A Pilot Study for Early Detection of Oral Premalignant Diseases Using Oral Cytology and Raman Micro-Spectroscopy: Assessment of Confounding Factors

This study demonstrates the efficacy of Raman micro-spectroscopy of oral cytological samples for differentiating dysplastic, potentially malignant lesions from those of normal, healthy donors. Cells were collected using brush biopsy from healthy donors (n = 20) and patients attending a Dysplasia Clinic (n = 20). Donors were sampled at four different sites (buccal mucosa, tongue, alveolus, gingiva), to ensure matched normal sites for all lesions, while patient samples were taken from clinically evident, histologically verified dysplastic lesions. Spectra were acquired from the nucleus and cytoplasm of individual cells of all samples and subjected to partial least squares-discriminant analysis. Discriminative sensitivities of 94% and 86% and specificity of 85% were achieved for the cytoplasm and nucleus, respectively, largely based on lipidic contributions of dysplastic cells. Alveolar/gingival samples were differentiated from tongue/buccal samples, indicating that anatomical site is potentially a confounding factor, while age, gender, smoking and alcohol consumption were confirmed not to be

Raman microspectroscopic study for the detection of oral field cancerisation using brush biopsy samples

Field cancerisation (FC) is potentially an underlying cause of poor treatment outcomes of oral squamous cell carcinoma (OSCC). To explore the phenomenon using Raman microspectroscopy, brush biopsies from the buccal mucosa, tongue, gingiva and alveolus of healthy donors (n = 40) and from potentially malignant lesions (PML) of Dysplasia Clinic patients (n = 40) were examined. Contralateral normal samples (n = 38) were also collected from the patients. Raman spectra were acquired from the nucleus and cytoplasm of each cell, and subjected to partial least squares-discriminant analysis (PLS-DA). High discriminatory accuracy for donor and PML samples was achieved for both cytopalmic and nuclear data sets. Notably, contralateral normal (patient) samples were also accurately discriminated from donor samples and contralateral normal samples from patients with multiple lesions showed a similar spectral profile to PML samples, strongly indicating a FC effect. These findings support the potential of Raman microspectroscopy as a screening tool for PML using oral exfoliated cells

Proposition of integrated electrical mechanism and facial prosthesis for eyelid motion on prosthetic oculopalpebral rehabilitation: technical note

Surgical reconstruction of large facial defects may not be always possible, therefore extraoral maxillofacial prosthesis is a good restorative option. The oculopalpebral prosthesis has a natural appearance however it can be easily noticed because its eyelids do not move. For esthetic purposes, it is desirable that the prosthetic eyelids open and close synchronously with the contralateral eye, which provides a challenge to the prosthetic reconstruction of the oculopalpebral region. To improve the esthetic outcome, an oculopalpebral prosthesis prototype with mechanical and electric features allowing synchronization of the eyelid motion with the sound eye was planned, designed, and built. An oculopalpebral prosthesis was made in thermoactivated acrylic resin. A gap was created to accommodate an electrical system and allow free motion of a thin eyelid made of silicone attached to the appliance. The movable eyelid was made with medical grade silicone (SILASTIC® MDX4-4210) and connected to an electrical and electronic system responsible to command the opening and closing movements. This mechanical and electrical prototype with the system connected to a sensor, successfully captured the eyelid motion of the contralateral sound eye. The proposed mechanical and electrical system attached to an oculopalpebral prosthesis could successfully establish and synchronize the eyelid movements with the sound eye

Prosthetic rehabilitation in the auricular region: finite elements analysis of extraoral maxillofacial implants, photostability investigation and spectroscopy characterisation of modified maxillofacial elastomers type-A

