Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Squamous cell carcinoma (SCC) of the dorsum of the tongue is extremely rare, and it clinically resembles various benign lesions. Somatic mutations in TP53 and some driver genes were implicated in the development of SCC; however, the somatic genetic characteristics of dorsal tongue SCC remain unknown. With a detailed analysis of gene mutations in dorsal tongue SCC, we aimed to better understand its biology.

Methods

Four cases of SCC initially occurring on the tongue dorsum were evaluated for clinical and histological findings and immunohistochemical expression of p53 and p16. Gene mutations were analyzed using next-generation sequencing with a custom panel of driver genes.

Results

We retrospectively investigated 557 cases of tongue SCC, and only four cases of SCC initially occurred on the tongue dorsum. The four patients (cases 1–4) were one woman and three men with a mean age of 53.75 years (range: 15–74 years). Histological analysis revealed well-differentiated SCC. Through molecular analysis, we identified pathogenic somatic mutations, namely, TP53 p.C176F (c.527G > T) in case 3 and TP53 p.R282W (c.844 C > T) in case 4. No pathogenic variants were identified in the PI3K/AKT or RAS/RAF pathways. The p53 immunohistochemical examination revealed a wild-type expression pattern in cases 1–3 and strong expression in case 4. The results of p16 immunostaining were negative in all cases.

Conclusions

We described four previously unreported genetic characteristics of dorsal tongue SCC. Somatic TP53 mutations may contribute to the development of a subset of dorsal tongue SCC; however, more cases with genetic analysis need to be accumulated.

DOI： 10.1186/s13000-024-01487-0

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Other Link： https://link.springer.com/article/10.1186/s13000-024-01487-0/fulltext.html

Language：Japanese   Publisher：香川県立中央病院  

顎顔面外傷患者では顎骨骨折に伴う上顎骨の後方移動,下顎骨の連続性消失や軟組織の浮腫および出血による気道閉塞リスクがあり,適切な気道の評価および気道管理が重要となる.下顎骨単独の骨折で緊急気道管理を行うことは少ないが,下顎骨は気道周囲の軟組織や舌骨を支持しているため,骨折の様式によっては気道閉塞を生じる可能性がある.特に,オトガイ部骨折と下顎骨関節突起部骨折を併発する骨折様式では,下顎角部が外旋し,下顎骨骨体部が内側に偏位する事で,口底と舌の後方移動をもたらすフレア形態[1]を呈するため,緊急気道管理を必要とする可能性が高くなる.そのため,初療時における気道リスク評価および気道管理の判断は,顎顔面外科専門の診療科と麻酔科医・救急科医が連携し慎重に行う必要がある.今回,われわれは,下顎骨がフレア形態を呈したことで緊急気道管理が必要となった顔面多発骨折の症例を経験したので報告する.(著者抄録)

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jcms.2024.01.015

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Language：Japanese   Publisher：(公社)日本口腔外科学会  

26歳男性。左側下唇を誤咬した後、滲出液を伴う腫瘤を自覚し、近在病院の歯科を受診した。加療されるも改善なく、腫瘤の増大傾向がみられたため、精査目的で当科へ紹介となった。初診時、左側下唇粘膜には25×12mm大の潰瘍を伴う腫瘤が認められた。造影CT画像では腫瘤は不整な外形を呈するが、明らかな内部性状の異常はみられなかった。アレルギー疾患や梅毒を疑い、血液検査が行われたが否定的で、組織生検によりランゲルハンス細胞組織球症(LCH)と診断された。全身検索の結果、下唇と左側眼瞼皮膚に発生したLCH SM型であり、下唇の病変にはコルチコステロイドを局所注射し、眼瞼の病変にはコルチコステロイド軟膏を塗布した。治療開始8ヵ月後には下唇の病変と左眼瞼皮膚の紅斑は消失し、8年経過現在、再燃や他臓器病変の出現はみられていない。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01073&link_issn=&doc_id=20230630350002&doc_link_id=10.5794%2Fjjoms.69.298&url=https%3A%2F%2Fdoi.org%2F10.5794%2Fjjoms.69.298&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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Language：Japanese   Publisher：日本口腔組織培養学会  

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Language：Japanese   Publisher：(NPO)日本顎変形症学会  

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Language：Japanese   Publisher：(NPO)日本顎変形症学会  

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Language：Japanese   Publisher：(NPO)日本顎変形症学会  

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Language：Japanese   Publisher：(一社)日本口腔診断学会  

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Language：Japanese   Publisher：(一社)日本口腔診断学会  

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Language：Japanese   Publisher：(一社)日本口腔内科学会  

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Language：English  

In younger patients of LCH, we should consider that the effectiveness of follow-up without aggressive treatment for SS-type LCH in the oral and maxillofacial bone. However, there are very rare case in which an SS-type LCH recurred after showing a healing tendency. Regular follow-up must be performed even after healing.

