site of the lesion, size, radiographic appearance, histopathological sub-type, and the incidence of recurrence post-treatment. Descriptive and bivariate statistics were computed. Results A retrospective audit of 234 cases was included in the study that was typical (solid/multicystic) ameloblastoma. The age of patients ranged from 20 to 66 years with a mean age of 33.4 ± 9.6 years, and a male-to-female ratio of 1.2: 1 (P = 0.52). The follicular and plexiform types accounted for the majority of histopathological variants (89.8%; P = 0.000). Overall, 6.8% of cases relapsed after the initial primary surgery. The rate of recurrence was high with a resection margin of 1.0 or 1.5 cm than 2.0 cm (P = 0.001). No case of recurrence was seen with a resection margin of 2.5 cm margin. Conclusion A low recurrence rate of 6.8% was noted in our series of cases. A wide 2.5 cm resection margin is recommended in the adjacent healthy tissues.
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Affiliation(s)
- Charles Ezechukwu Anyanechi
- Department of Oral and Maxillofacial Surgery, University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Sameep S. Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, 575001, India
- Manipal Academy of Higher Education, a Constituent of MAHE, Manipal, India
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8
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Abstract
BACKGROUND Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that may be reactive or neoplastic in nature. While most cystic jaw lesions are benign, variability in biologic behavior makes distinction between these entities absolutely crucial. METHODS Review. RESULTS Two clinical cases are presented in parallel and are followed by an illustrated discussion of the ten most likely differential diagnoses that should be considered when confronted with a cystic jaw lesion. Strong emphasis is placed on the histologic differences between these entities, empowering readers to diagnose them with confidence. Perhaps even more importantly, the more common diagnostic pitfalls in gnathic pathology are discussed, recognizing that a definitive diagnosis cannot be rendered in every situation. The histologic diagnoses for the two clinical cases are finally revealed. CONCLUSION Cystic lesions of the maxilla and mandible may be odontogenic or non-odontogenic. The most common cystic lesions are the reactive periapical cyst, and the dentigerous cyst (which is developmental in nature). It is important to note that cystic neoplasms also occur in the jaws, and that the presence of inflammation may obscure the diagnostic histologic features of lesions like odontogenic keratocyst and unicystic ameloblastoma. Ancillary testing is of limited diagnostic value in most scenarios. However, both clinical and radiographic information (such as the location, size, duration, associated symptoms, and morphology of the lesion in its natural habitat) are significantly useful.
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Affiliation(s)
- Anne C McLean
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Clements University Hospital UT Southwestern Medical Center, 6201 Harry Hines Blvd, RM UH04.252, Dallas, TX, 75390, USA.
| | - Pablo A Vargas
- Department of Oral Diagnosis, The State University of Campinas, Piracicaba, São Paulo, Brazil
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9
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Santos GNM, da Silva HEC, Ossege FEL, Figueiredo PTDS, Melo NDS, Stefani CM, Leite AF. Radiomics in bone pathology of the jaws. Dentomaxillofac Radiol 2023; 52:20220225. [PMID: 36416666 PMCID: PMC9793454 DOI: 10.1259/dmfr.20220225] [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: 06/29/2022] [Revised: 09/02/2022] [Accepted: 10/02/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To define which are and how the radiomics features of jawbone pathologies are extracted for diagnosis, predicting prognosis and therapeutic response. METHODS A comprehensive literature search was conducted using eight databases and gray literature. Two independent observers rated these articles according to exclusion and inclusion criteria. 23 papers were included to assess the radiomics features related to jawbone pathologies. Included studies were evaluated by using JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RESULTS Agnostic features were mined from periapical, dental panoramic radiographs, cone beam CT, CT and MRI images of six different jawbone alterations. The most frequent features mined were texture-, shape- and intensity-based features. Only 13 studies described the machine learning step, and the best results were obtained with Support Vector Machine and random forest classifier. For osteoporosis diagnosis and classification, filtering, shape-based and Tamura texture features showed the best performance. For temporomandibular joint pathology, gray-level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), Gray Level Size Zone Matrix (GLSZM), first-order statistics analysis and shape-based analysis showed the best results. Considering odontogenic and non-odontogenic cysts and tumors, contourlet and SPHARM features, first-order statistical features, GLRLM, GLCM had better indexes. For odontogenic cysts and granulomas, first-order statistical analysis showed better classification results. CONCLUSIONS GLCM was the most frequent feature, followed by first-order statistics, and GLRLM features. No study reported predicting response, prognosis or therapeutic response, but instead diseases diagnosis or classification. Although the lack of standardization in the radiomics workflow of the included studies, texture analysis showed potential to contribute to radiologists' reports, decreasing the subjectivity and leading to personalized healthcare.
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Affiliation(s)
| | | | | | | | - Nilce de Santos Melo
- Dentistry Department, Faculty of Health Science, University of Brasília, Brasilia, Brazil
| | - Cristine Miron Stefani
- Dentistry Department, Faculty of Health Science, University of Brasília, Brasilia, Brazil
| | - André Ferreira Leite
- Dentistry Department, Faculty of Health Science, University of Brasília, Brasilia, Brazil
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Ervolino E, Olivo MB, Toro LF, Freire JOA, Ganzaroli VF, Guiati IZ, Nuernberg MAA, Franciscon JPS, Ângelo Cintra LT, Garcia VG, Wainwright M, Theodoro LH. Effectiveness of antimicrobial photodynamic therapy mediated by butyl toluidine blue in preventing medication-related osteonecrosis of the jaws in rats. Photodiagnosis Photodyn Ther 2022; 40:103172. [PMID: 36283616 DOI: 10.1016/j.pdpdt.2022.103172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Medication-related osteonecrosis of the jaws (MRONJ) is difficult to treat, therefore, prevention would be the ideal clinical approach. This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT), mediated by butyl toluidine blue (BuTB) in the prevention of MRONJ-like lesions after tooth extraction in rats. METHODS Twenty-eight senescent female rats were distributed in groups: VEH and VEH-aPDT, treated with vehicle, ZOL and ZOL-aPDT, treated with 100 µg/Kg of zoledronate, both treatments every three days over seven weeks. After three weeks from the commencement of treatment, the mandibular first molar was extracted. For the VEH and ZOL groups, no local treatment was performed, while with the VEH-aPDT and ZOL-aPDT groups, photodynamic treatment was carried out at 0, 2, and 4 days after extraction. For aPDT, 500μl of BuTB solution was deposited on the dental extraction site (0.5 mg/ml; 60 s), followed by irradiation with low-level laser (InGaAIP; 660 nm; 35 mW; 74.2 J/cm²; 60 s). After 28 postoperative days, euthanasia was performed. The hemimandibles were processed to: (1) histological analysis of tissue repair; (2) histometric analysis of the percentage of newly formed bone tissue (PNFBT) and percentage of non-vital bone tissue (PNVBT); (3) immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). RESULTS The ZOL and ZOL-aPDT groups showed less TRAP-positive cells when compared with VEH and VEH-aPDT. The ZOL group demonstrated great compromise in the tissue repair process, consistent with MRONJ-like lesions. VEH, VEH-aPDT and ZOL-aPDT presented a favorable tissue repair process. PNFBT in the ZOL group was lower than in the VEH, VEH-aPDT and ZOL-aPDT groups, whereas PNVBT in the ZOL group was higher than in the VEH, VEH-aPDT and ZOL-aPDT groups. CONCLUSION aPDT mediated by BuTB prevented the occurrence of MRONJ-like lesions after tooth extraction in rats.
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Marinho MFP, Marinho MCFL, de Andrade BAB, Pinto MAVR, Abrahão AC, Romañach MJ, Agostini M. Oral squamous cell carcinoma clinically resembling BRONJ. Oral Oncol 2022; 132:105974. [PMID: 35772186 DOI: 10.1016/j.oraloncology.2022.105974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Marcia Frias Pinto Marinho
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Clara Frias Lobo Marinho
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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12
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Labrador AJP, Marin NRG, Valdez LHM, Valentina MP, Sanchez KBT, Ibazetta KAR, Johan B, Cesar AV, Wright JM. Clear Cell Odontogenic Carcinoma a Systematic Review. Head Neck Pathol 2021; 16:838-848. [PMID: 34618301 PMCID: PMC9424403 DOI: 10.1007/s12105-021-01383-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023]
Abstract
Clear cell Odontogenic Carcinoma (CCOC) is an uncommon malignant odontogenic tumor (MOT). It is the fifth most common MOT. A systematic review is presented of reported cases, case series and retrospective studies of CCOC, to determine trends in presentation, diagnostic features, treatment, and patient outcome. Searches of detailed databases were carried out to identify papers reporting CCOC. The variables were demographics, patient symptoms, tumor location, histopathological findings, immunohistochemical studies, treatment, follow-up, and recurrence. 117 cases were identified; CCOC was most frequently seen in mature females 65% (n = 76). The total average age was 55.4 with a range from 17 to 89 years, for females 56.4 and males 53.6 years. The mean size was 3.41 cm. The most common location was in the mandibular body 36.2% (n = 42), followed by the anterior mandible 23.3% (n = 27). The most common clinical presentation was a swelling 80.4% (n = 74), and the main symptom was pain 41.3% (n = 31), followed by painless lesion 24% (n = 18). The most common Immunohistochemistry positive expression was CK19, EMA, and CEA, and for special staining periodic acid Shiff (PAS); 97% of cases were treated surgically. The average follow-up was 30.3 months, and recurrence was reported in 52.4% of the cases. Conclusion: CCOC shows a strong predilection for the body and anterior mandible, and females are more frequently affected. CCOCs can be painful and the principle clinical sign is swelling, CCOCs can metastasize, and the prognosis is fair.
