BRAF inhibitor treatment of primary BRAF-mutant ameloblastoma with pathologic assessment of response.

BRAF inhibitor treatment of primary BRAF-mutant ameloblastoma with pathologic assessment of response.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 23;

Authors: Tan S, Pollack JR, Kaplan MJ, Colevas AD, West RB

Abstract
OBJECTIVE: Molecular characterization of ameloblastoma has indicated a high frequency of driver mutations in BRAF and SMO. Preclinical data suggest that Food and Drug Administration-approved BRAF-targeted therapies may be immediately relevant for patients with ameloblastoma positive for the BRAF V600E mutation.
METHODS: A neoadjuvant treatment regime of dabrafenib was given to a patient with recurrent BRAF-mutant mandibular ameloblastoma. The patient subsequently underwent left mandible composite resection of the tumor and pathologic evaluation of treatment response.
RESULTS: The ameloblastoma had a slow but dramatic response with >90% tumor volume reduction. The inner areas of the tumor underwent degeneration and squamous differentiation, and intact ameloblastoma was present in the outer areas associated with bone.
CONCLUSIONS: Targeted neoadjuvant therapy for ameloblastoma may be useful in certain clinical settings of primary ameloblastoma. These might include tumors of advanced local stage when a neoadjuvant reduction could alter the extent of surgery and instances of local recurrence when surgical options are limited.

PMID: 27209484 [PubMed - as supplied by publisher]

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Accuracy of virtual surgical planning in two-jaw orthognathic surgery: comparison of planned and actual results.

Accuracy of virtual surgical planning in two-jaw orthognathic surgery: comparison of planned and actual results.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Mar 14;

Authors: Zhang N, Liu S, Hu Z, Hu J, Zhu S, Li Y

Abstract
OBJECTIVE: This study aims to evaluate the accuracy of virtual surgical planning in two-jaw orthognathic surgery via quantitative comparison of preoperative planned and postoperative actual skull models.
STUDY DESIGN: Thirty consecutive patients who required two-jaw orthognathic surgery were included. A composite skull model was reconstructed by using Digital Imaging and Communications in Medicine (DICOM) data from spiral computed tomography (CT) and STL (stereolithography) data from surface scanning of the dental arch. LeFort I osteotomy of the maxilla and bilateral sagittal split ramus osteotomy (of the mandible were simulated by using Dolphin Imaging 11.7 Premium (Dolphin Imaging and Management Solutions, Chatsworth, CA). Genioplasty was performed, if indicated. The virtual plan was then transferred to the operation room by using three-dimensional (3-D)-printed surgical templates. Linear and angular differences between virtually simulated and postoperative skull models were evaluated.
RESULTS: The virtual surgical planning was successfully transferred to actual surgery with the help of 3-D-printed surgical templates. All patients were satisfied with the postoperative facial profile and occlusion. The overall mean linear difference was 0.81 mm (0.71 mm for the maxilla and 0.91 mm for the mandible); and the overall mean angular difference was 0.95 degrees.
CONCLUSIONS: Virtual surgical planning and 3-D-printed surgical templates facilitated the diagnosis, treatment planning, and accurate repositioning of bony segments in two-jaw orthognathic surgery.

PMID: 27209483 [PubMed - as supplied by publisher]

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