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Carlson ER, Kademani D, Ward B, Oreadi D. American Association of Oral and Maxillofacial Surgeon's Position Paper on Oral Mucosal Dysplasia R2. J Oral Maxillofac Surg 2023:S0278-2391(23)00397-X. [PMID: 37244288 DOI: 10.1016/j.joms.2023.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/29/2023]
Abstract
Oral potentially malignant disorders (OPMDs) of the oral mucosa include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral lichenoid lesions, each with varying incidences of dysplastic disease at the time of presentation and each with observed incidences of malignant transformation over time. The primary goal of the management of dysplasia, therefore, includes their early detection and treatment prior to malignant transformation. The recognition and management of these OPMDs and an understanding of their potential progression to oral squamous cell carcinoma will reduce the morbidity and mortality associated with these lesions with expedient and properly executed treatment strategies that will have a positive effect on patient survival. It is the purpose of this position paper to discuss oral mucosal dysplasia in terms of its nomenclature, epidemiology, types, natural history, and treatment to acquaint clinicians regarding the timing of biopsy, type of biopsy, and follow-up of patients with these lesions of the oral mucosa. This position paper represents a synthesis of existing literature on this topic with the intention of closing gaps in our understanding of oral mucosal dysplasia while also stimulating new thinking to guide clinicians in the proper diagnosis and management of OPMDs. The fifth edition of the World Health Organization classification of head and neck tumors published in 2022 represents new information regarding this topic and a construct for this position paper.
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Affiliation(s)
- Eric R Carlson
- Professor and Kelly L. Krahwinkel Endowed Chairman, Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN.
| | - Deepak Kademani
- President, Minnesota Oral and Facial/Head and Neck Surgery, Fellowship Director, Oral/Head and Neck Oncologic and Reconstructive Surgery
| | - Brent Ward
- Professor and Chairman, Department of Oral and Maxillofacial Surgery, University of Michigan
| | - Daniel Oreadi
- Associate Professor, Department of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine
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Birkeland AC, Kademani D, Moore MG, Blair EA. Practice patterns for initial management of oral leukoplakia amongst otolaryngologists and oral and maxillofacial surgeons. Oral Oncol 2023; 139:106341. [PMID: 36842197 DOI: 10.1016/j.oraloncology.2023.106341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE Oral leukoplakia is encountered frequently by otolaryngologists and oral and maxillofacial surgeons (OMFS). There are no consensus practice management guidelines for oral leukoplakia, resulting in heterogeneity in practice patterns. Characterization of practice patterns of providers who treat oral leukoplakia will be valuable to establish standards of care and future practice guidelines. MATERIAL AND METHODS A survey was designed by the American Head and Neck Society Cancer Prevention Service collecting demographic and practice management data for treating oral leukoplakia. The survey was approved and distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery and American Association of Oral and Maxillofacial Surgeons. Data analysis was performed using chi square and t-test where appropriate. RESULTS 396 responses were collected: 83 OMFS, 81 head and neck fellowship-trained providers, and 232 otolaryngologists (non-head and neck fellowship-trained). Providers saw a wide volume of oral leukoplakia (23.0% >30 cases/year, 35.1% 11-30 cases/year, 41.2% 10 or less cases/year), with OMFS seeing more cases of oral leukoplakia. Factors most associated with consideration of initial biopsy included physical exam findings (94.4%), erythroplakia (82.3%), and smoking status (81.6%). The majority of respondents saw patients in follow-up within 1 month (24.8%) or within 1-3 months (46.5%). CONCLUSION This survey identifies a range of practice patterns in initial management of oral leukoplakia, including indications for biopsy, and time for follow-up. This data provide insight into practice patterns amongst different groups of providers and can potentially lead to consensus guidelines for initial management of oral leukoplakia.
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Affiliation(s)
- Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California - Davis, Sacramento, CA, USA.
| | - Deepak Kademani
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Robbinsdale, MN, USA
| | - Michael G Moore
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elizabeth A Blair
- Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, IL, USA
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Urquhart O, DeLong HR, Ziegler KM, Pilcher L, Pahlke S, Tampi MP, O'Brien KK, Patton LL, Agrawal N, Hofstede TM, Kademani D, Lingen MW, Treister NS, Tsai CJ, Carrasco-Labra A, Lipman RD. Effect of preradiation dental intervention on incidence of osteoradionecrosis in patients with head and neck cancer: A systematic review and meta-analysis. J Am Dent Assoc 2022; 153:931-942.e32. [PMID: 35985883 DOI: 10.1016/j.adaj.2022.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/23/2022] [Accepted: 06/07/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this systematic review was to examine whether dental intervention involving bone or soft-tissue manipulation preradiotherapy (pre-RT) is associated with lower rates of osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer (HNC). TYPES OF STUDIES REVIEWED The authors included relevant studies from MEDLINE, Embase, and Cochrane Library, including observational studies published from 2007 through 2021 and involving adults who underwent dental intervention pre-RT for HNC. Authors assessed evidence certainty by using the Grading of Recommendations Assessment, Development, and Evaluation approach. Random-effects models were used to calculate pooled relative risk estimates and hazard ratios. When meta-analysis was not possible, study-level measures of association and narrative summaries of the evidence were reported. RESULTS Twenty-two studies were included. From the pooled, unadjusted analysis, patients undergoing pre-RT extractions may have a 55% increased risk of experiencing ORNJ (relative risk, 1.55; 95% CI, 0.85 to 2.86; very low certainty); the unadjusted pooled hazard ratio was 3.19 (95% CI, 0.99 to 10.31; very low certainty), corresponding to a possible increased hazard of developing ORNJ (very low certainty). Findings for other pre-RT procedures manipulating bone or tissue relied on limited, observational studies with low or very low certainty evidence. CONCLUSIONS Mostly very low certainty evidence suggests that patients with HNC who need pre-RT dental intervention may have an increased risk of developing ORNJ compared with those who do not. PRACTICAL IMPLICATIONS Maintaining optimal oral health may help reduce the need for urgent pre-RT dental treatment, potentially reducing ORNJ risk and minimizing delay of oncologic treatment in patients with HNC.
