Cancer and orofacial pain.

Cancer and orofacial pain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Romero-Reyes M, Salvemini D

Abstract
BACKGROUND: Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia._Material and Methods: We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy. _Results: There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy. _Conclusions: The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.

PMID: 27694791 [PubMed - as supplied by publisher]

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Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Varela-Centelles P, Loira-Gago M, Gonzalez-Mosquera A, Seoane-Romero JM, Garcia-Martin JM, Seoane J

Abstract
BACKGROUND: In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. _Material and Methods: Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen._Results: A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance)._Conclusions: Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures.

PMID: 27694790 [PubMed - as supplied by publisher]

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Surgical complications in zygomatic implants: A systematic review.

Surgical complications in zygomatic implants: A systematic review.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Molinero-Mourelle P, Baca-Gonzalez L, Gao B, Saez-Alcaide L, Helm A, Lopez-Quiles J

Abstract
BACKGROUND: The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants._Material and Methods: An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications._Results: Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted. _Conclusions: The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.

PMID: 27694789 [PubMed - as supplied by publisher]

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Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Guarnieri R, Cavallini C, Vernucci R, Vichi M, Leonardi R, Barbato E

Abstract
BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%._The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors._An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography._Material and Methods: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements._Results: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06_Conclusions: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

PMID: 27694788 [PubMed - as supplied by publisher]

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Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Sáez-Prado B, Haya-Fernández MC, Sanz-García MT

Abstract
BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain._Material and Methods: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population.
SUBJECTS: 202 adults (103 men and 99 women). Age: 65 years of age and over.
SETTING: Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed._Results: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth._Conclusions: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people.

PMID: 27694787 [PubMed - as supplied by publisher]

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Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Li Y, Zhang P, Li R, Liu Y, Kan Q

Abstract
BACKGROUND: This study investigated the quality of life of Chinese patients with tongue cancer who had undergone immediate flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap (RFFF) surgery and others who had received pectoralis major myocutaneous flap (PMMF) surgery._Material and Methods: Patients who received RFFF or PMMF reconstruction after primary tongue cancer treated with total and subtotal tongue resection were eligible for the current study. The patients' demographic data, medical history, and quality of life scores (14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QOL) questionnaires) were collected. _Results: A total of 41 of 63 questionnaires were returned (65.08%). There were significant differences between the 2 groups in the gender (p< .05). Patients reconstructed with RFFF performed better in the shoulder domains, in addition to worse appearance domains_Conclusions: Using either RFFF or PMMF for reconstruction of defects after tongue cancer resection significantly influences a patient's quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for tongue cancers.

PMID: 27694786 [PubMed - as supplied by publisher]

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Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications.

Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Herranz-Aparicio J, Marques J, Almendros-Marqués N, Gay-Escoda C

Abstract
BACKGROUND: In order to choose the appropriate implant size and to prevent complications, an oral surgeon must know the size and shape of the mandible. In the posterior mandibular region, a lingual undercut is often found and could represent a difficulty hard to manage if a lingual or buccal perforation occur. _A large series of computed tomography (CT) images of first molar mandible was evaluated and it the bone morphology and the prevalence and the degree of the lingual concavity in the first molar region was studied. _Material and Methods: One hundred and fifty-one computed tomography (CT) examinations of patients were retrospectively evaluated to determine anatomical variations in bone morphology in the submandibular fossa region. _Results: A total of 151 subjects were included, consisting of 64 males (M) (42.4%) and 87 females (F) (57.6%). The under-cut type ridge was present in 64.2% of the cases. The concavity angle was 66.6 ± 8.9° (M) and 71.6 ± 8.4° (F) and the linear concavity depth 4.5 ± 2.3 mm (M) and 3.1 ± 1.7 mm (F) (p>0.05). _Conclusions: Mandibles with any lingual concavity present a potential increased risk of lingual cortical perforation during implant placement surgery. CT imaging allows characterizing the anatomy of the submandibular fossa and provides other important information for the preoperative assessment of the posterior mandible for dental implants placement.

PMID: 27694785 [PubMed - as supplied by publisher]

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Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample.

Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: de-Pedro-Herráez M, Mesa-Jiménez J, Fernández-de-Las-Peñas C, de-la-Hoz-Aizpurua JL

Abstract
BACKGROUND: Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. _Objetives: The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups._Material and Methods: Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions. _Results: It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain. _Conclusions: These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual's Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual's medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering.

PMID: 27694784 [PubMed - as supplied by publisher]

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Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Costantinides F, Biasotto M, Maglione M, Di Lenarda R

Abstract
BACKGROUND: The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). _Material and Methods: This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Difference in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated._Results: In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group._Conclusions: Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected.

PMID: 27694783 [PubMed - as supplied by publisher]

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Temporomandibular chronic dislocation: The long-standing condition.

