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[PMID]: 29267660 [Au] Autor: Ribeiro-Júnior O; Borba AM; Alves CAF; Gouveia MM; Deboni MCZ; Naclério-Homem MDG [Ad] Endereço: Universidade de São Paulo - USP, School of Dentistry, Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis, São Paulo, SP, Brazil. [Ti] Título: Reclassification and treatment of odontogenic keratocysts: A cohort study. [So] Source: Braz Oral Res;31:e98, 2017 Dec 18. [Is] ISSN: 1807-3107 [Cp] País de publicação: Brazil [La] Idioma: eng [Ab] Resumo: The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments. [Mh] Termos MeSH primário: Síndrome do Nevo Basocelular/classificação Síndrome do Nevo Basocelular/cirurgia Cistos Odontogênicos/classificação Cistos Odontogênicos/cirurgia [Mh] Termos MeSH secundário: Ácido Acético/uso terapêutico Adolescente Adulto Idoso Criança Clorofórmio/uso terapêutico Descompressão Cirúrgica/métodos Etanol/uso terapêutico Feminino Seres Humanos Masculino Doenças Mandibulares Doenças Maxilares Meia-Idade Tumores Odontogênicos/classificação Tumores Odontogênicos/cirurgia Osteotomia/métodos Fotografia Recidiva Estudos Retrospectivos Medição de Risco Fatores de Risco Fatores de Tempo Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Carnoy's solution); 3K9958V90M (Ethanol); 7V31YC746X (Chloroform); Q40Q9N063P (Acetic Acid) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: D; IM [Da] Data de entrada para processamento: 171222 [St] Status: MEDLINE

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[PMID]: 27771152 [Au] Autor: Bagan L; Leopoldo-Rodado M; Poveda-Roda R; Murillo-Cortes J; Diaz-Fernández JM; Bagan J [Ad] Endereço: Universidad Europea de Valencia, Valencia, Spain. [Ti] Título: Grade of sclerosis in the contralateral mandibular area in osteonecrosis of the jaws. [So] Source: Int J Oral Maxillofac Surg;46(2):167-172, 2017 Feb. [Is] ISSN: 1399-0020 [Cp] País de publicação: Denmark [La] Idioma: eng [Ab] Resumo: The objective of this study was to compare the grade of radiographic sclerosis between the area of osteonecrosis and the at-risk contralateral mandibular area without osteonecrosis. Three groups were studied: group 1 comprised 30 cases of medication-related osteonecrosis of the jaws (MRONJ); group 2 was the healthy contralateral area without osteonecrosis of the group 1 cases; group 3 comprised 30 healthy controls. ImageJ software was used to analyze the computed tomography images, and the grade of bone sclerosis was compared between the three groups. The grade of sclerosis was significantly higher in group 1 than in the other groups (P<0.05); the difference between groups 2 and 3 was not significant. Sclerosis was significantly greater in the area of bone necrosis than in the contralateral mandibular area in patients with MRONJ. No significant differences were found in the grade of sclerosis between the contralateral non-affected mandibular area of patients with MRONJ and the control patients. [Mh] Termos MeSH primário: Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/patologia Doenças Mandibulares/patologia [Mh] Termos MeSH secundário: Idoso Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem Estudos de Casos e Controles Feminino Seres Humanos Masculino Doenças Mandibulares/diagnóstico por imagem Esclerose [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180209 [Lr] Data última revisão: 180209 [Sb] Subgrupo de revista: D; IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE

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[PMID]: 29049202 [Au] Autor: Liu M; Liu W; Qiao C; Han B [Ad] Endereço: aDepartment of Oral and Maxillofacial Surgery bJilin Provincial Key Laboratory of Tooth Development and Bone Remodeling cDepartment of Oral Pathology, School and Hospital of Stomatology, Jilin University, Changchun, China. [Ti] Título: Mandibular Gorham-Stout disease: A case report and literature review. [So] Source: Medicine (Baltimore);96(42):e8184, 2017 Oct. