Perioperative Management in Patients With Undergoing Direct Oral Anticoagulant Therapy in Oral Surgery - A Multicentric Questionnaire Survey.

Aim: The purpose of this study was to survey the current opinions of hospitals and medical practices concerning the perioperative management of patients undergoing direct oral anticoagulant therapy (DOAC) and discuss recommendations for the clinical practice.

Materials And Methods: A questionnaire with 13 topics and multiple ordinal-polytomous subitems was designed and sent to 120 Departments of Oral and Maxillofacial Surgery in Austria, Switzerland and Germany, as well as to 85 oral and maxillofacial/oral surgeons in medical offices in Hamburg, Germany. The data were statistically evaluated by Chi-square, Fisher's exact and Jonckheere-Terpstra tests.

Repair of Occipital Bone Defects in Neurofibromatosis Type 1 by Means of CAD/CAM Prefabricated Titanium Plates.

Certain skeletal defects may develop in neurofibromatosis type 1 (NF1), a common tumor-suppressor syndrome, such as cranial lesions confined to the lambdoid suture region. Here, we report on the repair of osseous defects of occipital bone in a NF1 patient with history of skull trauma and tumorous hemorrhage. Computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted devices were applied to safely close the bone defects.

Evaluation of Periodontal Space Widening in Patients with Antiresorptive Drug-related Osteonecrosis of the Jaws (ARONJ) on Panoramic Radiographs.

Background/aim: The purpose of this study was to evaluate a potential widening of the periodontal space as an initial measurable imaging criterium on panoramic radiographs in patients with the diagnosis of antiresorptive drug related osteonecrosis of the jaw (ARONJ).

Patients And Methods: A retrospective analysis of panoramic radiographs of 16 patients (12 females and 4 males; mean age is 70.5 years, standard deviation is 14 years) was performed, over a period of 12 months with the diagnosis of ARONJ.

Sensitivity and specificity of sentinel lymph node biopsy in patients with oral squamous cell carcinomas using indocyanine green fluorescence imaging.

Purpose: The purpose of this clinical study was to evaluate the sensitivity and specificity of cervical sentinel lymph node biopsy after mapping with indocyanine green fluorescence (ICG) for imaging early-stage oral cancer.

Patients And Methods: A sentinel lymph node biopsy (SLNB) was performed during a selective neck dissection (SND) in 20 patients with oral squamous cell carcinoma (OSCC, cT1 or cT2, N0 status). The sentinel lymph nodes (SLN) were identified using an infrared video camera after ICG injection.

Functional donor site morbidity longer than one year after fibula free flap: A prospective biomechanical analysis.

Objectives: The fibula free flap is the workhorse procedure for osseous reconstruction. The objective of this study was to investigate long-term functional outcomes of the harvesting site.

Patients And Methods: About 19 patients (10 male, 9 female, mean age 58.

Obstacles in spatial evaluation of CBCT-reformatted panoramic imaging.

Objectives: Conventional panoramic radiography (cPR) underlines procedure-related limitations in the display of objects. CBCT is presumed to overcome these constraints. To virtualize a cPR view, reformatted panoramic images (rPIs) can be generated.

Prospective biomechanical evaluation of donor site morbidity after radial forearm free flap.

Although the radial forearm free flap (RFF) is a commonly-used microvascular flap for orofacial reconstruction, we are aware of few prospective biomechanical studies of the donor site. We have therefore evaluated the donor site morbidity biomechanically of 30 consecutive RFF for orofacial reconstruction preoperatively and three months postoperatively. This included the Mayo wrist score, the Disabilities of the Arm, Shoulder and Hand (DASH) score, grip strength, followed by tip pinch, key pinch, palmar pinch, and range of movement of the wrist.

Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy.

Objectives: The purpose of this study was to assess the risk of postoperative bleeding complications after oral procedures performed under continued mono or dual anticoagulation therapy with rivaroxaban (and aspirin).

Methods: This retrospective single-center observational study included 52 oral procedures performed under continued oral anticoagulant therapy with rivaroxaban (20 mg/day). Among them, two procedures were performed under continued dual therapy with aspirin (100 mg/day) added to the regimen.

Long-term biomechanical analysis of donor site morbidity after radial forearm free flap.

Background: Although the radial forearm free flap (RFF) is a commonly used microvascular graft for head and neck reconstruction, long-term biomechanical results regarding donor site morbidity are rare.

Patients And Methods: In a prospective panel study, 32 patients were included. Biomechanical assessment was performed preoperatively, three months postoperatively and two years postoperatively.

Thromboelastometry: A contribution to perioperative free-flap management.

Background: Microvascular tissue transfer is a fundamental part of reconstructive surgery. Different perioperative anticoagulation regimens exist, influencing hemostatic parameters. Since bleeding and thrombosis are major reasons for revision procedures and flap loss, current practice regarding anticoagulative treatment needs further refinement.

Intraosseous heat generation during sonic, ultrasonic and conventional osteotomy.

Objectives: To assess heat generation in osteotomies during application of sonic and ultrasonic saws compared to conventional bur.

Methods: Two glass-fiber isolated nickel-chromium thermocouples, connected to a recording device, were inserted into fresh bovine rib bone blocks and kept in 20 ± 0.5 °C water at determined depths of 1.

