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Menditti D, Santagata M, Guida D, Magliulo R, D'Antonio GM, Staglianò S, Boschetti CE. State of the Art in the Diagnosis and Assessment of Oral Malignant and Potentially Malignant Disorders: Present Insights and Future Outlook-An Overview. Bioengineering (Basel) 2024; 11:228. [PMID: 38534502 DOI: 10.3390/bioengineering11030228] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Oral Potentially Malignant Disorder (OPMD) is a significant concern for clinicians due to the risk of malignant transformation. Oral Squamous Cell Carcinoma (OSCC) is a common type of cancer with a low survival rate, causing over 200,000 new cases globally each year. Despite advancements in diagnosis and treatment, the five-year survival rate for OSCC patients remains under 50%. Early diagnosis can greatly improve the chances of survival. Therefore, understanding the development and transformation of OSCC and developing new diagnostic methods is crucial. The field of oral medicine has been advanced by technological and molecular innovations, leading to the integration of new medical technologies into dental practice. This study aims to outline the potential role of non-invasive imaging techniques and molecular signatures for the early detection of Oral Malignant and Potentially Malignant Disorders.
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Affiliation(s)
- Dardo Menditti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Mario Santagata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - David Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Roberta Magliulo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giovanni Maria D'Antonio
- Division of Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90128 Palermo, Italy
| | - Samuel Staglianò
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
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Menditti D, Santagata M, Imola G, Staglianò S, Vitagliano R, Boschetti CE, Inchingolo AM. Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review. J Pers Med 2023; 13:1397. [PMID: 37763165 PMCID: PMC10532745 DOI: 10.3390/jpm13091397] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
For decades, oral squamous cell carcinoma (OSCC) has been one of the most prevalent and mortal cancers worldwide. The gold standard for OSCC diagnosis is still histopathology but this narrative multidisciplinary review has the aim to explore the literature about conventional OSCC prognostic indicators related to the pTNM stage at the diagnosis such as the depth of invasion and the lymphovascular invasion associated with distant metastasis as indicators of poor life expectancy. Despite its multifactorial nature and recognizable precursors, its diagnosis at the early stages is still challenging. We wanted to highlight the importance of the screening as a primary weapon that a stomatologist should consider, intercepting all at-risk conditions and lesions associated with OSCC and its early stages. This narrative review also overviews the most promising imaging techniques, such as CT, MRI, and US-echography, and their application related to clinical and surgical practice, but also the most-investigated prognostic and diagnostic tissue and salivary biomarkers helpful in OSCC diagnosis and prognostic assessment. Our work highlighted remarkable potential biomarkers that could have a leading role in the future. However, we are still far from defining an appropriate and concrete protocol to apply in clinical practice. The hope is that the present and future research will overcome these limitations to benefit patients, clinicians, and welfare.
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Affiliation(s)
- Dardo Menditti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
| | - Mario Santagata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
| | - Gianmaria Imola
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
| | - Samuel Staglianò
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
| | - Rita Vitagliano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
| | - Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (D.M.); (M.S.); (G.I.); (S.S.); (C.E.B.)
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Boschetti CE, Vitagliano R, Cornacchini N, Santagata M, Caliendo V, Belfiore MP, Colella G, Tartaro G, Cappabianca S. Safety and Aesthetics of Autologous Dermis-Fat Graft after Parotidectomy: A Multidisciplinary Retrospective Study. J Pers Med 2023; 13:1200. [PMID: 37623451 PMCID: PMC10456015 DOI: 10.3390/jpm13081200] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative aesthetic asymmetry problems. (2) Methods: In this study, we enrolled thirty patients with parotid gland tumours in which a partial or complete parotidectomy was performed with positioning in the parotid bed of autologous dermis-fat grafts. We evaluated the satisfaction rate of the patients and the objective efficacy in solving the deformity by comparing MRI data before and after surgery. (3) Results: Twenty-six patients showed a satisfying cosmetic result with proper facial symmetry between the affected side and the healthy one. Two patients presented mild postsurgical complications such as haematomas, and two patients reported temporary weakness of the facial nerve related to the parotidectomy. (4) Conclusions: Based on the imaging data obtained via MRI before and after surgery, we can assess that the employment of fat grafts in parotidectomy surgical procedures gives good cosmetic results and does not affect the post operative management and follow up of oncologic patients.
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Affiliation(s)
- Ciro Emiliano Boschetti
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Rita Vitagliano
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Nicola Cornacchini
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Mario Santagata
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Valentina Caliendo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia, 80138 Naples, Italy; (V.C.); (M.P.B.); (S.C.)
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia, 80138 Naples, Italy; (V.C.); (M.P.B.); (S.C.)
| | - Giuseppe Colella
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Gianpaolo Tartaro
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.E.B.); (N.C.); (M.S.); (G.C.); (G.T.)
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia, 80138 Naples, Italy; (V.C.); (M.P.B.); (S.C.)
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De Cicco D, Boschetti CE, Santagata M, Colella G, Staglianò S, Gaggl A, Bottini GB, Vitagliano R, D'amato S. Medication-Related Osteonecrosis of the Jaws: A Comparison of SICMF-SIPMO and AAOMS Guidelines. Diagnostics (Basel) 2023; 13:2137. [PMID: 37443531 DOI: 10.3390/diagnostics13132137] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Medication-related osteonecrosis of the jaws (MRONJ) is an adverse drug reaction characterized by progressive bone disruption and necrosis in the mandibular and/or maxillary bones. It occurs in individuals who have received antiresorptive drugs without prior radiotherapy. Since its first reported cases in the USA in 2003, extensive literature has emerged worldwide, leading to significant advancements in understanding MRONJ's pathogenesis and management. (2) Results: This article aims to compare the current national recommendations provided by the Italian Society of Maxillofacial Surgery (SICMF)/Italian Society of Oral Pathology and Medicine (SIPMO) and the American Association of Oral and Maxillofacial Surgeons (AAOMS). (3) Conclusions: Historically, the AAOMS advocated for a more conservative approach compared to the Italian guidelines. However, in their 2022 update, the AAOMS adopted a different perspective based on reported evidence, highlighting the advantages of early surgical treatment. Despite resolving some initial controversies, differences still exist between the two sets of recommendations, particularly regarding diagnosis and staging.
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Affiliation(s)
- Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Ciro Emiliano Boschetti
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Mario Santagata
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Samuel Staglianò
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Alexander Gaggl
- Department of Oral and Craniomaxillofacial Surgery, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Craniomaxillofacial Surgery, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Rita Vitagliano
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Salvatore D'amato
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
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Boschetti CE, Pollice A, Fragola R, Guida D, Staglianò S, Vitagliano R, Santagata M, D'Amato S, Colella G, Tartaro G. The revival of the supraclavicular artery island flap (SCAIF) during the COVID-19 pandemic. Advances in Oral and Maxillofacial Surgery 2022:100358. [PMCID: PMC9575315 DOI: 10.1016/j.adoms.2022.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Annalisa Pollice
- Corresponding author. Multidisciplinary Department of Medical-Surgical and Dental Specialties. Oral and Maxillofacial Surgery Unit. AOU – University of Campania “Luigi Vanvitelli” via del Sole, 80138, Naples, Italy
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6
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Boschetti CE, Vitagliano R, Staglianò S, Pollice A, Giudice GL, Apice C, Santagata M, Tartaro G, Colella G. Development of an application for mobile phones (App) capable to predict the improvement of the degree House Brackmann scale in patients suffering from iatrogenic facial palsy. Advances in Oral and Maxillofacial Surgery 2022. [DOI: 10.1016/j.adoms.2022.100356] [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: 10/14/2022] Open
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Santagata M, Sgaramella N, Chirico F, D’Amato S, Ferrieri I, Corvo G, Corvo C, Tartaro G. W-Shaped Osteotomy to Avoid Paranasal Deformity After Standard Le Fort I in Orthognathic Surgery. Plast Surg (Oakv) 2022; 30:45-48. [PMID: 35096692 PMCID: PMC8793756 DOI: 10.1177/2292550320969655] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
When occlusal alterations are not accompanied by paranasal deficiencies, mobilization of the maxilla via Le Fort I osteotomy should be made with a different design. In this preliminary report, a W-shaped osteotomy that doesn't change the position of the maxillary bone surrounding the pyriform aperture was presented for the first time. Advantages and indications of this new procedure are discussed.