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Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg 2022; 80:920-943. [PMID: 35300956 DOI: 10.1016/j.joms.2022.02.008] [Citation(s) in RCA: 251] [Impact Index Per Article: 125.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022]
Abstract
Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaws (MRONJ) - formerly referred to as bisphosphonate-related osteonecrosis of the jaws (BRONJ)-were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007, 2009 and 2014. The position papers were developed by a committee appointed by the AAOMS Board of Trustees and comprising clinicians with extensive experience in caring for these patients, as well as clinical and basic science researchers. The knowledge base and experience in addressing MRONJ continues to evolve and expand, necessitating modifications and refinements to the previous position papers. Three members of the AAOMS Committee on Oral, Head, and Neck Oncologic and Reconstructive Surgery (COHNORS) and three authors of the 2014 position paper were appointed to serve as a working group to analyze the current literature and revise the guidance as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis and management strategies and highlights the current research status. AAOMS maintains that it is vitally important for this information to be disseminated to other relevant healthcare professionals and organizations.
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Affiliation(s)
- Salvatore L Ruggiero
- Clinical Professor, Division of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, New York Center for Orthognathic and Maxillofacial Surgery, Lake Success, NY.
| | - Thomas B Dodson
- Professor and Chair, University of Washington School of Dentistry, Department of Oral and Maxillofacial Surgery, Seattle, Wash
| | - Tara Aghaloo
- Professor, Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, Calif
| | - Eric R Carlson
- Professor and Kelly L. Krahwinkel Endowed Chairman, Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tenn
| | - Brent B Ward
- Chalmers J Lyons Professor of Oral and Maxillofacial Surgery, Associate Professor of Dentistry, Chair of the Department of Oral and Maxillofacial Surgery/Hospital Dentistry in the School of Dentistry and Associate Professor of Surgery for the Medical School, University of Michigan Hospital, Ann Arbor, Mich
| | - Deepak Kademani
- Chief of Staff North Memorial Health, Fellowship Director, Oral/Head and Neck Oncologic and Reconstructive Surgery Attending Surgeon, North Memorial Health and the University of Minnesota. Private practice, Minnesota Oral and Facial Surgery and Minnesota Head and Neck Surgery, Minneapolis, Minn
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Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. Reply: Can RECIST 1.1 Criteria Provide a Solution to the Achilles' Heel in the Management of Medication-Related Osteonecrosis of Jaws? J Oral Maxillofac Surg 2022; 80:1148. [DOI: 10.1016/j.joms.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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Carlson ER, Kademani D. Head and Neck Cancer Awareness Month. J Am Dent Assoc 2020; 151:223-224. [DOI: 10.1016/j.adaj.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/24/2020] [Accepted: 02/02/2020] [Indexed: 12/24/2022]
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Bouloux GF, Aghaloo T, Campbell JA, Chou J, Edwards SP, Kademani D, Reese DC, Cillo J, Dodson TB, Peacock Z. Proceedings From the Clinical and Scientific Innovations in Oral and Maxillofacial Surgery Conference 2019. J Oral Maxillofac Surg 2019; 78:327-334. [PMID: 31838088 DOI: 10.1016/j.joms.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Gary F Bouloux
- J. David Allen and Family Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Tara Aghaloo
- Professor and Assistant Dean for Clinical Research, Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, University of California, Los Angeles, School of Dentistry, Los Angeles, CA.
| | - Joshua A Campbell
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee School of Medicine, Knoxville, TN
| | - Jolie Chou
- Associate Professor, Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Sean P Edwards
- Professor, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Deepak Kademani
- Chief, Department of Oral and Maxillofacial Surgery, North Memorial Health Hospital, Minneapolis, MN
| | - Daniel C Reese
- Resident, Department of Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, Cleveland, OH
| | - Joe Cillo
- Oral Surgeon, Allegheny Oral and Maxillofacial Surgery, Pittsburgh, PA
| | - Thomas B Dodson
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA
| | - Zachary Peacock
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA
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Argyris PP, Slama Z, Malz C, Koutlas IG, Pakzad B, Patel K, Kademani D, Khammanivong A, Herzberg MC. Intracellular calprotectin (S100A8/A9) controls epithelial differentiation and caspase-mediated cleavage of EGFR in head and neck squamous cell carcinoma. Oral Oncol 2019; 95:1-10. [PMID: 31345374 DOI: 10.1016/j.oraloncology.2019.05.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/21/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Calprotectin (S100A8/A9) appears to function as a tumor suppressor in head and neck squamous cell carcinoma (HNSCC) and expression in the carcinoma cells and patient survival rates are directly related. We seek to characterize the suppressive role of calprotectin in HNSCC. AIMS (1) Investigate changes in S100A8/A9 expression as oral carcinogenesis progresses and (2) determine whether intracellular calprotectin can regulate epidermal growth factor receptor (EGFR), a negative prognostic factor, in HNSCC. MATERIALS AND METHODS Using immunohistochemistry (IHC), S100A8/A9 was analyzed in HNSCC specimens (N = 46), including well-differentiated (WD, N = 19), moderately-differentiated (MD, N = 14), poorly-differentiated (PD, N = 5) and non-keratinizing/basaloid (NK/BAS, N = 8), and premalignant epithelial dysplasias (PED, N = 16). Similarly, EGFR was analyzed in HNSCCs (N = 21). To determine whether calprotectin and EGFR expression are mechanistically linked, TR146 HNSCC cells that are S100A8/A9-expressing or silenced (shRNA) were compared for EGFR levels and caspase-3/7 activity using western blotting and immunofluorescence microscopy. RESULTS In normal oral mucosal epithelium, S100A8/A9 stained strongly in the cytoplasm and nucleus of suprabasal cells; basal cells were consistently S100A8/A9 negative. In PED and HNSCC, S100A8/A9 expression was lower than in adjacent normal epithelial tissues (NAT) and declined progressively in WD, MD, PD and NK/BAS HNSCCs. S100A8/A9 and EGFR levels appeared inversely related, which was simulated in vitro when S100A8/A9 was silenced in TR146 cells. Silencing S100A8/A9 significantly reduced caspase-3/7 activity, whereas EGFR levels increased. CONCLUSIONS In HNSCC, S100A8/A9 is directly associated with cellular differentiation and appears to promote caspase-3/7-mediated cleavage of EGFR, which could explain why patients with S100A8/A9-high tumors survive longer.
