Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Chondrosarcoma of the jaw: a retrospective series Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Akram Abdo Almansoori, Hui-Young Kim, Bongju Kim, Soung-Min Kim, Jong-Ho Lee Objectives Low-grade chondrosarcoma presents with features similar to those of benign lesions, such as chondroma and synovial chondromatosis, increasing the difficulty in reaching an accurate diagnosis preoperatively. In this study, we retrospectively reviewed 10 chondrosarcoma cases and evaluated the diagnostic approaches and management modalities. Study Design Ten cases were included in the present study. We evaluated the clinical features, initial diagnosis, histopathology subtype, immunohistologic markers, final diagnosis, and treatment modalities. Results Most of the lesions were found in the mandible. Two cases were followed up for 1 month and 4 years, respectively as benign lesions before malignant changes were detected. With regard to chondrosarcoma histopathology subtypes, 6 cases were identified as conventional chondrosarcoma, whereas 4 cases were diagnosed as mesenchymal chondrosarcoma with aggressive behavior; of these, 3 were associated with local recurrence and metastasis. The immunohistologic markers showed no specificity for chondrosarcoma. Conclusions Distinguishing low-grade chondrosarcoma, particularly in the temporomandibular joint, from benign lesions, such as chondroma or synovial chondromatosis, remains difficult. Currently, the correlation between clinical, radiographic, and histologic features accompanied by close follow-up is extremely important for patients diagnosed with chondrogenic lesions. Postoperative radiotherapy seems to be beneficial in patients with positive surgical margins.

Data management practices of cone beam computed tomography volumes: An exploratory user survey Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Dwight D. Rice, Kenneth Abramovitch, Gregory W. Olson, Edwin L. Christiansen Objective The aim of this study was to query cone beam computed tomography (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 2 CBCT user groups. The survey consisted of 18 questions on 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: (1) 53% of respondents utilized Digital Imaging and Communications in Medicine volumetric data sets for initial storage. (2) 46% of respondents saved data in raw or native file formats. (3) 60% of storage sites were in onsite servers. (4) 35% of volumes saved were in a “Zip” compression format. (5) 37% of respondents used a picture archiving and communication system for storage. Conclusions The absence of consensus on postcapture management of volumetric data sets indicates that a dentistry-wide data management standard would benefit patient care while mitigating information technology storage issues.

Desmoplastic fibroma associated with tuberous sclerosis: case report and literature review Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Mina D. Fahmy, Anish Gupta, Ricardo J. Padilla, Annette Segura, Carolyn Dicus Brookes Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder that affects the skin, brain, kidneys, and other organ systems. It may exhibit a wide spectrum of clinical manifestations. Desmoplastic fibroma (DF) of the jaw is a rare benign myofibroblastic neoplasm. Less than 10 cases of DF associated with TSC have been published previously. We report a new case of a maxillary DF in a 12-year-old girl with TSC. The presentation, diagnostic process, and management of this case are discussed, and the literature is reviewed for the additional cases of DF associated with TSC; 7 previously reported cases are summarized. Small sample size limits conclusions, but there may be differences in the presentations of DF of the jaws in patients with TSC vs those in the general population. DF of the jaws may be a manifestation of TSC, and the authors propose surveillance panoramic radiographs every 2 to 3 years in patients with TSC.

KLF4 expression in the surgical cut margin is associated with disease relapse of oral squamous cell carcinoma Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Souvick Roy, Madhabananda Kar, Shomereeta Roy, Swatishree Padhi, Arka Saha, Birendranath Banerjee Objective The presence of cancer stem-like cells (CSCs) in the majority of tumors is one of the factors responsible for disease relapse in oral squamous cell carcinoma (OSCC). In this study, we investigated the role of octamer-binding transcription factor 4 (OCT4) and Kruppel-like factor 4 (KLF4) in OSCC progression and disease relapse. Study Design In this study, 102 patients with OSCC were included. The expression of β-catenin and CSC markers (KLF4 and OCT4) in surgical cut margin and tumor were investigated through Western blot analysis, immunohistochemistry, and quantitative polymerase chain reaction analysis. The χ2 test was used to evaluate the association of β-catenin, OCT4, and KLF4 expression with clinicopathologic characteristics. Kaplan-Meier and Cox regression analyses were performed to correlate different clinical factors with the prognoses of patients with OSCC. Results We observed increased expression of OCT4, KLF4, and β-catenin in the cut margins (CMs) in recurrent OSCC. The χ2 test exhibited recurrence as one of the key factors associated with high expression of these markers. Kaplan-Meier and COX regression analyses demonstrated that increased expression of KLF4 in the CM region of recurrent patients was independently associated with a poor prognosis. Conclusions Our findings indicated that expression of KLF4 can be used for monitoring disease progression and may serve as prognostic marker to predict recurrence.

