International Journal of Oral and Maxillofacial Surgery




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سفارش

Editorial Board/Reviewing Committee

doi : 10.1016/S0901-5027(22)00051-0

Volume 51, Issue 4, April 2022, Page i

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The accuracy of magnetic resonance imaging to measure the depth of invasion in oral tongue cancer: a systematic review and meta-analysis

M.Li1Z.Yuan2Z.Tang1

doi : 10.1016/j.ijom.2021.07.010

Volume 51, Issue 4, April 2022, Pages 431-440

The accuracy of magnetic resonance imaging (MRI)-derived depth of invasion (DOI) compared to histopathological DOI is still controversial. A meta-analysis was performed to address this controversy and further investigate the best imaging sequence to measure DOI of tongue squamous cell carcinomas (SCC). A comprehensive literature search of five electronic databases was conducted. Stata/SE was used to establish a continuous variable model to assess the consistency between MRI-derived DOI and histopathological DOI. IBM SPSS Statistics 22.0 was used to evaluate the correlation between MRI-derived DOI and histopathological DOI. The meta-analysis showed that the weighted mean difference (WMD) of DOI measured by MRI had an acceptable overestimation compared with that measured by histopathology (WMD 1.64 mm; P < 0.001). In the subgroup analyses, there was no difference between T1-weighted imaging (T1WI) and histopathological values (WMD 0.77 mm; P = 0.273), while T2-weighted imaging (T2WI) had a major overestimation (WMD 2.09 mm; P < 0.001). The overall inter-class correlation coefficient (ICC) between MRI-derived DOI and histopathological DOI was 0.869 (95% CI 0.837–0.895), and was 0.923 (95% CI 0.894–0.944) in the T1WI subgroup and 0.790 (95% CI 0.718–0.845) in the T2WI subgroup. MRI is an accurate modality for evaluating the DOI in oral tongue SCC, and T1WI showed relatively higher validity than T2WI for DOI measurements.

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The impact of lymph node density as a predictive factor for survival and recurrence of tongue squamous cell carcinoma

S.Nseir1N.Zeineh2T.Capucha1Y.Israel1O.Emodi12I.Abu El-Naaj34A.Rachmiel12

doi : 10.1016/j.ijom.2021.06.009

Volume 51, Issue 4, April 2022, Pages 441-449

The oral tongue is considered the most frequently involved site in cases of oral squamous cell carcinoma (OSCC). Lymph node (LN) density, defined as the number of positive LNs divided by the total number of resected LNs, is considered an important prognostic factor in OSCC; however the cut-off point remains uncertain. A retrospective study was performed involving 104 patients who underwent a glossectomy procedure for oral tongue squamous cell carcinoma (OTSCC) between the years 2008 and 2018. LN density and other related prognostic factors, including pathological N-stage (pN), extranodal extension (ENE), perineural invasion (PNI), and depth of invasion (DOI), were investigated in relation to survival and recurrence rates. pN + stage, the presence of ENE, the presence of PNI, and increased DOI were found to be associated with increased LN density values, as well as lower patient survival and higher recurrence rates. The statistical analysis identified a cut-off point for LN density of 2.5%. In advanced stage disease, LN density values above 2.5% had a significant impact on the survival rate (P = 0.005), as well as the recurrence rate (P = 0.038). In conclusion, in addition to other previously known prognostic factors, LN density may serve as a strong prognostic factor for survival and recurrence in patients with advanced- and early-stage OTSCC.

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Tumor–stroma ratio is a crucial histological predictor of occult cervical lymph node metastasis and survival in early-stage (cT1/2N0) oral squamous cell carcinoma

