Oral Region Research Articles

Evaluation of Dose Calculation Based on Cone-Beam CT Using Different Measuring Correction Methods for Head and Neck Cancer Patients.

Purpose: To investigate and compare 2 cone-beam computed tomography (CBCT) correction methods for CBCT-based dose calculation. Materials and Methods: Routine CBCT image sets of 12 head and neck cancer patients who received volumetric modulated arc therapy (VMAT) treatment were retrospectively analyzed. The CBCT images obtained using an on-board imager (OBI) at the first treatment fraction were firstly deformable registered and padded with the kVCT images to provide enough anatomical information about the tissues for dose calculation. Then, 2 CBCT correction methods were developed and applied to correct CBCT Hounsfield unit (HU) values. One method (HD method) is based on protocol-specific CBCT HU to physical density (HD) curve, and the other method (HM method) is based on histogram matching (HM) of HU value. The corrected CBCT images (CBCTHD and CBCTHM for HD and HM methods) were imported into the original planning system for dose calculation based on the HD curve of kVCT (the planning CT). The dose computation result was analyzed and discussed to compare these 2 CBCT-correction methods. Results: Dosimetric parameters, such as the Dmean, Dmax and D5% of the target volume in CBCT plan doses, were higher than those in the kVCT plan doses; however, the deviations were less than 2%. The D2%, in parallel organs such as the parotid glands, the deviations from the CBCTHM plan dose were less than those of the CBCTHD plan dose. The differences were statistically significant (P < .05). Meanwhile, the V30 value based on the HM method was better than that based on the HD method in the oral cavity region (P = .016). In addition, we also compared the γ passing rates of kVCT plan doses with the 2 CBCT plan doses, and negligible differences were found. Conclusion: The HM method was more suitable for head and neck cancer patients than the HD one. Furthermore, with the CBCTHM-based method, the dose calculation result better matches the kVCT-based dose calculation.

Treatment of Orofacial Granulomatosis—9-Month Follow-up: A Case Report

Orofacial granulomatosis is a condition that manifests clinically as painless labial enlargement, perioral and mucosal edema, oral ulcers, and gingivitis. It is characterized by non-necrotizing granulomatous inflammation of the oral and maxillofacial region. When the swelling only affects the lips, the pathology is called Miescher's granulomatous cheilitis; however, when it also causes facial paresis and lingua plicata, it is known as Melkersson-Rosenthal syndrome. We report a case that was successfully treated with a combination of a local (intralesional) steroid, a systemic antibiotic, and a systemic steroid. After 6 months of therapy, we observed improvement in gingival hyperplasia and buccal mucosa and lip edema.

Evaluation of the Microbiota and Integrity of Respirators Reused by Health Professionals in a Hospital Environment

The shortage of PFF2, N95, and KN95 respirators and their equivalents for the respiratory protection of the population and health professionals during COVID-19 pandemic has driven the adoption of alternative measures to address the lack of personal protective equipment (PPE). The use of surgical masks, handmade masks, and even the prolonged use of respirators were some of the measures adopted in response to the high demand for these products, and their consequent shortage. In this context, the present study evaluated the microbiota and integrity of reused PFF2 respirators in the central sterile services department of a hospital. Respirators that had been used for 0 h, 12 h, 24 h, and 36 h were sampled for the inoculation and cultivation of fungi and bacteria and the identification of their microbiota. To assess the integrity of the respirators, a filtration efficiency assessment test was conducted of the respirators used for 36 h. The results obtained showed that the microbiota of the respirators comprised commensal fungi and bacteria from the oral and nasal regions of human beings. It was also found that after 36 h of use, the respirators did not demonstrate a decrease in filtration efficiency; that is, they retained their 97% filtration efficiency Considering the findings regarding the presence and pathogenicity of microorganisms, it is possible that the reuse of respirators for up to 36 h does not harm the health of immunocompetent users. In terms of PPE efficiency, no compromises were evidenced.

Solitary fibrous tumor of the buccal mucosa: A case report

Solitary fibrous tumors （SFTs） were reported in 1931 as tumors derived from mesenchymal tissue. They occur mainly in the pleura and peritoneum and rarely in the oral and maxillary regions. This report presents the case of a 48-year-old woman with a tumor in the left buccal mucosa. We suspected a salivary gland tumor or hemangioma. Excision was performed under general anesthesia. The lesion was removed as a single mass. Histopathological and immunohistochemical analyses led to the diagnosis of SFT. We report this case based on a literature review.