DOI： 10.1002/ccr3.4321

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Language：Japanese   Publisher：(NPO)日本顎変形症学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Lower third molar removal is the most commonly performed dental surgical procedure. Nevertheless, it is difficult to ensure that all the informed consent forms given to patients are based on the best evidence as many newer publications could change the conclusions of previous research. Therefore, the goal of this review article is to cover existing meta-analyses, randomized control trials, and related articles in order to collect data for improved and more current informed consent.

DOI： 10.1002/ca.23693

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Language：English  

Consideration of unexpected metastasis in patients who have undergone neck dissection with advanced tumors must be anticipated with careful follow-up.

DOI： 10.1002/ccr3.3086

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Language：English   Publishing type：Research paper (scientific journal)  

Advanced head and neck cancer (HNC) can invade facial bone and cause bone pain, thus posing a significant challenge to the quality of life of patients presenting with advanced HNC. The present study was designed to investigate HNC bone pain (HNC‑BP) in an intratibial mouse xenograft model that utilized an HNC cell line (SAS cells). These mice develop HNC‑BP that is associated with an expression of phosphorylated ERK1/2 (pERK1/2), which is a molecular indicator of neuron excitation in dorsal root ganglia (DRG) sensory neurons. Our experiments demonstrated that the inhibition of high mobility group box 1 (HMGB1) by short hairpin (shRNA) transduction, HMGB1 neutralizing antibody, and HMGB1 receptor antagonist suppressed the HNC‑BP and the pERK1/2 expression in DRG. It was also observed that HNC‑derived HMGB1 increased the expression of the acid‑sensing nociceptor, transient receptor potential vanilloid 1 (TRPV1), which is a major cause of osteoclastic HNC‑BP in DRG. Collectively, our results demonstrated that HMGB1 originating in HNC evokes HNC‑BP via direct HMGB1 signaling and hypersensitization for the acid environment in sensory neurons.

DOI： 10.3892/or.2020.7788

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Language：English   Publishing type：Research paper (scientific journal)  

Bone destruction of maxillary and mandibular bone by invasive oral squamous cell cancer (OSCC) raises various problems in the management of patients, resulting in poor outcomes and survival. However, the mechanism behind bone destruction by OSCC remains unclear. High-mobility group box 1 (HMGB1), a highly conserved ubiquitous nuclear non-histone DNA-binding protein, has been demonstrated to be secreted by aggressive cancers and regulate osteoclastogenesis, a central player during bone destruction. We therefore reasoned that HMGB1 secreted by OSCCs contributes to bone destruction. Our results showed that HMGB1 is produced by human cell lines of OSCC and promotes osteoclastogenesis via up-regulation of the expression of receptor activator of nuclear factor kappa-Β ligand in osteoblasts and osteocytes, and consequently osteoclastic bone destruction in mice. Further, we found that these actions of HMGB1 are mediated via the receptor for advanced glycation end products and toll-like receptors. These findings suggest that HMGB1 of OSCC and its down-stream signal pathways are potential targets for the treatment of bone destruction associated with advanced OSCC.

DOI： 10.1016/j.bbrc.2020.07.120

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

The authors examined the timing and causes of titanium miniplate removal after maxillofacial trauma surgery. The authors performed a retrospective study of maxillofacial fracture patients in whom maxillofacial osteosynthesis miniplates were inserted or removed at the Kagawa Prefectural Central Hospital, between 2008 and 2017. Predictive variables were age, sex, fracture site distribution, and time to miniplate removal with or without complications in relation to primary outcome variables. Among 185 patients, 440 miniplates were inserted and 272 miniplates were removed. In total, 116 patients (73.4%) had 282 miniplates (64.1%) removed, of which 4.8% fracture sites and 5.7% miniplates were removed because of complications. The mean time to miniplate removal was 630.9 and 258.0 days in patients with and without complications, respectively. There was a statistically significant difference in miniplate removal and miniplate retention relative to age and sex. This difference was not related to the presence or absence of sex- or age-related complications. The miniplates as osteosynthesis material were safe and useful for a long period of time with relatively few complications. Because complications requiring miniplate removal occurred within 1 or after 5 years postoperatively, osteosynthesis miniplate treatments should be decided while considering the patient's age and sex. Long-term follow-up is recommended for miniplates that remain implanted for >1 year.

