Oral Surgery, Oral Medicine, Oral Pathology ,Oral Radiology

Using rare diseases as teaching models to increase awareness Publication date: Available online 1 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Faizan Alawi

MIGRATION OF THE ROOT COMPLEX AFTER CORONECTOMY OCCURS WITHIN THE FIRST YEAR AFTER SURGERY. A 5-YEAR RADIOGRAPHIC ANALYSIS AND PROTOCOL SUGGESTION Publication date: Available online 27 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Mads Hagen Pedersen, Louise Hauge Matzen, Louise Hermann, Sven Erik Nørholt Abstract Objectives No study exists evaluating the radiographic follow-up protocol after coronectomy. This study aims to assess root migration after coronectomy of mandibular third molars in panoramic images one, three and five years after surgery. Study Design This was a prospective cohort study of patients undergoing coronectomy of a mandibular third molar. The patients followed a five-year follow-up regimen with a panoramic examination at one, three and five years after the surgical intervention. Three observers assessed the panoramic images in a blinded randomized order evaluating bone coverage; superimposition of roots and mandibular canal; and migratory changes of the roots. Descriptive statistics were used to describe changes. Furthermore, reproducibility among the observers was calculated. Results Sixty-two patients were included. Ingrowth of bone superior to the root complex during the first year was registered by all observers (observer 1 100%, observer 2 77.4% and observer 3 85.5%). Superimposition of the mandibular canal and the root complex at the post-surgical panoramic images and after one year showed that 53.2-62.9% went from superimposition to no superimposition. Inter-observer reproducibility was high. Conclusions Migration of the root complex occurs primarily within the first year after coronectomy. Therefore, a routine radiographic follow-up after one year only is recommended.

Therapeutic efficacy of propranolol for infantile hemangiomas Publication date: Available online 26 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Wenli Wu, Hongtao Wang, Jiansuo Hao, Zijun Gao, Fan Li, Yiyang Chen Abstract Objectives This study retrospective analyzes the clinical therapeutic efficacy of propranolol for patients with infantile hemangiomas (IH). Study design Patients with IH were treated with propranolol (2–4.5 mg/kg/day). Those patients who did not have a good response to propranolol underwent intertumoral injection of pingyangmycin or surgery. Results Relative therapeutic responses to propranolol among the 51 patients were 31.37% (16/51) excellent, 39.21% (20/51) good, 23.53% (12/51) poor, and 3.92% (3/51) non-responsive. Of the 15 patients who had a poor or no response to propranolol, two then received injected pingyangmycin and three had surgical resection; the remaining 10 patients received no further therapy. The relevance of many clinical factors (gender, age, dose, depth, and diameter) to the efficacy of propranolol was assessed with univariate and multivariate ordinal logistic regression models, indicating that young (≤ 5 months) age was significantly associated with better efficacy (P ˂ 0.05). The most common side effect was diarrhea (52.2%). There was no significant association between dose of propranolol and side effects (P = 0.12). Conclusions The effect of oral propranolol was better in younger patients. A 3–4.5 mg/kg/day dose might not be better than the conventional recommended dose of 2–3 mg/kg/day.

TMJ Total Joint Replacement using the Zimmer Biomet Microfixation patient fitted prosthesis results in reduced pain and improved function Publication date: Available online 26 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Alero Boyo, Julia McKay, Gerald Lebovic, David J. Psutka Abstract Objective To evaluate the pain and maximum incisal opening (MIO) of patients treated with the Zimmer Biomet Microfixation patient fitted alloplastic temporomandibular joint (TMJ) prosthesis. Methods The authors implemented a retrospective cohort study of patients who had undergone bilateral or unilateral TMJ total joint replacement (TJR). The primary outcome variables were pain and MIO which were measured at various time points between 12 months to over 60 months. Secondary outcomes included perceived masticatory efficiency and patient satisfaction. Results A total of 33 patients (62 joints) met inclusion criteria for the study. The relationship between time and the change in pain scores, although significant immediately after surgery in an unadjusted model, was not statistically significant in an adjusted model. A statistically significant improvement between time and MIO is noted in both adjusted and unadjusted models. A majority of patients (91%) reported a subjective improvement in their diet. Similarly, 91% of patients felt that TJR was beneficial and in retrospect, would repeat their decision to undergo TJR. Conclusion Patients treated with the Zimmer Biomet Microfixation patient fitted TMJ prosthesis experience improvements in their pain, MIO and ability to masticate. Future studies are needed to assess long-term outcomes prospectively.

