Hyaluronic acid (HA) injections into the oral mucosa have proven to be effective as a non-invasive method for the reconstruction of interproximal papillary defects in aesthetic areas. Despite being a ...minimally invasive and safe technique, certain side effects may occur after treatment.We report the first case of a patient with unilateral necrosis of the mucosa of the hard palate after HA filling in the maxillary anterior gingiva. Familiarity with these events and competent knowledge of the anatomy is essential to avoid complications, achieve and offer adequate treatment and good results to our patients.
Personalized surgery (PS) involves virtual planning (VP) and the use of 3D printing technology to design and manufacture custom-made elements to be used during surgery. The widespread use of PS has ...fostered a paradigm shift in the surgical process. A recent analysis performed in our hospital—along with several studies published in the literature—showed that the extensive use of PS does not preclude the lack of standardization in the process. This means that despite the widely accepted use of this technology, standard individual roles and responsibilities have not been properly defined, and this could hinder the logistics and cost savings in the PS process. The aim of our study was to describe the method followed and the outcomes obtained for the creation of a PS service for the Oral and Maxillofacial Surgery Unit that resolves the current absence of internal structure, allows for the integration of all professionals involved and improves the efficiency and quality of the PS process. We performed a literature search on the implementation of PS techniques in tertiary hospitals and observed a lack of studies on the creation of PS units or services in such hospitals. Therefore, we believe that our work is innovative and has the potential to contribute to the implementation of PS units in other hospitals.
The aim of this survey was to investigate the surgical management of bilateral mandibular angle fracture (BMAF) in Europe.
Data were collected from 2008 to 2018 on patients ≥ 16 years of age who ...underwent open reduction internal fixation (ORIF) for BMAF with a third molar in the fracture line. The study was conducted at 6 European trauma centers. The following data were recorded: sex, age, cause of the fracture, type of fracture (nondisplaced, displaced, comminuted), type of approach (intraoral, transbuccal, or extraoral), thickness of the plate (≤1.4 mm or ≥1.5 mm), number of plates, cause of plate removal, and third molar extraction status.
25 patients with BMAF (24 males, 1 female, 17 to 83 years old mean: 28.2 years) were collected. The main cause of BMAF was assault, and the main surgical approach was intraoral. The most common types of BMAF were displaced + undisplaced (11 patients), displaced + displaced (7 patients), undisplaced + undisplaced (6 patients), and comminuted + comminuted (1 patient). Osteosynthesis was performed with 2 ≤1.4 mm plates on 1 angular fracture and 1 ≤1.4 mm plate on the other fracture in 11 patients, 1 ≤1.4 mm plate on both angular fractures in 6 patients, 1 ≥1.5 mm plate on both fractures in 5 patients, and 2 ≤1.4 mm plates on both fractures in the remaining 3 patients. Out of 25 patients with BMAF, 7 third molars were extracted during ORIF. Among these patients, angular fracture fixation was performed in 3 cases with 1 ≥1.5 mm plate and in 4 patients with 2 ≤1.4 mm plates.
This retrospective multicenter survey indicates a trend of treating with open reduction and rigid internal fixation at least 1 angular fracture of BMAF and those cases requiring extraction of the third molar in the line of fracture.
The purpose of this study was to evaluate the healing benefit provided by the antioxidant and antifibrotic properties of pentoxifylline–tocopherol or pentoxifylline–tocopherol–clodronate in ...combination therapy for osteoradionecrosis.
We searched for relevant reports in PubMed by using a combination of “osteoradionecrosis” and the following keywords: “pentoxifillyne,” “tocopherol,” “vitamin E,” or “clodronate.” We considered articles in English or Spanish, with no limitations on the publication date.
The combination of pentoxifylline plus tocopherol with or without clodronate was found to be effective for the treatment of mandibular osteoradionecrosis, although data were generally scarce and mostly came from retrospective case series.
This drug therapy is well tolerated and could be promising for the treatment of mandibular osteoradionecrosis, but prospective randomized controlled clinical trials are needed for further clarification.
Purpose
Oral and maxillofacial surgery (OMS) malpractice risk is of special interest due to both the aesthetic component of some procedures and the complexity of the pathologies involved. This study ...aims to identify relevant factors involved in OMS professional liability (PL) claims to help achive better management of risks and improve patient safety.
Methods
We performed a retrospective analysis of 315 OMS claims opened between 1990 and 2014 from the database of the PL Department of the Catalonian Council of Medical Colleges, and identified their clinical, economical and juridical characteristics.
Results
OMS showed a high rate of compensation (33.8%). Dental implant surgery, third molar surgery and rhinoplasty presented the greatest exposure to claims, and in these cases, lack of osteointegration of dental implants, neurologic injury of inferior dentoalveolar/lingual nerves and a poor aesthetic result were the most frequently compensated sequelae. Statistically, significant association was found between this perioperative complications group and the presence of PL. Poorly documented patient information (informed consent document) was also significantly related with PL outcome.
Conclusions
OMS is a specialty of medium risk for claims, especially oral surgery cases. Surgical complications, such as neurologic damage after oral/head and neck procedures and poor aesthetic results, do occur and deserve special attention to improve patient safety, as well as patient-information procedure.
Although there is scientific evidence demonstrating causation of human papilloma virus (HPV) on squamous cell carcinoma of head and neck, its percentage of causality on the anatomic region remains in ...dispute. This study was developed with the objectives of evaluating the relationship between HPV and oral and oropharyngeal squamous cell carcinomas (OOSCC), and of studying the correlation between HPV detection tests (PCR and p16).
