Oral Region Research Articles

The sagittal evaluation and classification of midfacial morphology in Chinese Han Youth: A cross-sectional study

Midface is located in the central area of the facial region and plays a crucial role in the aesthetic evaluation of one's appearance. The East Asian, especially the Chinese, has wide and flat midfacial bone structure, low piriform aperture area compared with the prominent zygomatic and oral region, which results in an unpleasant appearance. 1 Jin H.R. Won T.B. Rhinoplasty in the Asian Patient. Clin Plast Surg. 2016; 43: 265-279 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar In contrast to the patients' surging demand of midface filling surgery, there is a lack of evaluation standard for midfacial depression, nor quantitative and objective grading system for midface morphology. In the current study, we collected the three-dimensional (3D) facial information of Chinese Han Youth and summarized the morphological characteristics of their midface, focusing on the concavity and convexity from the sagittal plane.

Facial Reconstruction Using Sternocleidomastoid (SCM) Flap: A Review of the Literature.

The sternocleidomastoid (SCM) flap has been used for a long time in protective coverage of major vessels, reconstruction of intraoral pharyngeal, closure of pharyngo-cutaneous fistulas, and augmentation of soft tissue defects in the oral and maxillofacial region. However, this flap is not yet commonly used due to doubtful blood supply to the flap. This flap offers favorable esthetic results, combined flap, rich vascularization, and the possibility of shifting the two heads of the muscle. Thus, this flap has been used broadly in the maxillofacial region to reconstruct the defects of the post-parotidectomy, mandible, pharynx, and floor of the mouth defects. Previous studies discussed the use of a SCM flap following parotidectomy. However, few studies explained the use of SCMs in facial reconstruction. This study aims to review published articles discussing the use of SCMs for facial reconstruction.

Role of immunohistochemistry in diagnosing round-cell tumours affecting the oral and maxillofacial regions.

One of the most challenging spectra of lesions in the oral and maxillofacial region (OMFR) are round-cell tumours (RCTs). They show a considerable degree of overlap in microscopy and immunophenotypes. The main aim of this study is to analyse the spectrum of RCTs encountered in the oral and maxillofacial regions. We emphasise the role of immunohistochemistry (IHC) which in conjunction with histological, clinical, and imaging findings is necessary for their correct characterisation. The secondary objectives are to discuss differential diagnosis, workflow, and diagnostic algorithm for round-cell lesions affecting the OMFR. Formalin-fixed, paraffin-embedded sections of RCTs were retrieved from the archives of the Department of Oral Pathology (January 2018 to March 2020). These cases were analysed by three pathologists independently by evaluating haematoxylin and eosin-stained sections, and immunohistochemical markers employed to characterise these lesions. Under the spectrum of RCTs, 11 cases (0.53%) were diagnosed with a predominance of non-Hodgkin lymphoma (55%) followed by Ewing sarcoma (18%). The remaining were Langerhans cell histiocytosis (9%), neuroendocrine carcinoma (9%), and sinonasal undifferentiated carcinoma (9%). Except for one case, in all cases, the final diagnosis was established with the use of adjunctive IHC. RCTs can pose a diagnostic challenge for inexperienced oral pathologists. Thorough knowledge of the differentials of RCT occurring in oral and maxillofacial is helpful. An algorithm-based diagnostic approach incorporating the clinical, imaging, and histomorphological findings and immunohistochemical evaluation can help in minimizing diagnostic confusion and errors.