DOI： 10.1097/SCS.0000000000006352

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Condylar fractures are the most common fractures of the mandible, and treatment of mandibular condylar fractures by maxillofacial surgeons is a very important procedure. However, the surgical approaches have anatomical limitations. Therefore, it is difficult to evaluate the reduction achieved in open reduction and internal fixation because of the uncertainty in securing a sufficient operative field. As a potential solution, the authors evaluated the benefits of intraoperative cone-beam computed tomography (CBCT) with high image quality performed in a hybrid operating room. Intraoperative CBCT is easy to perform in a hybrid operating room, and it is possible to quickly evaluate high-quality CT images, including 3D images. Because the state of reduction of mandibular condylar fractures also affects the prognosis of treatment, more precise reduction and fixation should improve prognoses. The use of CBCT in a hybrid operating room also avoids re-operation, and patients benefit from minimum invasive surgery. Intraoperative CBCT is a very useful strategy for evaluation of mandibular condylar fracture surgical treatment.

DOI： 10.1097/SCS.0000000000006101

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Language：Japanese   Publisher：香川県立中央病院  

口腔癌における20歳代の若年者成人の割合は非常に少なく、早期発見による口腔癌治療の役割は大きい。今回、香川県歯科医師会主催の口腔がん検診で発見された若年成人早期舌癌を経験したのでその概要を報告する。症例は27歳女性。平成X年8月頃より、左側舌の白斑を認知するも自覚症状を認めなかった。平成X+1年1月に口腔がん検診を受診し、口腔癌の可能性を指摘され、精査加療依頼に当科を紹介受診した。左側舌縁部に25×15mm大の外向性白色粘膜病変を認め、中心やや後方部は、10×10mm大で中心部に硬結を伴うびらん性病変であった。悪性腫瘍を疑い生検を施行し、舌扁平上皮癌(cT1N0M0、Stage I)の診断を得た。根治的治療を目的に左側舌部切除術を行った。現在術後1年を経過し、腫瘍の再発や所属リンパ節への転移、遠隔転移は認められない。口腔がん検診による啓蒙、社会貢献度は高く、癌の早期発見、早期治療に導き得る可能性は高いと考えられた。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: This study compared the clinical success rates of mandibular fracture treatment using reconstruction plates or miniplates and clarified the selection criteria for reconstruction plates. METHODS: All patients who had surgically-treated mandible fractures from 2008 to 2017 with sufficient follow-up were retrospectively analyzed for information about the fracture condition, treatment, and outcomes. RESULTS: A total of 126 surgically-treated mandible fractures without mandibular condylar fracture in 105 patients (76 male, 29 female) were included. Reconstruction plates were used in 32 fractures with very good postoperative occlusal function. Four cases with complications requiring reoperation were treated using only miniplates. Variables that were statistically associated with follow-up surgery included simple versus comminuted mandible fracture, and the absence of teeth that could be used for intermaxillary fixation (P < 0.05). In the miniplates treatment for comminuted fracture, there was a significant difference in the treatment outcome depending on the number of free bone-fragments and the presence of bone-fragments requiring removal within 1 cm (P < 0.05). CONCLUSION: Reconstruction plates provided better treatment outcomes for comminuted fractures and fractures without teeth. Selecting a reconstruction plate that is capable of sufficiently overloading is important in comminuted fractures with multiple free bone-fragments and bone-fragments requiring removal.

DOI： 10.1016/j.jcms.2018.09.025

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare the clinical outcomes of a single three-dimensional (3-D) anatomical plate versus two conventional straight miniplates for the open treatment of mandibular subcondylar fractures. METHODS: This retrospective clinical study included patients with mandibular subcondylar fractures treated by the retromandibular transparotid approach using a 3-D plate or two straight miniplates. Outcome variables included preoperative conditions of patients and fractures, extent of postoperative bone healing, and incidence of complications. Other variables included age, sex, fracture site, and follow-up duration. Variables were evaluated using descriptive statistics and compared between groups. RESULTS: Twenty-eight fractures were analyzed: 13 fractures using 3-D plate and 15 fractures using two straight miniplates. None of the assessed variables showed significant differences between the two groups (p < 0.05). Unfortunately, in the 3-D plate group, reoperation was necessary for nonunion owing to plate breakage in one case with a bone defect around the fracture. CONCLUSION: The 3-D plate and two straight miniplates were equally effective for the surgical management of mandibular subcondylar fractures. Although a 3-D plate is sufficient for a typical simple fracture, in cases with a bone defect around the fracture, selection of the plate fixation method should be carefully considered.

