1
|
Hu S, Li S, Xu Y, Huang X, Mai Z, Chen Y, Xiao H, Ning W, Gaus S, Savkovic V, Lethaus B, Zimmerer R, Acharya A, Ziebolz D, Schmalz G, Huang S, Zhao J, Hu X. The antitumor effects of herbal medicine Triphala on oral cancer by inactivating PI3K/Akt signaling pathway: based on the network pharmacology, molecular docking, in vitro and in vivo experimental validation. Phytomedicine 2024; 128:155488. [PMID: 38493718 DOI: 10.1016/j.phymed.2024.155488] [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: 04/17/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND This research aimed to investigate the anti-tumor effects and underlying genetic mechanisms of herbal medicine Triphala (TRP) in oral squamous cell carcinoma (OSCC). METHODS The target genes of Triphala (TRP) in oral squamous cell carcinoma (OSCC) were identified, and subsequent functional enrichment analysis was conducted to determine the enriched signaling pathways. Based on these genes, a protein-protein interaction network was constructed to identify the top 10 genes with the highest degree. Genes deregulated in OSCC tumor samples were identified to be hub genes among the top 10 genes. In vitro experiments were performed to investigate the influence of TRP extracts on the cell metabolic activity, migration, invasion, apoptosis, and proliferation of two OSCC cell lines (CAL-27 and SCC-9). The functional rescue assay was conducted to investigate the effect of applying the inhibitor and activator of an enriched pathway on the phenotypes of cancer cells. In addition, the zebrafish xenograft tumor model was established to investigate the influence of TRP extracts on tumor growth and metastasis in vivo. RESULTS The target genes of TRP in OSCC were prominently enriched in the PI3K-Akt signaling pathway, with the identification of five hub genes (JUN, EGFR, ESR1, RELA, and AKT1). TRP extracts significantly inhibited cell metabolic activity, migration, invasion, and proliferation and promoted cell apoptosis in OSCC cells. Notably, the application of TRP extracts exhibited the capacity to downregulate mRNA and phosphorylated protein levels of AKT1 and ESR1, while concomitantly inducing upregulation of mRNA and phosphorylated protein levels in the remaining three hub genes (EGFR, JUN, and RELA). The functional rescue assay demonstrated that the co-administration of TRP and the PI3K activator 740Y-P effectively reversed the impact of TRP on the phenotypes of OSCC cells. Conversely, the combination of TRP and the PI3K inhibitor LY294002 further enhanced the effect of TRP on the phenotypes of OSCC cells. Remarkably, treatment with TRP in zebrafish xenograft models demonstrated a significant reduction in both tumor growth and metastatic spread. CONCLUSIONS Triphala exerted significant inhibitory effects on cell metabolic activity, migration, invasion, and proliferation in OSCC cell lines, accompanied by the induction of apoptosis, which was mediated through the inactivation of the PI3K/Akt pathway.
Collapse
Affiliation(s)
- Shaonan Hu
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Simin Li
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Xiuhong Huang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Zhaoyi Mai
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Yuanxin Chen
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Hui Xiao
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Wanchen Ning
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Sebastian Gaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig 04103, Germany
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig 04103, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig 04103, Germany
| | - Rüdiger Zimmerer
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig 04103, Germany
| | - Aneesha Acharya
- Dr. D. Y. Patil Dental College & Hospital, Pune 411018, India
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig 04103, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig 04103, Germany
| | - Shaohong Huang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China.
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen 518118, China.
| | - Xianda Hu
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, Beijing 100029, China; Institute for the History of Chinese Medicine and Medical Literature, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| |
Collapse
|
2
|
Schoenhof R, Schoenhof R, Blumenstock G, Lethaus B, Hoefert S. Synthetic, non-person related panoramic radiographs created by generative adversarial networks in research, clinical, and teaching applications. J Dent 2024; 146:105042. [PMID: 38710314 DOI: 10.1016/j.jdent.2024.105042] [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: 03/17/2024] [Accepted: 05/03/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES Generative Adversarial Networks (GANs) can produce synthetic images free from personal data. They hold significant value in medical research, where data protection is increasingly regulated. Panoramic radiographs (PRs) are a well-suited modality due to their significant level of standardization while simultaneously displaying a high degree of personally identifiable data. METHODS We produced synthetic PRs (syPRs) out of real PRs (rePRs) using StyleGAN2-ADA by NVIDIA©. A survey was performed on 54 medical professionals and 33 dentistry students. They assessed 45 radiological images (20 rePRs, 20 syPRs, and 5 syPRcontrols) as real or synthetic and interpreted a single-image syPR according to the image quality (0-10) and 14 different items (agreement/disagreement). They also rated the importance for the profession (0-10). A follow-up was performed for test-retest reliability with >10 % of all participants. RESULTS Overall, the sensitivity was 78.2 % and the specificity was 82.5 %. For professionals, the sensitivity was 79.9 % and the specificity was 82.3 %. For students, the sensitivity was 75.5 % and the specificity was 82.7 %. In the single syPR-interpretation image quality was rated at a median of 6 and 11 items were considered as agreement. The importance for the profession was rated at a median score of 7. The Test-retest reliability yielded a value of 0.23 (Cohen's kappa). CONCLUSIONS The study marks a comprehensive testing to demonstrate that GANs can produce synthetic radiological images that even health professionals can sometimes not differentiate from real radiological images, thereby being genuinely considered authentic. This enables their utilization and/or modification free from personally identifiable information. CLINICAL SIGNIFICANCE Synthetic images can be used for university teaching and patient education without relying on patient-related data. They can also be utilized to upscale existing training datasets to improve the accuracy of AI-based diagnostic systems. The study thereby supports clinical teaching as well as diagnostic and therapeutic decision-making.
Collapse
Affiliation(s)
- Rouven Schoenhof
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. B. Lethaus), University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
| | - Raoul Schoenhof
- Fraunhofer Society for the Advancement of Applied Research, Hansastraße 27c, 80686 München, Germany
| | - Gunnar Blumenstock
- Institute for Clinical Epidemiology and Applied Biometry (Head: Prof. Dr. rer. nat. P. Martus), University Hospital Tuebingen, Silcherstrasse 5, 72076 Tuebingen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. B. Lethaus), University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany
| | - Sebastian Hoefert
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. B. Lethaus), University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany
| |
Collapse
|
3
|
Fenske F, Kujat B, Krause L, Meyer S, Sander AK, Repmann J, Neuhaus M, Haak R, Roth A, Lethaus B, Ziebolz D, Schmalz G. Preoperative dental screening can reduce periprosthetic infections of hip and knee endoprostheses in the first month after surgery: results of a cohort study. Infection 2024; 52:535-543. [PMID: 38060067 PMCID: PMC10954939 DOI: 10.1007/s15010-023-02128-2] [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: 04/18/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE The oral cavity and, in particular, potential oral foci might pose a risk of periprosthetic joint infection (PJI). The aim of this cohort study was to determine whether practical preoperative dental screening would reduce the prevalence of early PJI in the first month after surgery. METHODS Patients attending a specialized endoprosthesis implantation clinic between 2018 and 2022 were recruited. Two groups were examined. The test group consisted of patients attending the clinic between 2020 and 2022 and who were referred to their family dentist using a standardized form. The comparison group consisted of patients who were treated in the clinic between 2018 and 2020. They were not referred to their family dentist. The two groups were compared for the prevalence of PJI. Univariate analysis followed by multiple logistic regression was performed to confirm risk factors for PJI in this cohort. RESULTS 2560 individuals (test group: 1227, comparison group: 1333) were included. The prevalence of PJI was significantly lower in the test group (0.8% vs. 1.8%, p = 0.04). Multiple logistic regression with PJI as the dependent variable showed that a dental referral was a strong predictor of a lower prevalence of PJI (OR: 0.43, CI95 0.205-0.917, p = 0.03). Male gender was also strongly associated with a higher frequency of PJI (OR: 2.68, CI95 1.32-5.42, p = 0.01). Age (OR: 1.06, CI95 1.01-1.10, p = 0.01) and BMI (OR: 1.11, CI95 1.05-1.17, p < 0.01) had little effect on the risk of PJI. CONCLUSION Dental referral using a standardized form can reduce the prevalence of early PJI. Accordingly, orthopedists and dentists should collaborate in this practical way.
Collapse
Affiliation(s)
- Fabian Fenske
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Benjamin Kujat
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Leah Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Stephan Meyer
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Anna-Katharina Sander
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Jaqueline Repmann
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Michael Neuhaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Andreas Roth
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| |
Collapse
|
4
|
Thiem DGE, Siegberg F, Vinayahalingam S, Blatt S, Krüger M, Lethaus B, Al-Nawas B, Zimmerer R, Kämmerer PW. The Perfect Timing-Immediate versus Delayed Microvascular Reconstruction of the Mandible. Cancers (Basel) 2024; 16:974. [PMID: 38473338 DOI: 10.3390/cancers16050974] [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: 01/18/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
In this retrospective study, the clinical and economic implications of microvascular reconstruction of the mandible were assessed, comparing immediate versus delayed surgical approaches. Utilizing data from two German university departments for oral and maxillofacial surgery, the study included patients who underwent mandibular reconstruction following continuity resection. The data assessed included demographic information, reconstruction details, medical history, dental rehabilitation status, and flap survival rates. In total, 177 cases (131 male and 46 females; mean age: 59 years) of bony free flap reconstruction (72 immediate and 105 delayed) were included. Most patients received adjuvant treatment (81% with radiotherapy and 51% combined radiochemotherapy), primarily for tumor resection. Flap survival was not significantly influenced by the timing of reconstruction, radiotherapy status, or the mean interval (14.5 months) between resection and reconstruction. However, immediate reconstruction had consumed significantly fewer resources. The rate of implant-supported masticatory rehabilitation was only 18% overall. This study suggests that immediate jaw reconstruction is economically advantageous without impacting flap survival rates. It emphasizes patient welfare as paramount over financial aspects in clinical decisions. Furthermore, this study highlights the need for improved pathways for masticatory rehabilitation, as evidenced by only 18% of patients with implant-supported dentures, to enhance quality of life and social integration.
Collapse
Affiliation(s)
- Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Fabia Siegberg
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Maximilian Krüger
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
5
|
Koenig A, Rotenburg L, Fuchs F, Sander S, Lethaus B, Hahnel S. Influence of aging of PEEK attachment inserts on the pull-off force of implant-retained overdentures - A laboratory study. Clin Oral Implants Res 2023; 34:1363-1372. [PMID: 37694944 DOI: 10.1111/clr.14180] [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: 03/14/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The aim of the current study is to investigate the influence of mechanical stress as well as cleaning agents on the performance of various polyether ether ketone (PEEK) inserts for implant-retained overdentures (IOD). MATERIALS AND METHODS Three different standard PEEK inserts were subjected to rapid artificial aging through storage in chemical denture cleaning agents (acetic acid, sodium hypochlorite, or sparkling denture cleaner) as well as demineralized water. The pre-aged PEEK inserts were then placed in unilateral IOD and subjected to 200,000 chewing loads (5 kg ~ 50 N), with 5000 thermal cycles (5/55°C), and 1100 removal/insertion cycles (vertical movement 2 mm). RESULTS For all the PEEK inserts, the retention forces decreased significantly with an increasing number of mechanical load cycles and after exposure to all the cleaning agents. PEEK inserts aged by exposure to chemical cleaning agents showed a significantly higher decline in retention force than the inserts stored in water. Confocal laser scanning microscopy indicated that the decline in retention force might be caused by wear on the internal insert surface in contact with the patrix. CONCLUSIONS Within the limitations of this study, it can be concluded that the application of chemical cleaning agents accelerates the decline in the retention forces of PEEK retentive inserts in IODs.
Collapse
Affiliation(s)
- Andreas Koenig
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Laura Rotenburg
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Stephan Sander
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
6
|
Kamal M, Möbius M, Bartella AK, Lethaus B. Perception of aesthetic features after surgical treatment of craniofacial malformations by observers of the same age: An eye-tracking study. J Craniomaxillofac Surg 2023; 51:708-715. [PMID: 37813772 DOI: 10.1016/j.jcms.2023.09.009] [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: 12/29/2022] [Revised: 02/11/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023] Open
Abstract
The aim of this study is to evaluate where exactly children and adolescents of the same group look when they interact with each other, and attempt to record and analyse the data recorded by eye-tracking technology. MATERIALS AND METHODS 60 subjects participated in the study, evenly divided into three age categories of 20 each in pre-school/primary school age (5-9 years), early adolescence (10-14 years) and late adolescence/transition to adulthood (15-19 years). Age groups were matched and categorized to be used both for creating the picture series and testing. Photographs of patients with both unilateral and bilateral cleft lip and palate were used to create the series of images which consisted of a total of 15 photos, 5 of which were photos of patients with surgically treated cleft deformity and 10 control photos with healthy faces, that were presented in random order. Using the eye-tracking module, the data on "area of first view" (area of initial attention), "area with longest view" (area of sustained attention), "time until view in this area" (time of initial attention) and "frequency of view in each area" (time of sustained attention) were calculated. RESULTS Across all groups, there was no significant difference for the individual regions for the parameters of initial attention (area of first view), while the time until first fixation of one of the AOIs (time until view in this area) was significant for all facial regions. A predictable path of the facial scan is abandoned when secondary facial deformities are present and attention is focused more on the region of an existing deformity, which are the nose and mouth regions. CONCLUSIONS There are significant differences in both male and female participants' viewing of faces with and without secondary cleft deformity. While in the age group of the younger test persons it was still the mouth region that received special attention from the male viewers, this shifted in the male test persons of the middle age group to the nose region, which was fixed significantly more often and faster. In the female participants, the mouth and nose regions were each looked at for twice as long compared to the healthy faces, making both the mouth and the nose region are in the focus of observation.
