Microbial community alteration in tongue squamous cell carcinoma.

Tongue squamous cell carcinoma (TSCC) is the most common oral cavity malignancy. The role of the microbial community in TSCC development and progression is unclear. In the present study, 23 patients with TSCC were recruited. Tissue DNA was extracted from cancer and paracancerous normal tissues from all participants. Next-generation 16S rDNA amplicon sequencing and functional prediction were applied for taxonomic analysis. Alpha diversity measurements using the Shannon and Simpson diversity indexes indicated a significant increase in the microbiotic diversity of cancer samples (Shannon index: P = 0.001, Simpson index: P = 0.015); otherwise, no differences were found when using observed operational taxonomic units (OTUs) and Chao1 index (observed OTUs: P = 0.261, Chao1 index: P = 0.054). The dominant phyla of the microbiota included Bacteroidetes, Proteobacteria, Firmicutes, Actinobacteria, and Fusobacteria. Multivariate analysis of variance (Adonis) and nonparametric analysis of similarities (ANOSIM) based on unweighted unifrac distances demonstrated differences in the bacterial community structure between the two groups (P = 0.001 for Adonis, P = 0.001 for ANOSIM). Compared with the normal samples, Neisseria, Streptococcus, and Actinomyces levels decreased significantly in cancer samples. Co-occurrence network analysis implied that the bacterial community in cancer was more conserved than that in normal tissue. Matched-pair analysis of cancer and control samples revealed a significant alteration in the relative abundance of specific taxa. These findings will enrich our knowledge of the association between the oral microbial community and TSCC. Further experiments should investigate the potential carcinogenic mechanism of microbial community alterations in TSCC. KEY POINTS: • Microbial community role in tongue squamous cell carcinoma. • Significant alteration of microbiome found between cancer and normal tissues. • Microbial community alteration and potential carcinogenic mechanism.

The Role of Autologous Platelet Concentrates in the Treatment of Medication-Related Osteonecrosis of the Jaw.

ABSTRACT: The frequent refractory response of patients to the treatment of medication-related osteonecrosis of the jaw (MRJON) has attracted clinicians' attention to several treatments. However, they are at best, palliative, and have a higher failure rate than previous treatments. The present meta-analysis was performed to evaluate the clinical effectiveness of autologous platelet concentrates (APCs) combined with surgery in the treatment of MRONJ. The authors conducted a meta-analysis involving a systematic search of PubMed, EMBASE, Wiley Online Library and the Cochrane Library for eligible studies from their inception to November 2019, in accordance with preselected criteria. The inverse variance method was applied to fixed or random effects models based on the heterogeneity of the studies. Thirteen studies that investigated APCs in the treatment of MRONJ were eligible for inclusion in the meta-analysis of 223 patients and 33 lesions. The pooled success rate of APCs combined with surgery for MRONJ was 90% (95%CI, 80%-97%) and the pooled OR was 7.67 (95%CI, 2.10-27.98), indicating the combination was 7.67 times more effective than surgery alone. The results suggest that the use of APCs is a promising therapeutic regimen, as it provided additional benefits to surgery in the treatment of MRONJ. To achieve the benefits, a tension-free primary closure of the soft tissue is recommended as well. Randomized studies with large sample sizes is warranted to confirm our finding.

Autologous Platelet Concentrates as Clinical Substitutes for Connective Tissue Graft in the Treatment of Miller Class I and II Gingival Recessions: An Updated Meta-Analysis.

This meta-analysis aimed to evaluate the clinical effectiveness of autologous platelet concentrates (APC) + coronally advanced flap (CAF) (Group A) compared with connective tissue graft (CTG) + CAF (Group B), and CAF alone (Group C), in patients with Miller Class I or II gingival recessions. Relevant articles published before December 2018 were retrieved electronically without date or language restriction and screened according to inclusion criteria. Quantitative meta-analysis was conducted comparing the groups. The inverse variance method was applied in fixed or random effects models according to heterogeneity. Sixteen randomized controlled trials were included. Root coverage (RC), clinical attachment level (CAL), gingival thickness (GT), and probing depth (PD) did not differ significantly between Groups A and B. The keratinized gingival width (KGW) of Group A was significantly less than that of Group B. The RC and GT of Group A were significantly greater than that in Group C. CAL and PD for Group A were lower than for Group C. KGW for Group A did not differ significantly from that of Group C. The results suggested that APC + CAF represents a promising alternative for root coverage for Miller Class I and II gingival recession defects. Nevertheless, CTG + CAF exhibits superior outcomes in terms of KGW. Hence, in scenarios lacking keratinized gingiva (Miller Class II), APC + CAF might not be the most suitable therapeutic choice.

[A revised scheme for LeFort classification of upper jaw fractures].

OBJECTIVE: To put forward a revised scheme on LeFort classification for the upper jaw fractures. METHODS: 193 consecutive cases with the primary diagnoses of upper jaw fractures were involved in this study, for each one of which water's and CT scan were available to decide the fracture site and pattern. Data were filed in term of classification items as LeFort I, II and III fracture, as well as sagittal fracture and alveolar fracture. Statistical analysis was done to validate the meliorating thought on and revised scheme on LeFort classification. RESULTS: It was validated that of 185 cases with upper jaw fractures only 30.81% which presented single-line fracture and 34.06% which presented multiple-line fracture were covered with LeFort classification. Additional 13.51% with single-line fracture and 21.61% with multiple-line fracture could be included when LeFort classification was extended with increase of items of sagittal fracture and alveolar fracture. Further results revealed that among total 344 sites or fracture lines included in 193 cases, 81.10% could be diagnosed fracture pattern of LeFort classification. Of 65 fracture sites presenting LeFort III type, 92.31% were concomitant with LeFort II type or LeFort I and II type, very few being alone. CONCLUSIONS: A revised classification was proposeded that upper jaw fractures could be classified into four types as follows: (1) high horizontal fracture (corresponding to LeFort II and III type), (2) low horizontal fracture (corresponding to LeFort I type), (3) sagittal fracture (including midline and para-midline fracture) and (4) alveolar fracture.