A systematic review of molecular responses to cancer therapy in normal human mucosa

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Publication date: Available online 15 August 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Mette Marcussen, Conni Skrubbeltrang, Julie Støve Bødker, Ilse Christiansen, Martin Bøgsted, Karen Dybkær, Olav Jonas Bergmann, Hans Erik Johnsen
ObjectiveCancer therapy-induced inflammation of oral and gastrointestinal mucosa affects patients non-uniformly. Preventive strategies are limited; no biomarker exists for pretreatment identification of patients likely to be severely affected. Animal models are preferred for studying molecular responses in mucosa during chemotherapy, but translation into clinical practice is difficult. We performed a systematic review to retrieve papers that described molecular changes in human mucosa during cancer therapy.Study DesignWe searched MEDLINE and Ovid Embase searches for English-language literature from January 1990 to November 2016 and studies referenced in selected papers, that analyzed human mucosa from patients at risk of developing mucositis during cancer therapy. Two authors extracted data according to predefined data fields, including study quality indicators.ResultsWe identified 17 human studies on chemotherapy (n=9) and radiotherapy (n=8), but no targeted therapy studies. Studies were heterogeneous regarding patient cohort, analysis methods, cancer treatment, biopsy timing, and correlations to clinical mucositis. Consequently, meta-analysis was not feasible.ConclusionsFew human studies described the molecular responses of normal mucosa to cancer therapy. Studies were heterogeneous with sparse correlations to clinical mucositis. We proposed a model for acquiring data on treatment- and disease-specific phenotypes and transcriptomes for predictive or preventive initiatives.

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Dentoskeletal parameters related to visual perception of facial asymmetry in patients with skeletal class III malocclusion after orthognathic surgery

The purpose of the study is to explore the critical parameters determining the visual perception of postoperative facial symmetry. This study retrospectively included 24 patients with skeletal class III malocclusion and double-jaw orthognathic surgery (OgS). The patients were classified according to the outcome of subjective visual perception scores (SVPS) based on the postoperative frontal images by 10 orthodontists: symmetrical surgical outcome (S group, n=12) and facial asymmetry after surgery (A group, n=12).

http://ift.tt/2w3pPYd

Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning

Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon.

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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy

This study aimed to assess the value of cone beam computed tomography (CBCT) in the detection of salivary stones in patients with signs and symptoms of salivary gland obstruction. A total of 142 major salivary glands were analysed in a cohort of 127 patients with signs and symptoms of salivary gland obstruction. CBCT scans were performed in order to determine the presence of one or more salivary stones. All glands were also investigated by sialendoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for the submandibular gland, the parotid gland, and the whole group, based on the observers’ abilities to diagnose the presence or absence of calculi in the CBCT scan using the sialendoscopy data as the gold standard.

http://ift.tt/2w3mQ1U

Signs of disease occur in the majority of third molars in an adult population

The purpose of this study was to assess clinical and radiographic signs of disease in third molars within a population that is representative of the Finnish adult population aged 30 years and older. A two-stage stratified cluster sampling method was used to collect the 6005 subjects, who were examined clinically and also by panoramic radiography. The state of impaction, presence of dentinal caries and/or restorations, presence of root canal fillings, periodontal pocket depth, and additional pathological findings such as over-eruption and widened follicle were assessed.

http://ift.tt/2uQIHpq

Signs of disease occur in the majority of third molars in an adult population

The purpose of this study was to assess clinical and radiographic signs of disease in third molars within a population that is representative of the Finnish adult population aged 30 years and older. A two-stage stratified cluster sampling method was used to collect the 6005 subjects, who were examined clinically and also by panoramic radiography. The state of impaction, presence of dentinal caries and/or restorations, presence of root canal fillings, periodontal pocket depth, and additional pathological findings such as over-eruption and widened follicle were assessed.

http://ift.tt/2uQIHpq

Periodontal ligament-like Tissue Regeneration with Drilled Porous Decalcified Dentin Matrix Sheet Composite

Abstract

Objective

In this study, we constructed a composite by combining the human dental follicle cell sheet and a manual drilled porous decalcified dentin matrix that was used to construct ectopic tissue-engineered periodontal ligament-like tissues in renal capsules of nude mice.

