Oral Surgery, Oral Medicine, Oral Pathology ,Oral Radiology

Comparison of in situ cone beam CT scan data with ex vivo optical scan data in the measurement of root surface area Publication date: Available online 16 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Pengcheng Jia, Gang Yang, Wenjie Hu, Kwok-Hung Chung, Yijiao Zhao, Muqing Liu, Curtis S.K. Chen Abstract Objective To compare root surface area (RSA) measurements of single-root teeth in a sheep mandible based on cone beam computed tomography (CBCT) to measurements made with an optical scanner. Study Design Eight anterior teeth of a sheep cadaver mandible were scanned in situ using CBCT with 3 different exposure parameters, followed by treatment with smoothing software. The teeth were then extracted and scanned individually with an optical scanner. Three-dimensional (3-D) digital models of the teeth were reconstructed based on CBCT and optical scanner data. RSA data were calculated and an equivalence test was used to statistically compare the measurements with significance of difference established at α=0.05. Results The means of the differences between RSA measurements from CBCT and optical scanning ranged from 0.33% to 3.01%. There were no statistically significant differences between the two methods. The smoothing parameters for good fitness of the linear regression were determined to be 0.8 for the smooth factor, 8 for iterations, and 0 for compensate shrinkage. Conclusions The proposed CBCT technique to measure RSA is feasible. RSA data obtained from CBCT in situ are as accurate as optical scanner measurements ex vivo.

Risk factors for hypoesthesia following repair of facial fractures Publication date: Available online 16 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Jae Min Song, Sang Hun Shin, Jae Yeol Lee Abstract Objective The aim of this study was to investigate the incidence of hypoesthesia in patients with facial bone fractures, and to identify the relationships between post-traumatic hypoesthesia and risk factors, including general and fracture-related characteristics. Study Design A total of 437 patients who underwent surgery for facial bone fractures were included. Clinical neurosensory testing was performed at different time points (post-trauma and 1 week, 1 month, and 6 months after surgery). The results of these assessments were compared between characteristics and fracture sites. Results The hypoesthesia incidences were highest in the mandible (19.1%), maxilla (18.3%), and orbit (8.5%). Sensation was recovered by 97.3% of all patients by 6 months after surgery. Risk factors for hypoesthesia were direct nerve injury (p = .002), distance (≤ 10 mm) between the fracture and nerve foramen (p = .002), the amount of bony displacement (p = .035), and age (p = .004). There were significant differences among the fracture sites. Conclusions Post-traumatic hypoesthesia increased temporarily after surgery but most patients recovered by 6 months postoperatively. Recovery from postoperative hypoesthesia was related to the fracture site and pattern. Cases in which the patient did not recover involved direct nerve injury.

Oral health-related quality of life in women with temporomandibular joint disc anterior displacement, before and after disc repositioning and anchoring surgery, assessed with The Oral Health Impact Profile (OHIP-14) Publication date: Available online 16 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Roberto Ferreira Zanin, Guilherme Ommizolo, Alexandre Weber, Cláiton Heitz, Eduardo Martinelli Santayana de Lima ABSTRACT Objectives to assess and compare oral health-related quality of life (OHRQOL) in women with temporomandibular join (TMJ) disc displacement without reduction, before disc repositioning and anchoring surgery, in short-term follow-up, different age groups, and using the Oral Health Impact Profile (OHIP-14). Study Design fifty women between 17 and 60-years-old were divided into four age groups: 17-27, 28-38, 39-49, and 50-60 years. All the patients were asked to answer the OHIP-14 form before surgery and during their short-term follow-up. Seven domains of OHRQoL were rated in a five-point Likert scale from 0 (never) to 4 (very often). Domains' scores and total OHIP-14 wer compared between times with Student's t test in whole sample and age groups. Results The whole sample and groups 17-27, 28-38, 39-49 years showed a decrease statistically significant in all scores (p < 0.01). The group 50-60 years showed a decrease in score significant only in functional limitation (p = 0.05) Conclusion TMJ disc anterior displacement had a negative impact on women's OHRQOL due to physical pain, physical disability, and psychological discomfort. TMJ disc repositioning and anchoring surgery improved overall OHRQOL in patients between 17 and 49-years-old; however, in patients between 50 and 60-years-old only improved physical pain.