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Affiliation(s)
- Mario Santagata
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Nicola Sgaramella
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Fabrizio Chirico
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy,Fabrizio Chirico, Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, 80138 Naples, Italy.
| | - Salvatore D’Amato
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Ivo Ferrieri
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Giovanni Corvo
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Camilla Corvo
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical and Dental Specialities, Oral and Maxillofacial Department, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples, Italy
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Lo Giudice G, Troiano A, Lo Faro C, Santagata M, Montella M, D’Amato S, Tartaro G, Colella G. Is the Mandibular Condyle Involved in Medication-Related Osteonecrosis of the Jaw? Audit of a Single Tertiary Referral Center and Literature Review. Open Dent J 2021. [DOI: 10.2174/1874210602115010769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Medication-related osteonecrosis of the jaw (MRONJ) may manifest as exposed mandible bone. Recent reviews of the incidence of MRONJ report primarily as exposed cortical bone of the mandibular body, ramus, and symphysis with no reports of condylar involvement.
Objective:
The aim of this study is to analyze the topographical incidence of MRONJ, comorbidities, demographics data, and clinical characteristics of patients diagnosed with MRONJ between 2014 and 2019 in the Maxillo-Facial Surgery Department University of Campania “Luigi Vanvitelli”, and compare these results with published reports.
Methods:
Data on 179 patients were collected for the study, including gender, age, underlying malignancy, medical history, and specific lesion location-identifying premaxilla and posterior sectors area involvement for the maxilla and symphysis, body, ramus, and condyle area for the mandible. A literature review was performed in order to compare our results with similar or higher sample sizes and find if any condylar involvement was ever reported. The research was carried out on PubMed database identifying articles from January 2003 to November 2020, where MRONJ site distribution was discussed, and data were examined to scan for condylar localization reports.
Results:
30 patients had maxillary MRONJ, 136 patients had mandibular MRONJ, and 13 patients had lesions located in both maxilla and mandible. None of the patients reported condylar involvement, neither as a single site nor as an additional localization. Literature review results were coherent to our findings showing no mention of condylar MRONJ.
Conclusion:
Results do not show reports of condylar involvement in MRONJ. Although the pathophysiology of the disease has not been fully elucidated, two possible explanations were developed: the first one based on the condyle embryogenetic origin; the second one based on the bisphosphonate and anti-resorptive medications effects on the different vascular patterns of the mandible areas.
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Rauso R, Tartaro G, Nicoletti GF, Fragola R, Lo Giudice G, Santagata M. Alar cinch sutures in orthognathic surgery: scoping review and proposal of a classification. Int J Oral Maxillofac Surg 2021; 51:643-650. [PMID: 34716071 DOI: 10.1016/j.ijom.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/15/2020] [Revised: 07/28/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022]
Abstract
Orthognathic surgery and the Le Fort I osteotomy result in noticeable alterations to the nasal/nasolabial anatomy. The alar base cinch technique is a surgical technique to control lateralization of the base of the nose and is well described in the literature. The aim of this scoping review was to identify every unique alar cinch suture technique reported in orthognathic surgery and to propose a classification for the different techniques described. A search was conducted in the PubMed, Cochrane Library, and Scopus electronic databases covering the period May 1980 to July 2020, which identified 10 articles that were eligible for this review. Among these, there were several proposals for modifications to the technique, and different studies to show the effectiveness of one type among all others. Despite observing multiple techniques and variations of these while performing this review, the lack of a classification for alar cinch suture was noticed. Therefore, we propose a classification of the alar cinch suture that includes four types, which cover all of the cinching techniques described. It is believed that the use of a standardized classification may be useful to avoid duplicate publishing of techniques and to set a standard for further studies.
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Affiliation(s)
- R Rauso
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Tartaro
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G F Nicoletti
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - R Fragola
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Lo Giudice
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - M Santagata
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Sica A, Casale B, Sagnelli C, Di Dato MT, Rispoli M, Santagata M, Buonavolontà P, Fiorelli A, Vitiello P, Caccavale S, Creta M, Salzano AM, Sagnelli E, Saracco E, Gazzerro G, Famiglietti V, Tammaro D, Papa A. Chronic Chest Pain Control after Trans-Thoracic Biopsy in Mediastinal Lymphomas. Healthcare (Basel) 2021; 9:589. [PMID: 34069774 PMCID: PMC8157245 DOI: 10.3390/healthcare9050589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/01/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022] Open
Abstract
Chest pain following a trans-thoracic biopsy often has multiple etiologies, especially in patients with lymphomas. Pathological neuronal mechanisms integrate with an overproduction of IL-6, TNF-α, IL1-β by macrophages and monocytes, which amplifies inflammation and pain. In consideration of this complex pathogenesis, international guidelines recommend diversified analgesia protocols: thoracic epidural, paravertebral block, and systemic administration of opioids. This study reports an attempt to reduce chest pain and prevent chronic pain in 51 patients undergoing trans-thoracic biopsy for mediastinal lymphoma. The entity of pain, measured 72nd hour after biopsy by the Numerical Rating Scale (NRS), was compared with that seen at a 6th month checkpoint in 46 patients. The pain decreased in all cases. At the 6th month checkpoint, among 31 opioid-treated patients, none of the 16 patients with NRS < 6 within the 72nd hour post biopsy had developed chronic chest pain, while 8 of the 15 with higher values did (p < 0.01). Of 10 patients undergoing thoracotomy and treated with opioids, eight had a NRS of no more than 2, of which six had no chronic pain. Of the twenty-one patients who underwent VATS biopsy and were treated with opioids, fifteen had NRS no greater than 2, of which ten had no chronic pain. Subgroups of patients biopsied under mediastinotomy or video-assisted thoracoscopic surgery (VATS) and treated with thoracic epidural analgesia (TEA) or PVB were too small for such analysis.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Maria Teresa Di Dato
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Marco Rispoli
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Mario Santagata
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Pietro Buonavolontà
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Paola Vitiello
- Dermatology Unit, University of Campania, 80131 Naples, Italy; (P.V.); (S.C.)
| | - Stefano Caccavale
- Dermatology Unit, University of Campania, 80131 Naples, Italy; (P.V.); (S.C.)
| | - Massimiliano Creta
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Anna Maria Salzano
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Elisabetta Saracco
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Giuseppe Gazzerro
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Vincenzo Famiglietti
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Dario Tammaro
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Alfonso Papa
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
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Sica A, Santagata M, Sagnelli C, Rambaldi P, Franco R, Creta M, Vitiello P, Caccavale S, Tammaro V, Sagnelli E, Ronchi A. Primary Extra-Nodal DLBCL of Glands: Our Experiences outside Guidelines of Treatment. Healthcare (Basel) 2021; 9:healthcare9030286. [PMID: 33807793 PMCID: PMC8002204 DOI: 10.3390/healthcare9030286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
Lymphomas usually involve lymph nodes and other lymphoid tissues, but sometimes occur in non-lymphoid organs, called extra-nodal sites. Primary diffuse extra-lymph node large B-cell lymphoma (DLBCL) of the thyroid and parotid gland have been observed rarely. According to the most accredited guidelines, primary extra-nodal DLBCL of the parotid and thyroid glands should be treated with three cycles of R-CHOP followed by radiotherapy of the involved site (ISRT). Surgery alone is not enough to treat DLBCL. We describe two unusual cases of primary extra-nodal DLBCL in elderly patients treated exclusively with surgical resection, given the inability to apply chemotherapy. Both patients achieved clinical recovery, which was maintained after a follow-up of more than 18 months, despite not having performed the indicated chemotherapy protocol. The two cases presented here, and a few others reported in the literature, should be considered exceptions to the rule, and do not allow the conclusion that surgery alone might be sufficient for complete remission.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (A.S.); (P.R.)
| | - Mario Santagata
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-3332253315 or +39-08119573375
| | - Piero Rambaldi
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (A.S.); (P.R.)
| | - Renato Franco
- Division of Pathology, Department of Mental Health and Preventive, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Paola Vitiello
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.V.); (S.C.)
| | - Stefano Caccavale
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.V.); (S.C.)
