A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study / Una nueva clasificación morfológica de la cresta alveolar después de la distracción osteogénesis en pacientes humanos. Un estudio de serie de casos retrospectivo de 17 años

Background: To perform a morphologic classification based on the results of bone augmentation after a distractionosteogenesis.Material and Methods: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range,23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dentalimplants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis andANOVA one-way test were used.Results: Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): widealveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface con-cavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath andrequiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position dueto the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost.Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories Ito IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone heightachieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The im-plants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in categoryIII with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035).Conclusions: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categorieswhich provide a useful basis for decision-making regarding implant placement.(AU)

Global Gene Expression Characterization of Circulating Tumor Cells in Metastasic Castration-Resistant Prostate Cancer Patients.

BACKGROUND: Current therapeutic options in the course of metastatic castration-resistant prostate cancers (mCRPC) reinforce the need for reliable tools to characterize the tumor in a dynamic way. Circulating tumor cells (CTCs) have emerged as a viable solution to the problem, whereby patients with a variety of solid tumors, including PC, often do not have recent tumor tissue available for analysis. The biomarker characterization in CTCs could provide insights into the current state of the disease and an overall picture of the intra-tumor heterogeneity. METHODS: in the present study, we applied a global gene expression characterization of the CTC population from mCRPC (n = 9), with the goal to better understand the biology of these cells and identify the relevant molecules favoring this tumor progression. RESULTS: This analysis allowed the identification of 50 genes specifically expressed in CTCs from patients. Six of these markers (HOXB13, QKI, MAOA, MOSPD1, SDK1, and FGD4), were validated in a cohort of 28 mCRPC, showing clinical interest for the management of these patients. Of note, the activity of this CTC signature was related to the regulation of MYC, a gene strongly implicated in the biology of mCRPC. CONCLUSIONS: Overall, our results represent new evidence on the great value of CTCs as a non-invasive biopsy to characterize PC.

Detection of MET Alterations Using Cell Free DNA and Circulating Tumor Cells from Cancer Patients.

MET alterations may provide a potential biomarker to evaluate patients who will benefit from treatment with MET inhibitors. Therefore, the purpose of the present study is to investigate the utility of a liquid biopsy-based strategy to assess MET alterations in cancer patients. We analyzed MET amplification in circulating free DNA (cfDNA) from 174 patients with cancer and 49 healthy controls and demonstrated the accuracy of the analysis to detect its alteration in patients. Importantly, a significant correlation between cfDNA concentration and MET copy number (CN) in cancer patients (r = 0.57, p <10-10) was determined. Furthermore, we evaluated two approaches to detect the presence of MET on circulating tumor cells (CTCs), using the CellSearch® and Parsortix systems and monitored patients under anti-EGFR treatment (n = 30) combining both cfDNA and CTCs analyses. This follow-up provides evidence for the potential of MET CN assessment when patients develop resistance to anti-EGFR therapy and a significant association between the presence of CTCs MET+ and the Overall Survival (OS) in head and neck cancer patients (P = 0.05; HR = 6.66). In conclusion, we develop specific and noninvasive assays to monitor MET status in cfDNA/CTCs and demonstrate the utility of plasma MET CN determination as a biomarker for monitoring the appearance of resistance to anti-EGFR therapy.

In situ chlorhexidine substantivity on saliva and plaque-like biofilm: influence of circadian rhythm.

BACKGROUND: The aim of the present study is to assess in situ substantivity of a single mouthrinse with 0.2% chlorhexidine (CHX) on saliva and on undisturbed de novo plaque-like biofilm (PL-biofilm), differentiating between two times of application: 1) CHX mouthrinse in the morning; and 2) CHX mouthrinse at night. METHODS: The study participants were 10 healthy volunteers who wore an individualized splint with glass disks for 48 hours to boost the growth of PL-biofilm. Saliva samples were collected, and two disks were removed from each volunteer's splint at 8, 10, and 12 hours after performing a mouthrinse with 0.2% CHX at 7:00 am (M-0.2% CHX-diurnal) and 1:00 am (M-0.2% CHX-nocturnal). The saliva and plaque samples were analyzed by epifluorescence and confocal laser scanning microscopy, respectively, using a green fluorescent nucleic acid stain/propidium iodide staining. RESULTS: With M-0.2% CHX-diurnal, the frequency of vital bacteria in saliva was significantly higher than in the PL-biofilm at 8, 10, and 12 hours after mouthrinse. After M-0.2% CHX-nocturnal, the frequency of vital bacteria in saliva was significantly lower than in the PL-biofilm at 8 hours and higher than in the PL-biofilm at 12 hours after mouthrinse. CONCLUSION: These results support the more active physiologic dynamics of the salivary flora and the possible reservoir function associated with the structure of undisturbed de novo PL-biofilm.