Collapse
Affiliation(s)
- Mohammad Kamal
- Department of Surgical Sciences, College of Dentistry, Health Sciences Center, Kuwait University, Safat, Kuwait.
| | - Marianne Möbius
- Department of Oral and Maxillofacial Surgery, Leipzig University Hospital, Leipzig, Germany.
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University Hospital, Leipzig, Germany.
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University Hospital, Leipzig, Germany.
| |
Collapse
|
7
|
Li H, Xiong S, Masieri FF, Monika S, Lethaus B, Savkovic V. Mesenchymal Stem Cells Isolated from Equine Hair Follicles Using a Method of Air-Liquid Interface. Stem Cell Rev Rep 2023; 19:2943-2956. [PMID: 37733199 PMCID: PMC10661790 DOI: 10.1007/s12015-023-10619-w] [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] [Accepted: 08/28/2023] [Indexed: 09/22/2023]
Abstract
Equine mesenchymal stem cells (MSC) of various origins have been identified in horses, including MSCs from the bone marrow and adipose tissue. However, these stem cell sources are highly invasive in sampling, which thereby limits their clinical application in equine veterinary medicine. This study presents a novel method using an air-liquid interface to isolate stem cells from the hair follicle outer root sheath of the equine forehead skin. These stem cells cultured herewith showed high proliferation and asumed MSC phenotype by expressing MSC positive biomarkers (CD29, CD44 CD90) while not expressing negative markers (CD14, CD34 and CD45). They were capable of differentiating towards chondrogenic, osteogenic and adipogenic lineages, which was comparable with MSCs from adipose tissue. Due to their proliferative phenotype in vitro, MSC-like profile and differentiation capacities, we named them equine mesenchymal stem cells from the hair follicle outer root sheath (eMSCORS). eMSCORS present a promising alternative stem cell source for the equine veterinary medicine.
Collapse
Affiliation(s)
- Hanluo Li
- National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, Hubei University of Technology, Wuhan, 430068, Hubei Province, China
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany
| | - Shiwen Xiong
- National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, Hubei University of Technology, Wuhan, 430068, Hubei Province, China
| | | | - Seltenhammer Monika
- Institute of Livestock Sciences (NUWI), University of Natural Resources and Life Sciences, Vienna, Gregor-Mendel-Straße 33/II, A-1180, Vienna, Austria
| | - Bernd Lethaus
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany
| | - Vuk Savkovic
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany.
| |
Collapse
|
8
|
Fenske F, Stoltze A, Neuhaus M, Zimmerer R, Häfner J, Kloss-Brandstätter A, Lethaus B, Sander AK. Evaluating the efficacy of single-shot versus prolonged antibiotic prophylaxis in alveolar cleft osteoplasty - A retrospective cohort study. J Craniomaxillofac Surg 2023; 51:644-648. [PMID: 37813773 DOI: 10.1016/j.jcms.2023.09.002] [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: 03/17/2023] [Revised: 06/28/2023] [Accepted: 09/05/2023] [Indexed: 10/11/2023] Open
Abstract
This retrospective cohort study aimed to compare the outcomes of alveolar cleft osteoplasty using single-shot antibiotic prophylaxis versus a prolonged antibiotic regimen. The primary endpoints assessed were the incidence of infection, failure of surgical correction, and antibiotic-related side effects. Patients with orofacial clefts affecting the alveolar ridge who underwent alveolar cleft osteoplasty at a tertiary care center between 2015 and 2021 were included. The prolonged antibiotic group received extended antibiotic treatment, while the single-shot group received preoperative antibiotics only. Among 83 patients (mean age 12.8 years), 51 interventions were performed under prolonged antibiotic prophylaxis (mean duration 5.82 days) whereas in 40 interventions only single-shot prophylaxis was administered. There were no significant differences in infection frequency, surgical correction failure, implant loss, or adverse events between the groups. However, after single-shot antibiotic regimen, patients had significantly shorter hospital stays, being discharged on average one day earlier. The study suggests that single-shot antibiotic prophylaxis does not have drawbacks compared to prolonged antibiotic treatment in alveolar cleft osteoplasty. Considering increasing antibiotic resistance and potential side effects, omitting prolonged antibiotic prophylaxis is recommended for patients undergoing alveolar cleft osteoplasty.
Collapse
Affiliation(s)
- Fabian Fenske
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Anette Stoltze
- Department of Children's and Youth Medicine, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Michael Neuhaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Johannes Häfner
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Anita Kloss-Brandstätter
- Faculty of Mathematics and Statistics, Carinthia University of Applied Sciences, Europastrasse 4, 9524, Villach, Austria
| | - Bernd Lethaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Anna Katharina Sander
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| |
Collapse
|
9
|
Fenske F, Krause L, Meyer S, Kujat B, Repmann J, Neuhaus M, Zimmerer R, Roth A, Lethaus B, Ziebolz D, Schmalz G. Oral Health Screening for Risk Reduction for Early Periprosthetic Joint Infections of Hip and Knee Endoprostheses-Results of a Prospective Cohort Study. J Clin Med 2023; 12:4451. [PMID: 37445486 DOI: 10.3390/jcm12134451] [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: 02/17/2023] [Revised: 05/29/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
This prospective observational study had two aims: (I) to assess whether a preoperative dental screening before endoprosthesis (EP) implantation with need-based dental intervention would decrease the prevalence of periprosthetic joint infection (PJI) and (II) to evaluate whether instructed orthopedic surgeons would achieve similar results in oral screening as dentists. The preoperative oral health statuses of the patients, prior to EP insertion, were either evaluated by the patients' general dentists (Ia) or, if the patient had not visited a general dentist, by an instructed orthopedic surgeon (Ib). Both the dentist and orthopedic surgeon used standardized risk estimation (low risk, moderate risk, and high risk) for an oral-health-related infectious complication after EP insertion, including a recommendation for further management of the patient. If required, a need-based dental rehabilitation was performed. In addition, retrospective data evaluation of a comparison group (II) was performed, which had not been screened orally preoperatively. A total of 777 patients (screening group (I): n = 402, of which 229 were screened by a dentist (Ia), 173 were screened by an orthopedic surgeon (Ib); comparison group (II): n = 375) were included. No general association between early infection rate and preoperative oral screening in general was found (1% PJI in screening group (I), 1.6% PJI in comparison group (II); p = 0.455). However, screening performance (dentist vs. orthopedic surgeon) had a significant impact on the prevalence of developed PJIs (p = 0.021). Thereby, 100% of observed infections in the screening group (I) occurred in the group with previous oral screening by an orthopedic surgeon (Ib). Furthermore, the C-reactive protein (CRP) value at discharge was significantly lower when general preoperative oral screening had been performed (group I vs. group II, p = 0.03). Only preoperative oral screening by a dentist had the potential to reduce oral-focus-associated EP infections; therefore, increased attention should be paid to the further promotion of interdisciplinary work between dentists and orthopedic surgeons. Dental screenings, using objectifiable criteria, as applied in this study, seem reasonable but require further validation in larger cohorts.
Collapse
Affiliation(s)
- Fabian Fenske
- Department of Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Leah Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Stephan Meyer
- Department of Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Benjamin Kujat
- Specialised Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848 Bad Düben, Germany
| | - Jacqueline Repmann
- Specialised Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848 Bad Düben, Germany
| | - Michael Neuhaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Andreas Roth
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| |
Collapse
|
10
|
Bartella AK, Laser J, Kamal M, Krause M, Neuhaus M, Pausch NC, Sander AK, Lethaus B, Zimmerer R. Accuracy of low-cost alternative facial scanners: a prospective cohort study. Oral Maxillofac Surg 2023; 27:33-41. [PMID: 35249150 PMCID: PMC9938030 DOI: 10.1007/s10006-022-01050-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/13/2022] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Three-dimensional facial scans have recently begun to play an increasingly important role in the peri-therapeutic management of oral and maxillofacial and head and neck surgery cases. Face scan images can be generated by optical facial scanners utilizing line-laser, stereophotography, or structured light modalities, as well as from volumetric data: for example, from cone beam computed tomography (CBCT). This study aimed to evaluate whether two low-cost procedures for the creation of three-dimensional face scan images were capable of producing sufficiently accurate data sets for clinical analysis. MATERIALS AND METHODS Fifty healthy volunteers were included in the study. Two test objects with defined dimensions (Lego bricks) were attached to the forehead and the left cheek of each volunteer. Facial anthropometric values (i.e., the distances between the medial canthi, the lateral canthi, the nasal alae, and the angles of the mouth) were first measured manually. Subsequently, face scans were performed with a smart device and manual photogrammetry and the values obtained were compared with the manually measured data sets. RESULTS The anthropometric distances deviated, on average, 2.17 mm from the manual measurements (smart device scanning deviation 3.01 mm, photogrammetry deviation 1.34 mm), with seven out of eight deviations being statistically significant. For the Lego brick, from a total of 32 angles, 19 values demonstrated a significant difference from the original 90° angles. The average deviation was 6.5° (smart device scanning deviation 10.1°, photogrammetry deviation 2.8°). CONCLUSION Manual photogrammetry demonstrated greater accuracy when creating three-dimensional face scan images; however, smart devices are more user-friendly. Dental professionals should monitor camera and smart device technical improvements carefully when choosing and adequate technique for 3D scanning.
Collapse
Affiliation(s)
- Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| | - Josefine Laser
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Matthias Krause
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Michael Neuhaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Niels C Pausch
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Anna K Sander
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| |
Collapse
|
11
|
Krause M, Halama D, Gladilin E, Kauder B, Neuhaus MT, Sander AK, Lethaus B, Zimmerer R. Effect of the lateral wall valgisation in the treatment of patients with endocrine orbitopathy. Br J Oral Maxillofac Surg 2023; 61:152-157. [PMID: 36658060 DOI: 10.1016/j.bjoms.2022.11.284] [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: 09/06/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
Orbital decompression is an established procedure used to correct exophthalmos that results from excess orbital soft tissue. This study aimed to explore a new minimally-invasive technique that features three-dimensional planning and patient-specific implants for lateral valgisation (LAVA) of the orbital wall. We analysed the outcomes of this procedure in nine endocrine orbitopathy (EO) patients (32-65 years of age with a mean clinical activity score of 4.3) who underwent this procedure between 2021 and 2022, including seven patients diagnosed with dysthyroid optic neuropathy. The impact of LAVA and wall resection on orbital areas, volumes, Hertel values, visual acuity, and new-onset diplopia was determined. Among our results, we found that LAVA and resection of 18 orbital walls resulted in significant enlargement of the orbital volume from a preoperative mean of 30.8 ± 3.5 cm3 to a mean of 37.3 ± 5.8 cm3 postoperatively (mean difference, 6.2 ± 1.8 cm3; p < 0.001); this procedure also resulted in a significant reduction in the mean Hertel value, from 28.7 ± 1.9 mm to 20.0 ± 1.9 mm (mean difference, 8.7 ± 1.9 mm; p < 0.001). The procedure resulted in visual acuity declined in three patients (33.3 %) with reductions from 0.25 to 0.125, 0.8 to 0.125, and 1.2 to 0.7, respectively. No new diplopia occurred postoperatively, however, our study included five patients with preoperative diplopia that did not improve postoperatively and required additional surgical intervention. Similarly, four patients required supplemental eyelid surgery. In conclusion, our study suggests the effects of the LAVA with the partial floor resection seems to be effective, which provides a substantially improved outcome for patients undergoing surgical treatment of EO via the use of double navigation and piezosurgical methods.
