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Objective To describe the technique, feasibility and short-term outcomes of buccal mucosa grafts in robotic lower urinary tract reconstruction. Methods We reviewed 9 patients who underwent single-port robotic posterior urethroplasty with buccal mucosa graft from May–December 2019. Variables included patient demographics, diagnosis/etiology, and intraoperative parameters. Intraabdominal or extraperitoneal transvesical approaches are used for the stricture via supraumbilical access, and if necessary, perineal dissection is performed. Cystoscopy identifies the extent of stenosis. Anastomosis is completed with buccal mucosal graft and rectus abdominis, omental or gracilis flaps as needed. Results The mean age was 65.4 years. Robotic urethroplasty with buccal mucosa graft was performed for vesicourethral anastomotic strictures (n=7), urethral strictures (n=4), pubic fistula after robotic posterior urethroplasty (n=1), and anastomotic distraction (n=1). Strictures occurred after prostate cancer treatments (n=8) and trauma (n=1). All patients had prior failed endoscopic interventions: balloon dilatation, resection/incision of bladder neck, internal urethrotomy under direct vision, urethral stents, and posterior urethroplasty. Mean defect length was 3.9 cm. Five of 9 patients had ancillary procedures including rectus abdominis (n=3), omental or gracilis (both n=1) flap harvests. No intraoperative complications occurred. Median operative time was 377 minutes, blood loss was 200 mL, and length of stay was 2 days. Postoperative 30-day complications included urinary tract infection, epididymitis, anemia, recurrent stricture, and small bowel obstruction requiring surgery (all n=1). Median follow-up was 11.7 months. Conclusions Buccal mucosa grafts with ancillary maneuvers such as flap interposition or adjacent tissue transfer in robotic lower tract reconstruction is durable, safe, and comparable to open approaches.

Objective: There are many reconstruction techniques for the repair of the intraoral buccal defects following oncological resections. The pedicled buccal fat pad (BFP) flap can be used for reconstruction of medium-sized buccal defects. The purpose of this study was to investigate the outcomes of the reconstruction with BFP flap following the resection of buccal tumors and risk factors on BFP flap success. Methods: This study was designed as a retrospective case series research. Ten patients with squamous cell carcinoma of the buccal mucosa underwent BFP flap reconstruction following tumor resection. The dimensions of the primary tumor and post-resection defect were calculated. The intraoral operation field was evaluated on the postoperative 7th day and in the postoperative 1 st and 6th months. Postoperative flap status, disease recurrence, risk factors for flap success were assessed. Results: The mean greatest dimension of the post-resection buccal defect was 41.9 +/- 10.3 mm. A partial dehiscence was observed in three patients in the postoperative 7th day. The 6th month-examination revealed no flap complications. The mean greatest dimension of post-resection buccal defect in uncomplicated patients was 42.7 +/- 11.4 mm and in patients with partial dehiscence was 40 +/- 8.6 mm (p = 0.727). There was no significant difference between uncomplicated patients and patients with partial dehiscence according to body mass index (normal vs overweight, p = 0.667). Conclusion: The BFP flap is a reliable reconstruction method in medium sized buccal defects following oncological resection. It has low complication and donor site morbidity rates and also good anatomical and oncological outcomes. (C) 2021 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.

Purpose To assess the effects of buccal mucosal graft site non-closure versus closure on postoperative oral morbidity for male undergoing augmentation urethroplasty for urethral stricture. Materials and methods We included randomized controlled trials. Inclusion criteria were male over the age of 18 with urethral stricture disease requiring reconstruction with buccal mucosal graft harvest. Primary outcomes of the review were postoperative oral pain, need for secondary oral procedures and cosmetic defects. Results We included 5 studies with 346 randomized patients with urethral strictures, of whom 260 completed the trials. In terms of primary outcomes, non-closure graft site may reduce oral pain on postoperative day #1 (standard mean difference [SMD] 0.24 lower; 95% confidence interval [CI] 0.61 lower to 0.12 higher; low certainty evidence [CoE]) but we are uncertain how this impacts pain on postoperative days 3 to 6 (SMD 0.35; 95% CI 0.12 to 0.81 higher; very low CoE). We are also very uncertain as to how it affects the need for secondary oral procedures (risk ratio [RR] 0.22; 95% CI 0.01 to 4.28; very low CoE). Non-closure may increase the risk of cosmetic defects (RR 2.40; 95% CI 0.93 to 6.22; low CoE). Conclusions This review describes the trade-off for buccal mucosal graft site non-closure versus closure for various patient-important outcomes; decision-making will likely hinge on the relative value individual patients and surgeons place on them. The supporting evidence was rated as low and very low, thereby signaling substantial underlying uncertainty and the need for better trials.

Pedicled buccal fat flaps have been adopted in primary Furlow double-opposing Z-plasty palatoplasty to reduce oronasal fistula formation or to attenuate maxillary growth disturbance. We combined both goals in a single intervention. This study describes a series of 33 modified Furlow small double-opposing Z-plasty palatoplasties reinforced with a middle layer of pedicled buccal fat flaps between the oral and nasal layers for full coverage of the dissected palatal surfaces, with rapid mucosalization of lateral relaxing incisions and no dehiscence or fistula formation.

Objective To describe and assess the outcomes of dorsal onlay oral mucosa graft urethroplasty for female urethral stricture. Methods We retrospectively reviewed the charts of all female patients who underwent dorsal onlay oral (buccal or lingual) mucosa urethroplasty for urethral stricture between 2011 and 2020 at two academic institutions. The primary endpoint was clinical success defined as any subjective improvement in LUTS self-assessed by the patients 1-3 months after catheter removal. Four surgeons performed the urethroplasties using a standardized technique: suprameatal incision, dissection and longitudinal opening of the dorsal aspect of the urethra, harvest of the oral mucosa graft, graft onlay sutured into the urethral opening. Results Nineteen patients were included. The clinical success rate was 94.7% at 1-3 months and 90.9% at 1 year. After a median follow-up of 12 months (range 1-49) there was one recurrence (5.3%), clinical success was achieved in 17 patients (89.5%) and both the maximum urinary flow rate and post void residual were significantly improved (15.2 vs 7.4 ml/s preoperatively; P = .008 and 71.5 vs 161.1 ml preoperatively; P = .001 respectively). The de novo stress urinary incontinence rate was 15.7% at 1-3 months and 9.1% at 1 year. Conclusion Dorsal onlay oral mucosa graft urethroplasty for female urethral stricture appears feasible across multiple surgeons and is associated with a low perioperative morbidity, satisfactory functional outcomes and a low recurrence rate. Other series with larger sample size and longer follow-up are needed to confirm these findings.

Objective To review our experience in the management of paediatric urethral strictures with buccal mucosal graft urethroplasty and its long term outcomes. Methods This was a retrospective analysis of a prospectively maintained data base between 2009–2019. Circumcised children with long segment urethral strictures (> 1.5 cm) were included. They were characterized as either peno-bulbar (PBS) or isolated bulbar strictures (IBS) based on a standardized protocol. All children underwent single stage dorsal onlay buccal mucosal graft urethroplasty by either the Kulkarni technique (PBS group) or the Barbagli technique (IBS group). All children were followed up at 3 months, then annually thereafter with flow rates at each visit. Success was defined as a flow rate > 10ml/sec with a bell-shaped curve and absence of need for any secondary procedures. Results 28 children underwent buccal mucosal graft uretheroplasty.16 children were diagnosed with PBS & 12 children with IBS. The median age was 7.5 years (2–17 years) in PBS and 5.5 years (3–10 years) in IBS. Iatrogenic injury was the commonest aetiology ie 71 % (20/28). Mean length of stricture was 4 cm (3–5.5 cm) in PBS and 2.5 cm (2–3.5 cm) in IBS. Median follow up was 96 months (24-120 months) in PBS and 90 months (36-120 months) in IBS. The success rate was 87.5% (14/16) in PBS and 83.3% (10/12) in IBS. Conclusion Single stage dorsal on lay buccal mucosal graft urethroplasty, ie Kulkarni and Barbagli techniques are safe and feasible in children with long segment urethral strictures with good long-term outcomes.

