Impacted third molar transplantation on the malpracticed extraction socket

Autotransplantation with or without endodontic therapy is regarded as an alternative treatment option for the replacement of missing teeth. A primary responsibility of a maxillofacial surgeon is to reverse any malpractice to promote successful outcomes and improve the patient’s quality of life. This paper presents a malpractice case of incorrect extraction of the lower second molar instead of the impacted third molar. A simple technique of transplanting the impacted third molar to the site of the extracted second molar is introduced by a maxillofacial specialist in Ghana. By making an intentional root socket and fixation without using additional appliances, a novel second molar was achieved with complete recovery. This patient was followed after transplant for a four-year period with the best satisfaction.Funding: A grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea. (HI15C0689)Keywords: Autotransplantation, Endodontic treatment, Impacted third molar, Malpracticed extraction, Maxillofacial specialt

Development of a dental handpiece angle correction device

Background Preparation of a uniform angle of walls is essential for making an ideal convergence angle in fixed prosthodontics. We developed a de novo detachable angle-correction apparatus for dental handpiece drills that could help the ideal tooth preparation. Methods We utilized a gyro sensor to measure the angular velocities to calculate the slope of an object by integrating the values, acceleration sensor to calculate the slope of an object by measuring the acceleration relative to gravity, and Kalman filter algorithm. Converting the angulation of the handpiece body to its drill part could be performed by a specific matrix formulation set on two reference points (2° and 6°). A flexible printed circuit board was used to minimize the size of the device. For convergence angle investigation, 16 volunteers were divided randomly into two groups for performing tooth preparation on a mandibular first molar resin tooth. All abutments were scanned by a 3D scanner (D700®, 3Shape Co., Japan), the convergence angle and tooth axis deviation were analyzed by a CAD program (SolidWorks 2013®, Dassault Systems Co., USA) with statistical analysis by Wilcoxon signed-rank test (α = 0.05) using SPSS statistical software (Version 16.0, SPSS Inc.). Results This device successfully maintained the stable zero point (less than 1° deviation) at different angles (0°, 30°, 60°, 80°) for the first 30 min. In single tooth preparation, without this apparatus, the average bucco-lingual convergence angle was 20.26° (SD 7.85), and the average mesio–distal (MD) convergence angle was 17.88° (SD 7.64). However, the use of this apparatus improved the average BL convergence angle to 13.21° (SD 4.77) and the average MD convergence angle to 10.79° (SD 4.48). The angle correction device showed a statistically significant effect on reducing the convergence angle of both directions regardless of the order of the directions. Conclusions The angle correction device developed in this study is capable of guiding practitioners with high accuracy comparable to that of commercial navigation surgery. The volume of the angle correction device is much smaller than that of any other commercial navigation surgery system. This device is expected to be widely utilized in various fields of orofacial surgery.This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education (2017R1D1A1B03036054)

A standardized formula for aesthetic mandibular reconstruction using an osteocutaneous fibular free flap

Ameloblastoma is the most common benign odontogenic tumor of the jaw, and expansional growth of a huge untreated ameloblastoma can result in disturbances in facial aesthetics and function, such as difficulty with mouth opening, swallowing, chewing, breathing, neurologic deficits, and pathologic fractures. Radical wide resection with safety margins and subsequent reconstruction is generally recommended. A fibular free flap (FFF) is commonlyused to reconstruct the mandible in order to adequately restore both aesthetic appearance and function. The aim of this brief clinical report is to present a case of huge ameloblastoma after wide resection with free safety margins, and describe the immediate one-step mandibular reconstruction using a vascularized composite FFF. The sterolithographic(rapid prototype, RP) model, a wax pattern of the resected mandible, and a surgical fibular stent made from the wax pattern were constructed preoperatively. We suggest a standardized surgical protocol for mandibular reconstruction with FFF.Funding: Supported by the International Research & Development Program of the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2015K1A3A9A01028230)Keywords: Mandibular reconstruction, fibular osteocutaneous free flap, huge ameloblastoma, stereolithographicmodel, standardized formul