O grande desafio da Implantodontia é alcançar resultados a longo prazo com maior preservação dos tecidos ósseos, resposta adequada dos tecidos conjuntivos e manutenção da estabilidade secundária adequada para a retenção de próteses. Estes fatores evitam a perda indesejável tanto do tratamento reabilitador quanto dos tecidos ósseos de suporte. A região extraoral apresenta menores espessuras ósseas em comparação às regiões de maxila e mandíbula, especialmente no osso temporal. Portanto, os seguintes aspectos foram investigados: (i) Análise pelo Método dos Elementos Finitos (FEA) de 16 modelos virtuais, com aplicação de forças estáticas de tensão e compressão nos pontos médios entre os implantes. Três implantes maxilofaciais extraorais foram posicionados no osso temporal, onde um deles foi posicionado sobre o processo mastóide. Este estudo foi totalmente realizado em ambiente computacional. Foram empregados dois tipos de conexões protéticas e intermediários retos de conicidades 20º e 45º, posicionados virtualmente no modelo de osso temporal, com paralelismo entre eles. Foi desenhada uma barra virtual para retenção protética do tipo barra-clipe da prótese auricular. Foram consideradas as melhores configurações aquelas apresentando distribuição uniforme e branda das tensões de von Mises sobre o tecido ósseo adjacente aos implantes. (ii) Confecção de corpos de prova com graus variáveis de pigmentação para (a) melhorar a reprodutibilidade da coloração (b) entender e reduzir o processo de descoloração para melhorar a longevidade das próteses. Um elastômero maxilofacial tipo A foi pigmentado intrinsecamente de acordo com os seis tons da Escala de Fitzpatrick. Uma técnica de pigmentação foi desenvolvida a partir dos resultados obtidos a partir de uma Escala de Fitzpatrick impressa em papel e dos pigmentos intrínsecos de cores primárias. Este dimetil-metilvinil-siloxano reforçado por platina A 223-30 (Factor II, Inc., Lakeside, AZ, USA) apresenta dureza \"Shore-A\" 30. As amostras foram expostas a fotoenvelhecimento acelerado, e sua degradação mapeada com Espectroscopia UV/Vis/NIR. Concluiu-se que: (i) Os implantes com conexão cone Morse plataforma 3.7 tem melhor comportamento biomecânico com intermediários de 45o e altura de 2mm. Sugere-se planejamento cirúrgico visando a instalação a 3 horas para o temporal esquerdo e 9 horas para o temporal direito, mais 6 horas (mastóide). Implantes com conexão cone Morse plataforma 4.0 apresentaram comportamento biomecânico desejável com intermediários de 20o e alturas de 2mm or 4mm. Para implantes com conexão cone Morse plataforma 4.0, sugere-se a instalação a 6-9-12 horas para o temporal direito, e 12-6-3 para o esquerdo, visando comportamento biomecânico adequado. Sugere-se que os implantes extraorais Brånemark hexágono externo com plataforma 4.1 regular ou expandida sejam preferencialmente empregados com intermediários de 20o. (ii) O SiO2 5% pode ser adicionado à preparação do silicone para retardar o desbotamento da prótese maxilofacial. O TiO2 traz mudanças visuais significativas e pode ser considerado como opacificador.Major challenges in Implantology include: achieving longevity of implants, bone tissue preservation, connective tissue suitable answer and maintenance of secondary stability in order to retain prosthesis. These factors avoid the undesirable loss of both rehabilitation treatment and supporting bone tissues. The extraoral region has less bone depth compared to the maxilla and mandible regions, especially for the temporal bone. Therefore, the following aspects were investigated: (i) Finite Elements Analysis (FEA) of 16 virtual models, with static application of tension and compression forces in medium points between implants. Three extraoral maxillofacial implants were placed on the temporal bone, which one of them was placed on the mastoid process. This study was made entirely in a computational environment. Two prosthetic connection types and straight Intermediários were employed, with conicities of 20º and 45º, placed virtually on the temporal bone model, mutually parallel. A virtual bar for bar-clip prosthetic retention of auricular prosthesis was designed. The best configurations were considered to be the ones presenting uniform and mild von Mises tension distribution over the bone tissue around the implants. (ii) Generation of samples with varying degree of pigmentation to (a) improve the reproducibility of the colouration (b) understand and minimise the discolouration process to improve prosthetics longevity. A maxillofacial elastomer type A was intrinsically pigmented according to the six tones of the Fitzpatrick Scale. A pigmentation technique was developed from spectroscopy outcomes of paper printed Fitzpatrick Scale and the primary colors pigments. This platinum reinforced dimethyl methylvinyl siloxane A 223-30 (Factor II, Inc., Lakeside, AZ, USA) presents \"Shore-A\" hardness 30. The samples were exposed to accelerated photo aging, and their degradation mapped with UV/Vis/NIR Spectroscopy. The effects of exclusion of oxygen and inclusion of nanoparticle fillers during prosthetic formulation were investigated. It was concluded that: (i) Morse taper prosthetic connection 3.7 platform implants, should be employed with 45o abutments with 2mm height. The surgical planning shall be for placement 3 hours for the left temporal bone and 9 hours for the right, and in 6 hours (mastoid). Morse taper prosthetic connection 4.0 platform implants behaved biomechanically desirably with 20o abutments in 2mm or 4mm heights. For the Morse taper connection 4.0 platform implants, their placement shall be in 6-9-12 hours, for the right temporal, and 12-3-6, for the left temporal, in order to achieve proper biomechanical behaviour. The Brånemark extraoral external hexagon implant, with 4.1 platform (normal or expanded) should preferrably be used with 20o abutments. (ii) The SiO2 5% may be added to the silicone preparation in order to slow maxillofacial prosthesis colour fading. The TiO2 brings visually significant changes and may be considered as an opacifier

ESB 2016 - 22nd Congress of the European Society of Biomechanics - 40th Annual Conference of the European Society of Biomechanics

Facial prosthetics requires a means of retention. Over the last three decades, osseo integrated implants have been used to improve the hold and retention of facial prosthesis. This finite elements analysis (FEA) was performed aiming the behavior of Br?nemark extraoral implants with extended platform and bar-clip system placed for auricular prosthesis support

ESB 2016 - 22nd Congress of the European Society of Biomechanics - 40th Annual Conference of the European Society of Biomechanics

In sport competitions, facial bone fractures, particularly in the zygomatic bone,are becoming increasingly common. Thus, further studies on the material possibilities for an efficient protection are extremely valuable. The present work aims to test different layer thickness combinations of semi-rigid and flexible EVA ?Ethylene-vinyl acetate ?looking for an optimized performance for the impact protection of the zygomatic bone. Results will guide subsequent indications for individualized face protectors