DOI： 10.1016/j.jcms.2019.01.033

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICINA ORAL S L  

Background: This study aimed to identify (1) the predilection site of postoperative infection after third molar extraction surgery, (2) risk factors associated with postoperative infection, and (3) the cause of the difference between delayed- and early-onset infections.Material and Methods: This retrospective study included 1010 patients (396 male, 614 female) who had >= 1 third molars extracted (2407; 812 maxilla, 1595 mandible). The risk factors were classified as attributes, general health, anatomic, and operative. Outcome variables were delayed- and early-onset infections.Results: Postoperative infection was completely absent in the maxilla, and all infections occurred in the mandible, with a probability of 1.94% (31/1595). Bivariate analysis for postoperative infection showed depth of inclusion and intraoperative hemostatic treatment to be significantly associated with the development of infections. Bivariate analysis for delayed- and early-onset infections showed simultaneous extraction of the left and right mandibular third molars to be prominent risk factors.Conclusions: Postoperative infection occurs mainly in the mandible. and that in the maxilla is very rare. The risk of postoperative infection in the mandible was found to be related to the depth of inclusion and intraoperative hemostatic treatment. Simultaneous extraction of the left and right mandibular third molars appear to increase the risk of delayed-onset postoperative infection.

DOI： 10.4317/medoral.22556

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：INT INST ANTICANCER RESEARCH  

Background/Aim: Retinoid signaling is important for the maturation of growth-plate chondrocytes. The effect of retinoid receptor gamma (RAR gamma) signaling on the expression of genes in hypertrophic chondrocytes is unclear. This study investigated the role of RAR gamma signaling in regulation of hypertrophic chondrocyte-specific genes. Materials and Methods: The gene expression in mouse E17.5 tibial cartilage was examined by in situ hybridization analysis. Real-time reverse transcription-polymerase chain reaction (RT-PCR) and immunoblotting were used for analysis of mRNA and phosphorylated mitogen-activated protein kinase (MAPK). Results: mRNA expression of Rarg and connective tissue growth factor (Ccn2) was detected in maturing chondrocytes throughout the cartilaginous skeletal elements. In chondrogenic ATDC5 cells, an RAR gamma agonist induced the gene expression of type-X collagen (Col10A1), transglutaminase-2 (Tg2), matrix metalloproteinase-13 (Mmp13), and Ccn2 mRNA, whereas a retinoic acid pan-agonist suppressed RAR gamma agonist-stimulated gene expression. Phosphorylated extracellular signal regulated-kinases (pERK1/2), p-p38, and phosphorylated c-Jun N-terminal kinase (pJNK) MAPK were time-dependently increased by RAR gamma agonist treatment. Experimental p38 inhibition led to a severe drop in the RAR gamma agonist-stimulated expressions of Col10A1, Tg2, Mmp13, and Ccn2 mRNA. Conclusion: RARy signaling is required for the differentiation of hypertrophic chondrocytes, with differential cooperation with p38 MAPK.

DOI： 10.21873/invivo.11443

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Language：English   Publishing type：Research paper (scientific journal)  

Hemangiomas are benign vascular soft tissue tumors, which most frequently occur in the skin or subcutaneous tissue. Intramuscular hemangiomas typically occur in the trunk and extremities and less frequently in the head and neck. Among these, those occurring in the temporalis muscle are extremely rare. The authors report the case of a 43-year-old Japanese male with a mass in his left temporal fossa. Computed tomography images showed no erosion of the zygomatic bone, and magnetic resonance imaging revealed an ovoid well-marginated mass within the temporal muscle. The lesion was surgically excised with an endoscopy procedure used for minimally invasive lesions and complete removal. Histopathological examination confirmed the diagnosis of intramuscular cavernous hemangioma. The postoperative clinical course was good, with no indications of temporary nerve paralysis. No signs of local recurrence were observed postoperatively. Therefore, a cavernous hemangioma should be suspected when a mass occurs in the temporal region with accompanying radiologic findings suggesting vascular origin. In surgical treatment, the endoscopy-assisted technique is very useful to achieve complete tumor resection and prevent relapse while avoiding serious complications due to surgical procedures.

DOI： 10.1097/SCS.0000000000004933

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Publishing type：Research paper (scientific journal)  

The removal of titanium miniplates is a controversial topic in oral and maxillofacial surgery. This retrospective study examined the timing of and reasons for titanium plate removal after orthognathic surgery. The study included 240 orthognathic surgery patients (71 male, 169 female; age range 16–55 years, mean 25.0 ± 8.8 years) who had maxillofacial osteosynthesis plates inserted or inserted and then removed at the Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, between April 2003 and March 2017. During the study period, a total of 717 miniplates were inserted in the 240 patients, and 71 of the patients (29.6%) had 236 plates (32.9%) removed. Ten patients (14.1%) had their plates removed within a year due to early complications. Although no patient had their plate removed due to complications at 1–5 years postoperative, a further 14 patients (19.7%) had their plates removed after more than 5 years of long-term follow-up due to plate-related complications. Complications requiring plate removal were evidently biphasic, occurring within 1 year after the operation and at ≥5 years after the operation. Therefore, after confirming postoperative bone healing, it is necessary to explain to patients the risks of plate removal and the importance of long-term follow-up.