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Affiliation(s)
| | | | | | - Martinez P. Valentina
- grid.442123.20000 0001 1940 3465Universidad de Cuenca Facultad de Odontologia, Cuenca, Ecuador
| | | | | | | | - Abad Villacrez Cesar
- grid.441720.40000 0001 0573 4474Universidad Señor de SIPAN Dental School, Chiclayo, Peru
| | - John M. Wright
- grid.264756.40000 0004 4687 2082Department of Diagnostic Sciences, Texas A&M University College of Dentistry, 3302, Gaston Ave, Dallas, TX 75246 USA
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Koth VS, Salum FG, de Figueiredo MAZ, Cherubini K. Repercussions of osteoporosis on the maxillofacial complex: a critical overview. J Bone Miner Metab 2021; 39:117-125. [PMID: 33048242 DOI: 10.1007/s00774-020-01156-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/15/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We present here a literature review focusing on the repercussions of osteoporosis on the oral and maxillofacial complex. Osteoporosis is a silent metabolic disorder characterized by reduced bone mineral density (BMD), which can lead to bone fractures, particularly affecting elderly women. The prevalence of this disease has increased significantly worldwide, and since it accelerates bone resorption also in the jaw bones, some attention has been paid to possible oral and maxillofacial manifestations. MATERIALS AND METHODS The databases PubMed and Google Scholar were searched for reports of oral and maxillofacial changes related to osteoporosis. RESULTS Several parameters evaluating bone changes in panoramic radiography have been proposed to estimate osteoporosis-related BMD loss, but they tend to warn about the possibility of osteoporosis, rather than being diagnostic criteria. Meanwhile, it seems that osteoporosis-related BMD loss could delay alveolar bone healing and potentiate bone loss in periodontal disease. CONCLUSION Even though orofacial bones are not compromised by osteoporosis as much as the axial/appendicular skeleton, a regular dental follow-up of osteoporotic patients is advised, especially in the case of periodontal disease and maxillofacial surgery. Further controlled longitudinal studies considering the site-specificity of osteogenesis would be helpful regarding this issue.
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Affiliation(s)
- Valesca Sander Koth
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil.
| | - Fernanda Gonçalves Salum
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
| | - Karen Cherubini
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
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Chugh A, Kaur A, Kumar Patnana A, Kumar P, Chugh VK. Unisystem Langerhans cell histiocytosis in maxillofacial region in pediatrics: comprehensive and systematic review. Oral Maxillofac Surg 2021; 25:429-444. [PMID: 33591444 DOI: 10.1007/s10006-021-00949-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The study aimed to identify, enlist, and analyze cases of unisystem LCH in the maxillofacial pediatric population to understand the clinical presentation and encourage the consideration of this rare disease in the differential diagnosis. Langerhans cell histiocytosis (LCH) is an aggressive benign condition affecting mainly the pediatric population. It can be easily masked as periodontal disease in the maxillofacial region. Early diagnosis and a systemic evaluation are of utmost importance. METHODOLOGY We are presenting a complete review of literature in the pediatric population according to PRISMA guidelines for clinicopathologic, histopathological, immunohistochemistry, and treatment for unisystem LCH. The risk of bias assessment across studies was done using a Case series appraisal checklist by Guo et al. 53 RESULTS: Forty-nine articles (152 cases) were selected which met our inclusion and exclusion criteria to be included in our review. Most of the patients fall in 6-12 years of age with the involvement of the mandibular body region in 40.79% cases. This disease mainly presents as erythematous gingiva, pain, swelling, and mobile teeth. Management can range from minimal intervention to chemotherapy and surgery. CONCLUSION AND PRACTICAL IMPLICATIONS Although this is a rare condition, it should be considered especially in the pediatric population with periodontitis type lesions and floating teeth and comprehensive management should be followed. Early diagnosis of the disease is very important.
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Affiliation(s)
- Ankita Chugh
- Oral and maxillofacial surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Amanjot Kaur
- Oral and maxillofacial surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Arun Kumar Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinay Kumar Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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de França GM, Felix FA, de Morais EF, Medeiros MRDS, Andrade ACDM, Galvão HC. Osteomyelitis of the jaws in patients with pycnodysostosis: a systematic review. Braz J Otorhinolaryngol 2021; 87:620-628. [PMID: 33579598 PMCID: PMC9422419 DOI: 10.1016/j.bjorl.2020.12.009] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Pycnodysostosis is a rare autosomal recessive syndrome that provides the abnormal bone metabolism that increases the susceptibility of patients to develop osteomyelitis. Objective This systematic review was conducted to analyze the risk factors associated with the development of complications in the jaws (fractures and osteomyelitis), as well as their clinical-pathological characteristics and therapeutic approaches in patients with pycnodysostosis. Methods Searches were performed in the PubMed, Web of Science, Scopus, Lilacs, and Cochrane databases. Case reports or case series that met the eligibility criteria according to the PRISMA statement were included. The full texts of 31 articles were retrieved. Twenty of these articles published between 1969 and 2018 were selected, which described 26 cases of osteomyelitis in patients with pycnodysostosis. Results The mean age of the patients was 37.84 years; the male-to-female was 1.36:1. The mandible was the most affected site (76.9%). Tooth extraction was the main risk factor for osteomyelitis (61.5%), followed by infection (26.8%) and mandibular fracture (23.0%). Antibiotic therapy alone or combined with some surgical procedure was the treatment used in most cases (80.7%). Conclusion The findings of this review showed that patients with pycnodysostosis are more likely to develop osteomyelitis of the jaws after surgical procedures, especially tooth extraction which remains the main risk factor for its establishment. In addition, prophylactic antibiotic-therapy in the pre- and postoperative periods may prevent the development of osteomyelitis in pycnodysostosis.
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Affiliation(s)
- Glória Maria de França
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Patologia Oral e Estomatologia, Natal, RN, Brazil.
| | - Fernanda Aragão Felix
- Universidade Federal do Rio Grande do Norte (UFRN), Centro de Biociências, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Biologia Oral, Natal, RN, Brazil
| | - Everton Freitas de Morais
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Patologia Oral e Estomatologia, Natal, RN, Brazil
| | - Maurília Raquel de Souto Medeiros
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Patologia Oral e Estomatologia, Natal, RN, Brazil
| | - Ana Cláudia de Macedo Andrade
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Patologia Oral e Estomatologia, Natal, RN, Brazil
| | - Hébel Cavalcanti Galvão
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas, Área de Concentração em Patologia Oral e Estomatologia, Natal, RN, Brazil
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Whitefield S, Lazarovici TS, Sommer-Umansky M, Friedlander-Barenboim S, Yahalom R, Yarom N. Changing face of medication-related osteonecrosis of the jaw: Sheba Medical Center experience-fifteen years. J Bone Miner Metab 2020; 38:819-825. [PMID: 32507944 DOI: 10.1007/s00774-020-01113-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/18/2019] [Accepted: 05/11/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Our aim is to track the development of the epidemiological characteristics in patient populations diagnosed with MRONJ at the Sheba Medical Center. MATERIALS AND METHODS The files of patients diagnosed with MRONJ from 2003 until December 2017 were retrieved. Data on demographics, medical background, type and duration of drug use and triggering events at presentation was collected. RESULTS The study included 448 patients, 336 females and 112 males. A decrease in the proportion of multiple myeloma patients (p < 0.05) and an increase in the proportion of patients with bone metastases of solid tumors has been observed recently. An increase in the proportion of cases in osteoporosis patients compared with oncology patients is evident (p < 0.01). Overtime a higher proportion of patients presented at an earlier stage of MRONJ (p < 0.01). CONCLUSIONS As a result of changes in treatment protocols and increased awareness of oncology caregivers, including referral and consultation with Oral Medicine specialists, there has been a change in the demographics and presentation of the disease.