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Affiliation(s)
- Prokopios P Argyris
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zachary Slama
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Chris Malz
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ioannis G Koutlas
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Betty Pakzad
- Anatomic Clinical Pathology, North Memorial Health Hospital, Minneapolis, MN 55422, USA
| | - Ketan Patel
- Oral and Maxillofacial Surgery Clinic, North Memorial Health Hospital, Minneapolis, MN 55422, USA
| | - Deepak Kademani
- Oral and Maxillofacial Surgery Clinic, North Memorial Health Hospital, Minneapolis, MN 55422, USA
| | - Ali Khammanivong
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Mark C Herzberg
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
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Johnson A, Baeten J, Patel K, Killian M, Sunny S, Suresh A, Uma K, Birur P, Kuriakose M, Kademani D. Evaluation of a Lectin-Based Imaging System for the Chairside Detection of Oral Dysplasia and Malignancy. J Oral Maxillofac Surg 2019; 77:1941-1951. [PMID: 31004587 DOI: 10.1016/j.joms.2019.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Currently available oral cancer screening adjuncts have not enhanced clinical screening methods because of high false positives and negatives, highlighting the need for a molecularly specific technique for accurate screening of suspicious oral lesions. The purpose of this study was to evaluate the in vivo screening accuracy of an oral lesion identification system that evaluates aberrant glycosylation patterns using a fluorescently labeled lectin (wheat germ agglutinin and fluorescein isothiocyanate [WGA-FITC]). MATERIALS AND METHODS The authors designed and implemented a prospective cohort study at 3 institutions composed of patients with and without suspicious oral lesions. Oral cavities were screened by clinical examination and with the oral lesion identification system according to a stepwise procedure that included the topical application and fluorescence visualization of a fluorescent nuclear stain and WGA-FITC. Tissue samples were obtained from all enrolled patients for histopathological diagnosis and were used to calculate sensitivity and specificity metrics (primary outcome variable) irrespective of the oral lesion identification system result. RESULTS The sample was composed of 97 patients; 86 had 100 clinically suspicious lesions and 11 without such lesions were included as a control group. Use of the oral lesion identification system resulted in 100, 100, and 74% sensitivity for cancer, high-grade dysplasia, and low-grade dysplasia, respectively, and a specificity of 80%. Clinical diagnosis yielded similar sensitivity values of 84, 100, and 88% for cancer, high-grade dysplasia, and low-grade dysplasia, respectively, and a specificity of 76%. Use of the oral lesion identification system enhanced the visualization of lesion dimensionality and borders. CONCLUSIONS The results of this study suggest the oral lesion identification system was a beneficial adjunct to standard clinical examination, because the system provided sensitivity and specificity values similar to or greater than clinical diagnosis.
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Affiliation(s)
| | - John Baeten
- Director of Engineering/Research and Development, Inter-Med, Inc, Racine, WI
| | - Ketan Patel
- Attending Surgeon, North Memorial Health Care, Robbinsdale, MN
| | - Molly Killian
- Clinical Research Coordinator, North Memorial Health Care, Robbinsdale, MN
| | - Sumsum Sunny
- Fellow, Mazumdar Shaw Cancer Center, Bangalore, India
| | - Amritha Suresh
- Research Scientist, Mazumdar Shaw Cancer Center, Bangalore, India
| | - K Uma
- Oral Pathologist, KLES Dental College, Bangalore, India
| | - Praveen Birur
- Professor and Department Head, Oral Medicine and Radiology, KLES Dental College, Bangalore, India
| | - Moni Kuriakose
- Professor and Director, Department of Surgical Oncology, Narayana Hrudayalaya Hospital, Bangalore, India; Professor of Oncology and Director of Head and Neck Oncology Research Program, Roswell Park Cancer Institute, Buffalo, NY
| | - Deepak Kademani
- Chief of Surgery, Chief and Fellowship Director, Oral and Maxillofacial Surgery, North Memorial Medical Center, Robbinsdale, MN.
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Affiliation(s)
- Rishi Jay Gupta
- Oral and Maxillofacial Surgery Section, Department of Dental Service, San Francisco VA Health Care System, 4150 Clement Street (160), San Francisco, CA 94121, USA; Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 707 Parnassus Ave, San Francisco, CA 94143, USA; Department of Otolaryngology Head and Neck Surgery, University of California, Davis, 2521 Stockton Blvd, Sacramento, CA 95817, USA
| | - Deepak Kademani
- Head and Neck Oncologic and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN 55422, USA
| | - Stanley Yung-Chuan Liu
- Division of Sleep Surgery, Department of Otolaryngology, Stanford Sleep Surgery Fellowship, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA.
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Dillon JK, Villing AS, Jones RS, Futran ND, Brockhoff HC, Carlson ER, Schlieve T, Kademani D, Patel K, Claiborne ST, Dierks EJ, Ying YP, Ward BB. What Is the Role of Elective Neck Dissection in the Management of Patients With Buccal Squamous Cell Carcinoma and Clinically Negative Neck? J Oral Maxillofac Surg 2018; 77:641-647. [PMID: 30503978 DOI: 10.1016/j.joms.2018.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/06/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Buccal squamous cell carcinoma (BSCC) is rare in the United States. Given its location, few anatomic barriers to spread exist and it has been found to have a high locoregional recurrence rate. The role of elective neck dissection (END) in patients with clinically negative neck (N0) is not clear. This study aims to answer the following research question: Among patients with N0 BSCC, does END improve locoregional control rates, distant metastasis rates, and 2- and 5-year survival rates? MATERIALS AND METHODS A retrospective cohort study was conducted. The sample included patients who received a diagnosis of BSCC. The primary predictor variable was END status (yes or no). Five institutions participated between June 2001 and June 2011: University of Washington, University of Michigan, University of Tennessee, North Memorial Oral and Maxillofacial Surgery in Minnesota, and Head and Neck Surgical Associates (Portland, OR). The primary outcome variable was locoregional recurrence. Secondary outcome variables were distant metastasis and 2- and 5-year survival rates. Other variables collected were demographic characteristics, initial operation, adjuvant therapy, clinical and pathologic data, and staging. Kaplan-Meier and Cox proportional hazards statistics were computed. RESULTS The sample was composed of 98 patients with clinical N0 BSCC. The mean age was 66 years (range, 30-88 years), and 54% were men. Of the patients, 74 (76%) underwent END. The locoregional recurrence-free rate was 61% for END versus 38% for no END (P = .042). The distant metastasis rate was 4% for END versus 9% for no END. The 2- and 5-year disease-free survival rates were 91% and 75% (P = .042), respectively, for END and 85% and 63% (P = .019), respectively, for no END. CONCLUSIONS END had a therapeutic effect, as evidenced by a lower locoregional recurrence rate, lower distant metastasis rate, and improved 2- and 5-year survival rates.
