2017 Jul-Sep; Vol 8, No 3
Oral Cancer around Dental Implants Appearing in Patients with\without a History of Oral or Systemic Malignancy: a Systematic Review
J Oral Maxillofac Res 2017;8(3):e1
Objectives: The purpose of this article is to systematically review the circumstance of oral cancer around osseointegrated dental implants.
Material and Methods: An electronic literature search was conducted through the MEDLINE (PubMed) and EMBASE databases. The search was restricted for articles published during the last 21 years from January 1996 to April 2017 and articles were limited to English language.
Results: A total of 35 articles were reviewed, and 19 of the most relevant articles that are suitable to the criteria were selected. Case reports were analysed when oral cancer was present in patients with dental implants. Finally, the present data included 28 patients.
Conclusions: A direct link between dental implants and oral cancer was not found. It was observed that there were no significant differences in number of incidences of oral cancer between patients with history of malignancy and those without. More research should be made to document such cases. It was noticed that in many cases oral cancer around dental implant present itself as peri-implantitis, correct differential diagnosis is essential in such cases.
Keywords: cancer; dental implants; inflammation; oral cancer; peri-implantitis; squamous cell carcinoma.
Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review
J Oral Maxillofac Res 2017;8(3):e2
Objectives: The authors performed a systematic review to evaluate the potential beneficial effects of the nasoalveolar molding appliance on nonsyndromic unilateral clefts of the lip and/or palate prior to primary lip repair.
Material and Methods: A literature search was performed using three electronic databases (PubMed, Embase, Web of Science) and three journals (“Cleft Palate-Craniofacial journal”, “Plastic and Reconstructive Surgery Journal” and “American Journal of Orthodontics and Dentofacial Orthopaedic”) from January 1980 to April 2017. Data extraction was performed with tables treating different subjects: surgical, aesthetical, functional, socio-economical effects of nasoalveolar molding (NAM) appliances and the evolution of NAM appliances, especially three-dimensional technology.
Results: Of the 145 articles retrieved in the literature surveys, 28 were qualified for the final analysis and 20 studies were excluded because of their small sample size (less than 10 patients) and/or too long follow-up (exceeded 18 months). Four randomized controlled trials were available. Although literature allowed discussing the short-term benefits of NAM appliance and the three-dimensional technology, scientific evidence is lacking.
Conclusions: Based on the results, nasoalveolar molding appliances have positive surgical, aesthetical, functional and socio-economical effects on unilateral clefts of the lip and/or palate treatment before the primary repair surgeries. Three-dimensional technology results in a more efficient and predictable nasoalveolar molding appliance treatment. However, nasoalveolar molding appliance effect in a short term remains unclear with the available literature. Further studies that integrate three-dimensional technology in a large scale are still needed.
Keywords: cleft lip; cleft palate; orthodontic appliances; newborn infant.
Maxillary Sinus Floor Augmentation: a Review of Selected Treatment Modalities
J Oral Maxillofac Res 2017;8(3):e3
Objectives: The objective of the present study is to present the current best evidence for enhancement of the vertical alveolar bone height and oral rehabilitation of the atrophic posterior maxilla with dental implants and propose some evidence-based treatment guidelines.
Material and Methods: A comprehensive review of the English literature including MEDLINE (PubMed), Embase and Cochrane Library search was conducted assessing the final implant treatment outcome after oral rehabilitation of the atrophic posterior maxilla with dental implants. No year of publication restriction was applied. The clinical, radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without the use of a graft material.
Results: High implant survival rate and new bone formation was reported with the three treatment modalities. Perforation of the Schneiderian membrane was the most common complication, but the final implant treatment outcome was not influenced by a Schneiderian membrane perforation.
Conclusions: The different surgical techniques for enhancement of the vertical alveolar bone height in the posterior part of the maxilla revealed high implant survival with a low incidence of complications. However, the indication for the various surgical techniques is not strictly equivalent and the treatment choice should be based on a careful evaluation of the individual case. Moreover, further high evidence-based and well reported long-term studies are needed before one treatment modality might be considered superior to another.
Keywords: alveolar ridge augmentation; dental implants; oral surgical procedures; review; sinus floor augmentation.
Pharyngeal Airway Dimensions and Head Posture in Obstructive Sleep Apnea Patients with and without Morphological Deviations in the Upper Cervical Spine
J Oral Maxillofac Res 2017;8(3):e4
Objectives: The aim of the study was to analyse differences in pharyngeal airway dimensions and head posture between obstructive sleep apnea patients with and without morphological deviations in the upper cervical spine and to analyse associations between pharyngeal airway dimensions and head posture in the total sample.
Material and Methods: The sample comprised 53 obstructive sleep apnea (OSA) patients of which 32.1% had upper spine morphological deviations. Accordingly two groups were defined: 17 OSA patients with morphological deviations in the upper spine and 36 without upper spine deviations. Pharyngeal airway dimensions in terms of distances, cross-sectional areas and volume and upper spine morphological deviations were evaluated on cone-beam computed tomography. Head posture was evaluated on two-dimensional generated lateral cephalograms. Differences were analysed and adjusted for age and gender by multiple linear regression analysis.
Results: OSA patients with upper spine morphological deviations had a significantly more backward and curved neck posture (OPT/HOR, P < 0.01; OPT/CVT, P < 0.05) compared to OSA patients without spine deviations. No significant differences were found in airway dimensions between patients with and without upper spine deviations. In the total group significant associations were found between head posture and pharyngeal airway distances and cross-sectional area at the nasal floor, epiglottis and hyoid bone level (P < 0.05, P < 0.01, P < 0.001). No significant association was found between head posture and airway volume.
Conclusions: The results may contribute to differentiate obstructive sleep apnea patients and thereby may prove valuable in diagnosis and treatment planning of obstructive sleep apnea patients.
Keywords: nasopharynx; obstructive sleep apnea; oropharynx; standing position; vertebral column.
Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study
J Oral Maxillofac Res 2017;8(3):e5
Objectives: The aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing.
Material and Methods: Thirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement.
Results: The vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm) and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm) were found significantly lower (P < 0.001), when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm).
In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material.
Conclusions: At the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.
Keywords: alveolar bone loss; alveolar ridge augmentation; bone resorption; bone substitutes; dental implants; tooth socket.