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OBJECTIVE: The study's purpose was to compare the quality of life (QoL) in oncologic patients treated with different rehabilitation protocols following maxillary tumor resections. PATIENTS AND METHODS: The patients were divided into three groups. Group A: 18 patients with maxillary obturator prosthesis. Group B: 17 patients with simultaneous autologous tissue reconstruction. Group C: 12 patients with prosthesis on zygomatic implants. The post-operative QoL was compared using standard questionnaires, investigating items like pain, mood, social relations, and specific functions that could potentially compromise the post-operative QoL. A secondary analysis compared reconstructed vs. non-reconstructed pa-tients. RESULTS: Most questionnaire items did not show significant differences among groups. Statistically significant outcomes were found in two parameters (social contact and sexuality), in which patients treated with zygomatic implants had the best satisfaction, and patients with obturator prostheses showed the lowest satisfaction. Patients belonging to the non-reconstructed group showed better moods than those in the reconstructed group, while taste problem complaints and pain were lower in the reconstructed group. CONCLUSIONS: Although the type of reconstruction procedure depends on the type of maxillectomy to be performed and on the general health situation of each patient, the impact of the rehabilitation protocol on the patients' QoL should be accounted for when planning the treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Zygomatic implant insertion surgery is a challenging operation. The primary aim of this pilot study was to assess the accuracy of EZgoma® "Inverted Support Technique" for the zygomatic implant-guided surgery. Secondly, any factors which may affect the surgical protocol results, such as implant-prosthetic virtual plan, surgical model matching, intra or post-operative complications, time rate between surgical procedure and prosthetic loading, zygomatic implant survival rate and implant success rate were analyzed. PATIENTS AND METHODS: A total of 20 zygomatic implants were placed in atrophic maxillae of 5 patients. The final position of zygomatic implants after surgery was compared with the pre-operative digitally planned position. The analyzed parameters were zygomatic implants apex and base mean linear distance and zygomatic implants axis mean angular deviation. RESULTS: The comparison was provided by a tridimensional imaging elaboration platform, provided by Geomagic, which allows the overlay of virtual plan STL data with post-operative control CT scan DICOM data. As a result, all the mean values regarding the 20 placed zygomatic implants respected the universally agreed values in guided zygomatic implant surgery: the mean linear distance of the implant platform and of the implant apex were 1.59 mm and 1.62 mm respectively, while the mean angular deviation of the implant axis was equal to 1.74°. One of the patients had mucositis as a post-operative complication. In one patient the anterior wall of the maxillary sinus fractured, and in one zygomatic implant primary stabilization was not achieved. No other complications occurred. CONCLUSIONS: As a conclusion, data obtained from this study suggested that guided zygomatic implant rehabilitation may represent a reliable, efficient, rapid, ergonomie, and safe surgical protocol, however further investigations are needed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To contribute toward the identification of population-based clinical and histopathological profile of oral squamous cell carcinoma (OSCC), this study was undertaken at the Regional Cancer Centre of Odisha (AHRCC), India. PATIENTS AND METHODS: This retrospective study included all patients diagnosed with OSCC registered at AHRCC, Odisha from 1st January 2015 to 31st December 2018. Demographic, clinical, and pathological data of each patient were retrieved from patient records. Patients with incomplete records were excluded. No postoperative treatment details were collected. RESULTS: The study included 851 cases of OSCC with the mean age of the population found to be 53.8±14.2 years. Male to female ratio was found to be 2.18:1. Gingivobuccal complex was the most common site of OSCC. While 679 patients were reported to undergo incision biopsy only 172 patients underwent excision biopsy in four years. Well differentiation (n=782) is the most common histological grading. The median clinical size of the tumour was 4 cm. Upon analyzing histological parameters in excision specimens lymphovascular and perineural invasion were seen in 38 and 26 cases, respectively. Cervical lymph node metastasis was seen in 42 cases out of 172 excision specimens (24%). 63.23% of cases presented with a depth of invasion between 5 to 10 mm. CONCLUSIONS: This is the largest comprehensive data from the regional cancer center of Odisha population which highlights the demographic, clinical, and histopathological data reported to date. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Optical Coherence Tomography (OCT) is a non-invasive imaging technique that produces cross-sectional images through biological tissues, allowing three-dimensional reconstruction and analysis. Aim was to evaluate if OCT may discriminate among tissues with different bone density and composition, by measuring the depth of light penetration in porcine and rat bone samples. MATERIALS AND METHODS: Two carpal bone samples (2 cm length) were harvested from the porcine forelimb and fixed overnight in 3.7% buffered formal saline. Following fixation, one sample was decalcified in a 1:1 mixture of 8% hydrochloric acid and 8% formic acid solution for three days, with solution changes each day. Samples were imaged using an OCT microscope. Furthermore, the calvaria, ulnar, alveolar and basal bone of mandible of 6 male and 6 female rats were cleared of overlying soft tissues and scanned under OCT. The light penetration depth in each sample was measured using the software Image J, and Scattering Attenuation Microscopy. RESULTS: In the mineralized bone the average depth (µm) and standard deviation (SD) of light penetration were 790.1±18.05 and 410.4±21.7 for periosteal and endosteal surface, respectively, and 507.3±21.03 for cross-section surfaces, while it was 858.4±32.03 for periosteal surface, 1150±26.9 for endosteal, and 627.3±31.8 for cross-section bone surfaces in demineralized porcine bone. There was a significant difference (p<0.001) in depth of light penetration between normal and de-mineralized bone for all regions evaluated. No systematic significant difference in light penetration depth between-gender was found at any site evaluated, while there were variations between sites (p<0.001). The OCT detected differences in bone mineral and porosity among gender (p<0.0001) CONCLUSIONS: This study suggests that OCT may represent a valuable technique to estimate local variations in bone mineral content. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was twofold: (1) to compare soft tissue measurements of the same distances obtained from 3D computed tomography reconstructions with 2D cephalometric radiograms, (2) to compare data from 3D measurements from direct anthropometry and 2D "norms" for the facial measurements. PATIENTS AND METHODS: A total of 40 Caucasian patients that had their CBCT scans for various dental and dentoskeletal reasons were enrolled in this study. All the patients had large field of view (from the forehead to the chin). The data were stored in DICOM format and imported into a software for 3D reconstructions. After 3D facial soft tissue model generation, the distances between 18 soft tissue points were measured. The 3D soft tissue analysis was performed, and the facial indices were calculated. The mean 3D values were compared with 2D measurements performed on lateral cephalograms and Arnett's and Farkas' norms. The measurements were statistically compared using Student's f-test. RESULTS: Assessments from 2D and 3D mea-surements showed no statistical difference except for the distance Pogonion (for both male and female) and Labial superius prominence (females) to the True Vertical Line in 2D /Plane in case of 3D measurements. There was a significant difference between all 3D measurements and Arnett's and anthropometric Farkas' "norms". The mean difference between Farkas' "norms" and 3D measurements was within 3 mm for 70% of measurements. CONCLUSIONS: According to the results, 3D soft tissue analysis allows for complete diagnostic determination. The 3D "norms" are to be verified on a greater sample. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Ascorbyl palmitate is a fat-soluble ester of vitamin C and is used as an antioxidant food additive. While literature reports that ascorbyl palmitate can prevent exacerbation of pain and improve the quality of life of patients suffering from pain, this is not yet supported by clinical trial data. Our study aimed to investigate the effectiveness of ascorbyl palmitate in managing trigeminal neuralgia. PATIENTS AND METHODS: This study was carried out in a single-centre clinical trial in which subjects suffering from trigeminal neuralgia (N=11) were included. All patients were on carbamazepine when first included and, after washout period, received Ascorbyl palmitate. Eligible patients had the most severe trigeminal neuralgia pain in the oral cavity or pain on touching trigger zones, aged 20 years or older, were capable of proper assessment of the severity of pain and their condition, and had experienced multiple episodes of intraoral pain for at least 3 months with a pain intensity of more than 4 points on the numerical rating scale. The Brief Pain Questionnaire was used to evaluate patient’s quality of life. RESULTS: A total of 11 patients were included with a mean age 55.36±10.67 years (7 males, 4 females). Most patients had compression by the superior cerebellar artery and vascular loops upon magnetic resonance examination. The mean numerical rating scale score for carbamazepine after one month was 7.9±0.56 (95% CI 7.49, 8.30). Similarly, for ascorbyl palmitate was 5.5±1.50 (95% CI 4.42, 6.57) (p<0.001). CONCLUSIONS: Ascorbyl palmitate can be used as an adjunct intervention in managing trigeminal neuralgia pain. According to the results, ascorbyl palmitate prevents frequent exacerbation of pain and improves patient quality of life. [ABSTRACT FROM AUTHOR]

