A Pilot Study of the Association of Tumor Necrosis Factor Alpha Polymorphisms with Psoriatic Arthritis in the Romanian Population

Tumor necrosis factor alpha (TNF-alpha) is an important pro-inflammatory cytokine implicated in the pathogenesis of psoriatic arthritis. We have performed a case-control association study of three TNF-alpha gene polymorphisms in a group of Romanian psoriatic arthritis patients versus ethnically matched controls. A second group of patients with undifferentiated spondyloarthritis was used in order to look for similarities in the genetic background of the two rheumatic disorders. The −857C/T polymorphism was associated with susceptibility to psoriatic arthritis in our population at the individual level (p = 0.03, OR 1.65, 95% CI 1.05–2.57) and in combined haplotypes with the −238G/A and −308G/A SNPs. Regarding the investigated polymorphisms and derived haplotypes, no potential association was found with the susceptibility to undifferentiated spondyloarthritis in Romanian patients

THE USE OF CONE BEAM COMPUTED TOMOGRAPHY IN THE DIAGNOSIS AND TREATMENT OF MEDICATION-RELATED OSTEONECROSIS OF THE JAW

In the diagnosis of osteonecrosis of the jaw (ONJ), imaging may have an important role in determining the extent of the disease, diagnosing early stages of osteonecrosis, identifying a potential association between metastasis of the jaw and ONJ lesions, excluding other diseases or complications of the jaws, such as fractures, and evaluating the jaw before surgical orofacial procedures. Since the appearance of ONJ at imaging is variable and very often nonspecific, imaging findings should always be related to the clinical context. The panoramic radiography is the most often used imaging technique in cases of ONJ, whereas CBCT is an adequate tool in evaluating bone involvement, in addition to offering the advantage that destructive processes can be seen at high resolution

ORAL AND MAXILLOFACIAL NON-HODGKIN’S LYMPHOMAS

Aim of the study is to assess the clinical-epidemiological and morphological features of the lymphomas located in the oral and maxillofacial territory, including the research of histopathological forms involved and anatomical sites affected. It has also been analyzed their progress and response to treatment, as well as the patients` rate of survival. Material and methods The study has been conducted within the Department of Oral and Maxillofacial Surgery – “Sf. Spiridon” Iasi for a period of 7 years (from 2010 to 2017), analyzing the data recorded in 70 patients diagnosed with oral and maxillofacial non-Hodgkin’s lymphomas. Results Oral and maxillofacial Non-Hodgkin’s lymphomas are most often diagnosed in elder people, in advanced stages (42% of the cases in stage IV). The extranodal presentation occurs in 55% of the patients, the parotid gland being the most frequent site. Conclusions Diffuse Large B-cell Lymphoma is the most common subtype. Chemotherapy is the most used therapeutic method in a multimodal treatment and the survival rate is 58%, with better results when the treatment is applied in the early stages

BROWN TUMOR OF THE JAW: A RARE ENTITY

Aim of the study The aim of this study is to present the development of brown tumors in the jaws as a consequence of secondary hyperparathyroidism (HPT). Material and methods We analysed 10 cases with brown tumor of the jaws developed in patients with HPT which presented in our Oral and Maxillofacial Clinic for evaluation and treatment of their disease. The patients were 7 females and 3 males, with ages between 13 and 58 years. Results All patients were symptomatic and bone deformation was noted in all cases. The mandible was involved in 5 patients, the maxillary bone in 4 cases and in one case the tumor was localized in both jaws. The PTH values ranged from 630 pg/ml to 2500 pg/ml. All patients were referred for parathyroidectomy and for 2 patients, local excision was performed. Conclusions Regression of brown tumors may be achieved by performing parathyroidectomy. Multidisciplinary follow-up is essential for the control of brown tumors in order to prevent rapid growth which may lead to severe deformities and functional alterations

DENTAL AND PERIODONTAL HEALTH IN END STAGE RENAL DISEASE PATIENTS

In end stage renal disease, a whole range of changes occur in the oral cavity concerning the teeth, oral mucosa, bone, periodontium, salivary glands or temporomandibular joint. Adults with chronic renal failure have more severe oral disease than the general population Material and methods 39 patients undergoing dialysis and requiring oral surgery procedures were evaluated in terms of age, gender, aetiology of renal failure, duration of dialysis, reason for admission, local status and treatment. Results 32 patients presented for complications of carious disease, from which 29 had non-restorable teeth. Severe periodontitis (attachment loss greater than 5mm) was recorded in 17,94 % of cases, while moderate periodontitis (attachment loss 3-5mm) in 54.4% cases. 61.5% of patients presented maxillary or mandibular terminal edentatulism. Conclusions Poor oral health is common among ESRD patients and regular dental consultation should be integrated into care of chronic kidney disease

MANAGEMENT OF ORBITAL TUMORS PRESENTING AS UNILATERAL EXOPHTHALMOS

Aim of the study. We aim to present our experience regarding the management of exophthalmos as the first clinical manifestation of a space-occupying orbital lesion. Material and methods. We performed a retrospective review, selecting 17 patients with orbital tumors that initially presented for proptosis. Results. Following multidisciplinary clinical and imaging evaluation, three primary orbital tumors were diagnosed, one mass pertaining to the lacrimal gland, and 13 secondary tumors. Surgical treatment was performed in 11 patients. Complete excision was performed in three benign tumors, complete removal and orbital content preservation was achieved in eight patients, orbital exenteration was necessary in two cases of orbital malignancies, and extended orbital exenteration was performed in one patient. Four cases did not have indication of surgery due to internal carotid artery invasion or extensive intracranial invasion. Two patients were diagnosed with lymphoma following biopsy and underwent oncologic treatment. Conclusion. An early diagnosis of an orbital mass presenting as proptosis involves multidisciplinary evaluation for the exclusion of other causes of exophthalmos. Orbital content and function preservation are the main goals of the surgical treatment

STUDY ON MANDIBULAR MEDIAL FLEXURE VALUE (MMF) FOR NATURAL TOOTH AND DENTAL IMPLANT SUPPORT

The mandible is a mobile bone, capable of extremely complex movement in which, horizontal ram, especially the two vertical branches are subject to deformation that may be combined in different ways. Aim Highlighting the mandibular deformation by medial flexure and comparing it on natural and implanted arches by using a computer analysis method. Material and method Measurements were performed on a group of 15 volunteers of both sexes among students of the Faculty of Dental Medicine Iasi. Selection criteria included: dental arches integrity (presence of the wisdom tooth was considered to be optional); aged between 20 and 30and balanced occlusion. The study was completed by selecting 10 volunteers from a group of 25 patients addressed to Oral Rehabilitation Service, Faculty of Dentistry, Iasi. Patients of both sexes, aged between 25 and 47 years presented different classes of edentulous maxilla and /or mandible. The impression was performed with silicone impression material of the addition type (vinilpolisiloxan) with very high viscosity and fast curing (Virtual Putty Ivoclar Vivadent-, fast set). Then, there were 2D scanned using a personal scanner (BENQ SCANNER 555O) at a magnification of 1200% and a resolution of 600 pixels. Each image was calibrated for 10 mm opening. Using Image Tool software. Results The jaw displacement, from rest position relative to maximum opening, determined a mandibular arch narrowing up to 1.5 mm. The results vary widely between subjects. The magnitude of the deflections increased with distance from the foramen. The values obtained so far are similar to those published in the literature. Conclusions Maximum medial flexure has been determined in the maximum opening of the mouth, intermolars distance being less than 100 μm for implant arches. The values for dental implant arches are lower from those of natural dental arches