DOI： 10.1016/j.ijom.2018.07.001

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Language：English   Publisher：(公社)日本顎顔面インプラント学会  

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Language：English   Publishing type：Research paper (scientific journal)  

The purpose of this study was to retrospectively evaluate and examine the incidence of complications using poly-L-lactic acid and polyglycolic acid (PLLA/PGA) copolymer plate system in maxillofacial osteosynthesis. The retrospective study included 87 patients (50 men, 37 women), who needed maxillofacial surgery. We examined the proportion of complications and their factors from clinical data. A comparison was also made for plate decomposition using the molecular weight of the plate without plate exposure and complications. Osteosynthesis sites healed in all patients. Ten cases (11.5%) showed plate exposure-related complications, with all occurring at intraoral surgical sites. There was no significant difference in molecular weight changes of plates in resorbable process. Statistical analysis of study variables between patients with and without exposed plates showed that the plate thickness was significantly associated with the risk of exposed plates (p < 0.05). The commercially available PLLA/PGA device could be a useful rapid resorbable material for maxillofacial osteosynthesis. When thick plates are used on the intraoral site, it may be necessary to pay attention to the complication of plate exposure. Even if exposure-related complications have occurred, resorption and degradation of this material proceeds, suggesting the ease of appropriate risk management.

DOI： 10.1007/s10266-018-0345-6

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Language：English   Publishing type：Research paper (scientific journal)  

Low-intensity pulsed ultrasound (LIPUS) has been used as an adjunct to fracture healing therapies, but the mechanisms underlying its action are not known. We reported that sonic hedgehog (SHH) signaling was activated in osteoblasts at the dynamic remodeling site of a bone fracture. Mechanical stimulation is a crucial factor in bone remodeling, and it is related to the primary cilia as a sensor of hedgehog signaling. Here we observed that LIPUS promoted callus formation in accord with Gli2-positive cells after 14 days at the mouse femur fractured site compared with a control group. An immunofluorescence analysis showed that the numbers of primary cilia and cilia/osterix double-positive osteoblasts were increased at the fracture site by LIPUS. LIPUS stimulated not only the number and the length of primary cilia, but also the levels of ciliated protein, Ift88 mRNA, and SHH, Gli1, and Gli2 in MC3T3-E1 cells. Further experiments revealed that LIPUS stimulated osteogenic differentiation in the presence of smoothened agonist (SAG) treatment. These results indicate that LIPUS stimulates osteogenic differentiation and the maturation of osteoblasts by a primary cilium-mediated activation of hedgehog signaling.

DOI： 10.1002/jcb.26418

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Language：English   Publishing type：Research paper (scientific journal)  

The ATP-binding cassette transporter G1 (ABCG1) is a cholesterol lipid efflux pump whose role in tumor growth has been largely unknown. Our transcriptomics revealed that ABCG1 was powerfully expressed in rapidly metastatic, aggregative colon cancer cells, in all the ABC transporter family members. Coincidently, genetic amplification of ABCG1 is found in 10-35% of clinical samples of metastatic cancer cases. Expression of ABCG1 was further elevated in three-dimensional tumoroids (tumor organoids) within stemness-enhancing tumor milieu, whereas depletion of ABCG1 lowered cellular aggregation and tumoroid growth in vitro as well as hypoxia-inducible factor 1α in cancer cells around the central necrotic areas in tumors in vivo. Notably, depletion of ABCG1 triggered the intracellular accumulation of extracellular vesicles (EVs) and regression of tumoroids. Collectively, these data suggest that ABCG1 plays a crucial role in tumorigenesis in metastatic cancer and that depletion of ABCG1 triggers tumor regression with the accumulation of EVs and their derivatives and cargos, implicating a novel ABCG1-targeting therapeutic strategy by which redundant and toxic substances may be accumulated in tumors leading to their regression.

DOI： 10.3389/fonc.2018.00376.

