Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

: To evaluate the impact of orthognathic surgery on the quality of life, and to compare single and double-jaw surgeries in terms of ratio and patient's perception about the postoperative period.

This study investigated the association of computed tomography (CT)-verified degenerative condylar changes with disk displacement (DD) and gender.

Ameloblastoma is the most clinically significant benign odontogenic tumor of the jaws. Ameloblastomas have a locally aggressive growth pattern and a high rate of malignant transformation. The etiopathogenesis of ameloblastoma is still unknown, and there is still a paucity of information on the factors regulating the locally aggressive growth characteristics of ameloblastoma. Hypoxia and autophagy are 2 mechanistic processes associated with tumor behavior as several tumor cells induce a hypoxic microenvironment to survive.

The immunomodulatory and antiangiogenic effects of thalidomide have been demonstrated in a number of refractory ulcerative oromucosal conditions, including recurrent aphthous stomatitis (RAS), Behçet disease, erythema multiforme (EM), erosive lichen planus, and orofacial granulomatosis (OFG). Thalidomide acts by modulating the inflammatory cascade, interacting with various cytokines, including tumor necrosis factor-α, interleukin 10, and cyclooxygenase 2. Despite its efficacy, thalidomide is associated with a number of risks, including peripheral neuropathy, thromboembolic disease, and embryofetal toxicity, which limit its clinical use.

The aims of this study were as follows: (1) to review the learning impact of The Oral Cavity: Portal to Health and Disease (TOC), a massive open online course in oral medicine developed by Penn Dental Medicine using the Coursera platform; and (2) to analyze course enrollment to determine worldwide interest in accessible, high-quality oral medicine education.

Given the evolving drug therapy options and consequent opportunistic infections, antifungal drug resistance is a major concern in patients with human immunodeficiency virus (HIV) undergoing highly active antiretroviral therapy (HAART), prompting the need for clinically relevant antifungal susceptibility testing. The goals of the present study were to determine the asymptomatic oral fungal carriage and species distribution in patients with HIV infection receiving HAART in Kerala State, India, and to evaluate the antifungal susceptibility/resistance profile of these oral fungal isolates.

We sought to determine potential differences in the humoral immune response to herpes simplex virus type 1 (HSV-1) in patients after primary infection in either oral or genital sites.

Several lesions of diverse origin may be detected in the oral cavity of young children, affecting the oral mucosa, jaws, or teeth. Their clinicopathologic features may show considerable overlap. We present an interesting case of a “ringlike hard mass” of initially unknown nature around the cervical area of a primary tooth in a young child, and we discuss the diagnostic challenges.

Osteonecrosis of the jaw (ONJ) is necrosis of mandibular or maxillary bone, which may lead to bone exposure, regardless of the etiology. It is thought to be attributed to insufficient blood supply and altered bone turnover, resulting in a disrupted repair process and eventually leading to the collapse of bone in the setting of microfractures. We report what is, to the best of our knowledge, the first case of ONJ secondary to stem cell transplant (SCT).

Ameloblastoma is a benign but aggressive odontogenic tumor of the jaws that may be divided into unicystic and multicystic/solid histologic subtypes. Unicystic lesions can be further subdivided based on the presence of mural involvement of the surrounding bone, and these classifications are important in directing treatment. Ameloblastomas are relatively rare in the pediatric population and there remains controversy surrounding their management in these patients. Classically, pediatric ameloblastomas have been reported as presenting with the unicystic subtype the majority of the time (76.5%),1 yet recurrence rates in pediatric ameloblastomas have been reported to be much higher than recurrence rates for ameloblastoma overall.

Chronic inflammation caused by infection may lead to the production of proinflammatory cytokines (PICs) that can cause DNA damage and cell proliferation, thus playing a role in carcinogenesis. Candida infection has been reported to be increased in oral leukoplakia (OL) and is associated with an increased rate of malignant transformation into oral squamous cell carcinoma (OSCC). In vitro studies have demonstrated that the interactions between Candida and the oral epithelium lead to the release of PICs (interleukin [IL]-6, IL-8.

This article describes a novel technique for replacing the temporomandibular joint (TMJ) with a prosthesis. The technique applies a simple endaural incision to approach the temporomandibular joint in order to place a total joint prosthesis. This is followed by small trochar site incisions for plating of the prosthesis. The technique was performed on 4 patients (8 TMJs). The potential benefits and complications of this approach are discussed throughout the article.

Social factors have been implicated in the development of various peri-implant pathologies, including implant failure. This study aims to investigate whether varying levels of alcohol consumption affects late dental implant failures.