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Andrea Ronchi
- Division of Pathology, Department of Mental Health and Preventive, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
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12
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Zavattero E, Bolzoni A, Dell'Aversana G, Santagata M, Massarelli O, Ferri A, Della Monaca M, Copelli C, Gessaroli M, Valsecchi S, Borbon C, Beltramini GA, Ramieri G, Valentini V, Tartaro GP, Cocchi R, Varazzani A, Califano L, Baj A. Accuracy of Fibula Reconstruction Using Patient-Specific Cad/Cam Plates: A Multicenter Study on 47 Patients. Laryngoscope 2021; 131:E2169-E2175. [PMID: 33452834 DOI: 10.1002/lary.29379] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/03/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This prospective study evaluated the accuracy of mandibular reconstruction using free fibular flaps (by comparing virtual plans to the three-dimensional postoperative results), and the extent of bone-to-bone contact after computer-assisted surgery. METHODS We included 65 patients who underwent partial-continuity mandibular resections from February 2013 to January 2017, and evaluated virtual planning, surgical techniques, and accuracy. RESULTS Forty-seven patients were analysed. A total of 112 fibular segments received 54 implants. We measured 227 distances between landmarks to assess the accuracy of reconstruction. Postoperative reconstruction accuracy ranged from 0.5 to 3 mm. CONCLUSION Virtual surgical planning very accurately translated simulation into reality, particularly in patients requiring large, complex mandibular reconstructions using multiple fibular segments. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2169-E2175, 2021.
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Affiliation(s)
- Emanuele Zavattero
- Division of Maxillofacial Surgery, Surgical Science Department, Maxillofacial Unit, University of Torino, Italy
| | - Alessandro Bolzoni
- Division of Maxillofacial Surgery, Fondazione IRCCS Ca' Granda, Policlinico Hospital, Milano, Department of Biomedical Dental Sciences, University of Milano, Italy
| | - Giovanni Dell'Aversana
- Division of Maxillofacial Surgery, Department of Neuroscience, Reproductive and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - Mario Santagata
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Speciality, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Olindo Massarelli
- Maxillo-Facial Surgery and Odontostomatology Unit, University Hospital of Sassari, Sassari, Italy
| | - Andrea Ferri
- Maxillo-Facial Surgery Division, Head and Neck Department, Parma, Italy
| | - Marco Della Monaca
- Odontostomatological Science and Maxillofacial Surgery Department, Sapienza University of Rome, Rome, Italy
| | - Chiara Copelli
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy
| | | | | | - Claudia Borbon
- Division of Maxillofacial Surgery, Surgical Science Department, Maxillofacial Unit, University of Torino, Italy
| | - Giada Anna Beltramini
- Division of Maxillofacial Surgery, Fondazione IRCCS Ca' Granda, Policlinico Hospital, Milano, Department of Biomedical Dental Sciences, University of Milano, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Surgical Science Department, Maxillofacial Unit, University of Torino, Italy
| | - Valentino Valentini
- Odontostomatological Science and Maxillofacial Surgery Department, Sapienza University of Rome, Rome, Italy
| | - Gian Paolo Tartaro
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Speciality, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Roberto Cocchi
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy
| | - Andrea Varazzani
- Maxillo-Facial Surgery Division, Head and Neck Department, Parma, Italy
| | - Luigi Califano
- Division of Maxillofacial Surgery, Department of Neuroscience, Reproductive and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Baj
- Division of Maxillofacial Surgery, Fondazione IRCCS Ca' Granda, Policlinico Hospital, Milano, Department of Biomedical Dental Sciences, University of Milano, Italy
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13
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Fiorelli A, Vitiello F, Morgillo F, Santagata M, Spuntarelli C, Di Domenico M, Santini M, Bianco A. Pembrolizumab monotherapy in advanced NSCLC patients with low PD-L1 expression: is there real evidence? Transl Cancer Res 2019; 8:S618-S620. [PMID: 35117144 PMCID: PMC8799010 DOI: 10.21037/tcr.2019.06.28] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Alfonso Fiorelli
- Department of Translational Medical Sciences, Thoracic Surgery Unity, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Fabiana Vitiello
- Department of Pneumology and Oncology; Hospital Vincenzo Monaldi, Naples, Italy
| | - Floriana Morgillo
- Oncology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Santagata
- Maxillo and Oro-facial Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Chiara Spuntarelli
- Maxillo and Oro-facial Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marina Di Domenico
- General Pathology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Santini
- Department of Translational Medical Sciences, Thoracic Surgery Unity, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Bianco
- Department of Translational Medical Sciences, Pneumology Unity, University of Campania “Luigi Vanvitelli”, Naples, Italy
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14
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Lamart E, Santagata M, Tartaro G, D'Amato S, Colella G. Orofacial pain evaluation in children. Eur J Paediatr Dent 2019; 20:151-154. [PMID: 31246094 DOI: 10.23804/ejpd.2019.20.02.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM Pain evaluation in children and its diagnosis are problems not always easy to solve. Children, because of their immaturity, are not always able to well communicate or to describe the clear characteristics of the disease by which they are affected. Moreover, they are often unable to report the real intensity of the pain they experience. These problems are related to their immature, not fully evolved psyche. Such problems can create difficulties to the physician who is called to examine and evaluate the origin of orofacial pain, as well as hesitation regarding when it could be necessary to start a drug therapy. Aim of this work is to propose the basic tools for the evaluation and measurement of pain that are better suitable for children, as these instruments can be used together with an accurate anamnesis and a meticulous examination, in order to formulate a precise differential diagnosis among the pathologies that affect the head and neck. A list of the most common painful diseases affecting this area is also presented. METHODS A systematic literature review about the methods for evaluation and measurement of pain in children was conducted. The commonly used scales of measurement were examined: VAS, VSN, CAS, FPS and the Oucher SCALE. The different pathologies of head and neck and their characteristics are described and the possible causes of orofacial pain have been divided into extracranial and intracranial, in order to easily direct diagnosis. RESULTS Orofacial pain in children is an issue of great interest in consideration of its high frequency in paediatric dentistry. Its measurement and evaluation is possible despite the small compliance of paediatric patients. Thanks to the modern technique and knowledge this evaluation can be realistic and reproducible. CONCLUSION Evaluation scales of pain are suitable at any age and skill of the child and, together with a careful anamnesis and a proper clinical examination, allow the clinician to conduct a precise differential diagnosis of the pain so as to set the ideal therapy for the little patient.
