Recurrent Deeply Invasive Basal Cell Carcinoma.

INTRODUCTION: Basal cell carcinoma (BCC) is the most frequent skin malignancy worldwide. The majority of BCCs grow slowly and have a low metastatic potential. However, they can be destructive to surrounding tissues since they are locally invasive. METHODS: This case report was conducted on a 78-year-old woman complaining of a solid lump on the left side of the neck and nonhealing lesion. Three years earlier, she had BCC on the same site. Clinical and radiographic examinations were made. The biopsy specimens revealed that it is a recurrent BCC. In operating room, during blunt tissue dissection, the arterial wall was damaged. Tumor was overgrown left internal carotid artery near the bifurcation. Infiltrated part of arteria wall was resected, and a synthetic arterial prosthesis was placed. RESULTS: Follow-up after 4 months showed that the wound was healing well. No complications regarding cardiovascular and other organ systems were seen.

The Role of Facial Expression Analysis and Electrodermal Activity as an Objective Evaluation of Persistent Idiopathic Facial Pain.

ABSTRACT: Persistent idiopathic facial pain (PIFP) is an enigmatic condition presenting with variable features. Psychiatric comorbidities are speculated to influence PIFP.In this study, the authors evaluated patients with PIFP through the hospital anxiety and depression scale, facial expression analysis, and electrodermal activity.A total of 67 respondents enrolled as the experimental group and 28 participants as the control group. Pain scores were higher in the experimental group (5.24; SD 2.349) P < 0.001 depression (5.58 (SD 3.766) versus 3.07 (SD 2.418), P = 0.002) and anxiety scores (9.78 (SD 4.923) versus 6.75 (SD 4.097) P = 0.007) were higher in the experimental group. The experimental group expressed more negative episodes (P = 0.024); Electrodermal Activity data in terms of peaks/min (P = 0.872) and average peak amplitude (P = 0.168) were not significantly different between the groups.It may be concluded that pain levels may be influenced by psychiatric comorbidity as PIFP patients showed insignificant physiological response to pain.

Does persistent idiopathic facial pain relate to mood (affective) disorders.

OBJECTIVE: Persistent idiopathic facial pain (PIFP) is a condition in the absence of clear pathology. Pathogenesis is still enigmatic, although comorbidity with mood/affective disorders is observed. The aim of this study was to investigate the association between personality traits, mood and sleep disorders, and PIFP; and to compare them with posttraumatic chronic orofacial pain. METHOD AND MATERIALS: A cross-sectional, single-center study was designed to evaluate patients diagnosed with PIFP according to ICOP (International Classification of Orofacial Pain) diagnostic criteria through Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Five Factor Model, and visual analog scale indexes. Data were analyzed and compared with patients suffering from organic pathology - unilateral chronic mandibular fracture pain. RESULTS: A total of 67 respondents enrolled as the experimental group and 28 participants as a control group. Pain scores were higher in the experimental group (P < .001) and had positive correlation with depression (r = .44, P < .001) and sleep index scores (r = .415, P < .001). Personality trait scores did not differ between the groups. However, neuroticism correlated with depression (r = .466, P < .01) and anxiety (r = .634, P < .01) scores in the experimental group. Depression (P = .002) and anxiety scores (P = .007) were higher in the experimental group, as well as sleep indexes (P = .038). Depression (r = .609, P < .001) and anxiety (r = .655, P < .001) scores had positive correlation with sleep index scores. Sleep scores in the experimental group positively correlated with neuroticism score (r = .442, P < .001). PIFP increases the chance of experiencing depression (OR 10.688; 95% CI 1.355-84.309, P = .006) as well as poor quality of sleep (OR 3.389; 95% CI 1.023-11.228, P = .006). CONCLUSIONS: The results suggest that personality traits (neuroticism), anxiety, depression, and sleep disorders are associated with PIFP.

Influence of PRGF and PRF on postextractive alveolus regeneration: a randomised controlled trial.