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Language：English   Publisher：Bio Integration Society  

Purpose: Various maxillary sinus floor elevation techniques are used together with augmentation proceduresfor oral rehabilitation. Dental implants with or without bone substitutes or autologous bone grafting, and appliedusing the lateral window technique or the transcrestal osteotome-mediated sinus floor elevation technique, areused to enhance bone stability for implant installation. The aim of this study was to retrospectively evaluate theimplant status of patients who had undergone maxillary sinus floor elevation and immediate or delayed implantplacement via such techniques, with or without graft materials.Materials and Methods: In total, 398 dental implants placed in 169 maxillary sinuses of 169 patients (106 females,63 males; mean age, 57.5 years), who were fitted with Astra Tech dental implants, and required maxillary sinusfloor elevation, were evaluated in terms of the amount of residual bone remaining following treatment; the residualbone was assessed by elevation technique subgroup. The vertical height of the residual maxillary alveolarbone and the augmented vertical bone height were analyzed using digitalized panoramic radiographs. Clinicaland radiological follow-up was carried out over a period of 120 months after functional loading of a fixed prosthesis.The mean follow-up period was 55 months.Results: In total, 277 implants, with a mean residual vertical bone height of 3.72 mm, were installed in 113 maxillarysinuses using the lateral window technique. Of these, 216 implants (mean vertical bone height, 4.87 mm)were installed in 96 sinuses simultaneous with sinus floor elevation using β-tricalcium phosphate (βTCP) using nograft material or intraoral autologous bone. The remaining 17 sinuses underwent 61 implants (mean vertical boneheight, 2.57 mm) according to a delayed installation schedule using βTCP or iliac autologous bone. In 56 sinuses,121 implants (mean vertical height, 8.60 mm) were installed simultaneous via the transcrestal osteotome-mediatedtechnique with βTCP. Although seven implants failed (three early and four late failures) over a follow-up periodof 120 months (mean follow-up, 55 months), the other implants remained stable, with a high survival rate of 98.2%.No elevation technique or graft material subgroup showed any statistical significance, and complications wereminimal.Conclusions: The findings of this study demonstrate that various maxillary sinus floor elevation techniques forimplant installation, with or without graft material, are safe, having low complication rates and yielding predictableresults.

DOI： 10.32176/biointeg.8.1_83

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Sonic hedgehog (SHH) signaling is related to the pathogenesis of oral squamous cell carcinoma (OSCC), but its role in OSCC is not yet well understood. In this study, we analyzed the role of SHH signaling in OSCC. MATERIALS AND METHODS: We examined the expression pattern of SHH and its signal proteins in clinically resected OSCC samples by immunohistochemistry. We also evaluated the function of SHH signaling using the hedgehog signaling inhibitor cyclopamine in vivo and in vitro by proliferation, migration and angiogenesis analyses. RESULTS: We found that SHH was highly expressed in human tongue OSCC, whereas patched (PTCH1), glioma-associated oncogene 1 (GLI1) and GLI2 proteins were expressed in the microvascular cells in the tumor invasive front. Administration of cyclopamine to mice suppressed the growth and angiogenesis of OSCC xenografts in vivo. Moreover, cyclopamine inhibited endothelial cell proliferation and migration, and reduced aorta vascular length in the rat. CONCLUSION: These findings suggest that OSCC-derived SHH stimulates angiogenesis at the tumor invasive front.

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BACKGROUND: Elongated styloid process syndrome (Eagle's syndrome) is the term given to the symptomatic elongation of the styloid process or the mineralization of the stylohyoid or stylomandibular ligament. The two commonly used approaches for the surgical treatment of this syndrome are the transcervical and transoral approaches. Both have their limitations and specific intraoperative risks. Here, we report the treatment of a patient with Eagle's syndrome using the transoral approach in conjunction with piezoelectric surgery, surgical planning, and intraoperative navigation to reduce the risk of complications. CASE PRESENTATION: The elongated styloid process was resected in a 45-year-old Japanese man using a minimally invasive approach with an intraoperative navigation system. Preoperative preparation involved the use of a custom interocclusal splint to produce the mouth opening conditions required during surgery. Using the three-dimensional position of the navigation probe, the location of the elongated styloid process was identified. After confirmation of the resection spot via the transoral approach, the styloid process was dissected by piezoelectric surgery. Follow-up examination showed an uneventful recovery with no associated complications. CONCLUSION: The resection of the styloid process using an intraoperative navigation system and a custom interocclusal splint during a transoral approach, together with a piezoelectric cutting device, is safe and effective for the treatment of Eagle's syndrome.

DOI： 10.1186/s13256-017-1464-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JOURNAL HARD TISSUE BIOLOGY  

Ameloblastic fibro-odontoma (AFO) is defined as a tumor with general characteristics of an ameloblastic fibroma along with the presence of enamel and dentine. AFO is a well-encapsulated, painless, slow-growing, and expanding tumor in young patients. Histologically, it has been classified as an ameloblastic fibroma or odontoma. In the 2017 new WHO classification of odontogenic tumor, AFO is described that they in most cases represent developmental stages of either complex or compound odontoma and that retaining them as separate entities would therefore be illogical. However, there is still considerable confusion concerning the nature and histology of AFO and the surgical therapy for this lesion. Here we present a case of maxillary AFO and review the relevant literature regarding the clinical and surgical features of this lesion.