Temporomandibular chronic dislocation: The long-standing condition.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Marqués-Mateo M, Puche-Torres M, Iglesias-Gimilio ME

Abstract
BACKGROUND: The temporomandibular joint (TMJ) dislocation can be categorised into three groups: acute, habitual or recurrent and long-standing. The long-standing or protracted lower jaw dislocation refers to a condition that persists for more than one month without reduction. There are a great variety of methods for its treatment, from the manual or non-surgical, to surgical ones like the indirect approach (conservative surgical approach) and direct approach (open joint). Additional procedures in unsuccessful cases may include extra-articular orthognathic techniques to correct a malocclusion until joint replacement. _Material and Methods: We report four new cases with a minimum of 6 weeks dislocation who were seen since 1995 to 2015 in the Maxillofacial Department of the Clínico Hospital (Valencia, Spain), in which the mean age was 57.5 years. Most of them were bilateral and the gender was predominantly female. Additionally, we have reviewed the related literature. _Results: All of the cases were successfully treated and half of them required open surgery. _Conclusions: The report confirms the difficulty of the treatment and reaffirms the necessity to bear in mind the wide variety of methods available for the treatment of this pathology. We stress the difficulties associated with managing the treatment and of suggesting new guidelines. The best option still remains not to delay the diagnostic and to select the appropriate initial treatment.

PMID: 27694782 [PubMed - as supplied by publisher]

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Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Singh P, Ajmera DH, Xiao SS, Yang XZ, Liu X, Peng B

Abstract
BACKGROUND: The purpose of this study was to identify potential concealed variables associated with the difficulty of lower third molar (M3) extractions. _Material and Methods: To address the research purpose, we implemented a prospective study and enrolled a sample of subjects presenting for M3 removal. Predictor variables were categorized into Group-I and Group-II, based on predetermined criteria. The primary outcome variable was the difficulty of extraction, measured as extraction time. Appropriate univariate and multivariate statistics were computed using ordinal logistic regression. _Results: The sample comprised of 1235 subjects with a mean age of 29.49 +/- 8.92 years in Group-I and 26.20 +/- 11.55 years in Group-II subjects. The mean operating time per M3 extraction was 21.24 +/- 12.80 and 20.24 +/- 12.50 minutes for Group-I and Group-II subjects respectively. Three linear parameters including B-M2 height (distance between imaginary point B on the inferior border of mandibular body, and M2), lingual cortical thickness, bone density and one angular parameter including Rc-Cs angle (angle between ramus curvature and curve of spee), in addition to patient's age, profile type, facial type, cant of occlusal plane, and decreased overbite, were found to be statistically associated ( p < or = 0.05) with extraction difficulty under regression models. _Conclusions: In conclusion, our study indicates that the difficulty of lower M3 extractions is possibly governed by morphological and biomechanical factors with substantial influence of myofunctional factors._Practical Implications: Preoperative evaluation of dynamic concealed factors may not only help in envisaging the difficulty and planning of surgical approach but might also help in better time management in clinical practice.

PMID: 27694781 [PubMed - as supplied by publisher]

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Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature.

Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Muñoz-Corcuera M, Ramírez-Martínez-Acitores L, López-Pintor RM, Casañas-Gil E, Hernández-Vallejo G

Abstract
BACKGROUND: Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. _Material and Methods: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library. We excluded articles dealing with all anticoagulants other than dabigatran, and works about surgical treatments in anatomical locations other than the oral cavity. _Results: We included a total of 13 papers of which 1 was a randomized clinical trial, 9 narrative literature reviews, 1 case series, 2 clinical cases and 1 expert opinion. Because we did not obtain any properly designed clinical trials, we were unable to conduct a meta-analysis. _Conclusions: Currently, there is no consensus on the procedure to be followed in patients taking dabigatran. However, all authors agree to treat each case individually in accordance to the risk of embolism, postoperative bleeding and renal function. Also, it is necessary to perform minimally invasive interventions, and take the appropriate local anti-hemolytic measures.

PMID: 27694780 [PubMed - as supplied by publisher]

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Oral tongue cancer in public hospitals in Madrid, Spain (1990-2008).

Oral tongue cancer in public hospitals in Madrid, Spain (1990-2008).

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: García-Kass A, Herrero-Sánchez A, Esparza-Gómez G

Abstract
BACKGROUND: The cancer which appears in the mobile portion of the tongue is the most common neoplasm of the oral cavity. The objective of this study was to analyse oral tongue cancer epidemiology in a population of 610 patients diagnosed between 1990 and 2008 and detailed in the Tumour Registry of the Madrid region. _Material and Methods: A retrospective analysis based on the following variables provided in the Tumour Registry was achieved: age, gender, histology, stage, location, treatment. Descriptive and analytic statistics with these variables, using Pearson's Chi-square test to study the relationship between the qualitative variables. _Results: Patients' mean age was 61.53±13.95 years, with a gender ratio of 2.09:1 (413 males vs 197 females). The lesion was mainly localized in the lateral border of tongue, with other sites (dorsal face, ventral face, lingual tonsil, contiguous sites, tongue NOS) represented at lower rates. Squamous cell carcinomas (94.9%) far outweighted other histologies (salivary gland tumours, soft tissue tumours, haematolymphoid tumours). 59% of the cases appeared in localized stages, versus 35.2% in regional and 4.8% in distant stages. Surgery was the most frequently used treatment, followed by surgery in combination with radiotherapy. _Conclusions: Oral tongue cancer is a disease of the elderly, with a male predominance. It mainly appears in its lateral border, localized squamous cell carcinomas representing the great majority of lingual neoplasms.