OBJECTIVES: Healing of postextraction alveolus is a complex process that involves soft and hard tissue regeneration. Pain, swelling, difficulty in opening the mouth, delayed bone tissue healing, alveolitis, and horizontal or vertical resorption of bone tissue are the main problems that impact on consequent treatment. Blood concentrates PRGF (plasma rich in growth factors) and PRF (platelet-rich fibrin), which are rich in growth factors, create better conditions for postextraction alveolus healing, enhance quality of soft tissues and bone regeneration, and decrease pain. The study objective was to compare physiologic healing of the postextraction zone with PRF- and PRGF-induced changes. METHOD AND MATERIALS: In total, 43 patients were randomly divided into three groups: control group (mandibular molar extraction and filling of postextraction alveolus with hemostatic sponge containing gentamicin), group 2 (postextraction alveolus filled with PRGF), and group 3 (postextraction alveolus filled with PRF). Bone regeneration was evaluated in CBCT scans after 1 month. Pain was evaluated using the visual analog scale (VAS). RESULTS: After evaluating VAS results 1 day after surgery the lowest pain score was in the PRGF group. Tooth alveolus vertical and diagonal dimensions in the control group were significantly (P = .017) smaller than in the PRGF group. The vertical dimension of the alveolar ridge did not change significantly (P = .859) in the PRGF group; however, it was significantly reduced (P = .04) in the PRF group. One month after surgery the age of the control group was inversely proportionally correlated with the height and diagonal dimension of callus. CONCLUSION: Both blood concentrates had great anti-inflammatory properties, but PRGF had better osteoblastic properties and resulted in lower postoperative pain.

Plasma rich in growth factors injection effectiveness for myofascial pain treatment in masticatory muscles. Randomised controlled trial.

BACKGROUND: Myofascial pain in masticatory muscles is one of the most common temporomandibular disorder. Nowadays, the most usable treatment methods are based on the muscle taut band cell membrane disruption, which releases the taut band. Platelet-rich plasma, made with PRGF Endoret® method, gives an opportunity to use platelet-derived growth factors in treatment processes. It has been proven that platelet-derived growth factors can relief pain and activate muscle regeneration. OBJECTIVE: To test a hypothesis that PRGF injections can be effective for treating myofascial pain in masticatory muscles. METHODS: Fifty adult patients participated in the study. Participants were randomly divided into two groups. The first group received 1-mL lidocaine injections to trigger point in their masseter muscle. The second group of patients received 1-mL PRGF injections. The patients' pain was measured by using visual analogue scale (VAS). RESULT: Statistically significant difference in pain levels before the procedure and 4 weeks after it was found in both groups. There was no statistically significant difference between groups in pain levels before the procedure (P = .063) and 2 weeks after it (P = .123); however, statistically significant difference was noticed 4 weeks after the procedure (P < .001). Four weeks after the procedure, patients' average pain in lidocaine group was 3.4 on VAS, and it was 0.9 in PRGF group. CONCLUSIONS: PRGF injections in masseter muscle affected by myofascial pain syndrome are an effective treatment method. PRGF injections more effectively relief myofascial pain in masseter muscle than lidocaine injections.

Implant-supported prosthesis treatment planning aspects of Kaunas city dentists and dental specialists.

OBJECTIVE: Rehabilitation of mastication using fixed or removable prosthesis on dental implants is a daily procedure in modern dentistry.The huge variety of diagnostic tools and methods, such as cone beam computed tomography or surgical guides help to avoid complications. A vast quantity of diagnostic tools and prosthesis require a tight communication between surgeons and prosthodontists in order to achieve better treatment plan. METHODS: The questionnaire was approved by LUHS Committee of Ethics. A questionnaire of 17 demographic and specialized questions was composed. A randomized survey of dentists and dental specialists was conducted in Kaunas. A statistical analysis was performed using χ2test and Student's T-test criteria. RESULTS: Most of correspondents believe that treatment plan should be created by the current dentist, regardless his/hers specialization. All correspondents performing dental implantation, use elevation of mucoperiosteal flap. The most common diagnostic tool among dentists and oral surgeons is panoramic x-ray. The most common diagnostic tools between prosthodontists are panoramic x-ray and analysis of dental stone castings. The most common complications among dentists and prosthodontists are improper adjustment of soft tissue and errors of dental technicians, among oral surgeons - improper adjustment of soft tissues and implant position. CONCLUSIONS: 1. The creation of treatment plan does not depend on specialization of dentist. 2. The elevation of mucoperiosteal flap is more common than non-flap procedure. 3. The most used diagnostic method is panoramic x-ray. 4. The most prevalent complications are improper adjustment of soft tissues and errors of dental technicians.