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Oral & Maxillofacial
Surgery Current Awareness Newsletter
February 2015
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Contents Your Friendly Local Librarian… ........................................................................................................... 2
New Cochrane Library Systematic Reviews on Oral and Maxillofacial Surgery .................................... 3
New Activity in UptoDate and DynaMed ............................................................................................ 3
Recent Literature Searches on Oral and Maxillofacial Surgery ............................................................ 4
Current Awareness Database Articles on Oral and Maxillofacial Surgery ............................................ 4
Oral ............................................................................................................................................... 4
Bisphosphonate-related osteonecrosis of the jaw ............................................................................ 9
Maxillofacial ............................................................................................................................... 14
General/other ............................................................................................................................... 19
Journal Tables of Contents............................................................................................................... 23
Head and Neck ............................................................................................................................ 23
British Journal of Oral and Maxillofacial Surgery .......................................................................... 24
Oral Surgery Oral Medicine Oral Pathology Oral Radiology .......................................................... 26
Oral Surgery ................................................................................................................................ 29
Your Friendly Local Librarian… Whatever your information needs, the library is here to help. As your outreach librarian I offer
literature searching services as well as training and guidance in searching the evidence and critical
appraisal – just email me at [email protected]
Outreach
Your Outreach Librarian can help facilitate evidence-based practise for all in the oral and
maxillofacial surgery team, as well as assisting with academic study and research. We can help with
literature searching, obtaining journal articles and books, and setting up individual current
awareness alerts. We also offer one-to-one or small group training in literature searching,
accessing electronic journals, and critical appraisal. Get in touch: [email protected]
Literature Searching
We provide a literature searching service for any library member. For those embarking on their own
research it is advisable to book some time with one of the librarians for a 1 to 1 session where we
can guide you through the process of creating a well-focused literature research and introduce you
to the health databases access via NHS Evidence. Please email requests to
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New Cochrane Library Systematic Reviews on
Oral and Maxillofacial Surgery
Antibiotic prophylaxis for preventing infectious complications in orthognathic surgery
Romina Brignardello-Petersen et al
Published 5th Jan 2015
Orthognathic surgery (OS) is a term that refers to many elective surgical techniques to correct facial
deformity; the associated malocclusion and functional disorders related to the stomatognathic
system. Whilst such surgery is classed as "clean-contaminated", the usefulness of and the most
appropriate regimen for antibiotic prophylaxis in these patients are still debated. Objectives: To
assess the effects of antibiotic prophylaxis for preventing surgical site infection (SSI) in people
undergoing orthognathic surgery.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010266.pub2/abstract
New Activity in UptoDate and DynaMed
Single-dose oral analgesic plus caffeine associated with improved pain relief compared to
analgesic alone (level 2 [mid-level] evidence)
based on Cochrane review limited by clinical heterogeneity
systematic review of 20 randomized trials comparing single-dose oral analgesic plus caffeine
vs. single-dose analgesic alone in 7,238 patients > 16 years old with acute pain from any
condition
results for pain relief limited by heterogeneity in interventions and patient populations
authors note large amount of unpublished data known to exist but unavailable for analysis
10 trials evaluated addition of caffeine to single-dose oral analgesic in patients with
o postpartum pain (4 trials)
o postsurgical dental pain (5 trials)
o pain due to orthopedic surgery (1 trial)
these 10 trials were combined for analysis without stratification by surgery type
oral analgesics for postsurgical or postpartum pain included paracetamol (acetaminophen),
ibuprofen, and aspirin
single-dose oral analgesic plus caffeine associated with increase in ≥ 50% maximum pain
relief in analysis of 10 trials with 2,139 patients
o risk ratio 1.16 (95% CI 1.08-1.25)
o NNT 10 (95% CI 8-18)
Reference - Cochrane Database Syst Rev 2014 Dec 11;(12):CD009281
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Recent Literature Searches on Oral and
Maxillofacial Surgery
Below is a sample of literature searches carried out by librarians for UH Bristol members of staff
on the subject of maxillofacial and oral surgery. For further details get in touch:
Dental abscess sensitivity and antibiotic treatment
Perioperative and stress steroids
Current Awareness Database Articles on Oral
and Maxillofacial Surgery
Below is a selection of articles on oral and maxillofacial surgery recently added to the healthcare
databases, grouped in the following categories:
Oral
Bisphosphonate-related osteonecrosis of the jaw
Maxillofacial
General/other
If you would like any of the following articles in full text, or if you would like a more focused
search on your own topic, then get in touch: [email protected]
Oral
Title: Postoperative Bleeding Risk for Oral Surgery under Continued Clopidogrel Antiplatelet
Therapy.
Citation: BioMed Research International, 2015, vol./is. 2015/(823651), 2314-6141 (2015)
Author(s): Grobe A, Fraederich M, Smeets R, Heiland M, Kluwe L, Zeuch J, Haase M, Wikner J,
Hanken H, Semmusch J, Al-Dam A, Eichhorn W
Abstract: Object. To determine the incidence of postoperative bleeding for oral osteotomy carried
out under continued monoantiplatelet therapy with clopidogrel and dual therapy with
clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a
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control group. Methods. A total of 64 and 60 oral osteotomy procedures carried out under
continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were
followed for two weeks for postoperative bleeding. Another 281 similar procedures were also
followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.
Results. We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64
(1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group.
The corresponding 95% confidence intervals are 0-1.7%, 0-4.7%, and 0-7.8%, respectively, and the
incidences did not differ significantly among the three groups (P > 0.09). Postoperative hemorrhage
was treated successfully in all cases with local measures. No changes of antiplatelet medication,
transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.
Conclusions. Our results indicate that minor oral surgery can be performed safely under continued
monoantiplatelet medication with clopidogrel or dual antiplatelet medication with
clopidogrel/aspirin.
Title: Implant therapy in a surgical specialty clinic: an analysis of patients, indications, surgical
procedures, risk factors, and early failures.
Citation: International Journal of Oral & Maxillofacial Implants, January 2015, vol./is. 30/1(151-60),
0882-2786;1942-4434 (2015 Jan-Feb)
Author(s): Brugger OE, Bornstein MM, Kuchler U, Janner SF, Chappuis V, Buser D
Abstract: PURPOSE: The aim of this study was to analyze the patient pool referred to a specialty
clinic for implant surgery over a 3-year period.MATERIALS AND METHODS: All patients receiving
dental implants between 2008 and 2010 at the Department of Oral Surgery and Stomatology were
included in the study. As primary outcome parameters, the patients were analyzed according to the
following criteria: age, sex, systemic diseases, and indication for therapy. For the inserted implants,
the type of surgical procedure, the types of implants placed, postsurgical complications, and early
failures were recorded. A logistic regression analysis was performed to identify possible local and
systemic risk factors for complications. As a secondary outcome, data regarding demographics and
surgical procedures were compared with the findings of a historic study group (2002 to
2004).RESULTS: A total of 1,568 patients (792 women and 776 men; mean age, 52.6 years) received
2,279 implants. The most frequent indication was a single-tooth gap (52.8%). Augmentative
procedures were performed in 60% of the cases. Tissue-level implants (72.1%) were more frequently
used than bone-level implants (27.9%). Regarding dimensions of the implants, a diameter of 4.1 mm
(59.7%) and a length of 10 mm (55.0%) were most often utilized. An early failure rate of 0.6% was
recorded (13 implants). Patients were older and received more implants in the maxilla, and the
complexity of surgical interventions had increased when compared to the patient pool of 2002 to
2004.CONCLUSION: Implant therapy performed in a surgical specialty clinic utilizing strict patient
selection and evidence-based surgical protocols showed a very low early failure rate of 0.6%.
Title: A case of glandular odontogenic cyst in the mandible treated with the dredging method.
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Citation: Odontology/The Society of the Nippon Dental University, January 2015, vol./is. 103/1(112-
5), 1618-1247;1618-1255 (2015 Jan)
Author(s): Motooka N, Ohba S, Uehara M, Fujita S, Asahina I
Abstract: Glandular odontogenic cyst (GOC) is a rare odontogenic cyst derived from the odontogenic
epithelium. GOC shows unpredictable and potentially aggressive behavior. Although enucleation and
curettage are applied in most cases, the recurrence rate remains relatively high. Because a standard
care procedure for GOC has not been established, we propose a new treatment procedure for GOC.
In this case report, we describe a 62-year-old Japanese woman who suffered from GOC arising at the
anterior region of her mandible and who was treated using the dredging method. She underwent
enucleation and curettage twice using the dredging method with preservation of the teeth, which
were involved with the lesion, but the lesion recurred 2 years later. In addition to enucleation and
curettage, apicoectomy of the teeth was performed with a third dredging method procedure, and
prognosis has been good with no recurrence for 18 months since the last treatment.