S.Huang12H.Cai12F.Song12Y.Zhu12C.Hou12J.Hou12

doi : 10.1016/j.ijom.2021.06.011

Volume 51, Issue 4, April 2022, Pages 450-458

Occult cervical lymph node metastasis is a significant prognostic factor in patients with early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC). The aim of this study was to investigate the potential value of the tumor–stroma ratio (TSR) as a histological predictor of occult cervical metastasis and survival in early-stage OSCC. This retrospective study included 151 patients who underwent excision of the primary lesion and elective neck dissection from 2013 to 2017. The clinicopathological features of the tumor, risk factors associated with occult neck metastasis, and prognostic factors for overall survival (OS) and disease-free survival (DFS) were studied. A significant correlation of TSR (P = 0.009) was found with occult neck metastasis in the multivariate logistic regression model. Multivariate Cox proportional hazards regression analysis showed that the TSR (P = 0.002) and perineural invasion (P = 0.011) were associated with OS. Occult neck metastasis (P = 0.032) was associated with DFS. These findings indicate that assessment of the TSR might be useful in prognostication for early-stage OSCC patients. Moreover, the TSR is effective in allowing an accurate evaluation of the risk of occult neck metastasis, and this may be easily applicable in the routine pathological diagnosis and clinical decision-making for elective neck dissection.

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Transoral retroauricular neck dissection (TREND): A novel combination approach

A.KudpajeB.BhanuPrakashS.ThakurG.ArakeriV.U.S.Rao

doi : 10.1016/j.ijom.2021.07.009

Volume 51, Issue 4, April 2022, Pages 459-462

Early-stage oral squamous cell carcinoma is treated preferably by wide local tumour excision along with elective neck dissection. The conventional neck dissection leaves an unaesthetic scar, which remains a major challenge that adversely impacts patient satisfaction, their social interactions, and quality of life (QoL). In recent times, retroauricular assisted endoscopic and robotic neck dissection techniques that avoid unaesthetic neck scars have gained popularity. The pitfalls in attaining universal acceptance of these techniques are the need for specialized instrumentation, training, and increased costs. The need for an endoscope or robotic camera when using the retroauricular approach arises mainly while addressing the level I lymph nodes, due to poor access. A combination of transoral and retroauricular approaches that overcomes these factors is presented here, named the transoral retroauricular neck dissection (TREND). The technique successfully avoids a visible neck scar while providing adequate exposure of level I lymph nodes without the need for specialized instrumentation. This approach has been applied, with adequate lymph node clearance achieved in all patients. This novel combination approach of neck dissection is oncologically safe, easy to replicate, and improves patient aesthetics, functional outcomes, and QoL. We recommend that clinicians practice this simple technique and enhance the practice of remote access neck dissection.

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Primary oncocytic carcinoma of ectopic salivary gland: a unique case

E.Touli1A.Manganaris1C.Nikolaidou2I.Karasmanis1

doi : 10.1016/j.ijom.2021.08.010

Volume 51, Issue 4, April 2022, Pages 463-466

Oncocytic carcinoma of the salivary glands is an extremely rare malignant neoplasm. The parotid is the most frequently involved salivary gland, but tumours in the submandibular gland and minor salivary glands have also been described. It appears that oncocytic carcinoma of an ectopic salivary gland has not been reported so far. The unique case of a 78-year-old male patient diagnosed with oncocytic adenocarcinoma of an ectopic salivary gland is reported here. The patient underwent surgery and adjuvant radiotherapy. The clinical, morphological, and immunohistochemical features of this rare entity are also described.

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Rare anatomical variant of the spinal accessory nerve: case report and comprehensive review

S.MillsC.AristotelousL.L.TouilR.C.W.James

doi : 10.1016/j.ijom.2021.08.003

Volume 51, Issue 4, April 2022, Pages 467-472

Historical studies of the anatomy of the spinal accessory nerve (SAN) have reported conflicting results regarding its relationship with the internal jugular vein (IJV). A literature review was undertaken to establish the prevalence of anatomical variations of the SAN encountered during routine neck dissection surgery, in order to increase awareness and reduce morbidity associated with iatrogenic SAN injury. The published literature was analysed by qualitative synthesis and nine articles were yielded following application of the inclusion and exclusion criteria. Incidences of the SAN lateral to the IJV and medial to the IJV ranged from 39.8% to 96.6%, and 2.6% to 57.4%, respectively. Five of the studies reported incidences of the SAN traversing the IJV, which occurred in 0.9% to 2.8% of cases. One study reported an isolated variant of the SAN dividing around the IJV, with a prevalence of 0.5%. We present a case report demonstrating the rare variant of the SAN traversing the IJV. Preoperative identification of rare anatomical association of the SAN and IJV may reduce perioperative injury to vital structures during neck dissection.

