Epidemiology of maxillofacial fractures at two maxillofacial units in South Africa

This article compares epidemiologic characteristics of maxillofacial fractures seen in patients presenting at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) with those seen at Polokwane – Mankweng Hospital Complex (PMHC).CW201

Temporomandibular Joint Ankylosis In Children

Abstract: Temporomandibular joint (TMJ) ankylosis is defined as osseous or fibrous fusion of the condyle of the mandible and the mandibular fossa of temporal bone (Nitzan et. al. 1998

Audit of the workload in a maxillofacial and oral surgical unit in Johannesburg

Maxillofacial and oral surgical (MFOS) audits are able to provide data to both current and prospective patients regarding the quality of care an institution is capable of providing. The more frequently performed MFOS procedures can be determined and the allocation of funding and resources can therefore be achieved more appropriately. To conduct an audit to evaluate the workload and scopeof practice of the MFOS unit of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) for the year 2015 by quantifying MFOS conditions and the respective treatment modalities. The study was retrospective and cross-sectional. Data was retrieved from the patient logbook of the unit which was then entered into a Microsoft Excel Spreadsheet. Pie graphs and bar charts representing the data were then generated. A total of 1 750 patients were treated in the unit. The male to female ratio was 1.3:1 and the majority of these patients were in their 3rd and 4th age decade. Most patients required a tooth extraction mainly for an impacted 3rd molar. Dentoalveolar surgery was the most commonly performed procedure followed by the treatment of facial fractures. Pathological and other MFOS conditions were less commonly encountered. The CMJAH MFOS unit treats a high volume of patients according to comparisons with global studies

Audit of the workload in a maxillofacial and oral surgical unit in Johannesburg

INTRODUCTION : Maxillofacial and oral surgical (MFOS) audits are able to provide data to both current and prospective patients regarding the quality of care an institution is capable of providing. The more frequently performed MFOS procedures can be determined and the allocation of funding and resources can therefore be achieved more appropriately. AIMS AND OBJECTIVES : To conduct an audit to evaluate the workload and scope of practice of the MFOS unit of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) for the year 2015 by quantifying MFOS conditions and the respective treatment modalities. DESIGN : The study was retrospective and cross-sectional. METHODS : Data was retrieved from the patient logbook of the unit which was then entered into a Microsoft Excel Spreadsheet. Pie graphs and bar charts representing the data were then generated. RESULTS : A total of 1 750 patients were treated in the unit. The male to female ratio was 1.3:1 and the majority of these patients were in their 3rd and 4th age decade. Most patients required a tooth extraction mainly for an impacted 3rd molar. CONCLUSIONS : Dentoalveolar surgery was the most commonly performed procedure followed by the treatment of facial fractures. Pathological and other MFOS conditions were less commonly encountered. The CMJAH MFOS unit treats a high volume of patients according to comparisons with global studies.https://www.sada.co.za/the-sadjam2022Maxillo-Facial and Oral Surger

Prevalence and aetiological factors of maxillofacial trauma in a rural district hospital in the Eastern Cape

AIM : To determine the prevalence, aetiological factors and demographic data of patients presenting with injuries sustained from maxillofacial trauma over a six month period at Zithulele Hospital. MATERIALS AND METHODS : In a retrospective, descriptive study, data collected and analysed included records of all patients who had suffered maxillofacial trauma, their demographics, clinical features and the aetiology. The radiographic records were assessed by a maxillofacial surgeon and a radiologist for a diagnosis as well as gaining opinions regarding the types of fractures observed. RESULTS : A total of 239 patients sustained maxillofacial trauma. The most common aetiological factor was interpersonal violence (55%) followed by road traffic accidents (16%), falls (10%), animals (4%) and other causes (2%). The male to female ratio was 2.6:1 and the 18-24 years age group endured the most trauma. A total of 210 (88%) patients sustained soft tissue injuries while 29 (12%) experienced hard tissue injuries, with 39 fractures diagnosed. A total of 165 maxillofacial radiographs were assessed, 37% were diagnostically acceptable, 56% had poor diagnostic value and 7% had no diagnostic value. CONCLUSION : Maxillofacial trauma is prevalent in rural parts of South Africa. Males aged 18-24 years are frequent victims, with interpersonal violence being the major aetiology.https://www.sada.co.za/the-sadjam2018Maxillo-Facial and Oral Surger