Objective: The aim of this study was to evaluate the efficiency of a buccal spray form of vitamin D compared to single oral dose (stoss therapy) and oral drops therapy in the treatment of vitamin D deficiency. Methods: Ninety healthy children and adolescents (3-18 years) with vitamin D deficiency [serum level of 25-hydroxyvitamin D (25(OH) D)

Background A pilot study reported an autologous buccal mucosal cell transplant in humans through the trans-urethral route using the buccal epithelium expanded and encapsulated in scaffold—hybrid approach to urethral stricture (BEES-HAUS), a minimally invasive approach to treat urethral stricture. Although successful outcomes were achieved in that study, for further validation, it is essential to prove that the transplanted buccal epithelium was engrafted over the urothelium through histological examination of the urethra, harvested post-transplant, which is infeasible in humans. Herein, we report the successful creation of an animal model of urethral stricture and the engraftment of epithelial cells derived from autologous buccal mucosal tissue, encapsulated in a thermo-reversible gelation polymer (TGP) scaffold, transplanted by trans-urethral route. Methods An animal model of urethral stricture was created in Japanese white male rabbits using electro-coagulation. Buccal tissue was harvested from the rabbits and subjected to enzyme digestion, followed by 5–7 days of in vitro culture in conventional two-dimensional (2D) culture and in a 3D platform of thermo-reversible gelation polymer (3D-TGP) culture. The cells harvested from the groups were mixed and encapsulated and transplanted with TGP, by transurethral catheterization. Fourteen days later, the urethra was harvested and subjected to histological examination. The buccal biopsy tissue, cells after digestion and cells post-culture were also subjected to histological examination. Urethrogram and endoscopy images were recorded at different time points. Results The stricture was successfully created, with the coagulated area markedly stenosed. Histological staining of the cells after in vitro processing showed that the cells grew with native epithelial and rounded cell morphology in 3D-TGP while they differentiated into fibroblast like-cells in 2D culture. Histological staining of the urethral tissue after transplantation revealed the engraftment of the transplanted buccal mucosal cells, with stratified squamous epithelium over the specialized stratified urothelium in the urethrotomy site. Conclusion We used histology to prove the successful engraftment of TGP-encapsulated buccal mucosal epithelial cells in an animal model of urethral injury with healing of the injured tissue. The model of urethral stricture and cell therapy, using a transurethral approach, recapitulates the previously reported BEES-HAUS approach and lays the foundation for larger multi-centric translational clinical studies., Highlights • An animal model of urethral stricture that closely resembles that occurring in humans could be created. • Trans-urethral transplantation of polymer scaffold encapsulated buccal mucosal epithelial cells could be accomplished. • Successful engraftment of transplanted cells onto urethrotomy site with healing, proven in this first of its kind report.

The demands of the correction of severe buccal crossbites warrants the need for early intervention - as soon as the malocclusion is identified. The severity of buccal crossbites in warrants the need for early interventions as soon as the malocclusion is detected. The main characteristic of a buccal crossbite malocclusion is the complete deep bite, with total absence of occlusal and incisal contacts in centric relation. The objective of this article is to offer interceptive orthopedic and orthodontic treatment modalities for the correction of this type of malocclusion. Successful treatment of three very severe buccal crossbite malocclusions are presented. Appropriate application of physiology and biomechanics led to favorable results. Orthopedic and orthodontic treatments using lip bumpers, Frankel regulators and eventually crossbite elastics proved to be efficient means to minimize and correct buccal crossbites, with a long-term stability.

Cigarette smoking is an established risk factor for oral cancer. The health effects of e-cigarettes are still under investigation but may disturb oral cavity homeostasis and cause lung and cardiovascular diseases. Carcinogens and toxicants in tobacco products and e-cigarettes may damage DNA, resulting in the formation of apurinic/apyrimidinic (AP) sites, and initiation of the carcinogenic process. In this study, we optimized a liquid chromatography-nanoelectrospray ionization-high resolution tandem mass spectrometry method to analyze AP sites in buccal cell DNA of 35 nonsmokers, 30 smokers, and 30 e-cigarette users. AP sites in e-cigarette users (median 3.3 per 10(7) nts) were significantly lower than in smokers (median 5.7 per 10(7) nts) and nonsmokers (median 6.0 per 10(7) nts). AP sites in smokers were not significantly different from nonsmokers (p > 0.05). The e-cigarette vaporizing solvents propylene glycol and glycerin were tested and did not protect against AP site formation in in vitro control and carcinogen exposed rat liver homogenates. However, propylene glycol may inhibit bacteria in oral cells, resulting in reduced inflammation and related effects, and reduced AP site levels in e-cigarette user DNA. This is the first study to examine AP site formation in e-cigarette users and to evaluate AP sites in human oral cell DNA.

To evaluate the functional efficacy of two different grafting techniques following the fibrotomy among subjects with oral submucous fibrosis (OSMF). Forty consecutively treated OSMF subjects between 20 and 40 years who had grades 3 and 4a OSMF and mouth opening

Performing 1-stage urethroplasty in patients with urethral strictures caused by lichen sclerosus (LS) is hotly debated among reconstructive urologists due to conflicting reports of success. Therefore, the objective of this study was to determine the pooled incidence of stricture recurrence following 1-stage buccal mucosal graft (BMG) urethroplasty in patients with LS, to determine the impact of surgical technique on recurrence and to compare recurrence risk between patients with and without LS after 1-stage repairs.A systematic review was conducted in accordance with PRISMA criteria. The primary outcome was pooled incidence of recurrence, which was calculated using a Der-Simonian-Laird binary random effects model with a Freeman-Tukey arcsine transformation. A total of 21 studies were included, of which 15 provided data for comparative analyses.Pooled data from 625 LS patients revealed a stricture recurrence rate of 10% (95% CI 6-14). Among studies with longer followup (≥24 months), this increased to 18%. Among patients with penile urethral involvement, studies utilizing a penile skin incision had significantly higher pooled recurrence rates than those utilizing penile invagination (p=0.004). Across all studies, there was no evidence to suggest a difference in pooled recurrence rate between patients with and without LS (p=0.36). However, across only long-term studies, recurrence risk was significantly higher for patients with LS (OR 1.83, p=0.05).One-stage BMG urethroplasty is likely a viable surgical option for patients with LS-related strictures; however, high-quality data are limited. Future multi-institutional, long-term prospective studies are needed to assess durability of 1-stage repair.