Retrospective study of patients treated for OOSCC during 2011, with a follow-up of 6 years. The sample was divided into 2 groups according to HPV positivity, detected by 2 techniques: p16 by immunohistochemistry and PCR. Demographic and clinical variables were analysed using SPSS® 22.0, considering P<.05 to be statistically significant.
We analysed 155 patients affected by OOSCC (mean age of 62.7, where 69% were males). Twenty six cases were p16+ (16.8%) and 19 cases PCR+ (12.3%), The HPV+ tumours were located predominantly in the oropharynx (42.1%, P=.017) and demonstrated the tendency to be more frequent in males, with higher incidence in younger patients, lower in smokers and drinkers, and higher when patients have a greater cervical lymph node involvement at the time of diagnosis. The PCR+ patients had higher survival (P=.024), as did the p16+ (P=.005).
The incidence of HPV in OOSCC is low (12.3%), but the clinical presentation and prognosis of the HPV+ patient differs from the classic smoker and/or drinker, which implies assessing the management of these patients independently. The p16 staining has a great diagnostic capacity to predict HPV (95.5%), although the detection of the HPV genome is still the gold standard technique.
Since the approval of anti-EGFR and anti-PD1 monoclonal antibodies in head and neck squamous cell carcinoma, there is an increased interest in developing novel therapeutics in head and neck ...malignancies. The purpose of this study is to analyze all phase I clinical trials conducted at the Vall d'Hebron Institute of Oncology for head and neck cancers since 2010. We aimed to evaluate the proportion of phase I studies with dedicated cohorts for head and neck cancers, assessing the types of agents in development and tumor types included, as well as analyzing the patient characteristics participating in these trials.
We have reviewed all the phase 1 clinical trials conducted in the Early Drug Development Unit, from Vall d'Hebron Institute of Oncology from January 2010 to June 2023, and identify which of these studies have cohorts for head and neck cancers. We use descriptive statistics to describe the tumor types and drug types included in these cohorts. We have also collected data from all the patients with head and neck cancers, included in phase I clinical trials from January 2010 to December 2022 and describe tumor types and agents used to identify potential opportunities for development in head and neck tumors.
Among the 634 phase I clinical trials activated from 2010 to 2023, 151 clinical trials had at least one cohort for patients with head and neck malignancies. Most of these studies include other solid tumors, and only 2 studies were tumor-specific. The majority of the 151 studies with dedicated head and neck cohorts were focused on head and neck squamous cell carcinoma (84%), while only 21% and 2.8% included salivary gland cancers or nasopharyngeal carcinomas (7.5% of studies include two or more histologies). Sixty-two studies evaluated agents in monotherapy, while 38% evaluated combinations. The anticancer agents evaluated included: targeted therapy 131 (87%), immunotherapy 61 (40%), chemotherapy 17 (11%), and hormone therapy 1 (0.7%). The proportion of studies evaluating immunotherapies was higher in the studies with dedicated head and neck cohorts, in comparison to the global pool of phase I studies conducted in the unit (32.5%). Although the absolute number of phase I studies with dedicated head and neck cohorts has progressively increased (29 studies in 2022), the proportion compared to the global pool of phase I studies remained stable since 2016 ranging from 25-30% of the total.
From January 2010 to December 2022 we have included 275 patients in phase I clinical trials: 63% had HNSCC, 28% had salivary gland cancers, 8% had nasopharyngeal carcinomas, and 1% had other tumor types. The new agents evaluated included: immunotherapies (52%), targeted agents (41%), novel chemotherapies or antibody-drug conjugates (6%), and other therapies such as nanoparticles (1%).
There is an increasing interest in developing novel drugs for head and neck cancers. In recent years, 25-30% of the phase clinical trials conducted in our institution have at least one cohort dedicated to head and neck malignancies, especially HNSCC. Despite these positive trends, clinical trial opportunities for rare/less frequent head and neck cancers remain limited.
Background/Aims
Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study ...was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period.
Methods
The following data were collected: age (preschool 0–6 years, school age 7–12 years, and adolescent 13–18 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.
Results
Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).
Conclusion
The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
Manejo quirúrgico del ameloblastoma Valls, Adaia; Montané, Esther; Bescós, Coro ...
Revista española de cirugía oral y maxilofacial,
July-September 2012, Letnik:
34, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Resumen El ameloblastoma es un tumor odontogénico de estirpe epitelial. Aunque se clasifica como una tumoración benigna, suele ser localmente agresiva presentando elevada invasión local, con gran ...tendencia a la recidiva y con posibilidad metastásica ocasional. Se manifiesta preferentemente durante la tercera, cuarta y quinta décadas de la vida, sin predilección por razón de sexo, aunque puede darse en cualquier grupo de edad, incluidos los niños. La mayoría de los ameloblastomas se encuentran sobre todo en mandíbula (al nivel del ángulo y rama). En el tratamiento se debe valorar su tipología clínica (sólido, multiquístico, uniquístico, mixto o periférico), su localización y el tamaño del tumor, así como la edad y las condiciones clínicas del paciente. Presentamos una revisión de los pacientes afectos de ameloblastomas tratados en nuestro Centro durante los últimos 10 años. Se aportan datos acerca de su aparición clínica, sus características histológicas, el manejo terapéutico realizado y analizamos el seguimiento y comparamos la aparición de recidivas en los pacientes presentados. Las características clínicas, incluso si se complementan con radiografías y/o muestras histológicas, no son siempre determinantes del comportamiento biológico y, por tanto tampoco lo son del pronóstico de un ameloblastoma individual.
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