Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Nov 2010
Comparative StudyOsteonecrosis of the jaw: effect of bisphosphonate type, local concentration, and acidic milieu on the pathomechanism.
Osteonecrosis of the jaw has been reported in patients receiving high doses of intravenous nitrogen-containing bisphosphonates (N-BPs) because of malignant disease. The exact pathomechanisms have been elusive and questions of paramount importance remain unanswered. Recent studies have indicated toxic effects of bisphosphonates on different cell types, apart from osteoclast inhibition. Multipotent stem cells play an important role in the processes of wound healing and bone regeneration, which seem to be especially impaired in the jaws of patients receiving high doses of N-BPs. Therefore, the aim of the present study was to investigate the effects of different bisphosphonate derivatives and dose levels combined with varying pH levels on the mesenchymal stem cells in vitro. ⋯ Our results have shown that high concentrations of N-BPs and a local acidic milieu, which is commonly present in infections of the jaw, might play a key role in the pathogenesis of osteonecrosis of the jaw in patients receiving high doses of N-BPs for malignant diseases. Also the potency of N-BPs might be different, suggesting a greater risk of osteonecrosis of the jaw with zoledronate.
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J. Oral Maxillofac. Surg. · Nov 2010
Comparative StudyAnxiety sensitivity as a predictor of anxiety and pain related to third molar removal.
Anxiety sensitivity (AS) refers to the fear of anxiety-related symptoms resulting from beliefs that such sensations have negative somatic, social, or psychological consequences. The aim of the present study was to investigate whether AS can predict both anticipated and experienced pain and state and trait anxiety related to third molar removal. ⋯ In the present study, AS did not predict anxiety and pain related to third molar removal. One possible explanation is that most measures were taken postoperatively, a period in which anticipatory anxiety is irrelevant.
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J. Oral Maxillofac. Surg. · Nov 2010
Comparative StudyCephalometric measurement of upper airway length correlates with the presence and severity of obstructive sleep apnea.
The purpose of this study was to measure upper airway length (UAL) on lateral cephalograms and to assess its relationship with the presence and severity of obstructive sleep apnea (OSA). ⋯ Increased upper airway length was correlated with the presence and severity of OSA in this sample of adult patients.
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J. Oral Maxillofac. Surg. · Nov 2010
Microsurgical repair of the peripheral trigeminal nerve after mandibular sagittal split ramus osteotomy.
Injuries to the inferior alveolar nerve (IAN) and lingual nerves (LNs) have long been known complications of the mandibular sagittal split ramus osteotomy (SSRO). Most postoperative paresthesias resolve without treatment. However, microsurgical exploration of the nerve may be indicated in cases of significant persistent sensory dysfunction associated with observed or suspected localized IAN or LN injury. We report the demographics and outcome of microsurgical exploration and repair of peripheral branches of the trigeminal nerve injured because of the SSRO. ⋯ Microsurgical repair of the IAN or LN injured during the SSRO can be considered in patients with persistent, unacceptable sensory dysfunction in the distribution of the involved nerve. Modifications of surgical technique may be helpful in reducing the incidence of such injuries. Based on our experience, an algorithm for evaluation and treatment is presented.