Mucocutaneous leishmaniasis in a 10-year-old female patient from the ecuadorian amazon. Case report [Version 1; Peer Review - In process

Leishmaniasis comprises a set of clinical syndromes caused by protozoa of the genus Leishmania. The infection can be located in the skin and/or subcutaneous tissue with or without regional adenopathy (cutaneous leishmaniasis), in the oro-nasal mucosa (mucocutaneous leishmaniasis) or generally affect the phagocytic mononuclear system (visceral leishmaniasis). 400 000 new cases of human leishmaniasis in Asia, Africa, countries of the Mediterranean basin, the Near East and America. Each Leishmania species has a specific geographic distribution and causes characteristic clinical syndromes. This case report presents a 10-year-old patient with painful ulcerative lesions located in the oral region and whitish plaques on the tongue that prevent food intake. Receive treatment for the patient's clinic using Meglumine Antimonate with a favorable prognosis

Tween-20-Modified BiVO4 Nanorods for CT Imaging-Guided Radiotherapy of Tumor.

Oral cancer is the most common malignant tumor in the oral and maxillofacial region, which seriously threatens the health of patients. At present, radiotherapy is one of the commonly used methods for oral cancer treatment. However, the resistance of cancerous tissues to ionizing radiation, as well as the side effects of X-rays on healthy tissues, still limit the application of radiotherapy. Therefore, how to effectively solve the above problems is still a challenge at present. Generally speaking, elements with high atomic numbers, such as bismuth, tungsten, and iodine, have a high X-ray attenuation capacity. Using nanomaterials containing these elements as radiosensitizers can greatly improve the radiotherapy effect. At the same time, the modification of nanomaterials based on the above elements with the biocompatible polymer can effectively reduce the side effects of radiosensitizers, providing a new method for the realization of efficient and safe radiotherapy for oral cancer. In this work, we prepared Tween-20-modified BiVO4 nanorods (Tw20-BiVO4 NRs) and further used them in the radiotherapy of human tongue squamous cell carcinoma. Tw20-BiVO4 NRs are promising radiosensitizers, which can generate a large number of free radicals under X-rays, leading to the damage of cancer cells and thus playing a role in tumor therapy. In cell experiments, radiotherapy sensitization of Tw20-BiVO4 NRs significantly enhanced the production of free radicals in oral cancer cells, aggravated the destruction of chromosomes, and improved the therapeutic effect of radiotherapy. In animal experiments, the strong X-ray absorption ability of Tw20-BiVO4 NRs makes them effective contrast agents in computed tomography (CT) imaging. After the tumors are located by CT imaging, it helps to apply precise radiotherapy; the growth of subcutaneous tumors in nude mice was significantly inhibited, confirming the remarkable effect of CT imaging-guided radiotherapy.

Real-world human gender classification from oral region using convolutional neural netwrok

Gender classification is an important biometric task. It has been widely studied in the literature. Face modality is the most studied aspect of human-gender classification. Moreover, the task has also been investigated in terms of different face components such as irises, ears, and the periocular region. In this paper, we aim to investigate gender classification based on the oral region. In the proposed approach, we adopt a convolutional neural network. For experimentation, we extracted the region of interest using the RetinaFace algorithm from the FFHQ faces dataset. We achieved acceptable results, surpassing those that use the mouth as a modality or facial sub-region in geometric approaches. The obtained results also proclaim the importance of the oral region as a facial part lost in the Covid-19 context when people wear facial mask. We suppose that the adaptation of existing facial data analysis solutions from the whole face is indispensable to keep-up their robustness.

The prevalence of oral and maxillofacial pathologic lesions in pathology centers of Zanjan (Iran) over a 5-years period (2014-2020)

Background and objectives: The oral and maxillofacial region is exposed to many harmful agents and can be affected by a wide range of reactive, infectious, cystic, precancerous, and neoplastic lesions. This study aimed to determine the prevalence of oral and maxillofacial pathological lesions in pathology laboratories in Zanjan. 
 Method: This retrospective descriptive study was conducted in the period 2014 -2020 by referring to the hospitals and laboratories with pathologists in Zanjan. Information about patients with histopathological lesions of oral and maxillofacial region was extracted, and studied in terms of age, gender, location and histopathological type of lesion. Finally, the collected data were entered into SPSS software version 22 and statistically analyzed (P <0.05).
 Results: A total of 176 histopathological lesions were investigated. Of them, 120 cases (58%) were female and 74 (42%) were male. The mean age of the patients was 39.4 years. The most prevalent lesion was periapical cyst (14.8%).In terms of tissue involved, the most lesions were related to soft tissue (67%) and in terms of anatomical location, the most lesions were gingival mucosal lesions (35.2%).
 Conclusion: The prevalence of pathological lesions was higher in females than in males. Soft tissue lesions were more than hard tissue lesions. Gingival mucosal lesions were the most prevalent and lesions of the floor of the mouth and nasal vestibule lesions were the least prevalent ones. Given the histopathologic nature of lesions, periapical cyst was the most prevalent lesion.