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Affiliation(s)
- Sara Whitefield
- Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel
- School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Towi Sorel Lazarovici
- Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - Ran Yahalom
- Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel.
- School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Abstract
MRI has become an invaluable diagnostic tool in all areas of the body. However, it has not been widely used to image odontogenic tumors of the jaw. Major advantages of MRI include excellent soft tissue contrast in the absence of ionizing radiation. Furthermore, diffusion-weighted MRI and dynamic contrast-enhanced MRI can be used as functional imaging techniques for assessing tissue biology. In this review article, we present representative MR images of several types of odontogenic tumors, and discuss MR imaging characteristics useful for differential diagnosis.
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Affiliation(s)
- Tohru Kurabayashi
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Naoto Ohbayashi
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Junichiro Sakamoto
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Shin Nakamura
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Koth VS, Salum FG, de Figueiredo MAZ, Cherubini K. Morphological and immunohistochemical features of tooth extraction sites in rats treated with alendronate, raloxifene, or strontium ranelate. Clin Oral Investig 2020; 25:2705-2716. [PMID: 32968945 DOI: 10.1007/s00784-020-03585-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/15/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate morphological and immunohistochemical features of tooth extraction sites in rats subjected to different antiresorptive drugs. MATERIALS AND METHODS Wistar rats were allocated into 4 groups according to the treatment: (1) alendronate, (2) raloxifene, (3) strontium ranelate, and (4) control. The animals underwent tooth extraction (60th day of treatment) and afterwards were euthanized (90th day of treatment). Tooth extraction sites were analyzed by means of scanning electron microscopy (SEM), hematoxylin-eosin staining (H&E), and immunohistochemical staining (RANKL and OPG). RESULTS On H&E analysis, the alendronate group showed greater amounts of non-vital bone, biofilm, inflammatory infiltrate and root fragment, and smaller amount of vital bone. The strontium ranelate group showed great amount of non-vital bone. This group also had lower levels of OPG, while the alendronate group showed lower OPG and RANKL than the other groups. On SEM analysis, the alendronate group showed a considerable number of microcracks on the alveolar bone surface and few Howship lacunae and lack of bone cells as well. The raloxifene, strontium ranelate, and control groups showed a large number of bone cells and Howship lacunae on the bone surface and few microcracks. CONCLUSION Alendronate therapy is associated with macro- and microscopic features of medication-related osteonecrosis of the jaw at tooth extraction sites, whereas raloxifene therapy is not, and strontium ranelate therapy is associated with non-vital bone. CLINICAL RELEVANCE Osteonecrosis of the jaws is a serious side effect of alendronate therapy, where tooth extraction is a major risk factor. Considering the significant number of patients undergoing antiresorptive therapies worldwide, the present study investigated whether raloxifene and strontium ranelate interfere with bone repair after tooth extraction in a similar way to bisphosphonates.
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Affiliation(s)
- Valesca Sander Koth
- Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
- Serviço de Estomatologia-Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil.
| | - Fernanda Gonçalves Salum
- Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Estomatologia-Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Estomatologia-Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil
| | - Karen Cherubini
- Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Estomatologia-Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil
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Woo HK, Ajmera DH, Singh P, Li KY, Bornstein MM, Tse KL, Yang Y, Gu M. Evaluation of the relationship between malar projection and lower facial convexity in terms of perceived attractiveness in 3-dimensional reconstructed images. Head Face Med 2020; 16:8. [PMID: 32345357 PMCID: PMC7187519 DOI: 10.1186/s13005-020-00223-5] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 04/16/2020] [Indexed: 12/05/2022] Open
Abstract
Background This study aimed to investigate dental student’s perception of facial attractiveness with regard to different combinations of anteroposterior malar-jaw positions using 3-dimensional (3-D) reconstructed images of subjects. Methods Two Chinese young adults (1 male and 1 female) with straight profiles and average malar projections were selected for the study. 3-D facial images and cone-beam computed tomography images of these two subjects were superimposed using 3-D imaging software. Lateral and oblique views of nine different images were created by moving the maxillomandibular complex and/or zygomatic bone by 4 mm either forward or backward along the sagittal plane. One hundred three undergraduate dental students (n = 24, 33, and 46 students from the Year 3, 4, and 5, respectively) then scored lateral and 45° oblique view images of the newly reconstructed faces. Results In the present study, images with a neutral malar and retruded jaws were found to be the most attractive in both male and female subjects. In addition, the Protruded malar (PM) group (p < 0.001), and the Retruded Jaws (RJ) group were rated more attractive (p < 0.001). Furthermore, the Relatively Prominent malar (RP) group was rated more attractive (p < 0.001) when malar-jaw relative positions were compared. Conclusion This study shows that a neutral or a protruded malar favours facial attractiveness in both Chinese male and female subjects. Therefore, an appropriate relationship between malar projection and lower facial convexity should be taken into consideration while designing the orthodontic/orthognathic treatment plans for enhanced aesthetic outcomes.
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Affiliation(s)
- Hon Kwan Woo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Pradeep Singh
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kar Yan Li
- Central Research Laboratories, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael Marc Bornstein
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Kwan Lok Tse
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Min Gu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Cunha JLS, Rodrigues-Fernandes CI, Soares CD, Sánchez-Romero C, Vargas PA, Trento CL, de Andrade BAB, de Sousa SF, de Albuquerque-Júnior RLC. Aggressive Intraosseous Myofibroma of the Maxilla: Report of a Rare Case and Literature Review. Head Neck Pathol 2021; 15:303-10. [PMID: 32335819 DOI: 10.1007/s12105-020-01162-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/09/2020] [Indexed: 01/03/2023]
Abstract
Myofibroma (MF) is a benign mesenchymal myofibroblast-derived tumor, which occurs most frequently in children, and rarely affects the maxilla. We reported a case of an aggressive intraosseous lesion found in the maxilla of a 9-year-old female child. Intraorally, the swelling extended from tooth 12 to 16, causing displacement of teeth 13, 14, and 15. Computed tomography revealed a large osteolytic lesion causing thinning and cortical erosion. Microscopically, the lesion showed a proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical analysis revealed cytoplasmic positivity for α-SMA and HHF-35, and negativity for desmin, laminin, S-100, β-catenin, and CD34. Ki-67 was positive in 8% of tumor cells. The diagnosis was MF. Herein, we describe an additional case of central MF arising in the maxilla, including clinical, imaging, microscopical, and immunohistochemical features, as well as a review of the literature.
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Kato CDNADO, Barra SG, Amaral TMP, Silva TA, Abreu LG, Brasileiro CB, Mesquita RA. Cone-beam computed tomography analysis of cemento-osseous dysplasia-induced changes in adjacent structures in a Brazilian population. Clin Oral Investig 2020; 24:2899-2908. [PMID: 32076867 DOI: 10.1007/s00784-019-03154-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/12/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To describe the effects of cemento-osseous dysplasia (COD) on anatomical structures. METHODS CBCT scans were retrospectively selected from a database of individuals who attended an Oral Medicine service. Cases with a confirmed diagnosis of periapical, focal, or florid COD were included. Two oral and maxillofacial radiologists assessed the scans. Frequencies of the variables were described according to COD case, lesion areas, and teeth. RESULTS Sixty COD cases affected 244 areas and 426 teeth. Florid COD was the most common (n = 48). Cortical bone (buccal, lingual, palatine, or mandibular) (n = 42) and the maxillary sinus (n = 13) were the structures most frequently affected by displacement or perforation. Thinning (n = 80), expansion (n = 62), and perforation (n = 60) of the cortical bone were common effects. The median size of the lesions was 12 mm in the mesiodistal direction, 8 mm in the buccal-lingual/palatal direction, and 9 mm in the superior-inferior direction. Root resorption was observed in 18.1% of all teeth, while tooth displacement was uncommon (0.6%). All teeth affected by COD had a discontinuous lamina dura and non-uniformly visible periodontal ligament space. CONCLUSIONS CBCT images revealed that cortical bone, lamina dura, and periodontal ligament space were the structures most affected by COD and the effects of COD on anatomical structures were more frequent than previously described. CLINICAL RELEVANCE CODs are fibro-osseous lesions common in the clinical practice, and relationship with anatomical structures is poorly described. CBCT is an appropriate method for the diagnosis and follow-up of patients with COD.