Objective To describe the outcomes of single-stage and staged repairs in properly selected patients with phalloplasty anastomotic strictures. Methods A bi-institutional retrospective review was performed of all patients who underwent anastomotic stricture repairs between 7/2014-8/2020. Those who had prior augmented urethroplasties or poorly vascularized tissue underwent two-stage repairs (Group-2), all others underwent single-stage repair with a double-face (dorsal inlay and ventral onlay) buccal mucosal graft urethroplasty (Group-1). Postoperatively, urethral patency and patient reported outcome measures (PROMs) were assessed. Results Twenty-three patients with anastomotic strictures were identified. Fourteen patients met inclusion criteria and had 1-year follow-up (9 in Group-1; 5 in Group-2). Nine patients (64%) had prior failed interventions (56% Group-1; 80% Group-2). At a mean follow-up of 33.9 (Group-1) and 35.2 months (Group-2) there were two stricture recurrences in Group-1 (22%) and none in Group-2. PROMs were completed by 12 patients. All patients reported the ability to void standing. Post-void dribbling was present in the majority of patients (7/7 Group-1; 2/4 in Group-2). Mean IPSS was 3.9 (0-14) for Group-1 and 1 (0-3) for Group-2. All reported at least a moderate improvement in their condition on GRA (Group-1 +3 71%, +2 29%; Group-2 +3 100%). Conclusion Single-stage repairs are feasible for patients with anastomotic strictures who have well vascularized tissue and no prior single-stage buccal mucosa augmented urethroplasty failures. Staged repairs are feasible for patients with poor tissue quality. Proper patient selection is important for successful reconstruction.

76 male hamsters were divided equally into 4 groups (19 each). Group I served as control group with no intervention. Group II received topical application of 0.5% 7, 12-dimethylbenz[a]anthracene (DMBA) on the left buccal pouches for 16week with no intervention. Group III received a 0.5ml of Pomegranate molasses plus 0.5 ml distilled water through ingestion daily concomitant with DMBA application and continued for 3 months post induction period. Group IV received a red grape vinegar in a protocol similar to group III. Then the pouches were collected fixed and processed for H&E, anti-TGF-β and anti-CK-19 staining. Results: group II showed classical dysplastic changes with statistically significant higher expression of anti-TGF-β and CK-19 (P

Graphical abstract, Irritable bowel syndrome (IBS); a widespread disorder in gastrointestinal tract especially in children, burdens their healthcare systems and upsets families. Great attention was paid to understand the pathophysiological cause of disorder. However, developing a convenient treatment especially for children remains a challenge. Phosphodiesterase inhibitors were recently introduced for IBS management. Vardenafil (VDF), a phosphodiesterase-5 inhibitor, exhibiting limited bioavailability when taken orally due to extensive first-pass effect, was the choice for study. This study aimed to formulate VDF jellies as a buccal dosage form to improve pediatric compliance and achieve maximum drug efficacy. VDF oral jellies were prepared by heat and congeal method, and were evaluated for their pH, content uniformity, physical stability, general appearance, and in-vitro drug release. VDF jellies (F1), with satisfactory organoleptic properties and highest percent of drug released compared to other formulations was selected as a master formula for further study to ensure in-vivo efficacy. cyclic Guanosine Mono Phosphate (cGMP), used as indicator of VDF concentration in blood, was highly increased after administration of VDF jellies (F1), compared to oral VDF suspension. Increased defecation with improved fecal consistency strongly favored oral jellies as a potential alternative route for VDF for IBS management with high pediatric acceptance.

The objective of the study: to analyze the effectiveness of surgery in patients with pos t-t uberculous urethral stricture s/o bliterations when buccal mucosa is used for reconstruction. Subjects and Methods. The surgery was performed in 5 patients with sequelae of specific urethral lesions such as extended strictures or obliterations. All patients underwent ureteroplasty with buccal graft ( BG ). In 4 cases, tubularized BG was used, and in 1 case it was onlay one. Results. The patients were followed up for 3-5 5 months. Over this period no relapse or severe complications were observed. Conclusion. Buccal ureteroplasty is a promising method for the treatment of pos t-t uberculous urethral stricture s/o bliterations with a high risk of other reconstructive surgeries.

Purpose Identifying buccal and oral bone as an important supporting periodontal structure for teeth provides important information for treatment planning in periodontics and orthodontics. This study aims to add evidence to the knowledge of preciseness of cone beam computed tomography (CBCT) measurements of the vertical dimension of buccal and oral bone. The hypothesis is that CBCT is an accurate and reliable method to measure vertical vestibular and oral bone loss. Methods The amount of vertical buccal and oral bone loss (bl) of 260 sites of 10 human cadavers was investigated clinically and radiographically by CBCT. Radiographic measurements were rated by two blinded raters. Measurements and the corresponding differences between clinical and radiological findings are described by medians and quartiles (Q1–Q3). For statistical analysis, Lin’s concordance correlation coefficient (CCC) and Bland–Altman plots were calculated. Results The CCC between the raters was 0.994 (95% confidence interval 0.992–0.995). The median bone loss (bl) distance from the cementoenamel junction (CEJ) to the bony defect (BD) was 3.5 mm (range 3–5 mm). The median bl measured in the CBCT was 3.8 mm (range 3.1–4.8 mm). The median difference of the 2 measurements for all sites included in the study (N = 260) was −0.2 mm (−0.7 to 0.3 mm). Conclusions CBCT seems to be an accurate and highly reliable method to detect and describe vertical buccal and oral bone loss. It could improve planning and prediction for successful combined periodontal and orthodontic therapies.

BACKGROUND Achieving profound pulpal anaesthesia with an inferior alveolar nerve block (IANB) in lower molars suffering irreversible pulpitis is difficult and quite challenging. In many instances, supplemental anaesthesia is required during endodontic therapy. The present study was done to evaluate the efficiency of 2 % lidocaine and 4 % articaine comparatively, as an inferior alveolar nerve block (IANB) and supplemental infiltration buccally in providing complete mandibular molar anaesthesia. METHODS This is a randomized double-blinded study. Sixty patients were categorized randomly into test group (n= 30) and control group (n= 30). Patients in the test group were anaesthetized with 4 % articaine (1:100,000 epinephrine dilution), and those in the control group were anaesthetized with 2 % lidocaine (1:80,000 epinephrine dilution). The Heft-Parker visual analog scale (HP-VAS) was utilized for rating patient’s pain during the treatment procedure. In case of pain after IANB, a supplemental buccal infiltration was given with the same anaesthetic used for IANB. Complete pain absence or mild pain was regarded as an anaesthetic efficacy, and moderate to severe pain was regarded as an anaesthetic failure. Recorded data was analyzed using the chi-square test and two proportion Z test. The set significance level was 0.05. RESULTS After an IANB, observed anaesthetic success was 56 % in the articaine (test) group and that in the lidocaine (control) group was 33 %. After buccal infiltration, it was 92 % in the articaine group and 75 % in the lidocaine group. The difference was not found significant between the two groups statistically following IANB and infiltration buccally. The overall success of articaine was 96 %, and lidocaine was 83 %. CONCLUSIONS Compared to 2 % lidocaine, 4 % articaine was found more efficient in achieving profound pulpal anaesthesia in mandibular molars suffering irreversible pulpitis after IANB and buccal infiltration though the difference was insignificant statistically. KEY WORDS Articaine, Lidocaine, Inferior Alveolar Nerve Block, Buccal Infiltration, Heft-Parker Visual Analog Scale, Irreversible Pulpitis

The management of panurethral stricture was still challenging and controversial. We presented a case of pan urethral strictures management by using a one-sided dissection of dorsal onlay buccal mucosal graft (BMG) urethroplasty (Kulkarni technique). A 53-years old man admitted with panurethral stricture who had previously undergone several procedures. Bipolar micturition cystourethrography procedure revealed 17 cm stricture length. One-sided dissection dorsal onlay buccal mucosal graft urethroplasty was performed. No drain was placed. The Foley catheter was removed four weeks after surgery, and the results of the micturition were favourable. No fistulae were found at a straight erection and meatus at a normal position. The postoperative flow rate (Qmax) was 24.9 ml/second. As a conclusion Kulkarni technique urethroplasty gained good outcome for panurethral stricture in our case.