Post-traumatic Implant Surgical Rehabilitation of the Alveolar Ridge of the upper Jaw

Introduction; Dental trauma can be defined as an injuryto the oral region including the lips, teeth, periodontal tissues, tongue and/or alveolar processes.
 The aims of management will depend on the age of the patient, type of tooth (primary or permanent) and the extent of the injuries. The treatment varies from preserving the tooth,extraction of the tooth and immediate implant placement. Immediate implantation is defined as placement of the implant into alveolus of the extracted teeth immediately after extraction.
 Materials and methods; A 45-year-old patient, suffered teethand dental bridge fracture and injury during car accident.Immediate teeth extraction was performed and immediate implantation with bone ridge preservation was performed, to rehabilitate the lost teeth. Patient underwent successfully for prosthetic rehabilitation 8 months after these procedures.
 Conclusion; Affected traumatized teeth often have areduced prognosis and, in some instances, may requireextraction. The majority of dental trauma is initially seenwithin a primary rather than secondary care setting. General dental practitioners should therefore be able to effectively manage the most common dental injuries, and to referthe complicated ones to oral surgeon. Dental implants are reliable to replace teeth lost because of traumatic dental injury. The timing of implant placement may be immediate,early, conventional, or late and is determined by the extent of the trauma, remaining growth, and conditions of the hardand soft tissues.

Needle Removal in the Deep Maxillofacial Region Assisted by Computerized Navigation Technique and Digital Guiding Plate.

Retention of foreign bodies frequently happened in the region of oral and maxillofacial. In very rare cases, the positions of the foreign objects moved with the movement of muscles in the oral and maxillofacial regions. Precise locations of moving objects and minimally invasive surgeries pose a great challenge to surgeons. The case of a 44-year-old female patient diagnosed with retention of the fractured needle is reported in this study. A digital guide plate was manufactured to locate the precise position of the fractured needle and preoperatively mimic the surgery processes. The computerized navigation system guided us to make an incision and precisely target the fractured needle during the surgery. Combing the technologies of the digital guiding plate and navigation system, removing the moving foreign bodies becomes objective, time-saving, and minimally invasive.

Outcomes and predictive factors for re-stricture with urethroplasty methods for anterior urethra stricture.

We wished to compare the treatment success of urethroplasty methods (EPA and BMG) used for anterior urethra stricture after unsuccessful internal urethrotomy. A total of 85 and 51 patients, respectively, who underwent excision and primary anastomosis (EPA) and buccal mucosal graft (BMG) urethroplasty due to recurrent strictures after direct vision internal urethrotomy (DVIU) were evaluated retrospectively. On the uroflowmetry test, >15 ml/s urine flow and residual urine (PVR) below 50 ml were determined as success criteria. Cox regression analysis investigated the probable predictive factors for surgery success. Kaplan-Meier analysis assessed stricture free survival after redo-urethroplasty. After surgery, EPA and BMG patients were followed for 31.9 ± 9.8 (4-40) and 30.7 ± 10.3 (4-40) months. At the end of this follow-up duration, success was obtained for 71 (83.5%) and 44 (86.3%) patients. Mean re-stricture times were 13.9 ± 6.0 (4-19) and 10.2 ± 5.1 (4-26) months. Most re-strictures had penile location (10 (71.5%) and 7 (100%)). After one session of DVIU, there was 100% success in both groups, but after >3 sessions of DVIU, success fell to 70.3% and 78.3% in the groups respectively. Patients with high numbers of DVIU sessions had longer durations for urethroplasty surgery. Apart from complications related to the donor field in the oral region with BMG and four patients who developed fistula (7.8%), complications were similar in both groups. In this series of cases, it was not possible to identify which of the techniques employed provides the best result or predictive factors for stenosis recurrence after correction procedures for anterior urethral stenosis.

