Risk factors associated with onset of medication-related osteonecrosis of the jaw in patients treated with denosumab.

Objectives: While risk factors of bisphosphonate (BP) associated osteonecrosis of the jaw have been properly analyzed, studies focusing on risk factors associated with denosumab (DNO) are sparse. The purpose of this study was to identify risk factors influencing the onset of medication-related osteonecrosis of the jaw (MRONJ) in patients receiving antiresorptive treatment (ART) with DNO by comparing patients suffering from MRONJ and patients without MRONJ. Multiple variables were evaluated including the impact of a previous BP intake.

The Type of Antiresorptive Treatment Influences the Time to Onset and the Surgical Outcome of Medication-Related Osteonecrosis of the Jaw.

Purpose: Few data exist focusing on differences in the time to disease onset and the success rates in patients suffering from medication-related osteonecrosis of the jaw (MRONJ) dependent on their different antiresorptive treatment. The purpose of this study was to analyze and compare these variables for patients treated with bisphosphonate (BP) or denosumab (DNO) and for patients who switched the antiresorptive drug (BP/DNO).

Patients And Methodss: A retrospective single-center cohort study with patients suffering from MRONJ was conducted.

A dental myth bites the dust--no observable relation between the incidence of dental abscess and the weather and lunar phase: an ecological study.

Background: Anecdotal reports assert a relationship between weather and lunar activity and the odontogenic abscess (OA) incidence, but this relationship has not been validated. Therefore, the present study investigated the relationship between oral pain caused by OA and a variety of meteorological parameters and cyclic lunar activity.

Methods: The records of all dental emergency patients treated at the AllDent Zahnzentrum Emergency Unit in Munich, Germany during 2012 were retrospectively reviewed.

Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ).

The medication-related osteonecrosis of the jaw (MRONJ) is believed to be a therapy-resistant entity. Although the application of the recommended conservative and surgical treatment regimens have returned variable success rates, the increased awareness and experience with MRONJ suggests that surgical therapy can halt the progression of the disease, thereby allowing a histology-based diagnosis of the osteonecrosis. Surgical treatment protocols can achieve success rates of over 90% and novel techniques such as the visualization of bone fluorescence can assist in the intra-operative delineation of the osteonecrosis and standardize the procedure.

Effect of antiresorptive drugs on bony turnover in the jaw: denosumab compared with bisphosphonates.

Osteonecrosis of the jaw as a result of treatment with receptor activators of nuclear factor kappa-B ligand (RANKL) inhibitors (denosumab) is a new type of bony necrosis, the exact pathogenesis of which is unknown. Our aim was to find out whether the turnover of bone in the jaw is increased after denosumab has been given compared with other skeletal sites, and if that turnover might have a role in denosumab-related osteonecrosis of the jaw (DRONJ). Bone scintigraphic images of 45 female patients with breast cancer and bone metastases were analysed retrospectively, and divided into 3 groups: those given denosumab, those given a bisphosphonate, and a control group (n=15 in each).

Kinesiologic taping reduces morbidity after oral and maxillofacial surgery: a pooled analysis.

Background: Postoperative morbidity is a major disadvantage after oral and maxillofacial (OMF) surgery, often caused by pain, trismus and swelling affecting patients' quality of life. The goal of this study was to examine the effect of kinesiologic taping (KT) on swelling, pain, trismus and patients' satisfaction after OMF surgery.

Materials And Methods: Performing a pooled analysis of 96 patients that were assigned for maxillofacial treatment (midface fractures n = 30, mandibular fractures n = 26, wisdom tooth removal n = 40) divided into treatment either with or without kinesiologic tape application.

Is bone turnover of jawbone and its possible over suppression by bisphosphonates of etiologic importance in pathogenesis of bisphosphonate-related osteonecrosis?

Purpose: The pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is not completely understood. The most popular hypothesis has suggested that the bone turnover (BT) in the jawbone is greater than that in other sites and that this turnover will be overly suppressed by bisphosphonates. Using bone scintigraphy, a simple tool for the quantitative evaluation of bone metabolism and blood flow, the goals of the present study were to determine whether the rate of bone remodeling is greater in the jaw and whether the bone BT in the jaw is differentially altered after bisphosphonate intake compared with that in other skeletal sites.