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Gorham-Stout disease (GSD) is characterized by aggressive bone resorption, proliferation of vascular or lymphatic vessels, and soft-tissue swelling. Bones that initially appear normal start to resorb, partially or completely. However, the etiology of GSD is unknown. PATIENT CONCERNS: A 29-year-old man with a chief complaint of toothache and mobility in the lower right mandible for the previous 1 year. DIAGNOSES: Gorham-Stout disease (GSD). INTERVENTIONS: The RANK-ligand inhibitor denosumab was suggested to use to inhibit the development of osteoclasts and slow mandibular resorption. In addition, we proposed resection of the remaining mandible and reconstruction via vascularized bone graft, after resorption of the mandible had become stationary. OUTCOMES: Regular follow-ups were advised to this patient to monitor the stability of bone resorption prior to any surgical intervention. LESSONS: We strongly recommend that every attempt should be made for early diagnosis and prompt effective medical and surgical management. The failure to do so results in further complications and poor prognosis. [Mh] Termos MeSH primário: Doenças Mandibulares/complicações Osteólise Essencial/complicações Odontalgia/etiologia [Mh] Termos MeSH secundário: Adulto Seres Humanos Masculino Mandíbula/fisiopatologia Doenças Mandibulares/fisiopatologia Osteólise Essencial/fisiopatologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171122 [Lr] Data última revisão: 171122 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171020 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008184

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[PMID]: 28760283 [Au] Autor: Kristensen KD; Schmidt B; Stoustrup P; Pedersen TK [Ad] Endereço: Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; Oral Health Center for Western Norway, Stavanger, Rogaland, Norway. Electronic address: kdki@dent.au.dk. [Ti] Título: Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms. [So] Source: Am J Orthod Dentofacial Orthop;152(2):214-223, 2017 Aug. [Is] ISSN: 1097-6752 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Our aim was to describe 3-dimensional condylar deformation of the temporomandibular joint (TMJ) and symptoms and signs of temporomandibular dysfunction (TMD) in patients with idiopathic condylar resorption (ICR). METHODS: We included 25 patients with ICR and 25 controls. We performed cone-beam computed tomographic scans and analyzed condylar width, length, and height as well as the condylar axial angle and the condylar neck angle. TMJ cross sections were evaluated for degenerative characteristics and location of bony deformations. Furthermore, symptoms and signs of TMD were described in the ICR group. RESULTS: In the ICR group, we found statistically significantly reduced condylar width (mean difference, 2.0 mm), height (mean difference, 4.9 mm), and condylar axial angle (mean difference, 10.6°); 84% of the TMJs had a posterior condylar neck angle (control group, 22%). The most common degenerative changes were noncongruent shape of the condyle-fossa relationship (72%), condylar resorption (56%), and nonintact cortex (40%). More than 70% of the joints with bony deformations showed changes along the entire condylar head. Most patients with ICR showed symptoms and signs of TMD; nevertheless, 12% had no signs or symptoms of TMD. CONCLUSIONS: ICR in the TMJ changes the shape and reduces the size of the condyle. Deformity locations are unspecified, and the entire condyle is often affected. Most patients with ICR have signs or symptoms of TMD; however, a small group was asymptomatic and without clinical signs. [Mh] Termos MeSH primário: Reabsorção Óssea/diagnóstico Côndilo Mandibular Doenças Mandibulares/diagnóstico [Mh] Termos MeSH secundário: Adolescente Adulto Reabsorção Óssea/diagnóstico por imagem Reabsorção Óssea/patologia Estudos de Casos e Controles Criança Pré-Escolar Tomografia Computadorizada de Feixe Cônico Seres Humanos Masculino Côndilo Mandibular/diagnóstico por imagem Côndilo Mandibular/patologia Doenças Mandibulares/diagnóstico por imagem Doenças Mandibulares/epidemiologia Doenças Mandibulares/patologia Transtornos da Articulação Temporomandibular/diagnóstico Transtornos da Articulação Temporomandibular/diagnóstico por imagem Transtornos da Articulação Temporomandibular/patologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170821 [Lr] Data última revisão: 170821 [Sb] Subgrupo de revista: D; IM [Da] Data de entrada para processamento: 170802 [St] Status: MEDLINE