Progress in the study of lymph node metastasis status of squamous cell carcinoma of the oral and maxillofacial region

Progress in the study of lymph node metastasis status of squamous cell carcinoma of the oral and maxillofacial region

Evaluation of Efficacy of Low-Intensity Pulsed Ultrasound on Comorbidities Following Mandibular Impacted Third Molar Surgery: A Prospective Study.

Despite several in vitro and in vivo applications of low-intensity pulsed ultrasound (LIPUS), it remains an under-studied feature of the oral and maxillofacial region. The goal of this in vivo study was to objectively investigate the efficacy of low-intensity pulsed ultrasound on wound healing and related morbidities following surgical removal of an impacted third molar. The following in vivo prospective, comparative, randomised controlled clinical study was carried out amongst 56 patients who reported to the Department of Oral and Maxillofacial Surgery fulfilling the inclusion criteria. Group A received sham ultrasound, whereas Group B received LIPUS therapy. Based on the group allocated LIPUS 1 MHz, pulsed 20% and dose 1.0 watts/square centimetre (W/cm2)/sham, ultrasound therapy was given on 1st, 2nd and 3rd post-operative days. The assessment of post-operative pain, oedema, trismus and wound healing on preoperative, first, third and seventh postoperative days. The quantitative variables of the study were assessed using independent sample t-test, and qualitative variables were assessed using the Chi-square test. The P < 0.05 on third and seventh post-op days for pain, trismus and wound healing in the LIPUS group compared to control group making it statistically significant. There was no statistically significant difference in the reduction of oedema amongst the two groups. Post-LIPUS application in the patients, postoperative pain was significantly reduced, trismus was noticeably improved and wound healing was satisfactory and can be employed as a complementary technique.

Giant Cells Lesions of Oral and Maxillofacial Region &amp;ndash; A Proposed Diagnostic Algorithm

Multinucleated giant cells are commonly encountered in histopathology and are mostly a clue to diagnosis but sometimes pose a diagnostic confusion. The present study elucidates a case series of giant cell lesions (GCL) with emphasis on differential diagnosis and other investigations that contribute towards arriving at a final diagnosis. We also intended to devise an algorithmic approach for the accurate pathological characterization of these lesions. All the cases reported in the department from

A Clinical Study of Cellulitis of the Oral Region

A Clinical Study of Cellulitis of the Oral Region

Impact of pending dental treatments on patient's oral health during COVID-19 pandemic in the United Arab Emirates

Background: Untreated dental problems can have a negative impact on the health and well-being of affected individuals, and delayed treatment would lead to serious oral problems. The outbreak of COVID-19 has shut down many dental care services, and this has deferred dental treatment for many. Assessing the effect of pending dental treatment will clarify the role and importance of dental services in maintaining and controlling oral health. Aims and Objectives: This study was carried out to explore the impact of COVID-19 on pending dental treatment among United Arab Emirates (UAE) residents. Assessing the importance of dental services, studying patients' self-management of symptoms, comparing the most affected categories, and determining the demand of developing a forward strategy in case of a future pandemic. Methodology: A cross-sectional study was designed using a pre-tested questionnaire published in an online survey among UAE residents that included participants from all seven emirates. Consent was conducted from each participant after ensuring anonymity and confidentiality. The collected responses were tabulated and subjected to statistical analysis. Appropriate tests of significance were used, and a P< 0.05 was considered statistically significant. Results: The analysis showed about 34.2% of the participants had pending dental treatment due to COVID-19. The most deferred treatment was orthodontic treatment by 18.6% of participants. The commonly affected oral region was the teeth, where toothache was the most reported oral symptom. Conclusion: The findings showed that the pandemic had a significant impact on the dental health of UAE residents due to postponed treatment. It is suggested to raise the level of awareness and the shifting of the dental care paradigm to preventive strategies has to be developed according to the new guidelines focusing on reducing the risk factors of oral cancer. The new strategies emphasise dental health promotion, topical fluorides and nutritious diet. Oral health messaging and actions should be incorporated in pediatric offices and primary health-care facilities. Moreover, allocate mandatory periodic dental checkups for compromised patients. Dentists should consider alternative strategies to address these deferred treatments during such pandemics.