Collapse
Affiliation(s)
- Matthias Krause
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany.
| | - Dirk Halama
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| | - Evgeny Gladilin
- University Heidelberg, BioQuant, Im Neuenheimer Feld 267, Heidelberg 69120, Germany
| | - Birgit Kauder
- Department of Ophthalmology, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| | - Michael T Neuhaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| | - Anna K Sander
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstrasse 12, 04103 Leipzig, Germany
| |
Collapse
|
12
|
Hu S, Li S, Ning W, Huang X, Liu X, Deng Y, Franceschi D, Ogbuehi AC, Lethaus B, Savkovic V, Li H, Gaus S, Zimmerer R, Ziebolz D, Schmalz G, Huang S. Identifying crosstalk genetic biomarkers linking a neurodegenerative disease, Parkinson's disease, and periodontitis using integrated bioinformatics analyses. Front Aging Neurosci 2022; 14:1032401. [PMID: 36545026 PMCID: PMC9760933 DOI: 10.3389/fnagi.2022.1032401] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To identify the genetic linkage mechanisms underlying Parkinson's disease (PD) and periodontitis, and explore the role of immunology in the crosstalk between both these diseases. Methods The gene expression omnibus (GEO) datasets associated with whole blood tissue of PD patients and gingival tissue of periodontitis patients were obtained. Then, differential expression analysis was performed to identify the differentially expressed genes (DEGs) deregulated in both diseases, which were defined as crosstalk genes. Inflammatory response-related genes (IRRGs) were downloaded from the MSigDB database and used for dividing case samples of both diseases into different clusters using k-means cluster analysis. Feature selection was performed using the LASSO model. Thus, the hub crosstalk genes were identified. Next, the crosstalk IRRGs were selected and Pearson correlation coefficient analysis was applied to investigate the correlation between hub crosstalk genes and hub IRRGs. Additionally, immune infiltration analysis was performed to examine the enrichment of immune cells in both diseases. The correlation between hub crosstalk genes and highly enriched immune cells was also investigated. Results Overall, 37 crosstalk genes were found to be overlapping between the PD-associated DEGs and periodontitis-associated DEGs. Using clustering analysis, the most optimal clustering effects were obtained for periodontitis and PD when k = 2 and k = 3, respectively. Using the LASSO feature selection, five hub crosstalk genes, namely, FMNL1, MANSC1, PLAUR, RNASE6, and TCIRG1, were identified. In periodontitis, MANSC1 was negatively correlated and the other four hub crosstalk genes (FMNL1, PLAUR, RNASE6, and TCIRG1) were positively correlated with five hub IRRGs, namely, AQP9, C5AR1, CD14, CSF3R, and PLAUR. In PD, all five hub crosstalk genes were positively correlated with all five hub IRRGs. Additionally, RNASE6 was highly correlated with myeloid-derived suppressor cells (MDSCs) in periodontitis, and MANSC1 was highly correlated with plasmacytoid dendritic cells in PD. Conclusion Five genes (i.e., FMNL1, MANSC1, PLAUR, RNASE6, and TCIRG1) were identified as crosstalk biomarkers linking PD and periodontitis. The significant correlation between these crosstalk genes and immune cells strongly suggests the involvement of immunology in linking both diseases.
Collapse
Affiliation(s)
- Shaonan Hu
- Stomatological Hospital, Southern Medical University, Guangzhou, China,*Correspondence: Shaonan Hu,
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Wanchen Ning
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiuhong Huang
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiangqiong Liu
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, Beijing, China
| | - Yupei Deng
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, Beijing, China
| | - Debora Franceschi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Hanluo Li
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Sebastian Gaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Shaohong Huang
- Stomatological Hospital, Southern Medical University, Guangzhou, China,Shaohong Huang,
| |
Collapse
|
13
|
Sander AK, Grau E, Bartella AK, Kloss-Brandstätter A, Neuhaus M, Zimmerer R, Lethaus B. Dental anomalies and their therapeutic implications: retrospective assessment of a frequent finding in patients with cleft lip and palate. BMC Oral Health 2022; 22:553. [PMID: 36457084 PMCID: PMC9714158 DOI: 10.1186/s12903-022-02606-3] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Orofacial clefts are characterized by a frequent occurrence of dental anomalies. Numerous studies demonstrate the high prevalence of dental aplasia, supernumerary teeth, and hypoplastic teeth in patients with cleft lip with/without cleft palate (CL/P), yet the therapeutic consequences are rarely discussed. This study explores prevalence, localization, and association between primary and secondary dentition in a large European collective and begins to evaluate the significance of dental anomalies in the therapeutic course of patients with CL/P. METHODS The medical reports of 1070 patients with different entities of CL/P who presented to our clinic within a 15-year investigation period were evaluated retrospectively. Dental anomalies were classified into three different diagnostic groups: dental aplasia, supernumerary teeth and hypoplastic teeth. The statistical analyses included studies of the frequency and localization of dental anomalies in different cleft entities as well as of the association between primary and secondary dentition and the therapeutic consequences. RESULTS Uni- or bilateral cleft lip and palate (CLP) (47.5%) occurred most frequently, followed by cleft palate only (CPO) (32.9%) and cleft lip with or without alveolus (CL ± A) (19.6%). Dental anomalies were found significantly more often on the side of the cleft. Aplastic permanent teeth were mostly found in patients with CLP (54.8%), while supernumerary permanent teeth occurred primarily in patients with CL ± A (21.7%). Patients with CPO presented dental aplasia but no patient with CPO showed supernumerary teeth. The occurrence of dental aplasia in the primary dentition significantly increases the probability of aplastic teeth in the permanent dentition. Dental anomalies, in particular dental aplasia, significantly increase patients' need for subsequent orthodontic therapy and orthognathic surgery. CONCLUSION Dental aplasia and hypoplasia are common in patients with CL/P not only in the cleft area but in the whole dentition. In the event of dental aplasia in the primary dentition, the frequency of aplastic teeth in the permanent dentition is significantly higher. Additionally, the need for therapeutic interventions, especially concerning orthognathic surgery, seems to be significantly higher in patients with CL/P who are affected by dental anomalies. Clinicians should take this into account when creating long-term treatment plans.
Collapse
Affiliation(s)
- A. K. Sander
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - E. Grau
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A. K. Bartella
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A. Kloss-Brandstätter
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M. Neuhaus
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - R. Zimmerer
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - B. Lethaus
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| |
Collapse
|
14
|
Dietz A, Lethaus B, Pirlich M, Stöhr M, Zebralla V, Wichmann G, Zimmerer R, Wiegand S. [Current Therapy Standards for Soft Tissue Sarcomas in the Head and Neck Area - Part 2]. Laryngorhinootologie 2022; 101:820-831. [PMID: 36174568 DOI: 10.1055/a-1810-3790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
In September 2021, the first version of the German S3 guideline on adult soft tissue sarcomas, version 1.0 (AWMF register number 032/044OL) was presented as part of the oncology guideline program of the DKG, German Cancer Aid and the AWMF. After the basic features of soft tissue sarcomas were presented in Part 1, Part 2 describes the specific options for surgical therapy depending on the location in the head and neck area.
Collapse
Affiliation(s)
- Andreas Dietz
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitatsklinikum Leipzig, Leipzig, Germany
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Zimmerer RM, Sander AK, Schönfeld A, Lethaus B, Gellrich NC, Neuhaus MT. Congenital Mandibular Hypoplasia: Patient-Specific Total Joint Replacement as a Line Extension in the Treatment of Complex Craniofacial Anomalies. J Maxillofac Oral Surg 2022; 22:410-418. [PMID: 37122781 PMCID: PMC10130262 DOI: 10.1007/s12663-022-01780-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/14/2022] [Indexed: 10/14/2022] Open
Abstract
Abstract
Introduction
Congenital mandibular hypoplasia (CMH) remains challenging because of the underlying combined hard and soft tissue deficiency. Treatment options include craniofacial distraction, orthognathic surgery, and autologous grafts, although the latter produces inadequate results after distraction and autologous grafting. Unsatisfactory long-term stability may cause relapse, necessitating reoperation.
Material and Methods
We investigated the feasibility of using alloplastic total joint replacement (TJR) in growing and young adult CMH patients. The primary outcome was long-term reconstruction stability, without implant failure. Secondary outcomes were TMJ function and pain, and jaw movements achieved during surgery.
Results
Three patients (age: 9–22 years) were treated by the same surgeon at one institution during 2018–2021. Anamnesis and clinical parameters were obtained from patient records. Preoperative 3D-scans were superimposed with postoperative 3D-scans and preoperative plans, including TJR-implant STL files, to measure jaw movement. All patients underwent prior reconstructive surgery. Mandibular movement of 16.4–20.1 mm in the sagittal direction was achieved. Post-TJR follow-up ranged from 24 to 42 months. No long-term complications occurred. At the latest follow-up, the maximal interincisal opening was between 21 and 40 mm, and all implants were functioning, without failure.
Conclusion
In selected CMH cases, alloplastic TJR can deliver satisfactory medium-term results with predictable and stable outcomes, even in growing patients.
Collapse
|
16
|
Dietz A, Lethaus B, Pirlich M, Stöhr M, Zebralla V, Wichmann G, Zimmerer R, Wiegand S. [Current Therapy Standards for Soft Tissue Sarcomas in the Head and Neck Area - Part 1]. Laryngorhinootologie 2022; 101:751-762. [PMID: 36041450 DOI: 10.1055/a-1774-9318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The present work discusses soft tissue sarcoma in the head and neck area, due to the new published German S3-Guideline "adult soft tissue sarcoma". The head and neck surgeon plays the central role in the diagnosis and treatment of the vast majority of cases. It is crucial to admit the patients immediately to specialized centers for diagnoses and specific treatment. Regarding correct diagnostic procedures, in contrast to squamous cell carcinoma, a larger accidental excisional biopsy within the tumor tissue is strongly prognostic negative. After confirmation of histology and tumor extension, it is mandatory to discuss the interdisciplinary treatment concept. If possible, introduction of the patient in ongoing clinical studies is key.
Collapse
Affiliation(s)
- Andreas Dietz
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universität Leipzig, Leipzig
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Schmalz G, Lange J, Krause F, Haak R, Lethaus B, Zimmerer R, Ziebolz D. Evaluation of an individual anamnesis tool for teaching risk-oriented prevention - a pilot study in undergraduate dental students. BMC Med Educ 2022; 22:648. [PMID: 36038867 PMCID: PMC9426018 DOI: 10.1186/s12909-022-03710-2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND A comprehensive medical history is needed to establish and ensure a high standard in dental care; however, it is challenging to draw clinical consequences on the variety of potential diseases and medications, especially for dental students. Aim of this observational study was to investigate, whether undergraduate dental students using an analog anamnesis tool for risk classification would be more confident and have more knowledge in risk classification than other students in the same year of study. METHODS A cohort of 48 fifth year dental students was included and allocated into two groups based on their curriculum-related division (group A: n = 25, group B: n = 23). Group A received a teaching event and provision of an analog anamnesis tool for risk classification; group B received neither a teaching event nor the anamnesis tool. At baseline and after two weeks (follow-up), questionnaires regarding self-perceived confidence with risk classification, questions on different disease, medications and lifestyle factors and a task with 15 medical histories of prepared patient cases were applied. The data was statistically analyzed using Mann-Whitney or Wilcoxon test. RESULTS In group comparison of the differences between baseline and follow-up regarding self-perceived confidence, significantly higher improvement was noted in group A compared to group B for all questions (p < 0.05). With regard to knowledge, the group comparison revealed that the differences in all of the four tasks were significantly higher in group A compared to group B (pi ≤ 0.01). Thereby, the different tasks in group A differed between baseline and follow-up as follows: Risk of complications: 49.04 ± 13.59 vs. 67.96 ± 17.22, p < 0.01, Risk of oral diseases: 48.77 ± 13.57 vs. 63.44 ± 16.78, p = 0.01, Indication of antibiotic prophylaxis: 75.70 ± 13.45 vs. 87.97 ± 10.37, p < 0.01 and the Medical history task on 15 patient cases: 58.45 ± 4.74 vs. 71.47 ± 9.54, p < 0.01. CONCLUSION The applied analog anamnesis tool supported an increase in students´ confidence with issues related to at-risk patients alongside with their knowledge in risk classification. The applied anamnesis tool can be recommended for improving teaching of risk management for undergraduate dental students.
Collapse
Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Jacqueline Lange
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| |
Collapse
|
18
|
Kamal M, Al‐Obaidly S, Lethaus B, Bartella AK. A novel pilot animal model for bone augmentation using osseous shell technique for preclinical in vivo studies. Clin Exp Dent Res 2022; 8:1331-1340. [PMID: 35933723 PMCID: PMC9760144 DOI: 10.1002/cre2.644] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Bone grafting is commonly used to reconstruct skeletal defects in the craniofacial region. Several bone augmentation models have been developed to evaluate bone formation using novel bone substitute materials. The aim of this study was to evaluate a surgical animal model for establishing a three-dimensional (3D) grafting environment in the animal's mandibular ramus for bone augmentation using the osseous shell technique, as in humans. MATERIALS AND METHODS Osteological survey of New Zealand white (NZW) rabbit skull (Oryctolagus cuniculus): Initial osteological and imaging surveys were performed on a postmortem skull for a feasibility assessment of the surgical procedure. Postmortem pilot surgery and cone beam computed tomography imaging: a 3D osseous defect was created in the mandibular ramus through a submandibular incision. The osseous shell plates were stabilized with osteosynthesis fixation screws, and defects were filled with particular bone grafting material. In vivo surgical procedure: surgeries were conducted in four 8-week-old NZW rabbits utilizing two osseous shell materials: xenogeneic human cortical plates and autogenous rabbit cortical plates. The created 3D defects were filled using xenograft and allograft bone grafting materials. The healed defects were evaluated for bone formation after 12 weeks using histological and cone beam computed tomography imaging analysis. RESULTS Clinical analysis 12 weeks after surgery revealed the stability of the 3D grafted bone augmentation defects using the osseous shell technique. Imaging and histological analyses confirmed the effectiveness of this model in assessing bone formation. CONCLUSIONS The proposed animal model is a promising model with the potential to study various bone grafting materials for augmentation in the mandibular ramus using the osseous shell technique without compromising the health of the animal. The filled defects could be analyzed for osteogenesis, quantification of bone formation, and healing potential using histomorphometric analysis, in addition to 3D morphologic evaluation using radiation imaging.