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[PMID]: 28608925 [Au] Autor: Caparrotti F; Huang SH; Lu L; Bratman SV; Ringash J; Bayley A; Cho J; Giuliani M; Kim J; Waldron J; Hansen A; Tong L; Xu W; O'Sullivan B; Wood R; Goldstein D; Hope A [Ad] Endereço: Department of Radiation Oncology, the Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada. [Ti] Título: Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy. [So] Source: Cancer;123(19):3691-3700, 2017 Oct 01. [Is] ISSN: 1097-0142 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Osteoradionecrosis (ORN) of the mandible is a late toxicity affecting patients treated with radiotherapy for head and neck malignancies. To the authors' knowledge, ORN has no standardized grading system and its reporting is based on retrospective findings in heterogeneous patient populations. The rate of ORN in the era of intensity-modulated radiotherapy (IMRT) still is unknown. METHODS: The authors report the incidence of ORN from prospectively collected data regarding 1196 patients who were diagnosed with squamous cell carcinoma of the oropharynx and treated with curative-intent IMRT, with or without concomitant systemic treatment, from January 2005 to December 2014. Each case of ORN was graded according to its severity. Clinical and dosimetric comparisons were performed between patients with ORN and a matched control cohort of patients without ORN. RESULTS: The actuarial rate of ORN of the mandible was 3% at 1 year, 5% at 3 years, and 7% at 5 years. On multivariable analysis, smoking (hazard ratio, 1.9; 95% confidence interval, 1.07-3.4 [P = .03]) and T classification (hazard ratio, 1.78; 95% confidence interval, 1.02-3.1 [P = .041]) were found to be statistically significant risk factors. The presence of cardiovascular comorbidities, use of bisphosphonates, and pre-IMRT dental extractions were found to be different between the matched cohorts. The mandibular volume receiving 50 grays (Gy) (in cm ) and the volume receiving 60 Gy (in cm ) were found to be associated with ORN on multivariable analysis in the matched cohort patients receiving an IMRT regimen of 2 Gy per fraction. CONCLUSIONS: ORN is relatively uncommon among patients with oropharyngeal carcinoma who are treated with IMRT, but continues to occur beyond 5 years after treatment. Modifiable risk factors that are associated with higher rates of ORN include smoking and the use of bisphosphonates. Minimizing the volumes of the mandible receiving >50 Gy or > 60 Gy also may have an effect on the ORN rate. Cancer 2017;123:3691-3700. © 2017 American Cancer Society. [Mh] Termos MeSH primário: Carcinoma de Células Escamosas/radioterapia Doenças Mandibulares/epidemiologia Neoplasias Orofaríngeas/radioterapia Osteorradionecrose/epidemiologia Radioterapia de Intensidade Modulada/efeitos adversos [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Conservadores da Densidade Óssea/efeitos adversos Estudos de Casos e Controles Feminino Seres Humanos Incidência Masculino Mandíbula/efeitos da radiação Doenças Mandibulares/etiologia Meia-Idade Osteorradionecrose/etiologia Dosagem Radioterapêutica Estudos Retrospectivos Fatores de Risco Fumar/efeitos adversos Fatores de Tempo [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Bone Density Conservation Agents) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170927 [Lr] Data última revisão: 170927 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170614 [St] Status: MEDLINE [do] DOI: 10.1002/cncr.30803

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[PMID]: 28527295 [Au] Autor: Fukuda M; Inoue K; Sakashita H [Ad] Endereço: Lecturer, Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Sakado, Japan. Electronic address: fukudam@dent.meikai.ac.jp. [Ti] Título: Periostitis Ossificans Arising in the Mandibular Bone of a Young Patient: Report of an Unusual Case and Review of the Literature. [So] Source: J Oral Maxillofac Surg;75(9):1834.e1-1834.e8, 2017 Sep. [Is] ISSN: 1531-5053 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Periostitis ossificans, also known as Garré osteomyelitis, is a specific type of chronic osteomyelitis that forms new bone under the periosteum resulting from a periosteal reaction to chronic inflammation or infections. It