Surgical neurolysis for the treatment of neuropathic pain in 2 postmenopausal women with mandibular necrosis resulting from oral bisphosphonates.

We analyze the use of surgical neurolysis for the treatment of neuropathic pain of the inferior alveolar nerve. For that, 3 surgical neurolysis were performed on 2 postmenopausal women experiencing neuropathic pain of the inferior alveolar nerve due to mandibular necrosis resulting from treatment with oral bisphosphonates. Both patients showed sensory impairment of the inferior alveolar nerve. We obtained complete control of neuropathic pain after 6 months of the patients' evolution, preserving the function of the lingual nerve in all 3 neurolysis, without causing any impact as regards to the sensitive situation before treatment. Surgical neurolysis of the inferior alveolar nerve may be considered as the choice therapeutic technique to treat neuropathic pain of this nerve when there is a sensory impairment in patients showing mandibular necrosis resulting from bisphosphonates.

An analysis of oral biopsies extracted from 1995 to 2009, in an oral medicine and surgery unit in Galicia (Spain).

OBJECTIVE: To conduct an analysis of the frequency of oral lesions in biopsies over a 14-year period in the Oral Medicine, Oral Surgery and Implantology Unit. MATERIAL AND METHODS: We conducted a retrospective study of biopsies removed from 1995-2009, recording data regarding age, sex, location of the lesions, biopsy types, anatomical and pathological diagnosis and definitive diagnosis. RESULTS: Of the 562 patients studied, the average age was 51.8 years, with a standard deviation of 18.5 (range 5-96). The distribution by sex was 318 (56.6%) women and 244 (43.4%) men. The most common diagnostic category was mucosal pathologies in 37.9% of cases, followed by odontogenic cysts in 27.8%. Malignant tumors accounted for 3.9% of cases, oral squamous cell carcinomas were the most frequent malignancy, appearing in 22 cases. Bisphosphonate-related osteonecrosis of the jaws was the most common injury within the bone lesions group. CONCLUSION: Following the performance of 647 biopsies on 562 patients, we can say that the most common injury was radicular cysts (appearing in 108 cases), having found statistical differences in relation to the patients' sex and age.

Blood loss in orthognathic surgery: a systematic review.

PURPOSE: Intraoperative blood loss during orthognathic surgery is frequently abundant and sometimes requires blood transfusion. The aim of the present study was to conduct a systematic review of the published data regarding intraoperative blood loss during orthognathic surgical interventions, including Le Fort I osteotomy, mandibular ramus osteotomy, and both combined, to determine the range of information available to help surgeons better prepare themselves, their patients, and the auxiliary support needed for this type of surgery and the transfusion requirements. MATERIALS AND METHODS: Selected reports from the PubMed and Cochrane Library databases for studies conducted from 1978 to 2008 were evaluated to determine whether they included information on the volume of bleeding during surgery and the factors that might have influenced the amount of bleeding. Of the 90 reports examined and evaluated, 7 were included in the critical analysis conducted as a part of the present systematic review. RESULTS: Referring to the reports used for statistical analysis of the volume of blood loss, the mean intraoperative bleeding volume was 436.11 mL, the mean of the standard deviations was ±207.89 mL, and mean surgery duration was 196.9 minutes. CONCLUSIONS: Our results have shown that the intraoperative bleeding observed in patients during Le Fort I or mandibular ramus osteotomies or both combined was less than the limits set for blood transfusion. However, bleeding was occasionally heavier, and surgeons should be prepared for heavier bleeding by reserving blood at a blood bank or by preparing an autotransfusion.

Peri-implant bone resorption around implants placed in alveolar bone subjected to distraction osteogenesis.

PURPOSE: This study was conducted to evaluate bone resorption around implants placed in alveolar bone previously subjected to distraction osteogenesis (DO). PATIENTS AND METHODS: The study included 9 patients who had undergone alveolar DO with subsequent placement of 37 implants. None of the implants was lost. Vertical peri-implant bone deficit was measured on the distal and mesial surfaces from panoramic radiographs obtained at implant loading and again 1 year later. Resorption over the year of loading was calculated as the increase in vertical bone deficit. RESULTS: Mean peri-implant bone resorption over the first year after loading was 0.60 mm mesially and 0.68 mm distally. In both cases, the resorption (ie, the difference between the mean bone deficit at loading and 1 year later) was statistically significant (P < .05). CONCLUSION: Vertical bone resorption around implants placed in distracted alveolar bone is similar to that seen around implants placed in nondistracted bone.

Botulinum toxin A for treating muscular contractures in cephalic tetanus.

OBJECTIVE: This study reports the use of botulinum toxin for treatment of muscle contractures in a patient with cephalic tetanus. METHOD: Case report. RESULTS: An 80-year-old woman was diagnosed with cephalic tetanus, with contractures of the masseter, sternocleidomastoid, trapezius, and levator scapulae muscles. After one month of conventional treatment good recovery was observed, but with persistence of the contractures of the sternocleidomastoid, trapezius and levator scapulae. These contractures were treated with botulinum toxin A (75IU in the right sternocleidomastoid, 25IU in the right trapezius; one month later 50IU in the left levator scapulae, 50IU in the right levator scapulae, 75IU in the left sternocleidomastoid; two months later 25IU in the left trapezius). Full recovery was observed. CONCLUSIONS: Local infiltration with botulinum toxin A appears to be an effective treatment for persistent muscle contracture in cephalic tetanus.

Genetic and molecular alterations associated with oral squamous cell cancer (Review).

The development of oral squamous cell cancer (OSCC) is a multistep process involving the accumulation of multiple genetic alterations modulated by genetic pre-disposition and environmental influences such as tobacco and alcohol use, chronic inflammation, and viral infections. All of these factors can lead to a wide range of genetic and molecular alterations that can be detected using a range of molecular studies. The alterations mostly affect two large groups of genes: oncogenes and tumor suppressor genes, which can be either inactivated or overexpressed through mutations, loss of heterozygosity, deletions, or epigenetic modifications such as methylation. Other molecules that are closely associated with tumor pathogenesis and prognosis also exist and warrant further study. Important advances in molecular biology are helping to shed light on oral cancer and thus aiding in the early diagnosis and development of new personalized treatment approaches. The purpose of the review is to explore the genetic and molecular alterations associated with OSCC.

An analysis of oral biopsies extracted from 1995 to 2009, in an oral medicine and surgery unit in Galicia (Spain)

Objective: To conduct an analysis of the frequency of oral lesions in biopsies over a 14-year period in the Oral Medicine, Oral Surgery and Implantology Unit. Material and Methods: We conducted a retrospective study of biopsies removed from 1995-2009, recording data regarding age, sex, location of the lesions, biopsy types, anatomical and pathological diagnosis and definitive diagnosis. Results: Of the 562 patients studied, the average age was 51.8 years, with a standard deviation of 18.5 (range 5-96).The distribution by sex was 318 (56.6%) women and 244 (43.4%) men. The most common diagnostic category was mucosal pathologies in 37.9% of cases, followed by odontogenic cysts in 27.8%. Malignant tumors accounted for3.9% of cases, oral squamous cell carcinomas were the most frequent malignancy, appearing in 22 cases. Bisphosphonate-related osteonecrosis of the jaws was the most common injury within the bone lesions group. Conclusion: Following the performance of 647 biopsies on 562 patients, we can say that the most common injury was radicular cysts (appearing in 108 cases), having found statistical differences in relation to the patients’ sex and age (AU)