Asymptomatic intrabony radiolucency of the anterior mandible Publication date: Available online 16 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Ho-Hyun Sun, Sheng-Chuan Lin, Chan M. Park, Jeffrey A. Elo

In Memoriam: Ray Melrose Publication date: Available online 9 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s):

Relationship of Gray Values in Cone Beam Computed Tomography and Bone Mineral Density Obtained by Dual Energy X-ray Absorptiometry Publication date: Available online 7 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Abbas Shokri, Mahsa Ghanbari, Fatemeh Hafez Maleki, Leila Ramezani, Payam Amini, Leili Tapak Abstract Objectives To assess the correlation between bone mineral density (BMD) determined by cone-beam computed tomography (CBCT) gray values and BMD determined by dual energy X-ray absorptiometry (DEXA). Study Design Women over 50 years of age who required CBCT scans for implant treatment were selected. BMD was determined by calculating the mean gray value of CBCT cross-sectional images of anterior, premolar, retromolar, and tuberosity areas of the mandible and maxilla. Patients were then subjected to DEXA of the femoral neck and lumbar spine. Independent t-tests, ANOVA, Pearson's correlation tests, and receiver operating characteristic (ROC) evaluation were used for data analysis. Results Of 61 asymptomatic patients with a mean age of 64 years, 47.5% and 55.7% had abnormal BMD based on the T-score of the femoral neck and lumbar spine, respectively. Significant correlations were noted between T-scores of both the femoral neck and lumbar spine with gray values of the maxillary incisor and tuberosity areas. Conclusion A strong correlation exists between CBCT gray values at different sites in the maxilla and the results of DEXA. A gray value <298 at the maxillary tuberosity can differentiate between osteoporotic and normal individuals with 66 - 67% accuracy and suggests the need for DEXA analysis.

TMJ MORPHOLOGY DOES NOT INFLUENCE THE PRESENCE OF ARTHRALGIA IN PATIENTS WITH DISC DISPLACEMENT WITH REDUCTION: AN MRI-BASED STUDY Publication date: Available online 4 May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Rodrigo Lorenzi Poluha, Carolina Ortigosa Cunha, Leonardo Rigoldi Bonjardim, Paulo César Rodrigues Conti Abstract Objective To compare temporomandibular joint (TMJ) morphology, by magnetic resonance imaging (MRI), between patients with disc displacement with reduction (DDWR) with and without arthralgia and a control group, and to identify which factors are associated with the concomitant presence of arthralgia in DDWR patients. Methods In this investigation, 36 TMJ MRIs were divided into three groups. Group 1 (n=12): patients with DDWR and arthralgia; group 2 (n=12): patients with DDWR without arthralgia; and group 3 (n=12): control group. Disc and mandibular condyle morphology, articular eminence morphology and inclination; size of the mandibular fossa; joint space size; joint effusion; bone marrow of the mandibular condyle; and the relative signal intensity of retrodiscal tissue were evaluated. Results Fisher's exact test and one-way ANOVA revealed no significant differences (p>0.05) between groups for any variable. Logistic regression analysis showed that no anatomical variables were related to the concomitant presence of arthralgia in DDWR patients (p>0.05). Conclusion As evaluated on MRI scans, no significant differences in anatomical characteristics of the TMJ were detected between DDWR patients with and without concomitant arthralgia and with the control group. There were no factors associated with the concomitant presence of arthralgia in DDWR patients.