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Risk factors for oral epithelial dysplasias to become malignant: clinical implications

S.Gómez-Armayones12E.Chimenos-Küstner3C.Arranz4S.Tous567S.Marquez56R.M.Penín8B.Quirós567M.Taberna910L.Alemany567O.Servitje1M.Mena567

doi : 10.1016/j.ijom.2021.08.012

Volume 51, Issue 4, April 2022, Pages 473-480

There is a lack of effective clinical management of oral epithelial dysplasias to reduce their risk of malignant transformation and considerable gaps in knowledge regarding the most effective means of treating such lesions. A retrospective cohort of biopsy-confirmed oral epithelial dysplasias consecutively diagnosed in the period 1995–2014 and followed-up until 2017 was identified from pathology department files. Demographic, clinical and follow-up information was collected. Multivariate Cox proportional-hazards models were performed to evaluate sociodemographic, clinical and pathological factors associated with progression to oral squamous cell carcinoma. The study included 144 oral epithelial dysplasias, of which 42% progressed to oral cancer at the end of follow-up (21 years). Clinical aspect of the lesion was described for 77 (53.5%) of the patients. Treatment, age, grade of the lesion and diagnostic period were independent prognostic factors for progression. When considering only patients with described clinical aspect, only treatment and grade of the lesion were independently associated with cancer. The results from this non-selected retrospective cohort of oral epithelial dysplasias underscore the existing limitations of the current standard-of-care of the patients and provide novel insights on the management of these lesions with and without described clinical aspect. Well-designed, robust prospective studies, a homogenized staging system and multidisciplinary treatment guidelines are warranted.

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The external jugular vein axis: a new anatomical landmark for pre-operative prediction of the location of parotid gland tumours

A.Prevost1Z.Cavallier1S.Alshehri2F.Delanoe1F.Lauwers1R.Lopez3

doi : 10.1016/j.ijom.2021.08.016

Volume 51, Issue 4, April 2022, Pages 481-486

The relationships between parotid tumours and the facial nerve determine duration of surgical procedure and risks involved. As the division of the facial nerve is not visible using standard imaging techniques, other anatomical landmarks are used to determine the pre-operative location of tumours. This retrospective study aimed to evaluate reliability of the ‘external jugular vein axis’ compared with other landmarks generally used in imaging, such as the retromandibular vein, Conn’s arc, the facial nerve line and the Utrecht line. Forty-eight pre-operative imaging exams of patients who underwent parotid benign tumour surgery between 2010 and 2016 were examined. We determined the location of tumour using the five markers. A pre-operative simulation was compared with the description given by the surgeon intraoperatively, in terms of sensitivity and specificity for each marker. External jugular vein axis and retromandibular vein are the most sensitive markers for locating suprafacial tumours (Se = 1). External jugular vein axis and Conn’s arc are the most specific markers for locating suprafacial tumours (Spe = 0.92). External jugular vein axis is reproducible and present on all radiological sections, thereby overcoming any anatomical and nomenclature variations. This landmark appears to be the most representative marker of the dividing branches of the facial nerve.

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Are we able to predict airway dimensional changes in isolated mandibular setback?

M.D.Han1F.Antonini2A.M.Borba3M.Miloro1

doi : 10.1016/j.ijom.2021.07.015

Volume 51, Issue 4, April 2022, Pages 487-492

The goal of this study was to determine whether a relationship exists between the amount of mandibular setback and the amount of airway dimensional changes. Records and cone beam computed tomography (CBCT) of patients who had undergone isolated bilateral sagittal split osteotomy setback between January 1, 2013 and March 16, 2020 at a single institution were reviewed retrospectively. The primary outcome variable was upper airway volume dimension change, and the predictor variable was the magnitude of mandibular setback as measured by six different methods. Thirty-one patients were included in the study, with a mean mandibular setback ranging from 1.41 mm to 6.11 mm. None of the predictor variables showed an association with oropharyngeal (P = 0.54) or hypopharyngeal (P = 0.33) volume. Stepwise regression analysis failed to show any significant relationships. Similarly, there was no statistically significant association between any of the predictor variables and oropharyngeal (P = 0.44) or hypopharyngeal (P = 0.74) minimum axial area. The results showed that no correlation exists between the magnitude of mandibular setback and the amount of static airway dimensional changes; therefore, it may not be possible to predict whether obstructive sleep apnea will develop following mild to moderate mandibular setback based upon CBCT measurements.