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Affiliation(s)
- Camila de Nazaré Alves de Oliveira Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Sâmila Gonçalves Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Tânia Mara Pimenta Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Cláudia Borges Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
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Wilkinson PE, Merkourea S, Gopalakrishnan R, Argyris PP. Primary Intraosseous Xanthomas of the Jaws: A Series of Six Cases Including an Example with Formation of Apoptosis-Related Hyaline Globules, So-Called "Thanatosomes". Head Neck Pathol 2020; 14:859-868. [PMID: 31916206 PMCID: PMC7669974 DOI: 10.1007/s12105-020-01126-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/04/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
Primary intraosseous xanthomas of the jaws (PIXJ) are rare and predominantly affect the posterior mandible (86%) of normolipemic patients, with a mean age of 30 years and no gender predilection. Clinically, PIXJ exhibit indolent biologic behavior; curettage is considered treatment of choice. Only 36 PIXJ have been reported. Apoptosis-related hyaline globules (HGs), also known as "thanatosomes", have not been previously reported in PIXJ. Cases diagnosed as xanthoma of bone were retrieved. Six cases fulfilling currently accepted criteria were identified and their clinicopathologic and immunohistochemical properties are presented herein. Mean age for PIXJ was 21.8 years (range = 12-33) and F:M ratio = 2:1. All cases presented as well-demarcated, unilocular or multilocular radiolucencies. Microscopically, PIXJ featured sheets of lipid-laden macrophages with eosinophilic or foamy cytoplasm. A secondary fibroblastic population lacking storiform pattern was evident in two cases. Adipocytes (3/6), peripheral neurovascular bundles (1/6), bone fragments (3/6) and dystrophic calcifications (3/6) were observed enclosed by the xanthoma cells. Notably, one case exhibited numerous, spherical, eosinophilic HGs containing apoptotic nuclei. PIXJ were consistently CD68(+) and negative for CD1α and S100. CD45 decorated lymphocytes and the membrane of foamy histiocytes. Xanthoma cells stained for lysozyme and plasma proteins including alpha-1 antitrypsin (AAT), IgG and IgA in one probed case. HGs were lysozyme(+), AAT(+), IgG(+), IgA(+), PAS(+) and diastase-resistant, and fuchsinophilic with Masson's trichrome. PIXJ represent infrequent, solitary, mandibular lesions with a predilection for the second and third decade of life. Thanatosomes associated with cell injury and death can be present in PIXJ.
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Affiliation(s)
- Peter E. Wilkinson
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Stavroula Merkourea
- grid.5216.00000 0001 2155 0800School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Rajaram Gopalakrishnan
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Prokopios P. Argyris
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Department of Biochemistry, Molecular Biology, and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455 USA
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Abstract
This article focuses on describing nonodontogenic cysts of the oral and maxillofacial region. The lesions described include nasopalatine duct canal cyst, nasolabial cyst, traumatic bone cyst, Stafne bone cyst, aneurysmal bone cyst, focal osteoporotic bone marrow defect, dermoid cyst, epidermoid cyst, pilar cyst, and sebaceous cyst. The intent of this article is to make general dentists aware and knowledgeable of the nonodontogenic cysts they may encounter in everyday practice, so they can adequately manage or make an appropriate referral to improve treatment outcomes and reduce patient morbidity.
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Affiliation(s)
- Rawle Fabian Philbert
- Oral & Maxillofacial Surgery, Lincoln Medical & Mental Health Center, 234 East 149th Street, Bronx, NY 10451, USA.
| | - Navraj Singh Sandhu
- Oral & Maxillofacial Surgery, Lincoln Medical & Mental Health Center, 234 East 149th Street, Bronx, NY 10451, USA
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Munhoz L, Arita ES, Nishimura DA, Watanabe PCA. Maxillofacial manifestations of Proteus syndrome: a systematic review with a case report. Oral Radiol 2019; 37:2-12. [PMID: 31734933 DOI: 10.1007/s11282-019-00416-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/27/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Proteus syndrome (PS) is an extremely rare disorder with asymmetric and disproportionate bone overgrowth. Craniofacial abnormalities in PS are less frequent than skeletal abnormalities. Although there are recognized oral and maxillofacial manifestations of PS, few case reports describing these manifestations are available. Thus, the objective of this systematic review and case report is to describe oral and maxillofacial manifestations of PS and to report a PS case. METHODS A 31-year-old male presented with restricted mouth opening and pain during mastication. A panoramic radiograph and an occlusal radiograph were obtained. Reports with relevant keywords were assessed. Data were summarized and demonstrated using a critical appraisal checklist for case reports. RESULTS The panoramic radiograph demonstrated unilateral overgrowth of the mandible, impacted teeth, and deciduous prolonged retention. Thirteen PS case reports were identified. CONCLUSIONS Proteus syndrome oral and maxillofacial manifestations may include dental agenesis, impacted teeth, malocclusion, asymmetric dental growth and maturation, frontal line displacement, asymmetric tongue enlargement, mandibular hemihypertrophy and asymmetry, presence of exostoses/hyperostosis, degenerative changes in the temporomandibular joint, alterations of maxillary and mandibular vertical and/or horizontal growth, and enlargement of mandibular canal and foramen. The PROSPERO systematic review registration number is CRD42019140942.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, 2227 Lineu Prestes Avenue, São Paulo, SP, 05508-000, Brazil.
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, 2227 Lineu Prestes Avenue, São Paulo, SP, 05508-000, Brazil
| | - Danielle Ayumi Nishimura
- Department of Stomatology, School of Dentistry, University of São Paulo, 2227 Lineu Prestes Avenue, São Paulo, SP, 05508-000, Brazil
| | - Plauto Christopher Aranha Watanabe
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Café Avenue, Ribeirão Preto, SP, 14040-904, Brazil
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Martelli SJR, Damian MF, Schinestsck AR, Schuch LF, Cascaes AM, Vasconcelos ACU. Imaging and histomorphometric evaluation of mandible and tibia of rats treated with bisphosphonates. Oral Maxillofac Surg 2019; 23:473-9. [PMID: 31686251 DOI: 10.1007/s10006-019-00807-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/11/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the mandible and tibia of rats treated with bisphosphonates (BPs) by imaging and histomorphometric analysis. STUDY DESIGN Thirty-four rat specimens (Rattus norvegicus, Wistar strain) were distributed into 3 groups: (1) 12 rats treated with zoledronic acid; (2) 12 rats treated with clodronate; and (3) the control group, containing 10 rats that received saline. All bones were exposed to cone beam computed tomography (CBCT). The images were analyzed to determine bone density (BD), using the software OsiriX 7.0. Histological slides were prepared from the specimens and the proportion of bone volume (BV) was quantified using the software Adobe Photoshop CC. RESULTS There was no statistically significant difference in BD either between the drug groups or between mandible and tibia. BV between BPs and control group did not show a significant difference. However, comparing the two bones, the mandibles in the control group displayed higher BV than did the tibiae in the same group. CONCLUSION According to our results, we conclude that (1) BD was not altered by bone type or by type of BP administered, and (2) treatment with zoledronic acid or clodronate did not affect BV in the mandible or tibia of test groups.
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Rocha TG, Feitosa ÉF, Maiolino Â, de Magalhães Filho RJP, Guedes FR, Torres SR, Visconti MA. Imaginological characterization of multiple myeloma lesions of the jaws through cone-beam computed tomography. Oral Radiol 2020; 36:168-76. [PMID: 31222625 DOI: 10.1007/s11282-019-00394-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/11/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To establish an evaluation protocol for the identification and description of the variations in multiple myeloma (MM) lesions of the jaws, by means of cone-beam computed tomography (CBCT). MATERIALS AND METHODS Tomography exams from 33 MM patients were evaluated in this retrospective observational study. The reconstructions were analyzed simultaneously, according to the established protocol, with the following description criteria: anatomic location, size, margins, inner aspect, relationship with adjacent structures, and presence or absence of a punched-out aspect. The exams were further subdivided into groups of patients using, or not bisphosphonates. RESULTS There were osteolytic lesions in 100% of cases, most of which were extended to more than one anatomical region. Poorly defined margins were more frequent in the maxilla than in the mandible. Extensive bone resorption presenting multilocular areas was the most frequently observed aspect, being 86.2% for maxilla and 87.9% for mandible. In relation to bisphosphonates, patients who used the medication had more poorly defined bone margins and contortions (68.6%) than those who did not undergo drug therapy (31.4%). No well-defined lesions were observed (p = 0.34%). CONCLUSION It was possible to establish a protocol for evaluation of MM lesions in CBCT images and to identify that when evaluated three-dimensional, lesions tend to be poorly defined and have no pattern of description, as described in two-dimensional "punched-out".
