Salivary apoptotic cells in oral (pre-) cancer as a potential diagnostic means

Background: Apoptosis is a genetically programmed form of cell death which is indispensable for development and homeostasis of multi-cellular organism. Objectives: The aim of this study was to find out the salivary apoptotic cells in oral precancerous and cancerous patients and furthermore to observe the potential diagnostic value of salivary apoptotic cells in detection of oral pre-cancer and cancer. Materials and Methods: Unsimulated saliva was collected from a group of 103 subjects diagnosed with oral (pre-) cancer and a control group of 30 healthy age- and gender-matched individuals. The test group diagnosed with (pre-) cancer was further subdivided in 4 lesion groups oral squamous cell carcinoma (OSCC), oral lichen planus lesions (n=26), oral leukoplakia (n=25), oral sub-mucous fibrosis (n=24) Apoptotic cells were morphologically studied using fluorescence microscopy (TUNEL technique). Results: While the morphology of apoptotic cells in oral pre-cancer and cancer are morphological similar to the typical epithelial cells of oral cavity mucosa, the number of apoptotic cells was significantly less in OSCC as compared to precancerous and normal healthy tissues. Conclusions: It could therefore be concluded that salivary apoptotic epithelial cells might be used in early detection and diagnosis of oral pre-cancer and cance

Avulsie van bovenfrontelementen in het definitieve gebit, schade na reïmplantatie: een paradigmashift.

volledige tekst beschikbaar in pdf uploa

Use of long implants with distal anchorage in the skull base for treatment of extreme maxillary atrophy : the remote bone anchorage concept

The objectives of this study are to present a new concept of the bone anchorage using long implants in remote bone sites and to discuss four cases treated with this method. Our patients were treated with long implants with a distant anchorage in the skull bone. The planning procedure, the construction of the drill guide, and the surgical protocol are described. In the clinical cases described, all four patients were rehabilitated with the remote bone anchorage concept using long implants anchored in the skull base. Patients were followed for 5 - 12 years and the implants remained present and stable in these time periods. The skull base implant is a new concept of bone anchorage using long implants. It can be a solution for complicated clinical situations (often failed bone reconstructions and implant placements) or an alternative for bone grafting and maxillary augmentation procedures. There is effective implant retention in the skull base, an anatomical area that is often overlooked for implant placement

Coronectomy of deeply impacted lower third molar : incidence of outcomes and complications after one year follow-up

Objectives: The purpose of present study was to assess the surgical management of impacted third molar with proximity to the inferior alveolar nerve and complications associated with coronectomy in a series of patients undergoing third molar surgery. Material and Methods: The position of the mandibular canal in relation to the mandibular third molar region and mandibular foramen in the front part of the mandible (i.e., third molar in close proximity to the inferior alveolar nerve [IAN] or not) was identified on panoramic radiographs of patients scheduled for third molar extraction. Results: Close proximity to the IAN was observed in 64 patients (35 females, 29 males) with an impacted mandibular third molar. Coronectomy was performed in these patients. The most common complication was tooth migration away from the mandibular canal (n = 14), followed by root exposure (n = 5). Re-operation to remove the root was performed in cases with periapical infection and root exposure. Conclusions: The results indicate that coronectomy can be considered a reasonable and safe treatment alternative for patients who demonstrate elevated risk for injury to the inferior alveolar nerve with removal of the third molars. Coronectomy did not increase the incidence of damage to the inferior alveolar nerve and would be safer than complete extraction in situations in which the root of the mandibular third molar overlaps or is in close proximity to the mandibular canal

Clinical and pathological differences between the pyogenic granuloma and lobular capillary hemangioma in the oral cavity : a scoping review

Since initially described, the terms “pyogenic granuloma” (PG) and “lobular capillary hemangioma” (LCH) have undergone a significant change in meaning, which leads to a confusion in the literature. In this study, we attempted to investigate if there are any clinical and pathological differences between the pyogenic granuloma and lobular capillary hemangioma through a scoping review of the available literature. A Medline search has identified 342 articles from 2001 to 2018, from which English papers, case series, retrospective studies, and cross-sectional studies were selected. Data from the articles was charted using appropriate subheadings for the clinical question (e.g., number of patients, clinical features, histology, pathogenesis, differential diagnosis, treatment). Compared to LCH, PG seems to occur more in the middle-aged range, has a clearer predilection for (pregnant) females, and has more frequently a known triggering factor in the history. Histologically, PGs appear as radially organized capillaries (while LCHs have a lobular pattern), have a mixed inflammatory infiltrate (compared to the occasional lymphocytic infiltrate in LCHs), and can undergo fibrosing transformation when chronic, which is not seen in LCHs. Finally, besides basic excision, several other treatment options have been described for both lesions. Since the pyogenic granuloma and lobular capillary hemangioma show clinical and pathological differences, we propose them to be considered as distinct lesions, which makes interpreting the literature much easier.https://www.termedia.pl/Journal/Journal_of_Stomatology-137am2021Oral Pathology and Oral Biolog