Histopathologic Patterns of Oral and Maxillofacial Masses in Southwestern Ethiopia: A 5-Year Retrospective Study

Background Oral and maxillofacial region includes nasal cavity, sinuses, the lips, oral cavity, maxilla, mandible and the major and minor salivary glands with the overlying skin and soft tissues. This area is common site for different lesions, including the inflammatory and neoplastic lesions. Neoplastic tumors, in the area, account 5% of all human neoplasia. The distribution of these tumors’ changes with the socio-demographic change throughout the world and is not well-studied on the study area. Objectives To assess the histopathologic patterns of oral and maxillofacial masses among patients attending Histopathology Unit of Pathology Department in Jimma Medical Center from September 11, 2016 to September 10, 2021. Methods A retrospective cross-sectional study was conducted. Three-hundred and seventy-seventh (377) oral and maxillofacial (OMF) mass samples fulfilling the inclusion criteria were included in the study. Data was collected by structured check list and the data was interred into Epi-data version 3.1 and transferred to statistical package for the social sciences (SPSS) version 22 for analysis. The study was conducted from May 1, 2021 to August 30, 2021 GC. Results The age distribution of OMF masses are with minimum age value of 1-year and maximum value of 85-years and median age is 30-years. From 377 patient 194 (51.5%) were male while 183(48.5) were female with a ratio of M:F=1.06:1 showing increased male dominance. Mesenchymal tumors, other than bone tumor, have the highest number of 128 (33.9%) cases followed by surface epithelial tumors, 75(19.9%), odontogenic tumors 20(5.3%), salivary gland tumors 55(14.6%), benign cystic mass 47(12.5%), inflammatory masses 42(10.9%) and the least numbers of OMF biopsy was bone tumor with 11(2.9%) cases. From the benign tumors fibroepithelial tumor 53(22.8%) is the commonest. From the malignant tumors and from carcinoma, squamous cell carcinoma 56(57.1%), is the leading. From sarcomas osteosarcoma 8(8.2%) is the commonest one. Conclusion The result of this research shows the distribution of oral and maxillofacial tumors varies with the age, sex and anatomic site of the patients. OMF mass is common on the early adult age period and the risk of malignant tumors increases in those with age ≥41-years and the commonest malignant tumor is squamous cell carcinoma but in children and adolescents’ benign tumors specially fibroepithelial polyps are the commonest with male predominance.

INTRAORAL LYPHOMA ON THE MENTAL REGION: A Case Report

Introduction: Lyphoma is a benign tumor of mesenchymal origin composed of mature adipocytes, usually separated by a thin fibrous connective tissue capsule. Lyphomas are rare in the oral maxillofacial region (0.1% to 5%). The clinical presentation of intraoral lyphoma is usually an asymptomatic yellowish mass. Case: This case report present an intraoral lyphoma occurring in the mental region of a 44-years-old man. The patient came with complaints of fullness in his left chin since the last year. Intraoral examination revealed the presence of smooth sessile nodules, moderate in size with yellowish color. Case Management: Surgical excision under general anesthesia is performed to remove the tumor. Discussion: Lyphoma is the most common mesenchymal tumor, but incidence in the oral cavity is rare. The etiology of intraoral lyphoma still unclear, but the possible pathogenesis mechanisms are the “hypertrophy” and “metaplasia” theory. The diagnosis of intraoral lyphoma usually clinical. Techniques such as intraoral radiography, USG, CT and MRI make the diagnosis of these tumors easier. Histopathology remains the gold standard in the diagnosis of lyphomas. Intraoral lyphoma treatment is surgical excision. In this case, the intraoral lyphoma located near to the mental foramen so the mental nerve must be protected during surgery using blunt dissection and careful excision. With this technique no complications seen after the surgery. Conclusion: Intraoral lyphomas are rare, clinicians should be able to recognize this tumor. Through this, adequate surgical excision will be performed and the recurrence rate reduced.