Two different protein expression profiles of oral squamous cell carcinoma analyzed by immunoprecipitation high-performance liquid chromatography

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract Background Oral squamous cell carcinoma (OSCC) is one of the most dangerous cancers in the body, producing serious complications with individual behaviors. Many different pathogenetic factors are involved in the carcinogenesis of OSCC. Cancer cells derived from oral keratinocytes can produce different carcinogenic signaling pathways through differences in protein expression, but their protein expression profiles cannot be easily explored with ordinary detection methods. Methods The present study compared the protein expression profiles between two different types of OSCCs, which were analyzed through immunoprecipitation high-performance liquid chromatography (IP-HPLC). Results Two types of squamous cell carcinoma (SCC) occurred in a mandibular (SCC-1) and maxillary gingiva (SCC-2), but their clinical features and progression were quite different from each other. SCC-1 showed a large gingival ulceration with severe halitosis and extensive bony destruction, while SCC-2 showed a relatively small papillary gingival swelling but rapidly grew to form a large submucosal mass, followed by early cervical lymph node metastasis. In the histological observation, SCC-1 was relatively well differentiated with a severe inflammatory reaction, while SCC-2 showed severely infiltrative growth of each cancer islets accompanied with a mild inflammatory reaction. IP-HPLC analysis revealed contrary protein expression profiles analyzed by 72 different oncogenic proteins. SCC-1 showed more cellular apoptosis and invasive growth than SCC-2 through increased expression of caspases, MMPs, p53 signaling, FAS signaling, TGF-β1 signaling, and angiogenesis factors, while SCC-2 showed more cellular growth and survival than SCC-1 through the increased expression of proliferating factors, RAS signaling, eIF5A signaling, WNT signaling, and survivin. Conclusions The increased trends of cellular apoptosis and invasiveness in the protein expression profiles of SCC-1 were implicative of its extensive gingival ulceration and bony destruction, while the increased trends of cellular proliferation and survival in the protein profile of SCC-2 were implicative of its rapid growing tumor mass and early lymph node metastasis. These analyses of the essential oncogenic protein expression profiles in OSCC provide important information for genetic counseling or customized gene therapy in cancer treatment. Therefore, protein expression profile analysis through IP-HPLC is helpful not only for the molecular genetic diagnosis of cancer but also in identifying target molecules for customized gene therapy in near future

Recurrent odontogenic ghost cell carcinoma (OGCC) at a reconstructed fibular flap : a case report with immunohistochemical findings

Odontogenic ghost cell carcinoma (OGCC), a malignant counterpart of the odontogenic ghost cell tumor (OGCT), with aggressive growth characteristics, is exceedingly rare. A painful swelling in the jaw with local paresthesia is the most common symptom. We described a case of 47-year Korean woman who had a rare central epithelial odontogenic ghost cell carcinoma which recurred at reconstructed fibular flap. Immunohistochemical differences between OGCT and OGCC analyzed using primary and recurred surgical specimen. On the basis of this case, the tumor started as an OGCT and transformed into OGCC with highly aggressive, rapidly growing, infiltrative tumors. Our findings suggest that some of the cytokines produced by ghost cells may play important roles in causing extensive bone resorption in the odontogenic ghost cell carcinoma. Wide local excision with histologically clean margins is the treatment mode of selection. Also, we recommend close long-term surveillance of OGCT because of high recurrence and potential for malignancy transformation. © Medicina Oral

Beneficial Effects of Highly Palatable Food on the Behavioral and Neural Adversities induced by Early Life Stress Experience in Female Rats