Collapse
Affiliation(s)
- Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences CenterKuwait UniversityJabryiaKuwait
| | - Sara Al‐Obaidly
- Kuwait Dental AdministrationKuwait Ministry of HealthSafatKuwait
| | - Bernd Lethaus
- Department of Oral and Maxillofacial SurgeryLeipzig University HospitalLeipzigGermany
| | - Alexander K. Bartella
- Department of Oral and Maxillofacial SurgeryLeipzig University HospitalLeipzigGermany
| |
Collapse
|
19
|
Bartella AK, Hoshal SG, Lethaus B, Strong EB. Computer assisted skull base surgery: a contemporary review. Innov Surg Sci 2022. [DOI: 10.1515/iss-2021-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Skull base surgery has evolved significantly since Harvey Cushing‘s first descriptions in the early 1900s. Computer aided surgery (CAS) applications continue to expand; they include virtual surgical planning, augmented and virtual reality, 3D printing of models/cutting guides/implants, surgical navigation, and intraoperative imaging. The authors will review the current skull base CAS literature and propose a computer aided surgical workflow categorizing these applications into 3 phases: 1) Virtual planning, 2) Surgical execution, 3) Intraoperative verification.
Collapse
Affiliation(s)
| | - Steven G. Hoshal
- Department of Otolaryngology – Head and Neck Surgery , University of California, Davis , Sacramento , CA , USA
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery , Leipzig University Leipzig , Germany
| | - E. Bradley Strong
- Department of Otolaryngology – Head and Neck Surgery , University of California, Davis , Sacramento , CA , USA
| |
Collapse
|
20
|
Krause M, Neuhaus MT, Sterker I, Bartella AK, Schönfeld A, Lethaus B, Zimmerer R, Gladilin E. Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation. Eur J Med Res 2022; 27:92. [PMID: 35698208 PMCID: PMC9195310 DOI: 10.1186/s40001-022-00709-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Endocrine orbitopathy is typically treated by resecting orbital walls. This procedure reduces intraorbital pressure by releasing intraorbital tissue, effectively alleviating the symptoms. However, selection of an appropriate surgical plan for treatment of endocrine orbitopathy requires careful consideration because predicting the effects of one-, two-, or three-wall resections on the release of orbital tissues is difficult. Here, based on our experience, we describe two specific orbital sites (’key points’) that may significantly improve decompression results. Methodological framework of this work is mainly based on comparative analysis pre- and post-surgery tomographic images as well as image- and physics-based simulation of soft tissue outcome using the finite element modelling of mechanical soft tissue behaviour. Thereby, the optimal set of unknown modelling parameters was obtained iteratively from the minimum difference between model predictions and post-surgery ground truth data. This report presents a pre-/post-surgery study indicating a crucial role of these particular key points in improving the post-surgery outcome of decompression treatment of endocrine orbitopathy which was also supported by 3D biomechanical simulation of alternative two-wall resection plans. In particular, our experimental results show a nearly linear relationship between the resection area and amount of tissue released in the extraorbital space. However, a disproportionately higher volume of orbital outflow could be achieved under consideration of the two special key points. Our study demonstrates the importance of considering natural biomechanical obstacles to improved outcomes in two-wall resection treatment of endocrine orbitopathy. Further investigations of alternative surgery scenarios and post-surgery data are required to generalize the insights of this feasibility study.
Collapse
Affiliation(s)
- Matthias Krause
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| | - Michael-Tobias Neuhaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Ina Sterker
- Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Annika Schönfeld
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Evgeny Gladilin
- Applied Bioinformatics, German Cancer Research Center, Berliner Str. 41, 69120, Heidelberg, Germany.,Leibniz Institute of Plant Genetics and Crop Plant Research, Corrensstrasse 3, OT Gatersleben, 06466, Seeland, Germany
| |
Collapse
|
21
|
Neuhaus MT, Gellrich NC, Sander AK, Lethaus B, Halama D, Zimmerer RM. No Significant Bone Resorption after Open Treatment of Mandibular Condylar Head Fractures in the Medium-Term. J Clin Med 2022; 11:jcm11102868. [PMID: 35628994 PMCID: PMC9142930 DOI: 10.3390/jcm11102868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022] Open
Abstract
Open treatment of condylar head fractures (CHF) is considered controversial. In this retrospective cohort study our primary objective was therefore to assess bone resorption and remodeling as well as patients function after open treatment of CHF in a medium-term follow-up (15.1 ± 2.2 months). We included 18 patients with 25 CHF who underwent open reduction and internal fixation, between 2016 and 2021, in our analysis. The clinical data and cone-beam computed tomography (CBCT) datasets were analyzed. The condylar processes were segmented in the postoperative (T1) and follow-up (T2) CBCT scans. Volumetric and linear bone changes were the primary outcome variables, measured by using a sophisticated 3D-algorithm. The mean condylar head volume decreased non-significantly from 3022.01 ± 825.77 mm3 (T1) to 2878.8 ± 735.60 mm3 (T2; p = 0.52). Morphological alterations indicated remodeling and resorption. The pre-operative maximal interincisal opening (MIO) was 19.75 ± 3.07 mm and significantly improved to 40.47 ± 1.7 mm during follow-up (p = 0.0005). Low rates of postoperative complications were observed. Open reduction of CHF leads to good clinical outcomes and low rates of medium-term complications. This study underlines the feasibility and importance of open treatment of CHF and may help to spread its acceptance as the preferred treatment option.
Collapse
Affiliation(s)
- Michael-Tobias Neuhaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany; (A.K.S.); (B.L.); (D.H.); (R.M.Z.)
- Correspondence: ; Tel.: +49-(0)-341-97-21866
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany;
| | - Anna Katharina Sander
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany; (A.K.S.); (B.L.); (D.H.); (R.M.Z.)
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany; (A.K.S.); (B.L.); (D.H.); (R.M.Z.)
| | - Dirk Halama
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany; (A.K.S.); (B.L.); (D.H.); (R.M.Z.)
| | - Rüdiger M. Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany; (A.K.S.); (B.L.); (D.H.); (R.M.Z.)
| |
Collapse
|
22
|
Sander AK, Dietrich L, Kloss-Brandstätter A, Krause M, Zimmerer R, Neuhaus M, Bartella AK, Lethaus B. The Cleft-screen-questionnaire (CSQ) - A validated screening instrument for health-related quality of life in cleft patients. J Plast Reconstr Aesthet Surg 2022; 75:3429-3435. [PMID: 35610102 DOI: 10.1016/j.bjps.2022.04.040] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/01/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The objective of this study is to develop and validate a specific screening instrument for assessing the quality of life (QoL) of patients with orofacial clefts. The Cleft-Screen-Questionnaire (CSQ) aims at identifying the main problematic areas and is intended for the routine use in everyday clinical practice to constantly evaluate the conditions' and treatments' effects on patients' well-being. METHODS First, a pool of 58 questions is created by collecting items from validated questionnaires previously used for assessing the QoL in cleft populations. After the removal of duplicate questions, the questionnaires are answered by 152 patients from a tertiary care center. A factor analysis followed by the calculation of Cronbach's alpha as a reliability measurement led to the final CSQ presented here. RESULTS The applied factor analysis resulted in five factors. Items showing low factor loadings (seen as <0.5) were excluded initially. Accordingly, factor analysis led to a preliminary number of 43 items. A reliability analysis using Cronbach's alpha and corrected alpha if item deleted showed an overall moderate to high reliability (seen as: 0.6-0.9). After excluding questions with increasing alphas if item deleted, analyses yielded in a final number of 38 questions. CONCLUSION The final 38-item CSQ is a reliable instrument for evaluating the health-related QoL of cleft patients.
Collapse
Affiliation(s)
- A K Sander
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - L Dietrich
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A Kloss-Brandstätter
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M Krause
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - R Zimmerer
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M Neuhaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A K Bartella
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - B Lethaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| |
Collapse
|
23
|
Li H, Ziemer M, Stojanovic I, Saksida T, Maksimovic-Ivanic D, Mijatovic S, Djmura G, Gajic D, Koprivica I, Krajnovic T, Draca D, Simon JC, Lethaus B, Savkovic V. Mesenchymal Stem Cells From Mouse Hair Follicles Reduce Hypertrophic Scarring in a Murine Wound Healing Model. Stem Cell Rev Rep 2022; 18:2028-2044. [PMID: 35080748 PMCID: PMC9391240 DOI: 10.1007/s12015-021-10288-7] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 12/11/2022]
Abstract
Wound healing of acute full-thickness injuries and chronic non-healing ulcers leads to delayed wound closure, prolonged recovery period and hypertrophic scarring, generating a demand for an autologous cell therapy and a relevant pre-clinical research models for wound healing. In this study, an immunocompetent model for wound healing was employed using a syngeneic murine cell line of mesenchymal stem cells cultured from the mouse whisker hair follicle outer root sheath (named moMSCORS). moMSCORS were isolated using an air-liquid interface method, expanded in vitro and characterized according to the MSC definition criteria - cell viability, in vitro proliferation, MSC phenotype and multi-lineage differentiations. Moreover, upon applying moMSCORS in an in vivo full-thickness wound model in the syngeneic C57BL/6 mice, the treated wounds displayed different morphology to that of the untreated wound beds. Quantitative evaluation of angiogenesis, granulation and wound closure involving clinical scoring and software-based quantification indicated a lower degree of inflammation in the treated wounds. Histological staining of treated wounds by the means of H&E, Alcian Blue, PicroSirius Red and αSMA immune labelling showed lower cellularity, less collagen filaments as well as thinner dermal and epidermal layers compared with the untreated wounds, indicating a general reduction of hypertrophic scars. The decreased inflammation, accelerated wound closure and non-hypertrophic scarring, which were facilitated by moMSCORS, hereby address a common problem of hypertrophic scars and non-physiological tissue properties upon wound closure, and additionally offer an in vivo model for the autologous cell-based wound healing.
Collapse
Affiliation(s)
- Hanluo Li
- National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, Hubei University of Technology, Wuhan, 430068, Hubei Province, China.,Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany
| | - Mirjana Ziemer
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Ivana Stojanovic
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tamara Saksida
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Danijela Maksimovic-Ivanic
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Sanja Mijatovic
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Goran Djmura
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Dragica Gajic
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ivan Koprivica
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tamara Krajnovic
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Dijana Draca
- Institute for Biological Research "Sinisa Stankovic" (IBISS) - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jan-Christoph Simon
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany
| | - Vuk Savkovic
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103, Leipzig, Germany.
| |
Collapse
|
24
|
Yu Y, Tang H, Franceschi D, Mujagond P, Acharya A, Deng Y, Lethaus B, Savkovic V, Zimmerer R, Ziebolz D, Li S, Schmalz G. Immune Checkpoint Gene Expression Profiling Identifies Programmed Cell Death Ligand-1 Centered Immunologic Subtypes of Oral and Squamous Cell Carcinoma With Favorable Survival. Front Med (Lausanne) 2022; 8:759605. [PMID: 35127742 PMCID: PMC8810827 DOI: 10.3389/fmed.2021.759605] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022] Open
Abstract
Objective This study aimed to identify the programmed death ligand-1 (PDL1, also termed as CD274) and its positively correlated immune checkpoint genes (ICGs) and to determine the immune subtypes of CD274-centered ICG combinations in oral and squamous cell carcinoma (OSCC). Materials and Methods Firstly, the 95 ICGs obtained via literature reviews were identified in the Cancer Genome Atlas (TCGA) database in relation to OSCC, and such 88 ICG expression profiles were extracted. ICGs positively correlated with CD274 were utilized for subsequent analysis. The relationship between ICGs positively correlated with CD274 and immunotherapy biomarkers (tumor mutation burden (TMB), and adaptive immune resistance pathway genes) was investigated, and the relationships of these genes with OSCC clinical features were explored. The prognostic values of CD274 and its positively correlated ICGs and also their associated gene pairs were revealed using the survival analysis. Results Eight ICGs, including CTLA4, ICOS, TNFRSF4, CD27, B- and T-lymphocyte attenuator (BTLA), ADORA2A, CD40LG, and CD28, were found to be positively correlated with CD274. Among the eight ICGs, seven ICGs (CTLA4, ICOS, TNFRSF4, CD27, BTLA, CD40LG, and CD28) were significantly negatively correlated with TMB. The majority of the adaptive immune resistance pathway genes were positively correlated with ICGs positively correlated with CD274. The survival analysis utilizing the TCGA-OSCC data showed that, although CD274 was not significantly associated with overall survival (OS), the majority of ICGs positively correlated with CD274 (BTLA, CD27, CTLA4, CD40LG, CD28, ICOS, and TNFRSF4) were significantly correlated with OS, whereby their low-expression predicted a favorable prognosis. The survival analysis based on the gene pair subtypes showed that the combination subtypes of CD274_low/BTLA_low, CD274_low/CD27_low, CD274_low/CTLA4_low, CD8A_high/BTLA_low, CD8A_high/CD27_low, and CD8A_high/CTLA4_low predicted favorable OS. Conclusion The results in this study provide a theoretical basis for prognostic immune subtyping of OSCC and highlight the importance of developing future immunotherapeutic strategies for treating oral cancer.