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Sood R, Gamit M, Shah N, Mansuri Y, Naria G. Maxillofacial Osteomyelitis in Immunocompromised Patients: A Demographic Retrospective Study. J Maxillofac Oral Surg 2020; 19:273-82. [PMID: 32346240 DOI: 10.1007/s12663-019-01201-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/05/2019] [Indexed: 10/27/2022] Open
Abstract
Objective To retrospectively study the cases diagnosed with osteomyelitis of jaw in AMC Dental Hospital. Study Design A total of 27 cases of osteomyelitis of jaw were analysed retrospectively from 2014 to 2018 at Department of oral and maxillofacial surgery, AMC Dental Hospital, Ahmedabad, India. Result Totally 27 cases of osteomyelitis were noted; 12 (44.44%) patients had involvement of maxilla, and 15 (55.55%) patients had involvement of the mandible. Twenty-one patients had underlying systemic disease, and 13 patients had history of substance abuse. The underlying aetiology in 20 patients was found due to odontogenic cause. There were only 3 patients having osteomyelitis without any underlying disease or any other predisposing factors. Conclusion Incidence of osteomyelitis and its outcome in the present study led to a better understanding of the aetiologic factors and its treatment. The results hypothesized a substantial correlation for onset of osteomyelitis with the underlying medical conditions and substance abuse. There was a higher correlation found between comorbid conditions and osteomyelitis of maxilla. Thorough study of the treatment revealed that conventional treatment plan is adequate for treating cases of osteomyelitis if the associated medical problem is also simultaneously treated and given due importance.
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Prevost R, Kimakhe J, Diep D, Drouet J, Benateau H, Veyssiere A. The significance of computer-assisted surgery in avoiding double-barrel fibula grafts in reconstruction of the horizontal mandibular ramus. J Stomatol Oral Maxillofac Surg 2019; 120:167-71. [PMID: 30718213 DOI: 10.1016/j.jormas.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/06/2018] [Accepted: 09/26/2018] [Indexed: 11/20/2022]
Abstract
It is recognized that the mandibular reconstruction with free flap allows for both functional and aesthetic restoration. The flap must be used for reconstruction of a smooth lower mandibular contour and also the alveolar bone to allow dental rehabilitation. The double-barrel fibula free flap does respond well to these imperatives, but it increases risk of vascular complications. To overcome these risks, we propose a single-barrel fibula free flap, positioned at the alveolar level and a customized 3D implant, designed by computer-assisted surgery, at the basilar level. The interest of the single-barrel fibula associated with a customized 3D implant compared to the double-barrel fibula free flap is twofold: it decreases the vascular risks associated with the plication of the second pedicle and allows patients to have a pedicle of greater length. It also allows them to have a good cortical bone placed in the alveolar bone to rehabilitate the mastication function.
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Baldini N, Pare A, Badja S, Veyssiere A, Kün-Darbois JD. Cholesterol granuloma of the maxilla. Morphologie 2018; 102:41-43. [PMID: 29426795 DOI: 10.1016/j.morpho.2018.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/01/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 11/18/2022]
Abstract
Intra-osseous cholesterol granuloma (CG) is a rare and benign lesion. Very few cases of CG of the jaws have been described in the literature. CG of the jaws seems to be due to the accumulation of cholesterol of hematogenous origin in odontogenic cysts. We report on one case of CG of the maxilla treated by surgical enucleation in a 46-year-old man who presented an asymptomatic swelling of the maxilla.
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Affiliation(s)
- N Baldini
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - A Pare
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - S Badja
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - A Veyssiere
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - J D Kün-Darbois
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France; Groupe études remodelage osseux et biomatériaux (GEROM) - LHEA, IRIS-Institut de biologie en santé (IBS), université d'Angers, CHU d'Angers, 49933 Angers cedex, France.
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Abstract
Objective To review published data on oral manifestations of multiple myeloma. Methods An electronic database search was performed of articles published from 1971 to November 2016 in order to identify studies that reported oral manifestations of patients with multiple myeloma. Case reports and case series with oral manifestations of multiple myeloma in English were included in the study. An additional search was performed of the references of the selected articles. Results Thirty-seven articles that reported 81 patients with oral manifestations of multiple myeloma were selected: 30 case reports (82%) and seven case series (18%). The most common clinical features in the dental cavity were swelling (65.4%), bone pain (33.3%), paresthesia (27.1%) and amyloidosis lesions (11.1%). Osteolytic lesions detected on imaging exams were reported in the majority of the patients (90.1%) as plasmacytomas or ‘punched-out’ lesions. Conclusions Swelling and osteolytic lesions represent the most common clinical and radiographic signs of the jaws relating to multiple myeloma, respectively.
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Affiliation(s)
| | | | | | | | - Angelo Maiolino
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Andre CV, Khonsari RH, Ernenwein D, Goudot P, Ruhin B. Osteomyelitis of the jaws: A retrospective series of 40 patients. J Stomatol Oral Maxillofac Surg 2017; 118:261-264. [PMID: 28502763 DOI: 10.1016/j.jormas.2017.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 03/17/2017] [Accepted: 04/14/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The caseload of jaw osteomyelitis seem to have decreased considerably over the last fifty years thanks to the progress of oral hygiene, the appearance and the use of antibiotics, and early screening. 'Limited osteitis' remains frequent in general practice (alveolitis after dental extraction), but osteomyelitis is much rarer as evidenced by the lack of current literature and the low number of reported patients in the published series. The aim of this study was to analyze retrospectively all the cases of maxillo-mandibular osteomyelitis treated in a large academic department of Stomatology and Maxillofacial Surgery over a period of 6 years and to compare the results to data from the literature. MATERIAL AND METHOD All patients diagnosed with maxillo-mandibular osteomyelitis by one of the staff surgeons between January 2009 and December 2015 was included. An epidemiological record (sex, age, ethnic background, risk factors, clinical, origin of disease, imaging and biology, treatments and progression) were collected for each patient. Osteomyelitis cases were classified according to the Zurich Classification System. Results were compared to data from the literature. RESULTS Forty patients were retained. Three presented acute osteomyelitis, 26 secondary chronic osteomyelitis and 11 a primary chronic osteomyelitis. Osteomyelitis affected predominantly the mandible (87%). Dental origin was found in 90% of cases. Nine patients (22.5%) recovered and 29 (90%) were clinically improved. Ten of the 11 patients with primary chronic osteomyelitis were improved. DISCUSSION This cohort study is one of the largest series currently available and presents results comparable to those of the literature of the last 25 years.
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Affiliation(s)
- C-V Andre
- Department of stomatology and maxillofacial surgery, Pierre-et-Marie-Curie university Paris-6, Pitié-Salpêtrière hospital, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | - R-H Khonsari
- Department of stomatology and maxillofacial surgery, Pierre-et-Marie-Curie university Paris-6, Pitié-Salpêtrière hospital, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | | | - P Goudot
- Department of stomatology and maxillofacial surgery, Pierre-et-Marie-Curie university Paris-6, Pitié-Salpêtrière hospital, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - B Ruhin
- Department of stomatology and maxillofacial surgery, Pierre-et-Marie-Curie university Paris-6, Pitié-Salpêtrière hospital, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
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Zwetyenga N, Broly E, Guillier D, Hallier A, Levasseur J, Moris V. Classification proposed of malignant intraosseous odontogenic tumors (MIOT). J Stomatol Oral Maxillofac Surg 2017; 118:143-146. [PMID: 28400320 DOI: 10.1016/j.jormas.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
Malignant intraosseous odontogenic tumors (MIOT) of the jaws are very rare. The diagnosis is difficult. Clinical, paraclinical and histological diagnostic criteria, strict are well established. But the International Union Against Cancer (UICC) does not provide TNM classification that will allow harmonization of the treatment. Indeed, despite their location, they cannot be classified as primary tumors of the oral cavity because of their localization in the bone marrow, making them systematically classified as T4. We propose a classification taking into account the clinical and radiological data.