Risk factors for caries development in Primary Sjogren's Syndrome Publication date: Available online 26 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Nicola Berman, Frederick Vivino, Joshua Baker, Jonathan Dunham, Andres Pinto Abstract Objectives To compare risk factors for caries between SS (primary SS) and non-Sjogren's Syndrome (NSS) salivary hypofunction subjects, and to identify the prevalence of incisal or cervical/root caries in each group. Study Design This was a retrospective, cross-sectional study conducted at a single site between 2012 and 2015 for assessment of subjects with possible SS. Two-hundred and twenty-five (225) subjects (99 SS and 126 NSS) participated in the study Results T-tests and Wilcoxon rank sum tests evaluated group differences in continuous variables and, chi-squared tests determined differences in categorical variables. Significant univariate associations were further assessed using multivariate ordinal regression models. SS were more likely to have a greater number of total caries [OR 1.72 (1.03, 2.88) p=0.04], a focus score ≥ 1/ 4 mm2 was associated to greater number of total caries [OR 2.88 (1.05, 7.93) p=0.04]. Adjusted analysis for salivary flow did not yield a significant association between stimulated or unstimulated, or glandular specific flow and total number of carious lesions. Conclusion Subjects with salivary hypofunction secondary to SS do have a greater caries risk compared to subjects with salivary hypofunction due to other causes. In this cohort, this finding was not associated to salivary flow rates.

Investigation of foreign materials in gingival lesions: A clinicopathologic, energy-dispersive microanalysis of the lesions and in vitro confirmation of pro-inflammatory effects of the foreign materials Publication date: Available online 20 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Leticia Ferreira, Hsin-Hsin Peng, Darren P. Cox, David W. Chambers, Avni Bhula, John D. Young, David M. Ojcius, Erivan S. Ramos-Junior, Ana Carolina Morandini Abstract Objectives This study aimed to evaluate the clinical and histopathological features of gingival lesions containing foreign material (GLFM). In parallel, the composition of the foreign material and its effects in primary human gingival fibroblasts (HGF) were investigated. Study Design Eighty six GLFM were retrieved from an oral pathology biopsy service. Clinical and microscopic data were analyzed and the composition of the particles was identified by energy-dispersive x-ray spectroscopy (EDX). Furthermore, HGF were stimulated with silica (SiO2) microparticles to investigate the production of COL-1, MMP2, and inflammatory cytokines. Results GLFM were most commonly found in women (60.5%) and most frequently described as white plaques. Histopathological examination identified verrucous hyperplasia in 59% and epithelial dysplasia in 28% of the cases. EDX microanalysis revealed that Si (94%) was the most frequently detected foreign element. SiO2 micro-particles induced higher COL-1 expression, higher levels of pro-inflammatory cytokines such as IL-6, IL-8 and TGF-ß, and increased MMP-2 activity in HGF. Conclusion There was a strong association between the presence of foreign material in gingiva and white verrucous clinical lesions. In addition, the most common element in the foreign material was Si, and our in vitro findings demonstrate the importance of silica-mediated effects on gingival fibroblasts.