This study examined the effects of highly palatable food during adolescence on the psycho-emotional and neural disturbances caused by early life stress experience in female rats. Female Sprague-Dawley pups were separated from dam for 3 h daily during the first two weeks of birth (MS) or left undisturbed (NH). Half of MS females received free access to chocolate cookies in addition to ad libitum chow from postnatal day 28. Pups were subjected to the behavioral tests during young adulthood. The plasma corticosterone response to acute stress, ΔFosB and brain-derived neurotrophic factor (BDNF) levels in the brain regions were analyzed. Total caloric intake and body weight gain during the whole experimental period did not differ among the experimental groups. Cookie access during adolescence and youth improved anxiety-/depression-like behaviors by MS experience. ΔFosB expression was decreased, but BDNF was increased in the nucleus accumbens of MS females, and ΔFosB expression was normalized and BDNF was further increased following cookie access. Corticosterone response to acute stress was blunted by MS experience and cookie access did not improve it. Results suggest that cookie access during adolescence improves the psycho-emotional disturbances of MS females, and ΔFosB and/or BDNF expression in the nucleus accumbens may play a role in its underlying neural mechanisms. © 2015 Ivyspring International Publisher.1

Molecular genetic study of novel biomarkers for early diagnosis of oral squamous cell carcinoma

Objectives: Early detection and treatment of an oral squamous cell carcinoma (OSCC) is critical because of its rapid growth, frequent lymph-node metastasis, and poor prognosis. However, no clinically-valuable methods of early diagnosis exist, and genetic analysis of OSCCs has yielded no biomarkers. Study D esign: We investigated the expression of genes associated with inflammation in OSCCs via a quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) analysis of microarray data. Tumor and normal tissues from five patients with an OSCC were used for microarray analysis. Differentially-expressed genes, identified using permutation, local pooled error (LPE), t-tests, and significance analysis of microarrays (SAM), were selected as candidate genetic markers. Results: Two groups corresponding to tissue identity were evident, implying that their differentially-expressed genes represented biological differences between tissues. Fifteen genes were identified using the Student’s paired t-test ( p< 0.05) and the SAM, with a false discovery rate of less than 0.02. Based on gene expression, these 15 genes can be used to classify an OSCC. A genetic analysis of functional networks and ontologies, validated by using a qRT-PCR analysis of the tissue samples, identified four genes, ADAM15, CDC7, IL12RB2 and TNFRSF8, that demonstrated excellent concordance with the microarray data. Conclusions: Our study demonstrated that four genes (ADAM15, CDC7, IL12RB2 and TNFRSF8) had potential as novel biomarkers for the diagnosis and the treatment of an OSCC

Changes in oncogenic protein levels in peri-implant oral malignancy: a case report

Background Oral squamous cell carcinoma (OSCC) constitutes a group of tumors that exhibit heterogeneous biology, histopathology, and clinical behaviors. Case presentation A 73-year-old male had a whitish leukoplakia-like lesion around inflamed peri-implant area (#42, #43, and #44), and this lesion had transformed to OSCC within 3 years. He underwent mass resection, selective neck dissection, and reconstructive surgery. To detect any carcinogenesis progression, we examined the removed tumor tissue as well as the patients preoperative and postoperative sera to identify causative oncogenic proteins using immunoprecipitation high-performance liquid chromatography (IP-HPLC). Conclusions The protein expression levels of p53, E-cadherin, β-catenin, MMP-10, HER2, NRAS, Met, HER2, and ERb were significantly lower in the serum collected on postoperative day 10 than in the preoperative serum, and if these proteins are consistently not elevated in the serum 3 months after surgery compared with the preoperative serum, these proteins can be potential oncogenic proteins. However, we also found that the serum extracted 3 months after the operation had elevated levels of oncogenic proteins compared with that of the preoperative and 10-day postoperative serum indicating the possibility of tumor recurrence. At postoperative follow-up period, ipsilateral neck metastasis and second primary lesion were found and additional surgery was performed to the patient. IP-HPLC using the patients serum shows the possibility of oncogenic protein detection. However, follow-up IP-HPLC data is needed to find out patient-specific prognostic factors