Title: Two- and tridimensional analysis of periapical repair after endodontic surgery.
Citation: Clinical Oral Investigations, January 2015, vol./is. 19/1(17-25), 1432-6981;1436-3771 (2015
Jan)
Author(s): Tanomaru-FIlho M, Jorge EG, Guerreiro-Tanomaru JM, Reis JM, Spin-Neto R, Goncalves M
Abstract: OBJECTIVE: The aim of this study was to evaluate repair after endodontic surgery using
two- and tridimensional imaging methods.MATERIALS AND METHODS: Periapical radiographs and
cone beam computed tomography (CBCT) were performed before the surgeries and after 48 h
(baseline), 4 months, and 8 months. The area (square millimeters) of periapical lesions in CBCT and
in radiographs was compared regarding the percentage of repair. In the CBCT, multiple areas were
converted to volume. Repeated-measures analyses and paired t tests (alpha=0.05) were used to
compare the methods. Correlation coefficients were calculated between the periods of evaluation
within the CBCT volumetric analysis. Bland-Altman plots were used to compare the methods, based
on the 95 % limits of agreement for the difference of the means.RESULTS: Baseline showed a larger
lesion volume (192.54 mm(3)) than 4-month (79.79 mm(3)) and 8-month (47.51 mm(3)) periods. No
differences were found in the percentage of repair in the first 4 months and after 8 months. The
volumetric analysis showed a higher percentage of repair when the first and last 4 months were
compared. No differences were found in the percentage of repair by area in the CBCTs. Repair of 73
% was obtained after 8 months. Similar results were observed by the Bland-Altman agreement
analyses.CONCLUSIONS: The percentage of repair varied after 8 months, when lower values were
obtained by volumetric evaluation.CLINICAL RELEVANCE: Considering the outcome at follow-up
periods over 4 months, tridimensional evaluation by CBCT is more capable of determining the
absence of periapical bone repair than conventional two-dimensional radiographs. Therefore, the
use of CBCT would be suggested only for more complex cases with slower evolution of repair or for
the association of factors that make prognosis difficult after surgery.
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Title: Trigeminal nerve injuries after mandibular oral surgery in a university outpatient setting-a
retrospective analysis of 1,559 cases.
Citation: Clinical Oral Investigations, January 2015, vol./is. 19/1(149-57), 1432-6981;1436-3771
(2015 Jan)
Author(s): Deppe H, Mucke T, Wagenpfeil S, Kesting M, Linsenmeyer E, Tolle T
Abstract: BACKGROUND: In general, trigeminal nerve injury is known as a potential risk of many
surgical procedures in the oral cavity. Recent literature demonstrated that the risk of nerve injury is
correlated with the experience of the surgeon. Therefore, the purpose of this study was to evaluate
retrospectively the incidence of trigeminal nerve injuries in a teaching university setting.MATERIAL
AND METHODS: From January 2000 to December 2009, a total of 1,559 patients underwent one
intervention in the postcanine region of the mandible. Interventions included extractions,
osteotomies, periradicular surgery, and implant surgery. In 2010, all 1,559 patient charts were
screened. A record was made if trigeminal nerve injury was documented within the first month
following surgery. These patients were re-evaluated.RESULTS: Documentation in the charts revealed
that sensorial disturbance following surgery was seen in 42 patients (2.69 %). Among them, nine
patients were clinically re-evaluated by the authors and 12 were interviewed by phone and observed
by their dentist without any problems. Persistence of sensory disturbance was found in 5 of the 21
patients (0.32 %), and four of these five lesions were in the lingual nerve (0.25 %). Related to the
type of surgery, most sensory disturbances were seen following periradicular surgery.DISCUSSION:
Within the limitations of this study, it may be stated that oral surgery in an outpatient setting of a
teaching university hospital resulted in very low rates of trigeminal nerve injuries. It may be
concluded that adequately surveyed trainees can perform mandibular surgery without an increased
risk of trigeminal sensorial disturbance.
Title: Antibiotic prophylaxis for third molar extraction in healthy patients: Current scientific
evidence.
Citation: Quintessence International, 2015, vol./is. 46/2(149-61), 0033-6572;1936-7163 (2015)
Author(s): Rodrigues WC, Okamoto R, Pellizzer EP, Carrijo AC, Almeida RS, de Melo WM
Abstract: Third molar extraction is one of the most frequently performed procedures in the dental
clinic, and it is associated with innumerable trans- and postoperative complications, such as pain,
trismus, edema, localized alveolar osteitis, and surgical site infection. Some authors advocate the
use of local or systemic antibiotics to reduce the incidence of these postoperative complications.
However, several studies have revealed an insignificant gain after using antibiotics. Despite the risks
of allergic reactions, toxicity, and the development of resistant microorganisms, about 50% of
dentists routinely prescribe the use of prophylactic antibiotics for this purpose. The goal of this
paper is to evaluate the scientific evidence that justifies antibiotic prescription to healthy patients
undergoing third molar extraction.
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Title: Effect of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on the incidence of
alveolar osteitis following the extraction of mandibular third molars. A double-blind randomized
clinical trial
Citation: Medicina Oral, Patologia Oral y Cirugia Bucal, January 2015, vol./is. 20/1(e117-e222), 1698-
4447;1698-6946 (01 Jan 2015)
Author(s): Rubio-Palau J., Garcia-Linares J., Hueto-Madrid J.-A., Gonzalez-Lagunas J., Raspall-Martin
G.-L., Mareque-Bueno J.
Abstract: Alveolar osteitis (AO) is a common complication after third molar surgery. One of the most
studied agents in its prevention is chlorhexidine (CHX), which has proved to be effective.Objectives:
The aim of this randomized double-blind clinical trial was to evaluate the efficacy of 0.2%
bioadhesive chlorhexidine gel placed intra-alveolar in the prevention of AO after the extraction of
mandibular third molars and to analyze the impact of risk factors such as smoking and oral
contraceptives in the development of AO. Study Design: The study was a randomized, double-blind,
clinical trial performed in the Ambulatory Surgery Unit of Hospital Vall d'Hebron and was approved
by the Ethics Committee. A total of 160 patients randomly received 0.2% bioadhesive gel (80
patients) or bioadhesive placebo (80 patients).Results: 0.2% bioadhesive chlorhexidine gel applied in
the alveolus after third molar extraction reduced the incidence of dry socket by 22% compared to
placebo with differences that were not statistically significant. Smoking and the use of oral
contraceptives were not related to higher incidence of dry socket. Female patients and the difficulty
of the surgery were associated with a higher incidence of AO with statistically significant differences.
0.2% bioadhesive chlorhexidine gel did not produce any of the side effects related to chlorhexidine
rinses.Conclusions: A 22% reduction of the incidence of alveolar osteitis with the application of 0.2%
bioadhesive chlo-rhexidine gel compared to placebo with differences that were not statistically
significant was found in this clinical trial. The lack of adverse reactions and complications related to
chlorhexidine gel supports its clinical use spe-cially in simple extractions and adds some advantages
compared to the rinses in terms of duration of the treatment and reduction of staining and taste
disturbance.
Title: A randomized clinical trial compared the effect of intra-alveolar 0.2% chlorohexidine bio-
adhesive gel versus 0.12% chlorohexidine rinse in reducing alveolar osteitis following molar teeth
extractions
Citation: Medicina Oral, Patologia Oral y Cirugia Bucal, January 2015, vol./is. 20/1(e82-e87), 1698-
4447;1698-6946 (01 Jan 2015)
Author(s): Abu-Mostafa N.-A., Alqahtani A., Abu-Hasna M., Alhokail A., Aladsani A.
Abstract: Objectives: To evaluate socket healing, incidence of acute alveolar ostieitis (AO) and
associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2%
chlorhexidine (CHX) gel, and those who rinsed with 0.12% CHX rinse.Study Design: A prospective
randomized clinical trial was conducted on two parallel groups of patients. Group1 (141 patients):
Rinsed with 0.12% CHX rinse from the second postoperative day, two times daily for a week. Group2
(160 patients): Who had direct intra-alveolar application of 0.2% CHX gel and day 3 post-operatively.
