Long-term effect of photodynamic therapy on oral squamous cell carcinoma and epithelial dysplasia.

BACKGROUND: Oral squamous cell carcinoma (OSCC) treatment consists mainly of surgery, chemotherapy, and radiotherapy, alone or in combination. Epithelial dysplasia (ED) is also treated with surgery. However, these treatments can induce functional and/or aesthetic disturbances. Photodynamic therapy (PDT) can preserve organs. Although short-term studies have shown good progress, long-term evaluations have not yet been conducted. This study aimed to clarify the long-term effects of PDT on OSCC and ED. METHODS: Patients who underwent PDT with the first (porfimer sodium) or second generation photosensitizers (talaporfin sodium) for early OSCC (T1 and T2) and ED were included in this study. The long-term prognosis was assessed. RESULTS: Twenty-three patients were included. Complete response (CR) was observed in 19 patients (82.6%) and partial response (PR) in 4 patients (17.4%) 4 weeks after PDT. Regarding long-term progress, local region recurrence occurred in 11 of 19 CR cases (57.9%), and the term of recurrence was 27.4 ± 30.4 months. Surgical resection was performed in all local recurrence and PR cases, and 3 patients died of the underlying disease. CONCLUSIONS: PDT provides a good outcome in the short term, but its long-term effects are limited.

Remarkably Elongated Coronoid Processes: A Cadaveric Case Report.

An elongated coronoid process (ECP) can lead to impingement of the coronoid process on the body or arch of the zygomatic bone when opening the mouth. The etiology of ECP is unclear, but several theories have been postulated. We present a case of an ECP found in a 63-year-old in a Caucasian cadaveric specimen. The length of the coronoid process was 26.6 mm on the left side and 26.3 mm on the right side. To our knowledge, this is the longest coronoid process reported in the extant literature. The details of this case and the clinical significance are discussed.

Application of the sliding window method and Mask-RCNN method to nuclear recognition in oral cytology.

BACKGROUND: We aimed to develop an artificial intelligence (AI)-assisted oral cytology method, similar to cervical cytology. We focused on the detection of cell nuclei because the ratio of cell nuclei to cytoplasm increases with increasing cell malignancy. As an initial step in the development of AI-assisted cytology, we investigated two methods for the automatic detection of cell nuclei in blue-stained cells in cytopreparation images. METHODS: We evaluated the usefulness of the sliding window method (SWM) and mask region-based convolutional neural network (Mask-RCNN) in identifying the cell nuclei in oral cytopreparation images. Thirty cases of liquid-based oral cytology were analyzed. First, we performed the SWM by dividing each image into 96 × 96 pixels. Overall, 591 images with or without blue-stained cell nuclei were prepared as the training data and 197 as the test data (total: 1,576 images). Next, we performed the Mask-RCNN by preparing 130 images of Class II and III lesions and creating mask images showing cell regions based on these images. RESULTS: Using the SWM method, the highest detection rate for blue-stained cells in the evaluation group was 0.9314. For Mask-RCNN, 37 cell nuclei were identified, and 1 cell nucleus was identified as a non-nucleus after 40 epochs (error rate:0.027). CONCLUSIONS: Mask-RCNN is more accurate than SWM in identifying the cell nuclei. If the blue-stained cell nuclei can be correctly identified automatically, the entire cell morphology can be grasped faster, and the diagnostic performance of cytology can be improved.

Safety and feasibility assessment of biodegradable poly (l-lactic acid/ε-caprolactone) membrane for guided bone regeneration: A case series of first-in-human pilot study.

BACKGROUND/PURPOSE: Guided bone regeneration (GBR) is the most popular technique for alveolar ridge augmentation in implant dentistry, and resorbable cell barrier membrane, made of collagen, is widely used. We tried to develop a new resorbable cell barrier membrane from an animal-free product. This study aimed to investigate the safety and feasibility for clinical application of poly (l-lactic acid/ε-caprolactone) [P (LA/CL)] membrane, a novel biodegradable synthetic material used for GBR. MATERIALS AND METHODS: Patients who required horizontal bone augmentation (≥3 mm implant exposure) for implant treatment were included in the study. P (LA/CL) membrane was used simultaneously with implant placement to achieve bone augmentation by GBR. The occurrence of adverse events was assessed until the follow-up period of a second surgical procedure. The amount of bone augmentation was assessed by means of cone-beam computed tomography, and implant stability was assessed by measuring the implant stability quotient (ISQ). Student's t-test was used and the level of significance was set at p < 0.05. RESULTS: This first-in-human study comprised five participants. Adverse events were observed in three of five patients, and a cause-and-effect relationship of the membrane could not be denied in one of them. Good bone formation was observed in the GBR region of all five patients. The ISQ during the second surgical procedure indicated good osseointegration in all the patients. CONCLUSION: The application of P (LA/CL) membrane for bone augmentation with GBR made it possible to maintain the augmented bone volume without causing any irreversible adverse events. However, further investigations on humans are required to confirm the safety of this biomaterial.

Parotid Branches of the Auriculotemporal Nerve: An Anatomical Study With Implications for Frey Syndrome.

The auriculotemporal nerve is one of the many branches of the mandibular division of the trigeminal nerve. Of these, its superficial temporal branch has been most described. Although the parotid branches, secretomotor fibers to the parotid gland, are well known as the cause of Frey syndrome, there have been almost no descriptions of their anatomy. In this study, the authors dissected the parotid branches of the auriculotemporal nerve to elucidate their anatomy. A total of 10 sides from 7 adult and embalmed cadaver heads were used in this study. The specimens were derived from 3 males and 4 females, the age of cadavers at death ranged from 65 to 92 years old. Measurements included their diameter and the distance of their branching point from the main trunk of the auriculotemporal nerve from the middle of the tragus. Three of 10 sides had 2 parotid branches and 7 sides were found to have 1 parotid branch. The vertical distance between middle of the tragus to branching point of the parotid branch ranged from 1.79 to 16.17 mm. The horizontal distance between middle of the tragus to branching point of the parotid branch ranged from 3.03 to 12.62 mm. The diameter of the parotid branch ranged from 0.31 to 0.49 mm. An improved knowledge of the parotid branch of the auriculotemporal nerve might decrease injury to these structures with the potential for postoperative.