Tumor-Induced Osteomalacia as a Result of a Phosphaturic Mesenchymal Tumor: Detecting Rare Origin

Phosphaturic mesenchymal tumor (PMT) is strongly related to tumor-induced osteomalacia (TIO) which brings diverse skeletal events, such as bony deformities, gait disturbance, and multiple bone fractures. Overexpressed fibroblast growth factor 23 by the tumor induces hypophosphatemia leading to the oncogenic osteomalacia, a rare paraneoplastic syndrome. PMT occurring in the oral and maxillofacial regions is extremely rare, and this case highlights the need to understand mechanisms by which local lesions can affect systemic conditions, and the importance of a combination of physical examinations, laboratory investigations, and radiologic investigations for a decisive diagnosis.

Can Our Blood Help Ensure Antimicrobial and Anti-Inflammatory Properties in Oral and Maxillofacial Surgery?

In recent decades, the potential of PRF has been extensively studied. The number of studies about PRF has increased three times since the year 2012, but the full spectrum of its fundamental properties, such as antimicrobial and anti-inflammatory activity, is not clearly described. In oral and maxillofacial surgery, PRF is described in alveolar ridge preservation, orthognathic surgery, cleft lip and palate surgery, maxillary sinus augmentation, and dental implant placement as demonstrating favorable results and its clinical advantages. The structural complexity, inhomogeneous nature, and clotting ability of PRF make its antimicrobial effect evaluation complicated. Nevertheless, most of the used antimicrobial testing methods are based on antibacterial agent diffusion ability in culture media. Because the oral and maxillofacial region is the most frequent area of PRF application, its antimicrobial activity evaluation also prevails in the oral microbiome. PRF's biological potential is highly dependent on the specific preparation protocol and methodology used; it should be carefully prepared and kept under proper conditions to keep cellular content alive. PRF's influence on living cells demonstrates a stimulating effect on bone regeneration, and an angiogenetic effect, and it provides anti-inflammatory activity. According to analyzed studies, PRF demonstrated success in oral and maxillofacial surgery in various methods of application. Antibacterial and anti-inflammatory properties were proven by antibacterial activity against different bacterial species, sustained growth factor, sustained release, and cell activity on the material application. Accurately and correctly prepared PRF can ensure antibacterial and anti-inflammatory properties, and it can be a beneficial clinical tool in oral and maxillofacial surgery.

Perimandibularna metastaza karcinoma rektuma - prikaz slučaja

Introduction. Colorectal cancer is the third most common cancer and metastatic disease is an important and frequent clinical problem. Metastases in the oral and maxillofacial region are rare, comprising 1-2% of all malignant lesions, and clinically resemble common benign conditions. Case report. A 59-year-old woman diagnosed with rectal cancer developed perimandibular lesion as a first sign of metastatic process. Metastasis manifested clinically during the curative intent treatment of rectal cancer (preoperative chemo-irradiation) as a rapidly growing tumefaction close to the mandible angle. After the biopsy and histopathological examination of the lesion that clinically resembled abscess, metastasis of rectal cancer was diagnosed. Incidentally, a cerebral metastasis was diagnosed as well. Although it was oligometastatic rectal cancer, surgical treatment was not indicated due to extensive infiltrative characteristics of the perimandibular lesion. The patient was treated with chemotherapy, with good clinical response. Biological therapy was not available at that moment. Cerebral metastasis was treated with stereotactic neuroradiosurgery with gamma knife. Unfortunately, the patient died from cerebrovascular insult. Conclusion. Lesions in the oral and maxillofacial region may be the first manifestation of metastatic disease. Since early diagnosis of metastatic process has prognostic implications, any new formation in the oral and maxillofacial region in a patient with colorectal cancer requires cautious observation and histological examination.