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Affiliation(s)
- E Lamart
- Policlinico I, Università Luigi Vanvitelli, Naples, Italy
| | - M Santagata
- Policlinico I, Università Luigi Vanvitelli, Naples, Italy
| | - G Tartaro
- Policlinico I, Università Luigi Vanvitelli, Naples, Italy
| | - S D'Amato
- Policlinico I, Università Luigi Vanvitelli, Naples, Italy
| | - G Colella
- Policlinico I, Università Luigi Vanvitelli, Naples, Italy
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15
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Sica A, Casale B, Dato MTD, Calogero A, Spada A, Sagnelli C, Santagata M, Buonavolontà P, Fiorelli A, Salzano A, Dodaro CA, Martinelli E, Saracco E, Troiani T, Tammaro D, Ciardiello F, Papa A. Cancer- and Non-cancer Related Chronic Pain: From the Physiopathological Basics to Management. Open Med (Wars) 2019; 14:761-766. [PMID: 31637307 PMCID: PMC6795027 DOI: 10.1515/med-2019-0088] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/16/2019] [Indexed: 12/15/2022] Open
Abstract
The prevalence of chronic pain is between 33% to 64% and is due to cancer pain, but it has also been observed in non-cancer patients. Chronic pain is associated with lower quality of life and higher psychological distress and depressive/anxiety disorders in patients without a history of disorder. In this study we evaluated in clinical practice the effectiveness of the intrathecal pump in 140 patients who underwent pain therapy at our Center. These patients were consecutively enrolled from January 2010 to July 2018. Follow-up was carried out over these eight years regarding the infusion modalities. Pain relief was obtained in 71 (50,7%) patients out of the 140 that experienced satisfactory pain control globally. Intrathecal therapy is one of the best options for chronic severe refractory pain. The greatest advantage of this therapy is due to the possibility of treating the pain with minimal dosages of the drug, avoiding the appearance of troublesome side effects.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AO Dei Colli - V. Monaldi, Naples, Italy
| | | | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Spada
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Santagata
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anna Salzano
- Pain Department, AO Dei Colli - V. Monaldi, Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Erika Martinelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Teresa Troiani
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Dario Tammaro
- Pain Department, AO Dei Colli - V. Monaldi, Naples, Italy
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alfonso Papa
- Pain Department, AO Dei Colli - V. Monaldi, Naples, Italy
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16
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Reginelli A, Clemente A, Renzulli M, Maggialetti N, Santagata M, Colella G, Nardone V, Golfieri R, Brunese L, Cappabianca S. Delayed enhancement in differential diagnosis of salivary gland neoplasm. Gland Surg 2019; 8:S130-S135. [PMID: 31559179 DOI: 10.21037/gs.2019.03.03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Multi-phasic Computed Tomography (CT) evaluation allows to study the enhancement features of parotid gland masses. The aim of our study was to evaluate the role of delayed enhancement in the characterization of different histologic types of parotid tumours. Methods Forty-eight patients (22 male and 26 female) with at least one parotid gland tumor, were included in our study. Multi-phase CT images were obtained before and 30, 120 s and 8 minutes after intravenous contrast injection. The images were evaluated by two radiologists for lesion enhancement degree. A quantitative assessment was performed using a region of interest on each lesion and density changes between different phases were compared. The tumoral enhancement ratio was calculated between the 8 minutes delayed and the early (30 s) phase. The pathological diagnosis was confirmed in all patients after surgery. Results All patients had unilateral lesion for a total of 48 lesions. Twenty-eight were pleomorphic adenomas, 15 Warthin's tumours and 5 carcinomas. All Warthin tumours showed a rapid contrast enhancement at the early phase (30 sec) followed by a progressive wash-out during the delayed scans. Most of pleomorphic adenomas (89.2%) showed the highest density at the 8-minutes delayed phase. Malignant tumours showed slower contrast enhancement and 3 out of 5 (60%) showed a marked decrease at the 8 minutes delayed phase while the remaining 2 (40%), did not show any density reduction. The tumoral enhancement ratio was significantly different between Warthin tumours and pleomorphic adenomas and between Warthin's and malignant tumours. Conclusions Multi-phasic CT examination with 8 minutes delayed acquisition has shown to be useful in parotid gland lesion differentiation.
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Affiliation(s)
- Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Matteo Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - Nicola Maggialetti
- Life and Health Department "V. Tiberio", University of Molise, Campobasso, Italy
| | - Mario Santagata
- Multidisciplinary Department of Medical, Surgical and Dental Specialities, Maxillo-Facial Unit, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialities, Maxillo-Facial Unit, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Rita Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - Luca Brunese
- Life and Health Department "V. Tiberio", University of Molise, Campobasso, Italy
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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17
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Santagata M, Corvo G, Chagas-Júnior OL, Tartaro G. Tunnel technique through three vertical buccal incisions to reduce nasolabial changes due to surgically assisted rapid palatal expansion. Int J Oral Maxillofac Surg 2019; 48:1337-1339. [PMID: 30902549 DOI: 10.1016/j.ijom.2019.02.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
The aim of this technical note is to present a minimally invasive approach to the maxilla for segmental Le Fort I osteotomy in surgically assisted rapid palatal expansion (SARPE). This approach reduces the nasolabial changes that occur with the traditional circumvestibular approach.
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Affiliation(s)
- M Santagata
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Corvo
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
| | - O L Chagas-Júnior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.
| | - G Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
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18
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Sgaramella N, Wilms T, Boldrup L, Loljung L, Gu X, Coates PJ, Hassellöf P, Califano L, Lo Muzio L, Fåhraeus R, Norberg Spaak L, Franco R, Tartaro G, Colella G, Santagata M, Dell'Aversana Orabona G, Chirico F, Danielsson K, Troiano G, Ardito F, Nylander K. Ethnicity based variation in expression of E-cadherin in patients with squamous cell carcinoma of the oral tongue. Oncol Lett 2018; 16:6603-6607. [PMID: 30405799 PMCID: PMC6202509 DOI: 10.3892/ol.2018.9452] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/31/2018] [Indexed: 12/16/2022] Open
Abstract
The oral tongue is the most common site for tumours within the oral cavity. Despite intense research, there has been no improvement in the survival rate for patients with oral tongue squamous cell carcinoma (OTSCC) during the last decades. Differences between oral cancer patients based on ethno-geographical distribution have been reported. The present study used immunohistochemistry to evaluate commonly used markers of cancer cell phenotypes, E-cadherin, β-catenin and cytokeratins 5 and 19, in 120 patients with OTSCC. To evaluate the impact of ethnicity, patients from Sweden and Italy were included. A higher proportion of Swedish patients exhibited high expression of E-cadherin in their tumours (P=0.039), and high levels of E-cadherin in Swedish OTSCC patients that had succumbed to their disease were associated with poor prognosis. These data demonstrated differences in the pathological characteristics of OTSCC between two different European populations. The findings emphasise the need to take ethnicity/geographical location of patients into account when comparing results from different studies of OTSCC.
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Affiliation(s)
- Nicola Sgaramella
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden.,Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, I-801 38 Naples, Italy.,Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples Federico II, I-801 38 Naples, Italy
| | - Torben Wilms
- Department of Clinical Sciences/ENT, Umeå University, SE-901 85 Umeå, Sweden
| | - Linda Boldrup
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Lotta Loljung
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Xiaolian Gu
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Philip J Coates
- RECAMO, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic
| | - Petra Hassellöf
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Luigi Califano
- Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples Federico II, I-801 38 Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, I-71122 Foggia, Italy
| | - Robin Fåhraeus
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden.,RECAMO, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic.,University Paris Diderot, INSERM UMRS1162, Paris, 75010, France
| | - Lena Norberg Spaak
- Department of Clinical Sciences/ENT, Umeå University, SE-901 85 Umeå, Sweden
| | - Renato Franco
- Dipartimento Universitario di Anatomia Patologica, Second University of Naples, Piazza Miraglia, I-801 38 Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, I-801 38 Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, I-801 38 Naples, Italy
| | - Mario Santagata
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, I-801 38 Naples, Italy
| | - Giovanni Dell'Aversana Orabona
- Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples Federico II, I-801 38 Naples, Italy
| | - Fabrizio Chirico
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, I-801 38 Naples, Italy
| | - Karin Danielsson
- Department of Odontology, Umeå University, SE-901 85 Umeå, Sweden
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, I-71122 Foggia, Italy
| | - Fatima Ardito
- Department of Clinical and Experimental Medicine, University of Foggia, I-71122 Foggia, Italy
| | - Karin Nylander
- Department of Medical Biosciences, Umeå University, SE-901 85 Umeå, Sweden
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19
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Sgaramella N, Gu X, Boldrup L, Coates PJ, Fahraeus R, Califano L, Tartaro G, Colella G, Spaak LN, Strom A, Wilms T, Muzio LL, Orabona GD, Santagata M, Loljung L, Rossiello R, Danielsson K, Strindlund K, Lillqvist S, Nylander K. Searching for New Targets and Treatments in the Battle Against Squamous Cell Carcinoma of the Head and Neck, with Specific Focus on Tumours of the Tongue. Curr Top Med Chem 2018; 18:214-218. [DOI: 10.2174/1568026618666180116121624] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/11/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022]
Abstract
Squamous cell carcinoma of the head and neck, SCCHN, is a heterogeneous group of tumours
not only concerning the site of origin but also regarding aetiology. The 5-year survival for the
whole group of SCCHN tumours has not significantly improved over the last 20-25 years. Apart from
tumour spread to lymph nodes, N status, gains and losses of specific chromosomes are the only factors
shown to be independent prognostic markers for these tumours. Worldwide, an increasing number
of people ≤ 40 years are seen being affected by tongue SCC, the most common tumour within the
SCCHN group. Even without any clinical signs of metastasis, up to 30% of all tongue SCC have histologically
detectable spread to lymph nodes.