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The socket was evaluated 3 and 7 day postoperatively for the presence of AO by checking probing
tenderness in the socket, empty socket, food debris, halitosis and pain assessment by VAS.Results:
Forty-eight AO cases were diagnosed out of 301 extractions (15.9%). In Group1, 25 cases were found
(17.7%) while 23 cases were found in Group2 (14.4%). The difference was not statistically significant
(p=0.428). Presence of empty socket and food debris in Group1 were higher than in Group2 but the
difference was not statistically significant (p= 0.390 & p = 0.415). Occurrence of halitosis in Group2
was more than Group1, but the difference was not significant (p= 0.440). Statistical significance was
found between AO in extraction done by root separation (29%) and those routinely extracted
(12.3%) (p=0.001).Conclusions: Postoperative evaluation of molar extraction sockets that received
direct intra-alveolar application of 0.2% CHX gel showed insignificant less occurrence of AO when
compared with 0.12% CHX rinse.
Title: Effect of low-concentration povidone iodine on postoperative complications after third
molar surgery: A pilot split-mouth study
Citation: Journal of Oral and Maxillofacial Surgery, January 2015, vol./is. 73/1(18-21), 0278-
2391;1531-5053 (01 Jan 2015)
Author(s): Mahmoud Hashemi H., Mohammadi F., Hasheminasab M., Mahmoud Hashemi A., Zahraei
S., Mahmoud Hashemi T.
Abstract: Purpose Povidone iodine is used primarily as an antiseptic to decrease surgical site
infection. Its hemostatic and antiedematous properties in oral surgery also have been investigated
recently.Patients and Methods A randomized controlled clinical trial was performed in 30 patients
undergoing mandibular third molar removal in a split-mouth design. In the study group, a povidone
iodine solution with a concentration of 0.5 mg/mL was used as the coolant and irrigant solution,
whereas normal saline was used in the control group. Swelling (orotragus and mentotragus
distances), trismus (maximum interincisal opening), and pain (visual analog scale score) were
evaluated on postoperative days 2 and 7.Results In the study group, a significant decrease in
swelling and trismus was observed at the 2 postoperative visits (P =.00) compared with the control
group. The decrease of pain in the study group was not statistically significant at either
postoperative visit (P >.05). More patients (63%) were subjectively satisfied with the side treated
with povidone iodine.Conclusion Povidone iodine irrigation is an inexpensive and safe method to
lessen the postoperative sequelae of third molar surgery.
Bisphosphonate-related osteonecrosis of the jaw
Title: Doxycycline fluorescence-guided Er:YAG laser ablation combined with
Nd:YAG/diode laser biostimulation for treating bisphosphonate-related osteonecrosis of
the jaw.
Citation: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, January 2015, vol./is.
119/1(e6-e12), 2212-4411 (2015 Jan)
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Author(s): Porcaro G, Amosso E, Scarpella R, Carini F
Abstract: Laser therapy and fluorescence-guided surgery are highly reliable and predictable
methods, but their combination has not been found to yield useful outcomes. We present a new
therapeutic approach combining fluorescence-guided Er:YAG laser ablation with Nd:YAG/diode
laser biostimulation for bisphosphonate-related osteonecrosis of the jaw (BRONJ). A woman
was treated with zoledronic acid for bone metastasis from clear cell renal cell carcinoma and
subsequently developed BRONJ in the left jaw. The management protocol included
perioperative medical therapy (1% chlorhexidine gel, rifamycin, and doxycycline for 10
preoperative and 7 postoperative days), Er:YAG laser ablation guided by doxycycline
fluorescence in vital bone under UV light, and Nd:YAG/diode laser biostimulation. The lesion
regressed from stage 3 to stage 1 and showed nearly complete healing after laser therapy (3 and
23 cycles of ablation and biostimulation, respectively). These preliminary findings suggest the
feasibility of the new approach, which is minimally invasive and biostimulative and causes very
low morbidity. Copyright 2015 Elsevier Inc. All rights reserved.
Title: FDG-PET may predict the effectiveness of hyperbaric oxygen therapy in a patient
with bisphosphonate-related osteonecrosis of the jaw: report of a case.
Citation: Odontology/The Society of the Nippon Dental University, January 2015, vol./is.
103/1(105-8), 1618-1247;1618-1255 (2015 Jan)
Author(s): Fatema CN, Sato J, Yamazaki Y, Hata H, Hattori N, Shiga T, Tamaki N, Kitagawa Y
Abstract: We report an advanced case of bisphosphonate-related osteonecrosis of the jaw
(BRONJ) in an osteoporotic patient treated with oral risedronate sodium for 2 years. An 80-
year-old woman presented to our hospital complaining of pain, swelling and pus discharge in
the lower alveolar ridge. Fluorine-18 labeled fluorodeoxyglucose positron emission tomography
(FDG-PET) and bone scintigraphy showed definite uptake in the mandible. Under clinical
diagnosis of BRONJ, we applied systematic treatments including antibiotic therapy, irrigation,
cessation of bisphosphonate, hyperbaric oxygen (HBO) therapy, and debridement of necrotic
bone. After pre-operative 20 sessions of HBO therapy, her clinical symptoms disappeared.
SUVmax of FDG-PET decreased definitely from 4.5 to 2.5, although magnetic resonance image
and bone scintigraphy did not show remarkable changes. After minor surgery with debridement
of necrotic bone, she received another ten sessions of HBO therapy. After the treatment, her
clinical course was excellent. In conclusion, this report demonstrates FDG-PET may predict the
effect of HBO therapy in BRONJ.
Title: Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.
Citation: Journal of the Chinese Medical Association: JCMA, January 2015, vol./is. 78/1(76-9),
1726-4901;1728-7731 (2015 Jan)
Author(s): Yang RH, Shen SH, Li WY, Chu YK
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Abstract: Ludwig's angina is a life-threatening cellulitis that involves the submandibular and
sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern
dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We
present here a cancer patient exhibiting the sequential features of bisphosphonate related
osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights
the need for medical practitioners to be alert to these rare combinations in the compromised
patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina
secondary to osteonecrosis of the jaw has been reported. Copyright 2014. Published by Elsevier
Taiwan.
Title: In vitro effects of bisphosphonates on chemotaxis, phagocytosis, and oxidative
burst of neutrophil granulocytes.
Citation: Clinical Oral Investigations, January 2015, vol./is. 19/1(139-48), 1432-6981;1436-
3771 (2015 Jan)
Author(s): Hagelauer N, Pabst AM, Ziebart T, Ulbrich H, Walter C
Abstract: OBJECTIVES: Bisphosphonate-associated osteonecrosis of the jaws is a serious side
effect that mainly occurs in patients receiving highly potent, nitrogen-containing
bisphosphonates. Usually the diagnosis is made due to exposed bone and a nonhealing wound.
Neutrophil granulocytes are essential for sufficient wound healing; therefore, the influence of
different bisphosphonates on neutrophil granulocytes was the focus of this study.MATERIAL
AND METHODS: The effect of nitrogen-containing bisphosphonates (ibandronate, pamidronate,
and zoledronate) and one non-nitrogen-containing bisphosphonate (clodronate) on chemotaxis,
phagocytosis, and oxidative burst of neutrophil granulocytes in human whole blood was
analyzed using standard cytometric flow assays.RESULTS: Chemotaxis of neutrophils was
reduced by almost 50 % when cells were treated with ibandronate and zoledronate. All tested
nitrogen-containing bisphosphonates moderately increased the percentage of phagocytizing
neutrophils, whereas the percentage of oxidizing cells was extremely affected. Zoledronate
increased the oxidative burst activity even at low concentrations. Treatment with ibandronate
and pamidronate reached the same level, but only in at least 10 times the higher concentrations.
The maximal burst activity of a single cell reached nearly 150 % compared to control. In this
case, zoledronate also caused maximal effects even at low concentrations. Clodronate did not
show any effects.CONCLUSION: The results show a proinflammatory effect of the nitrogen-
containing effect on neutrophil granulocytes which might contribute to the development of
osteonecrosis.CLINICAL RELEVANCE: The altered neutrophil defense might play a key role in
the pathogenesis of bisphosphonate-associated osteonecrosis of the jaws, although the
underlying causation between inflammatory reaction and the development of necrosis is yet
unknown.
Title: Bisphosphonate-related osteonecrosis of the jaw in patients with breast cancer.
Citation: European journal of orthopaedic surgery & traumatologie, January 2015, vol./is.
25/1(29-37), 1633-8065;1633-8065 (2015 Jan)
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Author(s): Piccioli A
Abstract: Bisphosphonate represents a well-established treatment option in the management
of metastatic bone disease and bone loss/osteoporosis in women with breast cancer. These
drugs reduce osteoclast. Some bisphosphonate also have osteoblastic function leading to a
reducted bone turnover and thereby skeletal-related events. The aim of this review is to
evaluate the bisphosphonate-related osteonecrosis of the jaw in patients with breast cancer.