Diagnostic Dilemma in a Rare Jaw Metastasis: A Case Report

Malignant tumors that have metastasized to the oral and maxillofacial region from distant sites account for only 1% of all malignancies of the jaw. These metastasize most often to the mandibular molar region. The commonest primary sources of metastatic tumors found in the oral and maxillofacial region are the lung, kidney and prostate gland for the males, and the breast, genital organs and kidneys for females. Uterine cervix cancer is the second most common female cancer and the third most common cause of female cancer mortality. The tumor spreads into the surrounding tissues by direct infiltration, but hematogenous dissemination is relatively unusual and the involvement of oral and maxillofacial region is extremely rare in gynecological cancer. Here a case of a 45-year-old woman is presented, who had a lesion of sunburst type appearance radiographically and poorly differentiated squamous cell carcinoma histologically involving the maxillofacial region, which metastasized from uterus cervix.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study.

The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

An Overview of Vascular Malformations in the Oral and Maxillofacial Region

This review provides a comprehensive overview of vascular malformations in the oral and maxillofacial region, focusing on their historical context, classifications, clinical characteristics, and treatment options. Vascular anomalies (VA) encompass a diverse range of medical conditions affecting the body's vasculature. The study highlights the challenges in diagnosing and managing these conditions due to their varied presentations. It delves into the historical terminology, highlighting how terms like cherry, port-wine stain, and strawberry were used to describe these anomalies. The paper discusses the classification system proposed by the International Society for the Study of Vascular Anomalies (ISSVA), which categorizes vascular anomalies into tumors and malformations based on the presence or absence of endothelial mitotic activity. The importance of accurate histopathological descriptions in diagnosing and treating these anomalies is emphasized. Furthermore, the article provides a detailed discussion of the major types of vascular anomalies, including capillary malformations, venous malformations, arteriovenous malformations, and lymphatic malformations. Each type is characterized by its own unique features, clinical presentations, and associated complications. In terms of treatment, the review discusses various options, including laser therapy, sclerotherapy, embolization, and surgical resection, highlighting the factors that influence treatment decisions, such as lesion type, location, and extent.

Correlation between the variation of head type and malocclusion: A Scooping Review

Aim: Examination of head type in orthodontics is pivotal. Examining the head type aims to monitor growth patterns and predict the outcome of an orthodontic treatment. Malocclusion is a disease with a complex etiology. Anomaly in the development pattern of the oral and maxillofacial region can be suspected as the etiology of malocclusion. A specific type of head will result from specific growth patterns. As a result, dental and skeletal malocclusion occurrences are linked to particular head forms. Materials and Methods: These articles’ literature sources were from various databases that described cephalic index correlation and cephalic index malocclusion. Results: A correlation is found between mesocephalic head type with skeletal and dental malocclusion class II, mesocephalic head type with skeletal and dental malocclusion class I, mesocephalic head type with skeletal malocclusion class I and dental class II, mesocephalic head type with skeletal malocclusion class I, and dental class III. Meanwhile, dolichocephalic head type correlates with dental and skeletal malocclusion class II, dolichocephalic head type with skeletal 111 class II, and dental class I, dolichocephalic head type with skeletal malocclusion class I, and dental class II. In addition, brachycephalic head type correlates to skeletal and dental malocclusion class II and the relationship between brachycephalic head type with skeletal malocclusion class III and dental class II. Class I malocclusion is associated with the mesocephalic head type because the mesocephalic head type favors balanced development of the craniomaxillofacial complex. Class II malocclusion is associated with dolichocephalic head type, selecting the face’s predominantly long morphology. Class III malocclusion is associated with brachycephalic head type, favoring the maxilla’s retrusion. Conclusion: Malocclusion classification correlates with variations in head types. Genetic and environmental variables, or possibly both, impact this disease.