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Determination of blood loss in bimaxillary surgery: does the formula and the time point affect results?

M.Schwaiger1S.-J.Edmondson2M.Merkl1T.Gary3W.Zemann1J.Wallner1

doi : 10.1016/j.ijom.2021.08.006

Volume 51, Issue 4, April 2022, Pages 493-500

The amount of blood loss determined in orthognathic surgery differs greatly among studies. This can be attributed to the inhomogeneity in study cohorts analysed, but may also be a result of the varying methodologies used for blood loss determination. However, this has yet to be explored. Thus, the aim of this study was to investigate the extent to which the formula and time point used to measure blood loss affect the blood loss volume, determined in a homogeneous cohort undergoing bimaxillary surgery. Blood loss was calculated at 24 and 48 hours postoperatively using the haemoglobin balance method and the formula of Hurle et al. The estimated total blood volume was established based on the formulae of Nadler et al. and Choi et al. Differences in blood loss volume with respect to time point and formula were analysed and compared. Fifty-four patients were included in the final analysis. Statistically significant differences in blood loss were observed: a significant increase in the blood loss volume from 24 hours to 48 hours postoperatively was detected. When comparing the formulae used, blood loss differed significantly at 24 hours after surgery; however no such difference resulted at 48 hours postoperatively. These findings imply that the time point of measuring blood loss is highly relevant, whereas the formulae applied seem to have less of an impact on the blood loss volumes calculated.

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Three-dimensional evaluation of long-term skeletal relapse following Le Fort I maxillary advancement surgery: a 2-year follow-up study

S.Shujaat1E.Shaheen1C.Politis1R.Jacobs12

doi : 10.1016/j.ijom.2021.07.006

Volume 51, Issue 4, April 2022, Pages 501-508

The aim of this study was to assess relapse following Le Fort I (LFI) maxillary advancement with superior or inferior repositioning at 2 years of follow-up. A total of 50 patients (26 female, 24 male; age range 15–56 years) with skeletal class II or III, who underwent bimaxillary surgery with LFI maxillary advancement in combination with either superior or inferior repositioning and also mandibular advancement/setback, were recruited. Preoperative (T0), immediate postoperative (T1), and 2-year postoperative (T2) cone beam computed tomography scans were acquired. Data were imported into a validated module to assess the skeletal movement (T0–T1) and relapse (T1–T2). Overall, the majority of the translational and rotational movements showed a relapse of <1 mm and <1°. Patients undergoing maxillary advancement with inferior repositioning in combination with mandibular advancement showed the highest amount of translational relapse in a superior (0.86 ± 0.85 mm, P < 0.0001) and posterior direction (−0.65 ± 1.11 mm, P < 0.0001). In relation to patients who received a bone graft, inferior repositioning with mandibular setback showed the highest maxillary relapse in a superior direction (1.20 ± 1.56 mm, P = 0.0719) with counterclockwise pitch rotation (2.15 ± 0.64°, P = 0.3759). Amongst the non-grafted procedures, superior repositioning with mandibular setback exhibited the highest relapse in a medial direction (1.38 ± 2.78 mm, P = 0.3981). Maxillary advancement was found to be a highly stable procedure with a lack of superoinferior stability in patients undergoing inferior repositioning.

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Three-dimensional condylar displacement and remodelling in patients with asymmetrical mandibular prognathism following bilateral sagittal split osteotomy