DOI： 10.2485/jhtb.26.425

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Language：English   Publishing type：Research paper (scientific journal)  

Head and neck squamous cell carcinomas (HNSCCs) frequently invade the bones of the facial skeleton. Semaphorin 4D (Sema4D) is an axon guidance molecule produced by oligodendrocytes. Sema4D was also identified in the bone microenvironment and many cancer tissues including HNSCC. To date, however, the role of Sema4D in cancer-associated bone disease is still unknown. This is the first study to demonstrate the role of Sema4D in bone invasion of cancer. In the clinical tissue samples of bone lesion of HNSCC, Sema4D was detected at high levels, and its expression was correlated with insulin-like growth factor-I (IGF-I) expression. In vitro experiments showed that IGF-I regulates Sema4D expression and Sema4D increased proliferation, migration and invasion in HNSCC cells. Sema4D also regulated the expression of receptor activator of nuclear factor κβ ligand (RANKL) in osteoblasts, and this stimulated osteoclastgenesis. Furthermore, knockdown of Sema4D in HNSCC cells inhibited tumor growth and decreased the number of osteoclasts in a mouse xenograft model. Taken together, IGF-I-driven production of Sema4D in HNSCCs promotes osteoclastogenesis and bone invasion.

DOI： 10.3892/ijo.2017.4050

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OSTEOTRANS MX® (Takiron Co., Ltd., Osaka, Japan) is a bioactive resorbable maxillofacial osteosynthetic material composed of an unsintered hydroxyapatite/poly-l-lactide composite, and its effective osteoconductive capacity has been previously documented. However, the mechanical strength of this plate system is unclear. Thus, the aim of this in vitro study was to assess its tensile and shear strength and evaluate the biomechanical intensity of different osteosynthesis plate designs after sagittal split ramus osteotomy by simulating masticatory forces in a clinical setting. For tensile and shear strength analyses, three mechanical strength measurement samples were prepared by fixing unsintered hydroxyapatite/poly-l-lactide composed plates to polycarbonate skeletal models. Regarding biomechanical loading evaluation, 12 mandibular replicas were used and divided into four groups for sagittal split ramus osteotomy fixation. Each sample was secured in a jig and subjected to vertical load on the first molar teeth. Regarding shear strength, the novel-shaped unsintered hydroxyapatite/poly-l-lactide plate had significantly high intensity. Upon biomechanical loading evaluation, this plate system also displayed significantly high stability in addition to bioactivity, with no observed plate fracture. Thus, we have clearly demonstrated the efficacy of this plate system using an in vitro model of bilateral sagittal split ramus osteotomy of the mandible.

DOI： 10.3390/ma10070764

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JOURNAL HARD TISSUE BIOLOGY  

The purpose of this study was to assess the level of accuracy that can be achieved in patients undergoing orbital reconstruction for orbital floor defect accompanied by midfacial fracture using an unsintered hydroxyapatite particles/poly-L-lactide composite plate system with and without the use of intraoperative navigation. Eight consecutive patients treated using the u-HA/PLLA mesh plate system between 2014 and 2016 were included in this retrospective study. We analyzed the clinical and radiological data of these patients with orbital floor defect and midfacial fracture extending to the orbit. We examined the patients' postoperative healing status, including visual activity, diplopia, and enophthalmos. The overall volume of the orbit was calculated in cubic millimeter sand was compared between the reconstructed orbit and the uninjured orbit for with and without the use of navigation groups. No patients complained of visual problems, and no further treatment was required postoperatively. Except for one patient with persistence of slight supraversion diplopia in the group without navigation, all the preoperative diplopia symptoms postoperatively improved, and none of the patients complained of problems in daily living. There was a significant difference (p < 0.05) in the mean reconstructed orbital volume accuracy between with and without navigation. In conclusion, complex orbital reconstruction using optimal bioactive/resorbable material with intraoperative navigation is an accurate and reliable method of reconstruction.