Objectives To compare the root resorption resulting from miniscrew-supported maxillary posterior dentoalveolar intrusion using two different force magnitudes. Materials and Methods Adult patients with skeletal open bite, indicated for maxillary posterior dentoalveolar intrusion, were recruited and randomly assigned to the comparison or intervention groups. The comparison group involved applying 200 g of intrusive force per segment, which measured 20 g per root, while this force was 400 g per segment in the intervention group, measuring 40 g per root. Results Twenty participants were included in the final analysis after 2 patients dropped out, 1 in each group, to end up with 10 subjects (200 roots) per group. There was statistically significant root resorption of 0.84 ± 0.96 mm and 0.93 ± 1.00 mm in the comparison and the intervention groups, respectively. However, there was no statistically significant difference between the groups. Conclusions Root resorption inevitably took place in association with orthodontic intrusion. However, increasing the magnitude of the intrusive force did not increase the amount of root resorption, either statistically or clinically.

Here is a case report of a 20-year-old female patient with skeletal Class I malocclusion, with Angle’s Class I molar relation on the right and super Class I molar relation on the left side. The patient was diagnosed with hyperdivergent face pattern, proclined upper and lower anteriors, convex profile, potentially competent lips, short upper lip, average nasolabial angle, and anterior facial divergence. Treatment was organized by Damon System and En-masse distalization using the Infrazygomatic Crest and buccal shelf bone screws. The facial changes produced as a result of treatment were directly related to skeletal and dentoalveolar modifications that were designed as goals for patient treatment. It provided a minimal friction environment for the full-arch distalization. In this borderline bimaxillary protrusion case with a good profile, en-masse distalization turned out to be a better option than extracting the premolars and retracting incisors. It also stands out to be an example for the management of the same.

Objective: to confirm a therapeutic equivalence and similar safety profile of “Midazolam, oromucosal (buccal) solution” and “Sibazon, solution for intravenous and intramuscular administration” used in children aged from 1 year to 18 years suffering from primary generalized and bilateral tonic, clonic and tonic-clonic seizures.Material and methods. An open-label, randomized clinical trial on efficacy and safety was conducted with 25 patients having primary generalized and bilateral tonic, clonic and tonic-clonic seizures due to epilepsy or epileptic syndrome. The study used age-appropriate doses of Midazolam with a single buccal administration as well as diazepam (Sibazon) for single intramuscular administration. Midazolam dosing was as follows: 5 mg for children of the younger age group (1 tube-dropper 5 mg/ml), 7.5 mg for children of the middle age group (1 tube-dropper 5 mg/ml and 1 tube-dropper 2.5 mg/ml), 10 mg for older children (2 tube-droppers 5 mg/ml). The drug effectiveness was assessed by primary and secondary criteria. The number of cases of drug administration in each group was used as the primary criteria, in which the convulsions ended up within 10 minutes after using the drug and did not resume within 60 minutes after drug administration. The following criteria were used as secondary: no repeated convulsive seizures within 24 hours after drug administration, no repeated convulsive seizure within 48 hours after drug administration, time before repeated convulsive seizure within 48 hours after drug administration. Clinical assessment was carried out according to clinical data, electroneurophysiologic (electroencephalographic) studies, electrocardiography, clinical blood and urine tests, aswell as biochemical blood tests by measuring glucose, total protein, albumin, total bilirubin, cholesterol, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase, alkaline phosphatase, creatinine, urea, and creatinine clearance level.Results. Compliance with the first efficacy criterion after using Midazolam and Sibazon was observed in 11 (84.6%) and 9 (75%) patients in Group 1 and Group 2, respectively, showing insignificant differences (Fisher's exact test (FET): p=0.645). The number of no cases of repeated convulsive seizure within 24 hours after drug administration differed significantly and was 12 (92.3%) and 6 (50%), respectively (FET: p=0.030). The number of cases with no second seizures within 48 hours after drug administration in Group 1 and Group 2 was 12 (92.3%) and 5 (41.7%), respectively, showing insignificant differences (FET: p=0.0112). No serious adverse events were reported during the study. No patients cancelled participation in the study due to developed adverse event.Conclusion. The data obtained evidence about compatibility of therapeutic efficacy profile and similar safety profile for “Midazolam, oromucosal (buccal) solution” and “Sibazon, solution for intravenous and intramuscular administration” that agrees with multiple data of earlier studies.

Subcutaneous insulin injection is one of the therapies in the treatment of diabetes mellitus. However, problems such as pain at the injection site and lipodystrophy present a challenge that will influence patient compliance. This study aims to develop and characterise buccal film formulations containing insulin, utilising the glucose-lowering and pharmaceutical properties of Aloe vera. Characterisation tests such as morphology, rheological measurement, pH value, mechanical properties, and permeation test were performed on the optimal formulation. Assessment of the glucose-lowering efficacy was performed using alloxan-induced diabetic rabbits. Composition of the final film formulation included 3% w/w sodium carboxymethyl cellulose, 40% v/v glycerol, 70% v/v Aloe vera, 0.5% w/v mannitol, 0.125% w/v aspartame, 0.125% v/v Tween 80 and 15.3 mg insulin. The drug content has been determined to be 56.77 ± 8.55%. The formulation shows a low variation in weight and thickness measurements and acceptable physicochemical properties, in addition to sustained drug release for 6 h. The final film formulation that combined insulin and Aloe vera was effective enough to reduce blood glucose levels compared to the negative control (p > 0.05), despite fluctuation in the blood glucose levels throughout the study, and did not show any enhancement in reduction compared to the insulin-only film. In conclusion, the developed buccal film formulation has the potential to be used as a vessel for the delivery of insulin. Nevertheless, further studies are required to ensure the stability of the insulin via buccal route and stabilisation of insulin within the formulation.

Objectives To report the surgical technique and postoperative outcome of corneal repair with autologous buccal mucous membrane grafts in dogs and cats with descemetoceles, deep corneal ulcers, and perforated corneal ulcers with or without iris prolapse. Animal studied Twelve cats (13 eyes) and fourteen dogs (14 eyes) were treated. Procedures Grafts were harvested from the unpigmented superior labial mucosa using a biopsy punch. The corneal lesion was carefully debrided and cleaned. The graft was secured to the healthy cornea with a combination of simple interrupted and continuous 9-0 polyglycolic acid sutures. In 25/27 treated eyes, an overlying pedicle conjunctival graft was also performed. A temporary nictitating membrane flap was used in all cases. The pedicle conjunctival graft was trimmed about 10-20 days postoperatively. The median follow-up period was 549.2 days (range 14-2691 days). Results No surgical intra-operative complications were observed. The ulcers healed and the integrity of the globe was restored in 24/27 treated eyes. Different grades of corneal fibrosis and/or vascularization and/or pigmentation were observed in all cases at the long-term follow-up. In two cases, enucleation was performed due to postoperative complications and one animal developed phthisis bulbi. A total of 22/27 treated eyes appeared to have regained effective visual function at the last clinical evaluation. Conclusions Autologous buccal mucous membrane grafts appear to successfully manage severe corneal ulcers in dogs and cats, providing a useful and economical alternative to other corneal grafts.