Based on the proven effect of bone protection during adjuvant endocrine therapy, new
treatment guidelines recommend the routine use of bisphosphonates to prevent bone loss
during adjuvant therapy, which may likely become the standard practice.
Title: Salivary proteomics in bisphosphonate-related osteonecrosis of the jaw.
Citation: Oral Diseases, January 2015, vol./is. 21/1(46-56), 1354-523X;1601-0825 (2015 Jan)
Author(s): Thumbigere-Math V, Michalowicz B, de Jong E, Griffin T, Basi D, Hughes P, Tsai M,
Swenson K, Rockwell L, Gopalakrishnan R
Abstract: OBJECTIVE: The objective of this study was to identify differentially expressed
salivary proteins in bisphosphonate-related osteonecrosis of the jaw (BRONJ) patients that
could serve as biomarkers for BRONJ diagnosis.SUBJECTS AND METHODS: Whole saliva
obtained from 20 BRONJ patients and 20 controls were pooled within groups. The samples were
analyzed using iTRAQ-labeled two-dimensional liquid chromatography-tandem mass
spectrometry.RESULTS: Overall, 1340 proteins were identified. Of these, biomarker candidates
were selected based on P-value (<0.001), changes in protein expression (>1.5-fold increase or
decrease), and unique peptides identified (>2). Three comparisons made between BRONJ and
control patients identified 200 proteins to be differentially expressed in BRONJ patients. A
majority of these proteins were predicted to have a role in drug metabolism and immunological
and dermatological diseases. Of all the differentially expressed proteins, we selected
metalloproteinase-9 and desmoplakin for further validation. Immunoassays confirmed
increased expression of metalloproteinase-9 in individual saliva (P = 0.048) and serum samples
(P = 0.05) of BRONJ patients. Desmoplakin was undetectable in saliva. However, desmoplakin
levels tended to be lower in BRONJ serum than controls (P = 0.157).CONCLUSIONS: Multiple
pathological reactions are involved in BRONJ development. One or more proteins identified by
this study may prove to be useful biomarkers for BRONJ diagnosis. The role of
metalloproteinase-9 and desmoplakin in BRONJ requires further investigation.Copyright 2013
John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Title: Up to a quarter of patients with osteonecrosis of the jaw associated with
antiresorptive agents remain undiagnosed.
Citation: British Journal of Oral & Maxillofacial Surgery, January 2015, vol./is. 53/1(13-7),
0266-4356;1532-1940 (2015 Jan)
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Author(s): Fedele S, Bedogni G, Scoletta M, Favia G, Colella G, Agrillo A, Bettini G, Di Fede O,
Oteri G, Fusco V, Gabriele M, Ottolenghi L, Valsecchi S, Porter S, Fung PP, Saia G, Campisi G,
Bedogni A
Abstract: Recent data suggest that the traditional definition of bisphosphonate-associated
osteonecrosis of the jaw (ONJ) may exclude patients who present with the non-exposed variant
of the condition. To test the hypothesis that a proportion of patients with ONJ remain
undiagnosed because their symptoms do not conform to the traditional case definition, we did a
secondary analysis of data from MISSION (Multicentre study on phenotype, definition and
classification of osteonecrosis of the jaws associated with bisphosphonates), a cross-sectional
study of a large population of patients with bisphosphonate-associated ONJ who were recruited
in 13 European centres. Patients with exposed and non-exposed ONJ were included. The main
aim was to quantify the proportion of those who, according to the traditional case definition,
would not be diagnosed with ONJ because they had no exposed necrotic bone. Data analysis
included descriptive statistics, median regression, and Fisher's exact test. A total of 886
consecutive patients were recruited and 799 were studied after data cleaning (removal or
correction of inaccurate data). Of these, 607 (76%) were diagnosed according to the traditional
definition. Diagnosis in the remaining 192 (24%) could not be adjudicated, as they had several
abnormal features relating to the jaws but no visible necrotic bone. The groups were similar for
most of the phenotypic variables tested. To our knowledge this is the first study in a large
population that shows that use of the traditional definition may result in one quarter of patients
remaining undiagnosed. Those not considered to have ONJ had the non-exposed variant. These
findings show the importance of adding this description to the traditional case definition.
Copyright 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Title: Diagnosis and management of osteonecrosis of the jaw: A systematic review and
international consensus
Citation: Journal of Bone and Mineral Research, January 2015, vol./is. 30/1(3-23), 0884-
0431;1523-4681 (01 Jan 2015)
Author(s): Khan A.A., Morrison A., Hanley D.A., Felsenberg D., McCauley L.K., O'Ryan F., Reid
I.R., Ruggiero S.L., Taguchi A., Tetradis S., Watts N.B., Brandi M.L., Peters E., Guise T., Eastell R.,
Cheung A.M., Morin S.N., Masri B., Cooper C., Morgan S.L., Obermayer-Pietsch B., Langdahl B.L.,
Al Dabagh R., Davison K.S., Kendler D.L., Sandor G.K., Josse R.G., Bhandari M., El Rabbany M.,
Pierroz D.D., Sulimani R., Saunders D.P., Brown J.P., Compston J.
Abstract: This work provides a systematic review of the literature from January 2003 to April
2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of
the jaw (ONJ), and offers recommendations for its management based on multidisciplinary
international consensus. ONJ is associated with oncology-dose parenteral antiresorptive
therapy of bisphosphonates (BP) and denosumab (Dmab). The incidence of ONJ is greatest in
the oncology patient population (1% to 15%), where high doses of these medications are used
at frequent intervals. In the osteoporosis patient population, the incidence of ONJ is estimated at
0.001% to 0.01%, marginally higher than the incidence in the general population (<0.001%).
New insights into the pathophysiology of ONJ include antiresorptive effects of BPs and Dmab,
effects of BPs on gamma delta T-cells and on monocyte and macrophage function, as well as the
14
role of local bacterial infection, inflammation, and necrosis. Advances in imaging include the use
of cone beam computerized tomography assessing cortical and cancellous architecture with
lower radiation exposure, magnetic resonance imaging, bone scanning, and positron emission
tomography, although plain films often suffice. Other risk factors for ONJ include glucocorticoid
use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes
mellitus, illfitting dentures, as well as other drugs, including antiangiogenic agents. Prevention
strategies for ONJ include elimination or stabilization of oral disease prior to initiation of
antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk
for the development of ONJ, including cancer patients receiving high-dose BP or Dmab therapy,
consideration should be given to withholding antiresorptive therapy following extensive oral
surgery until the surgical site heals with mature mucosal coverage. Management of ONJ is based
on the stage of the disease, size of the lesions, and the presence of contributing drug therapy
and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic
antibiotic therapy. Localized surgical debridement is indicated in advanced nonresponsive
disease and has been successful. Early data have suggested enhanced osseous wound healing
with teriparatide in those without contraindications for its use. Experimental therapy includes
bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-
derived growth factor application, hyperbaric oxygen, and tissue grafting.
Maxillofacial
Title: Impact of the economic recession on the etiology of maxillofacial fractures in Greece.
Citation: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, January 2015, vol./is.
119/1(32-4), 2212-4411 (2015 Jan)
Author(s): Rallis G, Igoumenakis D, Krasadakis C, Stathopoulos P
Abstract: OBJECTIVE: The global economic crisis and the subsequent austerity measures taken in
Greece in 2010 have moved the country to the epicenter of a financial storm with negative effects
on the national health sector and all aspects of social life.METHODS: Records of patients admitted
for treatment of maxillofacial fractures in two different periods of time were used in this study. Data
concerning the etiology of fractures from 2006 to 2009 were compared with data from 2010 to 2013
to investigate whether the economic recession has significantly influenced the causality of
trauma.RESULTS AND CONCLUSION: Our study demonstrates that the rate of facial fractures caused
by motor vehicle accidents before the worsening of the crisis was significantly reduced in the period
after 2010 but that the incidence of fractures due to interpersonal violence increased during the
period of the severe economic crisis. We discuss the reasons that may have led to these changing
patterns of trauma.Copyright 2015 Elsevier Inc. All rights reserved.
Title: Tumors of the pediatric maxillofacial skeleton: a 20-year clinical study.