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Affiliation(s)
- Jasjit K Dillon
- Clinical Associate Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA.
| | - Akashdeep S Villing
- Formerly, Chief Resident, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA. Currently, Private Practice, Surrey, British Columbia
| | - Richard S Jones
- Formerly, Chief Resident, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA. Currently, Private Practice, Spokane, WA
| | - Neal D Futran
- Professor and Chair, Department of Otolaryngology, Head and Neck Surgery, University of Washington, Seattle, WA
| | - Hans C Brockhoff
- Formerly Oral and Maxillofaical Oncology and Microvascular Reconstruction Fellow, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI. Currently, High Desert Oral and Facial Surgery, University Medical Center, El Paso, TX
| | - Eric R Carlson
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Tennessee, Knoxville, TN
| | - Thomas Schlieve
- Formerly, Fellow, Department of Oral and Maxillofacial Surgery, University of Tennessee, Knoxville, TN. Currently, Assistant Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Texas Southwestern/Parkland Memorial Hospital, Dallas, TX
| | - Deepak Kademani
- Clinical Associate Professor, North Memorial Oral and Maxillofacial Surgery, Minneapolis, MN
| | - Ketan Patel
- Clinical Associate Professor, North Memorial Oral and Maxillofacial Surgery, Minneapolis, MN
| | - Scott T Claiborne
- Clinical Associate Professor, North Memorial Oral and Maxillofacial Surgery, Minneapolis, MN
| | - Eric J Dierks
- Affiliate Professor of Oral and Maxillofacial Surgery at Oregon Health and Science University Hospital, Portland, OR. Head and Neck Associates, Emmanuel Hospital, Portland, OR
| | - Yedeh P Ying
- Formerly, Fellow, Head and Neck Associates, Emanuel Hospital. Currently, Assistant Professor, Oral & Maxillofacial Surgery, University of Alabama, Birmingham, AL
| | - Brent B Ward
- Associate Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
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Patel K, Idle M, Awadallah M, Kademani D. UPPER Airway Stimulator for Management of Moderate to Severe Obstructive SLEEP Apnea. J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.joms.2018.06.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Awadallah M, Idle M, Patel K, Kademani D. Management update of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:628-636. [PMID: 29656948 DOI: 10.1016/j.oooo.2018.03.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 11/26/2022]
Abstract
The term oral potentially malignant disorders, proposed at the World Health Organization workshop in 2005, has now been renamed potentially premalignant oral epithelial lesions (PPOELs). It is important to differentiate among PPOELs, which is a broad term to define a wide variety of clinical lesions, and oral epithelial dysplasia, which should be reserved specifically for lesions with biopsy-proven foci of dysplasia. PPOELs encompass lesions that include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral submucous fibrosis. The primary goal of management of dysplasia includes prevention, early detection, and treatment before malignant transformation. The aim of this article is to inform the clinician about management of PPOELs.
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Affiliation(s)
- Michael Awadallah
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Matthew Idle
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Ketan Patel
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Deepak Kademani
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA.
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Cillo JE, Aghaloo T, Basi D, Bouloux GF, Campbell JA, Chou J, Dodson T, Edwards SP, Kademani D, Peacock Z. Proceedings of the American Association of Oral and Maxillofacial Surgeon's 2017 Clinical and Scientific Innovations in Oral and Maxillofacial Surgery (CSIOMS). J Oral Maxillofac Surg 2017; 76:248-257. [PMID: 29156177 DOI: 10.1016/j.joms.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Abstract
The sixth biennial Clinical and Scientific Innovations in Oral and Maxillofacial Surgery, formerly the Research Summit, of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois from April 28 to 30, 2017. The goal of the symposium is to provide a forum for the latest clinical and scientific advances to be brought to the specialty. It also nurtures collaboration and the development of relationships between oral and maxillofacial surgeons and researchers to bridge the gap between clinical and basic science. The goal is to improve the care of oral and maxillofacial surgical patients through the advancement of translational and clinical research.
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Affiliation(s)
- Joseph E Cillo
- Associate Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.
| | - Tara Aghaloo
- Professor and Assistant Dean for Clinical Research, UCLA School of Dentistry, Los Angeles, CA
| | | | - Gary F Bouloux
- Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA
| | - Joshua A Campbell
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee, Knoxville, TN
| | - Joli Chou
- Assistant Professor, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Thomas Dodson
- Professor and Chair, Oral and Maxillofacial Surgery, University of Washington, School of Dentistry, Seattle, WA
| | - Sean P Edwards
- Clinical Associate Professor; Director, Residency Program; Chief, Pediatric Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Deepak Kademani
- Chairman, Medical Director, and Fellowship Director, Department of Surgery, Oral and Maxillofacial Surgery, Oral-Head and Neck Oncologic and Reconstructive Surgery, North Memorial and Hubert Humphrey Cancer Center, Minneapolis, MN
| | - Zachary Peacock
- Assistant Professor, Oral and Maxillofacial Surgery; Director, Research and the Skeletal Biology Research Center, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA
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Claiborne S, Kademani D, Patel K, Idle M. Non-Union Rates in Fibula Free-Flap Reconstruction of Head and Neck Oncologic Defects. J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.joms.2017.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Baeten J, Johnson A, Sunny S, Suresh A, Birur P, Uma K, Kademani D. Chairside molecular imaging of aberrant glycosylation in subjects with suspicious oral lesions using fluorescently labeled wheat germ agglutinin. Head Neck 2017; 40:292-301. [PMID: 28963821 DOI: 10.1002/hed.24943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/22/2017] [Accepted: 07/31/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Aberrant sialylation is accepted as a carcinogenic biomarker. In previous work, fluorescently labeled wheat germ agglutinin (WGA) distinguished between cancerous and normal oral biopsies. The purpose of this study was to investigate WGA-fluorescein isothiocyanate (FITC) as a point-of-care tool for detecting oral malignant and dysplastic lesions in vivo. METHODS Subject recruitment was divided into two groups: (1) the clinically normal oral mucosa group; or (2) the presence of clinically suspicious oral lesion(s) group. A WGA-FITC solution was topically applied to observable lesions or to half the subject's mouth (sagittal plane) if lesions were absent. Fluorescent molecular imaging was used to evaluate WGA-FITC localization. RESULTS Fluorescent imaging in 55 subjects demonstrated that WGA-FITC could detect histopathologically-confirmed cancerous and dysplastic lesions with high sensitivity (100% and 81%, respectively) and specificity (82%). CONCLUSION This study supports in vivo fluorescent molecular imaging of WGA-FITC to visualize aberrant sialic acid expression associated with carcinogenesis. This technique resulted in the immediate chairside detection of oral cancerous and dysplastic lesions.