Dental and Orofacial Trauma Impacts on Oral-Health-Related—Quality of Life in Children: Low- and Middle-Income Countries

Orofacial trauma including traumatic dental injuries is a public health problem and has the potential to adversely affect the quality of life in children. These injuries include hard and soft tissue. Quality of life is impacted when the health and oral health of the children and their parents and family are affected. Oral health includes the ability to speak, smile, smell, taste, chew, swallow, and convey emotions through facial expressions with confidence. Poor oral health conditions include dental injuries from trauma, result in pain, soreness, discomfort, and embarrassment during routine daily activities. Traumatic dental injuries contribute to the aesthetic, functional, psychological, social, and economic distress lowering self-image and negatively impacting the quality of life among children, and their families in both developed and low- and middle-income countries. It is important to appreciate the impacts of dental trauma on children and their families more so in areas of low income as these areas have a higher propensity of above average oral-related quality of life impacts. Necessary dental management and treatment should be performed as soon as possible consequent to injury to relieve pain and discomfort, restore function, uplift appearance, and self-esteem, and enhance social well-being. This holistic management approach will improve treatment outcomes and ultimately enhance the quality-of-life post-dental injury

Genetic drivers of head and neck squamous cell carcinoma : aberrant splicing events, mutational burden, hpv infection and future targets

Head and neck cancers include cancers that originate from a variety of locations. These include the mouth, nasal cavity, throat, sinuses, and salivary glands. These cancers are the sixth most diagnosed cancers worldwide. Due to the tissues they arise from, they are collectively named head and neck squamous cell carcinomas (HNSCC). The most important risk factors for head and neck cancers are infection with human papillomavirus (HPV), tobacco use and alcohol consumption. The genetic basis behind the development and progression of HNSCC includes aberrant non-coding RNA levels. However, one of the most important differences between healthy tissue and HNSCC tissue is changes in the alternative splicing of genes that play a vital role in processes that can be described as the hallmarks of cancer. These changes in the expression profile of alternately spliced mRNA give rise to various protein isoforms. These protein isoforms, alternate methylation of proteins, and changes in the transcription of non-coding RNAs (ncRNA) can be used as diagnostic or prognostic markers and as targets for the development of new therapeutic agents. This review aims to describe changes in alternative splicing and ncRNA patterns that contribute to the development and progression of HNSCC. It will also review the use of the changes in gene expression as biomarkers or as the basis for the development of new therapies.The South African Medical Research Councilhttps://www.mdpi.com/journal/genesam2022Community DentistryMaxillo-Facial and Oral SurgerySurger

MicroRNA and alternative mRNA splicing events in cancer drug response/resistance : potent therapeutic targets

Cancer is a multifaceted disease that involves several molecular mechanisms including changes in gene expression. Two important processes altered in cancer that lead to changes in gene expression include altered microRNA (miRNA) expression and aberrant splicing events. MiRNAs are short non-coding RNAs that play a central role in regulating RNA silencing and gene expression. Alternative splicing increases the diversity of the proteome by producing several different spliced mRNAs from a single gene for translation. MiRNA expression and alternative splicing events are rigorously regulated processes. Dysregulation of miRNA and splicing events promote carcinogenesis and drug resistance in cancers including breast, cervical, prostate, colorectal, ovarian and leukemia. Alternative splicing may change the target mRNA 30UTR binding site. This alteration can affect the produced protein and may ultimately affect the drug affinity of target proteins, eventually leading to drug resistance. Drug resistance can be caused by intrinsic and extrinsic factors. The interplay between miRNA and alternative splicing is largely due to splicing resulting in altered 30UTR targeted binding of miRNAs. This can result in the altered targeting of these isoforms and altered drug targets and drug resistance. Furthermore, the increasing prevalence of cancer drug resistance poses a substantial challenge in the management of the disease. Henceforth, molecular alterations have become highly attractive drug targets to reverse the aberrant effects of miRNAs and splicing events that promote malignancy and drug resistance. While the miRNA–mRNA splicing interplay in cancer drug resistance remains largely to be elucidated, this review focuses on miRNA and alternative mRNA splicing (AS) events in breast, cervical, prostate, colorectal and ovarian cancer, as well as leukemia, and the role these events play in drug resistance. MiRNA induced cancer drug resistance; alternative mRNA splicing (AS) in cancer drug resistance; the interplay between AS and miRNA in chemoresistance will be discussed. Despite this great potential, the interplay between aberrant splicing events and miRNA is understudied but holds great potential in deciphering miRNA-mediated drug resistance.This research was funded by the South African Medical Research Council (SAMRC).The South African Medical Research Council (SAMRC)https://www.mdpi.com/journal/biomedicinesam2022Maxillo-Facial and Oral SurgeryMedical OncologySurger

