Outcomes and Treatments of Mal Fractures Caused by the Split-Crest Technique in the Mandible

In this study, we investigated cases of mal fracture occurring during the split-crest procedure. In all subjects (six patients), the free cortical bone segment caused by the mal fracture was carefully maintained in the lateral position without fixation using a titanium plate or screw. On pre- and postoperative multiplanar reconstruction CT, the average total alveolar increase was 5.0 mm in the lower portion 1 mm from the top of the alveolar ridge, and the average total alveolar increase in the lower portion 11 mm from the top of the alveolar ridge was 2.2 mm. A total of 11 dental implants were placed immediately at the same time as the split-crest procedure, while three dental implants were placed after a waiting period of 4-11 months from bone augmentation. During an average follow-up of 27.8 months, there were no complications or cases of failed implants. Consequently, among the patients who experienced mal fracture during the split-crest technique, a sufficient volume of alveolar bone was obtained without the need for rigid fixation of the free bone segment, and the dental implants placed within the area of the mal fracture showed a good prognosis

Novel PTCH1 mutation in Gorlin syndrome

Gorlin syndrome is an autosomal dominant disorder characterized by a wide range of developmental abnormalities and a predisposition to various tumors, and it is linked to the alteration of several causative genes, including PTCH1. We performed targeted resequencing using a next-generation sequencer to analyze genes associated with known clinical phenotypes in an 11-year-old male with sporadic jaw keratocysts. A novel duplication mutation (c.426dup) in PTCH1, resulting in a truncated protein, was identified

p16 overexpression in malignant and premalignant lesions of the oral and esophageal mucosa following allogeneic hematopoietic stem cell transplantation

OBJECTIVES: Secondary malignancy in the oral mucosa is recognized as one of the most serious complications in patients who received allogenic hematopoietic stem cell transplantation (HSCT). However, potential risk factors associated with carcinogenesis after HSCT that have been reported remain elusive. We experienced a rare case of secondary malignancies of the oral and esophageal mucosa and analyzed the expression of tumor suppressor gene product p16. CASE REPORT: A 35-year-old male had malignant lesions of the oral and esophageal mucosa two years after HSCT. Partial maxillectomy and endoscopic submucosal dissection were performed. Immunohistochemical analyses revealed that the tumor cells of malignant and premalignant lesions of the oral cavity and esophagus but not keratosis were positive for p16. CONCLUSIONS: Pathological examinations with p16 immunohistochemistry may contribute to an early diagnosis of secondary malignancy after HSCT

Novel CLCN7 mutations in IARO

Osteopetrosis is a heritable disorder of the skeleton that is characterized by increased bone density on radiographs caused by defects in osteoclast formation and function. Mutations in >10 genes are identified as causative for this clinically and genetically heterogeneous disease in humans. We report two novel missense variations in a compound heterozygous state in the CLCN7 gene, detected through targeted exome sequencing, in a 15-year-old Japanese female with intermediate autosomal recessive osteopetrosis

Analysis of the 619 Brånemark System TiUnite Implants : A Retrospective Study

The purpose of this retrospective study was to determine the outcome of Brånemark System TiUnite® implants (Nobel Biocare/Sweden), and to identify the risk factors associated with implant failure. A total of 151 patients (83 maxillae and 91 mandibles) received 619 implants from July 2003 until May 2010. The patients included 86 males and 65 females, with a median age of 51.6 years and an age range of 16 to 90 years at the time of implant surgery. Seventeen maxillae and 16 mandibles were completely edentulous, and 66 maxillae and 75 mandibles were partially edentulous. All the patients were followed until June 2011. Among the 619 implants, 9 maxillary implants and 8 mandibular implants were unsuccessful. The overall survival rate was 96.82%. A logistic regression analysis identified that a history of steroid treatment, application of a dento-maxillary prosthesis, a lack of mechanical coupling between the implants, and the length of the implants (≤8.5mm) were significant predictors of implant failure

Dental injuries caused by endotracheal intubation - A retrospective study

Objective: Dental injury is the most common complication of general anaesthesia. The primary purpose of this study was to report the occurrence, location, type, and treatment of dental injury caused by endotracheal intubation. Methods: This retrospective study evaluated 36,627 cases of general anaesthesia at our hospital from January 2008 through December 2015. The examination items included risk factors such as age; sex; surgical department; type of intubation(orotracheal or nasotracheal intubation); presence of preoperative trismus; Cormack–Lehane classification; experience of the attending anaesthesiologist; intubation appliance; mouth guard use; tooth mobility diagnosed by attending anaesthesiologist before surgery; the location, type, and treatment of injured teeth; and forensic implications. Results: The incidence of dental injury was 0.06% (22 of 36,627 patients). There was a significant difference in the rate of dental injury according to age (0.026% among those <60 years of age vs. 0.096% among those ≥60 years; P < 0.05) and according to surgical department (0.189% among neurosurgery patients; P < 0.05). The most common Cormack–Lehane classification of laryngeal view in the 22 patients with dental injury was grade 2 (50%). Tooth mobility was diagnosed by anaesthesiologists in 50% of injured patients before surgery. There was no preoperative dental consultation in our department in any of the patients with injured teeth. Conclusions: Dental screening is recommended for patients in whom anaesthesiologists find mobile teeth and difficult intubation. A system to facilitate cooperation between anaesthesiologists and dental surgeons should be established

Extracellular inorganic phosphate regulates gibbon ape leukemia virus receptor-2/phosphate transporter mRNA expression in rat bone marrow stromal cells

In mammalian cells, several observations indicate not only that phosphate transport probably regulates local inorganic phosphate (Pi) concentration, but also that Pi affects normal cellular metabolism, which in turn regulates apoptosis and the process of mineralization. To elucidate how extracellular Pi regulates cellular functions of pre-osteoblastic cells, we investigated the expression of type III sodium (Na)-dependent Pi transporters in rat bone marrow stromal cells and ROB-C26 pre-osteoblastic cells. The mRNA expression level of gibbon ape leukemia virus receptor (Glvr)-2 was increased by the addition of Pi in rat bone marrow stromal cells, but not in ROB-C26 or normal rat kidney (NRK) cells. In contrast, the level of Glvr-1 mRNA was not altered by the addition of extracellular Pi in these cells. The induction of Glvr-2 mRNA by Pi was inhibited in the presence of cycloheximide (CHX). Moreover, mitogen-activated protein kinase (MEK) /extracellular-signal-regulated kinase (ERK) pathway inhibitors; U0126 (1.4-diamino-2, 3-dicyano-1, 4-bis [2-amino-phenylthio] butadiene) and PD98059 (2-Amino-3-methoxyflavone) inhibited inducible Glvr-2 mRNA expression, but p38 MEK inhibitor SB203580 [4-(4-fluorophenyl)-2-(4-methyl-sulfinylphenyl)-5-(4pyridyl) imidazole] did not inhibit the induction of Glvr-2 mRNA expression, suggesting that extracellular Pi regulates de novo protein synthesis and MEK/ERK activity in rat bone marrow stromal cells, and through these, induction of Glvr-2 mRNA. Although Pi also induced osteopontin mRNA expression in rat bone marrow stromal cells but not in ROB-C26 and NRK cells, changes in cell viability with the addition of Pi were similar in both cell types. These data indicate that extracellular Pi regulates Glvr-2 mRNA expression, provide insights into possible mechanisms whereby Pi may regulate protein phosphorylation, and suggest a potential role for the Pi transporter in rat bone marrow stromal cells