Collapse
Affiliation(s)
- Yang Yu
- Department of Stomatology, Qunli Branch, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- *Correspondence: Yang Yu
| | - Huiwen Tang
- Department of Stomatology, Qunli Branch, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Debora Franceschi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Prabhakar Mujagond
- Regional Centre for Biotechnology, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, India
| | - Aneesha Acharya
- Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Yupei Deng
- Laboratory of Molecular Cell Biology, China Tibetology Research Center, Beijing Tibetan Hospital, Beijing, China
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
25
|
Schmutzler A, Rauch A, Nitschke I, Lethaus B, Hahnel S. CLEANING OF REMOVABLE DENTAL PROSTHESES - A SYSTEMATIC REVIEW. J Evid Based Dent Pract 2021; 21:101644. [PMID: 34922732 DOI: 10.1016/j.jebdp.2021.101644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/09/2021] [Revised: 09/19/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
Objectives The aim of this systematic review was to provide an overview of the scientific evidence available from prospective clinical studies regarding denture hygiene interventions. Therefore, investigations addressing the efficacy of removing microorganisms and biofilms formed on the surface of removable dental prostheses (RDPs) and denture base materials in situ and their impact on the properties of denture base materials, such as color stability, surface roughness, and dimensional stability, were included. Methods A systematic literature search was conducted from June 1975-May 2020 and included articles published in English that have been indexed in the digital archives of PubMed and Cochrane (including PubMed, Embase, ICTRP, CT.gov). A complementary manual search of the initially retrieved studies was conducted. Inclusion criteria comprised prospective clinical trials with a minimum of ten participants investigating (1) approaches and methods to remove biofilms formed on the surface of RDPs and denture base materials in situ and/or (2) the influence of these biofilms on denture base materials. A total of forty-four studies were included in this systematic review, which was registered in the PROSPERO database (CRD42020189649). Results and Conclusions Data gathered from the systematic review indicate that the combined use of chemical and mechanical denture hygiene interventions is significantly more effective than single cleaning approaches. Only limited evidence is available from clinical studies regarding the effect of denture hygiene interventions on the properties of denture base materials.
Collapse
Affiliation(s)
- Anne Schmutzler
- Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany.
| | - Angelika Rauch
- Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany
| | - Ina Nitschke
- Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany; Clinic of General, Special Care and Geriatric Dentistry, University of Zurich, Zürich, Switzerland
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany
| |
Collapse
|
26
|
Wichmann G, Pavlychenko M, Willner M, Halama D, Kuhnt T, Kluge R, Gradistanac T, Fest S, Wald T, Lethaus B, Dietz A, Wiegand S, Zebralla V. Standardized Diagnostic Workup and Patient-Centered Decision Making for Surgery and Neck Dissection Followed by Risk-Factor Adapted Adjuvant Therapy Improve Loco-Regional Control in Local Advanced Oral Squamous Cell Carcinoma. Front Oncol 2021; 11:737080. [PMID: 34868927 PMCID: PMC8636007 DOI: 10.3389/fonc.2021.737080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background Standardized staging procedures and presentation of oral squamous cell carcinoma (OSCC) patients in multidisciplinary tumor boards (MDTB) before treatment and utilization of elective neck dissection (ND) are expected to improve the outcome, especially in local advanced LAOSCC (UICC stages III–IVB). As standardized diagnostics but also increased heterogeneity in treatment applied so far have not been demonstrated to improve outcome in LAOSCC, a retrospective study was initiated. Methods As MDTB was introduced into clinical routine in 2007, 316 LAOSCC patients treated during 1991-2017 in our hospital were stratified into cohort 1 treated before (n=104) and cohort 2 since 2007 (n=212). Clinical characteristics, diagnostic procedures and treatment modality of patients were compared using Chi-square tests and outcome analyzed applying Kaplan-Meier plots and log-rank tests as well as Cox proportional hazard regression. Propensity scores (PS) were used to elucidate predictors for impaired distant metastasis-free survival (DMFS) in PS-matched patients. Results Most patient characteristics and treatment modalities applied showed insignificant alteration. Surgical treatment included significantly more often resection of the primary tumor plus neck dissection, tracheostomy and percutaneous endoscopic gastrostomy tube use. Cisplatin-based chemo-radiotherapy was the most frequent. Only insignificant improved disease- (DFS), progression- (PFS) and event-free (EFS) as well as tumor-specific (TSS) and overall survival (OS) were found after 2006 as local (LC) and loco-regional control (LRC) were significantly improved but DMFS significantly impaired. Cox regression applied to PS-matched patients elucidated N3, belonging to cohort 2 and cisplatin-based chemo-radiotherapy as independent predictors for shortened DMFS. The along chemo-radiotherapy increased dexamethasone use in cohort 2 correlates with increased DM. Conclusions Despite standardized diagnostic procedures, decision-making considering clear indications and improved therapy algorithms leading to improved LC and LRC, shortened DMFS hypothetically linked to increased dexamethasone use had a detrimental effect on TSS and OS.
Collapse
Affiliation(s)
- Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Mykola Pavlychenko
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Maria Willner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Dirk Halama
- Department of Maxillofacial Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Thomas Kuhnt
- Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Tanja Gradistanac
- Department of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Sandra Fest
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Bernd Lethaus
- Department of Maxillofacial Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| |
Collapse
|
27
|
Krause M, Kamal M, Kruber D, Sterker I, Sander AK, Zimmerer R, Lethaus B, Bartella AK. Effect of orbital wall resection areas in the treatment of patients with endocrine orbitopathy. Br J Oral Maxillofac Surg 2021; 60:610-616. [PMID: 35184917 DOI: 10.1016/j.bjoms.2021.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
In patients treated by orbital wall decompression for endocrine orbitopathy (EO) there is limited evidence on the effect of orbital wall resections. Thus, the aim of this study was to evaluate the effect of one, two, and three-wall resections on orbital parameters to determine if any such correlations exist. Preoperative and postoperative data from all patients at a tertiary care centre who underwent decompression surgery from 2010 - 2020 were digitally analysed. The effect of the number and area of resected walls on orbital area, orbital volume, and Hertel value, and the effect of lateral rim advancement (LARA) were determined. A total of 131 orbital areas showed an increase from a mean (SD) preoperative area of 42.0 (4.6) cm2 to 47.3 (6.1) cm2 postoperatively (p<0.001). In total, the mean (SD) area of osseous wall removed in all patients was 6.2 (1.7) cm2 at the lateral orbit (n = 129), 6.7 (2.3) cm2 at the orbital floor (n = 123), and 5.8 (1.8) cm2 at the medial orbital wall (n =30). The mean (SD) orbital volume increased by 6.0 (3.0) cm3 after decompression. There was also a significant reduction in exophthalmos of 7.3 (3.2) mm (from 25.2 (3.9) to 17.9 (3.5), p<0.001). LARA was performed in 50 patients. Changes in volume and area, and reduction in exophthalmos were not significantly different with or without LARA. The postoperative effects of orbital wall resection are predictable and exhibit a relation with six units of change. Two-wall resection is the most common intervention.
Collapse
Affiliation(s)
- Matthias Krause
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Daniel Kruber
- Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl- Liebknecht Str. 145, 04277 Leipzig, Germany
| | - Ina Sterker
- Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Anna K Sander
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany.
| |
Collapse
|
28
|
Harbrecht A, Endlich F, Hackl M, Seyboth K, Lethaus B, Müller LP, Wegmann K. "Crack under pressure"-Inducing life-like mandible fractures as a potential benefit to surgical education in oral and maxillofacial surgery. Ann Anat 2021; 240:151878. [PMID: 34863911 DOI: 10.1016/j.aanat.2021.151878] [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: 05/27/2021] [Revised: 10/22/2021] [Accepted: 11/27/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to investigate whether life-like fractures of human cadaveric mandibles with a focus on the condylar process and the intact soft tissue envelope could be simulated. A total of nine fresh-frozen human head specimens were fractured in a custom-made drop-test bench. This reproducible method is based on a weight falling from a defined height onto the fixed specimens, simulating a direct blow to the symphysis of the mandible. All the fractures were analyzed by fluoroscopy and CT-scans. In all the specimens that were included in this study, several typical lesions could be created, resulting in a total of 27 mandible fractures. Seven condylar head fractures with intracapsular fracture patterns, three high, two low and five subcondylar fractures as well as different corpus fractures occurred. Human cadaveric mandibles as part of a complete head specimen with intact soft tissue can be successfully fractured by means of a drop-test bench setup. The amount of load and the exact angle at which the load is applied seem to be of high relevance. Such fractured specimens can be implemented in surgical education courses to teach and improve osteosynthetic techniques.
Collapse
Affiliation(s)
- Andreas Harbrecht
- University of Cologne, Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Cologne, Germany; Department of Anatomy I, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - Fabian Endlich
- University of Cologne, Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Cologne, Germany
| | - Michael Hackl
- University of Cologne, Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Cologne, Germany
| | | | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany.
| | - Lars P Müller
- University of Cologne, Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Cologne, Germany
| | - Kilian Wegmann
- University of Cologne, Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Cologne, Germany
| |
Collapse
|
29
|
Krause M, Kamal M, Halama D, Hierl T, Sterker I, Zimmerer R, Lethaus B, Bartella AK. Eyes wide shut: necessity and effect of adjunctive procedures after decompression surgery in patients with endocrine orbitopathy. Head Face Med 2021; 17:41. [PMID: 34526052 PMCID: PMC8442390 DOI: 10.1186/s13005-021-00290-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Orbital decompression surgery is frequently the last therapeutic measure in the surgical treatment of endocrine orbitopathy (EO). Additional rehabilitative and corrective surgical treatments are often used to improve the resulting eyelid stigmata, such as an increased lid aperture and scleral show. The aim of the study was to evaluate the effect of adjunctive surgical procedures after orbital decompression surgery in patients with EO. METHODS A total of 120 orbitae from 65 patients with EO from 2010 to 2020 at a tertiary care center in Germany were retrospectively evaluated. Ocular surface area (OSA) and vertical palpebral fissures were three-dimensionally analyzed at the following stages: presurgical decompression, postsurgical decompression, and post-adjunctive surgical procedures. For the analysis of vertical palpebral fissures, predefined vertical line distances were measured on the upper and lower lids in the central, medial, and lateral pupillary regions. RESULTS The initial OSA was 2,98 ± 0.85 cm2, and it decreased significantly after decompression surgery to 2.52 ± 0.62 cm2. After adjunct surgical procedures, OSA further decreased to 2,31 ± 0,55 cm2. Furthermore, a statistically significant reduction in all pupillary parameters was noted after each treatment step. More lid-lengthening procedures were performed on the lower lid than on the upper lid. Canthoplasty (n = 13) was the most frequently performed procedure during rehabilitation. CONCLUSION Surgical decompression surgery improves OSA and leads to a significant reduction in lid aperture. Adjunctive surgical procedures, addressing the upper and lower lid, have a significant influence on the ongoing clinical course and contribute to a reduction in OSA.
Collapse
Affiliation(s)
- Matthias Krause
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Dirk Halama
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Thomas Hierl
- Department of Oral and Maxillofacial Surgery, Helios Vogtland Klinikum Plauen, Röntgenstraße 2, 08529, Plauen, Germany
| | - Ina Sterker
- Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Alexander K Bartella
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| |
Collapse
|
30
|
Sander AK, Grau E, Kloss-Brandstätter A, Zimmerer R, Neuhaus M, Bartella AK, Lethaus B. Continuous Multidisciplinary Care for Patients With Orofacial Clefts-Should the Follow-up Interval Depend on the Cleft Entity? Cleft Palate Craniofac J 2021; 59:1139-1144. [PMID: 34410173 PMCID: PMC9411700 DOI: 10.1177/10556656211035253] [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] [Indexed: 11/25/2022] Open
Abstract
Objective The multidisciplinary follow-up of patients with cleft lip with or without palate (CL/P) is organized differently in specialized centers worldwide. The aim of this study was to evaluate the different treatment needs of patients with different manifestations of CL/P and to potentially adapt the frequency and timing of checkup examinations accordingly. Design We retrospectively analyzed the data of all patients attending the CL/P consultation hour at a tertiary care center between June 2005 and August 2020 (n = 1126). We defined 3 groups of cleft entities: (1) isolated clefts of lip or lip and alveolus (CL/A), (2) isolated clefts of the hard and/or soft palate, and (3) complete clefts of lip, alveolus and palate (CLP). Timing and type of therapy recommendations given by the specialists of different disciplines were analyzed for statistical differences. Results Patients with CLP made up the largest group (n = 537), followed by patients with cleft of the soft palate (n = 371) and CL ± A (n = 218). There were significant differences between the groups with regard to type and frequency of treatment recommendations. A therapy was recommended in a high proportion of examinations in all groups at all ages. Conclusion Although there are differences between cleft entities, the treatment need of patients with orofacial clefts is generally high during the growth period. Patients with CL/A showed a similarly high treatment demand and should be monitored closely. A close follow-up for patients with diagnosis of CL/P is crucial and measures should be taken to increase participation in follow-up appointments.