Contrast-enhanced computed tomography image assessment of cervical lymph node metastasis in patients with oral cancer by using a deep learning system of artificial intelligence Publication date: May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 5 Author(s): Yoshiko Ariji, Motoki Fukuda, Yoshitaka Kise, Michihito Nozawa, Yudai Yanashita, Hiroshi Fujita, Akitoshi Katsumata, Eiichiro Ariji Objective Although the deep learning system has been applied to interpretation of medical images, its application to the diagnosis of cervical lymph nodes in patients with oral cancer has not yet been reported. The purpose of this study was to evaluate the performance of deep learning image classification for diagnosis of lymph node metastasis. Study Design The imaging data used for evaluation consisted of computed tomography (CT) images of 127 histologically proven positive cervical lymph nodes and 314 histologically proven negative lymph nodes from 45 patients with oral squamous cell carcinoma. The performance of a deep learning image classification system for the diagnosis of lymph node metastasis on CT images was compared with the diagnostic interpretations of 2 experienced radiologists by using the Mann-Whitney U test and χ2 analysis. Results The performance of the deep learning image classification system resulted in accuracy of 78.2%, sensitivity of 75.4%, specificity of 81.0%, positive predictive value of 79.9%, negative predictive value of 77.1%, and area under the receiver operating characteristic curve of 0.80. These values were not significantly different from those found by the radiologists. Conclusions The deep learning system yielded diagnostic results similar to those of the radiologists, which suggests that this system may be valuable for diagnostic support.

Fixed drug eruption on the tongue associated with piroxicam: report of two cases and literature review Publication date: May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 5 Author(s): Eleni-Marina Kalogirou, Konstantinos I. Tosios Objective The aim of this study was to describe 2 patients with piroxicam-associated fixed drug eruption on the tongue and to review the literature. Study Design Two females presented with recurrent ulcers after taking piroxicam for dysmenorrhea and pelvic pain. The English language literature was reviewed for cases of piroxicam-induced fixed drug eruptions, with a report on the site of occurrence. Results The ulcers reappeared in the identical lingual site after piroxicam intake; 3 times in patient #1 and 2 times in patient #2. Extraoral lesions were not observed. Following discontinuation of piroxicam, no relapse was reported. The literature review found 25 patients with piroxicam-associated fixed drug eruption. The oral mucosa/lips were affected in 8 patients who also had cutaneous/genital lesions. Solitary tongue involvement was not reported in any of them. Cross-sensitivity among different drugs of the same class is not unusual. Conclusions Fixed drug reactions to piroxicam are rare, although nonsteroidal antiinflammatory drugs are among the most common causes of fixed drug eruptions. Of these rare fixed drug reactions to piroxicam, cutaneous lesions are reported much more often compared with oral mucosal lesions. Discontinuation of the causative drug is essential to promote healing and to avoid recurrences. Patients with history of piroxicam-induced fixed drug eruption should also avoid other oxicams because of potential cross-sensitivity.

Effect of "surgery first" orthognathic approach on temporomandibular symptoms and function: a comparison with "orthodontic first" approach Publication date: May 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 5 Author(s): Kensuke Yamauchi, Tetsu Takahashi, Yoshihiro Yamaguchi, Hikari Suzuki, Shinnosuke Nogami, Junji Sugawara Objective The aim of this study was to comparatively evaluate the effects of the surgery-first approach (SFA) and the orthodontics-first approach (OFA) on temporomandibular joint (TMJ) function and maximum mouth opening. Study Design This retrospective study investigated the outcomes of patients with diagnosed skeletal class III dentofacial deformities. Twenty-four patients were enrolled in the OFA group, and 23 patients were enrolled in the SFA group. All patients were examined in the same manner 4 times: before surgery and at 1, 3, 6, and 12 months after surgery. Range of mouth opening (ROM) was measured between the maxillary and mandibular central incisors. Symptoms were evaluated subjectively by using a questionnaire with items pertaining to pain on mandibular movements, TMJ sounds, and pain in masticatory muscles region. Results No severe complications or relapse occurred in either group during the 12-month follow-up period. Postoperative changes in ROM showed similar tendencies, but there was no significant difference in ROM during the follow-up period between the OFA and SFA groups (P < .05). The percentage reduction was nearly 45% at 1 month postoperatively and 20% at 3 months postoperatively compared with the preoperative situation. After 6 months postoperatively, the ROM was almost the same as before surgery. The number of patients with such sounds increased with time until 12-month postoperative examinations in the OFA group but increased slightly during this period in the SFA group. During the first 3 months postoperatively, less than 10% of patients in both groups had newly detected pain of TMJ and/or muscles. At 6 and 12 months postoperatively, only 1 patient in the SFA group had pain. Conclusions No significant differences in TMJ symptoms or function were observed during a 12-month follow-up period between patients with skeletal class III malocclusion treated with the SFA and those treated with the OFA.

Alexandros Sfakianakis
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