Does regular zoledronic acid change the bone turnover of the jaw in men with metastatic prostate cancer: a possible clue to the pathogenesis of bisphosphonate related osteonecrosis of the jaw?

Purpose: To find out whether the most popular pathogenesis hypothesis of the bisphosphonate (BP) related osteonecrosis of the jaw (BRONJ) is comprehensible: (1) is there a higher bone remodeling in the jaw compared with other skeletal sites? (2) Is the bone turnover (BT) of the jaw overly altered after BP intake? (3) Are there gender- or entity-specific differences in BT before and after BP intake?

Methods: Bone scintigraphies of 42 patients with prostate cancer were retrospectively analyzed (n = 21 with BP intake; n = 21 no BP). All patients received bone scintigraphy prior to the therapy and in the course of the treatment (after 12 and 24 months). Data were quantitatively analyzed using six predetermined regions of interest and compared with a breast cancer cohort.

Therapeutic elastic tape reduces morbidity after wisdom teeth removal--a clinical trial.

Objectives: Although the extraction of an impacted third molar (3M) is a routine procedure, postoperative morbidities typically include swelling, pain, and trismus. The aim of the present study was to investigate whether the application of kinesiologic tape can improve the postoperative morbidities associated with 3M surgery, thereby improving the postoperative well-being of patients.

Materials And Methods: Forty patients assigned for prospective 3M removal were randomized into two treatment groups (with/without kinesiologic tape).

Influence of kinesiologic tape on postoperative swelling, pain and trismus after zygomatico-orbital fractures.

Surgical treatment of zygomatico-orbital (ZO) fractures is a common procedure in maxillofacial surgery. Often accompanied by pain, trismus and swelling, postoperative morbidity is a major disadvantage, affecting patients' quality of life. The appliance of kinesiologic tape (KT) improves the blood and lymph flow, removing congestions of lymphatic fluid and haemorrhages.

The use of a head-mounted display in oral implantology: a feasibility study.

Purpose: To compare the accuracy of a navigation system for oral implantology using either a head-mounted display (HMD) or a monitor as a device for visualization.

Methods: Drilling experiments in plastic mandibles were performed by seven investigators supported by a navigation system using an HMD. A set of drilling experiments was carried out using a traditional monitor setup as standard of reference.

Does elastic therapeutic tape reduce postoperative swelling, pain, and trismus after open reduction and internal fixation of mandibular fractures?

Purpose: The aim of the present study was to investigate whether the application of elastic therapeutic tape (Kinesio Tape [KT]) prevents or decreases swelling, pain, and trismus after open reduction and internal fixation of mandibular fracture, thus improving patients' postoperative morbidity.

Materials And Methods: To address the research purpose, the investigators designed and implemented an open-label, monocentric, parallel-group, randomized clinical trial. Patients were prospectively assigned for treatment of unilateral mandibular fractures and randomly allocated to receive treatment with or without KT application.

Impact of radiotherapy on microsurgical reconstruction of the head and neck.

Purpose: To examine tissue oxygenation and perfusion of free microvascular grafts after primary reconstruction, regarding outcome for patients received adjuvant radiotherapy and different types of grafts.

Patients And Methods: Free microvascular grafts (n = 48) after primary reconstruction of the head and neck were examined for tissue oxygenation and perfusion over a period of 6 months. 28 patients received adjuvant radiotherapy.

Accuracy of navigated control concepts using an Er: Yag-laser for cavity preparation.

This paper describes a method for measuring the shape accuracy of a cylindrical hole which is created by means of an automatically power-controlled laser system using navigated control. In dental surgery, drills or mills are used for bone treatment. For most patients the use of these instruments is very inconvenient.

Qualitative and quantitative evaluation of bony structures based on DICOM dataset.

Purpose: The aim of this study was to investigate bone mass using different cone-beam computed tomographies (CBCTs) combined with image analysis and to determine whether bone quantity or quality was detected.

Materials And Methods: Different measurements recorded on mandible bones of pigs in the retromolar region were evaluated on ProMax 3D (Planmeca Oy, Finland) and the ILUMA™CT (IMTEC™ Imaging, Ardmore, OK) to calculate a calibration curve. The spatial relationships of pig mandible halves relative to adjacent defined anatomical structures were assessed by means of 3D visualization software.