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Affiliation(s)
| | | | - Sumsum Sunny
- Mazumdar Shaw Cancer Center, Narayana Health City, Bangalore, Karnataka, India.,Mazumdar Shaw Center for Translational Research, Bangalore, Karnataka, India
| | - Amritha Suresh
- Mazumdar Shaw Cancer Center, Narayana Health City, Bangalore, Karnataka, India.,Mazumdar Shaw Center for Translational Research, Bangalore, Karnataka, India.,Roswell Park Cancer Institute, Buffalo, New York
| | - Praveen Birur
- KLES Dental College, Department of Oral Medicine, Bangalore, Karnataka, India
| | - K Uma
- KLES Dental College, Department of Oral Pathology, Bangalore, Karnataka, India
| | - Deepak Kademani
- University of Minnesota, Minneapolis, Minnesota.,North Memorial Oral and Maxillofacial Surgery, Minneapolis, Minnesota
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Kademani J, Baeten J, Johnson A, Claiborne S, Idle M, Patel K, Kuriakose M, Kademani D. The use of fluorescent lecthins to detect oral cancer and dysplasia. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kademani D. Midface trauma and reconstruction. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kademani D, Woo B, Ward B, Fernandes R, Carlson E, Helman J, Ghali GE, Lambert P. Oral/Head and Neck Oncologic and Reconstructive Surgery Fellowship Training Programs: Transformation of the Specialty From 2005 to 2015: Report from the AAOMS Committee on Maxillofacial Oncology and Reconstructive Surgery. J Oral Maxillofac Surg 2016; 74:2123-2127. [DOI: 10.1016/j.joms.2016.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 07/20/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
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Lipon J, Kademani D, Leon-Salazar V, Rykken J, Patel K. Pediatric Airway Assessment. a Retrospective Computerized Axial Tomography Study to Determine the Optimal Localization to Secure an Emergent Pediatric Airway. J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.joms.2016.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Claiborne S, Patel K, Kademani D. Pain as a Presenting Symptom in Patients With Newly Diagnosed Oral Squamous Cell Carcinoma. J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.joms.2016.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cillo JE, Basi D, Peacock Z, Aghaloo T, Bouloux G, Dodson T, Edwards SP, Kademani D. Proceedings of the American Association of Oral and Maxillofacial Surgeons 2015 Research Summit. J Oral Maxillofac Surg 2015; 74:429-37. [PMID: 26707430 DOI: 10.1016/j.joms.2015.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 11/15/2022]
Abstract
The Fifth Biennial Research Summit of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois on May 6 and 7, 2015. The goal of the symposium is to provide a forum for the most recent clinical and scientific advances to be brought to the specialty. The proceedings of the events of that summit are presented in this report.
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Affiliation(s)
- Joseph E Cillo
- Assistant Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.
| | | | - Zachary Peacock
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Tara Aghaloo
- Assistant Dean, Clinical Research; Professor, Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA
| | - Gary Bouloux
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Emory University, Atlanta, GA
| | - Thomas Dodson
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA
| | - Sean P Edwards
- Clinical Associate Professor; Director, Residency Program; Chief, Pediatric Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Deepak Kademani
- Medical Director, Department of Oral and Maxillofacial Surgery; Fellowship Director, Oral-Head and Neck Oncologic and Reconstructive Surgery, North Memorial and Hubert Humphrey Cancer Center, Minneapolis, MN
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Baeten J, Suresh A, Johnson A, Patel K, Kuriakose M, Flynn A, Kademani D. Molecular imaging of oral premalignant and malignant lesions using fluorescently labeled lectins. Transl Oncol 2014; 7:213-20. [PMID: 24913673 PMCID: PMC4101339 DOI: 10.1016/j.tranon.2014.02.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 12/16/2013] [Accepted: 12/20/2013] [Indexed: 11/25/2022] Open
Abstract
Aberrant glycosylation during carcinogenesis results in altered glycan expression on oral cancer cells. The objective of this study was to detect this atypical glycosylation via imaging of fluorophore-conjugated lectins. Paired normal and tumor tissue from seven patients with oral squamous cell carcinoma were investigated for sialic acid expression via the legume protein wheat germ agglutinin (WGA). Fluorophore (Alexa Fluor 350 and Alexa Fluor 647) conjugated WGA was topically applied to the tissue samples and imaged using a custom wide-field fluorescence imaging system. All seven patients had histologically confirmed disease with 6/7 exhibiting squamous cell carcinoma and 1/7 exhibiting dysplasia. Fluorescent data collected from all patients demonstrated that fluorophore conjugated WGA could distinguish between pathologically normal and diseased tissue with the average signal-to-noise ratio (SNR) among all patients being 5.88 (P = .00046). This SNR was statistically significantly higher than the SNR from differences in tissue autofluorescence (P = .0049). A lectin inhibitory experiment confirmed that lectin binding is molecularly specific to overexpressed tumor glycans and that fluorescence is not due to tissue optical properties or tissue diffusion differences. These results illustrate that changes in tumor glycan content of oral neoplasms can be detected with optical imaging using topically applied fluorescently labeled WGA. Lectin targeting of oral lesions using optical imaging may provide a new avenue for the early detection of oral cancers.