OBJECTIVE: COVID-19 toes represent the main dermatological COVID-19 cutaneous manifestation in pediatric patients. Its diagnosis exposes the whole family to social stigma and this aspect was not previously evaluated. PATIENTS AND METHODS: This was a multicenter, case-control, observational study that compared the family impact of COVID-19 toes vs. psoriasis (PsO). We enrolled 46 pediatric patients (23 with psoriasis and 23 with COVID-19 toes, age and gender matched) and their parents/caregivers that had to fill the Dermatitis Family Impact (DFI) questionnaire. RESULTS: DFI index did not differ significantly between both subgroups (p=0.48), and in psoriatic patients did not correlate with both Psoriasis Area Severity Index (PASI) (p=0.59) and itchVAS (p=0.16). CONCLUSIONS: COVID-19 toes, a transitory dermatosis, exerted a similar impact/perturbation on family dynamics than PsO, a well-known stigmatizing, chronic inflammatory dermatosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to evaluate the impact of orthognathic surgery on the patients’ satisfaction and quality of life (QoL) in patients with dental skeletal dysmorphisms and Obstructive Sleep Apnea (OSA). SUBJECTS AND METHODS: Patients were grouped into two cohorts, patients with OSA (G1) and patients with dento-skeletal dysmorphisms (G2). SF-36 questionnaire was obtained from all subjects before interventions. A standardized follow-up protocol, including a second SF-36 questionnaire was planned as at least 6 months after surgery. The impact of surgery on satisfaction was evaluated by post-operative patient satisfaction-based survey. RESULTS: 61 patients were included as: 21 OSA (G1), 12 Class II (G2-a) and 28 Class III (G2-b) patients. The mean post-operative follow-up was 65.47±26.36 months. In the SF-36 results, when pre and post operative surveys were compared, the quality of life increased significantly for G1 in all items except for body pain. In G2, when pre and post operative surveys were compared, the quality of life increased significantly in items related to emotional well-being, health transition, role limitations due to emotional problems, while other parameters did not significantly change. When groups were compared, there was no difference among them except for physical functioning which was improved for OSA patients. According to the Rustemeyer results, overall post-operative satisfaction score was 84.92±14.72%. There was a significant difference for patient satisfaction considering facial aesthetics in both groups. For chewing function there was no difference for patient satisfaction in G1, but there was a significant difference in G2 patients. CONCLUSIONS: Orthognathic surgery seems to be beneficial in terms of patients’ satisfaction and patients’ satisfaction for both dental skeletal dysmorphism and OSA patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the study was to evaluate the results and immediate postoperative complications following open reduction and internal fixation of mandibular fractures with or without postoperative maxillo-mandibular fixation MATERIALS AND METHODS: The study spanned over a period of 24 months, extending from October 2015 to October 2017. The study sample comprised 24 subjects between the age range of 18 to 65 years. They were randomly divided into two groups: Group A included subjects in whom open reduction and internal fixation was followed by maxilla-mandibular fixation for 15 days, and Group B subjects in whom only open reduction and internal fixation was done, followed by immediate mobilization. The outcomes evaluated were swelling, pain, simplified oral hygiene index and occlusion. The subjects were followed for all these outcomes on 1st, 7th and 15th days. The occlusion was assessed for 5 days. Any other intra/post-operative complications were additionally noted. RESULTS: There was no statistical difference between the groups for swelling, pain and occlusion. The patients with postoperative maxilla-mandibular fixation had poorer oral hygiene when compared to the other group (p<0.001). CONCLUSIONS: The use of maxilla-mandibular fixation post open reduction and internal fixation seems to offer no additional benefits to the patients. According to the results of the study, this traditional surgical dictum seems to be used by the surgeons due to the lack of any scientific evidence. However, further studies should be conducted to confirm this statement. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Reconstruction after radical cancer surgery in terms of function and esthetics can be quite demanding. The aim of this study was to evaluate oral rehabilitation with autogenous flaps and dental implants for maxillofacial reconstruction in oncologic patients after implant insertions. MATERIALS AND METHODS: The study consisted of 19 patients diagnosed with either squamous cell carcinoma, fusocellular carcinoma, or mucoepidermoid carcinoma. The reconstruction of the maxillofacial defects was done with autogenous flaps (free fibular flap, antero-lateral thigh flap, radial forearm flap, or rotational pedicled temporal muscle flap). Implants were inserted on the average 32.03±19.51 months after reconstructive operations. A total of 82 implants were inserted. Mean follow-up after maxillo-facial surgery was 7.2 years (mean 86.56±22.04 months). Mean follow-up after implant insertions was 4.5 years (mean 54.6±21.82). Primary outcome was implant survival. Secondary outcome was evaluation of post-surgical complications. RESULTS: There were surgical revisions in seven patients after reconstructive surgery with flaps, mainly due to tumor relapse. Complications were seen in 11 patients. There was one implant failure. Overall implant survival rate was 98.8%. No relations were found between implant survival rate and gender, type of tumor, type of microvascular free flap, radiation therapy, chemotherapy, and prosthesis type. CONCLUSIONS: According to the results of this study, oral rehabilitation with dental implants inserted in free flaps for maxillofacial reconstruction after ablative oncologic surgery can be considered as a safe treatment modality with successful outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This case report represents a solitary fibrous tumor, which is a very rare neoplasm in the parotid gland. CASE PRESENTATION: 80-year-old Caucasian female patient with palpable, immobile, painless, slow growing, semi-rigid-elastic neoplasm in the left parotid gland, that was existing for four months. There were no signs of inflammation and facial paralysis. The tumor was initially interpreted as a salivary gland neoplasm of uncertain origin. Fine needle aspiration was performed 2 times; however, the precise diagnosis was challenging. The tumor was excised, regional lymphadenectomy was performed. Morphological and immunophenotypical findings were consistent with solitary fibrous tumor of parotid gland. Currently, the patient is under regular follow-up period at 9 months with no evidence of metastasis or recurrence. CONCLUSIONS: Although very rare, solitary fibrous tumor (SFT) should be suspected in cases of slow growing, solid, well-defined nodules of the parotid gland. The SFT of the parotid gland are usually benign tumors, however there is a low risk of recurrency and malignant behavior with metastatic potential. Complete resection of the tumor should be performed since it is crucial for management without any recurrence. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this retrospective case series report was to evaluate the results of oral rehabilitation with extra-sinus zygomatic implant surgery with a minimum follow-up of 7.5 years. PATIENTS AND METHODS: A total of 35 patients with 87 zygomatic implants were included. The mean follow-up period of the patients was 93 months. The zygomatic implant survival and complications were evaluated as criteria for success. RESULTS: There were no implant failures. Overall success rate without complications for zygomatic implant was 88.5%. Complications developed in 4 patients (1 cutaneous fistula and 3 mucositis). According to the results on an implant basis, patients with previously failed conventional implants had greater probability of complications. Patients with quad zygomatic implants had higher incidence of complications than those with two zygomatic implants. Fully threaded implant design was associated with higher incidence of mucositis than partially threaded design. No relation was found between implant success and smoking, prosthesis type, and antagonist dentition. When conducting the analysis using the patient as unit, only the antagonist dentition showed significant difference, the worst outcome being associated with the Toronto resin prosthesis. CONCLUSIONS: Zygomatic implants can be considered as a safe alternative to conventional implant insertions and bone grafting procedures in oral rehabilitation of patients with severely atrophic maxillary bone. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Temporomandibular joint reconstructive surgery in a growing patient represents a challenging situation. Autogenous and alloplastic reconstructive options are being studied in literature; however, there are still some limitations. The objective of this case report is to evaluate a novel custom-made prosthetic system in a 12-year-old TMJ ankylosis patient. CASE PRESENTATION: The patient had complaints of temporomandibular joint ankylosis and hypoplasia. The patient had already been operated two times with autogenous grafts. Swelling and tumefaction were apparent on the right side of the face. Mouth opening was 1.5 centimeters, with limitations in lateral and protrusive movements of the jaws. Hypertonic muscles and pain upon palpation were registered. There were no signs of luxation, fracture, or traumatic avulsion. After examination, unilateral TMJ ankylosis was apparent on TC scans. Revision surgery was planned with the use of true plastic temporomandibular joint customized prosthesis. The patient underwent a TMJ reconstruction surgery using CADCAM custom-made patient specific prosthesis. The follow up period of this patient was 46 months and showed successful healing with no complications. CONCLUSIONS: Replacement of TMJ with custom made alloplastic material that is reported can be considered as a safe and useful option for growing young individuals in selected cases. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this systematic review is to assess the efficacy of locally delivered statins used in adjunct to scaling and root planing (SRP), compared with SRP alone. MATERIALS AND METHODS: An electronic and hand search was carried out up to April 2020. Only randomized controlled trials (RCTs) were included. Clinical attachment level gain (CALgain) and probing depth reduction (PDred), modified sulcular bleeding index reduction (mSBIred), and intrabony defect reduction (IBDred) were the investigated outcomes. Meta-analysis was performed, and the power of the meta-analytic findings was determined by trial sequential analysis (TSA). Studies were also sub-grouped based on the type of statin used. Statistical heterogeneity and publication bias were assessed. RESULTS: Twenty RCTs were included (1212 patients, 1289 defects). An overall statistically significant effect size in favor of statins for CALgain and PDred was found. As opposed to atorvastatin and rosuvastatin, simvastatin did not reach statistical significance for these outcomes, as shown by the sub-group analysis. CONCLUSIONS: Within the limits of the available studies, the local administration of statins (in particular, atorvastatin and rosuvastatin) in adjunct to SRP may result in additional significant improvement in terms of CALgain and PDred compared with SRP alone. The high heterogeneity of data and the high risk of bias found, however, impose caution. No approved preparations, moreover, exist, and further well-designed RCTs from independent research centers are needed to confirm the beneficial effects of the different statins and their mutual differences in the non-surgical periodontal treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) is a severe drug-related side effect mostly seen in the maxillofacial region of patients under current or previous treatment with antiresorptive and/or angiogenic agents. There is a wide range of treatment options explained in literature for the management of this condition, from conservative treatments to surgical procedures of various levels of invasiveness, which are sometimes supplemented with adjunctive therapies. The present systematic review aimed at evaluating the treatment options of MRONJ in terms of successful outcomes. MATERIALS AND METHODS: Medline, Scopus, and Cochrane databases were searched. The search was limited to clinical studies involving human subjects with at least 3 cases. There was no other limitation for language, publication date, and study design for the articles to be included. A hand search of the bibliographies of identified articles was also performed. The evaluation criterion was an improvement in the healing of the treated site after treatment procedures. RESULTS: After evaluation of the full text of the articles, 118 articles were selected for evaluation (15 platelet concentrates, 4 teriparatide, 10 laser therapy, 3 hyperbaric oxygen, 2 ozone applications, 9 conservative protocols, and 75 surgical interventions articles). The evaluated articles reported positive improvements in healing/staging of the osteonecrosis sites. CONCLUSIONS: Due to the low evidence level and the limited sample size of the studies included, the results of this review must be cautiously interpreted. However, they can be suggestive for evaluating the possible benefits of these treatment options in MRONJ management. Further prospective comparative studies with a large sample size are urgently needed to confirm the results. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Bisphosphonate related osteonecrosis of the jaw (BRONJ) is progressive bone destruction in the maxillofacial region of patients under current or previous treatment with Bisphosphonates. The present case series study aimed to evaluate if ozone/ oxygen therapy and debridement with piezoelectric surgery may improve the treatment of BRONJ. PATIENTS AND METHODS: The treatment modality of the patients included ozone/oxygen mixture from medical oxygen. The protocol for ozone/oxygen mixture therapy appointments was set as twice a week for 10 weeks, for a total of 20 applications for each patient. The evaluation of the lesions was based on the clinical and radiologic parameters. The primary outcome was the necrotic lesion reduction during ozone/oxygen therapy sessions and up to the end of follow up periods. The healing of the lesion was taken as a positive result. The level of significance was taken as p <0.05. RESULTS: A total of 14 patients affected by osteonecrosis were included. The mean follow-up of the patients was 14.3 months. The overall success rate after treatment was 64.2%. CONCLUSIONS: According to the results, ozone/oxygen therapy and debridement with Piezoelectric surgery for BRONJ treatment is a safe procedure with successful outcomes. [ABSTRACT FROM AUTHOR]