In this mini review, field cancerization, tumour microenvironment, the so called EMT (epithelial
mesenchymal transition) process and the role of viruses in development of SCCHN are discussed as
well as potential new therapeutic targets.
For the group of tongue SCC, with the increasing incidence seen in young patients and particularly
women, new data with impact on prognosis and treatment are urgently needed. But as long as data
from the analyses of several sub sites are presented as valid for the whole group of tumours, this vital
point is missed.
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Affiliation(s)
| | - Xiaolian Gu
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Linda Boldrup
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Philip J Coates
- RECAMO, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech Republic
| | - Robin Fahraeus
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Luigi Califano
- Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
| | - Gianpaolo Tartaro
- Department of Medical, Surgical and Dental Specialties, Second University of Naples, Multidisciplinary Naples, Italy
| | - Giuseppe Colella
- Department of Medical, Surgical and Dental Specialties, Second University of Naples, Multidisciplinary Naples, Italy
| | | | - Adrian Strom
- Department of Clinical Sciences/ENT, Umea University, Umea, Sweden
| | - Torben Wilms
- Department of Clinical Sciences/ENT, Umea University, Umea, Sweden
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | | | - Mario Santagata
- Department of Medical, Surgical and Dental Specialties, Second University of Naples, Multidisciplinary Naples, Italy
| | - Lotta Loljung
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Riccardo Rossiello
- Dipartimento Universitario di Anatomia Patologica, Seconda Universita` Degli Studi di Napoli, Piazza Miraglia, Naples, Italy
| | | | - Klas Strindlund
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Sandra Lillqvist
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Karin Nylander
- Department of Medical Biosciences, Umea University, Umea, Sweden
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Santagata M, Cecere A, Prisco RVE, Tartaro G, D'Amato S. The three-dimensional reconstruction of the jaw with "bone slat technique" in conjunction with third molar removal. Ann Stomatol (Roma) 2018; 8:123-130. [PMID: 29682225 DOI: 10.11138/ads/2017.8.3.123] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The purpose of this study was to report the outcome of the management of both horizontal and vertical defects of alveolar crest using the bone slat technique approach in conjunction with third molar removal prior to implant placement in the aesthetic area. Methods We present a 20-year-old female patient who lost a maxillary lateral incisor. The objective of treatment was to replace the lateral incisor with an implant-supported crown restoration without interfering with the integrity and topography of the adjacent gingival tissues. Because the future implant site showed horizontal and vertical bone defect the Authors decided to perform bone regeneration. The need for such bone augmentation in the younger patient often coincides with the timing for third molar removal. By combining third molar extraction with bone harvest and alveolar grafting, the patient undergoes only one surgical approach. The bone height (9.5 mm) and width (5.7 mm) were measured at the point of interest (tooth 12) both before and after implant placement in the reconstructed panoramic and parasagittal views by Cone Beam Computed Tomography (CBCT) scan. Results The final results demonstrated an increase in length of 5 mm after bone slat technique (from 9.5 mm to 13.5 mm) and an increase in width of 1 mm (from 5.7 mm to 6.7 mm). ISQ measurements were recorded at the time of implant placement (the mean was: 68.5) and immediately after individualized screw-retained provisional crown (the mean was: 77). Conclusions This technique is reliable and aesthetic and functional results appear to be stable and respect this requisite: simple and fast graft harvesting and low risk of morbidity especially in conjunction with third molar removal.
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Affiliation(s)
- Mario Santagata
- Medical Director - Multidisciplinary Department of Medical and Dental Specialties; Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Atirge Cecere
- Medical Director - Multidisciplinary Department of Medical and Dental Specialties; Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Gianpaolo Tartaro
- Medical Director - Multidisciplinary Department of Medical and Dental Specialties; Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore D'Amato
- Medical Director - Multidisciplinary Department of Medical and Dental Specialties; Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli", Naples, Italy
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Abstract
BACKGROUND The reconstruction of alveolar ridges for implant placement is still a challenging surgical procedure, especially in the case of extensive vertical and horizontal bone atrophy. OBJECTIVE The objective of the present study was to evaluate the quantity and quality of newly regenerated bone; clinically by means of direct clinical measuring, ridges augmented by autogenous cortical bone associated with autogenous particulate bone graft in the posterior lower jaw defect. METHODS For the preliminary study, a bone defects in partially edentulous in patient aged 52 years were selected to receive horizontal ridge augumentation prior autolougous bone block and particulate graft. The donor site was the ramus of the same side. Prior the clinical evaluation, periapical X-ray and the cone beam computerized tomography (CBCT) was observed the quality, quantity and the stability the soft and hard tissue healing process, final result and the outcome. RESULT The bone augmentation achieved with this technique created the ideal bone volume of hard and soft tissue, in quantity and quality, for placement of implants. CONCLUSION The surgical technique was found to be easy in terms of technique and surgical trauma.
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Affiliation(s)
- Salvatore D'Amato
- Multidisciplinary Department of Medical and Dental Specialties, AOU - SUN, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical and Dental Specialties, AOU - SUN, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angelo Itro
- Director of Multidisciplinary Department of Medical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Santagata
- Division of Oral and Maxillofacial Surgery, Multidisciplinary Department of Medical and Dental Specialties, AOU, University of Campania "Luigi Vanvitelli", Naples, Italy
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Santagata M, Sgaramella N, Ferrieri I, Corvo G, Tartaro G, D'Amato S. Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report. Int J Implant Dent 2017; 3:14. [PMID: 28459123 PMCID: PMC5410420 DOI: 10.1186/s40729-017-0077-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/22/2017] [Indexed: 11/23/2022] Open
Abstract
Background A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible. Case presentation A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue healing. Conclusions Segmental mandibular sandwich osteotomy is an easy and safety technique that could be performed in an atrophic posterior mandible. Future studies involving long-term follow-up are needed to evaluate the permanence of these results.
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Affiliation(s)
- Mario Santagata
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy. .,, Piazza Fuori Sant'Anna 17, 81031, Aversa, Italy.
| | - Nicola Sgaramella
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ivo Ferrieri
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Corvo
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore D'Amato
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania "Luigi Vanvitelli", Naples, Italy
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Mazzella A, Santagata M, Cecere A, La Mart E, Fiorelli A, Tartaro G, Tafuri D, Testa D, Grella E, Perrotta F, Bianco A, Mazzarella G, Santini M. Descending necrotizing mediastinitis in the elderly patients. Open Med (Wars) 2016; 11:449-460. [PMID: 28352835 PMCID: PMC5329867 DOI: 10.1515/med-2016-0080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022] Open
Abstract
Descending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.