commonly affects the mandible secondary to odontogenic infection. The therapeutic approach involves eliminating the infectious cause and antibiotic administration. This report describes an unusual case of periostitis ossificans arising from the mandible of an 11-year-old boy. The cause of infection was correlated with a lower right unerupted third molar, which had no obvious connection with the oral cavity. The histologic diagnosis was chronic osteomyelitis with proliferative periostitis. The patient has been followed for 1 year, without any evidence of recurrence. Periostitis ossificans can be diagnostically problematic, and various conditions must be considered in the differential diagnosis. [Mh] Termos MeSH primário: Doenças Mandibulares/diagnóstico Periostite/diagnóstico [Mh] Termos MeSH secundário: Biópsia Criança Diagnóstico Diferencial Diagnóstico por Imagem Seres Humanos Masculino Doenças Mandibulares/etiologia Doenças Mandibulares/cirurgia Dente Serotino Periostite/etiologia Periostite/cirurgia Extração Dentária Dente Impactado/complicações Dente Impactado/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170920 [Lr] Data última revisão: 170920 [Sb] Subgrupo de revista: AIM; D; IM [Da] Data de entrada para processamento: 170521 [St] Status: MEDLINE

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[PMID]: 28472562 [Au] Autor: Raj A; Ramesh G; Nagarajappa R; Pandey A; Raj A [Ad] Endereço: Department of Oral and Maxillofacial Pathology, Rama Dental College Hospital and Research Centre, Kanpur-208024, Uttar Pradesh, India. [Ti] Título: Prevalence of odontogenic lesions among the Kanpur population: an institutional study. [So] Source: J Exp Ther Oncol;12(1):35-42, 2017 May. [Is] ISSN: 1359-4117 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The frequency and incidence of odontogenic cysts and tumors are controversial and depends in the geographic location. These lesions have great clinical and histopathological diversity, and reflect a need for epidemiological profile to be considered when these lesions are studied. AIM: The purpose of this study was to determine the prevalence of odontogenic cysts and tumors over a period of 10 years and to compare with other data reported around the world. MATERIALS AND METHODS: Data for the study were obtained from the archives of the Department of Oral and Maxillofacial Pathology, diagnosed as the cases of Odontogenic cysts and tumors histopathologically, reported from January 2007 to March 2016. Case records of the patients that fit the histological classification of the World Health Organization (2005) were included in the study and the variables analyzed were: Age, sex, anatomical location, and histological type. RESULTS: In a total of 1319 biopsies reported, 112 were odontogenic in nature. Of these 112 odontogenic lesions reported, Odontogenic Cysts accounted for 54.4% and odontogenic tumors of 45.53%. Of them 61.60% of the patients were males. Common age of occurrence was 21-50 years and mandibular posterior was the most common site of occurrence. Most common odontogenic cyst and tumor reported was dentigerous cyst and ameloblastoma respectively. CONCLUSION: This study provides epidemiological information on odontogenic cyst and tumors at an institutional level. The relative frequency of these cysts and tumors can be analyzed at a global level to understand their prevalence, incidence, biological behaviour, and distribution. [Mh] Termos MeSH primário: Cistos Odontogênicos/epidemiologia Tumores Odontogênicos/epidemiologia [Mh] Termos MeSH secundário: Adolescente Adulto Fatores Etários Idoso Ameloblastoma/epidemiologia Ameloblastoma/patologia Criança Feminino Seres Humanos Incidência Masculino Doenças Mandibulares/epidemiologia Doenças Mandibulares/patologia Doenças Maxilares/epidemiologia Doenças Maxilares/patologia Meia-Idade Odontogênese/fisiologia Cistos Odontogênicos/patologia Tumores Odontogênicos/patologia Prevalência Estudos Retrospectivos Fatores Sexuais Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171019 [Lr] Data última revisão: 171019 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE

