Analyzing the teeth next to the alveolar cleft: Examination and treatment proposal prior to bone grafting based on three-dimensional versus two-dimensional diagnosis-A diagnostic study.

PURPOSE: The objective was to evaluate the diagnostic and prognostic value of three-dimensional (3D) cone beam computed tomography (CBCT) on information about the cleft and alignment of cleft neighboring teeth. MATERIALS AND METHODS: Panoramic X-rays, small-volume CBCTs, and study casts of 20 patients with a total of 22 alveolar clefts were analyzed prior to secondary bone grafting. Six maxillofacial surgeons and 6 orthodontists rated the following parameters: visibility of alveolar cleft expansion, position and probability of alignment of cleft neighbored teeth. Two-dimensional (2D) X-rays and casts were rated first; CBCT and casts followed at least 4 weeks later. Radiologic bone height in the region of the former alveolar cleft, as well as alignment and reasons for nonalignment of cleft neighbored teeth, were recorded 4 years later. RESULTS: The rate of proper proposals regarding the real treatment outcome using 2D- or 3D-material did not differ statistically. Although 5%-45% of the proposals were changed when using 3D instead of 2D records, Fleiss multirater kappas showed no essential differences. Raters' profession and experience had no influence on the rate of correct proposals. CONCLUSION: In orthodontics, small-volume CBCT may be justified only as supplement to a routine panoramic X-ray, and only in selected cases or for surgical preparation.

Single nucleotide polymorphisms of the vascular endothelial growth factor gene associated with incidence of oral squamous cell carcinoma.

BACKGROUND: Vascular endothelial growth factor (VEGF) plays an important role in promoting angiogenesis and is overexpressed in several malignancies. Polymorphisms of the VEGF gene can alter VEGF protein expression, which may be biologically significant and account for heterogeneity in disease risk and outcome. The aim of this case-control study was to evaluate potential associations between single nucleotide polymorphisms (SNP) of the VEGF gene with susceptibility of oral squamous cell carcinoma (OSCC). PATIENTS AND METHODS: Five VEGF SNP (-1154 G/A, +405 G/C, +936 C/T, -2578 C/A and -460 C/T) were determined in peripheral blood isolated from 80 patients with OSCC and from 40 age- and gender-matched healthy volunteers (RT-PCR). RESULTS: The +936 T allele and the -2578 C/A SNP were expressed significantly more often in the OSCC-group (P=0.002; P<0.0001) where three associations between two SNPs (+936 and +405, -2578 and -1154, -460 and -2578) were found. CONCLUSION: Our findings provide support that +936 T allele and -2578 C/A SNP of the VEGF gene alone or in combination with other SNP are associated with OSCC. The SNPs may be used as biomarker for the development of specialized anti-VEGF drugs. Further studies must confirm the value of preoperative genetic analysis for prognosis.

Hemangioma of the mandible: case report with special emphasis on bone degradation.

PURPOSE: Intraosseous hemangioma of the mandible is a rare tumor. In this report, we present a case with a particularly prominent osteolysis and discuss the histological features of bone degradation. MATERIALS AND METHODS: We describe a 64-year-old female patient with a cystic tumor mass of the mandible leading to pathologic bone fracture. X-ray analysis was suggestive for aneurysmatic bone cyst. A segment resection was performed. RESULTS: The histological examination revealed a mesenchymal tumor with numerous capillaries and dilated vessels immunohistochemically being positive for CD31, but not for D2-40. In addition, there was a remarkable increase of osteoclasts that sometimes exhibited Howship's lacunae. The tumor was diagnosed as intraosseous hemangioma with prominent bone degradation. CONCLUSIONS: Based on our histological findings, it should be further investigated whether there could be an association between angiogenesis and osteoclastogenesis as a central pathway leading to bone destruction in the case of intraosseous hemangiomas.