Neurotoxin injection into muscles to reduce movement or pain has seen increasing use and study. For orofacial pain, however, patient selection factors and long-term efficacy are not well characterized. The objective of the present study was to describe the clinical characteristics and effects in a series of patients with temporomandibular disorder [TMD] pain who had received multiple masseter neurotoxin injections over the course of years.

On January 7, 2020, China reported a group of cases of pneumonia caused by the novel coronavirus 2019 (COVID-19). This novel virus spread rapidly to other countries. As of August 2020, there are close to 6 million diagnosed cases in the United States and 460,000 diagnosed cases in New York State. The purpose of this article is to examine the psychological impact of the COVID-19 outbreak on trainees in a New York City hospital. To achieve this goal, trainees of the Brooklyn Hospital Center were sent a questionnaire via e-mail.

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease. It has been related to hepatitis C virus (HCV) infection as one of the extrahepatic pathologic manifestations. The current treatment for HCV infection with direct-acting antivirals (DAAs) is highly effective and safe. This study aimed to evaluate the impact of HCV eradication on OLP clinical manifestations.

Three-dimensional surgical planning (3-DSP) is becoming commonplace in the management of benign and malignant disease for oral and maxillofacial surgery practice within the last decade.1 In pathologic resections of the head and neck cysts and tumors in particular, a virtual wrap is used to delineate the tumor resection margin. However, there has yet to be a study in regard to the accuracy of this wrap and its effect on bony margin status. This study aims to discuss our experiences with the use of wraps created with 3-DSP and explore the accuracy of the wrap for margin status.

We sought to determine whether the nomenclature, disease definition, and diagnostic criteria for burning mouth syndrome (BMS) should be revised on the basis of expert agreement using the Delphi method of consensus.

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 (severe acute respiratory disorder 2) has emerged as the primary global health concern of 2020. Oral and maxillofacial surgery (OMS) residents, like other health care personnel, have been on the front line providing care to SARS-CoV-2-negative and SARS-CoV-2-positive patients across the United States. As surgeons of the head and neck, OMS residents may be at an increased risk of infection; however, little is known about the prevalence of SARS-CoV-2 infection among OMS residents across the United States.

Proliferative fasciitis is a benign and reactive lesion involving fibroblasts in the subcutaneous tissues and deep fascia, with a rare occurrence in the head and neck region. It is considered a variant of nodular fasciitis, which could involve trauma as an etiology. Proliferative fasciitis mostly occurs in adults, but cases in children have been reported. Clinically, it can present as an aggressive lesion with pain or no symptoms, mimicking sarcomas.

The purpose of this study was to test whether the placement of a standardized cleaning protocol in oral and maxillofacial surgery operatories could effectively reduce MRSA (methicillin-resistant Staphylococcus aureus) colonization rates on operatory surfaces.

The practice of giving feedback has never been evaluated in OMS (oral and maxillofacial surgery) education. The aim of this study was to characterize variations in feedback-giving strategies utilized in resident education and compare this to their preferred ways of receiving feedback. As a secondary aim, we wish to gauge residents’ satisfaction with the feedback they receive. As a tertiary aim, we wish to compare residents’ and attendings’ perception of said feedback.

The timing of ideal repair of the cleft nasal deformity has been a contentious topic among craniomaxillofacial surgeons over the last several decades. Several tissues are adversely affected, from bone through the vestibule, cartilage, and external skin. While surgical techniques, paradigms and philosophies have evolved, several important considerations are factored into the clinical decision making to perform a rhinoplasty at the time of cleft repair, such as growth interruption and several craniofacial growth centers, scarring, and the predicted aesthetic result at growth maturity.

Studies have indicated that cases of HPV-associated squamous cell carcinoma (SCC) in the oropharynx and the oral cavity are on the rise. However, the distribution of human papilloma virus (HPV) in different sites of the oral cavity affected by oral SCC (OSSC) has not been well characterized. The present study was designed to investigate the anatomic sites of HPV-16 infection associated with OSCC in the oral cavity and correlate HPV-16 positivity with tumor suppressor gene expression and clinical/pathologic features of OSCC.

A 58-year-old female presented with an asymptomatic mild buccal cortical expansion between teeth #29 and #30. Her medical history was unremarkable. A periapical x-ray, panoramic radiograph, and computed tomography scan were taken (Figures 1-3). Upon surgical excision, a solid mass was removed and submitted for microscopic examination.

We sought to analyze the types and quantity of dry mouth products patients use as well as the reported dry mouth symptom severity and frequency in relation to salivary flows. We hypothesized that respondents with higher stimulated flow would report better responses to products that stimulate flow.