Materials and Methods

Human dental follicle cells were harvested from human lower third molars and then embedded into a temperature-sensitive culture dish. These cells were then placed into frozen porous decalcified dentin matrix sheets and induced by 50 g/ml ascorbic acid. This established a “sandwich structure” in vitro implant that was placed in nude mice under the renal capsule. The mice were sacrificed at 4 weeks and 8 weeks after implantation, and the implants were assessed after haematoxylin-eosin staining, Masson staining and immunohistochemical staining.

Results

The experimental group showed a fibre structure between the dentin and HA-TCP after 4 weeks. After 8 weeks, the collagen fibres increased, and the direction was perpendicular to the dentin. Immunohistochemistry showed positive staining in the osteopontin and periostin.

Conclusion

The composite can induce ectopic bone and fibre formation, and the fibre had a certain directionality. Besides, the composite can maintain the stability of the periodontal ligament width.

This article is protected by copyright. All rights reserved.

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Lipoid proteinosis unveiled by oral mucosal lesions: a comprehensive analysis of 137 cases

Abstract

                <span> 
                  </span><h3>Objectives</h3> 
                  <p>Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized by deposits of hyaline material within skin and mucous membranes of the upper aerodigestive tract, especially the vocal cords. We aimed to investigate possible associations between oral LP (oLP) manifestations and demographic data and extra-oral lesions.</p> 

                <span> 
                  </span><h3>Material and methods</h3> 
                  <p>Cases of oLP were collected following a systematic search of Medline’s PubMed and Google Scholar (1948–2014). We added four new cases. Demographic data, consanguineous marriage status, oral lesion site(s), and related symptoms were analyzed for potential associations.</p> 

                <span> 
                  </span><h3>Results</h3> 
                  <p>A total of 137 patients with oLP lesions were analyzed. Parental consanguinity status was known for 52 patients, and the parents were not related in 38 (73%) of them. The tongue was the most commonly affected oral site (68%), and it was associated with significantly more affected family members (<em>P</em> = 0.002). The palate and gingiva were the least involved sites (25 and 6%, respectively): the former had a tendency to be affected in younger patients and the latter in older ones. Patients with palatal and labial lesions had significantly less skin scarring (<em>P</em> &lt; 0.001 and <em>P</em> = 0.002, respectively).</p> 

                <span> 
                  </span><h3>Conclusions</h3> 
                  <p>Extra-oral manifestations are easily recognizable and they can lead to early and accurate diagnosis of LP. In spite of early voice manifestations, diagnosis of LP might be obvious only later in life and usually sought due to presence of oral lesions.</p> 

                <span> 
                  </span><h3>Clinical relevance</h3> 
                  <p>The diagnosis of oLP with obscure extra-oral signs is challenging, with dental surgeons playing a key role in its establishment.</p> 
                <br /><br />

http://ift.tt/2vHg8fl

Pragmatic approach to manage new oral anticoagulants in patients undergoing dental extractions: a prospective case-control study

Abstract

                <span> 
                  </span><h3>Objectives</h3> 
                  <p>The aim of this study was to validate a standardized pragmatic approach to manage new oral anticoagulants (NOACs) in patients who undergo dental extractions.</p> 

                <span> 
                  </span><h3>Materials and methods</h3> 
                  <p>This prospective case-control study in patients undergoing dental extraction included 26 patients (mean age 76 years, 57% male) treated with dabigatran, rivaroxaban, or apixaban and 26 matched controls. Regardless of timing of extraction, drug regimen, or renal function, patients were instructed to skip only the dose on the morning of the procedure. A procedural bleeding score was recorded and early and delayed bleeding was assessed at day 1 and day 7. Bleeding events were compared with a prospectively matched control group not taking any antithrombotic drug.</p> 

                <span> 
                  </span><h3>Results</h3> 
                  <p>There was no difference in the procedural bleeding score or in early bleeding events (5 in both groups). However, delayed bleeding occurred more frequently in anticoagulated compared to non-anticoagulated patients (7 versus none, <em>p</em> = 0.01).</p> 

                <span> 
                  </span><h3>Conclusions</h3> 
                  <p>Skipping the morning dose of NOACs avoids excess bleeding during and early after the procedure. However, anticoagulated patients had an increased risk of delayed bleedings. Further study is needed to determine the optimal post-procedural management.</p> 

                <span> 
                  </span><h3>Clinical relevance</h3> 
                  <p>This is the first prospective study for the management of patients on NOACs undergoing dental extraction. Our pragmatic approach, omitting only a single morning dose, can guide clinical practice. Both patients and physicians should be aware of the increased delayed bleeding risk.</p> 
                <br /><br />

http://ift.tt/2vGRZpb