PMID: 27694779 [PubMed - as supplied by publisher]

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Lubricin in synovial fluid of mild and severe temporomandibular joint internal derangements.

Lubricin in synovial fluid of mild and severe temporomandibular joint internal derangements.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Leonardi R, Perrotta RE, Almeida LE, Loreto C, Musumeci G

Abstract
BACKGROUND: To understand the molecular basis of temporomandibular joint (TMJ) pathologies, we aimed to investigate the lubricin levels in the TMJ synovial fluid (SF) of patients with mild to severe internal derangements (IDs)._Material and Methods: A total, 34 joints were the study group. Only patients, with a Wilkes stage of III, IV and V were included, in this sample. Control group consisted of SF from eight joints, from patients undergoing to orthognatic surgery. Concentrations of lubricin in the SF from both samples were measured using ELISA system._Results: the mean lubricin concentration was 7.029 ± 0.21 µg/mL in stage III patients; 5.64 ± 0.10 µg/mL in stage IV patients, and 4.78 ± 0.11 µg/mL in stage V patients. The lubricin levels from stage IV and stage V patients differed significantly (P ≤ 0.001) from those of control subjects. Lubricin levels were inversely correlated with age and to VAS score._Conclusions: The results of this cross-sectional study highlight the relationship between disease severity and the levels of lubricin in TMJ SF. Our findings suggest that novel biotherapeutic approaches, including the administration of recombinant lubricin in the joint cavity, for the treatment of TMJ diseases can be developed.

PMID: 27694778 [PubMed - as supplied by publisher]

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Cancer and orofacial pain.

Cancer and orofacial pain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Romero-Reyes M, Salvemini D

Abstract
BACKGROUND: Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia._Material and Methods: We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy. _Results: There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy. _Conclusions: The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.

PMID: 27694791 [PubMed - as supplied by publisher]

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Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Varela-Centelles P, Loira-Gago M, Gonzalez-Mosquera A, Seoane-Romero JM, Garcia-Martin JM, Seoane J

Abstract
BACKGROUND: In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. _Material and Methods: Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen._Results: A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance)._Conclusions: Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures.

PMID: 27694790 [PubMed - as supplied by publisher]

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Surgical complications in zygomatic implants: A systematic review.

Surgical complications in zygomatic implants: A systematic review.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Molinero-Mourelle P, Baca-Gonzalez L, Gao B, Saez-Alcaide L, Helm A, Lopez-Quiles J

Abstract
BACKGROUND: The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants._Material and Methods: An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications._Results: Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted. _Conclusions: The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.

PMID: 27694789 [PubMed - as supplied by publisher]

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Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Guarnieri R, Cavallini C, Vernucci R, Vichi M, Leonardi R, Barbato E

Abstract
BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%._The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors._An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography._Material and Methods: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements._Results: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06_Conclusions: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

PMID: 27694788 [PubMed - as supplied by publisher]

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Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Sáez-Prado B, Haya-Fernández MC, Sanz-García MT

Abstract
BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain._Material and Methods: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population.
SUBJECTS: 202 adults (103 men and 99 women). Age: 65 years of age and over.
SETTING: Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed._Results: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth._Conclusions: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people.

PMID: 27694787 [PubMed - as supplied by publisher]

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Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Li Y, Zhang P, Li R, Liu Y, Kan Q

Abstract
BACKGROUND: This study investigated the quality of life of Chinese patients with tongue cancer who had undergone immediate flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap (RFFF) surgery and others who had received pectoralis major myocutaneous flap (PMMF) surgery._Material and Methods: Patients who received RFFF or PMMF reconstruction after primary tongue cancer treated with total and subtotal tongue resection were eligible for the current study. The patients' demographic data, medical history, and quality of life scores (14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QOL) questionnaires) were collected. _Results: A total of 41 of 63 questionnaires were returned (65.08%). There were significant differences between the 2 groups in the gender (p< .05). Patients reconstructed with RFFF performed better in the shoulder domains, in addition to worse appearance domains_Conclusions: Using either RFFF or PMMF for reconstruction of defects after tongue cancer resection significantly influences a patient's quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for tongue cancers.

PMID: 27694786 [PubMed - as supplied by publisher]

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Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications.

Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Herranz-Aparicio J, Marques J, Almendros-Marqués N, Gay-Escoda C

Abstract
BACKGROUND: In order to choose the appropriate implant size and to prevent complications, an oral surgeon must know the size and shape of the mandible. In the posterior mandibular region, a lingual undercut is often found and could represent a difficulty hard to manage if a lingual or buccal perforation occur. _A large series of computed tomography (CT) images of first molar mandible was evaluated and it the bone morphology and the prevalence and the degree of the lingual concavity in the first molar region was studied. _Material and Methods: One hundred and fifty-one computed tomography (CT) examinations of patients were retrospectively evaluated to determine anatomical variations in bone morphology in the submandibular fossa region. _Results: A total of 151 subjects were included, consisting of 64 males (M) (42.4%) and 87 females (F) (57.6%). The under-cut type ridge was present in 64.2% of the cases. The concavity angle was 66.6 ± 8.9° (M) and 71.6 ± 8.4° (F) and the linear concavity depth 4.5 ± 2.3 mm (M) and 3.1 ± 1.7 mm (F) (p>0.05). _Conclusions: Mandibles with any lingual concavity present a potential increased risk of lingual cortical perforation during implant placement surgery. CT imaging allows characterizing the anatomy of the submandibular fossa and provides other important information for the preoperative assessment of the posterior mandible for dental implants placement.

PMID: 27694785 [PubMed - as supplied by publisher]

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Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample.

Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: de-Pedro-Herráez M, Mesa-Jiménez J, Fernández-de-Las-Peñas C, de-la-Hoz-Aizpurua JL

Abstract
BACKGROUND: Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. _Objetives: The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups._Material and Methods: Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions. _Results: It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain. _Conclusions: These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual's Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual's medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering.

PMID: 27694784 [PubMed - as supplied by publisher]

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Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Costantinides F, Biasotto M, Maglione M, Di Lenarda R

Abstract
BACKGROUND: The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). _Material and Methods: This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Difference in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated._Results: In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group._Conclusions: Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected.

PMID: 27694783 [PubMed - as supplied by publisher]

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Temporomandibular chronic dislocation: The long-standing condition.

Temporomandibular chronic dislocation: The long-standing condition.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Marqués-Mateo M, Puche-Torres M, Iglesias-Gimilio ME

Abstract
BACKGROUND: The temporomandibular joint (TMJ) dislocation can be categorised into three groups: acute, habitual or recurrent and long-standing. The long-standing or protracted lower jaw dislocation refers to a condition that persists for more than one month without reduction. There are a great variety of methods for its treatment, from the manual or non-surgical, to surgical ones like the indirect approach (conservative surgical approach) and direct approach (open joint). Additional procedures in unsuccessful cases may include extra-articular orthognathic techniques to correct a malocclusion until joint replacement. _Material and Methods: We report four new cases with a minimum of 6 weeks dislocation who were seen since 1995 to 2015 in the Maxillofacial Department of the Clínico Hospital (Valencia, Spain), in which the mean age was 57.5 years. Most of them were bilateral and the gender was predominantly female. Additionally, we have reviewed the related literature. _Results: All of the cases were successfully treated and half of them required open surgery. _Conclusions: The report confirms the difficulty of the treatment and reaffirms the necessity to bear in mind the wide variety of methods available for the treatment of this pathology. We stress the difficulties associated with managing the treatment and of suggesting new guidelines. The best option still remains not to delay the diagnostic and to select the appropriate initial treatment.

PMID: 27694782 [PubMed - as supplied by publisher]

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Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Singh P, Ajmera DH, Xiao SS, Yang XZ, Liu X, Peng B

Abstract
BACKGROUND: The purpose of this study was to identify potential concealed variables associated with the difficulty of lower third molar (M3) extractions. _Material and Methods: To address the research purpose, we implemented a prospective study and enrolled a sample of subjects presenting for M3 removal. Predictor variables were categorized into Group-I and Group-II, based on predetermined criteria. The primary outcome variable was the difficulty of extraction, measured as extraction time. Appropriate univariate and multivariate statistics were computed using ordinal logistic regression. _Results: The sample comprised of 1235 subjects with a mean age of 29.49 +/- 8.92 years in Group-I and 26.20 +/- 11.55 years in Group-II subjects. The mean operating time per M3 extraction was 21.24 +/- 12.80 and 20.24 +/- 12.50 minutes for Group-I and Group-II subjects respectively. Three linear parameters including B-M2 height (distance between imaginary point B on the inferior border of mandibular body, and M2), lingual cortical thickness, bone density and one angular parameter including Rc-Cs angle (angle between ramus curvature and curve of spee), in addition to patient's age, profile type, facial type, cant of occlusal plane, and decreased overbite, were found to be statistically associated ( p < or = 0.05) with extraction difficulty under regression models. _Conclusions: In conclusion, our study indicates that the difficulty of lower M3 extractions is possibly governed by morphological and biomechanical factors with substantial influence of myofunctional factors._Practical Implications: Preoperative evaluation of dynamic concealed factors may not only help in envisaging the difficulty and planning of surgical approach but might also help in better time management in clinical practice.

PMID: 27694781 [PubMed - as supplied by publisher]

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Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature.

Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Muñoz-Corcuera M, Ramírez-Martínez-Acitores L, López-Pintor RM, Casañas-Gil E, Hernández-Vallejo G

Abstract
BACKGROUND: Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. _Material and Methods: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library. We excluded articles dealing with all anticoagulants other than dabigatran, and works about surgical treatments in anatomical locations other than the oral cavity. _Results: We included a total of 13 papers of which 1 was a randomized clinical trial, 9 narrative literature reviews, 1 case series, 2 clinical cases and 1 expert opinion. Because we did not obtain any properly designed clinical trials, we were unable to conduct a meta-analysis. _Conclusions: Currently, there is no consensus on the procedure to be followed in patients taking dabigatran. However, all authors agree to treat each case individually in accordance to the risk of embolism, postoperative bleeding and renal function. Also, it is necessary to perform minimally invasive interventions, and take the appropriate local anti-hemolytic measures.

PMID: 27694780 [PubMed - as supplied by publisher]

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Oral tongue cancer in public hospitals in Madrid, Spain (1990-2008).

Oral tongue cancer in public hospitals in Madrid, Spain (1990-2008).

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: García-Kass A, Herrero-Sánchez A, Esparza-Gómez G

Abstract
BACKGROUND: The cancer which appears in the mobile portion of the tongue is the most common neoplasm of the oral cavity. The objective of this study was to analyse oral tongue cancer epidemiology in a population of 610 patients diagnosed between 1990 and 2008 and detailed in the Tumour Registry of the Madrid region. _Material and Methods: A retrospective analysis based on the following variables provided in the Tumour Registry was achieved: age, gender, histology, stage, location, treatment. Descriptive and analytic statistics with these variables, using Pearson's Chi-square test to study the relationship between the qualitative variables. _Results: Patients' mean age was 61.53±13.95 years, with a gender ratio of 2.09:1 (413 males vs 197 females). The lesion was mainly localized in the lateral border of tongue, with other sites (dorsal face, ventral face, lingual tonsil, contiguous sites, tongue NOS) represented at lower rates. Squamous cell carcinomas (94.9%) far outweighted other histologies (salivary gland tumours, soft tissue tumours, haematolymphoid tumours). 59% of the cases appeared in localized stages, versus 35.2% in regional and 4.8% in distant stages. Surgery was the most frequently used treatment, followed by surgery in combination with radiotherapy. _Conclusions: Oral tongue cancer is a disease of the elderly, with a male predominance. It mainly appears in its lateral border, localized squamous cell carcinomas representing the great majority of lingual neoplasms.

PMID: 27694779 [PubMed - as supplied by publisher]

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Lubricin in synovial fluid of mild and severe temporomandibular joint internal derangements.

Lubricin in synovial fluid of mild and severe temporomandibular joint internal derangements.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Leonardi R, Perrotta RE, Almeida LE, Loreto C, Musumeci G

Abstract
BACKGROUND: To understand the molecular basis of temporomandibular joint (TMJ) pathologies, we aimed to investigate the lubricin levels in the TMJ synovial fluid (SF) of patients with mild to severe internal derangements (IDs)._Material and Methods: A total, 34 joints were the study group. Only patients, with a Wilkes stage of III, IV and V were included, in this sample. Control group consisted of SF from eight joints, from patients undergoing to orthognatic surgery. Concentrations of lubricin in the SF from both samples were measured using ELISA system._Results: the mean lubricin concentration was 7.029 ± 0.21 µg/mL in stage III patients; 5.64 ± 0.10 µg/mL in stage IV patients, and 4.78 ± 0.11 µg/mL in stage V patients. The lubricin levels from stage IV and stage V patients differed significantly (P ≤ 0.001) from those of control subjects. Lubricin levels were inversely correlated with age and to VAS score._Conclusions: The results of this cross-sectional study highlight the relationship between disease severity and the levels of lubricin in TMJ SF. Our findings suggest that novel biotherapeutic approaches, including the administration of recombinant lubricin in the joint cavity, for the treatment of TMJ diseases can be developed.

PMID: 27694778 [PubMed - as supplied by publisher]

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Cancer and orofacial pain.

Cancer and orofacial pain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Romero-Reyes M, Salvemini D

Abstract
BACKGROUND: Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia._Material and Methods: We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy. _Results: There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy. _Conclusions: The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.

PMID: 27694791 [PubMed - as supplied by publisher]

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Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Varela-Centelles P, Loira-Gago M, Gonzalez-Mosquera A, Seoane-Romero JM, Garcia-Martin JM, Seoane J

Abstract
BACKGROUND: In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. _Material and Methods: Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen._Results: A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance)._Conclusions: Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures.

PMID: 27694790 [PubMed - as supplied by publisher]

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Surgical complications in zygomatic implants: A systematic review.

Surgical complications in zygomatic implants: A systematic review.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Molinero-Mourelle P, Baca-Gonzalez L, Gao B, Saez-Alcaide L, Helm A, Lopez-Quiles J

Abstract
BACKGROUND: The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants._Material and Methods: An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications._Results: Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted. _Conclusions: The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.

