Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors.

BACKGROUND: The American Joint Committee on Cancer (AJCC), in its 8th edition, introduces modifications to the previous TNM classification, incorporating tumour depth of invasion (DOI). The aim of this research is to analyse the prognosis (in terms of disease-free survival and overall survival) of clinical early stage (I and II) squamous cell carcinomas of the oral tongue according to the DOI levels established by the AJCC in its latest TNM classification to assess changes to the T category and global staging system and to evaluate the association between DOI and other histological risk factors. METHODS: A retrospective longitudinal observational study of a series of cases was designed. All patients were treated with upfront surgery at our institution between 2010 and 2019. The variables of interest were defined and classified into four groups: demographic, clinical, histological and evolutive control. Univariate and multivariate analyses were carried out and survival functions were calculated using the Kaplan-Meier method. Statistical significance was established for p values below 0.05. RESULTS: Sixty-one patients were included. The average follow-up time was 47.42 months. Fifteen patients presented a loco-regional relapse (24.59%) and five developed distant disease (8.19%). Twelve patients died (19.67%). Statistically significant differences were observed, with respect to disease-free survival (p = 0.043), but not with respect to overall survival (p = 0.139). A total of 49.1% of the sample upstaged their T category and 29.5% underwent modifications of their global stage. The analysis of the relationship between DOI with other histological variables showed a significant association with the presence of pathological cervical nodes (p = 0.012), perineural invasion (p = 0.004) and tumour differentiation grade (p = 0.034). Multivariate analysis showed association between depth of invasion and perineural invasion. CONCLUSIONS: Depth of invasion is a histological risk factor in early clinical stages of oral tongue squamous cell carcinoma. Depth of invasion impacts negatively on patient prognosis, is capable per se of modifying the T category and the global tumour staging, and is associated with the presence of cervical metastatic disease, perineural invasion and tumoural differentiation grade.

Long term oral health related quality of life after TMJ arthrocentesis with hyaluronic acid. A retrospective cohort study.

The purpose of the study was to assess the long-term oral health-related quality of life (oQoL) in patients with temporomandibular joint (TMJ) internal derangement (ID) after TMJ arthrocentesis plus hyaluronic acid (HA). Patients were analysed at different follow-up times using an analytical observational design. The Oral Health Impact Profile-14 (OHIP-14) score was evaluated according to age, sex, disc position, presence of degenerative joint disease (DJD), joint pain, maximum mouth opening and follow-up time. A total of 60 participants were enrolled, 88% female, with a mean age of 38 years (SD = 13.48). In an average follow-up of 25.02 months (SD = 5.32), the OHIP-14 total score decreased 8.67 (95% confidence interval [CI]: -11.21 to -6.11) after the intervention (Cohen's d = 1.22; 95% CI = 0.81 to 1.64). All OHIP-14 domain scores decreased (p < 0.05) except for the Functional limitation domain (p = 0.378). The oQoL after the intervention worsened in female patients (p = 0.039) and with a higher level of pain at baseline (p = 0.002). Self-perceived QoL improvement should be considered stable long term after temporomandibular joint arthrocentesis plus HA, regardless of concurrence with DJD or ID subtype. QoL should be used as clinical assessment measure of ID patients, with special attention to those with higher levels of pain.

Maxillary sinus augmentation with bovine hydroxyapatite alone: A safe technique with predictable outcomes in patients with severe maxillary atrophy / Elevación del seno maxilar con hidroxiapatita bovina sola: Una técnica segura con resultados predecibles en pacientes con atrofia maxilar grave

Sinus augmentation is a preprosthetic technique for rehabilitating posterior sector of the atrophied maxilla with implant-supported prosthesis. We retrospectively analyzed 34 consecutive sinus augmentations performed using only bovine hydroxyapatite. The presurgical height in 92% of the cases was 4 mm or less. The success rate of the maxillary sinus augmentation was 100% for this technique. 13.4% of the implants were placed immediately with a success rate of implants placement of 93.9%. The non-osseointegrated implants were all successfully replaced. Follow-up period was 1268 days. The success rate obtained using bovine hydroxyapatite alone is similar to that using other types of materials, while avoids morbidity of the autologous bone donor area (AU)

La elevación del seno es una técnica preprotésica para la rehabilitación del sector posterior atrofiado del maxilar con una prótesis de implantación. Analizamos retrospectivamente 34 casos consecutivos de elevación del seno maxilar con el empleo de tan solo hidroxiapatita bovina sola. La altura prequirúrgica era de 4 mm o menos en el 92% de los casos. El porcentaje de éxitos de la elevación del seno maxilar con esta técnica fue del 100%. Un 13,4% de los implantes se colocaron inmediatamente, con un porcentaje de éxitos de la implantación del 93,9%. Los implantes no osteointegrados se sustituyeron todos con éxito. El periodo de seguimiento fue de 1268 días. El porcentaje de éxitos obtenido con el empleo de hidroxiapatita bovina sola es similar al de otros tipos de materiales, al tiempo que se evita la morbilidad en el área donante de hueso autólogo (AU)

Carcinoma adenoide quístico / Adenoid cystic carcinoma

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