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[PMID]: 28419844 [Au] Autor: Ramella V; Franchi A; Bottosso S; Tirelli G; Novati FC; Arnez ZM [Ad] Endereço: Consultant, Department of Plastic and Reconstructive Surgery, Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste, Trieste, Italy. [Ti] Título: Triple-Cut Computer-Aided Design-Computer-Aided Modeling: More Oncologic Safety Added to Precise Mandible Modeling. [So] Source: J Oral Maxillofac Surg;75(7):1567.e1-1567.e6, 2017 Jul. [Is] ISSN: 1531-5053 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem. MATERIALS AND METHODS: Customized surgical devices with our "triple-cut" concept were used in 5 patients for mandibular reconstruction with free fibula flap (4 after mandibular resection for squamous cell carcinoma and 1 after mandibular osteoradionecrosis). In all patients the mandibular and fibular cutting guides were provided with 3 different cutting levels per side. RESULTS: Three different cutting levels on the mandible permitted an accurate resection based on the intraoperative needs. The corresponding 3 "cutting levels" on the fibula created perfectly matching segments of vascularized bone. Good contact of bony segments was obtained in all patients. CONCLUSIONS: The prefabricated triple-cut cutting guides make changing the dimensions of bony resection, while still using the prefabricated CAD-CAM reconstructive plate, possible. [Mh] Termos MeSH primário: Carcinoma de Células Escamosas/cirurgia Projeto Auxiliado por Computador Fíbula/transplante Retalhos de Tecido Biológico Doenças Mandibulares/cirurgia Neoplasias Mandibulares/cirurgia Reconstrução Mandibular/métodos Osteorradionecrose/cirurgia [Mh] Termos MeSH secundário: Placas Ósseas Seres Humanos Desenho de Prótese [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170831 [Lr] Data última revisão: 170831 [Sb] Subgrupo de revista: AIM; D; IM [Da] Data de entrada para processamento: 170419 [St] Status: MEDLINE

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[PMID]: 28401163 [Au] Autor: Xie Y; Su Y; Min S; Tang J; Goh BT; Saigo L; Ansari S; Moshaverinia A; Zhang C; Wang J; Liu Y; Khojasteh A; Zadeh HH; Wang S [Ad] Endereço: Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Tian Tan Xi Li No. 4, Beijing 100050, China; Laboratory of Tissue Regeneration and Immunology and Department of Pe [Ti] Título: Collagen Sponge Functionalized with Chimeric Anti-BMP-2 Monoclonal Antibody Mediates Repair of Critical-Size Mandibular Continuity Defects in a Nonhuman Primate Model. [So] Source: Biomed Res Int;2017:8094152, 2017. [Is] ISSN: 2314-6141 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Antibody-mediated osseous regeneration (AMOR) has been introduced by our research group as a tissue engineering approach to capture of endogenous growth factors through the application of specific monoclonal antibodies (mAbs) immobilized on a scaffold. Specifically, anti-Bone Morphogenetic Protein- (BMP-) 2 mAbs have been demonstrated to be efficacious in mediating bone repair in a number of bone defects. The present study sought to investigate the application of AMOR for repair of mandibular continuity defect in nonhuman primates. Critical-sized mandibular continuity defects were created in locally implanted with absorbable collagen sponges (ACS) functionalized with chimeric anti-BMP-2 mAb or isotype control mAb. 2D and 3D analysis of cone beam computed tomography (CBCT) imaging demonstrated increased bone density and volume observed within mandibular continuity defects implanted with collagen scaffolds functionalized with anti-BMP-2 mAb, compared with isotype-matched control mAb. Both CBCT imaging and histologic examination demonstrated de novo bone formation that was in direct apposition to the margins of the resected bone. It is hypothesized that bone injury may be necessary for AMOR. This is evidenced by de novo bone formation adjacent to resected bone margins, which may be the source of endogenous BMPs captured by anti-BMP-2 mAb, in turn mediating bone repair. [Mh] Termos MeSH primário: Anticorpos Monoclonais/uso terapêutico Proteína Morfogenética Óssea 2/imunologia Mandíbula/crescimento & desenvolvimento Doenças Mandibulares/terapia Engenharia Tecidual [Mh] Termos MeSH secundário: Animais Anticorpos Monoclonais/imunologia Proteína Morfogenética Óssea 2/uso terapêutico Regeneração Óssea/efeitos dos fármacos Regeneração Óssea/genética Colágeno/uso terapêutico Modelos Animais de Doenças Seres Humanos Macaca fascicularis Mandíbula/efeitos dos fármacos Mandíbula/patologia Doenças Mandibulares/fisiopatologia Osteogênese/efeitos dos fármacos Osteogênese/genética Tecidos Suporte Cicatrização [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antibodies, Monoclonal); 0 (Bone Morphogenetic Protein 2); 9007-34-5 (Collagen) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170428 [Lr] Data última revisão: 170428 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170413 [St] Status: MEDLINE [do] DOI: 10.1155/2017/8094152