PMID: 27694789 [PubMed - as supplied by publisher]

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Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Guarnieri R, Cavallini C, Vernucci R, Vichi M, Leonardi R, Barbato E

Abstract
BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%._The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors._An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography._Material and Methods: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements._Results: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06_Conclusions: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

PMID: 27694788 [PubMed - as supplied by publisher]

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Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Sáez-Prado B, Haya-Fernández MC, Sanz-García MT

Abstract
BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain._Material and Methods: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population.
SUBJECTS: 202 adults (103 men and 99 women). Age: 65 years of age and over.
SETTING: Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed._Results: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth._Conclusions: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people.

PMID: 27694787 [PubMed - as supplied by publisher]

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Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of lif.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Li Y, Zhang P, Li R, Liu Y, Kan Q

Abstract
BACKGROUND: This study investigated the quality of life of Chinese patients with tongue cancer who had undergone immediate flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap (RFFF) surgery and others who had received pectoralis major myocutaneous flap (PMMF) surgery._Material and Methods: Patients who received RFFF or PMMF reconstruction after primary tongue cancer treated with total and subtotal tongue resection were eligible for the current study. The patients' demographic data, medical history, and quality of life scores (14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QOL) questionnaires) were collected. _Results: A total of 41 of 63 questionnaires were returned (65.08%). There were significant differences between the 2 groups in the gender (p< .05). Patients reconstructed with RFFF performed better in the shoulder domains, in addition to worse appearance domains_Conclusions: Using either RFFF or PMMF for reconstruction of defects after tongue cancer resection significantly influences a patient's quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for tongue cancers.

PMID: 27694786 [PubMed - as supplied by publisher]

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Endoscopic and clinical benefits of hyaluronic acid in children with chronic adenoiditis and middle ear disease.

Endoscopic and clinical benefits of hyaluronic acid in children with chronic adenoiditis and middle ear disease.

Eur Arch Otorhinolaryngol. 2016 Oct 1;:

Authors: Torretta S, Marchisio P, Rinaldi V, Carioli D, Nazzari E, Pignataro L

Abstract
Hyaluronic acid (HA) is involved in modulating inflammatory airway processes and mucociliary clearance. Some studies have tested the effectiveness of the topical administration of HA in patients with upper airway diseases with positive preliminary results. A prospective, single-blind, 1:1 randomised controlled study was performed to assess the efficacy and safety of the daily topical administration of 9 mg of sodium hyaluronate in 3 mL of a 0.9 % sodium saline solution on the basis of endoscopic and clinical parameters in children with chronic adenoiditis associated with recurrent acute otitis media and otitis media with effusion; age- and gender-matched children receiving normal 0.9 % sodium chloride saline solution were used as controls. Analysis was based on 103 (mean age 63.3 ± 18.2 months; 52 males, 50.5 %) children: 54 in the study group and 49 in the control group. A statistically significant reduction in the mean number of all acute otitis media episodes (AOME) (mean reduction 0.8 ± 0.4 per month; p value 0.05) and AOME without tympanic membrane perforation (mean reduction 0.6 ± 0.3 per month; p value 0.04) after recruitment was documented only in the study group. HA significantly improved all the endoscopic outcomes (p values ranging between 0.05 and <0.01) but one. Nasal washing with saline solution was effective on only three of them (p values ranging between 0.03 and <0.01). No untoward effects were documented. Our results confirm the safety and document the positive effect of topically administered HA solution on children with chronic adenoiditis associated with middle ear disease.

PMID: 27695944 [PubMed - as supplied by publisher]

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The development of an ICF-based clinical guideline and screening tool for the standardized assessment and evaluation of functioning after head and neck cancer treatment.

The development of an ICF-based clinical guideline and screening tool for the standardized assessment and evaluation of functioning after head and neck cancer treatment.

Eur Arch Otorhinolaryngol. 2016 Sep 30;:

Authors: Kisser U, Adderson-Kisser C, Coenen M, Stier-Jarmer M, Becker S, Sabariego C, Harréus U

Abstract
The assessment and evaluation of functioning and quality of life after tumor treatment in head and neck cancer (HNC) are considered as essential aspects of clinical routine and studies. A huge number of instruments are available that have been designed to evaluate functioning and quality of life after HNC treatment. The diversity of these instruments in terms of content, response options and administration hinders the comparability of available studies and the performance of meta-analyses. The objective of this paper is to inform about the development of a screening tool for the standardized assessment and evaluation of functioning based on the International Classification of Functioning, Disability and Health (ICF) Core Set for HNC. We followed a multi-step approach including (1) preparatory studies to identify and preselect suitable instruments for the assessment of functioning, (2) a decision-making process to agree on an ICF-based clinical guideline including instruments assessing functioning and (3) the development of a computer-based standardized screening tool to assess and evaluate functioning based on this guideline in clinical routine. Twenty-one experts participated in a consensus meeting and decided on instruments to be included in an ICF-based clinical guideline and screening tool for the assessment and evaluation of functioning in HNC patients in cancer treatment. The chosen instruments cover all aspects of the ICF Core Set for HNC addressing therapy control, pain, food intake/swallowing, voice/speech/breathing, other somatic complaints and psychosocial aspects. The screening tool contains patient-reported outcome measures and a clinician's checklist. It has to be further tested in clinical practice.