Citation: JAMA Otolaryngology-- Head & Neck Surgery, January 2015, vol./is. 141/1(40-4), 2168-
6181;2168-619X (2015 Jan 1)
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Author(s): Perry KS, Tkaczuk AT, Caccamese JF Jr, Ord RA, Pereira KD
Abstract: IMPORTANCE: Pediatric jaw tumors are a rare clinical entity and are not well addressed in
the otolaryngology literature. It is important that otolaryngologists be familiar with the clinical
features, management, and outcomes associated with these lesions.OBJECTIVE: To review the
clinical presentation, management, and outcomes of jaw tumors in children treated at a tertiary care
academic center.DESIGN, SETTING, AND PARTICIPANTS: Retrospective medical record review of
children 16 years or younger who presented to the departments of Oral-Maxillofacial Surgery and
Otorhinolaryngology at the University of Maryland Medical Center between 1992 and 2012 and
were diagnosed as having a jaw tumor. A PubMed review of literature from 1992 to 2013 on jaw
tumors in children was also conducted.MAIN OUTCOMES AND MEASURES: Medical records were
reviewed for data on symptoms, physical findings, pathologic diagnosis, intervention, and
outcomes.RESULTS: The medical records of 76 patients evaluated for a jaw mass were reviewed, and
20 were found to have a diagnosis of a jaw tumor. The 2 most common pathologic diagnoses were
ameloblastoma (n=5) and juvenile ossifying fibroma (n=4). Two tumors were malignant, a
rhabdomyosarcoma and a teratoma. Thirteen patients presented with evidence of a mass or
swelling, 5 patients were asymptomatic with a lesion found on surveillance panoramic radiography,
and 1 patient presented with epistaxis and 1 with facial weakness and pain. All tumors excluding a
lymphangioma and a rhabdomyosarcoma were managed surgically. Eight patients underwent more
than 1 procedure including secondary reconstruction prior to a satisfactory outcome.CONCLUSIONS
AND RELEVANCE: Pediatric jaw tumors are rare lesions most commonly presenting with a swelling or
mass. Patients can be asymptomatic with the lesion identified on routine imaging. Certain clinical
features such as age, location of tumor, and presence or absence of bone and soft tissue can narrow
the differential diagnosis and identify tumors that may be malignant. Incisional biopsy is an
important first step. A majority of jaw tumors are benign but require surgical intervention for
eradication of disease. Multiple procedures, including reconstruction, may be required for certain
lesions prior to cure.
Title: Incidental findings of skull-base abnormalities in cone-beam computed tomography scans
with consultation by maxillofacial radiologists.
Citation: American Journal of Orthodontics & Dentofacial Orthopedics, January 2015, vol./is.
147/1(127-31), 0889-5406;1097-6752 (2015 Jan)
Author(s): Newaz ZA, Barghan S, Katkar RA, Bennett JA, Nair MK
Abstract: INTRODUCTION: Cone-beam computed tomography (CBCT) gives orthodontists and other
dental clinicians 3-dimensional information for planning treatment in the craniofacial region. Often
overlooked are incidental findings outside the treatment region of interest.METHODS: Two patients
with incidental findings of skull-base abnormalities are presented. The orthodontic patient was
tentatively diagnosed with a notochordal remnant in the clivus; the implant patient exhibited an
empty sella turcica.RESULTS: For the clivus lesion in the orthodontic patient, an artifact was ruled
out after a second CBCT image and further distinguished from a fat-containing tumor after magnetic
resonance imaging. The impression after magnetic resonance imaging was a notochordal remnant,
although chordoma was also included in the differential, warranting a 6-month follow-up magnetic
16
resonance image to confirm the diagnosis. The CBCT study for the implant patient demonstrated an
enlarged sella turcica. The impression after the magnetic resonance imaging was an enlarged and
partially empty sella with no evidence of a pituitary mass.CONCLUSIONS: Orthodontists and implant
surgeons may come across incidental findings outside their area of expertise on CBCT scans,
highlighting the importance of appropriate consultation with maxillofacial radiologists. Notochordal
remnants may present as nonexpansile intraosseous low-density areas. The challenge in
distinguishing these lesions radiographically with chordomas warrants follow-up to confirm a
diagnosis. An empty sella is a noteworthy finding because of its potential for endocrine and neuro-
ophthalmological disorders despite an asymptomatic presentation.Copyright 2015 American
Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Title: A review of cervical spine injury associated with maxillofacial trauma at a UK tertiary referral
centre.
Citation: Annals of the Royal College of Surgeons of England, January 2015, vol./is. 97/1(66-72),
0035-8843;1478-7083 (2015 Jan)
Author(s): Mukherjee S, Abhinav K, Revington P
Abstract: INTRODUCTION: The aim of this study was to determine the incidence and patterns of
cervical spine injury (CSI) associated with maxillofacial fractures at a UK trauma centre.METHODS: A
retrospective analysis was conducted of 714 maxillofacial fracture patients presenting to a single
trauma centre between 2006 and 2012.RESULTS: Of the 714 maxillofacial fracture patients, 2.2% had
associated CSI including a fracture, cord contusion or disc herniation. In comparison, 1.0% of
patients without maxillofacial trauma sustained a CSI (odds ratio: 2.2, p=0.01). The majority (88%) of
CSI cases of were caused by a road traffic accident (RTA) with the remainder due to falls. While 8.8%
of RTA related maxillofacial trauma patients sustained a CSI, only 2.0% of fall related patients did
(p=0.03, not significant). Most (70%) of the CSIs occurred at C1/C2 or C6/C7 levels. Overall, 455, 220
and 39 patients suffered non-mandibular, isolated mandibular and mixed mandibular/non-
mandibular fractures respectively. Their respective incidences of CSI were 1.5%, 1.8% and 12.8%
(p=0.005, significant). Twelve patients with concomitant CSI had their maxillofacial fractures treated
within twenty-four hours and all were treated within four days.CONCLUSIONS: The presence of
maxillofacial trauma mandates exclusion and prompt management of cervical spine injury,
particularly in RTA and trauma cases involving combined facial fracture patterns. This approach will
facilitate management of maxillofacial fractures within an optimum time period.
Title: The 5-year prevalence of maxillofacial fibro-osseous lesions in Uganda
Citation: Oral Diseases, January 2015, vol./is. 21/1(e79-e85), 1354-523X;1601-0825 (01 Jan 2015)
Author(s): Muwazi L.M., Kamulegeya A.
Abstract: Background: Fibro-osseous lesions of the jaws are a diagnostic challenge for the
pathologist because histologically, they are not easily distinguishable. African data on the prevalence
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of these lesions are scarce. We present a 5-year report of benign fibro-osseous lesions at Mulago
Hospital, Uganda, showing the frequency and distribution of these lesions. Materials and Methods:
Confirmed fibro-osseous lesions reports at the pathology department (2007-2012) were retrieved.
Patients' clinical data including age, gender, anatomic location, and diagnosis were recorded.
Descriptive statistics and simple proportion tests were carried out. Results: We retrieved 155
confirmed benign fibro-osseous lesions over this period, 65% were females, 34% males, and the
gender of one case was not specified. Fibrous dysplasia was the most prevalent lesion (n = 87,
56.1%) followed by ossifying fibroma (n = 50, 32.9%) and osseous dysplasia (n = 17, 10.9%). We
neither found craniofacial nor polyostotic fibrous dysplasia. Fibrous dysplasia and ossifying fibroma
peaked in the second decade at 40.2% and 40.0%, respectively. Florid osseous dysplasia was
commonest in the fifth decade. Conclusion: In this study, all the florid osseous dysplasia were seen
among females. We need to carry out prospective studies to establish as to why and what kind of
women get afflicted by this lesion.
Title: European Maxillofacial Trauma (EURMAT) project: A multicentre and prospective study
Citation: Journal of Cranio-Maxillofacial Surgery, January 2015, vol./is. 43/1(62-70), 1010-5182;1878-
4119 (01 Jan 2015)
Author(s): Boffano P., Roccia F., Zavattero E., Dediol E., Uglesic V., Kovacic Z., Vesnaver A.,
Konstantinovic V.S., Petrovic M., Stephens J., Kanzaria A., Bhatti N., Holmes S., Pechalova P.F.,
Bakardjiev A.G., Malanchuk V.A., Kopchak A.V., Galteland P., Mjoen E., Skjelbred P., Koudougou C.,
Mouallem G., Corre P., Loes S., Lekven N., Laverick S., Gordon P., Tamme T., Akermann S.,
Karagozoglu K.H., Kommers S.C., Forouzanfar T.
Abstract: The purpose of this study was to analyse the demographics, causes and characteristics of
maxillofacial fractures managed at several European departments of oral and maxillofacial surgery
over one year. The following data were recorded: gender, age, aetiology, site of facial fractures,
facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396
patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed
from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of
injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as
the most important aetiological factor in the various centres. The most frequently observed fracture
involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures.