Divergent tooth development mechanisms of Mexican tetra fish (Astyanax mexicanus) of Pachón cave origin

The Mexican tetra (Astyanax mexicanus) is one of the fresh water teleost fish models in evolutionary developmental biology. The existence of two morphs: eyed, pigmented surface fish and blind depigmented cavefish from multiple cave populations, provides a unique system to study adaptive radiation. Compared to the adult surface fish, cavefish have large oral jaws with an increased number of structurally-complex teeth. Early tooth development has not been studied in detail in cavefish populations. In this study, bone-stained growth series and vital dye staining was used to trace the development and replacement of dentitions in Pachón cavefish. Our results show that first tooth eruption was delayed in cavefish compared to the surface fish. In particular, the first tooth eruption cycle persisted until 35 days post fertilization (dpf). Unlike surface fish, there are multicuspid teeth in cavefish first generation dentition. In addition to the teeth in the marginal oral jaw bones, Pachón cavefish have teeth in the ectopterygoid bone of the palatine roof. Next, we characterised the expression of ectodysplasin signalling pathway genes in tooth-forming regions of surface and cavefish. Interestingly, higher expression of Eda and Edar was found in cavefish compared to the surface fish. The altered ectodysplasin expression needs further investigation to confirm the different molecular mechanisms for tooth development in the oral and pharyngeal regions of surface fish and cavefish.

Colour Doppler Imaging in Benign Malformation of Buccal MucosaA Case Report

Hamartomas, occurring in oral and maxillofacial region are basically indigenous tissue malformations that arise from epithelial derivatives, mesenchymal derivatives and odontogenic derivates. Vascular anomaly, is a mesenchymal hamartomatous condition- a broader term describing condition of blood vessels including abnormal number, structure and position imparting blue/purple colour to oral mucosa. Such anomalies are broadly classified into two basic types like vascular tumours and vascular malformations. A clinician should possess skills and knowledge for identifying such lesions and be aware of its diagnosis to avoid any event of uncontrolled bleeding in the dental chair.

Effect of topical ethanolic extract of noni leaf on post-extraction wound by observation of wound diameter and osteoblast cells

Objective: The aim of this study is to determine the effect of noni leaf ethanol extract gel on post extraction wound of rabbit teeth observed from wound diameter and osteoblasts cell count. Tooth extraction is one of the treatments performed in the oral region that cause wound. Application of substance or medicine might help accelerate and improve wound healing.&#x0D; Material and Methods: Twenty-four rabbits divided into three groups: negative control, positive control with 10% povidone iodine, and treatment group with 10% ethanol extract gel of noni leaf. The tooth was extracted from the mandibular left incisor. The diameter of the wound area was examined on day 0, 3, 7, and 14 while the osteoblasts cell count was obtained from rabbits’ specimen in each group on 14th day. Measurement of wound diameter was done by using calipers, while the number of osteoblasts were calculated using toluidine blue histochemistry stain and light microscope with 400x magnification.&#x0D; Results: The ratio of wound diameter were better in treatment group with significant difference (p=0.048) while osteoblasts cell count were not significantly different among all groups.&#x0D; Conclusion: Topical application of noni leaf had an effect in decreasing mucosal wound diameter but there was not any evidence yet that it was increased osteoblast cells on socket wound healing process.

Airway anomalies in patients with 22q11.2 deletion syndrome: A scoping review.

People with 22q11.2 deletion syndrome (22q11DS) can present with a wide variety of findings. Various airway anomalies have been described intermittently within this syndrome, but this feature has not been extensively investigated. Increased provider awareness of these findings may help guide clinical decision-making and improve overall patient outcomes. The objectives of this review are to identify the types of airway anomalies in 22q11DS and the prevalence of airway anomalies within symptomatic individuals. PubMed/MEDLINE, Cochrane Library, and EMBASE databases were searched in February 2022 for all available articles. Search terms included those that described 22q11DS or one of its synonymous conditions AND those that described airway anatomy and anomalies. The term airway anomaly was defined as any structural aberration in the conductive airway from the oral or nasal vestibule region to the mainstem bronchus. Studies were screened by two authors. A review of references was conducted. Eligible manuscripts underwent full-text review for quality appraisal and data extraction. From a total of 909 unique manuscripts, 58 studies were selected, describing 328 people. The prevalence of airway anomaly diagnosis within symptomatic individuals ranged from 14% to 74%. Twenty-two unique airway anomalies were described. Laryngeal web was the most frequently described anomaly, followed by airway malacia and subglottic stenosis. Laryngeal web was 40% sensitive for suggesting a diagnosis of 22q11DS. Among affected individuals, as many as 46% had multiple concomitant airway anomalies. Aside from respiratory symptoms, other features that prompted airway evaluation included difficult intubation or failed extubation. The findings within this review support the notion that a wide variety of airway anomalies may be seen in people with 22q11DS and that these findings have been discovered frequently in those with airway symptoms. Providers should maintain a low threshold to perform an airway examination in those with 22q11DS, especially when airway symptoms are present.