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Affiliation(s)
- N Zwetyenga
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France; University of Bourgogne Franche-Comté, Lipids Nutrition Cancer Team NuTox, UMR866, Boulevard Jeanne d'Arc, 21000 Dijon, France.
| | - E Broly
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France
| | - D Guillier
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France
| | - A Hallier
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France
| | - J Levasseur
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France
| | - V Moris
- CHU Dijon, Department of Oral and Maxillofacial Surgery, Department of Plastic Reconstructive and Hand Surgery - Centre Hospitalier Universitaire, Boulevard de Lattre-de-Tassigny, 21000 Dijon, France
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Noor A, Cheng A, Sambrook P, Goss A. Melanoma Metastatic to the Mandible: Symptoms Precede Imaging Findings. J Maxillofac Oral Surg 2018; 17:281-5. [PMID: 30034144 DOI: 10.1007/s12663-017-1000-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/08/2017] [Indexed: 10/20/2022] Open
Abstract
Background Malignant melanoma is an aggressive and unpredictable cancer with the propensity for widespread metastasis. Whilst metastatic spread to the axial skeleton is relatively common, metastasis to the jaws is rarely reported and the optimal approach to investigation and management is yet to be defined. Case presentation A 58-year-old woman presented with dental pain, swelling and mental neuropathy on a background of an excised cutaneous melanoma. Early radiological investigations showed non-specific osteolysis despite strong clinical findings. It was not until later that magnetic resonance imaging showed changes consistent with metastatic disease. Dental extraction and biopsy confirmed the diagnosis of metastatic melanoma to the mandible. Conclusion Metastatic melanoma to the mandible is a rare phenomenon which may arise many years following treatment of the cutaneous primary. This case demonstrates the difficulties in early diagnosis as symptoms preceded radiographic findings using high-resolution modalities. Earlier use of magnetic resonance imaging with or without the use of bone scintigraphy may provide the sensitivity required for early identification of metastatic disease in the mandible.
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Abstract
Optogenetic methods have been highly effective for suppressing neural activity and modulating behavior in rodents, but effects have been much smaller in primates, which have much larger brains. Here, we present a suite of technologies to use optogenetics effectively in primates and apply these tools to a classic question in oculomotor control. First, we measured light absorption and heat propagation in vivo, optimized the conditions for using the red-light-shifted halorhodopsin Jaws in primates, and developed a large-volume illuminator to maximize light delivery with minimal heating and tissue displacement. Together, these advances allowed for nearly universal neuronal inactivation across more than 10 mm3 of the cortex. Using these tools, we demonstrated large behavioral changes (i.e., up to several fold increases in error rate) with relatively low light power densities (≤100 mW/mm2) in the frontal eye field (FEF). Pharmacological inactivation studies have shown that the FEF is critical for executing saccades to remembered locations. FEF neurons increase their firing rate during the three epochs of the memory-guided saccade task: visual stimulus presentation, the delay interval, and motor preparation. It is unclear from earlier work, however, whether FEF activity during each epoch is necessary for memory-guided saccade execution. By harnessing the temporal specificity of optogenetics, we found that FEF contributes to memory-guided eye movements during every epoch of the memory-guided saccade task (the visual, delay, and motor periods).
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Ray AC, Foletti JM, Graillon N, Guyot L, Chossegros C. [De novo (type 3) primary intraosseous carcinoma of the jaws]. ACTA ACUST UNITED AC 2016; 117:411-420. [PMID: 27527660 DOI: 10.1016/j.revsto.2016.07.007] [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: 04/26/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature. MATERIAL AND METHODS Two search engines (Pubmed®, Sciencedirect®) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected. RESULTS Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No. 46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on. DISCUSSION The PIOC3 is a rare tumor, mainly arising in males around 50. Diagnosis should be evoked in the presence of painful swelling and nervous symptoms. The time to diagnosis is long. Tumors are usually seen at late stages. Treatment classically combines surgery and radiotherapy.
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Affiliation(s)
- A C Ray
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France.
| | - J M Foletti
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Aix-Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France
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Arango-Fernández H, Pineda S, Elneser N, Gómez-Delgado A. Conversion of Aneurysmal Bone Cyst into Fibrous Dysplasia: A Rare Pediatric Case Report. J Maxillofac Oral Surg 2016; 15:355-60. [PMID: 27408470 DOI: 10.1007/s12663-016-0899-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 10/29/2014] [Accepted: 03/21/2016] [Indexed: 11/29/2022] Open
Abstract
Aneurysmal bone cyst (ABC) is an uncommon, non-neoplastic, expansive and erosive bone lesion. Considered as a pseudocyst due the lack of epithelial lining, the presence of giant cells and similarity to other lesions can make preoperative diagnosis difficult; biopsy findings must be co-related to complete clinical and radiological assessment. ABC's controversial etiopathogenesis and variable clinicopathological presentations have been widely described, but to date, there are just a few reports in literature describing the development of fibrous dysplasia (FD) from an ABC, and even less cases occurring in the jaws. We describe the case of an ABC in an 8 year-old male patient, affecting the body of the mandible, which showed accelerated growth associated to thinning of the buccal, lingual and lower cortical plates. The treatment consisted of repetitive surgical resection, curettage of the lesion and mandibular reinforcement with osteosynthesis reconstruction plates. A 16-month follow-up showed self-limitation of the overgrowth. The final histopathological and radiological analysis confirmed the FD diagnosis.
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Affiliation(s)
| | - Saulo Pineda
- Universidad El Bosque and Clínica SOMECA, Barranquilla, Colombia
| | - Nadim Elneser
- Universidad El Bosque and Clínica SOMECA, Barranquilla, Colombia
| | - Andrés Gómez-Delgado
- Departmento de Cirugía Oral y Maxilofacial, Universidad El Bosque, Carrera 7 B Bis No. 132-11. Código Postal, Bogotá, 110121 Colombia
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Mücke T, Jung M, Mitchell DA, Wolff KD, Wagenpfeil S, Stockmann P, Kesting MR, Deppe H. Do measurements of inflammatory mediators in blood predict recurrence in patients with bisphosphonate-related osteonecrosis of the jaws? Br J Oral Maxillofac Surg 2016; 54:286-9. [PMID: 26818111 DOI: 10.1016/j.bjoms.2016.01.009] [Citation(s) in RCA: 2] [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: 05/03/2015] [Accepted: 01/03/2016] [Indexed: 01/26/2023]
Abstract
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is well-recognised, difficult to manage, and often recurs. The aim of this study was to examine the value of preoperative measurements of inflammatory mediators in blood in 212 patients with BRONJ who were studied prospectively. Multiple logistic regression analysis was used to assess the importance of the amounts of substances in the blood that are independently associated with the dependent variable "recurrence of BRONJ". The only factor that significantly influenced the development of recurrent BRONJ was reduction in the white cell count (p<0.0001; hazard ratio 5.324; 95% CI 2.373 to 11.945). Neither white cell counts nor C-reactive protein concentrations within or above the reference ranges were significantly associated with recurrent BRONJ. Patients whose white cell counts were lower than the reference range were at increased risk of recurrent BRONJ. This may be a marker of reduced immunocompetence, and additional prophylactic measures or treatment should be considered for these patients.
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Affiliation(s)
- Thomas Mücke
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
| | - Maximilian Jung
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - David A Mitchell
- Bradford Teaching Hospitals NHS Foundation Trust, Maxillofacial Unit, St. Lukes Hospital, Bradford, UK
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Stefan Wagenpfeil
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Philipp Stockmann
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
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Mücke T, Koerdt S, Jung M, Mitchell DA, Wolff KD, Kesting MR, Loeffelbein DJ. The role of mylohyoid flap in the treatment of bisphosphonate-related osteonecrosis of the jaws. J Craniomaxillofac Surg 2016; 44:369-73. [PMID: 26857755 DOI: 10.1016/j.jcms.2015.12.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 09/15/2015] [Revised: 11/26/2015] [Accepted: 12/30/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Surgical treatment of bisphosphonate-related osteonecrosis of the jaws (BRONJ) combines excision of adequate damaged bone and watertight coverage by appropriate vascularized tissue. Local tissues are preferred when possible. This study compares local mucoperiosteal flaps with mylohyoid flaps with special emphasis on their influence on wound healing. MATERIAL AND METHODS A total of 195 patients with BRONJ in the mandible were included in this prospective study. The control group (n = 169) were treated with a mucoperiosteal flap, whereas patients of the study group (n = 26) received a mylohyoid flap. RESULTS Recurrence of BRONJ was significantly reduced (p = 0.023) as was extent of necrosis (p = 0.001) in patients with mylohyoid flaps. DISCUSSION This study demonstrates the importance of a sufficient mucosal coverage in surgical treatment of BRONJ. The mylohyoid flap provides an additional tissue coverage, which seems to account for the significantly reduced rate of disease recurrence. CONCLUSION The vascularized mylohyoid flap is an important tool in the complex and challenging surgical care of BRONJ.