AI and precision oncology in clinical cancer genomics : from prevention to targeted cancer therapies-an outcomes based patient care

Precision medicine is the personalization of medicine to suit a specific group of people or even an individual patient, based on genetic or molecular profiling. This can be done using genomic, transcriptomic, epigenomic or proteomic information. Personalized medicine holds great promise, especially in cancer therapy and control, where precision oncology would allow medical practitioners to use this information to optimize the treatment of a patient. Personalized oncology for groups of individuals would also allow for the use of population group specific diagnostic or prognostic biomarkers. Additionally, this information can be used to track the progress of the disease or monitor the response of the patient to treatment. This can be used to establish the molecular basis for drug resistance and allow the targeting of the genes or pathways responsible for drug resistance. Personalized medicine requires the use of large data sets, which must be processed and analysed in order to identify the particular molecular patterns that can inform the decisions required for personalized care. However, the analysis of these large data sets is difficult and time consuming. This is further compounded by the increasing size of these datasets due to technologies such as next generation sequencing (NGS). These difficulties can be met through the use of artificial intelligence (AI) and machine learning (ML). These computational tools use specific neural networks, learning methods, decision making tools and algorithms to construct and improve on models for the analysis of different types of large data sets. These tools can also be used to answer specific questions. Artificial intelligence can also be used to predict the effects of genetic changes on protein structure and therefore function. This review will discuss the current state of the application of AI to omics data, specifically genomic data, and how this is applied to the development of personalized or precision medicine on the treatment of cancer.The South African Medical Research Council (SAMRC) and the National Research Foundation (NRF).https://www.elsevier.com/locate/imuhj2023Anatomical PathologyMaxillo-Facial and Oral SurgeryMedical OncologyOtorhinolaryngologyRadiologySurgeryUrolog

Genetic Drivers of Head and Neck Squamous Cell Carcinoma: Aberrant Splicing Events, Mutational Burden, HPV Infection and Future Targets

Head and neck cancers include cancers that originate from a variety of locations. These include the mouth, nasal cavity, throat, sinuses, and salivary glands. These cancers are the sixth most diagnosed cancers worldwide. Due to the tissues they arise from, they are collectively named head and neck squamous cell carcinomas (HNSCC). The most important risk factors for head and neck cancers are infection with human papillomavirus (HPV), tobacco use and alcohol consumption. The genetic basis behind the development and progression of HNSCC includes aberrant non-coding RNA levels. However, one of the most important differences between healthy tissue and HNSCC tissue is changes in the alternative splicing of genes that play a vital role in processes that can be described as the hallmarks of cancer. These changes in the expression profile of alternately spliced mRNA give rise to various protein isoforms. These protein isoforms, alternate methylation of proteins, and changes in the transcription of non-coding RNAs (ncRNA) can be used as diagnostic or prognostic markers and as targets for the development of new therapeutic agents. This review aims to describe changes in alternative splicing and ncRNA patterns that contribute to the development and progression of HNSCC. It will also review the use of the changes in gene expression as biomarkers or as the basis for the development of new therapies