Condylar fractures were the most commonly observed mandibular fracture. The results of the
EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe,
with trauma cases caused by assaults and falls now outnumbering those due to road traffic
accidents. The progressive ageing of the European population, in addition to strict road and work
legislation may have been responsible for this change. Men are still the most frequent victims of
maxillofacial injuries.
Title: Maxillofacial fibro-osseous lesions
Citation: Clinical Radiology, January 2015, vol./is. 70/1(25-36), 0009-9260;1365-229X (01 Jan 2015)
18
Author(s): MacDonald D.S.
Abstract: During the last decade much has changed in our understanding of fibro-osseous lesions
(FOLs) of the jaws with regards to their imaging, their nomenclature and classification, and their
potential impact on the overall health of the patient. The changes in nomenclature, classification,
and the FOLs' potential association with important syndromes are discussed with the assistance of a
flowchart. The lesions, fibrous dysplasia (FD), ossifying fibroma (OF), and osseous dysplasia (OD),
though with similar histopathology, have very different clinical and radiological presentations,
behaviour, and treatment outcomes. FD of the jaw, which though becoming inactive, does not
involute and therefore requires life-long review to monitor for occasional reactivation. OF is
completely removed surgically as it has a propensity to recur. No treatment is generally required for
an OD unless it is infected or displays expansion. Lesions outside the jaws associated with FOLs of
the jaws are identified. Radiology remains central to the diagnosis of FOLs of the jaw, because the
pathologist is still not able to distinguish between them. The advent of cone-beam computed
tomography (CBCT) with its better radiation dose reduction, accessibility, and spatial resolution has
transformed imaging of FOLs. Their presentations on CBCT and the clinical indications for its use are
discussed.
Title: Comprehensive therapy for hemangioma presenting with kasabach-merritt syndrome in the
maxillofacial region
Citation: Journal of Oral and Maxillofacial Surgery, January 2015, vol./is. 73/1(92-98), 0278-
2391;1531-5053 (01 Jan 2015)
Author(s): Su L., Wang D., Fan X.
Abstract: Purpose To summarize the characteristics of Kasabach-Merritt syndrome (KMS) and to
evaluate the therapeutic effect of drug therapy combined with transarterial embolization.Patients
and Methods From 2007 to 2011, 6 cases of KMS that underwent drug therapy and transarterial
embolization were retrospectively analyzed, comprising of 3 male and 3 female patients; the ages of
the patients ranged from 3 to 40 days. The lesions were located in the temporal region (1 of 6,
16.7%), parotid region (2 of 6, 33.3%), or submandibular region and neck (3 of 6, 50%). All the
patients were followed for 12 to 18 months. Therapeutic outcomes were assessed by evaluating the
platelet count, coagulation parameters, and size of the lesion.Conclusions For most hemangiomas
presenting with KMS, good results can be obtained with systemic medical treatment. Transcatheter
arterial embolization with polyvinyl alcohol particles combined with systemic medical treatment
should be considered an efficacious and important therapeutic option for challenging cases.Results
Positive responses were visible shrinkage of the hemangioma or lightening of the skin color of the
cutaneous tumor (or both) within 8 to 72 hours in 4 patients (66.67%). These occurred within 1 week
in 5 patients (83.33%) and within 2 weeks in all patients (100%). The mean platelet count before
treatment was 18,000/L (range, 8,000 to 33,000/L). After the first week of medical treatment, the
mean platelet count increased to above 80,000/L in 5 patients (83.33%); it began to increase on the
second day after embolization and reached 102,000/L in 1 patient (16.67%). All 6 cases (100%)
showed good results with treatment. A 12- to 18-month follow-up evaluation was obtained for all
19
treated patients, and no rebound growth or platelet count decreases were observed. No severe or
obvious adverse complications were noted during all treatment courses.
General/other
Title: Applying fault tree analysis to the prevention of wrong-site surgery.
Citation: Journal of Surgical Research, January 2015, vol./is. 193/1(88-94), 0022-4804;1095-8673
(2015 Jan)
Author(s): Abecassis ZA, McElroy LM, Patel RM, Khorzad R, Carroll C 4th, Mehrotra S
Abstract: Wrong-site surgery (WSS) is a rare event that occurs to hundreds of patients each year.
Despite national implementation of the Universal Protocol over the past decade, development of
effective interventions remains a challenge. We performed a systematic review of the literature
reporting root causes of WSS and used the results to perform a fault tree analysis to assess the
reliability of the system in preventing WSS and identifying high-priority targets for interventions
aimed at reducing WSS. Process components where a single error could result in WSS were labeled
with OR gates; process aspects reinforced by verification were labeled with AND gates. The overall
redundancy of the system was evaluated based on prevalence of AND gates and OR gates. In total,
37 studies described risk factors for WSS. The fault tree contains 35 faults, most of which fall into
five main categories. Despite the Universal Protocol mandating patient verification, surgical site
signing, and a brief time-out, a large proportion of the process relies on human transcription and
verification. Fault tree analysis provides a standardized perspective of errors or faults within the
system of surgical scheduling and site confirmation. It can be adapted by institutions or specialties to
lead to more targeted interventions to increase redundancy and reliability within the preoperative
process. Copyright 2015 Elsevier Inc. All rights reserved.
Title: Comparing disciplines: Outcomes of non melanoma cutaneous malignant lesions in oral and
maxillofacial surgery and dermatology.
Citation: European Journal of Surgical Oncology, January 2015, vol./is. 41/1(169-73), 0748-
7983;1532-2157 (2015 Jan)
Author(s): Thavarajah M, Szamocki S, Komath D, Cascarini L, Heliotis M
Abstract: 300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and
Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month
period between September 2011 and February 2012 were included in a retrospective case control
study. The results from each speciality were compared. The mean age of the OMFS group was 75.8
years compared to 69.9 years in the dermatology group. There was no statistically significant
difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical
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(17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5%
respectively). This could also account for the fact that the OMFS group carried out a higher number
of full excisions compared to dermatology. Both groups had a similar number of false positives (a
benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a
malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had
similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the
guidelines set out by the British Association of Dermatologists and the National Institute of Clinical
Excellence when managing such lesions. Crown Copyright 2014. Published by Elsevier Ltd. All rights
reserved.
Title: The use of a computed tomographic application for mobile devices in the diagnosis of oral
and maxillofacial surgery.
Citation: Journal of Craniofacial Surgery, January 2015, vol./is. 26/1(e18-21), 1049-2275;1536-3732
(2015 Jan)
Author(s): Aoki EM, Cortes AR, Arita ES
Abstract: The aim of the current technical report was to introduce a computed tomographic (CT)
application for mobile devices as a diagnostic tool for analyzing CT images. An iPad and an iPhone
(Apple, Cuppertino, CA) were used to navigate through multiplanar reconstructions of cone beam CT
scans, using an application derived from the OsiriX CT software. Tools and advantages of this method
were recorded. In addition, images rendered in the iPad were manipulated during dental implant
placement and grafting procedures to follow up and confirm the implant digital planning in real
time. The study population consisted of 10 patients. In all cases, it was possible to use image
manipulation tools, such as changing contrast and brightness, zooming, rotating, panning,
performing both linear and area measurements, and analyzing gray-scale values of a region of
interest. Furthermore, it was possible to use the OsiriX application in the dental clinic where the
study was conducted, to follow-up the analyzed implant placement and grafting procedures at the
chairside. The current findings suggest that technological and practical methods to visualize
radiographic images are invaluable resources to improve training, teaching, networking, and the
performance of real-time follow-up of oral and maxillofacial surgical procedures. This article
discusses the advantages and disadvantages of introducing this new technology in the clinical
routine.
Title: Factors affecting changes in compliance with infection control practices by dentists in Japan.
Citation: American Journal of Infection Control, January 2015, vol./is. 43/1(95-7), 0196-6553;1527-
3296 (2015 Jan 1)
Author(s): Tada A, Watanabe M, Senpuku H
Abstract: We surveyed compliance with infection control practices (ICPs) and factors associated with
ICPs reported by dentists in Japan in 2008 and 2011. ICPs improved during this period as did the
21
proportion of dentists specializing in oral surgery, the proportion of dentists reporting a willingness
to treat HIV and AIDS patients, and the proportion of dentists reporting knowledge about universal
and standard precautions. Stronger associations between ICPs and these 3 factors were found in
2011 than in 2008. Copyright 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Title: Spatial resolution in CBCT machines for dental/maxillofacial applications-what do we know
today?.
