Publications by authors named "Jerry Kwok"

The development of normal occlusion requires eruptive migration of teeth from their developmental position in the jaw into a functional position within the oral cavity. This process involves significant and coordinated movement in an axial direction and appropriate eruption through the gingival tissues. The mechanisms regulating these developmental events are poorly understood, and teeth retain eruptive potential throughout their lifespan.

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Background Patients taking oral anticoagulants (OACs) and oral antiplatelets (OAPs) have a risk of post-operative bleeding when dental extractions are required. Guidance exists to assist dental practitioners on how best to clinically manage these patients, but this is based upon low-quality evidence. The current service evaluation provides real world clinical data when these drugs are not discontinued for oral surgery procedures.

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Background: Osteoradionecrosis (ORN) of the jaws remains one of the most debilitating complications of radiotherapy (RT) in patients with head and neck cancer (HNC). Liquid pentoxifylline and vitamin E (PVe) presents an alternative formulation to tablets for patients with dysphagia or enteric feeding.

Objective: This study aimed to assess the clinical outcomes of using a liquid formulation of PVe for both established ORN and as a prophylaxis to avoid its occurrence after dental extractions.

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Objective: To evaluate the survival rates of dental implants placed in patients with head and neck pathologies treated with resective surgery with or without free flap reconstruction, radiotherapy alone, and/or chemotherapy.

Study Design: In this study, we retrospectively analyzed the survival of intraoral dental implants placed by the same surgeon over a 12-year period from 2007 to 2019. These implants were followed up clinically and radiographically for a period of 36 months postoperatively and throughout the restorative phase.

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Objective: Osteoradionecrosis (ORN) of the jaw is preceded by dental extractions in up to 10% of cases. We present a case series of post-radiotherapy patients undergoing dental extractions who have received the prophylactic antifibrotic agents pentoxifylline and vitamin E (PVe) to prevent ORN.

Study Design: A retrospective review was conducted of 219 patients with head and neck cancer (HNC) undergoing 1079 dental extractions between 2009 and 2020.

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Patients due to commence head and neck radiation treatment are expected to undergo a dental assessment and be deemed 'dentally fit'. Though this intervention is welcomed by the dental fraternity it is not without its challenges especially in human papilloma virus (HPV) related oropharyngeal cancer (OPC) which has seen a phenomenal rise over the past decade. This perspective piece presents these challenges and proposes a potential adaption of the dental assessment for HPV OPC patients though not necessarily exclusive to this tumour sub-site.

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Objectives: Dental rehabilitation post-radiotherapy often requires the consideration of dental implants. However, these are tentatively prescribed due to the concern of hypovascularisation and possible osteoradionecrosis. Hence, the current study assessed the microvasculature of the dento-alveolar bone at implant sites taking into consideration the exact radiotherapy dose received to the region.

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Objective: Diffuse sclerosing osteomyelitis (DSO) is a poorly understood chronic inflammatory disease, for which many etiologic theories and treatment modalities have been suggested. We retrospectively evaluated bisphosphonate treatment outcomes in patients with DSO and compared them with those of alternative treatment modalities and those reported in the current literature.

Study Design: This series was a retrospective analysis of patients diagnosed with DSO of the mandible.

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Introduction: The purpose of this retrospective study was to evaluate 34 years' experience of autotransplantation of teeth during orthodontic treatment.

Methodology: Treatment was completed at Queen Mary's Hospital, Sidcup, Kent, UK, during the period 1969-2003. A total of 366 teeth were transplanted in 314 patients.

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Background: Coronectomy has become an increasingly prescribed surgical treatment for mandibular third molars that are deemed to pose a risk to the inferior dental nerve. Retention of the roots poses a risk of need for root retrieval in the future if symptoms are present. Long-term outcomes and the symptoms that lead to root retrieval via coronectomy have not been well documented or studied, and this has understandably led to hesitation in some clinicians in offering the procedure.

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Axitinib-related osteonecrosis of the jaw.

Oral Surg Oral Med Oral Pathol Oral Radiol

November 2017

Tyrosine kinase inhibitors (TKIs) are oral chemotherapy drugs used primarily to treat leukemias, renal cell carcinomas, gastrointestinal stromal tumors, and neuroendocrine tumors. Within this group, a number of drugs have already been implicated in jaw necrosis. Axitinib (Inlyta) is a novel TKI currently licensed for the treatment of renal cell carcinoma.