A 70-year-old man presented to the University of Michigan School of Dentistry Oral Medicine Clinic with a 6-month history of “raw burning pain” in the left posterior mandible compromising his ability to eat and speak. He denied trauma or placement of any products in the area. The patient had a 10-year history of primary focal segmental glomerulosclerosis for which mycophenolate mofetil (CellCept) was being taken at a dose of 1500 mg bid. The patient also had a history of myocardial infarction 12 years prior, a total knee arthroplasty because of osteoarthritis 6 years prior, and gastroesophageal reflux disease.

Intraoral trays can be used to deliver treatment materials and medications for dental or mucosal conditions. Maintaining appropriate salivary levels of the active ingredient is challenging when using local application. We have previously analyzed salivary levels and local effects of slow-release varnishes (with clotrimazole or sirolimus as the active ingredient) during the daytime. The aims of the present study were as follows: (1) to optimize overnight appliances for slow-release medications by measuring saliva and blood levels and (2) to evaluate the safety of overnight use.

The patient was a 50-year-old male with a social history significant for heavy smoking of many years’ duration. On intraoral exam, the right buccal mucosa displayed multiple scattered areas of pigmentation that vary in size, shape, and intensity of color with 2 areas of overlying leukoplakia that were relatively well defined (Figure 1). There was also a solitary oval pigmented lesion that was heterogeneous in color on the left soft palate (Figure 2). Because of the patient's social history, the clinician was concerned about the leukoplakias on the right buccal mucosa, which prompted an incisional biopsy of the anterior and posterior leukoplakic areas.

Advanced dental and oral health conditions disproportionately affect racial and ethnic minority patients and patients of low socioeconomic status. The impact that the geographic distribution of dentists has on these disparities is largely unknown. The aims of this study were to map the geographic distribution of dentists within the United States at the county level and to determine whether this distribution explains a component of the observed health disparities.

A 19-year-old African American female presented with facial asymmetry and prominent left facial swelling for 2 years. The patient reported loss in her sense of smell and blurred vision as well as 2 episodes of severe headaches shortly before presentation. She also indicated little to no improvement when she used medications for headaches. On physical examination, facial asymmetry with bulging left maxillary bone and left upward proptosis was noted. Extraocular muscle movement and cranial nerves II-XII were grossly intact and symmetrical.

Oral lichen planus (OLP) is a chronic disease with immune-mediated pathogenesis. Selenium (Se), an antioxidant, plays a role in modulating immunity. The aim of this clinical trial was to evaluate 2 Se forms (novel topical hydrogel and oral capsules), solely, in treating erosive OLP based on clinical evaluation and salivary oxidative stress markers. To date, to our knowledge, this is the first study to evaluate the role of Se solely in treating erosive lesions associated with erosive OLP. This clinical trial has been registered in the Cochrane Database under registry number PACTR201901531815403.

A 62-year-old female presented to the emergency clinic with a carious and symptomatic mandibular second molar (tooth #18). Incidentally, a nodule was noted on her upper lip (Figure 1). According to the patient, the asymptomatic nodule had been present for several years with little change in size. Upon clinical examination, the nodule was firm and palpable from both the cutaneous and the mucosal aspects, revealing that it was centered within the substance of the lip.

Osteoblast deficiency is a key problem in bone tissue engineering, and transplant of mesenchymal stem cells combined with osteoblasts can achieve ideal results. We sought to investigate the in vivo ectopic osteogenesis of adipose-derived mesenchymal stem cells (ADSCs) and osteoblasts (OBs) combined with poly(l-lactic acid) (PLLA)/hydroxyapatite (HAp) nanostructured aerogel scaffolds.

A 30-year-old Hispanic male presented to an oral surgeon with a 2.5 cm × 1 cm ulcerated nodular mass on the right lateral hard palate (Figure 1). The mass extended from the lateral palatal margin to the midline and antero-posteriorly from the rugae to the distal aspect of tooth #2. The surface was ulcerated and covered by a yellow fibrinous exudate focally with a violaceous erythematous pigmentation in other areas. The mass had raised borders and was painful and tender to palpation. As per the patient, the mass was present for a month, and he thought he had burnt the roof of his mouth after consumption of pizza.

The objective of this study was to analyze use patterns of prescription sialagogues for management of xerostomia in patients with chronic graft-vs-host disease (cGVHD) after allogeneic hematopoietic cell transplant (allo-HSCT).