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Affiliation(s)
- John Baeten
- Inter-Med Inc., Vista Dental Products, 2200 Northwestern Ave., Racine, WI 53404, USA
| | - Amritha Suresh
- Mazumdar-Shaw Cancer Center, Department of Head and Neck Oncology, Narayana Health City, 258/A, Bommasandra Industrial Area, Anekal Taluk 560 099, Bangalore, India
| | - Alexander Johnson
- Inter-Med Inc., Vista Dental Products, 2200 Northwestern Ave., Racine, WI 53404, USA
| | - Ketan Patel
- University of Minnesota, Department of Oral and Maxillofacial Surgery, Moos Tower 7-174G, 515 Delaware Street, Minneapolis, MN 55455, USA
| | - Moni Kuriakose
- Mazumdar-Shaw Cancer Center, Department of Head and Neck Oncology, Narayana Health City, 258/A, Bommasandra Industrial Area, Anekal Taluk 560 099, Bangalore, India
| | - Anita Flynn
- Mazumdar-Shaw Cancer Center, Department of Head and Neck Oncology, Narayana Health City, 258/A, Bommasandra Industrial Area, Anekal Taluk 560 099, Bangalore, India
| | - Deepak Kademani
- University of Minnesota, Department of Oral and Maxillofacial Surgery, Moos Tower 7-174G, 515 Delaware Street, Minneapolis, MN 55455, USA.
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Peacock ZS, Aghaloo T, Bouloux GF, Cillo JE, Hale RG, Le AD, Lee JS, Kademani D. Proceedings from the 2013 American Association of Oral and Maxillofacial Surgeons Research Summit. J Oral Maxillofac Surg 2013; 72:241-53. [PMID: 24438595 DOI: 10.1016/j.joms.2013.09.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 11/24/2022]
Abstract
The American Association of Oral and Maxillofacial Surgeons, the Oral and Maxillofacial Surgery Foundation, and the International Association of Oral and Maxillofacial Surgeons sponsored the fifth research summit, which convened on May 2 and 3 in Rosemont, Illinois. The Research Summits are convened biennially to facilitate the discussion and collaboration of oral and maxillofacial surgeons with clinical and basic science researchers in fields affecting the specialty. The goal is to advance the field of oral and maxillofacial surgery through exposure and education in topics that ultimately benefit the oral and maxillofacial surgical patient. This edition of the research summit included the topics of robotic surgery and antiresorptive-related osteonecrosis of the jaws (ARONJ). Most importantly, this research summit saw the development of research interest groups (RIGs) in the fields of anesthesia, maxillofacial oncology and reconstructive surgery, obstructive sleep apnea and orthognathic surgery, temporomandibular joint surgery, and trauma. These RIGs developed specific research goals with a plan to continue working on potential projects at the AAOMS Clinical Trials Course on May 7 to 9, 2013 at the University of Michigan in Ann Arbor. The summit program was developed by the AAOMS Committee on Research Planning and Technology Assessment. The charge of the committee is to encourage and promote research within the specialty and to encourage interdisciplinary collaboration. The research summit serves as a platform for oral and maxillofacial surgeons to lead the goal of advancement of research relevant to the specialty. This article provides an overview of the presentations that were made in the sessions on robotic surgery and ARONJ. The research summit keynote address and two additional presentations on patient registries are summarized and updates from the RIGs that were formed at the 2013 research summit are highlighted.
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Affiliation(s)
- Zachary S Peacock
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA.
| | - Tara Aghaloo
- Associate Professor, Division of Oral and Maxillofacial Surgery, University of California, Los Angeles, Los Angeles, CA
| | - Gary F Bouloux
- Associate Professor, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine
| | - Joseph E Cillo
- Program Director and Director of Research, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA
| | - Robert G Hale
- Commander, Dental and Trauma Detachment, US Army Institute of Surgical Research, Fort Sam Houston, TX
| | - Anh D Le
- Chair and Norman Vine Endowed Professor of Oral Rehabilitation, Department of Oral and Maxillofacial Surgery/Pharmacology, University of Pennsylvania, Philadelphia, PA
| | - Janice S Lee
- Deputy Clinical Director, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - Deepak Kademani
- Associate Professor, Division of Oral and Maxillofacial Surgery, University of Minnesota, Minneapolis, MN
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Argyris PP, Kademani D, Pambuccian SE, Nguyen R, Tosios KI, Koutlas IG. Comparison Between p16INK4A Immunohistochemistry and Human Papillomavirus Polymerase Chain Reaction Assay in Oral Papillary Squamous Cell Carcinoma. J Oral Maxillofac Surg 2013; 71:1676-82. [DOI: 10.1016/j.joms.2013.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/01/2013] [Accepted: 04/08/2013] [Indexed: 01/13/2023]
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Patel K, Kademani D, Zhang L. Gene Expression Analysis Identifies a Signature Related to Lymph Node Metastasis of T1/2 Tumors Compared to Controls. J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.joms.2013.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ravi P, Kademani D. Use of Buccal Fat Pad Flap in Treatment of Bisphosphonate-related Osteonecrosis of the Jaws (BRONJ): Literature Review and Report of 15 Cases. J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.joms.2013.06.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Patel K, Kamdar P, Peterson P, Kademani D. OP179. Oral Oncol 2013. [DOI: 10.1016/j.oraloncology.2013.03.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Patel K, French C, Khariwala SS, Rohrer M, Kademani D. Intraosseous leiomyosarcoma of the mandible: a case report. J Oral Maxillofac Surg 2013; 71:1209-16. [PMID: 23540427 DOI: 10.1016/j.joms.2013.01.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/28/2013] [Accepted: 01/30/2013] [Indexed: 11/19/2022]
Abstract
Leiomyosarcomas are rare smooth muscle tumors that can occur anywhere in the body. These tumors rarely occur in the head and neck owing to the limited amount of smooth muscle in the region. The clinical diagnosis of leiomyosarcoma is challenging because of the nonspecific presentation of the disease. The most definitive diagnosis is based on tissue biopsy or surgical resection and histopathologic confirmation. A case of intraosseous leiomyosarcoma of the mandible and a review of the literature are presented.