B.M.Abotaleb123R.Bi12Y.Liu12N.Jiang12W.Telha12S.Zhu12

doi : 10.1016/j.ijom.2021.08.008

Volume 51, Issue 4, April 2022, Pages 509-517

This study aims to assess the postoperative condylar displacement and the long-term condylar remodelling in patients with mandibular prognathism with transverse asymmetry after bilateral sagittal split ramus osteotomy (BSSRO). Forty-one consecutive patients (82 condyles) with a transverse mandibular asymmetry of more than 4 mm without occlusal canting treated by BSSRO were included. The preoperative (T1), immediate postoperative (T2) and long-term follow-up of an average of 16.2 months (T3) spiral computed tomography scans were gathered and processed to measure the condylar displacement and remodelling based on cranial base voxel-based and rigid regional registrations. The statistical analysis revealed that the majority of condyles (T1–T2) were transitionally displaced forwards, downwards and laterally, and were not fully returned to the preoperative position at T3. Condylar lateral displacement was significantly higher on the deviated side (DS) (P = 0.035). Non-deviated side (NDS) condyles were mainly subjected to upward pitch, medial yaw and medial roll compared with downward pitch, lateral yaw and lateral roll on DS. Condylar remodelling at T3 was observed, with the superior and posterior surfaces commonly subjected to bone resorption, whereas the anterior and medial surfaces were commonly subjected to bone apposition. Condylar volumetric changes were relatively comparable on NDS (3 ± 85.2 mm3) and DS (8.3 ± 111.7 mm3) condyles. Age, amount of preoperative asymmetry and follow-up period were not correlated with the condylar remodelling. Transitional and rotational displacements were to some extent significantly correlated with the condylar remodelling on both sides. Consequently, passive condylar seating without torque might prevent the long-term unfavourable condylar remodelling.

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The effect of subspinal Le Fort 1 corticotomy on nasal morphology in surgically assisted rapid palatal expansion

D.Michaux1E.Van de Casteele234D.Dielen1G.Van Hemelen1234N.Nadjmi1234

doi : 10.1016/j.ijom.2021.08.007

Volume 51, Issue 4, April 2022, Pages 518-525

The purpose of this retrospective study was to evaluate the influence of subspinal Le Fort 1 corticotomy (SLF1C) on nasal morphology in patients treated with surgically assisted rapid palatal expansion (SARPE) using three-dimensional (3D) stereophotogrammetry images. A total of 64 patients were enrolled in the study and divided into two groups according to the surgical approach that was used: in group 1 (n = 32) SARPE was performed using a conventional Le Fort 1 corticotomy (CLF1C), and in group 2 (n = 32) SARPE was performed using a subspinal Le Fort 1 corticotomy (SLF1C). Measurements of alar and columellar width, and nasolabial angle were taken on 3D stereophotogrammetry images before and after SARPE using Vectra 3D camera system. Both surgical groups showed a statistically significant increase in alar and columellar width, and nasolabial angle postoperatively (p<0.05). SLF1C resulted in significantly smaller changes of the columellar base postoperatively (p=0.0456). The data suggests that SARPE with an osteotomy of the anterior nasal spine as an additional step to the conventional Le Fort 1 corticotomy results in a smaller increase of the columellar base.

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Is there any biomaterial substitute for peri-implant soft tissue phenotype modification? A network meta-analysis of the appraisal literature

V.Moraschini1I.C.C.Kischinhevsky2S.C.Sartoretto1J.A.Shibli3A.T.Dias1R.Sacco4J.Yates5M.D.Calasans-Maia6

doi : 10.1016/j.ijom.2021.07.005

Volume 51, Issue 4, April 2022, Pages 526-534

Evidence shows that an increased width and thickness of the keratinized mucosa favours peri-implant health. The aim of this network meta-analysis was to compare the clinical effects of alternative biomaterials for peri-implant soft tissue phenotype modification (PSPM) in patients with dental implants when compared to autologous tissue grafts. An electronic search without language or date limitations was performed in four databases and the grey literature for articles published until November 2020. The eligibility criteria included randomized clinical trials (RCTs) evaluating the clinical outcomes of biomaterials for PSPM. A pairwise and network meta-analysis was conducted for each parameter to assess and compare the outcomes between the different treatment arms for the primary and secondary outcomes. A total of 11 RCTs were included in this review. The free gingival graft (FGG) showed the best clinical effect for increasing keratinized mucosa width (KMW). When compared in a network, the FGG demonstrated the best treatment ranking of probability results, followed by connective tissue graft (CTG), acellular dermal matrix (ADM), and xenogeneic collagen matrix (XCM). For the parameters ‘mucosa thickness’ and ‘participant satisfaction with aesthetics’, the results were CTG > ADM > XCM and XCM > ADM > CTG, respectively. Autogenous tissue grafts (FGG/CTG) demonstrate the best results in increasing KMW and mucosa thickness when compared to the other biomaterials.