Emerging role of mesenchymal stem cell-derived extracellular vesicles in oral and craniomaxillofacial tissue regenerative medicine.

Mesenchymal stem cells (MSCs) are multipotent stem cells with differentiation potential and paracrine properties, drawing significant attention in the field of regenerative medicine. Extracellular vesicles (EVs), mainly including exosomes, microvesicles and apoptotic bodies (ABs), are predominantly endosomal in origin and contain bioactive molecules, such as miRNAs, mRNAs, and proteins, which are transferred from their original cells to target cells. Recently it has emerged that MSC-derived EVs (MSC-EVs) combine the advantages of MSCs and EVs, which may be used as a promising MSC-based therapy in tissue repair and regeneration. Oral and craniomaxillofacial diseases are clinically complications containing the soft and hard tissues in craniofacial and dental arches. These diseases are often induced by various factors, such as chemical, microbiological, physical factors, and systemic disorders. For decades, tissue repair and regeneration in oral and craniomaxillofacial regions provide substantial improvements in the prevention and treatment of some severe diseases. In this review we discuss MSC-EVs and their therapeutic potential in oral and craniomaxillofacial tissue regenerative medicine.

Sialendoscopy Enhances Saliva Production of Parotid Glands in Primary Sjögren's Syndrome Patients.

Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disorder which harm exocrinic glands located mainly in the oral and ocular regions. pSS patients often complain about pain and mouth dryness. The aim of this retrospective study was to evaluate the influence of parotid glands' sialendoscopy on salivary flow in pSS patients and to assess the tissue characteristics of the parotid glands during the sialendoscopy procedure. Twenty-six pSS patients (52 glands) treated with sialendoscopy for their parotid glands between the years 2017-2019 were included. Whole mouth salivary flow (UWS) was obtained 2 weeks before intervention (T1), 3 months post intervention (T2), for 20 patients, 6 months post intervention (T3) and for 11 patients, 12 months post intervention (T4). Patients were asked about their oral quality of life before and after sialendoscopy. UWS was significantly higher at T2, T3 and T4 compared to T1 (p=0.002, p= 0.01 and p= 0.04 respectively). 22 patients (84.6%) reported substantial improvement of their oral quality of life at T2. Of the 52 glands, 33 (63.5%) exhibited avascularity in the walls of the Stensen duct, 33 (63.5%) had strictures and in 8 (15.4%) mucus plugs were present. No major complications were observed in this study except for one patient who suffered from duct perforation which during follow-up was spontaneously healed. This study indicates a positive effect of sialendoscopy on salivary flow rate and oral quality of life in pSS patients. sialendoscopy should be considered as a vital tool in treating pSS patients.

Halofuginone inhibits tumor migration and invasion by affecting cancer-associated fibroblasts in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial regions, with a high rate of metastasis. Cancer-associated fibroblasts (CAFs) play critical roles in tumor growth, metastasis and invasion, making them attractive therapeutic targets for cancer treatment. As an old anti-coccidiosis drug for poultry, Halofuginone (HF) has also been reported to possess anti-fibrosis and anti-cancer activities in the recent decades. However, whether it works by targeting CAFs in OSCC, and the mechanisms involved remain unclear. In the present study, we observed HF dose-dependently inhibits OSCC-derived CAF viability and proliferation. Meanwhile, HF decreased the expressions of α-SMA, FSP-1 and PDGFRβ, markers of the malignant phenotype of CAFs, both at mRNA and protein levels. Furthermore, functional studies demonstrated that HF dramatically attenuates the promotion effect of CAFs on OSCC cell migration and invasion. Mechanistically, the inhibition of MMP2 secretion and the upstream TGF-β/Smad2/3 signaling pathway played an important role in these processes. In the orthotopic transplanted tongue carcinoma in mice model, we confirmed that HF administration inhibited tumor growth and lymph node metastasis (LNM) with reduced CAF population, MMP2 expression and collagen deposition in tumor. Altogether, these results indicate that HF can inhibit the migration and invasion of OSCC by targeting CAFs, which will provide new ideas for the treatment of OSCC.