To assess the impact of orthodontic treatment combined with piezocision (OT-PC) on root structure and alveolar bone. Twelve adults were treated with OT-PC. Pre- and post-treatment CBCT examinations evaluated apical root resorption (ARR) and alveolar bone height and thickness changes. Pre- and post-treatment differences were compared using one-sample t test and Wilcoxon signed-rank test. ARRs were generalized and significantly more severe in both anterior sextants compared with posterior sextants. Bone thickness decreased significantly in the maxilla at mid-root and apex areas. The majority of mandibular alveolar bone dehiscences occurred on the buccal aspect at the mid-root level, especially where thickness was less than 0.3 mm. Overall bone height decreased twice as much on the buccal aspect (1.43 mm, P

Background. Oral mucosal cancer is the most prevalent squamous cell cancer of head and neck, with 6,723 cases registered in Russia, including 94 per Volgograd Region, in 2018. A high tumour advancement and complex topography of the surgical area result in extensive soft-tissue defects and impaired swallowing, chewing and speech.Aim. Efficacy assessment of submental myodermal flap application in buccal reconstruction after extended combined oncological resections.Materials and methods. Submental myodermal flap was used as a buccal reconstruction technique in 112 patients aged 42 to 75 years during 2015–2020. Surgery for primary tumour was performed in 88 cases, and in 24 — for recurrence after radiotherapy or surgical excision.Results and discussion. A six-year experience of the submental myodermal flap usage in reconstructive surgery allowed evidently wider indications for extensive oral resection combined with extended, also bilateral, lymphadenectomy. Clinical records on the technique application in primary and recurrent cancer are presented.Conclusion. The submental myodermal flap technique in combination with extended or extended combined surgery for oral mucosal cancer notably increases the tumour resectability at this location and improves function restore in patients. The method widens indications for higher-volume operative aid, considerably reduces postoperative complications and holds a promise to enable more radical surgery. This plastic surgery technique is aesthetic and effectively repairs speech and digestive functions, bringing improvement to the patients’ quality of life and social adaptation.

To investigate the differences in the eyelid and buccal microbiomes between patients receiving long-term prostaglandin analogs for open-angle glaucoma (PG-OAG) and naive-OAG patients by using metagenomics. Eyelid and buccal samples were collected from 30 PG-OAG and 32 naive-OAG patients. The taxonomic composition of the microbiome was obtained via 16S rRNA gene sequencing, operational taxonomic unit analysis, and diversity analysis. Differential gene expression analysis (DEG) and Bland–Altman (MA) plots were used to determine taxon differences between the microbiomes of PG-OAG and naive-OAG patients. The eyelid microbiome showed marginally significant differences, while the alpha-diversity of the buccal microbiome showed significant differences between PG-OAG and naive-OAG patients. However, the beta-diversity of both eyelid and buccal microbiomes was higher in PG-OAG patients than in naive-OAG patients. The MA plot showed cluster differences in the eyelid microbiome. DEG analysis of the eyelid microbiome revealed various taxa differences, including enrichment of Azomonas, Pseudomonas, and Granulicatella in PG-OAG patients over naive-OAG patients, as well as significant depletion of Delftia and Rothia. In the buccal microbiome in PG-OAG patients, taxa such as Rikenella and Stenotrophomonas were significantly enriched. Our findings suggest that the eyelid microbiome differs between PG-OAG and naive-OAG patients, raising concerns regarding the eyelid environment in patients receiving these drugs. The overexpressed microbiome in the eyelid area suggests that microbiota may change after the administration of glaucoma medications in OAG.

Objectives To verify the utility of triangular extension of a hinge flap in buccal mucosal staged urethroplasty to resolve stomal stenosis after the first stage and ultimately prevent restenosis. Methods A total of 23 patients (triangular extension group) were studied in 2013-2019. In the first stage, buccal mucosa was transplanted, and an extended triangle portion of the mucosa was placed beside the proximal and/or distal stoma that was created when the stricture segment of the urethra was resected. In the second stage, during tubularization of the urethral plate, an incision was made at the stoma to increase the caliber to which the triangular extension was inserted. The procedure was considered successful when a 17-Fr flexible cystoscope passed through the reconstructed urethra at 6 months after the second-stage urethroplasty and no additional surgery or bougie dilation required. The clinical course of the triangular extension group was compared with 24 patients who underwent conventional staged urethroplasty (control group). Results In total, 20 patients from each group underwent second-stage surgery. No patients in the triangular extension group required additional revision surgery because of stomal stenosis after first-stage surgery, whereas five (20%) control patients did. Urethroplasty was successful in 19 patients (95%) in the triangular extension group and in 19 patients (95%) in the control group. Uroflowmetry after the second-stage surgery indicated that the mean maximum urinary flow rate was 21.5 and 15.8 mL/s after triangular extension and the control procedure, respectively (P = 0.027). Conclusions The triangular extension technique reduces the need for revision surgery and prevents postoperative restenosis.

Dyskeratosis Congenita is a severe disorder that involves several systems in the human body and is well-known for its transmission hereditarily through generations. The triad of a) reticular atrophy of the skin with pigmentation b) dystrophy of the nails c) leukoplakia of the oral mucosa characterises this uncommon disorder, which most commonly affects men. One of the key reasons for premature death in this disease is malignant transformation within areas of mucosal hyperkeratosis. In Dyskeratosis Congenita, the simultaneous existence of squamous cell carcinoma (SCC) with lichen planus and or lichenoid reactions in the mucosa of the oral cavity is a rare, stated condition. This report discusses a case of a Libyan male patient affected by Dyskeratosis Congenita that ended with buccal mucosal squamous cell carcinoma developed on a lichen planus background after thirty years of suffering at the age of 64.

Angioleiomyoma is a benign neoplasia originating from vascular smooth muscle and very uncommon in the oral cavity. In this report, we present a rare case of angioleiomyoma in oral cavity in a 46-year-old female buccal cheek and discuss the clinical, histological, and immunohistochemical characteristics. As the treatment of choice is the complete excision, the lesion was excised under local anesthesia with no further complications. In addition, a brief update on other reported cases of angiomyoma in the oral cavity is further discussed.

Noncarious cervical lesions (NCCLs) are a common clinical finding often linked with dentin hypersensitivity (DH). Aim. The aim of the study was to evaluate the influence of diode laser for the treatment of DH on microleakage of subsequent NCCL restorations. Materials and Methods. Forty-eight extracted human premolars were collected. All teeth received standardized cervical preparation on both the buccal and palatal surfaces and were randomly divided into three groups ( n = 16 ) according to the restorative material used: nanohybrid composite resin (CR), resin-modified glass ionomer (RMGI), and conventional glass ionomer (GIC). The prepared cavities on the palatal surfaces were treated by diode laser using SIROlaser Blue (Sirona Dental Systems, Bensheim, Germany) prior to restoration, while preparations on the buccal surfaces were directly restored. After thermocycling, the teeth were immersed in methylene blue dye for microleakage evaluation under 40x magnification at both occlusal and cervical margins. The Kruskal-Wallis test followed by the Bonferroni tests was conducted to determine inter- and intragroup differences ( P < 0.05 ). Results. All restorative materials tested showed some degree of microleakage with no statistically significantly different scores with or without the use of laser desensitization prior to restorative treatment. Group CR showed the least microleakage, followed by group RMGI, while group GIC showed the highest. Cervical margins showed greater microleakage than the occlusal margins where the difference was statistically significant in the RMGI group without laser pretreatment ( P = 0.006 ) and in both groups CR ( P = 0.02 ) and RMGI ( P = 0.006 ) with the laser pretreatment. Conclusion. Application of diode laser for the treatment of DH prior to the restoration of teeth with NCCL did not affect the microleakage of all the restorative materials tested. All the materials showed some degree of microleakage, which was higher in gingival margins compared to occlusal margins. The resin composite shows the least microleakage among all the tested materials.