Collapse
|
31
|
Li S, Mai Z, Gu W, Ogbuehi AC, Acharya A, Pelekos G, Ning W, Liu X, Deng Y, Li H, Lethaus B, Savkovic V, Zimmerer R, Ziebolz D, Schmalz G, Wang H, Xiao H, Zhao J. Molecular Subtypes of Oral Squamous Cell Carcinoma Based on Immunosuppression Genes Using a Deep Learning Approach. Front Cell Dev Biol 2021; 9:687245. [PMID: 34422810 PMCID: PMC8375681 DOI: 10.3389/fcell.2021.687245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The mechanisms through which immunosuppressed patients bear increased risk and worse survival in oral squamous cell carcinoma (OSCC) are unclear. Here, we used deep learning to investigate the genetic mechanisms underlying immunosuppression in the survival of OSCC patients, especially from the aspect of various survival-related subtypes. Materials and methods: OSCC samples data were obtained from The Cancer Genome Atlas (TCGA), International Cancer Genome Consortium (ICGC), and OSCC-related genetic datasets with survival data in the National Center for Biotechnology Information (NCBI). Immunosuppression genes (ISGs) were obtained from the HisgAtlas and DisGeNET databases. Survival analyses were performed to identify the ISGs with significant prognostic values in OSCC. A deep learning (DL)-based model was established for robustly differentiating the survival subpopulations of OSCC samples. In order to understand the characteristics of the different survival-risk subtypes of OSCC samples, differential expression analysis and functional enrichment analysis were performed. Results: A total of 317 OSCC samples were divided into one inferring cohort (TCGA) and four confirmation cohorts (ICGC set, GSE41613, GSE42743, and GSE75538). Eleven ISGs (i.e., BGLAP, CALCA, CTLA4, CXCL8, FGFR3, HPRT1, IL22, ORMDL3, TLR3, SPHK1, and INHBB) showed prognostic value in OSCC. The DL-based model provided two optimal subgroups of TCGA-OSCC samples with significant differences (p = 4.91E-22) and good model fitness [concordance index (C-index) = 0.77]. The DL model was validated by using four external confirmation cohorts: ICGC cohort (n = 40, C-index = 0.39), GSE41613 dataset (n = 97, C-index = 0.86), GSE42743 dataset (n = 71, C-index = 0.87), and GSE75538 dataset (n = 14, C-index = 0.48). Importantly, subtype Sub1 demonstrated a lower probability of survival and thus a more aggressive nature compared with subtype Sub2. ISGs in subtype Sub1 were enriched in the tumor-infiltrating immune cells-related pathways and cancer progression-related pathways, while those in subtype Sub2 were enriched in the metabolism-related pathways. Conclusion: The two survival subtypes of OSCC identified by deep learning can benefit clinical practitioners to divide immunocompromised patients with oral cancer into two subpopulations and give them target drugs and thus might be helpful for improving the survival of these patients and providing novel therapeutic strategies in the precision medicine area.
Collapse
Affiliation(s)
- Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Zhaoyi Mai
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Wenli Gu
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | | | - Aneesha Acharya
- Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - George Pelekos
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Wanchen Ning
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiangqiong Liu
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, Beijing, China
| | - Yupei Deng
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, Beijing, China
| | - Hanluo Li
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Rüdiger Zimmerer
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Hao Wang
- Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Hui Xiao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen, China
| |
Collapse
|
32
|
Lethaus B, Gruichev D, Gräfe D, Bartella AK, Hahnel S, Yovev T, Pausch NC, Krause M. "Black bone": the new backbone in CAD/CAM-assisted craniosynostosis surgery? Acta Neurochir (Wien) 2021; 163:1735-1741. [PMID: 32519160 PMCID: PMC8116246 DOI: 10.1007/s00701-020-04445-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Computer-assisted design and manufacturing (CAD/CAM) techniques have been implemented in craniosynostosis surgery to facilitate cranial remodeling. However, until now, computed tomography (CT) scans with ionizing radiation were necessary to plan the procedure and create guiding templates. The purpose of this study was to present our series using CAD/CAM techniques in planning and conducting fronto-orbital advancement surgery in patients with trigonocephaly with datasets acquired only by "black bone" magnetic resonance imaging (MRI). METHODS Six consecutively operated cases from 2019 were included in this study. All patients suffered from non-syndromic trigonocephaly with no primary surgeries. All patients underwent cranial MRI including black bone sequences. Preoperative planning and guides were created based on the DICOM datasets. We analyzed demographic data, clinical data, and outcome measured by Whitaker score. RESULTS In all cases, precise frontobasal advancement was possible with the CAD/CAM guides created by black bone MRI. The mean operation time and planning time were 222 and 32 min. The time on intensive and intermediate care unit (ICU/IMC) time was 4.5 days, respectively. All but one case were classified as Whitaker I. CONCLUSION In trigonocephaly treatment by frontobasal advancement, black bone MRI-based CAD/CAM craniosynostosis surgery is safe and feasible. It offers the major advantage of completely avoiding CT scans and ionizing radiation with superior imaging quality of intracranial structures. Thus, it improves intraoperative safety and-at the same time-has the potential to reduce operating room (OR) time.
Collapse
Affiliation(s)
- Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| | - Dimitar Gruichev
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Daniel Gräfe
- Department of Paediatric Radiology, Leipzig University, Liebigstraße 14, 04103, Leipzig, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Tsanko Yovev
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Niels Christian Pausch
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Matthias Krause
- Department of Neurosurgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| |
Collapse
|
33
|
Neuhaus MT, Zeller AN, Jehn P, Lethaus B, Gellrich NC, Zimmerer RM. Intraoperative real-time navigation and intraoperative three-dimensional imaging for patient-specific total temporomandibular joint replacement. Int J Oral Maxillofac Surg 2021; 50:1342-1350. [PMID: 33707038 DOI: 10.1016/j.ijom.2021.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/03/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/28/2022]
Abstract
Customized solutions for replacement of the temporomandibular joint (TMJ) along with surgical guides enable precise and fast transfer of the virtual plan to the patient. However, these guides lack information on screw vectors and length, and well-defined borders for bony resections towards the medial skull base. This retrospective study was performed to investigate the feasibility and benefit of real-time navigation and intraoperative three-dimensional imaging during total TMJ replacement (TJR), as well as patient clinical outcomes. Between 2016 and 2020, 26 customized prostheses were implanted in 21 patients either with or without real-time navigation and instrument tracking. The clinical, surgical, radiological, and navigational data were analysed. The accuracy of navigation registration with instrument tracking, precision of screw insertion, and implant and screw positions were analysed by fusion of the virtual plan and surgical outcome. Real-time navigation aided orientation during lateral skull base dissection and resection. However, the results of real-time navigation-aided drilling were inconclusive regarding vector and length control. At a mean 15.3±3.0 months of follow-up, average mouth opening had improved from 21.69±2.80mm to 36.40±1.25mm; the average pain score decreased from 6.18±0.74 to 1.06±0.52. Thus, intraoperative real-time navigation for TJR assists lateral skull base dissection and resection.
Collapse
Affiliation(s)
- M-T Neuhaus
- Department of Oral- and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany; Department of Oral- and Maxillofacial Surgery, Leipzig University, Leipzig, Germany.
| | - A-N Zeller
- Department of Oral- and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - P Jehn
- Department of Oral- and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - B Lethaus
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Leipzig, Germany
| | - N-C Gellrich
- Department of Oral- and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - R M Zimmerer
- Department of Oral- and Maxillofacial Surgery, Leipzig University, Leipzig, Germany
| |
Collapse
|
34
|
Bartella AK, Kamal M, Kuhnt T, Hering K, Halama D, Pausch NC, Lethaus B. Mixed reality in oral and maxillofacial surgery: a symbiosis of virtual and augmented reality or a pointless technological gadget? Int J Comput Dent 2021; 24:65-76. [PMID: 34006064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Mixed reality (MR) represents a new evolution in technological development that combines both virtual reality (VR) and augmented reality (AR) to create a blend of the physical and digital worlds. However, the potential role of MR in preoperative diagnostics in oral and maxillofacial surgery has not been scientifically investigated and remains generally unclear. This article presents a workflow that integrated MR in its scheme. It also evaluates the potential benefit of MR compared with its predecessors, VR and AR. MATERIAL AND METHODS MR technology was used to plan the surgical treatment of a clinical case with an extensive tumor of the left maxilla. A workflow proposal incorporating both the surgeon and radiation oncologist is presented based on this experience. A total of 10 examiners rated the usability and applicability of MR for daily routines. RESULTS MR showed good results during preoperative planning for a surgically extensive case in terms of displaying 3D structures and enhancing the physical and virtual interactions among the examiners. Previously described drawbacks of other VR/AR applications such as nausea and motion sickness were not observed with MR. However, MR seems to lack intraoperative usability, which is a drawback. CONCLUSION MR shows great potential in improving the preoperative assessment of 3D DICOM datasets and thus facilitating diagnostic measures. However, further improvements should be made to implement an MR workflow and incorporate it into the clinical treatment planning tree.
Collapse
|
35
|
Krause M, Kamal M, Kruber D, Halama D, Hierl T, Lethaus B, Bartella AK. Improved access in minimally invasive temporomandibular joint surgery through a novel endaural template. BMC Surg 2021; 21:93. [PMID: 33607985 PMCID: PMC7893953 DOI: 10.1186/s12893-021-01098-2] [Citation(s) in RCA: 3] [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: 09/28/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background Digitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety of these procedures. Given the TMJ anatomy, the template fitting and intraoperative overview are the most important issues for a safe surgery. This article is a technical advance article that aims to describe an endaural surgical template based on the Moses approach as a possible solution in TMJ surgery. Methods Three patients with internal derangement were treated with the guidance of a MITMJS template based on cone beam computed tomography (CBCT) and a surface imprint of the periauricular region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient. Results The template design and clinical use were satisfactory for MITMJS. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively. Conclusion Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points to improved access in arthroscopy or arthrocentesis of TMJ surgery through endaural access with an increased level of safety during surgery.
Collapse
Affiliation(s)
- Matthias Krause
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Daniel Kruber
- Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl-Liebknecht Str. 145, 04277, Leipzig, Germany
| | - Dirk Halama
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Thomas Hierl
- Department of Oral and Maxillofacial Surgery, Helios Voigtland-Klinikum Plauen, Röntgenstraße 2, 08529, Plauen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| |
Collapse
|
36
|
Lethaus B, Grau E, Kloss-Brandstätter A, Brauer L, Zimmerer R, Bartella AK, Hahnel S, Sander AK. Clinical Follow-Up in Orofacial Clefts-Why Multidisciplinary Care Is the Key. J Clin Med 2021; 10:jcm10040842. [PMID: 33670715 PMCID: PMC7922119 DOI: 10.3390/jcm10040842] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Although most clinicians involved in the treatment of cleft patients agree upon the major importance of interdisciplinary cooperation and many protocols and concepts have been discussed in the literature, there is little evidence of the relevance of continuous interdisciplinary care. We aimed to objectify the type and number of therapeutic decisions resulting from an annual multidisciplinary follow-up. (2) Methods: We retrospectively analyzed the data of all 1126 patients followed up in the weekly consultation hours for cleft patients at university clinics in Leipzig for the years 2005-2020. We assessed the clinical data of every patient and specifically evaluated the treatment decisions taken at different points in time by the participating experts of different specialties. (3) Results: In total, 3470 consultations were included in the evaluation, and in 70% of those, a therapeutic recommendation was given. Each specialty showed certain time frames with intense treatment demand, which partially overlapped. Nearly all therapy recommendations were statistically attached to a certain age (p < 0.001). (4) Conclusions: There is an exceptionally high need for the interdisciplinary assessment of patients with cleft formation. Some developmental phases are of particular importance with regard to regular follow-up and initiation of different treatment protocols. The therapy and checkup of cleft patients should be concentrated in specialized centers.
Collapse
Affiliation(s)
- Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
- Correspondence: ; Tel.: +49-341-9721100
| | - Elisabeth Grau
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
| | - Anita Kloss-Brandstätter
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
| | - Luise Brauer
- Department of Orthodontics, Leipzig University Medical Center, 04103 Leipzig, Germany;
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
| | - Alexander K. Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University Medical Center, 04103 Leipzig, Germany;
| | - Anna K. Sander
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, 04103 Leipzig, Germany; (E.G.); (A.K.-B.); (R.Z.); (A.K.B.); (A.K.S.)
| |
Collapse
|
37
|
Schneider M, Ziemer M, Lethaus B, Simon JC, Savkovic V. Generation of pigmented skin grafts from human hair follicles and dermal fibroblasts. Tissue Eng Part A 2021; 27:1333-1342. [PMID: 33573455 DOI: 10.1089/ten.tea.2020.0284] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Skin equivalents are able to mimic key features of human skin and they can be used for a very broad range of applications, such as fundamental studies of skin biology, disease and toxicological models, as well as an alternative for animal testing. The high end of their use is in therapy of wound healing and repigmentation, disorders that massively affect individual health as well as quality of life and pose considerable burden to healthcare systems worldwide. Tissue-engineered skin grafts often originate from invasively obtained cell material (i.e. biopsy). Hereby, an unmet need for non-invasively gained autologous biological starting material has been created. The hair follicle, entirely non-invasively available by plucking, harbors a heterogeneous cell pool including stem cells with an immense differentiation capacity, hereby representing an attractive source of cells, especially for purposes of regenerative medicine. In this study, we engineered three-dimensional pigmented epidermal and dermoepidermal grafts using human keratinocytes and melanocytes from the outer root sheath of hair follicles combined with dermal fibroblasts. The grafts were generally anatomically correct and functional regarding stratification, formation of epidermal melanin units as well as extracellular matrix deposition, exhibiting moderate differences to the skin anatomy and function, typical for the in vitro culture.