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Affiliation(s)
- Thomas Mücke
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
| | - Steffen Koerdt
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Maximilian Jung
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - David A Mitchell
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
| | - Denys John Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany
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Mücke T, Jung M, Koerdt S, Mitchell DA, Loeffelbein D, Kesting MR. Free flap reconstruction for patients with bisphosphonate related osteonecrosis of the jaws after mandibulectomy. J Craniomaxillofac Surg 2016; 44:142-7. [PMID: 26752221 DOI: 10.1016/j.jcms.2015.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Bisphosphonate related osteonecrosis of the jaws (BRONJ) is a recognised unwanted effect of these drugs which affect bone remodelling. Treatment options range from conservative approaches through local bone debridement to free flap reconstruction following segmental resection. This current study aims to evaluate clinical outcomes after microvascular tissue transfer in BRONJ patients. MATERIAL AND METHODS A total of 212 BRONJ patients were included in this prospective investigation. Those who met defined inclusion criteria and received a surgical intervention were reviewed regularly during a follow-up period of at least 6 months. RESULTS Twenty-five patients (11.8%) received free flap reconstructions. A mean of 2.12 local debridements were performed before microvascular tissue transfer. A mean of 29.25% showed BRONJ recurrence after minimalist surgical intervention, compared to significantly less in patients after resection and free flap reconstruction. The postoperative fistula rate was significantly higher in patients, who received mucoperiosteal flaps. DISCUSSION This study underlines the importance and effectiveness radical resection and free flap reconstruction in the complex and challenging surgical treatment of BRONJ patients in a large patient cohort study. Nevertheless, all patients received radical intervention after failure of minimally invasive treatment. An individualized analysis and planning is necessary to identify appropriate patients for free flap reconstructions.
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Rabelo GD, Assunção JNR, Chavassieux P, Soares HA, Alves FA, Lemos CA. Bisphosphonate-Related Osteonecrosis of the Jaws and Its Array of Manifestations. J Maxillofac Oral Surg 2014. [PMID: 26225065 DOI: 10.1007/s12663-014-0707-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 01/01/2023] Open
Abstract
PURPOSE Bisphosphonate (BP) therapy in the treatment of bone diseases and malignancy may induce a major side effect known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). A particular view of this condition is reported in this case series investigating eight patients. The aim of the study was to evaluate the BRONJ lesions concerning their aspects and progression. Also, identify if it is possible to predict the degree of severity in these cases. METHODS Patients were evaluated by their condition and systemic health. The lesions were evaluated in clinical and radiographic aspects. The patients were followed-up for 2 years. RESULTS The patients presented with specific peculiarities, and the BRONJ lesions varied in several characteristics. The BRONJ lesions ranged from simple to severe conditions, and the complicated cases presented with major pain, swelling, secondary infection and an extensive necrotic area, classified with high grade of severity. CONCLUSIONS The patients presented here confirm the existence of a relation between multiple features and BRONJ and to understand the whole process of aggravation, all systemic and local information have to be taken into account, together with all data related to the BP utilized. Regardless of the low incidence of this side effect in relation to osteoporosis treatment, in some cases, the BRONJ may become a severe condition and compromise the patient's quality of life.
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Affiliation(s)
- Gustavo Davi Rabelo
- UFR de Médecine Lyon-Est Domaine Laennec, INSERM UMR 1033, Université de Lyon, 7-11 Rue Guillaume Paradin, 69372 Lyon Cedex 08, France ; Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; A. C. Camargo Cancer Center, Fundação Antonio Prudente, Rua Professor Antônio Prudente 211, São Paulo, 01509-900 Brazil
| | - José Narciso Rosa Assunção
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; Santos Metropolitan University, Rua da Constituição 374, Vila Nova, Santos, 11015-470 Brazil
| | - Pascale Chavassieux
- UFR de Médecine Lyon-Est Domaine Laennec, INSERM UMR 1033, Université de Lyon, 7-11 Rue Guillaume Paradin, 69372 Lyon Cedex 08, France
| | - Haroldo Arid Soares
- Santos Metropolitan University, Rua da Constituição 374, Vila Nova, Santos, 11015-470 Brazil
| | - Fabio Abreu Alves
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; A. C. Camargo Cancer Center, Fundação Antonio Prudente, Rua Professor Antônio Prudente 211, São Paulo, 01509-900 Brazil
| | - Celso Augusto Lemos
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil
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Olivi P, Garcia C. Bi-maxillary advancement surgery: Technique, indications and results. Int Orthod 2014; 12:200-12. [PMID: 24813103 DOI: 10.1016/j.ortho.2014.03.007] [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] [Indexed: 10/25/2022]
Abstract
Esthetic analysis of the face in some patients presenting a dental Class II can reveal the need for maxillo-mandibular advancement surgery. In these cases, mandibular advancement alone would provide a result which was satisfactory from the occlusal viewpoint but esthetically displeasing. Using bi-maxillary advancement, the impact of nasal volume is reduced and the nasolabial relationship is corrected. The sub-mandibular length is increased, thus creating a better-defined cervico-mental angle. This treatment technique involving a prior mandibular procedure has the advantage of restoring patients' dental occlusion while optimizing their facial esthetics.
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Affiliation(s)
- Pierre Olivi
- 55 bis, boulevard Rodocanachi, 13008 Marseille, France.
| | - Claude Garcia
- 55 bis, boulevard Rodocanachi, 13008 Marseille, France
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Magremanne M, Picheca S, Reychler H. [Etiologic diagnosis of jaw osteonecrosis, other than bisphosphonate and radiotherapy related osteitis]. Rev Stomatol Chir Maxillofac Chir Orale 2014; 115:e1-e7. [PMID: 24456912 DOI: 10.1016/j.revsto.2013.12.010] [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] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/29/2013] [Accepted: 12/12/2013] [Indexed: 06/03/2023]
Abstract
Our purpose was to highlight the various etiologies of maxillo-mandibular osteonecrosis, other than radiotherapy and biphosphonate related osteitis that have been abundantly reported. We performed a PubMed search from August 1, 1972 to August 1, 2012 using the following MeSH terms: "osteonecrosis", "bone", "necrosis", "jaw", "maxilla", "mandible", "palate", "oral", "avascular necrosis", NOT "bisphosphonate" NOT "osteoradionecrosis". Most cases of osteonecrosis were iatrogenic. Viral, mycotic, or bacterial infections were less frequent causes. Cocaine abuse, Wegener's granulomatosis, and N/K lymphoma were other etiologies. It is important to identify the various etiologies rapidly to manage this sometimes very mutilating condition adequately.
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Affiliation(s)
- M Magremanne
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgique.
| | - S Picheca
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgique
| | - H Reychler
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgique
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Magremanne M, Picheca S, Reychler H. Etiologic diagnosis of jaw osteonecrosis, other than bisphosphonate and radiotherapy related osteonecrosis. ACTA ACUST UNITED AC 2014; 115:45-50. [PMID: 24456913 DOI: 10.1016/j.revsto.2013.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 11/08/2012] [Revised: 01/29/2013] [Accepted: 12/12/2013] [Indexed: 01/22/2023]
Abstract
Our purpose was to highlight the various etiologies of maxillo-mandibular osteonecrosis, other than radiotherapy and biphosphonate related osteitis that have been abundantly reported. We performed a PubMed search from August 1, 1972 to August 1, 2012 using the following MeSH terms: "osteonecrosis", "bone", "necrosis", "jaw", "maxilla", "mandible", "palate", "oral", "avascular necrosis", NOT "bisphosphonate" NOT "osteoradionecrosis". Most cases of osteonecrosis were iatrogenic. Viral, mycotic, or bacterial infections were less frequent causes. Cocaine abuse, Wegener's granulomatosis, and N/K lymphoma were other etiologies. It is important to identify the various etiologies rapidly to manage this sometimes very mutilating condition adequately.
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Affiliation(s)
- M Magremanne
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
| | - S Picheca
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgium
| | - H Reychler
- Service de stomatologie et chirurgie maxillofaciale, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgium
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Ben Slama L, Landoulsi Helal A, Fodha Ben Jilani H, Zairi I, Adouani A. [Fatty tumors of the jaws]. Rev Stomatol Chir Maxillofac Chir Orale 2014; 115:42-4. [PMID: 24412402 DOI: 10.1016/j.revsto.2013.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 12/01/2009] [Accepted: 09/17/2013] [Indexed: 11/24/2022]
Abstract
Intraosseous lipoma is a benign tumor of the bone. It is mostly seen in the metaphyses of the long bones and calcaneus. There are few documented cases of intraosseous lipomas in the jaw. Clinically, the lesion is usually silent and radiologically it appears as a radiolucent area rarely including some radio-opacities. Diagnosis is based on clinical, radiological and histopathological features. Surgical removal of the lesion is the recommended treatment.