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The effect of acemannan in implant placement with simultaneous guided bone regeneration in the aesthetic zone: a randomized controlled trial

N.Deesricharoenkiat1P.Jansisyanont1V.Chuenchompoonut2N.Mattheos13P.Thunyakitpisal4

doi : 10.1016/j.ijom.2021.07.017

Volume 51, Issue 4, April 2022, Pages 535-544

Acemannan, a linear polysaccharide produced by Aloe vera, has been shown to have important biological effects promoting wound healing and tissue regeneration. The aim of this randomized clinical trial was to investigate the impact of acemannan in guided bone regeneration (GBR) with simultaneous implant placement. Twenty patients were randomly allocated to a test group (deproteinized bovine bone with particulate acemannan (mean size 32.45 μm)) and a control group (deproteinized bovine bone only). Twenty implants were placed with simultaneous GBR. Radiographic measurements were conducted on cone beam computed tomography (CBCT) scans immediately post-surgery and at 3 and 6 months. Vertical and horizontal dimensions of the buccal bone were measured at the implant platform (0) and at points 2, 4, 6, and 8 mm apically. The dimensional reduction of vertical and horizontal buccal bone was significantly smaller in the test group at 3 months postoperative (P < 0.05) at every position measured (0, 2, 4, 6, 8 mm), but the difference was not statistically significant at 6 months. Acemannan was found to be a safe and predictable biomaterial for GBR, which resulted in enhanced dimensional stability of the regenerated tissue at 3 months. However, these results were not replicated at 6 months. Further studies are required to document the long-term efficacy and potential of acemannan use as a supplement in bone regeneration.

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Retrospective analysis of time-related three-dimensional iliac bone graft resorption following sinus lift and vertical augmentation in the maxilla

D.StellerM.FalougyP.MirzaeiS.G.Hakim

doi : 10.1016/j.ijom.2021.07.004

Volume 51, Issue 4, April 2022, Pages 545-551

The atrophic maxilla frequently requires bone grafting using an onlay graft (OG) or sinus lifting (SL) before implant rehabilitation. The resorption of bone grafts is influenced by the time until implantation, quality of donor bone, and grafting technique. The aim of this study was to investigate the impact of both grafting techniques on the time-related resorption of autologous iliac bone graft. Forty-three patients underwent either onlay grafting or a sinus lift at 73 sites in the maxilla. Graft height was measured by cone beam computed tomography after augmentation and during follow-up for up to 12 months prior to implant insertion. The effect of time and technique on graft resorption was evaluated retrospectively. The reduction in bone graft height was greater for OG than SL over the investigated time intervals (OG = 51%, SL = 28%; P = 0.002). Each technique followed a specific course of resorption, which was independent of the initial graft height and could be calculated by a non-linear regression model. Iliac bone graft undergoes rapid resorption when used as an OG prior to implant insertion. For SL, this resorption is reasonably lower. This is especially crucial to determine the optimal time for implant insertion after graft healing to improve implant survival.

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Accuracy of intentionally tilted implant placement in the maxilla using dynamic navigation: a retrospective clinical analysis

T.MengX.Zhang

doi : 10.1016/j.ijom.2021.09.004

Volume 51, Issue 4, April 2022, Pages 552-557

The aim of this retrospective study was to investigate the accuracy of dynamic navigation for the placement of intentionally tilted implants in the posterior maxilla. The study included 12 patients with edentulism or continuous multiple tooth loss, who had 48 implants inserted under dynamic navigation guidance in the posterior maxilla. Twenty-four implants near maxillary sinuses were intentionally tilted. The average platform deviation was 1.3 ± 0.4 mm (range 0.8–2.3 mm), apex deviation was 1.1 ± 0.5 mm (range 0.2–2.3 mm), and axis deviation was 3.1 ± 1.0° (range 1.8–6.7°). The other 24 implants were axially positioned. The average platform deviation was 1.5 ± 0.5 mm (range 0.7–3.1 mm), apex deviation was 1.3 ± 0.7 mm (range 0.5–3.1 mm), and axis deviation was 3.2 ± 1.5° (range 1.5–7.7°). There was no significant difference in platform deviation, apex deviation, or axis deviation between the tilted implants and implants in the axial position (P > 0.05). This analysis indicates that a dynamic navigation system can be used as a method of guidance to place intentionally tilted implants as accurately as axially positioned implants in the posterior maxilla, thereby preventing damage to the maxillary sinuses and the need to graft bone.