PMID: 27695934 [PubMed - as supplied by publisher]

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Evidence-based medicine in plastic surgery.

Evidence-based medicine in plastic surgery.

Eur Arch Otorhinolaryngol. 2016 Sep 30;:

Authors: Barone M, Cogliandro A, Persichetti P

PMID: 27695933 [PubMed - as supplied by publisher]

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Outcomes of cochlear implantation in patients with neurofibromatosis type 2.

Outcomes of cochlear implantation in patients with neurofibromatosis type 2.

Cochlear Implants Int. 2016 Jul;17(4):172-177

Authors: North HJ, Mawman D, O'Driscoll M, Freeman SR, Rutherford SA, King AT, Hammerbeck-Ward C, Evans DG, Lloyd SK

Abstract
In neurofibromatosis type 2 (NF2) bilateral vestibular schwannomas (VS) or their treatment usually results in bilateral hearing loss. Cochlear implantation (CI) was traditionally not used in these patients due to concern that retrocochlear disease would render the implant ineffective. This paper describes the auditory outcomes of CI in 13 patients with NF2 and includes patients with untreated VS and patients undergoing VS removal with cochlear nerve preservation. The non-user rate was 7.7%. Of the active users, median CUNY score was 98%, median BKB score in quiet was 90% and median BKB score in noise was 68%. CI is a viable option in selected patients with NF2.

PMID: 27691934 [PubMed - in process]

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Tyrosine Hydroxylase Expression in Type II Cochlear Afferents in Mice.

Tyrosine Hydroxylase Expression in Type II Cochlear Afferents in Mice.

J Assoc Res Otolaryngol. 2016 Sep 30;:

Authors: Vyas P, Wu JS, Zimmerman A, Fuchs P, Glowatzki E

Abstract
Acoustic information propagates from the ear to the brain via spiral ganglion neurons that innervate hair cells in the cochlea. These afferents include unmyelinated type II fibers that constitute 5 % of the total, the majority being myelinated type I neurons. Lack of specific genetic markers of type II afferents in the cochlea has been a roadblock in studying their functional role. Unexpectedly, type II afferents were visualized by reporter proteins induced by tyrosine hydroxylase (TH)-driven Cre recombinase. The present study was designed to determine whether TH-driven Cre recombinase (TH-2A-CreER) provides a selective and reliable tool for identification and genetic manipulation of type II rather than type I cochlear afferents. The "TH-2A-CreER neurons" radiated from the spiral lamina, crossed the tunnel of Corti, turned towards the base of the cochlea, and traveled beneath the rows of outer hair cells. Neither the processes nor the somata of TH-2A-CreER neurons were labeled by antibodies that specifically labeled type I afferents and medial efferents. TH-2A-CreER-positive processes partially co-labeled with antibodies to peripherin, a known marker of type II afferents. Individual TH-2A-CreER neurons gave off short branches contacting 7-25 outer hair cells (OHCs). Only a fraction of TH-2A-CreER boutons were associated with CtBP2-immunopositive ribbons. These results show that TH-2A-CreER provides a selective marker for type II versus type I afferents and can be used to describe the morphology and arborization pattern of type II cochlear afferents in the mouse cochlea.

PMID: 27696081 [PubMed - as supplied by publisher]

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Quality of life at 6 months in the Idiopathic Intracranial Hypertension Treatment Trial.

Quality of life at 6 months in the Idiopathic Intracranial Hypertension Treatment Trial.

Neurology. 2016 Sep 30;:

Authors: Bruce BB, Digre KB, McDermott MP, Schron EB, Wall M, NORDIC Idiopathic Intracranial Hypertension Study Group

Abstract
OBJECTIVE: To examine the changes in vision-specific and overall health-related quality of life (QOL) at 6 months in participants with idiopathic intracranial hypertension (IIH) and mild visual loss enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) and to determine the signs and symptoms of IIH that mediate the effect of acetazolamide on QOL.
METHODS: We assessed QOL using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), the 10-Item NEI-VFQ-25 Neuro-Ophthalmic Supplement, and the 36-Item Short Form Health Survey (SF-36). We examined associations among changes in QOL measures over 6 months, treatment status, and changes in signs and symptoms using linear and structural equation models.
RESULTS: Among the 165 participants with IIH (86 randomized to acetazolamide, 79 to placebo), beneficial effects of acetazolamide were seen on all QOL scales evaluated, as well as on the Near Activities (5.60 points, p = 0.03), Social Functioning (3.85 points, p = 0.04), and Mental Health (9.82, p = 0.04) subscales of the NEI-VFQ-25. Positive acetazolamide-related effects on QOL appeared to be primarily mediated by improvements in visual field, neck pain, pulsatile tinnitus, and dizziness/vertigo that outweighed the side effects of acetazolamide.
CONCLUSIONS: The marked reductions in baseline QOL seen among patients with mild visual loss from IIH are improved by treatment with acetazolamide. When combined with acetazolamide-associated improvements in visual field and other aspects of IIH, our findings with respect to QOL provide further support from the IIHTT in favor of acetazolamide to augment a dietary intervention in the treatment of IIH with mild visual loss (clinicaltrials.gov: NCT01003639).