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[PMID]: 28396232 [Au] Autor: Hudson JW; Daly AP; Foster M [Ad] Endereço: Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center, Knoxville, TN. Electronic address: jwhudson@utmck.edu. [Ti] Título: Treatment of Osteomyelitis: A Case for Disruption of the Affected Adjacent Periosteum. [So] Source: J Oral Maxillofac Surg;75(10):2127-2134, 2017 Oct. [Is] ISSN: 1531-5053 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To evaluate the response of mandibular osteomyelitis treated by surgical decortication with disruption of the affected adjacent periosteum in concert with long-term targeted antibiotic therapy. The hypothesis is that, by removing the buccal cortical plate and disrupting the hypertrophically inflamed adjacent periosteum, the medullary bone will be brought in contact with bleeding tissue and circulating immunologic factors and antibiotics, which will promote definitive resolution. PATIENTS AND METHODS: A retrospective review was conducted of 7 patient charts with associated radiographs from November 2010 to August 2016 treated by the first author at the University of Tennessee Medical Center (Knoxville, TN). Patients with chronic suppurative or nonsuppurative osteomyelitis of the mandible without condylar involvement or pathologic fracture were selected and treated with decortication with periosteal disruption in combination with long-term targeted antibiotic therapy. RESULTS: Seven patients (3 women and 4 men; mean age, 60 yr) underwent decortication with periosteal disruption of the affected area and received at least 6 weeks of targeted intravenous antibiotics. Computed tomography was performed preoperatively and a repeat study was performed after completion of antibiotics. In each case, post-treatment imaging showed definitive resolution after treatment with decortication in concert with disruption of the inflamed hypertrophic periosteum and intravenous antibiotics. CONCLUSION: Debridement of the infected cortical bone with restoration of the blood supply through disruption of the adjacent periosteum provided definitive resolution of mandibular osteomyelitis in the 7 patients treated. The hypothesis is that disruption of the affected adjacent periosteum reintroduces an immune-mediated response in concert with improved antibiotic delivery to and penetrance of the diseased mandible, aiding in definitive resolution. Decortication with periosteal disruption allows for preservation of the inferior alveolar nerve, maintains mandibular integrity, and obviates reconstructive surgery. Decortication with disruption of the adjacent periosteum, when combined with targeted antimicrobial therapy, produced definitive resolution of osteomyelitis as shown by postoperative imaging. It is the authors' assertion that not only decortication, but also disruption of the adjacent periosteum in combination with targeted antibiotic therapy should be considered a valid and principal therapeutic option for the surgical treatment of osteomyelitis of the mandible. [Mh] Termos MeSH primário: Antibacterianos/uso terapêutico Doenças Mandibulares/tratamento farmacológico Doenças Mandibulares/cirurgia Osteomielite/tratamento farmacológico Osteomielite/cirurgia Periósteo/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Terapia Combinada Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-Bacterial Agents) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171012 [Lr] Data última revisão: 171012 [Sb] Subgrupo de revista: AIM; D; IM [Da] Data de entrada para processamento: 170412 [St] Status: MEDLINE

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