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Local application of the osteogenic inducer sustained-release system promotes early bone remodeling around titanium implants

J.Chen124D.Lv14Q.Pan34Y.Chen34X.Liu14Y.He124

doi : 10.1016/j.ijom.2021.08.013

Volume 51, Issue 4, April 2022, Pages 558-565

Enhanced osseointegration and a shortened healing time are required for dental implant treatment. The aim of this study was to evaluate whether topical application of the osteogenic inducer (OI) sustained-release system over the implant promotes early bone remodeling around the implant. The mandibular canines of 15 New Zealand White rabbits were extracted. After 3 months of healing, implants coated with poly(lactic-co-glycolic acid) (PLGA)+OI, PLGA alone, or no material (control) were inserted into the canine sites. After 4 weeks, specimens were harvested from the three groups and evaluated. Implant stability recorded by Periotest revealed significantly higher values for the PLGA + OI group (−2.61 ± 0.43) than for the PLGA (−1.47 ± 0.45) and control groups (−1.08 ± 0.19) (P < 0.001). Moreover, the PLGA+OI group had improved bone volume and structural parameters around the implants at 4 weeks, as shown by significantly increased BV/TV, BSA/BV, Tb.Th, and BIC (P < 0.05), as well as decreased Tb.Sp (P = 0.010) compared with the other groups. The histological results showed more trabecular bone and bone matrix around the implants in the PLGA+OI group. Therefore, local application of the OI sustained-release system might be able to promote early bone remodeling around titanium implants and facilitate faster and better osseointegration.

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Osteoinductive potential of recombinant BMP-9 in bone defects of mice treated with antiresorptive agents

M.Fujioka-Kobayashi12S.D.Marjanowski1M.Kono13S.Hino14N.Saulacic1B.Schaller1

doi : 10.1016/j.ijom.2021.08.014

Volume 51, Issue 4, April 2022, Pages 566-575

The aim of the present study was to investigate the effects of recombinant human (rh)BMP-9 on bone regenerative potential in a mouse model of antibody-mediated antiresorptive therapy (AMART). A monoclonal anti-murine receptor activator of nuclear factor-kappa B ligand (RANKL) antibody (mAb) was used to create an AMART model in mice. rhBMP-9 combined with collagen membrane was implanted in calvarial defects in mAb-treated mice. After 4 weeks, the bone formative potential in the defects was evaluated by micro-computed tomography and histological approaches. The groups implanted with rhBMP-9-containing collagen membranes demonstrated substantial osteopromotive potential, with significantly greater new bone volume (Sham + BMP-9 group; 0.86 ± 0.29 mm3 and mAb + BMP-9 group; 0.64 ± 0.16 mm3) than control PBS-membranes (Sham + PBS group; 0.44 ± 0.29 mm3 and mAb + PBS group; 0.24 ± 0.12 mm3) in both sham and mAb-treated mice. In line with in vivo study, bone marrow cells isolated from both sham and mAb-treated mice confirmed greater osteogenic potential upon stimulation with rhBMP-9 in vitro. These findings suggest for the first time that local rhBMP-9 administration might be a strategy to accelerate bone regeneration in the context of AMART.

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Extracapsular dissection versus conventional parotidectomy: comparing ‘apples with oranges’?

K.MantsopoulosH.Iro

doi : 10.1016/j.ijom.2021.08.005

Volume 51, Issue 4, April 2022, Pages 576-577

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Response: Superficial parotidectomy versus extracapsular dissection

H.MartinT.Lowe

doi : 10.1016/j.ijom.2021.08.004

Volume 51, Issue 4, April 2022, Page 577

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Cone beam computed tomography, an overlooked modality in validated image ordering guidelines for odontogenic infections

M.TofangchihaK.Ramezani

doi : 10.1016/j.ijom.2021.08.009

Volume 51, Issue 4, April 2022, Pages 577-578

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