Upregulation of eukaryotic translation initiation factor 3 subunit a promotes cell survival in ameloblastoma Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Zhenjiang Ding, Jie Liu, Junting Wang, Biying Huang, Ming Zhong Objectives This study aimed to detect the expression of eukaryotic translation initiation factor 3 subunit a (eIF3a) in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate the roles of eIF3a in the immortalized ameloblastoma cell line (AM-1) cell proliferation and apoptosis. Study Design We performed immunohistochemistry to determine the expression of eIF3a in AB tissues (n = 83) and NOM tissues (n = 20). Real time–quantitative polymerase chain reaction and Western blot analyses were conducted with AB tissues (n = 30) and NOM tissues (n = 6). The correlation between eIF3a expression and the clinical/pathologic features of patients with AB is also presented. The functional role of eIF3a in AM-1 cells was assessed with lentiviral vector–mediated shRNA (small hairpin RNA). Results Our results indicated that eIF3a was significantly upregulated in AB. Additionally, eIF3a knockdown in AM-1 cells significantly inhibited cell proliferation and promoted apoptosis. Conclusions These data indicate that eIF3a facilitates the survival of AB cells and may serve as a promising therapeutic target in AB.

Chronic treatment with zoledronic acid alters the expression levels of inflammatory, bone, and apoptotic markers and Toll-like receptors 2 and 4 in rat dental pulp Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Paulo Goberlânio de Barros Silva, Antonio Ernando Carlos Ferreira, Camila Carvalho de Oliveira, Maria Elisa Quesado Lima Verde, Milena Oliveira Freitas, Fabrício Bitu Sousa, Mário Rogério Lima Mota, Ana Paula Negreiros Nunes Alves Objective The aim of this study was to evaluate the immunostaining of inflammatory, apoptotic, and bone markers, as well as Toll-like-receptors (TLRs) 2 and 4 in the dental pulp in rats treated with zoledronic acid (ZA). Study Design We administered 4 intravascular infusions of saline (control group) or 0.20 mg.kg−1 ZA in Wistar rats (n = 6/group). After 70 days, the 3 rights molars (n = 18/group) were microscopically evaluated (presence of ectasic/dilated blood vessels and inflammatory cells). Immunohistochemistry was performed for tartrate resistant acid phosphatase 5 (TRAP; cell counting), cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), TLR2, TLR4, receptor activator of nuclear kappa B ligand (RANKL), osteoprotegerin (OPG), and caspase-3 (scored 0–3 in odontoblast and nonodontoblast dental pulp cells). Mann-Whitney and Fisher's exact tests and Spearman's correlation were used (GraphPad Prism 5.0). Results There was no alteration in ectasic/dilated blood vessels (P = .101) or inflammatory cells (P = .500), but the number of TRAP-positive cells was reduced in the ZA-group (P = .027). In ZA-group odontoblasts, immunostaining for COX-2 (P = .044), TLR4 (P = .003), OPG (P = .035) and caspase-3 (P = .039) increased, and that for RANKL (P = 0.045) decreased. In nonodontoblast dental pulp cells, RANKL immunostaining decreased (P = .009). In the ZA group, the RANKL/OPG ratio decreased in odontoblast (P = .022) and nonodontoblast dental pulp cells (P = .007). IL-6 did not differ between the groups. Conclusions ZA increases the expression levels of inflammatory, apoptotic markers, and TLR4 and alters bone makers in the dental pulp of rats.

Therapeutic efficacy of propranolol for infantile hemangiomas Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Wenli Wu, Hongtao Wang, Jiansuo Hao, Zijun Gao, Fan Li, Yiyang Chen Objectives. This was a retrospective study to analyze the clinical therapeutic efficacy of propranolol in patients with infantile hemangioma (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 as follows: excellent in 31.37% (16 of 51); good in 39.21% (20 of 51); poor in 23.53% (12 of 51); and nonresponsive in 3.92% (3 of 51). Of the 15 patients who had a poor or no response to propranolol, 2 received injected pingyangmycin, and 3 underwent surgical resection; the remaining 10 patients received no further therapy. The relevance of many clinical factors (sex, age, dose, depth, and diameter) to the efficacy of propranolol was assessed with univariate and multivariate ordinal logistic regression models, which indicated that young age (≤5 months) was significantly associated with better efficacy (P ˂ .05). The most common side effect was diarrhea (52.2%). There was no significant association between dose of propranolol and side effects (P = .12). Conclusions. The effect of oral propranolol was better in younger patients. A 3- to 4.5-mg/kg/day dose may not be more effective than the conventional recommended dose of 2 to 3 mg/kg/day.

