Piezosurgery vs High Speed Rotary Handpiece: a comparison between the two techniques in the impacted third molar surgery.

OBJECTIVE: The aim of the Study was to compare the impacted third molar surgical technique by means of the high speed rotary handpiece with the piezoelectric one. MATERIALS AND METHODS: 192 patients have been selected among those who had to undergo a third molar surgical extraction. These patients' surgeries have been performed by means of one of the techniques, randomly chosen. Each patient has undergone the same analgesic therapy (paracetamol 1000 mg tablets). Each surgery has been performed by the same surgeon. The patients were asked to fill in a questionnaire concerning the postoperative pain ("happy face pain" rating scale). RESULTS: The average duration of the surgeries performed by means of the high speed rotary handpiece was 32 minutes, while the duration of the ones performed by means of the piezoelectric handpiece was much longer (54 minutes). The postoperative pain values were almost equal. CONCLUSIONS: In conclusion, the osteotomy performed by means of the traditional technique still represents the gold standard in the impacted third molar surgery. The piezoelectric technique may be an effective choice, especially for the less skilled surgeons, in order to guarantee the protection of the delicate locoregional anatomical structures.

Podoplanin in the development and progression of oral cavity cancer: a preliminary study.

OBJECTIVE.: Podoplanin is a mucin-like glycoprotein that is important in lymphangiogenesis but not in blood vessel formation. The aim of this preliminary study is to determine the role of podoplanin in the development and progression of head and neck cancer. MATERIAL AND METHODS.: Podoplanin over expression was analyzed in 20 patients with oral cancer, by immunohistochemical analysis. RESULT.: Podoplanin is not expressed in normal oral epithelial cells but was found in some hyperplastic and dysplastic lesions. Podoplanin high expression was found in 9 of 20 patients and was more frequent in cancers with lymph node metastasis, particularly in oral cavity cancers. In our preliminary study, patients who showed high levels of podoplanin had a statistically greater rate of lymph node metastasis (P<0,001); patients with lymph node metastasis and high-level podoplanin showed a shorter disease-specific survival (P = 0,004) than other patients. CONCLUSION.: The results of our preliminary study have provided interesting and encouraging data. We have observed that podoplanin expression increases in the early stages of tumourigenesis and it seems to be associated with a higher risk of head and neck cancer. While in squamous cell carcinoma podoplanin expression diminishes during tumour progression. These data support a role for podoplanin expression in the initiation but not in the progression of cancer. So we can conclude that podoplanin is involved in oral oncogenesis and can be a predictor for lymph node metastasis in asymptomatic patients. Histology and podoplanin analysis can be very useful to predict the risk of development, invasion and metastatic progression of a tumour in patients with oral cancer.

Oral cavity rare lesions: 15 years case histories.

OBJECTIVES.: Oral cavity rare diseases include a various group of uncommon morbid conditions. For this reason they are often called "orphan diseases", as they are not interesting for research and the description of their natural history is not easy. The aim of our study is to analyze the prevalence and the distribution of oral cavity rare diseases in order to increase their knowledge and allow a fast therapeutic approach. METHODS AND MATERIAL.: 3144 patients took part to our study, they were choosen according to specific criteria and included in a experimental program; they all were prepared for oral biopsy surgery at Fatebenefratelli Hospital - Tor Vergata University of Rome. Following the results of the histological diagnosis, patients have been grouped. RESULTS.: From 1996 to 2010, we observed 1635 men and 1509 women, average age was 53 years, higher for women (55y.) and lower for men (52y.). CONCLUSIONS.: Nevertheless the low level of accordance and the difficulty in description of natural history of diseases reported in literature, we can conclude that, according to our study the onset of rare diseases shows a percentage of appearing statistically significant.