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Affiliation(s)
| | - Mario Santagata
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | - Atirge Cecere
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | - Ettore La Mart
- Maxillo-Facial Surgery Unit, Second University of Naples, Italy
| | | | | | - Domenico Tafuri
- Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Domenico Testa
- Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy
| | - Edoardo Grella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Fabio Perrotta
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Andrea Bianco
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy
| | - Gennaro Mazzarella
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Second University of Naples, Italy
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Sgaramella N, Lindell Jonsson E, Boldrup L, Califano L, Coates PJ, Tartaro G, Lo Muzio L, Fåhraeus R, Colella G, Dell'Aversana Orabona G, Loljung L, Santagata M, Rossiello R, Wilms T, Danielsson K, Laurell G, Nylander K. High expression of podoplanin in squamous cell carcinoma of the tongue occurs predominantly in patients ≤40 years but does not correlate with tumour spread. J Pathol Clin Res 2015; 2:3-8. [PMID: 27499910 PMCID: PMC4858125 DOI: 10.1002/cjp2.28] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/24/2015] [Indexed: 12/15/2022]
Abstract
More than 30% of patients with squamous cell carcinoma (SCC) of the mobile tongue have clinically undetectable lymph node metastasis. Tumour cells can spread as single cells or collectively. A protein known to play a role in both processes is podoplanin, which is expressed in endothelial cells not only in lymph vessels but also in some aggressive tumours with high invasive and metastatic potential. Here we studied samples from 129 patients with primary SCC of the tongue for expression of podoplanin using immunohistochemistry. mRNA levels were analysed in another 27 cases of tongue SCC with adjacent clinically tumour‐free tongue tissue and 14 tongue samples from healthy donors. Higher levels of podoplanin were seen in tumours compared to both normal tongue and clinically normal tongue in the tumour vicinity. No association was found between levels of podoplanin, presence of lymph node metastases or other clinical factors. Patients aged 40 or less were more likely to express high levels of podoplanin protein compared to older patients (p = 0.027). We conclude that levels of podoplanin in primary tongue SCCs are not associated with lymph node metastases. However, tongue SCCs arising in young patients (≤40 years of age) are more likely to express high levels of podoplanin than tongue SCCs that arise in the more elderly. The data suggest that podoplanin has a distinctive role in young patients, who are known to have a poor prognosis: these patients may, therefore, benefit from podoplanin inhibitory therapies.
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Affiliation(s)
- Nicola Sgaramella
- Department of Medical BiosciencesUmeå UniversityUmeåSweden; Second University of Naples, Multidisciplinary Department of MedicalSurgical and Dental SpecialtiesNaplesItaly; Department of Neuroscience Reproductive and Dentistry SciencesUniversity of Naples Federico IINaplesItaly
| | - Eva Lindell Jonsson
- Department of Clinical Sciences ENT, Uppsala University SE-751 05 Uppsala Sweden
| | - Linda Boldrup
- Department of Medical Biosciences Umeå University Umeå Sweden
| | - Luigi Califano
- Department of Neuroscience Reproductive and Dentistry Sciences University of Naples Federico II Naples Italy
| | - Philip J Coates
- Division of Medical Sciences University of Dundee, Ninewells Hospital and Medical School DD1 9SY Dundee UK
| | - Gianpaolo Tartaro
- Second University of Naples, Multidisciplinary Department of Medical Surgical and Dental Specialties Naples Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine University of Foggia 71122 Foggia Italy
| | - Robin Fåhraeus
- University Paris Diderot, INSERM UMRS116227 rue Juliette DoduParis75010France; RECAMOMasaryk Memorial Cancer InstituteZluty kopec 7656 53BrnoCzech Republic
| | - Giuseppe Colella
- Second University of Naples, Multidisciplinary Department of Medical Surgical and Dental Specialties Naples Italy
| | | | - Lotta Loljung
- Department of Medical Biosciences Umeå University Umeå Sweden
| | - Mario Santagata
- Second University of Naples, Multidisciplinary Department of Medical Surgical and Dental Specialties Naples Italy
| | - Riccardo Rossiello
- Dipartimento Universitario di Anatomia Patologica Seconda Universita' Degli Studi di Napoli Piazza Miraglia 80138 Naples Italy
| | - Torben Wilms
- Department of Clinical Sciences/ENT Umeå University Umeå Sweden
| | | | - Göran Laurell
- Department of Clinical Sciences ENT, Uppsala University SE-751 05 Uppsala Sweden
| | - Karin Nylander
- Department of Medical Biosciences Umeå University Umeå Sweden
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Santagata M, Tozzi U, Lamart E, Tartaro G. Effect of Orthognathic Surgery on the Posterior Airway Space in Patients Affected by Skeletal Class III Malocclusion. J Maxillofac Oral Surg 2015. [PMID: 26225062 DOI: 10.1007/s12663-014-0687-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Dentofacial deformity refers to deviations from normal facial proportions and dental relationships that are severe enough to be handicapping. These anomalies involve many aspects of patient's life and are sometimes also associated with a reduction of pharyngeal air space. Through orthognathic surgery it is possible to treat dentofacial deformities: this kind of surgery has several effects on skeletal structures and it has changes, as it is demonstrated by many studies, also on the upper airways. The orthognathic surgeries commonly used to correct this deformity are the mandibular setback and the maxillary advancement procedures. This study aims to evaluate the effects of maxillary and mandibular surgery on pharyngeal airway dimensions in skeletal class III malocclusions. MATERIALS AND METHODS This study considers 76 patients, treated between 2007 and 2013 by maxillary advancement (11 patients), maxillary advancement and mandibular setback (39 patients), maxillary advancement, mandibular setback and genioplasty reduction (26 patients). Cranial latero-lateral radiography was used to compare oropharyngeal airway morphologies before and 1 year after surgery. CONCLUSION The surgeon should consider bimaxillary surgery rather than mandibular setback surgery to correct a class III deformity to prevent the development of obstructive sleep apnea syndrome; in fact, bimaxillary surgery might have less effect on reduction of the pharyngeal airway than mandibular setback surgery only.
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Affiliation(s)
- Mario Santagata
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy ; Piazza Fuori Sant'Anna, 17, 81031 Aversa, Italy
| | - Umberto Tozzi
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Ettore Lamart
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
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26
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Santini M, Fiorelli A, Santagata M, Tartaro GP. Resection of costal exostosis using piezosurgery associated with uniportal video-assisted thoracoscopy. Ann Thorac Surg 2015; 99:1080-2. [PMID: 25742839 DOI: 10.1016/j.athoracsur.2014.04.132] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 04/11/2014] [Accepted: 04/21/2014] [Indexed: 11/24/2022]
Abstract
We report a case of a 35-year-old woman affected by costal exostosis, originating from the posterior arc of the left fifth rib, who complained of a persistent intractable neuralgia in the left T5 dermatome. Both pain and the risk of visceral injury led us to resect exostosis. The procedure was performed using a uniportal videothoracoscopic approach without additional incisions. For bone resection, we used Piezosurgery, a soft tissue-sparing system based on ultrasound vibrations. Piezosurgery allowed the complete resection of exostosis without injuring the intercostal nerve and vessels. The histologic analysis confirmed the diagnosis of osteochondroma and showed no sign of malignancy. The patient was discharged 2 days after the operation. Considering the lack of symptoms, the low risk of degeneration, and the absence of recurrence at 12-month follow-up, the simple resection of exostosis without performing a more extensive rib resection was judged to be optimal.
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Affiliation(s)
- Mario Santini
- Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Second University of Naples, Naples, Italy
| | - Mario Santagata
- Division of Oral and Maxillofacial Surgery, Multidisciplinary Department of Medical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Gian Paolo Tartaro
- Division of Oral and Maxillofacial Surgery, Multidisciplinary Department of Medical and Dental Specialties, Second University of Naples, Naples, Italy
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Santagata M, Guariniello L, Tartaro G. Modified Edentulous Ridge Expansion Technique and Immediate Implant Placement: A 3-Year Follow-Up. J ORAL IMPLANTOL 2015; 41:184-7. [DOI: 10.1563/aaid-joi-d-12-00308] [Citation(s) in RCA: 7] [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: 11/22/2022]
Abstract
Restoration of the edentulous alveolar ridge with implants often requires the ridge width to be augmented to allow its placement. The aim of this study was to evaluate the split-crest technique, with subepithelial connective tissue graft used as biological barrier, in patients with narrow ridges, focusing on the status of soft and hard tissues and on implant success rate, at 36 months after implant loading. Thirteen patients (6 males and 7 females), ages 32–68 years (mean 49.4 years) with an atrophic maxillary jaw underwent modified edentulous ridge expansion technique for implant placement. A total of 33 Laser-Lok tapered internal implant, were placed in the maxilla. The following parameters were evaluated: (1) initial ridge width (time t0); (2) ridge width at the time of abutment connection (time t1); four months after implants placement, healing abutments were connected and the prosthetic rehabilitation was initiated, and all patients were evaluated clinically and radiographically with periapical radiograph at intervals of 3–6 months for the first year and annually thereafter for 3 years. The ridge width was measured with a cone beam computed tomography. The initial ridge width ranged from 3.5 mm to 7 mm (mean: 4.67 mm), while at the end of the expansion procedure the width ranged from 6.3 mm to 11.0 mm (mean: 8.2 mm). The width gain of the edentulous ridge ranged from 1.45–4.9 mm (mean: 3.5 mm). Two implants became exposed 1 month after surgery. One implant was lost before loading (3%). The diameter of failed implant was 5.8 mm and length was 10.5 mm. The remaining 32 implants were stable and free of complications at the end of the study. Thus, the implant survival rate was 97%. Because no implant failed after loading, the cumulative survival rate of loaded implants was 100%. The minimally invasive regenerative technique presented here avoids the use of bone graft, secondary surgery for soft tissue augmentation, and mechanical expansion devices. However, the follow-up period for outcome evaluation and exiguous patient's number in this series was limited.