Proliferation of epithelial rests of Malassez following auto-transplantation of third molars: a case report

<p>Abstract</p> <p>Introduction</p> <p>Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. However, little is known about the precise role of the periodontal membrane during this procedure. Therefore, we investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuro-epithelial relationship.</p> <p>Case presentation</p> <p>We report a case of a 21-year-old Caucasian woman who underwent an auto-transplantation of two third molars. After two years, renewed progressive caries of the auto-transplanted teeth led to the removal of the auto-transplanted elements. The periodontal ligament was removed and studied with a light and transmission electron microscope.</p> <p>Conclusion</p> <p>In this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention. We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following auto-transplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth. In order to minimalise the damage to the epithelial rests of Malassez, the extraction of the tooth should be as atraumatic as possible in order to provide an optimal conservation of the periodontal ligament which will be beneficial to the healing-process.</p

Signs and symptoms, quality of life and psychosocial data in 1331 post-traumatic trigeminal neuropathy patients seen in two tertiary referral centres in two countries

BACKGROUND: Post-traumatic trigeminal neuropathy (PTN) is a disturbance of function or pathological change of the trigeminal nerve branches following trauma and has an important impact on patient's quality of life (QoL).OBJECTIVES: To provide diagnostic data on PTN and illustrate differences in aetiology, injured nerve, pain distribution, sensory profile and QoL between PTN subgroups.METHODS: 1331 patients with painful or non-painful PTN were retrospectively reviewed in two centres, extracting demographic data, time and cause of trauma, clinical findings including signs and symptoms, basic neurosensory testing, imaging modalities, treatments, and QoL or psychosocial assessment.RESULTS: More females were represented (70%) than males. The inferior alveolar nerve was most frequently damaged (60%) followed by the lingual nerve (28%). Wisdom teeth removal was considered the main cause (48%). Pain was reported in 63% of patients and pain frequency increased with age without clinically significant gender differences. Numbness was reported in 50% of PTN patients. Neurosensory testing showed larger affected dermatome involvement in persistent injuries, with no differences between the non-painful and painful PTN groups. Patient clustering indicated different sensory profile distributions when stratified according to aetiology or affected nerve branch. High interference with lifestyle was reported (78%), and patients suffering from painful PTN had worse QoL and psychosocial outcomes.CONCLUSION: Patients with painful PTN had different clinical profiles and lower QoL scores than those with non-painful PTN. Sensory profiles may provide important prognostic and therapeutic information; however, more research is needed to assess the clustering procedure and link these clusters to therapeutic guidelines.</p

A systematic review on diagnostic test accuracy of magnetic resonance neurography versus clinical neurosensory assessment for post-traumatic trigeminal neuropathy in patients reporting neurosensory disturbance

Objectives: To perform a systematic review of published studies on diagnostic accuracy of magnetic resonance neurography (MRN) vs clinical neurosensory testing (NST) for post-traumatic trigeminal neuropathy (PTTN) in patients reporting neurosensory disturbances (NSD). Methods: Human studies except case reports, reviews, systematic reviews and meta-analyses were included. PubMed, Embase, Web of Science and Cochrane Library were consulted. Risk of bias assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Predetermined data extraction parameters were noted and summarized. Results: 8 studies met eligibility criteria of which 7 were retrospective, representing 444 subjects. Most studies were at high risk of bias with low applicability concerns. Populations and objectives were divergent with a large variation in timing (3 days-17 years post injury) and parameters (multiple coil designs, fat suppression techniques, additional contrast agent) of MRI acquisition. T-2 weighted 3 T imaging with short echo times (2.2-100 ms) and fat suppression was applied in seven studies, techniques varied. Determination of sensitivity and specificity could not be performed due to the methodological variation between studies and lacking comparative data between index and reference tests. Based on limited data, PTTN correlated reasonably well between clinical assessment, intraoperative findings and MRN abnormalities (k = 0.57). Increased signal intensity correlated with persistency of neurosensory disturbances in one study. Intra- (ICC 0.914-0.927) and interobserver (k = 0.70-0.891) MRN variability was considered good to excellent. One retrospective study showed substantial impact of MRN on clinical decision making in one-third of patients. Conclusion: Currently, there is insufficient scientific knowledge to support or refute the use of MRN. Based on limited data, MRN seems promising and reliable in detection and grading of PTTN. Methodological issues underline the importance for prospective blinded studies with standardization of signal intensity calculation and rigorous reporting of MRI acquisition parameters