Diagnostic performance of artificial intelligence using cone-beam computed tomography imaging of the oral and maxillofacial region: A scoping review and meta-analysis.

The aim of this study was to conduct a scoping review and meta-analysis to provide overall estimates of the recall and precision of artificial intelligence for detection and segmentation using oral and maxillofacial cone-beam computed tomography (CBCT) scans. A literature search was done in Embase, PubMed, and Scopus through October 31, 2022 to identify studies that reported the recall and precision values of artificial intelligence systems using oral and maxillofacial CBCT images for the automatic detection or segmentation of anatomical landmarks or pathological lesions. Recall (sensitivity) indicates the percentage of certain structures that are correctly detected. Precision (positive predictive value) indicates the percentage of accurately identified structures out of all detected structures. The performance values were extracted and pooled, and the estimates were presented with 95% confidence intervals (CIs). In total, 12 eligible studies were finally included. The overall pooled recall for artificial intelligence was 0.91 (95% CI: 0.87-0.94). In a subgroup analysis, the pooled recall was 0.88 (95% CI: 0.77-0.94) for detection and 0.92 (95% CI: 0.87-0.96) for segmentation. The overall pooled precision for artificial intelligence was 0.93 (95% CI: 0.88-0.95). A subgroup analysis showed that the pooled precision value was 0.90 (95% CI: 0.77-0.96) for detection and 0.94 (95% CI: 0.89-0.97) for segmentation. Excellent performance was found for artificial intelligence using oral and maxillofacial CBCT images.

PROSTHODONTIC MANAGEMENT OF TRAUMATIC INJURY IN AESTHETIC REGION: A CASE REPORT

The emergency of a traumatically injured oral and maxillofacial region occurs frequently, and such injuries certainly need dental treatment. Therapy of traumatic dental injury aims to restore the function of the tooth; Towards this goal dentists will need a carefully managed treatment planning that often involves a multidisciplinary approach. In cases of road trafc accidents, domestic violence, and sports injuries, multiple and/or complicated tooth fractures may be observed. The loss of anterior teeth leads to extreme psychological trauma, along with functional and aesthetic debilitations. A critical factor for the overall success is that of choosing a suitable restorative recourse. This case report describes the aesthetic rehabilitation of traumatic anterior teeth along with space management for missing teeth and peg lateral using all ceramic-xed prosthesis.

Brief History of Oral and Maxillofacial Pathology in Colombia: Milestones and Current State.

Oral and maxillofacial pathology, the branch of dentistry concerning clinical and histopathological diagnosis of pathologies of the oral and maxillofacial region, started to develop in Colombia in the mid- 19th century. Since 1950s, dedicated dental clinicians from different dental schools played an important role in its inception and subsequent development. The first significant wave of progress occurred in the 1970s with the appearance of the first formally trained oral pathologists. It was sometime in the late 1980s and early 1990s that dentists Ines Velez and Benjamin Herazo had separate initiatives and created the first oral pathology postgraduate programs in Bogotá. It was in the late 80's and early 90's that dentists Ines Velez and Benjamin Herazo had their own initiatives and created the first oral pathology postgraduate programs in the city of Bogotá. A concomitant of their achievements was the establishment of the first on-site oral pathology biopsies units and registers at Colegio Odontãlogico Colombiano, Pontificia Universidad Javeriana and Escuela Colombiana de Medicina dental schools. The programs have trained many dentists in the field over the years and two of them remain active and fully accredited. The past and present contributions and leaderships of some academic figures and graduates have allowed a steady evolution of the specialty nationwide. Currently, the ability to manage and overcome educational and professional challenges is necessary to advance the growth of this specialty in this country.