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Affiliation(s)
- Ketan Patel
- Oral Head and Neck Oncologic Surgery, Department of Oral and Maxillofacial Surgery, University of Minnesota, Minneapolis-St Paul, MN 55455, USA
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Sink J, Hamlar D, Kademani D, Khariwala SS. Computer-aided stereolithography for presurgical planning in fibula free tissue reconstruction of the mandible. J Reconstr Microsurg 2012; 28:395-403. [PMID: 22711196 DOI: 10.1055/s-0032-1315762] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Computer-aided imaging has facilitated presurgical modeling for free tissue mandibular reconstruction. The purpose of this study is to illustrate the utility of preoperative virtual surgical planning in fibula reconstruction of the mandible. METHODS Eight patients, age 17 to 72 years, treated between November 2009 and January 2011 were reviewed. Each required segmental resection and reconstruction of the mandible and were managed with presurgical virtual planning. RESULTS Our series includes five cases of squamous cell carcinoma (SCCA), one case of osteoradionecrosis (ORN), one leiomyosarcoma, and one odontogenic myxoma. All patients underwent a segmental resection of the mandible 5 to 14 cm in size (average 8 cm). In each case, prefabricated guides for segmental mandibulectomy and fibula osteotomy were employed and resulted in simplification of bony inset and reduced need for "fine tuning" of fibula segments. CONCLUSIONS Virtual surgical planning fosters multidisciplinary communication and provides accurate presurgical planning. This allows seamless reconstruction in patients requiring mandibular reconstruction via fibula free tissue transfer. The combination of mandibular and fibular cutting guides and templates allows for a precise and efficient surgical reconstruction. In our experience, this technology is most useful in the reconstruction of large mandibular defects requiring large reconstruction plates and multiple fibular osteotomies.
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Affiliation(s)
- Jill Sink
- Department of Oral and Maxillofacial Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA
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Peacock ZS, Kademani D, Le AD, Lee JS, Hale RG, Cunningham LL. Proceedings From the 2011 American Association of Oral and Maxillofacial Surgeons Research Summit. J Oral Maxillofac Surg 2012; 70:1271-9. [DOI: 10.1016/j.joms.2012.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 01/17/2012] [Indexed: 02/04/2023]
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Peterson P, Templeton R, Kademani D. Poster 60: Metastatic Adenocarcinoma of the TMJ: A Report of 2 Cases and Review of the Literature. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Baeten J, Kademani D. Clinical Investigation for the Use of Lectin Conjugates to Detect Oral Neoplasms. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Khariwala S, Sink J, Weimer K, Kademani D. O96. Computer-aided stereolithography for presurgical planning in fibula free tissue reconstruction of the mandible. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sink J, Kademani D. Maxillofacial oncology at the University of Minnesota: treating the epidemic of oral cancer. Northwest Dent 2011; 90:13-38. [PMID: 21736188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Oral cancer may present with a variety of signs and symptoms including pain, dysphagia, non-healing ulcers, red and white lesions, and indurated masses. Historically, oral cancer has been associated with the male population, particularly those who use tobacco and alcohol. Recently, there has been a dramatic increase in oral cancer rates seen in the population aged 40 years and younger. This increase has not been associated with the traditional risk factors for oral cancer and is likely linked to etiologic factors that remain still undefined. The proliferation of oral cancer is also mirrored by an increase in oropharyngeal malignancies such as base of tongue and tonsil cancer, although the increase in this subset of patients appears to be clearly associated with Human Papillomavirus (HPV). METHODS We present a summary of all oral malignancies treated at the University of Minnesota Oral and Maxillofacial Surgery Division from 2008 through early 2011. RESULTS Since July of 2008, the Oral and Maxillofacial Surgery Department at the University of Minnesota has been referred a total of 69 cases of head and neck malignant tumors, of which 58 were primarily managed with surgery. A broad range of head and neck cancers were seen, with the most common being oral squamous cell carcinoma (OSCC), which accounted for 81% of patients treated by oncologic tumor resection. The tongue was the most common site of occurrence of OSCC with 33% of cases. There was an even distribution between genders. Traditional treatment modalities included surgical resection of primary tumors including neck dissection, when indicated, with postoperative adjuvant therapies being reserved for advanced stage tumors or high-risk pathologic features for recurrence. At the conclusion of the study period in January, 2011, 83% of patients treated surgically for OSCC were living disease free, 4% had recurrent tumors not amenable to resection, 6% of patients had died from other causes, and 6% had succumbed to OSCC, resulting in a disease-specific survival rate of 93% with an overall survival rate of 87%. CONCLUSIONS Oral cancer continues to be diagnosed with advanced stage disease in 50% of patients. Dental practitioners play a significant role in the early detection and diagnosis of oral cavity cancer. It is incumbent upon dental practitioners to be aware of the early signs and symptoms of oral cancer and to make prompt referral to head and neck cancer specialists when indicated. Diligent and frequent examination, particularly in patients with risk factors, will greatly improve survival rates and minimize the complexity and morbidity of oncologic treatment when patients are diagnosed with earlier stage disease.