Serum and salivary interleukin-4 levels in patients with oral lichen planus: A systematic review and meta-analysis Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Hamid Reza Mozaffari, Elisa Zavattaro, Mina Saeedi, Pia Lopez-Jornet, Masoud Sadeghi, Mohsen Safaei, Mohammad Moslem Imani, Reza Nourbakhsh, Hedaiat Moradpoor, Amin Golshah, Roohollah Sharifi Objective Cytokines have an important role in keratinocyte immune damage and can act in the pathogenesis of different cutaneous diseases. Accordingly, in the literature, interleukin 4 (IL-4) concentration has been previously investigated in patients affected by oral lichen planus (OLP). Study design The present meta-analysis evaluated the serum and salivary levels of IL-4 in connection with several OLP variants. The search was performed from 1995 in Cochrane Library and 1983 in Scopus, PubMed, and Web of Science to September 2018. The quality of the studies included in the meta-analysis was assessed using the Newcastle-Ottawa Scale assessment. The analyses were done by Review Manager 5.3 using mean difference (MD) and 95% confidence intervals (CIs). Results Out of 108 studies retrieved in the databases, only 10 were included and analyzed in quantitative synthesis. The pooled MD of the serum and salivary IL-4 levels in OLP patients compared with the controls was 6.36 picograms/milliliter (pg/mL) (95% CI: 1.47, 11.24; P = .01) and 2.67 pg/mL (95% CI: 2.66, 2.68; P < .00001), respectively. In addition, the pooled MD of serum and salivary IL-4 level was 1.30 pg/mL (95% CI: –0.35, 2.95; P = .12) and 1.83 pg/mL (95% CI: 0.26, 3.40; P = .02), respectively, in patients with erosive, erythematous, bullous, and ulcerative variants of OLP compared with patients with reticular OLP. Conclusions This meta-analysis found that OLP patients present elevated serum and salivary IL-4 levels, thus indicating that IL-4 may represent a potential salivary biomarker for the disease. By contrast, clinicians must be aware that even other factors (e.g., secondary infection) may influence its concentration.

Risk factors for caries development in primary Sjogren syndrome Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Nicola Berman, Frederick Vivino, Joshua Baker, Jonathan Dunham, Andres Pinto Objectives The aim of this study was to compare the risk factors for caries between patients with primary Sjogren syndrome (SS) and those with non-Sjogren syndrome (NSS) salivary hypofunction 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 center between 2012 and 2015 for assessment of patients with possible SS. Two-hundred and twenty-five (225) patients (99 SS and 126 NSS) participated in the study. Results Student t test and Wilcoxon's rank sum test were used to evaluate group differences in continuous variables and the χ2 test was used to determined differences in categorical variables. Significant univariate associations were further assessed by using multivariate ordinal regression models. Patients with SS were more likely to have a greater number of total caries (odds ratio [OR] 1.72 [1.03–2.88]; P = .04). And a focus score greater than 1/4 mm2 was associated with greater number of total caries (OR 2.88 [1.05, 7.93]; P = .04]. Adjusted analysis for salivary flow did not show a significant association between stimulated or unstimulated salivary flow or glandular-specific salivary flow and the total number of carious lesions. Conclusions Patients with salivary hypofunction secondary to SS do have a greater caries risk compared with patients with salivary hypofunction caused by other factors. In this study cohort, this finding was not associated with salivary flow rates.

Oral health–related quality of life in women with temporomandibular joint disk anterior displacement before and after disk repositioning and anchoring surgery assessed with the Oral Health Impact Profile (OHIP-14) Publication date: August 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2 Author(s): Roberto Ferreira Zanin, Guilherme Ommizolo, Alexandre Weber, Cláiton Heitz, Eduardo Martinelli Santayana de Lima Objectives The aim of this study was to assess and compare oral health–related quality of life (OHRQOL) in women with temporomandibular joint (TMJ) disk displacement without reduction, before disk repositioning and anchoring surgery, in short-term follow-up, in different age groups, and with use of the Oral Health Impact Profile (OHIP-14). Study Design Fifty women ages between 17 and 60 years were divided into 4 age groups: 17–27, 28–38, 39–49, and 50–60 years. All the patients were asked to answer the OHIP-14 form before surgery and during their short-term follow-up. Seven domains of OHRQOL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domains’ scores and total OHIP-14 were compared between times by using Student's t test in the whole sample and in the 4 age groups. Results Both the whole sample and the age groups (17–27, 28–38, 39–49 years) showed a statistically significant decrease in all scores (P < .01). The age group 50–60 years showed a decrease in scores significant only in functional limitation (P = .05) Conclusions TMJ disk anterior displacement had a negative impact on women's OHRQOL because of physical pain, physical disability, and psychological discomfort. TMJ disk repositioning and anchoring surgery improved overall OHRQOL in patients between 17 and 49 years of age; however, in patients between 50 and 60 years of age, there was improvement only in physical pain.