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Baumhoer D, Brunner P, Eppenberger-Castori S, Smida J, Nathrath M, Jundt G. Osteosarcomas of the jaws differ from their peripheral counterparts and require a distinct treatment approach. Experiences from the DOESAK Registry. Oral Oncol 2014; 50:147-53. [PMID: 24246156 DOI: 10.1016/j.oraloncology.2013.10.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aim to emphasize crucial differences between osteosarcomas of the jaws (OSj) and those of the peripheral skeleton (OSp) and to question current therapeutic concepts in presenting a comprehensive study on 214 patients. BACKGROUND OSj account for only 6% of all osteosarcomas (OS) but seem to represent a clinically and prognostically distinct subgroup. Due to the limited experience with this rare disease it is still a matter of debate if (neo-)adjuvant chemotherapy can improve the outcome of patients like in OSp or if OSj patients can be cured by surgical treatment only. METHODS 214 well characterized OSj patients with long-term follow up are presented and the influence of clinico-pathological parameters affecting the prognosis of patients is discussed. RESULTS The OSj patients in our series showed metastatic spread far less frequently (17.6% of cases) and later in the course of the disease (26months after diagnosis on average) compared to OSp. Consequently, complete resection of the tumors resulted in an excellent long-term survival (83.2% after 10years). Neoadjuvant or adjuvant treatment applied in a smaller subset of patients, furthermore, failed to show any additional favorable effect. CONCLUSION Whereas OSp is regarded as systemic disease at the time of diagnosis in which >90% of patients develop lung metastases without multimodality treatment, the vast majority of OSj patients seem to be curable by complete resection only. Based on the findings presented here, multimodality treatment should be critically scrutinized in OSj patients.
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Jamdade A, John A. Bone scintigraphy and panoramic radiography in deciding the extent of bone resection in benign jaw lesions. J Clin Diagn Res 2013; 7:2351-5. [PMID: 24298527 PMCID: PMC3843459 DOI: 10.7860/jcdr/2013/5963.3522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 02/26/2013] [Accepted: 06/04/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To find out the value of correlating radiographic and scintigraphic imaging for defining the extent and nature of benign jaw lesions (BJL). MATERIAL AND METHODS Twenty patients with histologically proven benign lesions of the jaws were investigated pre-operatively by panoramic radiography (PR) and bone scintigraphy (BS). To test the efficacy of combination of these two imaging modalities, their results were compared with intra-operative and histopathological findings. RESULT Most of the benign lesions presented radiographically as well-defined bone destructions with fine sclerotic rims. Such lesions were found to be silent on scintigraphs and the extent of radionuclide uptake was same as radiographically visible extent of bone involvement. However, aggressive lesions showed ill-defined bone destructions without sclerotic rims on radiographs and their scintigraphic uptake correctly exceeded the radiographic extent of the bone involvement. CONCLUSION The efficacy of combination of both complementary imagings is rewarding in defining the extent of the BJL, especially when radiographic margins are not so well defined. So, that surgical excisions will be complete and the possibility recurrences is reduced.
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Affiliation(s)
- Anshuman Jamdade
- Professor, Department of Oral Medicine and Radiology, Mahatma Gandhi Dental College & Hospital, Jaipur, India
| | - Ani John
- Former Professor and Head, Department of Oral Medicine and Radiology, Government Dental College & Hospital, Mumbai, India
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Abstract
Osteosarcomas are malignant neoplasms of the bone which commonly affect the long bones. The involvement of the jaws are rarely noticed. These neoplasms often shows a typical clinical behaviour as well as varied radiological appearances. Similarly, their histological growth pattern can be quite diverse. Confirmation of the final diagnosis of an osteosarcoma often requires a histopathological examination of the multiple biopsy specimens and vigorous discussion amongst the experts. All these clinical features, radiographic appearances and histological diagnostic difficulties were encountered in a case of osteosarcoma of the mandible in a 29-year old female.
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Affiliation(s)
- Jitendra V Kalburge
- Professor, Department of Oral & Maxillofacial Pathology, Rural Dental College, Pravara Institute of Medical Sciences , Loni, India
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Hong CM, Ahn BC, Choi SY, Kim DH, Lee SW, Kwon TG, Lee J. Implications of three-phase bone scintigraphy for the diagnosis of bisphosphonate-related osteonecrosis of the jaw. Nucl Med Mol Imaging 2012; 46:162-8. [PMID: 24900055 DOI: 10.1007/s13139-012-0144-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 05/21/2012] [Accepted: 05/22/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a well-known serious complication of BP treatment. This study was undertaken to evaluate the diagnostic usefulness of three-phase bone scintigraphy in patients with BRONJ. METHODS Forty-one patients (48 lesions) with clinically proven BRONJ (2 males, 39 females, age 74.3 ± 6.7 years) underwent Tc-99 m HDP bone scintigraphy. Visual interpretation and semiquantitative analysis of uptakes using lesion-to-contralateral uptake ratios during the blood pool phase (BUR) and during the osseous phase (OUR) were performed, and relations were sought between these and various clinical parameters. RESULTS Three-phase bone scintigraphy showed increased perfusion and blood pooling in 21 (63.6 %) and 27 (81.8 %) of 33 lesions, respectively. The osseous phase was positive for 45 (93.8 %) of the 48 lesions. Of the four inflammatory clinical parameters of BRONJ [pus discharge, pain, swelling, and erythrocyte sedimentation rate (ESR)], patients with three or more parameters had more positive findings in vascular and blood pool phase images (p = 0.033, p = 0.027). By semiquantitative analysis, patients with a positive ESR had statistically higher BUR and OUR (both p < 0.001). Higher stage BRONJ lesions had higher OUR than lower stage lesions (p = 0.003). In addition, bone scintigraphy revealed three clinically covert BRONJ lesions without bone exposure, and four patients were up-staged based on bone scintigraphy. CONCLUSIONS Bone scintigraphy provides a relatively sensitive means of detecting BRONJ, so it was helpful for accurate BRONJ staging. Furthermore, increased uptakes in vascular and blood pool phases of three-phase bone scintigraphy were related to the inflammatory activity of BRONJ.
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Cankaya AB, Erdem MA, Isler SC, Demircan S, Soluk M, Kasapoglu C, Oral CK. Use of cone-beam computerized tomography for evaluation of bisphosphonate-associated osteonecrosis of the jaws in an experimental rat model. Int J Med Sci 2011; 8:667-72. [PMID: 22135613 PMCID: PMC3204436 DOI: 10.7150/ijms.8.667] [Citation(s) in RCA: 22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 10/18/2011] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is a frequently reported complication. The aim of this study was to investigate the clinical and histopathological presentation of BONJ with the Hounsfield score and to evaluate the reliability of the score for determining necrosis in an animal model. MATERIAL/METHODS Eighty rats were prospectively and randomly divided into two groups of 40 each: a control group and an experimental group. Half of the animals from each group underwent extraction of the left mandibular molars, and the other half underwent extraction of the left maxillary molars under pentobarbital-induced general anesthesia. All animals were euthanized 28 days after tooth extraction. Maxillae and mandibles were extracted, cone beam computed tomography (CBCT) was performed, and Hounsfield scores were evaluated. RESULTS The Hounsfield scores of the experimental group were found to be compatible with chronic osteomyelitis and periosteal reactions. The Hounsfield scores of the control group were compatible with a healthy healing period. CONCLUSION In light of these results, both cone beam computed tomography (CBCT) and the Hounsfield Units (HU) evaluations together are thought to be efficient in the diagnosis of BONJ.
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Suleman YF, Meer S, Lurie R. Bisphosphonate-induced osteonecrosis of the jaws: review, clinical implications and case report. Head Neck Pathol 2007; 1:156-64. [PMID: 20614268 PMCID: PMC2807517 DOI: 10.1007/s12105-007-0022-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 03/16/2007] [Accepted: 07/20/2007] [Indexed: 12/31/2022]
Abstract
The introduction of bisphosphonates has increased in the last decade following their indication for metastatic bone diseases, osteoporosis, hypercalcaemia of malignancy and Paget's disease. Although bisphosphonates have been used clinically for more than three decades there have been no documented long-term complications of their effects on the jaws until recently, where there is now growing evidence of the influence of bisphosphonates on osteonecrosis of the jaws. The aim of this paper is to report a case of this newly described complication, to review this phenomenon, including the clinical implications and to reiterate current clinical guidelines for management of patients in which bisphosphonate therapy is indicated. To the best of our knowledge this is the first reported case of bisphosphonate-induced necrosis of the jaw in South Africa.
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Affiliation(s)
- Yusuf Farouk Suleman
- Division of Maxillofacial and Oral Surgery, University of the Witwatersrand, P.O. Box 344, Lenasia, Johannesburg, 1820 South Africa
| | - Shabnum Meer
- Division of Oral Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Russel Lurie
- Division of Maxillofacial and Oral Surgery, University of the Witwatersrand, P.O. Box 344, Lenasia, Johannesburg, 1820 South Africa
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