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Purpose: To determine the long-term survival and outcomes of 252 autotransplanted teeth with a novel root canal therapy (RCT) and follow-up protocol and to establish whether elective RCT after autotransplantation is routinely required for teeth with complete root formation.

Patients And Methods: A retrospective analysis of 209 patients 10 to 58 years old, with a total of 252 autotransplants was carried out with a minimum observational period of 1 year and a maximum period of 29 years. Patients were reviewed at specified intervals.

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Objective: This large case series retrospectively reviewed the outcomes of coronectomy in conjunction with dentigerous cyst removal in 68 patients at the oral surgery department of Guy's Hospital.

Study Design: A retrospective review of 68 patients was undertaken in a single department where 73 teeth with associated dentigerous cysts were treated by coronectomy to reduce the risk of inferior alveolar nerve injury or mandibular fracture.

Results: One patient experienced permanent injury of the inferior alveolar nerve.

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Objectives: To analyze clinical features, dosimetric parameters, and outcomes of osteoradionecrosis (ORN).

Study Design: Thirty-six patients with ORN who had been previously treated with radiotherapy (RT) were retrospectively identified between January 2009 and April 2014. ORN volumes were contoured on planning computed tomography (CT) scans.

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Osteoradionecrosis (ORN) is a complication seen intermittently in patients who have had radiotherapy to the head and neck, and results of treatment with pentoxifylline and tocopherol (PVe) have been encouraging. As a consequence, some argue that this should be used prophylactically to lower the risk of ORN after dental extractions in this group. We retrospectively analysed data on 390 dental extractions in 82 patients who had had radiotherapy for cancer of the head and neck.

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Article Synopsis
  • Osteoradionecrosis (ORN) is a serious complication of radiotherapy that is challenging to treat after it occurs.
  • Recent research suggests that using pentoxifylline and vitamin E may help manage ORN effectively.
  • A study of 62 patients showed a 56% success rate with just pentoxifylline and vitamin E, but only a 27% success rate when combined with antibiotics, indicating the need for further randomized clinical trials to compare these treatments.
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Introduction: Antimicrobial resistance is a growing problem that is likely to have a major negative impact on healthcare in the future. Dentists have a key role in ensuring that antimicrobials are prescribed correctly to reduce the emergence of resistant strains.

Objective: To audit how appropriately antimicrobials were prescribed in the oral surgery acute dental department of Guy's Hospital in London, when compared to the standards set within the Faculty of General Dental Practice (UK) and Scottish Dental Clinical Effectiveness guidelines on antimicrobial prescribing in dentistry.

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There is a resurgence of interest in coronectomy for the management of mandibular third molars because it has a low risk of injury to the inferior dental nerve. However, there is concern that the root that is left in place will eventually become a source of infection. We describe the histological evaluation of 26 consecutive symptomatic coronectomy roots in 21 patients.

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Background Context: Nonsurgical rehabilitation therapy is a commonly used strategy to treat chronic low back pain (LBP). The selection of the most appropriate therapeutic options is still a big challenge in clinical practices. Surface electromyography (sEMG) topography has been proposed to be an objective assessment of LBP rehabilitation.

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Unlabelled: Coronectomy of mandibular third molars is a well established technique that is going through a resurgence as it seems to reduce the risk of inferior dental nerve (IDN) injury. The reservation with the technique arises because of fear that the retained root will become infected and symptomatic over time. General dental practitioners will be responsible for the long-term review and care of these patients and, consequently, it is important that they are aware of the technique and its sequelae.

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There is a resurgence of interest in coronectomy, but its appropriate application in the management of third molar teeth has yet to be defined. Dentigerous cysts associated with unerupted teeth are most commonly associated with mandibular third molars. In this case series we evaluate outcome after coronectomy of teeth with associated dentigerous cysts in cases where the inferior dental nerve was thought to be at risk, or there was an increased risk of mandibular fracture.

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Coronectomy was developed to reduce the incidence of iatrogenic injury to the inferior dental nerve, which can be a result of routine mandibular third molar surgery, but it is not widely accepted despite early studies that all showed positive results. This two-part paper looks at the technique in more detail to help clinicians gain a better understanding of the procedure. The first part dealt in detail with technical aspects.

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Coronectomy is a technique that reduces morbidity of the nerve after operation on high-risk mandibular third molars. This two-part paper aims to give an overview of the technique and a description of common problems that can be encountered during and after operation. In this paper we discuss the technique as an overview and then each type of impaction more specifically.

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