Collapse
Affiliation(s)
- Marie Schneider
- Leipzig University, Saxon Incubator for Clinical Translation; Phillip-Rosenthal-Str. 55, Leipzig, Sachsen, Germany.,Leipzig University, Dept.of Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, Liebigstr. 22 , 04103 Leipzig, Saxony, Germany;
| | - Mirjana Ziemer
- Leipzig University, Dept. of Dermatology, Venerology and Allergology, University Hospital Leipzig, Phillip-Rosenthal-Str. 23, Haus 10, Leipzig, Sachsen, Germany;
| | - Bernd Lethaus
- Leipzig University, Dept. of Cranio-Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, Leipzig, Sachsen, Germany;
| | - Jan Christoph Simon
- Leipzig University, 9180, Dept. of Dermatology, Venerology and Allergology, University Hospital Leipzig, Phillip-Rosenthal-Str. 23, Haus 10, Leipzig, Sachsen, Germany;
| | - Vuk Savkovic
- Leipzig University, Dept. of Cranio-Maxillofacial Surgery, Leipzig University Hospital, Liebigstr. 12, Leipzig, Sachsen, Germany;
| |
Collapse
|
38
|
Gaus S, Li H, Li S, Wang Q, Kottek T, Hahnel S, Liu X, Deng Y, Ziebolz D, Haak R, Schmalz G, Liu L, Savkovic V, Lethaus B. Shared Genetic and Epigenetic Mechanisms between the Osteogenic Differentiation of Dental Pulp Stem Cells and Bone Marrow Stem Cells. Biomed Res Int 2021; 2021:6697810. [PMID: 33628811 PMCID: PMC7884974 DOI: 10.1155/2021/6697810] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/04/2021] [Accepted: 01/20/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To identify the shared genetic and epigenetic mechanisms between the osteogenic differentiation of dental pulp stem cells (DPSC) and bone marrow stem cells (BMSC). MATERIALS AND METHODS The profiling datasets of miRNA expression in the osteogenic differentiation of mesenchymal stem cells from the dental pulp (DPSC) and bone marrow (BMSC) were searched in the Gene Expression Omnibus (GEO) database. The differential expression analysis was performed to identify differentially expressed miRNAs (DEmiRNAs) dysregulated in DPSC and BMSC osteodifferentiation. The target genes of the DEmiRNAs that were dysregulated in DPSC and BMSC osteodifferentiation were identified, followed by the identification of the signaling pathways and biological processes (BPs) of these target genes. Accordingly, the DEmiRNA-transcription factor (TFs) network and the DEmiRNAs-small molecular drug network involved in the DPSC and BMSC osteodifferentiation were constructed. RESULTS 16 dysregulated DEmiRNAs were found to be overlapped in the DPSC and BMSC osteodifferentiation, including 8 DEmiRNAs with a common expression pattern (8 upregulated DEmiRNAs (miR-101-3p, miR-143-3p, miR-145-3p/5p, miR-19a-3p, miR-34c-5p, miR-3607-3p, miR-378e, miR-671-3p, and miR-671-5p) and 1 downregulated DEmiRNA (miR-671-3p/5p)), as well as 8 DEmiRNAs with a different expression pattern (i.e., miR-1273g-3p, miR-146a-5p, miR-146b-5p, miR-337-3p, miR-382-3p, miR-4508, miR-4516, and miR-6087). Several signaling pathways (TNF, mTOR, Hippo, neutrophin, and pathways regulating pluripotency of stem cells), transcription factors (RUNX1, FOXA1, HIF1A, and MYC), and small molecule drugs (curcumin, docosahexaenoic acid (DHA), vitamin D3, arsenic trioxide, 5-fluorouracil (5-FU), and naringin) were identified as common regulators of both the DPSC and BMSC osteodifferentiation. CONCLUSION Common genetic and epigenetic mechanisms are involved in the osteodifferentiation of DPSCs and BMSCs.
Collapse
Affiliation(s)
- Sebastian Gaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Hanluo Li
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Simin Li
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Qian Wang
- Department of Central Laboratory, Taian Central Hospital, Longtan Road No. 29, Taian, 271000 Shandong Province, China
| | - Tina Kottek
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Sebastian Hahnel
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Xiangqiong Liu
- Department of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, 218 Anwaixiaoguanbeili Street, Chaoyang, Beijing 100029, China
| | - Yupei Deng
- Department of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, 218 Anwaixiaoguanbeili Street, Chaoyang, Beijing 100029, China
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Lei Liu
- Department of Neurology, Shandong Provincial Third Hospital, Cheeloo Chollege of Medicine, Shandong University, Jinan, 100191 Shandong Province, China
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| |
Collapse
|
39
|
Li H, Masieri FF, Schneider M, Bartella A, Gaus S, Hahnel S, Zimmerer R, Sack U, Maksimovic-Ivanic D, Mijatovic S, Simon JC, Lethaus B, Savkovic V. The Middle Part of the Plucked Hair Follicle Outer Root Sheath Is Identified as an Area Rich in Lineage-Specific Stem Cell Markers. Biomolecules 2021; 11:biom11020154. [PMID: 33503918 PMCID: PMC7912066 DOI: 10.3390/biom11020154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
Hair follicle outer root sheath (ORS) is a putative source of stem cells with therapeutic capacity. ORS contains several multipotent stem cell populations, primarily in the distal compartment of the bulge region. However, the bulge is routinely obtained using invasive isolation methods, which require human scalp tissue ex vivo. Non-invasive sampling has been standardized by means of the plucking procedure, enabling to reproducibly obtain the mid-ORS part. The mid-ORS shows potential for giving rise to multiple stem cell populations in vitro. To demonstrate the phenotypic features of distal, middle, and proximal ORS parts, gene and protein expression profiles were studied in physically separated portions. The mid-part of the ORS showed a comparable or higher NGFR, nestin/NES, CD34, CD73, CD44, CD133, CK5, PAX3, MITF, and PMEL expression on both protein and gene levels, when compared to the distal ORS part. Distinct subpopulations of cells exhibiting small and round morphology were characterized with flow cytometry as simultaneously expressing CD73/CD271, CD49f/CD105, nestin, and not CK10. Potentially, these distinct subpopulations can give rise to cultured neuroectodermal and mesenchymal stem cell populations in vitro. In conclusion, the mid part of the ORS holds the potential for yielding multiple stem cells, in particular mesenchymal stem cells.
Collapse
Affiliation(s)
- Hanluo Li
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
| | | | - Marie Schneider
- Clinic for Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Alexander Bartella
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
| | - Sebastian Gaus
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
| | - Sebastian Hahnel
- Polyclinic for Dental Prosthetics and Material Sciences, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Rüdiger Zimmerer
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
| | - Ulrich Sack
- Medical Faculty, Institute for Clinical Immunology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Danijela Maksimovic-Ivanic
- Department of Immunology, Institute for Biological Research ‘Sinisa Stankovic’ (IBISS)-National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (D.M.-I.); (S.M.)
| | - Sanja Mijatovic
- Department of Immunology, Institute for Biological Research ‘Sinisa Stankovic’ (IBISS)-National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (D.M.-I.); (S.M.)
| | - Jan-Christoph Simon
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Bernd Lethaus
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
| | - Vuk Savkovic
- Department of Cranial Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; (H.L.); (A.B.); (S.G.); (R.Z.); (B.L.)
- Correspondence: ; Tel.: +49-341-9721115
| |
Collapse
|
40
|
Imoto K, Yamauchi K, Odashima K, Nogami S, Shimizu Y, Kessler P, Lethaus B, Unuma H, Takahashi T. Periosteal expansion osteogenesis using an innovative, shape-memory polyethylene terephthalate membrane: An experimental study in rabbits. J Biomed Mater Res B Appl Biomater 2021; 109:1327-1333. [PMID: 33417286 DOI: 10.1002/jbm.b.34793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/05/2020] [Accepted: 12/27/2020] [Indexed: 11/08/2022]
Abstract
Periosteal expansion osteogenesis (PEO) results in the formation of new bone in the gap between periosteum and original bone. The purpose of this study is to evaluate the use of a polyethylene terephthalate (PET) membrane as an activation device. A dome-shaped PET membrane coated with hydroxyapatite/gelatin on the inner side was inserted between the elevated periosteum and bone at the rabbit calvaria. In the experimental group, the membrane was pushed, bent, and attached to the bone surface and fixed with a titanium screw. In control group, the membrane was only inserted and fixed with titanium screw at original shape under the periosteum. After 7 days, the screw was removed and the mesh was activated in the experimental group. Three animals per group with or without setting a latency period for activation were sacrificed at 3 and 5 weeks after surgery. Bone formation was evaluated via micro-computed tomography and determined by histomorphometric methods and histological evaluation. No PET membrane-associated complications were observed during this study. The quantitative data by the area and the occupation of newly formed bone indicated that the experimental group had a higher volume of new bone than the control group at 3 weeks after surgery. Histologically, bone formation progressed to areas adjacent to the cortical perforations; many sinusoidal vessels ran from the perforations to overlying fibrous tissue via the new bone. No bone or obvious inflammatory cells were observed over the membrane. The PET membrane has biocompatible device for PEO that induces a natural osteogenic response at the gap between the original bone and periosteum.
Collapse
Affiliation(s)
- Kazuhiro Imoto
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Odashima
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shinnosuke Nogami
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bernd Lethaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Hidero Unuma
- Graduate School of Science and Engineering, Yamagata University, Yonezawa, Japan
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
41
|
Bartella AK, Kamal M, Gerwing D, Halama D, Kloss-Brandstätter A, Pausch N, Hölzle F, Lethaus B. Quality of life in patients with oral hard or soft tissue defects after reconstructive microsurgery. Br J Oral Maxillofac Surg 2020; 59:70-75. [PMID: 33229060 DOI: 10.1016/j.bjoms.2020.08.096] [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: 04/06/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
With current advances in medicine, many surgical methods have emerged for the reconstruction of soft and hard tissue defects of the head and neck. Current literature provides only a limited amount of evidence in studies addressing differences in quality of life for specific therapeutic measures in microvascular reconstruction. The validated University of Washington quality of life questionnaire version 4 (UW-QoL v4), a distress thermometer, and two questions addressing donor-site morbidity were sent to 134 patients at a tertiary care centre. All participants had undergone a type of microvascular reconstructive surgery of the head and neck. They were distributed into three groups according to the defect and type of treatment: defects reconstructed by soft-tissue microvascular tissue transfer, defects involving the hard tissue and treated by alloplastic reconstruction, and hard tissue defects receiving microvascular osseous reconstruction. A total of 82 patients completed the questionnaire in full and returned it. Patients from all the groups showed improved distress thermometer values postoperatively. Those who underwent osseous microvascular reconstruction had better functional items than those who had alloplastic reconstruction plates. Donor-site morbidity was rated low in all groups. Microvascular osseous reconstructive surgery might help to improve functional outcomes in patients with osseous defects more than alloplastic reconstruction.
Collapse
Affiliation(s)
- Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany.
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Deborah Gerwing
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Dirk Halama
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | | | - Niels Pausch
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany
| |
Collapse
|
42
|
Kreutzmann T, Schönfeld A, Zange S, Lethaus B. A Case Report of Oculoglandular Tularemia-Chasing Zebras Among Potential Diagnoses. J Oral Maxillofac Surg 2020; 79:629-636. [PMID: 32949503 DOI: 10.1016/j.joms.2020.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
A 60-year-old man was admitted to a university hospital complaining of progressive orbital cellulitis and lymph-node swelling. Empiric treatment with sulbactam/ampicillin failed. The patient's cervical lymph nodes were removed and histologically examined. Based on the pathological results, acute tuberculosis was suspected but could not be confirmed by further analyses. During an extended screening of agents relevant for differential diagnosis, tularemia was diagnosed serologically and by means of a polymerase chain reaction test, which identified the bacterial subspecies Francisella tularensis holarctica. Treatment with ciprofloxacin was administered and later changed to doxycycline due to side effects. The patient made a full recovery without any sequelae. Clinical diagnosis of tularemia is often delayed due to its nonspecific symptoms, which can be caused by several infectious and noninfectious diseases. We try to give an overview of potential differential diagnoses and corresponding diagnostic techniques that can shorten the path to suitable treatment.
Collapse
Affiliation(s)
- Tobias Kreutzmann
- Resident, Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Leipzig University Hospital, Leipzig, Germany.
| | - Annika Schönfeld
- Resident, Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Sabine Zange
- Specialist, Bundeswehr Institute of Microbiology, Munich, Germany
| | - Bernd Lethaus
- Head of Department, Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Leipzig University Hospital, Leipzig, Germany
| |
Collapse
|
43
|
Li H, Masieri FF, Schneider M, Kottek T, Hahnel S, Yamauchi K, Obradović D, Seon JK, Yun SJ, Ferrer RA, Franz S, Simon JC, Lethaus B, Savković V. Autologous, Non-Invasively Available Mesenchymal Stem Cells from the Outer Root Sheath of Hair Follicle Are Obtainable by Migration from Plucked Hair Follicles and Expandable in Scalable Amounts. Cells 2020; 9:E2069. [PMID: 32927740 PMCID: PMC7564264 DOI: 10.3390/cells9092069] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Regenerative therapies based on autologous mesenchymal stem cells (MSC) as well as stem cells in general are still facing an unmet need for non-invasive sampling, availability, and scalability. The only known adult source of autologous MSCs permanently available with no pain, discomfort, or infection risk is the outer root sheath of the hair follicle (ORS). METHODS This study presents a non-invasively-based method for isolating and expanding MSCs from the ORS (MSCORS) by means of cell migration and expansion in air-liquid culture. RESULTS The method yielded 5 million cells of pure MSCORS cultured in 35 days, thereby superseding prior art methods of culturing MSCs from hair follicles. MSCORS features corresponded to the International Society for Cell Therapy characterization panel for MSCs: adherence to plastic, proliferation, colony forming, expression of MSC-markers, and adipo-, osteo-, and chondro-differentiation capacity. Additionally, MSCORS displayed facilitated random-oriented migration and high proliferation, pronounced marker expression, extended endothelial and smooth muscle differentiation capacity, as well as a paracrine immunomodulatory effect on monocytes. MSCORS matched or even exceeded control adipose-derived MSCs in most of the assessed qualities. CONCLUSIONS MSCORS qualify for a variety of autologous regenerative treatments of chronic disorders and prophylactic cryopreservation for purposes of acute treatments in personalized medicine.