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Affiliation(s)
- Jill Sink
- Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
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Nguyen R, Koutlas I, Pambuccian S, Kademani D. Poster Board Number: 24: Oral Papillary Squamous Cell Carcinomas (OPSCCa): Clinicopathologic Characteristics and ImmunoHistochemical Study of P16ink4a Reactivity. J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Le AD, Lee JS, Dodson TB, Kademani D, Feinberg SE, Shetty V, Wohlford ME, Zuniga JR, Cunningham LL. Proceedings of the American Association of Oral and Maxillofacial Surgeons 2009 Research Summit. J Oral Maxillofac Surg 2010; 68:1711-22. [PMID: 20542614 DOI: 10.1016/j.joms.2010.02.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 02/26/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Anh D Le
- Surgical, Therapeutic & Bioengineering Sciences, University of Southern California, Los Angeles, CA, USA
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Kademani D, Mardini S. S434: ABC's of Maxillofacial Reconstruction. J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.joms.2009.05.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kademani D, Salinas T, Moran SL. Medial Femoral Periosteal Microvascular Free Flap: A New Method for Maxillary Reconstruction. J Oral Maxillofac Surg 2009; 67:661-5. [DOI: 10.1016/j.joms.2008.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 07/08/2008] [Accepted: 08/08/2008] [Indexed: 10/21/2022]
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Kademani D, Bell RB, Schmidt BL, Blanchaert R, Fernandes R, Lambert P, Tucker WM. Oral and maxillofacial surgeons treating oral cancer: a preliminary report from the American Association of Oral and Maxillofacial Surgeons Task Force on Oral Cancer. J Oral Maxillofac Surg 2008; 66:2151-7. [PMID: 18848117 DOI: 10.1016/j.joms.2008.06.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 02/29/2008] [Accepted: 06/16/2008] [Indexed: 10/21/2022]
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Holahan CM, Koka S, Kennel KA, Weaver AL, Assad DA, Regennitter FJ, Kademani D. Effect of osteoporotic status on the survival of titanium dental implants. Int J Oral Maxillofac Implants 2008; 23:905-910. [PMID: 19014161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine whether a diagnosis of osteoporosis affected the survival rate of osseointegrated dental implants. Other variables that were studied were age, arch location of the implant, and smoking status on the effect of dental implant survival. MATERIALS AND METHODS A retrospective chart review was completed on all women who were 50 years of age or older at the time of dental implant placement at the Mayo Clinic between October 1, 1983, and December 31, 2004. Osteoporotic status was defined on the basis of bone mineral density (BMD) score utilizing World Health Organization criteria. Univariate analyses were performed to evaluate the following independent variables' effect on implant survival: BMD T-score, age, osteoporosis status, arch location of the implant, and smoking status at the time of implant placement. RESULTS A total of 3,224 implants in 746 female patients 50 years of age or older at the time of implant placement were evaluated. BMD scores within 3 years of implant placement were available for 646 implants (192 patients). In this group, 37 implant failures were noted. The 5-year implant survival rate was 93.8% in the group of patients with BMD scores. In this group of 192 patients, there were 94 (49%) who were not diagnosed with osteopenia or osteoporosis, 57 (29.7%) with a diagnosis of osteopenia, and 41 (21.4%) with a diagnosis of osteoporosis. Patients with a diagnosis of osteoporosis or osteopenia were not significantly more likely to develop implant failure compared to those without such a diagnosis (HR = 1.14, 95% CI = 0.50 to 0.60, P = .76 and HR = 0.98, 95% CI = 0.40 to 2.42, P = .97, respectively). Arch location and BMD score did not have a statistically significant effect on implant survival rates. The only tested variable to demonstrate a significant effect was smoking. Implants in patients who were smokers during the time of implant placement were 2.6 times more likely to fail compared to implants placed in patients who did not smoke (HR = 2.6, 95% CI = 1.20 to 5.63; P = .016). CONCLUSIONS Based upon the data derived from this retrospective study of 192 women at least 50 years of age at the time of implant placement, the following observations were made: (1) a diagnosis of osteoporosis and osteopenia did not contribute to increased risk of implant failure and (2) implants placed in patients who were smokers at the time of implant placement were 2.6 times more likely to fail than implants placed in nonsmokers. Based on these data, a diagnosis of osteoporosis or osteopenia is not a contraindication to dental implant therapy.
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Affiliation(s)
- Christopher M Holahan
- Division of Orthodontics, Mayo Clinic School of Graduate Medicine, Rochester, Minnesota, USA
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Kademani D, Liang X, O'Reilly A, Leightner A, Lewis J, Smith D, Foote R. Genomic Differences between Smoking and Drinking Patients and Non-smoking and Non-drinking Patients with Oral Tongue Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liang XH, Lewis J, Foote R, Smith D, Kademani D. Prevalence and Significance of Human Papillomavirus in Oral Tongue Cancer: The Mayo Clinic Experience. J Oral Maxillofac Surg 2008; 66:1875-80. [PMID: 18718395 DOI: 10.1016/j.joms.2008.04.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 01/18/2008] [Accepted: 04/14/2008] [Indexed: 11/28/2022]
Affiliation(s)
- Xin-Hua Liang
- Department of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, MN 55455, USA
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Soderberg C, Perez DS, Ukpo OC, Liang X, O'Reilly AG, Moore EJ, Kademani D, Smith DI. Differential loss of expression of common fragile site genes between oral tongue and oropharyngeal squamous cell carcinomas. Cytogenet Genome Res 2008; 121:201-10. [PMID: 18758160 DOI: 10.1159/000138886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2008] [Indexed: 11/19/2022] Open
Abstract
The common fragile sites (CFSs) are large regions of profound genomic instability found in all individuals. A number of the CFSs have been found to span genes that extend over large genomic regions (>700 kb). The expression of these genes is frequently abrogated in a number of different cancers and several of them have already been shown to function as tumor suppressor genes, both in vitro and in vivo. We analyzed the expression of 14 large CFS genes in two distinct groups of head and neck cancers using real-time RT-PCR. The first were oral tongue squamous cell carcinomas (SCCs) and the second were base of tongue/tonsillar (oropharyngeal) SCCs. These two groups were previously examined for the presence of human papillomavirus (HPV) and while 46% of the oropharyngeal cancers were positive for HPV16 only one of 52 oral cancers contained HPV16 sequences. We observed a distinct pattern of loss of expression of the large CFS genes in the two groups of head and neck cancers. In addition, there was no correlation between the relative instability in different CFS regions and which genes were inactivated. Thus, this report demonstrates another distinction between these two groups of head and neck cancer. In addition, it suggests that there is selection for loss of expression of specific CFS genes in these cancers.
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Affiliation(s)
- C Soderberg
- Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Abstract
Reconstruction of composite maxillofacial defects after tumor excision or trauma is difficult. The role of the reconstructive surgeon is to have a diverse armamentarium of reconstructive options to enable an aesthetic and functional reconstruction while minimizing the morbidity to the patient. This article will present a systematic review of composite maxillofacial reconstruction with free tissue transfer.
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Affiliation(s)
- Deepak Kademani
- Division of Oral and Maxillofacial Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota
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Moran SL, Kademani D. New horizons in vascularized bone grafts. Semin Plast Surg 2008; 22:139. [PMID: 20567708 DOI: 10.1055/s-2008-1081397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Steven L Moran
- Plastic Surgery and Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Foote RL, Liang X, O'Reilly A, Leightner A, Lewis J, Smith D, Kademani D. Genomic differences between smoking and drinking patients and non-smoking and non-drinking patients with oral tongue cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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