Clinicopathological features of peripheral ossifying fibroma in a series of 41 patients Publication date: Available online 8 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): H. Lázare, A. Peteiro, M. Pérez Sayáns, P. Gándara-Vila, J. Caneiro, A. García-García, I. Antón, J.M. Gándara-Rey, J.M. Suárez-Peñaranda Abstract Peripheral ossifying fibromas are benign mesenchymal lesions that usually arise in the anterior maxilla of young female patients. Histologically they consist of spindle cell proliferation with focal mineralisation. We reviewed 48 specimens from 41 patients and recorded the clinical data, sex, and age of the patients, site and size of the lesions, treatment, and postoperative outcome. Histologically the presence of mature, woven bone, cementum, and calcifications were evaluated and evaluated immunohistochemically. Lesions were more frequent in female patients in the third and fourth decade, and were usually in the lower maxilla and smaller than 2 cm. All lesions were conservatively excised, and they relapsed in eight patients. Histopathologically, the lesions were poorly circumscribed, moderately cellular proliferations, with no discernible architectural pattern. All tumours showed some degree of mineralisation, the presence of immature bone being the most common. Immunohistochemical examination showed staining of tumoural cells for smooth muscle actin and CD68. Lesions tended to occur more commonly in female patients, but one decade later than usually reported. We found a higher recurrence rate in lesions that contained cementum-like material but without bone formation, suggesting a lack of maturation in this group. Immunohistochemical results were consistent with myofibroblastic differentiation but they added no information about the behaviour of the lesions.

Re: adjuvant radiation in early oral cancers with isolated perineural invasion Publication date: Available online 8 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): S.S. Shetty, A. Kudpaje, V. Rao, R. Jayaraj

Treatment of dentigerous cysts with a modified Hawley plate in children: report of two cases with radiographic results Publication date: Available online 7 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): J. Nohra, A.R. Kassir, H. Akel, M. Dagher Abstract Dentigerous cysts in young adults may compromise the natural evolution of the dentition and can be treated surgically or non-surgically. We report the minimally-invasive treatment of dentigerous cysts in two young patients using a modified Hawley plate to avoid traumatic injury to anatomical structures, with up to four years’ follow up.

Use of an acrylic jig to aid orbital reconstruction after resection of a sphenoid intraosseous meningioma: a technical note Publication date: Available online 6 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): J.V. Williams, J.D. Parmar, L.M. Carter, P. Woodhead, R. Corns

Squamous cell carcinoma of the head and neck – screening in patients who misuse alcohol and tobacco in Switzerland: a prospective pilot study Publication date: Available online 6 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): M. Mermod, A. Adam, C. Clair, M. Faouzi, C. Simon, J.-B. Daeppen, N. Bertholet, Y. Monnier Abstract Squamous cell carcinoma (SCC) of the head and neck is the sixth most common cancer worldwide. It is preceded by early asymptomatic lesions which, if identified early enough and removed, would prevent malignant transformation or avoid delaying diagnosis to advanced stages. Our aim was to evaluate the feasibility of a screening programme for SCC of the head and neck in a group of high-risk patients, and to investigate their addiction profile. Patients admitted to an inpatient alcohol addiction centre (n = 101) were prospectively enrolled and asked to fill in a questionnaire about their use of tobacco and alcohol, and the presence of warning symptoms for SCC of the head and neck from 23 June 2014 to 21 January2016. Participants in the study had a physical examination by an alcohol addiction physician followed by a full examination of the head and neck by an otorhinolaryngologist to rule out premalignant or malignant lesions of the upper aerodigestive tract. Of the 101 patients, 62 (60%) had at least one warning symptom. Alcohol addiction physicians identified leukoplakia in six (6%) and erythroplakia in two. No pre-malignant or malignant lesions were confirmed on examination by the otolaryngologist. We were unable to draw conclusions about the cost-effectiveness or the yield of the screening programme. Despite our negative findings, we may need further investigation to clarify the relevance of such a programme on health-related outcome given the high compliance rate and minimal delay that was achieved by taking advantage of an in-patient alcohol rehabilitation centre.

Exploring the relation between patients’ resilience and quality of life after treatment for cancer of the head and neck Publication date: Available online 5 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): G. Clarke, Y.A. Asiedu, K. Herd, S. Sharma Abstract Resilience, which is a measure of a patient's ability to recover from a traumatic event, varies among the general population, and previous studies have suggested that it has an important influence on a patient's quality of life. We conducted a study of patients treated for cancer of the head and neck to investigate the relation between scores for resilience and quality of life (QoL). A total of 98 patients, who had been treated with curative intent, completed the University of Washington quality of life questionnaire (UW-QoL) and the Connor-Davidson resilience scale (CD-RISC). Retrospective analysis of patients’ records identified demographic data, stage of disease, and treatment. The Mann-Whitney U-test, Kruskal-Wallis test, and Spearman’s rank correlation were used to assess the significance of differences between the groups. The mean (SE) QoL score after treatment was 61 (2.081), and the mean CD-RISC score 0.427 for QoL in the last seven days. There was a significant correlation between overall scores for QoL and resilience (Spearman's Rho = 0.427, p < 0.005). As higher resilience scores had a significant correlation with a better QoL, strengthening a patient’s resilience might in turn help to improve their quality of life.

Pregnancy and childbirth after an iliac crest free flap Publication date: Available online 5 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): B.M. Fisher, M.D. Batstone Abstract We report two successful pregnancies and vaginal deliveries by patients who had previously had deep circumflex iliac artery free flaps that had been harvested for reconstruction in the head and neck.

The stair step genioplasty: a modification of the oblique sagittal sliding genioplasty Publication date: Available online 5 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): D.P. Tauro, R.S. Manay

Clinical experience and results with a Rhombic Plate for transoral endoscopically-assisted osteosynthesis of fractures of the condylar neck Publication date: Available online 5 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): H. Leonhardt, A. Franke, A. Nowak, NMH. McLeod, G. Lauer Abstract The intraoral approach is favoured by many patients and surgeons for the treatment of fractures of the condylar neck, but the limited space offered by this approach can make positioning and fixation of the osteosynthesis plate difficult. A rhombic-shaped plate was designed specifically for use with the intraoral approach, and introduced into our clinical practice in 2012. We present the clinical and functional results in 81 patients with 98 fractures of the condylar neck who we have treated with this technique. Of these six required surgical revision, and ultimately all but two had satisfactory occlusion and mandibular function. Our complication rate of 6/81 (7.4%) compares favourably with those reported elsewhere, and confirms that open reduction and internal fixation of condylar fractures using the Rhombic plate through an intra-oral approach provides good outcomes.

Our experience of a nurse-led oral and maxillofacial surgical clinic in a tertiary centre: two years on Publication date: Available online 5 October 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): J. Spellman, E.G. Walshaw, A. Kanatas, T.K. Ong Abstract We describe our two-year experience of a nurse led clinic (NLC) in a tertiary centre oral and maxillofacial surgical (OMFS) department. The clinic is run by a specialist nurse, in parallel with a consultant’s clinic and focuses on the management and review of non-malignant lesions. Increased clinical flexibility, reduced waiting times, and tailored educational resources have contributed to an improved experience for the patients.