Different CO2 laser vaporization protocols for the therapy of oral precancerous lesions and precancerous conditions: a 10-year follow-up.

Use of the CO(2) laser (λ = 10.6 μm, continuous wave, defocused) is an established procedure for the treatment of premalignant lesions. Through employment of the sp-mode as well as scanners, thermal laser effects can be reduced but, on the other hand, a lesser degree of destruction of dysplastic cells could lead to an increased recurrence rate.

Suitability of the anterolateral thigh perforator flap and the soleus perforator flap for intraoral reconstruction: a retrospective study.

Perforator flaps are suitable for numerous reconstructive purposes. However, there are few data about their usefulness for intraoral reconstruction. We reviewed data of 101 patients who were reconstructed by two types of perforator flaps after oral cancer.

Raising the osteocutaneous fibular flap for oral reconstruction with reduced tissue alteration.

Raising the osteocutaneous fibular flap offers excellent possibilities for oral reconstructive surgery but is associated with specific donor-site risks. Moreover, with inadequate surgical technique, flap-specific complications can occur, such as loss of the skin paddle or inadequate pedicle length. A flap-raising technique has been used to decrease surgical damage but provide maximal pedicle length.

Anatomical shape analysis of the mandible in Caucasian and Chinese for the production of preformed mandible reconstruction plates.

Purpose: The purpose of this study was to evaluate and analyze statistical shapes of the outer mandible contour of Caucasian and Chinese people, offering data for the production of preformed mandible reconstruction plates.

Methods: A CT-database of 925 Caucasians (male: n=463, female: n=462) and 960 Chinese (male: n=469, female: n=491) including scans of unaffected mandibles were used and imported into the 3D modeling software Voxim (IVS-Solutions, Chemnitz, Germany). Anatomical landmarks (n=22 points for both sides) were set using the 3D view along the outer contour of the mandible at the area where reconstruction plates are commonly located.

Fluorescence-guided bone resection in bisphosphonate-related osteonecrosis of the jaws: first clinical results of a prospective pilot study.

Purpose: Surgical debridement is the therapy of choice in advanced stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ). However, the therapy is currently only loosely standardized because no suitable imaging modalities exist. This study aims to redress this by exploring the suitability and reproducibility of applying a fluorescence-guided bone resection to patients with BRONJ.

Accuracy of templates for navigated implantation made by rapid prototyping with DICOM datasets of cone beam computer tomography (CBCT).

The aim of this study is to evaluate the accuracy of a surgical template-aided implant placement produced by rapid prototyping using a DICOM dataset from cone beam computer tomography (CBCT). On the basis of CBCT scans (Sirona® Galileos), a total of ten models were produced using a rapid-prototyping three-dimensional printer. On the same patients, impressions were performed to compare fitting accuracy of both methods.

Microvascular bone grafting: a new long-term solution for intraosseous arteriovenous malformations of the mandible in children.

Background: Intraosseous arteriovenous malformations (AVMs) in the maxillofacial area are rarely reported in the current literature. These malformations have been associated with severe hemorrhage resulting in significant morbidity and mortality. The recommended gold standard treatment of AVMs is an endovascular embolization, combined with surgery.

Pilot study for periodontal treatment and pregnancy outcome: a clinical prospective study.

Objective: Maternal periodontitis has been suggested as an important risk factor for preterm low birth weight. The aim of the present observational study was to assess whether full-mouth therapy of periodontitis in pregnant women reduces the risk of preterm low birth weight.

Method And Materials: From April 2006 to April 2007, 302 pregnant women who were at less than 22 weeks of gestation were invited to attend a periodontal examination.

Content of urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 in oral mucosa and inflamed periodontal tissue.

Objectives: Recent literature has demonstrated that local proteolytic enzymes participate in periodontitis and peri-implantitis. The aim of the present study was to evaluate whether the serine proteases urokinase-type plasminogen activator (uPA) and its plasminogen activator inhibitor type 1 (PAI-1) show elevated amounts in inflamed periodontal tissues as compared to healthy oral mucosa to determine if these proteins are involved in the process of periodontal breakdown.

Method And Materials: Fifty-eight patients with severe periodontitis were included in this study.