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Affiliation(s)
- Mario Santagata
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, University Hospital (AOU) – Second University of Naples, Naples, Italy
| | - Luigi Guariniello
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, University Hospital (AOU) – Second University of Naples, Naples, Italy
| | - Gianpaolo Tartaro
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, University Hospital (AOU) – Second University of Naples, Naples, Italy
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Tozzi U, Santagata M, Sellitto A, Tartaro GP. Influence of Kinesiologic Tape on Post-operative Swelling After Orthognathic Surgery. J Maxillofac Oral Surg 2015; 15:52-8. [PMID: 26929553 DOI: 10.1007/s12663-015-0787-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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: 07/19/2014] [Accepted: 03/14/2015] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Orthognathic surgery involves making several osteotomies that lead to varying degrees of post-operative swelling. The use of KT may be beneficial for postoperative treatment after head and neck surgery, accelerating drainage of tissue reaction or haemorrhages. The goal of this study was to find out if the application of KT prevents or improves swelling, pain and trismus after orthognathic surgery, improving patients' postoperative quality of life. MATERIALS AND METHODS In this double-blinded, randomized, control trial, 24 patients in whom bimaxillary orthognathic surgery was indicated, were included. Before surgery each patient alternatively was randomly included in the study group (treated with K-Taping(®) and corticosteroid) or in the control group (treated with corticosteroid). In the present study a MakerBot(®) Digitizer 3D™ was used to assess accurate volume measurements. All swelling measurements were expressed as total 3-D area of the landmarks (cm(2) ) in T0 pre-operative, T1 fourth day after surgery. RESULTS The differences T0-T1 are highly significant (p < 0.01) between group 1 or study group (treated with K-taping(®)) and group 2 (control group). DISCUSSION The use of KT appears promising, because it is simple to carry out, less traumatic, economical, can be performed everywhere in the world, free from side effects on the body. Even when swelling persists, KT gives patients the impression of a minor swelling detracting them from their pain and morbidity. Further studies have to be performed to find out if KT can reduce or replace the need for additional medications such as the use of steroids.
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Affiliation(s)
- U Tozzi
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU - SUN (Second University of Naples), Naples, Italy ; Via P. Riverso, 102, 81031 Aversa, CE Italy
| | - M Santagata
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU - SUN (Second University of Naples), Naples, Italy
| | - A Sellitto
- Department of Industrial and Information Engineering, SUN (Second University of Naples), Aversa, Italy
| | - G P Tartaro
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU - SUN (Second University of Naples), Naples, Italy
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Abstract
Calibre persistent labial artery (CPLA) usually presents as an asymptomatic papule on the lower lip and can be easily misdiagnosed as a mucocele, haemangioma, venous lake, varix or fibroma. When it is ulcerated, squamous cell carcinoma is the most usual differential diagnosis. Here, we report a case of a 25-year-old woman with no previous relevant medical history who presented with a complaint of an asymptomatic, non-ulcerated, progressively growing nodule (over the last 5 months) on the upper lip. In this case, the diagnosis was made clinically and confirmed by immunohistochemical analysis. We conclude that clinicians should be aware of CPLA and it should be included in the differential diagnosis of labial mucosal papules. Sometimes, the immunohistochemical analysis is necessary to make a correct diagnosis.
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Affiliation(s)
- M Santagata
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU-SUN (Second University of Naples), Naples, Italy ; Piazza Fuori Sant'Anna, 17, 81031 Aversa, Italy
| | - M Maglione
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU-SUN (Second University of Naples), Naples, Italy
| | - G Colella
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU-SUN (Second University of Naples), Naples, Italy
| | - S D'Amato
- Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical and Dental Specialties, AOU-SUN (Second University of Naples), Naples, Italy
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Santagata M, Tartaro G, D'Amato S. Clinical and Histologic Comparative Study of Subepithelial Connective Tissue Graft and Extracellular Matrix Membrane. A Preliminary Split-Mouth Study in Humans. INT J PERIODONT REST 2015; 35:85-91. [DOI: 10.11607/prd.1849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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D'Amato S, Tartaro G, Itro A, Nastri L, Santagata M. Block Versus Particulate/Titanium Mesh for Ridge Augmentation for Mandibular Lateral Incisor Defects: Clinical and Histologic Analysis. INT J PERIODONT REST 2015; 35:e1-8. [DOI: 10.11607/prd.2073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Reginelli A, Santagata M, Urraro F, Somma F, Izzo A, Cappabianca S, Rotondo A. Foreign bodies in the maxillofacial region: assessment with multidetector computed tomography. Semin Ultrasound CT MR 2014; 36:2-7. [PMID: 25639172 DOI: 10.1053/j.sult.2014.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Maxillofacial region is an anatomically complex area, representing a crossroads of different systems and apparatus. It is defined as the anatomical region lying on the facial skeleton from the inferior outline of maxilla up to an ideal plane passing through the skull base and the inion point, posteriorly. In this area, the digestive and respiratory systems connect to themselves and open in the mouth and sino-nasal cavities. Even the orbits with the ocular globes and their surrounding tissues lie in the same area. Despite the little exposed surface, the chance of penetrating injuries to this site is at least similar to other regions of the body due to the "pivotal role" of the face in human relations. Moreover, the external openings of respiratory and digestive systems and the orbital cavities represent an easy way in for foreign bodies (FBs). Based on the access paths, it is possible to distinguish ingested, inhaled, penetrating, and iatrogenic (owing to surgery) FBs. FB may stop in oral and ocular cavities, or proceed deeply, reaching the surrounding soft tissues, the facial bones, or other cavities such as sino-nasal region, mouth, orbits, and further spaces of the head and neck region, like infratemporal fossa, parapharyngeal space, and sphenopalatine fossa. Furthermore, FBs accidentally introduced and lost in visceral cavities (mouth, ear, and nose), particularly in pediatric subjects, may be quickly removed during direct inspection.
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Affiliation(s)
- Alfonso Reginelli
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy.
| | - Mario Santagata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Fabrizio Urraro
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy
| | - Francesco Somma
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy
| | - Andrea Izzo
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy
| | - Salvatore Cappabianca
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy
| | - Antonio Rotondo
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Second University of Naples, Naples, Italy
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Tozzi U, Santillo V, Tartaro GP, Sellitto A, Gravino GR, Santagata M. A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial Comparing the Efficacy of Anti-edema Drugs for Edema Control in Orthognathic Surgery Using Digitizer 3-D to Measure Facial Swelling. J Maxillofac Oral Surg 2014; 14:386-92. [PMID: 26028863 DOI: 10.1007/s12663-014-0685-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 02/26/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Orthognathic surgery involves making several osteotomies. Any osteotomies leads to varying degrees of post-operative swelling. The aim of this study was to evaluate the effectiveness of anti-edema drugs for the control of edema, using Digitizer 3D™ for measuring soft-tissue thickness, in patients who underwent bimaxillaryorthognathic surgery. MATERIALS AND METHODS In this double-blinded, randomized, control trial, 24 patients (study group: 12 patients, control group: 12 patients) in whom bimaxillary orthognathic surgery was indicated, were included in this study. All swelling measurements were expressed as total 3-D area of the landmarks (cm(2)) in T0 pre-operative, T1 first day after surgery, T2 fourth day after surgery, T3 4 months after surgery. For each patient we compared, by adding left and right area, the increase of swelling between T1-T0, T2-T0 and T1-T3. RESULTS The differences T0-T1 are highly significant (p < 0.01) between group 1 or study group (treated with Venoplant(®)) and group 2 (control group); the differences T0-T2 are significant (p < 0.05) between group 1 (treated with Venoplant(®)) and group 2 (control group). The differences T1-T3 are significant (p < 0.05) between group 1 (treated with Venoplant(®)) and group 2 (control group). DISCUSSION The present study suggests that Venoplant(®) significantly decreases postoperative edema in orthognathic surgery, thus precluding long-term corticosteroid use.