OBJECTIVES To assess platelet function, buccal mucosal bleeding time and plasma von Willebrand factor concentration in dogs with chronic inflammatory and/or fibrotic liver disease and to compare results with those obtained in healthy dogs. MATERIALS AND METHODS Preliminary study including 18 dogs with chronic inflammatory and/or fibrotic liver disease undergoing liver biopsy and 18 healthy age-matched control dogs. Platelet function was assessed by measuring closure time with the PFA-100® analyser using adenosine diphosphate (ADP) as an agonist. Buccal mucosal bleeding time, closure time and plasma von Willebrand factor antigen were measured in dogs in both groups. After undergoing ultrasound-guided needle biopsy, dogs were monitored for haemorrhage to determine if there was an association of any measurement with post-biopsy bleeding. RESULTS The closure time was not different between the liver disease group (median 76.3; range 53 to 118.5 seconds) and control group (72.8; 57 to 89.5 seconds). The buccal mucosal bleeding time was longer in the liver disease group (median 138; range 95 to 229 seconds) than the control group (103; 63 to 200 seconds). The plasma von Willebrand factor antigen concentration was not different between the liver disease group (median 203; range 109 to 351%) and control group (165.5; 63 to 246%). CLINICAL SIGNIFICANCE In this study, dogs with chronic necroinflammatory and/or fibrotic liver disease did not have overt, clinically relevant derangements in platelet function as assessed by buccal mucosal bleeding time, closure time and von Willebrand factor analysis. In addition, none of the dogs undergoing percutaneous ultrasound-guided biopsy in the study exhibited bleeding complications post-biopsy procedure.

Background: Oral submucous fibrosis is a treacherous, devastating state of the mouth bringing about critical wellbeing and social issues, which may meddle with the standard assessment of the oral depression for malignancy, satisfactory nourishing admission, dental cleanliness and discourse. Medicines proposed for OSMF have been palliative instead of remedial. They are pointed toward improving the patient’s capacity to open the mouth, which becomes confined when more scar tissue is shaped as the illness advances. Various unions are accessible today to cover the post fibrotic discharge deformity however none of them alone gave a drawn out victories. In our investigation we looked at two modalities as they were generally advantageous and convey less postoperative morbidity. Collagen sheet as a join to cover the careful deformity and the buccal cushion of fat turned onto the imperfection as a unite to cover it. Aims and Objectives: The current investigation was led to assess the clinical viability of collagen film and buccal cushion of fat join for careful administration of Oral Submucous fibrosis with extraction of third molars, two-sided coronoidotomy, masticatory muscle myotomy with arrival of fibrosis and remaking by collagen layer unite in five patients and buccal fat cushion join in five patients of clinically analyzed stage III, IV Oral Submucous fibrosis with a subsequent time of a half year from September 2010 to September 2012 at Department of Oral and maxillofacial Surgery in Al Badar Rural Dental College and Hospital. Materials and Methods: Ten patients with chief complaint of difficulty in mouth opening with no previous history of any medical or surgical line of treatment and clinically diagnosed as stage III, IV Oral submucous fibrosis were included in this study. Preoperative clinical findings, radiological investigations and maximum incisal distance were assessed for the need of surgical procedure for Oral submucous fibrosis. All the patients u

Objectives: (1) Assess risk factors associated with urethral stricture recurrence (USR). (2) Assess urethral stricture recurrence after end-to-end urethroplasty (EE) and buccal mucosal graft urethroplasty (BMG). Subjects and methods: A total of 29 males with urethral stricture who underwent either an end-to-end urethroplasty or a buccal mucosal graft urethroplasty were included in this study and followed for 18 months. The association between risk factors and stricture recurrence was assessed. Results: Overall mean patient age was 51.69 ± 14.22 years, time to recurrence was 3 months (IQR: 1–6.25), and stricture length was 2.57 ± 1.30 cm. Important risk factors for USR were stricture length ⩾ 2 cm ( p = 0.024), older age ( p = 0.042), BMI > 25 kg/m2 ( p = 0.021), Qmax after catheter removal 2 = 14.87 p ⩽ 2 = 6.10, p = 0.021). End-to-end urethroplasty showed less USR than BMG, however, these differences were not statistically significant (41.6% vs 22.2%, respectively, p ⩾ 0.05). Conclusions: Stricture length, age, BMI, and previous urethral procedures predict USR, furthermore, an initial Qmax after catheter removal is an objective measure predictive of USR. There’s no difference in USR rate between BMG and EE urethroplasties.

Objective The objective of this study was to evaluate and compare the efficacy of topical curcumin gel and buccal mucoadhesive patches in the management of oral submucous fibrosis (OSMF). Study Design Forty patients clinically diagnosed with OSMF were randomly divided into 2 groups. Group A received curcumin gel and group B received curcumin mucoadhesive patches, to be used twice daily for 8 weeks. Evaluation was done every 2 weeks. Serum lactate dehydrogenase (LDH) levels were measured before and after treatment and also in 20 healthy controls. Results A 100% reduction in burning sensation was observed in all 40 patients at the end of 4 weeks. Mouth opening improved by 5.45 ± 1.64 mm in group A and 5.9 ± 2.00 mm in group B. Pretreatment LDH was 359.72 ± 77.02 IU/L in patients with OSMF, which was significantly higher than that in healthy volunteers (173.2 ± 46.20 IU/L). In group A, LDH values reduced from 341.85 ± 71 IU/L to 264.95 ± 65.09 IU/L and in group B, values reduced from 377.6 ± 79.76 IU/L to 286.15 ± 72.95 IU/L after treatment. Conclusion Curcumin gel and mucoadhesive patches were effective in improving mouth opening and reducing burning sensation in patients with OSMF. They can therefore be considered as safe, noninvasive modalities for treatment of OSMF.

Background Oral tumors are uncommon in rabbits, and one study reports benign odontogenic tumors are relatively common compared to domestic companion animals, which has important treatment and prognostic implications. Case description A 10-year-old male intact dwarf-mix rabbit (Oryctolagus cuniculus) presented with weight loss and a 4-day history of progressive inappetence, decreased fecal output, and ptyalism. A head CT revealed a partially mineralized, mildly contrast enhancing oral mass associated with the right buccal mucosa and protruding to the level of the tongue. The head CT also revealed dental malocclusion with an odontogenic abscess ipsilaterally to the mass. An excisional biopsy of the oral mass revealed an ectopic elodontoma. Following excisional biopsy of the oral mass, the rabbit's dental malocclusion was treated with a dental trim and the abscess was treated with systemic antibiotics, anti-inflammatories, and surgical debridement with marsupialization. The rabbit continues to have periodic dental trims and has had no clinical recurrence of the mass in the sixteen months following excision, although the buccal mucosa in the location appears irregularly textured. Conclusion and case relevance This is the first report to characterize an ectopic oral elodontoma with advanced imaging. Ectopic elodontoma should be a differential diagnosis for buccal mucosal masses in rabbits. Odontogenic oral tumors are more commonly reported in rabbits compared to other nondomestic species, and reasonable long-term control was achieved in this case by excisional biopsy.