The true global prevalence of pediatric oral mucosal disease has historically proved difficult to determine, based on heterogeneity and inherent limitations in study designs and a largely descriptive narrative. The 2019 World Workshop on Oral Medicine VII: Relative Frequency of Oral Mucosal Lesions in Children, a Scoping Review quantified pediatric oral mucosal disease experience globally based on pooled and region-specific data from clinical studies and biopsy reports. The aim of this investigation was to retrospectively review clinical data to compare pediatric disease experience in a tertiary joint pediatric-oral medicine clinic at the Royal National ENT and Eastman Dental Hospital, UCLH, London, UK, with published global data from the world workshop.

The purpose of this study was to examine the relationships between subjective taste sensations and electrogustometry (EGM) results in patients with taste disorders according to the presence of burning mouth symptoms.

Oral squamous cell carcinoma is the most common multistep malignant tumor affecting the oral cavity. One of the most aggressive variants of this neoplasm is the basaloid squamous carcinoma. The cancer-associated fibroblasts in the tumor microenvironment are now the focus of intense research and are believed to correlate with poor prognosis. They are characterized by α-smooth muscle actin (α-SMA) expression, which is a myofibroblast marker. The aims of the present study were as follows: (1) to evaluate the role of α-SMA in the progression of both neoplasms, (2) to study the prevalence of this marker with different grades of this neoplasia, and (3) to determine the immunoreactive localization of α-SMA in the lymph nodes of patients with these tumors.

Intravascular papillary endothelial hyperplasia, or Masson tumor, is a benign lesion of the head and neck region. The etiology of the lesion arises within a blood vessel and is thought to be reactive and associated with vascular injury. Masson tumors comprise approximately 2% of all vascular tumors of skin and subcutaneous tissues; however, this is rarely seen intraorally. It is important to consider at the time of differential diagnosis to distinguish from malignancy and avoid aggressive surgery or unnecessary treatment.

Analysis of inflammatory biomarkers in saliva could offer an attractive opportunity for the diagnosis of different systemic conditions specifically in epidemiologic surveys. The aim of this study was to investigate if certain salivary biomarkers could be used for detection of common systemic diseases.

Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy causing amino acid substitution in the B-hemoglobin chain of erythrocytes. SCD affects 1 in 500 African American children. SCD is associated with multiorgan morbidity and significant reduction in life expectancy. Vaso-occlusive crisis associated with SCD is characterized by acute pain and local tissue hypoxia and necrosis. The extremities, back, and chest are frequently affected, and jaw involvement is very rare. To the best of our knowledge, only 3 cases of jaw osteonecrosis secondary to SCD have been reported in the English-language literature.

Research has shown an increasing number of adolescent patients who present with somatization of pain disorders. The importance of assessing a patient's psychological and behavioral status in diagnosing temporomandibular disorder (TMD) has been explored in adults; however, its application in adolescents is unclear. The objectives of this study are to determine the association between psychosocial stress and TMD among adolescents and to further investigate the type of psychosocial stress that has the highest impact on this population.

Primary Sjögren syndrome (pSS) is a chronic autoimmune disease mainly affecting women over the age of 40, causing dry mouth and eyes. The etiology of pSS is complex and includes the overexpression of inflammatory cytokines from affected salivary gland epithelial cells (SGECs). Our group has previously identified candidate biomarkers overexpressed in salivary gland tissues of patients with pSS. We showed that ETS proto-oncogene 1 (ETS1) had higher mRNA and protein expression in pSS salivary glands that correlated with higher levels of lymphocytic infiltration.

A 60-year-old male came to the oral medicine clinic to evaluate his non-healing oral sores, which had persisted for 12 months. He complained of painful tongue ulcers that affected his ability to eat and contributed to a 35-pound weight loss over the last 5 months. The patient reported fatigue in the last 3 months, accompanied by a 5-week history of skin abnormalities. He also had a brief history of a scrotal lesion in the past. The patient had been evaluated and treated by multiple providers throughout the past year without positive outcomes.

I am delighted to introduce Antonia (Toni) Kolokythas, DDS, MSc, MSed, FACS, as the new Oral Surgery Section Editor for Triple O. Dr. Kolokythas is currently the Department Head and Program Director of Oral and Maxillofacial Surgery at the University of Rochester. After earning a dental degree at the University of Thessaloniki in Greece, she completed her residency training in Oral and Maxillofacial Surgery at the University of Illinois at Chicago (UIC), followed by two surgical fellowships in Head and Neck-Maxillofacial Oncology and Reconstruction at the University of Maryland at Baltimore and the University of California at San Francisco.