Linear accuracy and reliability of volume data sets acquired by two CBCT-devices and an MSCT using virtual models: a comparative in-vitro study.

Objective: To discriminate clinically relevant aberrance, the accuracy of linear measurements in three-dimensional (3D) reconstructed datasets was investigated.

Materials And Methods: Three partly edentulous human skulls were examined. Landmarks were defined prior to acquisition.

Postoperative bleeding risk for oral surgery under continued clopidogrel antiplatelet therapy.

Object: To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group.

Imaging of the midfacial and orbital trauma.

The severity of midfacial and orbital injuries depends on the one hand on cause, force vector, load point, or area and on the other hand on the bony and soft tissue resistance as well as individual anatomy. These variables result in a variety of possible injuries of the midfacial and orbital complex. The time critical choice of an adequate imaging modality of these injuries is influenced by the possible severity of concomitant injuries.

Impact of malpositioning on panoramic radiography in implant dentistry.

Objectives: The widely used panoramic radiography as a special kind of tomography underlies intrinsic procedural restrictions such as poor definition, inconsistent magnification, geometric distortion and spatial depositioning of objects situated outside the focal trough. This results in a non-anatomic display of the radiographed anatomic structures. Individual mandibular angle and width of the jaws, adjustment of the focal trough, jaw incongruence as well as patient positioning increase the inconsistency in display of the radiographed objects.

Squamous cell carcinoma of the oral cavity and circulating tumour cells.

Due to a lack of substantial improvement in the outcome of patients suffering from oral squamous cell carcinoma (OSCC) during the past decades, current staging methods need to be revised. This disease is associated with poor survival rates despite considerable advances in diagnosis and treatment. The early detection of metastases is an important indicator of survival, prognosis and relapse.

Prognostic relevance of circulating tumor cells in blood and disseminated tumor cells in bone marrow of patients with squamous cell carcinoma of the oral cavity.

Purpose: Current staging methods for squamous cell carcinomas (SCC) of the oral cavity (OSCC) need to be improved to predict the risk of individual patients. Because hematogenous tumor cell dissemination is a key event in tumor progression, we assessed the prognostic significance of disseminated tumor cells (DTC) in bone marrow and circulating tumor cells (CTC) in peripheral blood from patients with OSCC.

Experimental Design: From 110 patients with OSCC, tumors were surgically resected (R0) without neoadjuvant therapy.

Incidence of bisphosphonate-related osteonecrosis of the jaw in consideration of primary diseases and concomitant therapies.

Background: Since its first description by Marx in 2003, the etiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the subject of numerous scientific discussions for oral and maxillofacial surgeons. Many retrospective studies on its etiology and pathogenesis have been carried out to explain pathological mechanisms; most of them just take a close look at the issue of dosage and application. Recently, attempts have been made, to identify co-factors which might promote the development of BRONJ.

Immunohistochemical and FISH analysis of EGFR and its prognostic value in patients with oral squamous cell carcinoma.

Objectives: To study immunohistochemical expression of the epithelial growth factor receptor (EGFR) in oral carcinomas and the head and neck region to examine possible associations with various features of the tumors and survival of the patients.

Materials And Methods: Sections were made from two tissue arrays composed of 206 oral squamous cell carcinomas and 427 squamous cell carcinomas of the head and neck region, respectively, and examined for EGFR expression and Ki-67 labeling index by means of immunohistochemistry, and for EGFR gene amplification by means of fluorescence in situ hybridization. Correlation between resulting parameters and with clinical features was evaluated using chi-square test and Kaplan-Meyer analysis.

Intraoperative efficiency of fluorescence imaging by Visually Enhanced Lesion Scope (VELscope) in patients with bisphosphonate related osteonecrosis of the jaw (BRONJ).

Objectives: The purpose of this study was to determine the potential of tissue fluorescence imaging by using Visually Enhanced Lesion Scope (VELscope) for the detection of osteonecrosis of the jaw induced by bisphosphonates (BRONJ).

Methods: We investigated 20 patients (11 females and 9 males; mean age 74 years, standard deviation ± 6.4 years), over a period of 18 month with the diagnosis of BRONJ in this prospective cohort study.

Hematoma growth and outcome in treated neurocritical care patients with intracerebral hemorrhage related to oral anticoagulant therapy: comparison of acute treatment strategies using vitamin K, fresh frozen plasma, and prothrombin complex concentrates.

Background And Purpose: Intracerebral hemorrhage (ICH) is the most serious and potentially fatal complication of oral anticoagulant therapy (OAT). Still, there are no universally accepted treatment regimens for patients with OAT-ICH, and randomized controlled trials do not exist. The aim of the present study was to compare the acute treatment strategies of OAT-associated ICH using vitamin K (VAK), fresh frozen plasma (FFP), and prothrombin complex concentrates (PCCs) with regard to hematoma growth and outcome.

Comparison of ABC/2 estimation technique to computer-assisted planimetric analysis in warfarin-related intracerebral parenchymal hemorrhage.

Background And Purpose: The ABC/2 formula is a reliable estimation technique of intracerebral hematoma volume. However, oral anticoagulant therapy (OAT)-related intracerebral hemorrhage (ICH) compared with primary ICH is based on a different pathophysiological mechanism, and various shapes of hematomas are more likely to occur. Our objective was to validate the ABC/2 technique based on analyses of the hematoma shapes in OAT-related ICH.