Background Oral lichen planus is a chronic inflammatory and immune-mediated disease that affects the oral mucosa. Recent findings have suggested that oral lichen planus is often associated with submucosal fibrotic changes. Fibrotic changes in the buccal submucosa may cause restricted mouth opening. This report discusses the histopathological examination (including specialized staining) and surgical treatment for oral lichen planus-induced fibrotic changes. Case presentation Here, we describe a 63-year-old woman who had oral lichen planus with fibrotic changes. Her maximum mouth opening distance was approximately 30 mm due to submucosal fibrotic changes, and she exhibited gradual fibrosis progression. Histological examinations were performed to assess the oral lichen planus-induced fibrotic changes. Then, double Z-plasty were performed as treatment for restricted mouth opening. The immunohistochemical staining results were negative for cytokeratin 13 and positive in some layers for cytokeratin 17 and Ki-67/MIB-1. Masson's trichrome staining showed enhanced collagen formation. Postoperative mouth opening training enabled the patient to achieve a mouth opening distance of > 50 mm. Conclusion Our findings suggest that histopathological examination with specialized staining can aid in the evaluation of oral lichen planus-induced fibrotic changes, and that Z-plasty is effective for the treatment of restricted mouth opening due to oral lichen planus.

Impacted mandibular third molar extraction is one of the most frequent procedures performed in the field of oral surgery. Oral surgeons sometimes face cases that cannot be extracted using the conventional procedure because of atypical tooth structure or irregular tooth position in the mandible. Here, we report an unusual impacted third mandibular molar with atypical root form, which was extracted by buccal cortex osteotomy of the mandibular ramus. A 42-year-old Japanese female presented with a complaint of discomfort in the left molar region. Radiographical examination showed an impacted third molar with a mushroom-like root overlapping the mandibular canal. This lesion was radiographically diagnosed as cemental hyperplasia. The tooth could not be extracted using the conventional procedure, and buccal cortex osteotomy was applied. Briefly, bones necessary for extraction were removed once from the mandibular ramus. After extraction, the bony fragment was repositioned in the original position. The patient experienced no postoperative complications such as nerve paralysis, mandibular angle fracture, and infections. Buccal cortex osteotomy is a simple and easy technique to extract impacted mandibular third molars that cannot be extracted by conventional methods.

Oral submucous fibrosis is a collagen disorder commonly seen in the population with areca nut chewing habit, which is more prevalent in the Indian subcontinent. Various studies have suggested a multifactorial origin with a high incidence of the disease in association with consumption of the areca nut. However, it has never reported being secondary to buccal mucosal graft procedures. We are presenting a case of submucous fibrosis secondary to buccal mucosal graft for urethroplasty.

Background The best treatment approach for wide oral leukoplakia (OL) remains to be determined. Aims To evaluate the outcomes of using an allograft dermal matrix (ADM) for reconstructing large oral epithelial defects following resection of OLs. Patients and methods A total of 27 OLs in 26 patients were excised, and residual large lingual and buccal epithelial defects were reconstructed using an ADM, which ranged in size from 3.0 × 5.0 to 6.0 × 6.0 cm. The patients were classified into mild (n = 1), moderate (n = 13), and severe dysplasia (n = 12) groups; 57.7% of the patients were tobacco smokers, 46.2% were alcoholics, 47.2% were both smokers and alcoholics, and 11.5% were both smoking and betel quid chewers. Patients who underwent surgery were advised to quit smoking, drink alcohol in moderation, or quit betel quid chewing. Results Two patients developed slight hematomas that resolved spontaneously within 2 weeks. A total of 76.9% of the smokers followed the advice to quit smoking, 83.3% of the alcoholics followed the advice to drink in moderation, and all three betel quid chewers followed the advice to quit chewing betel quid. The mean follow-up was 26.7 months. No MT occurred and recurrence was seen in two patients. Conclusions Large epithelial defect reconstruction using an ADM following resection of wide lingual and buccal OLs was safe and reliable for preventing MT of OL. The recurrence of OL may be related to patient habits such as tobacco smoking or/and drinking alcohol.

Background: The use of oral mucosa grafts in urethroplasty involves transplantation of non-keratinized oral mucosa for the repair of urethral strictures. In the last two decades this has emerged as the most widely used substitute tissue in urethral reconstruction. Harvesting of oral mucosal grafts for urethroplasty, however, has certain complications. Objective: This study evaluated the donor site complications associated with oral mucosa graft harvest for anterior urethral reconstruction for stricture. Materials and Patients: This prospective study of 28 consecutive patients presented at the Urology Unit of a University Teaching Hospital with long-segment urethral stricture and underwent oral mucosa graft harvest and substitution urethroplasty. The donor sites were evaluated at 48 hours, at discharge, 1 month and 3 months postoperatively for complications. Results: The patients' mean age in this study was 45.4 (+ 13.2) years with a range of 14-69 years. The mean length of graft was 5.25cm (+ 2.00), range of 1.5cm -11.0 cm. The location of strictures was bulbar urethra in 14 (50%), in 12 (43%), it was present in the penobulbar and 2 (7%) penile urethra. Graft donor sites were buccal in 25 (89.3%) in 2 (7.0%), buccal and labial and in 1 patient (3.5%) was lingual. Donor site complications included pain (32%), bleeding (14%) and peri-oral numbness (3.5%). All were able to eat and drink within 48hrs post-operatively and donor site complications resolved at discharge, and there were no events at follow-up. Conclusion: Harvesting of oral mucosa graft for substitution urethroplasty is safe, but maybe. associated with minimal short- term donor site complications

The role of platelet-rich fibrin (PRF) in accelerating orthodontic tooth movement has been controversially discussed in available clinical studies. To investigate the effectiveness of i‑PRF in accelerating maxillary canine retraction. A split-mouth design was applied in 21 participants (6 men, 15 women; mean age: 20.85 ± 3.85 years) whose class II division I malocclusion required the extraction of both maxillary first premolars. The right and left canines were randomized into intervention and control sides. After the initial leveling and alignment phase and immediately before canine retraction, i‑PRF obtained from the brachial vein was injected into the mucosa on the buccal and palatal aspects of the intervention sides. The injection was repeated one month later. Study casts were taken at the initiation of canine retraction (T0) and at monthly visits up to 5 months (T1 through T5). The paired t‑test was used to compare the total and monthly rates of canine retraction, canine rotation, and anchorage loss. The average rates of canine retraction were greater on the experimental side at T2, T3, and T4, but this difference with the control side was statistically significantly different only at T2 (P

This study aimed at comparing surgical outcomes and patient-reported donor site morbidity between lingual mucosal graft (LMG) and buccal mucosal graft (BMG) through a meta-analysis of comparative studies. A systematic literature search was performed in January 2019 including non-randomized comparative studies and randomized controlled trials (RCT). The assessed data included urethroplasty outcomes, complications, and donor site morbidities such as pain, bleeding, swelling, numbness, difficulty speaking, difficulty eating, mouth opening, and difficulty with tongue protrusion. A total of 632 patients (LMG 323, BMG 309) from 12 comparative studies (four RCTs and eight non-randomized) were included in the meta-analysis. Overall pooled effect estimates revealed no significant difference on reported surgical outcomes and operative stricture-related complications. The LMG group reported a higher proportion of patients with difficulty speaking (RR 6.96, 95% CI 2.04–23.70) and difficulty with tongue protrusion (RR 12.93, 95% CI 3.07–54.51) within 30 days post-op. In comparison, the BMG group had significantly more incidence of early post-procedural donor site swelling (RR 0.39, 95% CI 0.25–0.61) and numbness within 30 days post-op (RR 0.48, 95% CI 0.23–0.97) and 3–6 months (RR 0.52, 95% CI 0.30–0.90) post-op. The evidence suggests no overall significant difference between LMG and BMG with regard to urethroplasty outcomes at 1-year follow-up. While patients undergoing LMG urethroplasty have a higher chance of experiencing difficulty with speech and difficulty with tongue protrusion within 1 month of surgery, the BMG group is more likely to experience early donor site swelling and mouth opening difficulty within 30 days post-op, as well as oral numbness for up to 6 months.

