Objective We compared the anesthetic efficacy of inferior alveolar nerve block (IANB) plus buccal infiltration (BI) and IANB plus periodontal ligament (PDL) articaine injections in patients with ...irreversible pulpitis in the mandibular first molar. Study design Fifty-seven volunteers, patients with irreversible pulpitis in the mandibular first molar admitted to the Department of Stomatology, Second Affiliated Hospital, Sun Yat-Sen University, randomly received conventional IANB, containing 1.7 mL 4% articaine/HCl with 1:100,000 epinephrine, plus either BI or PDL injections containing 0.4 mL articaine/HCl with 1:100,000 epinephrine. The patients recorded the pain of the injections and endodontic access on a Heft–Parker visual analog scale (VAS). Results According to the VAS scores, all patients experienced no or mild pain with BI and PDL injections after the application of IANB. Anesthetic success occurred in 81.48% for IANB plus BI (IANB/BI) compared with 83.33% for IANB plus PDL injection (IANB/PDL injection). None of the observed differences between the 2 groups was significant ( P > .05). Conclusion Both injection combinations resulted in high anesthetic success in patients with irreversible pulpitis in the mandibular first molar.
Purpose The purpose of this study was to explore an effective repair method for oral and maxillofacial soft-tissue defects after salvage surgery for patients with recurrent oral carcinoma. Patients ...and Methods Eight patients (6 females and 2 males, mean age, 56.9 years) with recurrent oral squamous cell carcinoma of the tongue (n = 4), oral cavity floor (n = 2), and buccal (n = 2) were treated with salvage surgery, and the oral and maxillofacial soft-tissue defects were reconstructed primarily by extended vertical lower trapezius island myocutaneous flap. Results No flap failure occurred. The donor sites were closed primarily. There were no disabilities with regard to shoulder motion. Followed up after the operation, the survival period of the patients was 6 to 30 months and the average survival period was 13.1 months. There was 1 recurrent case. All of the patients survived. Conclusion The extended vertical lower trapezius island myocutaneous flap, which is a simple, reliable and large flap, can be preferred as a salvage procedure for oral and maxillofacial soft-tissue defects after salvage surgery for patients with recurrent oral squamous cell carcinoma.
Summary Objective This study presents an effective repair method for the hemimandibular and oral defects produced during the ablation of advanced oral malignant tumours. Methods Nine patients (five ...males and four females ranging in age from 18 to 74 years; mean age 51.3 years) with advanced oral malignant tumours were treated at our institution. Trapezius osteomyocutaneous island flaps (TOIFs) including the acromion, spine, and part of the medial scapular border were used to repair the hemimandibular and oral defects. Results No major flap failure occurred. Donor-site problems have been minimal, with limited shoulder motion in all patients. The functional results in terms of speech, swallowing, and facial contour were satisfactory. The patients were followed for 6–24 months (average 15.2 months): six of them are alive with no disease, two alive with disease; and one has died of a lung metastasis. Conclusion The TOIF is large, simple, and reliable, and is preferred for reconstructing hemimandibular and oral defects.
Objective Congenital arteriovenous malformations (AVMs) in the maxillofacial region are rare, potentially life-threatening, vascular lesions. This study reviewed our experience with a ...multidisciplinary approach to treating maxillofacial AVMs in children. Study design Thirteen patients (10 boys and 3 girls) with AVMs involving the facial soft tissues or jaws were treated using a multidisciplinary approach that included: 1) superselective intra-arterial embolization (SIAE); 2) bone wax packing (BWP) of the bone cavity and curettage; and 3) compartmentalization and sclerotherapy. Results The mean follow-up was 13.5 months, with a range of 6-22 months. The following outcomes were obtained: 9 lesions (69.2%) were completely involuted, 3 lesions (23.1%) were mostly involuted, and 1 lesion (7.7%) was partially involuted. The rates of completely and mostly involuted AVMs involving the jaws treated using SIAE, BWP, and curettage were 80% and 20%, respectively. The rates of completely, mostly, and partially involuted AVMs involving soft tissues treated by compartmentalization and sclerotherapy were 60%, 30%, and 10%, respectively. Conclusion SIAE was reliable for controlling bleeding and as adjunctive treatment for maxillofacial AVMs in children. SIAE followed by BWP of the bone cavity and curettage was a simple, safe, and effective method for treating AVMs of the jaws; SIAE followed by compartmentalization and the injection of OK-432 and pingyangmycin was a reliable alternative treatment for AVMs of the soft tissues in the maxillofacial region.
Objective The aim of the present study was to demonstrate whether articaine/HCl administered alone as a single buccal infiltration in maxillary tooth removal provided favorable palatal anesthesia as ...compared to buccal and palatal injection, for a surgical procedure. Study design In total, 71 patients for removal of bilateral permanent maxillary teeth were enrolled in the present study. For the experimental side, 1.7 mL of 4% articaine/HCl was injected into the buccal vestibule of the tooth. After 5 minutes, tooth extraction was performed. On the control side a similar protocol was applied with the addition of a palatal injection. All patients completed a 100-mm Visual Analogue Scale (VAS), Verbal Response Scale (VRS) after both injection and then extraction, respectively. Results According to the VAS scores, the pain of injection between buccal infiltration without a separate palatal injection and routine administration with additional palatal injection was statistically significant ( P < .05). However, the VAS scores for permanent maxillary tooth removal showed no significant difference between the 2 types of injection ( P > .05). All patients described both extractions as “acceptable” and no patient requested an additional palatal injection to ensure comfortable extraction. Conclusions The routine use of a palatal injection for the removal of permanent maxillary teeth may not be required when articaine/HCl is used as the local anesthetic.