Citation: Dento-Maxillo-Facial Radiology, 2015, vol./is. 44/1(20140204), 0250-832X;0250-832X
(2015)
Author(s): Brullmann D, Schulze RK
Abstract: Spatial resolution is one of the most important parameters objectively defining image
quality, particularly in dental imaging, where fine details often have to be depicted. Here, we review
the current status on assessment parameters for spatial resolution and on published data regarding
spatial resolution in CBCT images. The current concepts of visual [line-pair (lp) measurements] and
automated [modulation transfer function (MTF)] assessment of spatial resolution in CBCT images are
summarized and reviewed. Published measurement data on spatial resolution in CBCT are evaluated
and analysed. Effective (i.e. actual) spatial resolution available in CBCT images is being influenced by
the two-dimensional detector, the three-dimensional reconstruction process, patient movement
during the scan and various other parameters. In the literature, the values range between 0.6 and
2.8lpmm(-1) (visual assessment; median, 1.7lpmm(-1)) vs MTF (range, 0.5-2.3cycles per mm;
median, 2.1lpmm(-1)). Spatial resolution of CBCT images is approximately one order of magnitude
lower than that of intraoral radiographs. Considering movement, scatter effects and other influences
in real-world scans of living patients, a realistic spatial resolution of just above 1lpmm(-1) could be
expected.
Title: Human oral mucosa tissue-engineered constructs monitored by raman fiber-optic probe
Citation: Tissue Engineering - Part C: Methods, January 2015, vol./is. 21/1(46-51), 1937-3384;1937-
3392 (01 Jan 2015)
Author(s): Khmaladze A., Kuo S., Kim R.Y., Matthews R.V., Marcelo C.L., Feinberg S.E., Morris M.D.
Abstract: In maxillofacial and oral surgery, there is a need for the development of tissue-engineered
constructs. They are used for reconstructions due to trauma, dental implants, congenital defects, or
oral cancer. A noninvasive monitoring of the fabrication of tissue-engineered constructs at the
production and implantation stages done in real time is extremely important for predicting the
success of tissue-engineered grafts. We demonstrated a Raman spectroscopic probe system, its
design and application, for real-time ex vivo produced oral mucosa equivalent (EVPOME) constructs
noninvasive monitoring. We performed in vivo studies to find Raman spectroscopic indicators for
postimplanted EVPOME failure and determined that Raman spectra of EVPOMEs preexposed to
22
thermal stress during manufacturing procedures displayed correlation of the band height ratio of
CH<sub>2</sub> deformation to phenylalanine ring breathing modes, giving a Raman metric to
distinguish between healthy and compromised postimplanted constructs. This study is the step
toward our ultimate goal to develop a stand-alone system, to be used in a clinical setting, where the
data collection and analysis are conducted on the basis of these spectroscopic indicators with
minimal user intervention.
Title: The regenerative medicine in oral and maxillofacial surgery: The most important innovations
in the clinical application of mesenchymal stem cells
Citation: International Journal of Medical Sciences, January 2015, vol./is. 12/1(72-77), 1449-1907 (01
Jan 2015)
Author(s): Tatullo M., Marrelli M., Paduano F.
Abstract: Regenerative medicine is an emerging field of biotechnology that combines various
aspects of medicine, cell and molecular biology, materials science and bioengineering in order to
regenerate, repair or replace tissues.The oral surgery and maxillofacial surgery have a role in the
treatment of traumatic or degenerative diseases that lead to a tissue loss: frequently, to rehabilitate
these minuses, you should use techniques that have been improved over time. Since 1990, we
started with the use of growth factors and platelet concentrates in oral and maxillofacial surgery; in
the following period we start to use biomaterials, as well as several type of scaffolds and autologous
tissues. The frontier of regenerative medicine nowadays is represented by the mesenchymal stem
cells (MSCs): overcoming the ethical problems thanks to the use of mesenchymal stem cells from
adult patient, and with the increasingly sophisticated technology to support their manipulation,
MSCs are undoubtedly the future of medicine regenerative and they are showing perspectives
unimaginable just a few years ago. Most recent studies are aimed to tissues regeneration using
MSCs taken from sites that are even more accessible and rich in stem cells: the oral cavity turned out
to be an important source of MSCs with the advantage to be easily accessible to the surgeon, thus
avoiding to increase the morbidity of the patient.The future is the regeneration of whole organs or
biological systems consisting of many different tissues, starting from an initial stem cell line, perhaps
using innovative scaffolds together with the nano-engineering of biological tissues.
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Journal Tables of Contents
The most recent issues of the following journals:
Head and Neck
British Journal of Oral and Maxillofacial Surgery
Oral Surgery Oral Medicine Oral Pathology Oral Radiology
Oral Surgery
Click on the links for abstracts. If you would like any of these papers in full text then get in touch:
Head and Neck
Vol. 37, iss. 3, March 2015
Infraclavicular free flap for head and neck reconstruction: Surgical description and early outcomes
in 7 consecutive patients (pages 309–316)
Cancer stem cells: Mediators of tumorigenesis and metastasis in head and neck squamous cell
carcinoma (pages 317–326)
CD200: Association with cancer stem cell features and response to chemoradiation in head and
neck squamous cell carcinoma (pages 327–335)
Assessment of the new nodal classification for cutaneous squamous cell carcinoma and its effect
on patient stratification (pages 336–339)
Quality of life and voice assessment in patients with early-stage glottic cancer(pages 340–346)
Transfacial versus endoscopic approach in the treatment of woodworker's nasal
adenocarcinomas (pages 347–356)
Protein marker profiling in different T classification in laryngeal squamous cell carcinoma (pages
357–365)
Treatment outcomes and prognostic factors, including human papillomavirus, for sinonasal
undifferentiated carcinoma: A retrospective review (pages 366–374)
Clinicopathologic factors and adjuvant treatment effects on survival in adult head and neck
synovial cell sarcoma (pages 375–380)
Comparison of functional outcomes and quality of life between transoral surgery and definitive
chemoradiotherapy for oropharyngeal cancer (pages 381–385)
Concurrent cetuximab versus platinum-based chemoradiation for the definitive treatment of
locoregionally advanced head and neck cancer (pages 386–392)
24
Dissection and identification of parathyroid glands during thyroidectomy: Association with
hypocalcemia (pages 393–399)
Prognostic quality of the Union Internationale Contre le Cancer/American Joint Committee on
Cancer TNM classification, 7th edition, for cancer of the maxillary sinus (pages 400–406)
Pain and surgical outcomes with and without neck extension in standard open thyroidectomy: A
prospective randomized trial (pages 407–412)
Subsequent risk of nasopharyngeal carcinoma among patients with allergic rhinitis: A nationwide
population-based cohort study (pages 413–417)
Expression of metalloproteinases 2 and 9 and tissue inhibitors 1 and 2 as predictors of lymph node
metastases in oropharyngeal squamous cell carcinoma(pages 418–422)
Retromolar flexible fiber-optic orotracheal intubation: A novel alternative to nasal intubation and
tracheostomy in severe trismus (pages 423–424)
Outcomes toolbox for head and neck cancer research (pages 425–439)
Diffusion-weighted imaging in head and neck squamous cell carcinomas: A systematic
review (pages 440–448)
Clinical relevance of immune parameters in the tumor microenvironment of head and neck
cancers (pages 449–459)
Letter to the editor: The course of lingual artery from transoral robotic view (pages 460–461)
Reply to Letter to the Editor regarding course of lingual artery (pages 461–462)
Enchondroma of the nasal septum due to Ollier disease: A case report and review of the
literature (pages E30–E33)
Single-fraction stereotactic body radiation therapy for sinonasal malignant melanoma (pages E34–
E37)
Primary granulocytic sarcoma of larynx (pages E38–E44)
British Journal of Oral and Maxillofacial Surgery
Vol. 53, iss. 2, February 2015
Editorial Board
A review of oral surgery-related papers published in the British Journal of Oral and Maxillofacial
Surgery during 2011 and 2012
25
Planning the content of a brief educational course in maxillofacial emergencies for staff in accident
and emergency departments: a modified Delphi study
Antioxidant capacity of synovial fluid in the temporomandibular joint correlated with radiological
morphology of temporomandibular disorders
Predictive factors for premature loss of Martin 2.7 mandibular reconstruction plates
Systemic inflammatory response and survival in patients undergoing curative resection of oral
squamous cell carcinoma
Tumours of the salivary glands in northeastern China: a retrospective study of 2508 patients
Minimally invasive treatment of oral ranula with a mucosal tunnel
Outcome of excision of oral erythroplakia
Chimeric flaps pedicled with the lateral circumflex femoral artery for individualised reconstruction
of through-and-through oral and maxillofacial defects
Accuracy of three-dimensional soft tissue predictions in orthognathic surgery after Le Fort I
advancement osteotomies
Effects of recombinant human bone morphogenetic protein 7 (rhBMP-7) on the behaviour of oral
squamous cell carcinoma: a preliminary in vitro study
Margins of oral leukoplakia: autofluorescence and histopathology
Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle: a
longitudinal study
United Kingdom nationwide study of avascular necrosis of the jaws including bisphosphonate-
related necrosis
Effect of preoperative continuous positive airway pressure duration on outcomes after
maxillofacial surgery for obstructive sleep apnoea
Study of differential properties of fibrochondrocytes and hyaline chondrocytes in growing rabbits
CAD/CAM silicone simulator for teaching cheiloplasty: description of the technique
Orbital immunoglobulin IgG4-related inflammatory fibrosclerosing lesion treated with
pentoxifylline and α-tocopherol: case report
Role of culture of postoperative drainage fluid in the prediction of infection of the surgical site
after major oncological operations of the head and neck
Unusual complication of repair of fractured mandibular angle
Technique of sliding tongue flap after partial glossectomy
26
Customised reconstruction of the orbital wall and engineering of selective laser melting (SLM) core
implants
Wide-bladed mandibular channel retractor efficiently secures surgical manoeuvres during ramus
osteotomy
Re: Untreated dentofacial deformity: in defence of Luis Suárez
Training Groups
Oral Surgery Oral Medicine Oral Pathology Oral Radiology
Vol. 119, iss. 2, February 2015
Editorial Board
The future of dental education: toward disruptive innovation or incremental improvements?