Collapse
Affiliation(s)
- Hanluo Li
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Federica Francesca Masieri
- School of (EAST) Engineering, Arts, Science & Technology, University of Suffolk, Ipswich, Suffolk IP41QJ, UK;
| | - Marie Schneider
- Clinic for Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Tina Kottek
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Sebastian Hahnel
- Polyclinic for Dental Prosthetics and Material Sciences, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Kensuke Yamauchi
- Kensuke Yamauchi, Department of Oral & Maxillofacial Surgery, Tohoku University, Sendai 980-8577, Japan;
| | | | - Jong-Keun Seon
- Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Korea; (J.-K.S.); (S.J.Y.)
| | - Sook Jung Yun
- Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Korea; (J.-K.S.); (S.J.Y.)
| | - Rubén A. Ferrer
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Sandra Franz
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Jan-Christoph Simon
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Bernd Lethaus
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Vuk Savković
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| |
Collapse
|
44
|
Schmidt MB, Rauch A, Schwarzer M, Lethaus B, Hahnel S. Combination of Digital and Conventional Workflows in the CAD/CAM-Fabrication of an Implant-Supported Overdenture. Materials (Basel) 2020; 13:ma13173688. [PMID: 32825488 PMCID: PMC7503874 DOI: 10.3390/ma13173688] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication of implant-supported overdentures. The 53-year old patient was supplied with a digitally processed complete denture in the upper jaw and, simultaneously, with an overdenture supported by four interforaminal implants in the lower jaw. The overdenture included a completely digitally processed and manufactured alloy framework that had been fabricated by selective laser sintering. The case report indicates that digital manufacturing processes for extensive and complex removable restorations are possible. However, as it is currently not yet possible to digitally obtain functional impressions, future developments and innovations might focus on that issue.
Collapse
Affiliation(s)
- Michael Benno Schmidt
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
- Correspondence:
| | - Angelika Rauch
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| | - Marcus Schwarzer
- Flemming Dental Tec GmbH, Dental Technology Center, 04317 Leipzig, Germany;
| | - Bernd Lethaus
- Clinic for Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany;
| | - Sebastian Hahnel
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| |
Collapse
|
45
|
Pausch NC, Pankow T, Lethaus B, Bartella AKH, Halama D. The ideal auricular protrusion - An interactive perceptual pilot study. J Craniomaxillofac Surg 2020; 48:853-858. [PMID: 32709502 DOI: 10.1016/j.jcms.2020.06.002] [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: 03/06/2020] [Revised: 05/18/2020] [Accepted: 06/06/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Excessive ear protrusion (prominauris) can negatively affect facial appearance. Because the concept of an ideal auriculocephalic angle is controversial, however, it is difficult to define when an obtrusive auricle requires surgical intervention. It is often assumed that angles exceeding 30° require corrective surgery. However, little is known about public perception of ear protrusion. This study aimed to assess perceptions of different degrees of auricular protrusion. MATERIALS AND METHODS We conducted an interactive panel survey. Male and female evaluators assessed digitally processed cloned images of a male and female model that depicted various ear protrusions ranging from 0° to 90°. Predictor variables were the sex of the evaluator, the sex of the clone and the extent of auricular protrusion. The outcome variable was the overall attractiveness of auricular appearance. RESULTS Forty-four evaluators (students of dental medicine, mean age 25.43 years) participated in the study: 22 women and 22 men. The study results revealed sexual dimorphism, with the attractiveness of corresponding male and female clones rated differently. Male evaluators favoured female ear positions that fitted closer to the head; preferred alignments for female clones were: 18° (Mean) ± 9.38° (SD), p = 0.006; for male clones: 30° ± 7.94°, p = 0.003. Ear protrusion starts to negatively affect aesthetic appearance for male evaluators at positions of 42° ± 4.87° (female clone) and 54° ± 8.22° (male clone), p = 0.001. The panel of evaluators agreed to perceive angles of 21-24° ± 8.10° (female clones), ± 8.33° (male clones), as the ideal degree of protrusion in both sexes (p = 0.158). CONCLUSION In this study, perception of ear appearance depended on the sex of both the evaluator and the clone being assessed. Obtrusive ears were more readily accepted in male faces than in female ones. Nevertheless, the overall panel perception shows a preference for rather close fitting, unobtrusive ear alignments. For planning of corrective ear surgery, a target angle of approximately 22° can be considered as a desirable result.
Collapse
Affiliation(s)
- Niels Christian Pausch
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Bernd Lethaus), Faculty of Medicine, University Hospital of Leipzig, Germany.
| | - Tabea Pankow
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Bernd Lethaus), Faculty of Medicine, University Hospital of Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Bernd Lethaus), Faculty of Medicine, University Hospital of Leipzig, Germany
| | - Alexander Karl-Heinz Bartella
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Bernd Lethaus), Faculty of Medicine, University Hospital of Leipzig, Germany
| | - Dirk Halama
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Bernd Lethaus), Faculty of Medicine, University Hospital of Leipzig, Germany
| |
Collapse
|
46
|
Schiffers G, Arnold J, Bartella A, Mähönen P, Lethaus B. Avoiding the Alveolar Nerve Via a Real-Time Impedance Analysis: A Novel Method to Improve Implant Surgery Safety. J Med Device 2020. [DOI: 10.1115/1.4046212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Safe lower jaw implantations require precautions to avoid damaging the alveolar nerve. The prevailing methods are preoperative. In this study, we propose a novel approach to measure the distance between a pilot-drill and the alveolar nerve by employing high-frequency impedance measurements. The objective is to provide in vivo real-time information as an early warning of the proximity of the alveolar nerve. The method is examined and tested on animal samples. The impedance measurements were performed using a high-frequency network analyzer. Overall 40 pilot drillings were distributed over five sheep mandibles, with four on each side. Drillings were performed in three steps: inside the cortical layer, inside the spongiosa, and well inside the nerve canal. The inductance measurements were performed with a connected pilot drill, followed by an immediate 3D cone-beam computed tomography (CT) to measure the distance between the tip of the drill and the nerve canal. The measurements show that impedance information is a reliable indicator for proximity of the drill to the nerve. We observe a general trend of decreasing inductance as the drill approaches the nerve and find that at very high frequencies one can detect the closeness to the nerve from characteristic ratios of impedance at nearby frequencies. We report also that using phase information increases the reliability of this method. The findings provide a solid proof of concept for the proposed method. While the results are promising at this stage, the applicability for in vivo conditions requires further studies.
Collapse
Affiliation(s)
- Georg Schiffers
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstrasse 3, Aachen, Nordrhein-Westfalen DE 52074, Germany
| | - Julian Arnold
- Institute for Networked Systems, RWTH Aachen University, Aachen, Nordrhein-Westfalen 52072, Germany
| | - Alexander Bartella
- Department for Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Leipzig, Leipzig, Sachsen 04103, Germany
| | - Petri Mähönen
- Faculty of Electrical Engineering and Information Technology, Institute for Networked Systems, RWTH Aachen University, Aachen, Nordrhein-Westfalen 52072, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstrasse 3, Aachen, Nordrhein-Westfalen DE 52074, Germany; Department for Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Leipzig, Liebigstraße 12, Haus 1, Leipzig, Sachsen 04103, Germany
| |
Collapse
|
47
|
Bartella AK, Luderich C, Kamal M, Braunschweig T, Steegmann J, Modabber A, Kloss-Brandstätter A, Hölzle F, Lethaus B. Ankle Brachial Index Predicts for Difficulties in Performing Microvascular Anastomosis. J Oral Maxillofac Surg 2020; 78:1020-1026. [PMID: 32087118 DOI: 10.1016/j.joms.2020.01.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE In reconstructive microsurgery, severe arteriosclerosis is a known predictor for free flap failure because of problems with the vascular anastomosis. We investigated whether the ankle brachial index (ABI) could be a suitable preoperative measurement for the prediction of compromise regarding vascular anastomosis in patients undergoing microsurgical reconstruction. MATERIAL AND METHODS We conducted a prospective cohort study of patients who had undergone reconstructive microvascular surgery in a tertiary care center from 2015 to 2017. The ABI was preoperatively assessed by dividing the systolic blood pressure measured at the ankle by the brachial systolic blood pressure. Results from 0.9 to 1.3 are within the physiologic range. Values less than 0.9 indicate moderate to severe arteriosclerosis, and those greater than 1.3 indicate the major form of arteriosclerosis with complete calcification of the tunica media. The ABI value correlated with the ease of the anastomosis (rated from 1 [very straightforward] through 5 [very difficult]), gross examination findings (intraluminal plaque [yes vs no]), and the necessity of plaque removal before anastomosis (yes vs no). In addition, cross-sectional specimens were obtained from the arteries and veins of the donor and recipient sites intraoperatively. The specimens were rated histologically for the arteries and veins using an ordinal scale. Histologic evaluation was performed to confirm and objectify the results from the ABI. Statistical analysis was performed using SPSS software, version 24.0 (IBM Corp, Armonk, NY) and t tests, analysis of variance, and χ2 tests. RESULTS The sample included 41 patients with a mean age of 56.7 years; 59% were men. The mean ABI was 1.06. The mean ease of anastomosis was 1.8. The mean ABI was associated with the ease of anastomosis. A pathologic ABI was significantly related to problems with the arterial anastomosis (P = .004) and increased arteriosclerosis in the arteries from the donor (P = .047) and recipient (P = .036) sites. CONCLUSIONS A pathologic ABI was associated with increased difficulty with the microvascular anastomosis.
Collapse
Affiliation(s)
- Alexander K Bartella
- Resident, Department of Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany; and Resident, Department of Maxillofacial Surgery, Leipzig University, Leipzig, Germany.
| | - Carolin Luderich
- Resident, Department of Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany
| | - Mohammad Kamal
- Assistant Professor, Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Till Braunschweig
- Consultant, Department of Pathology, RWTH Aachen University, Aachen, Germany
| | - Julius Steegmann
- Resident, Department of Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany
| | - Ali Modabber
- Consultant, Department of Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany
| | - Anita Kloss-Brandstätter
- Assistant Professor, Department of Engineering & IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Frank Hölzle
- Head, Department of Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany
| | - Bernd Lethaus
- Head, Department of Maxillofacial Surgery, Leipzig University, Leipzig, Germany
| |
Collapse
|
48
|
Steegmann J, Bartella AK, Kloss-Brandstätter A, Kamal M, Hölzle F, Lethaus B. A randomized clinical trial on the efficacy of a patient-adapted autonomous exercise regime for patients with head and neck cancer. J Craniomaxillofac Surg 2019; 48:187-192. [PMID: 32113882 DOI: 10.1016/j.jcms.2019.12.009] [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: 05/12/2019] [Revised: 11/29/2019] [Accepted: 12/05/2019] [Indexed: 01/01/2023] Open
Abstract
Patients undergoing surgical therapy of head and neck malignancies are known to exhibit a high number of comorbidities and frequently present a high nosocomial morbidity. Physiotherapy (PT) improves the clinical course of patients after extensive surgery. The aim of this study was to establish and then compare an additional individualized autonomous exercise plan with standard physiotherapy. 69 consecutive patients undergoing surgical treatment of head and neck cancer were randomized into two groups. The control group received standard clinical physiotherapy, the intervention group an additional autonomous exercise plan, adapted to the patient's performance profile. The patients randomized to the intervention group showed significantly fewer signs of fatigue (5.5 ± 3.5 vs. 3.7 ± 2.7, p = 0.048) and fewer digestive problems (4.7 ± 3.3 vs. 2.3 ± 2.7; p = 0.009) compared with the patients of the control group. In addition, a significantly shorter hospital stay was observed (17.7 ± 6.3 vs. 13.4 ± 3.4 days, p = 0.005), which was positively influenced by the early start of the exercises (r = 0.623, p = 0.001) and frequent practice (r = 0.432, p = 0.031). Patients with head and neck cancer therapy can benefit from an autonomous, individualized exercise plan. In coordination with the physiotherapists, mobilization should be as early and intensive as possible.
Collapse
Affiliation(s)
- Julius Steegmann
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstr 12, 04103 Leipzig, Germany
| | - Anita Kloss-Brandstätter
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, P. O. Box 24923, Safat 13110, Kuwait
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstr 12, 04103 Leipzig, Germany.
| |
Collapse
|
49
|
Halama D, Dreilich R, Lethaus B, Bartella A, Pausch NC. Donor-site morbidity after harvesting of radial forearm free flaps—comparison of vacuum-assisted closure with conventional wound care: A randomized controlled trial. J Craniomaxillofac Surg 2019; 47:1980-1985. [DOI: 10.1016/j.jcms.2019.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/01/2019] [Accepted: 11/16/2019] [Indexed: 12/18/2022] Open
|
50
|
Bartella A, Kamal M, Steegmann J, Hölzle F, Lethaus B. “FlapApp” – contemporary microvascular free flap surveillance. Br J Oral Maxillofac Surg 2019; 57:1158-1160. [DOI: 10.1016/j.bjoms.2019.08.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/29/2019] [Indexed: 11/15/2022]
|