The association between the tumor subsites of the oral cavity and the risk of osteoradionecrosis of the jaw (ORNJ) remains unclear. We study the correlation between oral cavity tumor subsites and the risk of ORNJ in a nationwide population-based database. We enrolled 16,701 adult patients with oral cavity cancers who were treated with radiotherapy between 2000 and 2013. The subsites of the oral tumor, treatments of oral cavity cancers, and the timing of tooth extraction were examined for their association with ORNJ in oral cancer patients. 903 patients (5.40%) developed ORNJ. Of the relevant variables, pre-RT mandible surgery, tooth extraction either before or after RT, and tumor sites were associated with the risk of ORNJ. The adjusted HRs for ORNJ in the mouth floor, gums, retromolar, and buccal cancer were 2.056 (1.490–2.837), 1.909 (1.552–2.349), 1.683 (1.105–2.562), and 1.303 (1.111–1.528), respectively, compared with the risk of tongue cancer. There was no significant difference in the risk of ORNJ between the pre-RT extraction group, the during-RT extraction group, and the post-RT extraction (less than 6 months) group; the post-RT extraction (more than 6 months) group had a significantly higher risk of ORNJ. This study demonstrated that oral cavity tumor subsite is an independent risk factor of ORNJ after RT. Post-RT extraction (less than 6 months) group did not carry a significantly higher risk of ORNJ compared with pre-RT extraction group or during RT extraction group.

Introduction: Oral cancer is one of the worldwide health problems accounting as the 6th common of all malignancies. Majority of the oral cancer develop from premalignant conditions of the oral cavity due to the chronic habit of tobacco chewing and smoking. The prominent cells of the oral mucosa are fibroblasts playing a major role in synthesis of extracellular matrix, wound healing, and wound repair. Arecoline, one of main ingredients of tobacco is considered as a risk factor for the development of oral premalignant lesions and cancer. The arecoline is reported to have both genotoxic and morphological alteration of oral fibroblasts leading to Oral submucous fibrosis. Thus in our study a dose dependent effect of arecoline was assessed on the morphology of cultured Human Buccal Mucosal Fibroblasts. Aim: The aim of our experiment is to assess the effect of different concentration of arecoline on the morphological variation of primary cell lines of human buccal mucosal fibroblasts to develop a model of altered fibroblasts. Materials and Methods: The primary cell lines of human buccal mucosa were established in BSRC KAHER Belagavi, and authenticated by STR profiling from DNA forensics Lab New Delhi. The cells were further cultured and assessed after treating with different concentration of arecoline hydrobromide. The treated cells were then observed for the phenotypic changes and recorded. The morphological alterations were compared to the untreated fibroblasts. Results and Conclusion: In our study, a dose-dependent effect of arecoline was assessed on phenotypic or morphological alteration of buccal mucosal fibroblasts. The results justified that concentration of arecoline lower than 125 μg/ml did not show change in the morphology of buccal mucosal fibroblasts, whereas the concentration of arecoline >250 μg/ml showed altered fibroblasts. Hence, it can be concluded that the levels of arecoline in arecanut chewers if it is >250 μg/ml, the mucosal fibroblasts may undergo changes to cause fibrosis of collagen. The future scope of our study is to determine the genotoxic effects of arecoline on buccal mucosal fibroblasts and also to develop the therapeutic effects.

Aim: The present study was planned to clinically determine the effectiveness of colchicine as a monotherapy in oral submucous fibrosis (OSMF) patients. Materials and Methods: Thirty OSMF patients were enrolled in the study and randomly divided into two groups by permuted-block randomization. Group A: Patients were treated with 0.5 mg colchicine (Goutnil) tablets twice daily for 3 months. Whereas, in Group B, intralesional injection of dexamethasone 2 mL, hyaluronidase 1,500 IU with 2 mL lignocaine HCl biweekly for 4–6 weeks were given. For all the individuals, baseline parameters like mouth opening, buccal mucosal flexibility, burning sensation, and tongue protrusion were recorded and reassessment was done at 1, 3, and 6 months followed by statistical analysis. Results: A significant decrease in the Visual Analogue Scale (VAS) score for severity of burning sensation was observed in Group A whereas mouth opening and tongue protrusion were higher in Group B patients. Statistically significant differences in the buccal mucosal flexibility were appreciable in the intragroup comparisons of both the groups from baseline to 6-month follow-up. Conclusion : Colchicine can be suggested as an adjuvant drug for reducing the burning sensation for the OSMF patients in whom steroids are contraindicated.

Purpose: This study aimed to evaluate Peri-implant strain with locator and bar attachment during dislodging of maxillary implant overdenture Materials and methods: Four implants were inserted in completely edentulous acrylic maxillary model in canine and premolar areas. Experimental maxillary overdentures with 4 metal hooks were constructed and connected the implants with bar attachments (group I) or locator attachment (group 2). Two strain gauges were bonded at buccal and palatal surface of each implant. Micro strains were measured at buccal and palatal surface of canine and premolar implants during the vertical dislodging of the overdenture. Dislodging was made by chains connected at one end to the metal hooks and to a universal testing machine at the other end. Results: For canine and premolar implants, locator attachment showed significant higher microstrain values than bar attachments at buccal and palatal gauge positions. For bar group, no difference between buccal and palatal strain gauge positions was detected. However, for locator attachments, buccal strain gauges demonstrated significant higher strain than palatal gauges. For buccal and palatal strain gauges, canine implants showed higher strains than premolar implants for both groups Conclusion: Within the limitation of this in vitro study, could be concluded that bar attachments may be recommended to retain maxillary implant overdentures than locator attachments in terms of reduced peri-implant stresses that occur during the denture dislodgment which may lead to increased bone resorption around the implants.

The aim of this study was to correlate the absence of BB with skeletal patterns and incisor inclination using cone-beam computed tomography (CBCT). The sample comprised CBCT images of 45 patients undergoing orthodontic treatment. BB was classified in each third of the anterior teeth as critical, slender, regular, and thick. The skeletal pattern was determined by the ANB (A point, nasion, B point) angle and the incisor inclination using the 1.NA and 1.NB measurements and the interincisal angle (1:1). In both analyses, the skeletal pattern of class II revealed better BB in the cervical and middle thirds than classes I and III. A higher proportion of critical BB was found in the middle thirds, and the apical third presented the best regular and thick BB conditions, mainly class I. Less BB was observed in middle and apical thirds in the upper incisors and in cervical thirds in lower incisors, mostly when they were more upright. Knowledge of alveolar bone height and thickness can alter the treatment plan in orthodontics. During orthodontic treatment, more attention should be paid to the lower incisors and vertical teeth because of poor BB conditions, especially in class III skeletal patterns.