The spectrum of plasma cell neoplasia in oral pathology.

Plasma cell tumors are lymphoid neoplastic proliferations of B cells that may be classified as multiple myeloma (MM), solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (PEM). These types of neoplasia are typically found in adults and may occur as disseminated tumors of the bone marrow or in some cases as solitary bone or extramedullary tumors. Most SBP eventually develop into MM, whereas only 30% of the PEM do so. Oral manifestations in the form of oral and maxillofacial lesions are often the first sign of the disease. Treatment of these neoplastic tumors varies depending on the type of proliferation and may involve surgery, radiotherapy and chemotherapy, alone or combined. This paper reviews the main clinical and pathological aspects of these tumors and their relationship to the oral and maxillofacial area.

Angular photogrammetric analysis of the soft tissue facial profile.

All medical specialties interested in improving facial appearance need to measure the face to quantify the desired facial changes. The purpose of this investigation was to obtain objective average measurements of the soft tissue facial profile to use them as a guide for aesthetic treatment goals. The analysis of the soft tissue facial profile from photographic records provides information on the morphology of the profile and its relationship with the underlying dentoskeletal tissues. In this investigation the soft tissue facial profile of a young adult European Caucasian population (212 individual, 50 males and 162 females, 18-20 years of age) was studied by means of standardized photographic records taken in the natural head position (NHP). Angular measurements were analysed digitally. Sexual dimorphism was found for several angles: nasofrontal (G-N-Prn: P < 0.01), vertical nasal (Cm-Sn/N-Prn: P < 0.01), nasal (N-Prn/TV: P < 0.01), nasal dorsum (N-Mn-Prn: P < 0.05), and mandibular contour (C-Me/G-Pg: P < 0.01). Wide individual variations in nasolabial and mentolabial angles were also observed.

Characteristics of oral cancer in a central European population: defining the dentist's role.

BACKGROUND: The authors conducted a study to evaluate the effectiveness of dentists in the early detection, treatment and postoperative care of oral squamous cell carcinoma, or SCC, in a central European population. METHODS: This multicenter retrospective study was conducted under the auspices of DOSAK (a German, Austrian and Swiss cooperative group on tumors of the maxillofacial region). A questionnaire was used to evaluate the diagnostic, treatment and postoperative processes involved in managing the care of patients with oral SCC. A total of 3,894 questionnaires was sent to patients who had been diagnosed with and operated on for oral SCC at least six months previously; 1,761 questionnaires were returned. Another 1,652 additional questionnaires were sent to their oral surgeons; 1,543 were returned. RESULTS: The pT staging was pT2 (40.41 percent), pT1 (31.30 percent), pT4 (16.35 percent) and pT3 (11.90 percent). In 61.3 percent of the patients, there was no evidence of metastases. In 40 percent of the patients, the dentist treated the first symptoms, whereas the physician did so in 27 percent of the patients. A total of 72.5 percent of the dentists and 40.11 percent of the physicians identified oral SCC correctly. CONCLUSIONS: Dentists should participate actively in oral cancer patients' rehabilitation processes through regular clinical follow-up examinations and restoration of intraoral function. Clinical Implications. Dentists should conduct an oral cancer screening at each patient visit. Patients who are at risk should undergo more intense surveillance. Dentists should advise their patients to stop high-risk habits such as smoking and help them make choices for healthier lifestyles.

Linear photogrammetric analysis of the soft tissue facial profile.

This study digitally analyzes the soft tissue facial profile of a European white population of young adults by means of linear measurements made on standardized photographic records taken in natural head position. The application of the Student t test showed sexual dimorphism in most parameters of the labial, nasal, and chin areas. In general, males had greater heights and lengths as well as greater prominences of these 3 areas. They also had greater nasal and facial depths at the level of the tragus point.