Nodular swelling of the tongue
Clinical implications of prescribing nonsteroidal anti-inflammatory drugs in oral health care—a
review
Does watching a video on third molar surgery increase patients' anxiety level?
Assessment of morbidity following insertion of fixed preoperative orthopedic appliance in infants
with complete cleft lip and palate
Pharyngeal airway morphology in healthy individuals and in obstructive sleep apnea patients
treated with maxillomandibular advancement: a comparative study
Pulsed electromagnetic fields for postoperative pain: a randomized controlled clinical trial in
patients undergoing mandibular third molar extraction
Treatment of lip hemangioma using forced dehydration with induced photocoagulation via diode
laser: report of three cases
Giant life-threatening external carotid artery pseudoaneurysm caused by a mandibular condylar
fracture
Efficacy and safety of a new oral saliva equivalent in the management of xerostomia: a national,
multicenter, randomized study
Neuralgia associated with transcutaneous electrical nerve stimulation therapy in a patient initially
diagnosed with temporomandibular disorder
Histogenesis of keratoacanthoma: histochemical and immunohistochemical study
27
Oral squamous cell carcinoma associated with proliferative verrucous leukoplakia compared with
conventional squamous cell carcinoma—a clinical, histologic and immunohistochemical study
Twenty-first-century oral hairy leukoplakia—a non–HIV-associated entity
Comparison of the prevalence of human papilloma virus infection in histopathologically confirmed
premalignant oral lesions and healthy oral mucosa by brush smear detection
Over Expression of HuR and Podoplanin May Predict The Development of Oral Cancer in Patients
with Oral Preneoplastic Lesion
Diagnostic and Prognostic Implications of Cancer Stem Cells in Salivary Gland Neoplasms
A New Prognostic Model for Early Stage Oral Tongue Cancer
HOXB9 Expression in Salivary Gland Tumors: A Multi-Institutional Study
Expression of The Toll Like Receptor (TLR) 2, TLR4, TLR7 and TLR8 in Squamous Cell Carcinoma of
the Human Tongue
Hedgehog Inhibition Results in the Upregulation of Pro-Tumourigenic αvβ6 Integrin Expression
and Function in Cancer
Raman Micro-Spectroscopy for Rapid Screening of Oral Squamous Cell Carcinoma
OCT4 Expression in Oral Squamous Cell Carcinoma, Oral Epithelial Dysplasia and Normal Oral
Mucosa
Mammary Analogue Secretory Carcinoma of Salivary Glands Is a Distinct Entity
P16INK4a Expression in Benign HPV Associated Oral Lesions in Hiv-Infected Patients:
Clinicopathologic Correlation
Comparison of Morphologic Features and Outcome of Resected Squamous Cell Carcinoma
Associated with Proliferative Verrucous Leukoplakia and Conventional Squamous Cell Carcinoma
of the Gingiva, Buccal Mucosa and Palate: A Study Of 75 Cases
Chromosomal Aberrations in Mucoepidermoid Carcinoma of The Salivary Gland
Expression of Matrix Metalloproteinase-2 (MMP-2) and Carcinoma Associated Fibroblast (CAF) in
Benign & Malignant Salivary Gland Tumours
Overexpression of Akt2 in Oral Cancer Cells is Due To Reduced Protein Degradation Rate
Hormonal Changes in Exfoliated Normal Buccal Mucosal Cells
Combination of the Fatty Acid Synthase Inhibitor Orlistat with Cisplatin or Paclitaxel: Effects on
Metastatic Tongue Squamous Cell Carcinoma Cells
Expression of Prostanoid EP3 Receptors in Oral Squamous Cell Carcinoma
28
P27 and Ki67 Expression in Central and Peripheral Giant Cell Granuloma: An Immunohistochemical
Study
Radioprotective Effect of Ginseng and Fucoidan on Salivary Gland after Radioiodine Therapy In
Mice
Aberrant Wnt-1/Beta-Catenin Signaling and WIF-1 Deficiency Are Important Events Which
Promote Tumor Cell Invasion and Metastasis in Salivary Gland Adenoid Cystic Carcinoma
Histopathologic and Immunohistochemical Evaluation of Cellular Markers and Protooncogene c-
fos in Benign Fibro-Osseous Lesions (BFOL)
Cytomegalovirus Identification and Quantification from the Saliva of Human Immunodeficiency
Virus Seropositive and Seronegative Patients Using Real Time Polymerase Chain Reaction
Epithelial Loss Correlated with Decreased Beta Defensins and Increased Risk of Candida Infections
in Oral Lichen Planus
Differential Analysis of CALB2 Gene Expression Between Ameloblastomas and Keratocystic
Odontogenic Tumors
Oral Cytopathological Changes in Oral Squamous Cell Carcinoma Patients Receiving Concomitant
Chemoradiotherapy in Pakistan
Effect of Epigenetic Alterations on the Differentiation Potential of Dental Pulp Stem Cells
Desmoplastic Kaposi Sarcoma - A Newly Recognised Oral Mucosal Variant
Phenotypic Variability of Candida Species in Patients of Oral Lichen Planus and its Therapeutic
Implications
Xerostomia, Glucose Regulation and Serum Inflammatory Markers in Indonesians with Type 2
Diabetes Mellitus
Co-Expression of TLR2 and Treg in Oral Squamous Cell Carcinoma
Towards Drug Repositioning for Oral Squamous Cell Carcinoma
Immunohistochemichal Analysis of Maspin, Syndecan-1 and Ki-67 in The Keratocystic Odontogenic
Tumor
Non-Proliferating Plasma Cells Detected in the Salivary Gland and Bone Marrow of NOD.B10.H2b
Mice, A Model for Sjögren's Syndrome
Odontoameloblastoma and Ameloblastic Fibro-Odontoma: Using Case Reports to Illustrate
Differences Between Both Lesions
29
Oral Surgery
Vol. 8, iss. 1, February 2015
Systematic reviews of surgical practice (page 1)
A retrospective analysis of post-operative outcomes in a series of 108 labial gland biopsies (pages
2–9)
A systematic review of skin closure techniques in primary cleft lip surgery (pages 10–17)
Oral health-related quality of life: pre- and post-dental implant treatment (pages 18–22)
Distribution and morphological pattern of clefts in the craniofacial region seen in a sub-Saharan
tertiary hospital (pages 23–29)
The Oral Surgery trainee perspective (pages 30–37)
A CBCT measurement of the mandibular buccal bone thickness in dentate adults(pages 38–41)
A granular-cell odontogenic tumour occurring alongside orofacial granulomatosis: a report of the
first case (pages 42–47)
Trochlear calcification with coexisting orbital foreign bodies: case report and literature
review (pages 48–50)
Double accessory mental foramina: report of an anatomical variant (pages 51–53)
Management of the unstable isolated zygomatic arch fracture: a case study and review of the
literature (pages 54–58)
Non-syndromic bilateral dentigerous cysts with significant root resorption: a case report (pages
59–62)
Cast metal cap splint use for immobilisation of mandibular fracture (pages 63–64)
BAOS Newsletter (pages 65–66)
30
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