Changes in condylar dimensions in temporomandibular joints with disc displacement Publication date: Available online 20 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Bo-Yeon Seo, Jung-Sub An, Min-Seok Chang, Kyung-Hoe Huh, Sug-Joon Ahn ABSTRACT Objectives To investigate the condylar dimensions of the temporomandibular joint (TMJ) with respect to disc displacements and gender using computed tomography (CT) and magnetic resonance imaging (MRI). Study Design Disc displacements were divided into three groups based on MRI: normal disc position (NR), disc displacement with reduction (DDR), and disc displacement without reduction (DDNR). After the angular and linear condylar dimensions were calculated from CT images, differences in condylar dimensions with respect to disc displacements and gender were analyzed with two-way analysis of variance. Results Condylar depth and condylar height were significantly smaller in condyles with DDNR than those with NR or DDR (NR = DDR > DDNR). Condylar width gradually decreased significantly from NR to DDNR (NR > DDR > DDNR). The anterior condylar angle was significantly larger in condyles with NR than those with DDR or DDNR (NR > DDR = DDNR). Condyles with DDNR exhibited significantly larger horizontal condylar angles than those with NR or DDR (NR = DDR < DDNR). Altered condylar dimensions associated with disc displacement were not significantly different between men and women. Conclusion Condylar dimensions may be significantly associated with disc displacements of the TMJ, irrespective of gender.

Data Management Practices of CBCT Volumes: An Exploratory User Survey Publication date: Available online 17 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Dwight D. Rice, Kenneth Abramovitch, Gregory W. Olson, Edwin L. Christiansen Abstract Objective To query CBCT users about their storage and transfer practices: to identify trends in the handling of CBCT data in dentistry. Study Design A computer-based survey was distributed to two CBCT user groups. The survey consisted of eighteen questions including: settings for data capture, data storage, archiving strategies, bit depth/compression, monitoring user access to patient information, and dissemination to end users. All information was anonymously collected. Descriptive data and frequency patterns were collected and discussed. Results A total of 68 surveys were returned with 56 fully completed. Results reflected a low consensus about usage and management of radiographic data sets. Some preferential usage patterns however were noted along with the following trends; a. 53% of respondents utilized DICOM volumetric data sets for initial storage. b. 46% of respondents save data in raw, or native file formats. c. 60% of storage sites were in onsite servers. d. 35% of volumes saved were in a "Zip" compression format. e. 37% of respondents used PACS systems for storage. Conclusion The absence of consensus on post-capture management of volumetric data sets underscores that a dentistry-wide data management standard would benefit patient care while mitigating IT storage issues.

ADHERENT WHITE PLAQUES IN A NONSMOKER Publication date: Available online 17 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Andres Flores-Hidalgo, Alice E. Curran

Full blood counts are not predictive of the risk of medication-related osteonecrosis of the jaws: a case-control study. Publication date: Available online 17 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Kelly McGowan, Robert S Ware, Caroline Acton, Saso Ivanovski, Newell W Johnson ABSTRACT Objectives The role of immune function in susceptibility to medication-related osteonecrosis of the jaws (MRONJ) remains unclear. This study investigated whether full blood counts, as a measure of systemic health and immune function, predict the development of MRONJ. Study Design A case-control study was conducted in Brisbane, Australia. 57 cases diagnosed with MRONJ from January 2010 to March 2017 were identified from hospital records and individually matched with up to 4 controls using primary disease, sex, age and antiresorptive therapy (total sample = 249). Demographic and clinical data were extracted and associations were investigated using conditional logistic regression. Results 67% of cases and 65% of controls reported at least one result outside of the laboratory reference range (OR=0.7; 95%CI: 0.3, 1.5; p=0.29). The most commonly reported abnormal results were low haemoglobin (53% of cases, 48% of controls) and low haematocrit (33% of cases, 25% of controls). There were no significant differences between groups in any of the reported parameters. Conclusions Patients taking antiresorptive medications frequently return blood test results outside the standard laboratory reference range. Altered blood counts were not limited to patients who developed MRONJ and do not appear to be clinically useful in identifying patients at high risk for this condition.