DOI： 10.2485/jhtb.26.274

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Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: In recent years, patients with orthognathic surgery in middle-aged and elderly people have come to be a more frequent occurrence. Breast cancer is the most frequently diagnosed cancer in woman worldwide, and its prevalence rate is steadily increasing. PRESENTATION OF CASE: We report a case of a 47-year-old Japanese woman in whom left-side breast cancer (Stage 1) was unexpectedly found just before orthognathic surgery in April 2012. Breast-conserving surgery was performed (estrogen receptor+, progesterone receptor+, HER2 -, surgical margin+, sentinel lymph node +) that May. From June to August docetaxel (75mg/m2) and cyclophosphamide (600mg/m2) were administrated four times every 21days and thereafter radiotherapy (total 60Gy) was completed. The cancer surgeon declared the prognosis good and the patient had a strong desire to undergo orthognathic surgery, so in November we performed a bimaxillary osteotomy, and administration of tamoxifen began 6 weeks after the osteotomy. DISCUSSION: There are breast cancer cases in which the prognosis is sufficiently good for a planned orthognathic surgery to proceed. Good communication among surgeons and the patient is important. CONCLUSION: We experienced a case in which breast cancer was found just before the orthognathic surgery; we performed a bimaxillary osteotomy, including follow-up tamoxifen administration, during breast cancer treatment.

DOI： 10.1016/j.ijscr.2016.12.014

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：INT INST ANTICANCER RESEARCH  

Aging is one of the risk factors for delayed fracture healing. Sonic hedgehog (SHH) protein, an inducer of embryonic development, has been demonstrated to be activated in osteoblasts at the dynamic remodeling site of a bone fracture. Herein, we compared and examined the distribution patterns of SHH and the functional effect of SHH signaling on osteogenesis and osteoclastogenesis between young (5-week-old) and aged (60-week-old) mice during fracture healing. We found that SHH was expressed in bone marrow cells from the fractured site of the rib of young mice on day 5, but was barely detectable in the corresponding cells from the rib of aged mice. SHH was also detected in osteoblasts and bone marrow cells at the callus remodeling stage on days 14 and 28 in both young and aged mice. The number of alkaline phosphatase (ALP)-positive osteoblasts was significantly higher in young mice on days 5 and 14, whereas the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts was significantly higher in aged mice. SHH stimulated significantly more osteoblast formation in the young compared to old mice. SHH stimulated the osteoclast formation directly in the aged mice and suppressed the formation indirectly through osteoprotegerin expression in the young mice. Results indicate that an aged-related delay of fracture healing may contribute to the unbalanced bone formation and resorption, regulated by hedgehog signaling.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

Purpose: Sonic Hedgehog (SHH) is a regulatory protein involved in bone fracture healing. Orthognathic surgery involves surgical osteotomy of the mandible or maxilla to restore the proper anatomic and functional position in patients with dentofacial deformity. The purpose of this study was to analyze SHH local blood serum concentrations after osteotomy to gain further understanding of the molecular regulation of the initial stage of osteotomy healing.Methods: Serum samples (local drainage and peripheral venous) of 34 patients (24 females and 10 males, mean age was 23.4 (16-42) years) who underwent orthognathic surgery were isolated from patients at different time points during the perioperative period. The levels of SHH, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL) and osteoprotegerin (OPG) were measured using ELISA.Results: SHH was detected in the local drainage immediately after osteotomy (309.5 +/- 58.2 pg/ml), and decreased for 2 days after the operation (197.5 +/- 43.6 pg/ml). The sRANKL local serum concentrations were at the maximum level immediately after the operation (141.4 +/- 22.6 pg/ml) and decreased for 2 days (110.1 +/- 23.4 pg/ml). On the other hand, the OPG concentration in the local serum was at a minimum after osteotomy (59.4 +/- 4.6 pg/ml) and reached its maximum (181.5 +/- 17.8 pg/ml, P < 0.01) at 2 days after osteotomy. SHH and OPG local serum levels on day 2 were associated with the amount of bleeding during the operation. The local drainage serum level of SHH of maxillary/mandibular osteotomy had a tendency to be higher than that of mandible-only osteotomy at 2 days after operation.Conclusions: Elevated levels of SHH in local serum after osteotomy, especially during the initial stage of healing, indicates its importance in osteotomy healing. (c) 2016 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

DOI： 10.1016/j.ijso.2016.09.002

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Language：English   Publishing type：Research paper (scientific journal)  

An 88-year-old man was diagnosed with trigeminal neuralgia, and treatment of carbamazepine 200 mg/day was initiated. About 6 weeks later, the patient developed a skin rash accompanied by fever. He was admitted to hospital and diagnosed with drug-induced hypersensitivity syndrome (DIHS) caused by carbamazepine. Oral carbamazepine treatment was stopped, but blood tests showed acute liver and acute renal failure. Drug-induced lymphocyte stimulation test (DLST) for carbamazepine, human herpes virus-6 (HHV-6) IgG, and CMV-HRP were negative. Oral prednisolone therapy was begun 18 days later. The titer of HHV-6 IgG antibodies was then detected (640 times). Following treatment, liver and renal function improved and the erythema disappeared.

PubMed

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Language：Japanese   Publisher：(一社)日本骨代謝学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL  

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