Objective The aim of this study was to investigate the relationship between membrane cytoskeleton linker protein Ezrin and CD44v6, iNOS, Ki-67, and clinicopathologic characteristics, and the ...prognostic significance of Ezrin expression in salivary gland adenoid cystic carcinoma (SACC). Study design Immunohistochemistry and reverse-transcription polymerase chain reaction were used to quantify the expression of Ezrin, CD44v6, inducible nitric oxide synthase (iNOS), and Ki-67 in 75 primary SACCs, 25 tumor-free salivary tissues, and 2 SACC cell lines (ACC-M and ACC-2). Survival analysis was performed to find the prognostic significance of Ezrin expression. Results Expressions of Ezrin, CD44v6, iNOS, and Ki-67 in SACC tissues, especially with distant metastasis, were significantly higher than in tumor-free tissues. Ezrin mRNA and protein levels in ACC-M cells were significantly higher than in ACC-2 cells. Ezrin, CD44v6, iNOS, and Ki-67 expressions were significantly higher in solid pattern than in cribriform and tubular patterns. Ezrin and its partners, CD44v6, iNOS, and Ki-67, were significantly related to tumor size, clinical stage, perineural and vascular invasion, and recurrence. Furthermore, Ezrin had an independent prognostic effect on overall survival. Conclusions The increased expression of Ezrin and its partners, CD44v6, iNOS, and Ki-67, in SACC correlated with histologic patterns, may play a role in distant metastasis, and might indicate poor clinical outcome.
Purpose To evaluate the feasibility and outcome of a combined retroauricular and transoral approach for removing the submandibular gland. Patients and Methods Thirteen patients underwent removal of ...benign submandibular gland lesions (6 sialoadenitis with sialolithiasis, 4 chronic sialoadenitis, and 3 pleomorphic adenomas) using a combined retroauricular and intraoral approach. Results All 13 submandibular sialoadenectomies were successful and all of the wounds healed uneventfully. A temporary deficit of the lingual nerve developed in 2 cases and mild limited movement of the tongue developed in 3 cases. No patient suffered from weakness of the marginal mandibular branch of the facial nerve. The follow-up averaged 14.1 months (range, 6-24 months); no tumors recurred. The incision scars were invisible. Conclusion Submandibular gland resection using a combined retroauricular and transoral approach is a feasible method for benign submandibular gland lesions that provides an acceptable cosmetic outcome.
Objective The objective of this study was to examine the expression of cysteine-rich protein 61 (Cyr61) in the distant metastatic tumor cells of human primary salivary adenoid cystic carcinoma (SACC) ...and its relationship with tumor angiogensis and metastasis. Study design The experimental group comprised 35 paraffin-embedded tumor specimens of distant metastasis from primary SACC, with their corresponding primary tumor tissues and matched normal salivary gland tissues used as the control groups. Immunohistochemical staining was used to detect the expression of Cyr61 and vascular endothelial growth factor in the experimental and control groups. Vascular endothelial cells were highlighted by the anti-CD34 antibody, and the Weidner method was used to quantify microvessel density (MVD). Results Cyr61 was overexpressed in distant metastatic tumor cells of primary SACC. Positive expression of Cyr61 and vascular endothelial growth factor (VEGF) progressively increased in normal salivary gland tissues, primary tumor tissues, and tumor tissues of distant metastasis ( P < .05). Compared with primary tumor tissues, Cyr61 expression and VEGF expression showed significant increase in tumor tissues of distant metastasis ( P < .05). Cyr61 expression significantly correlated with VEGF expression and MVD ( P < .05). Conclusions Cyr61 appeared to have a significant association with tumor angiogenesis and metastasis in SACC and may be an important target in tumor antiangiogenesis therapy.
Objective The objective of this study was to examine the expression of hypoxia-inducible factor-1α (HIF-1α) in osteosarcoma of the jaw (OSJ) and its relationships with tumoral angiogenesis and ...clinicopathologic characteristics. Study design Streptavidin peroxidase immunohistochemical staining was used to detect the expression of HIF-1α and CD34 in paraffin-embedded samples from 25 patients. There were 14 male and 11 female patients, ages ranged from 3 to 63 years. Results HIF-1α was overexpressed in OSJ. HIF-1α expression was correlated with tumoral microvascular density, as well as with the size, pathologic grade, and clinical stage of OSJ. Expression of HIF-1α was also correlated with clinicopathologic characteristics, such as primary occurrence or recurrence of the tumor, but not with metastasis. Conclusion HIF-1α was significantly correlated with the size, pathologic grade, clinical stage, and primary occurrence or recurrence of the OSJ. HIF-1α appeared to promote tumoral angiogenesis in OSJ and may be an important target in antitumoral therapy.