PMID: 27694262 [PubMed - as supplied by publisher]

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Copy number profiling of tumor suppressor genes in head and neck cancer.

Copy number profiling of tumor suppressor genes in head and neck cancer.

Head Neck. 2016 Oct 3;:

Authors: Yalniz Z, Demokan S, Karabulut B, Ulusan M, Suoglu Y, Dalay N

Abstract
BACKGROUND: Sensitive and reliable new biomarkers are needed in head and neck cancer to predict the outcome and for therapy that is more effective. Copy number alterations are frequent and play a critical role in cancer.
METHODS: Copy number alterations of 24 tumor suppressor genes in head and neck cancer were analyzed simultaneously in matched tumor and normal samples from 93 patients using multiplex ligation-dependent probe amplification (MLPA).
RESULTS: Chromosomes 3p and 9p displayed the most common alterations. The gene displaying most frequent losses was the mutL homolog 1 (MLH1) gene, followed by the cyclin-dependent kinase inhibitor 2A (CDKN2A) and CDKN2B genes. A significant correlation was observed between the CDKN2A and CDKN2B genes. The tissue inhibitor of metalloproteinase (TIMP)3 gene alterations were observed in 8 tumors.
CONCLUSION: Our data confirm previous observations and suggest that losses of the MLH1 and CDKN2 genes and alterations of the TIMP3 gene play an important role in head and neck carcinogenesis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27696595 [PubMed - as supplied by publisher]

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Inflammation-induced myeloid-derived suppressor cells associated with squamous cell carcinoma of the head and neck.

Inflammation-induced myeloid-derived suppressor cells associated with squamous cell carcinoma of the head and neck.

Head Neck. 2016 Oct 3;:

Authors: Chen WC, Lai CH, Chuang HC, Lin PY, Chen MF

Abstract
BACKGROUND: The purpose of this study was to present our assessment of the significance of myeloid-derived suppressor cells (MDSCs) in head and neck squamous cell carcinoma (HNSCC).
METHODS: We examined the percentage of MDSCs in the peripheral blood of patients with HNSCC. The relationship among MDSC recruitment, tumor progression, and cyclooxygenase (COX)-2 inhibition was also evaluated by animal models.
RESULTS: Circulating MDSCs were significantly increased in patients with HNSCC compared with healthy people, and this was associated with the clinical tumor burden. In immunocompetent 4-nitroquinoline-1-oxide (4-NQO)-induced oral tumor and immunocompromised tumor implantation animal models, MDSC recruitment was associated with the duration of 4-NQO treatment and tumor progression. The responsible mechanisms included the suppressive ability of T-cell proliferation and augmenting angiogenesis by MDSC. Blockade of COX-2 attenuated the induction and function of MDSCs and subsequently inhibited tumor growth.
CONCLUSION: The levels of MDSC are linked with tumor progression in HNSCC. Moreover, targeting COX-2 could be a promising strategy for the treatment of HNSCC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27696591 [PubMed - as supplied by publisher]

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Changing epidemiology of oral squamous cell carcinoma of the tongue: A global study.

Changing epidemiology of oral squamous cell carcinoma of the tongue: A global study.

Head Neck. 2016 Oct 3;:

Authors: Ng JH, Iyer NG, Tan MH, Edgren G

Abstract
BACKGROUND: There are reports about the changing epidemiology of tongue squamous cell carcinoma (SCC), with recent reports indicating an increasing incidence in young women.
METHODS: Data on incident cases of tongue SCC were collected from cancer registries worldwide.
RESULTS: Data from a total of 22 cancer registries and 89,212 incident cases of tongue SCC worldwide were included. Most areas experienced an incidence increase ranging from 0.4% to 3.3% per year. There was a significant difference in the incidence increase between sexes in 11 of the 22 registries. In 14 of the 22 registries studied, the increase in incidence of tongue SCC was higher in the group of subjects <45 years old than those ≥45 years old.
CONCLUSION: This study suggests a general but not universal increase in the incidence of tongue SCC worldwide. In some regions of the world, we observed a shifting trend toward women and/or younger patients. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27696557 [PubMed - as supplied by publisher]

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Speech audiometry, speech perception, and cognitive functions : English version.

Speech audiometry, speech perception, and cognitive functions : English version.

HNO. 2016 Sep 30;:

Authors: Meister H

Abstract
Examination of cognitive functions in the framework of speech perception has recently gained increasing scientific and clinical interest. Especially against the background of age-related hearing impairment and cognitive decline, potential new perspectives in terms of a better individualization of auditory diagnosis and rehabilitation might arise. This review addresses the relationships between speech audiometry, speech perception, and cognitive functions. It presents models of speech perception, discusses associations of neuropsychological and audiometric outcomes, and shows examples of recent efforts undertaken in Germany to consider cognitive functions with speech audiometry.

PMID: 27695891 [PubMed - as supplied by publisher]

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