Ontogenesis and systematic position of a new hypotrichous ciliate, Chaetospira sinica sp. nov., with an improved diagnosis of the poorly defined family Chaetospiridae Jankowski, 1985 (Protozoa, Ciliophora, Hypotrichia).

Ciliates are unique single-celled organisms that play important roles in ecological, environmental, evolutionary, and ontogenetic research. In the present study, phylogenetic analyses based on 18S rRNA gene sequence data reveal that Chaetospira sinica sp. nov. clusters with Stichotricha aculeata with strong to full support (97% ML, 1.00 BI), but is not closely related to members of Spirofilidae Gelei, 1929 to which Chaetospira and Stichotricha have previously been assigned. Phylogenetic analyses, together with morphological and morphogenetic data from Chaetospira sinica sp. nov., support the validity of family Chaetospiridae Jankowski, 1985. Chaetospira and Stichotricha are here assigned to the family Chaetospiridae, the improved diagnosis of which is as follows: non-dorsomarginalian Hypotrichia with flask-shaped body; oral region extending along narrow anterior neck region; lorica usually present; two ventral and two marginal cirral rows, all distinctly spiraled or obliquely curved; pretransverse and transverse cirri absent. The basic morphogenetic features in C. sinica sp. nov. can be summarized as: (1) the oral primordium for the opisthe develops de novo and the parental adoral zone is completely retained by the proter; (2) all ventral cirral anlagen and marginal anlagen developed intrakinetally; (3) three dorsal kineties anlagen formed intrakinetally in each daughter cell; and (4) macronuclear nodules fuse into a single mass. Exconjugant cells were also isolated and their morphologic and molecular data are provided.

Outstanding surgeon of the twentieth century, professor Natalya Ivanovna Butikova

The purpose of the study is to highlight the scientific, clinical, pedagogical and social activities of the outstanding maxillofacial and plastic surgeon, Doctor of Medical Sciences, Professor N.I. Butikova.&#x0D; Material and methods. Based on the analysis of domestic literature, as well as the life, professional activities and scientific works of Doctor of Medical Sciences, Professor N.I. Butikova to present her role in the formation and development of domestic maxillofacial and plastic surgery.&#x0D; Results. Information from the life of a well-known surgeon in our country, one of the patriarchs of Russian pediatric traumatology and maxillofacial surgery, Doctor of Medical Sciences, Professor Natalia Ivanovna Butikova, who turned 110 years old in 2020, is presented. The formation of N.I. Butikova as a doctor, researcher and teacher, her activities during the Great Patriotic War are noted. The main directions of her scientific activity in the development and improvement of methods for the treatment of gunshot injuries of organs and tissues of the maxillofacial region and neck, the rehabilitation of the wounded with defects in the jaws and tissues of the oral region using the methods of bone autoplasty and Filatov's stalk are highlighted. Natalya Ivanovna paid much attention to improving the treatment of face and neck burns and their consequences, as well as to surgical methods for eliminating mimic muscle paralysis. Its role in the development of oncostomatology, combustiology, pediatric traumatology and orthopedics is revealed. N.I. Butikova developed surgical methods for the treatment of syndactyly in children under the age of one year and the first years of life using zigzag incisions, improved the methods of free tissue grafting and plasty with split skin grafts, and proposed an apparatus for preventing secondary contraction of skin grafts during transplantation.&#x0D; Conclusions. It is emphasized that she was one of the pioneers of domestic maxillofacial surgery. N.I. Butikova, being one of the founders of domestic surgery, the creators of the school of pediatric traumatologists and orthopedists, as well as maxillofacial surgeons, is rightfully recognized as one of the patriarchs of national healthcare.