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Affiliation(s)
- U Tozzi
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - SUN (Second University of Naples), Naples, Italy ; Via P. Riverso, 102, 81031 Aversa, CE Italy
| | - V Santillo
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - SUN (Second University of Naples), Naples, Italy
| | - G P Tartaro
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - SUN (Second University of Naples), Naples, Italy
| | - A Sellitto
- Department of Industrial and Information Engineering, SUN (Second University of Naples), Aversa, Italy
| | - G R Gravino
- Department of Industrial and Information Engineering, SUN (Second University of Naples), Aversa, Italy
| | - M Santagata
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - SUN (Second University of Naples), Naples, Italy
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Santagata M, Guariniello L, Prisco RVE, Tartaro G, D'Amato S. Use of Subepithelial Connective Tissue Graft as a Biological Barrier: A Human Clinical and Histologic Case Report. J ORAL IMPLANTOL 2014; 40:465-8. [DOI: 10.1563/aaid-joi-d-11-00109] [Citation(s) in RCA: 4] [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] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to develop a method to study the healing process after gingival grafting and to observe the histologic results after use of the modified edentulous ridge expansion technique. A 47-year-old nonsmoking woman with a noncontributory past medical history affected by edentulism associated with a horizontal alveolar ridge defect was referred to the authors for surgical correction of the deficit to improve implant support and the final esthetics of an implant-borne prosthesis. At the 4-month follow-up visit, a biopsy was performed by a punch technique in the same sites of healing abutment connection. The tissue was elevated from the attached gingival. Clinically, the grafted tissues seemed to be attached to the bone surfaces. The histologic findings revealed dense grafted tissues, providing long-term stability to the area. No ligament or bone, characteristic for periodontal regeneration, were observed. The presence of thick attached keratinized tissue around implants may constitute a protective factor against marginal inflammation or trauma.
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Affiliation(s)
- Mario Santagata
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
| | - Luigi Guariniello
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
| | | | - Gianpaolo Tartaro
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
| | - Salvatore D'Amato
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
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Sgaramella N, Tartaro G, D'Amato S, Santagata M, Colella G. Displacement of Dental Implants Into the Maxillary Sinus: A Retrospective Study of Twenty-One Patients. Clin Implant Dent Relat Res 2014; 18:62-72. [PMID: 24889650 DOI: 10.1111/cid.12244] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND One possible complication of implant surgery in the posterior maxilla is the displacement of implants into the maxillary sinus. PURPOSE To report on clinical and radiological findings and on biological, surgical, and biomechanical considerations in cases of implant displacement. MATERIALS AND METHODS This is a retrospective study of 21 patients referred to the Department of Head and Neck Surgery, Second University of Naples, due to implants displaced into the maxillary sinus. Patient, implant, and treatment data were collected, and 1-year follow-up was made. RESULTS A total of 24 displaced implants were diagnosed and surgically removed through an antrostomy in the lateral sinus wall. Implant displacement occurred after functional loading in only one case; in the remaining cases, displacement occurred either perioperatively or postoperatively prior to loading. Besides the displacement, eight patients suffered from maxillary sinusitis, treated with a Caldwell-Luc operation. Healing was uneventful for all patients, and no sinusitis relapse or late postoperative complication was present at 1-year follow-up. CONCLUSIONS It is reasonable to affirm that the major cause of displacement of implants is related, most of the time, to incorrect treatment planning and/or a poorly performed surgical procedure. When implant displacement occurs, the displaced foreign body has to be removed in order to avoid sinus pathology.
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Affiliation(s)
- Nicola Sgaramella
- Department of Oral and Maxillofacial Surgery, Second University of Naples, Naples, Italy
| | - Gianpaolo Tartaro
- Department of Oral and Maxillofacial Surgery, Second University of Naples, Naples, Italy
| | - Salvatore D'Amato
- Department of Oral and Maxillofacial Surgery, Second University of Naples, Naples, Italy
| | - Mario Santagata
- Department of Oral and Maxillofacial Surgery, Second University of Naples, Naples, Italy
| | - Giuseppe Colella
- Department of Oral and Maxillofacial Surgery, Second University of Naples, Naples, Italy
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D’Amato S, Sgaramella N, Vanore L, Piombino P, Orabona GD, Santagata M. Piezoelectric bone surgery in the treatment of an osteoma associated with an impacted inferior third molar: a case report. Clin Cases Miner Bone Metab 2014; 11:73-76. [PMID: 25002883 PMCID: PMC4064445] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Operative removal of impacted mandibular third molars is a common and not riskless surgical procedure. We present an emblematic case of an osteoma closely associated with an impacted third left mandibular molar treated by Mectron Piezosurgery medical ultrasonic device.
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Affiliation(s)
- Salvatore D’Amato
- Maxillofacial Surgery, Multidisciplinary Department of Medicine and Dentistry, AOU - Second University of Naples, Naples, Italy
| | - Nicola Sgaramella
- Multidisciplinary Department of Medicine and Dentistry, AOU - Second University of Naples, Naples, Italy
| | - Laura Vanore
- Multidisciplinary Department of Medicine and Dentistry, AOU - Second University of Naples, Naples, Italy
| | | | | | - Mario Santagata
- Maxillofacial Surgery, Multidisciplinary Department of Medicine and Dentistry, AOU - Second University of Naples, Naples, Italy
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Santagata M, Tartaro G, Tozzi U, D′Amato S, Prisco R. Autologous bone graft harvested during implant site preparation: histological study. ACTA ACUST UNITED AC 2014. [DOI: 10.4103/2347-9264.143553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Genovese EA, Mallardo V, Vaccaro A, Santagata M, Raucci A, D'Agosto G, Fontanarosa A, Schillirò F. [Effectiveness of conventional diagnostic radiology and nuclear medicine in the treatment of pain from bone metastases]. Recenti Prog Med 2013; 104:350-5. [PMID: 24042406 DOI: 10.1701/1315.14574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Bone is one of the most common metastasis sites from solid tumors. Bone pain due to metastatic neoplastic growth is due to tumor infiltration and expansion of bone membranes. Treatment of acute and chronic pain represents one of the greatest problems in clinical oncology, requiring a multidisciplinary approach. This review focuses on the effectiveness of conventional diagnostic radiology and nuclear medicine for the detection, management and treatment of pain from bone metastasis.
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Conforti R, Faella P, Marrone V, Iasiello F, Di Maio N, Rossi C, Giganti M, Santagata M. [Enlargment of Virchow-Robin spaces in cranial trauma: literature review]. Recenti Prog Med 2013; 104:318-21. [PMID: 24042400 DOI: 10.1701/1315.14568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this review it is discussed the role of mild traumatic brain injury as a cause of Virchow-Robin spaces (VRS) pathological enlargement. Anatomy and physiology of normal VRS, and their immunological role are described. Special attention is given to magnetic resonance imaging findings of both normal and enlarged perivascular spaces.
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Genovese EA, Mallardo V, Rosati I, Prisco MR, Fontanarosa A, Della Vecchia N, D'Agosto G, Santagata M, Basile A. [Choice of the imaging technique for the diagnosis of bone metastases]. Recenti Prog Med 2013; 104:361-6. [PMID: 24042408 DOI: 10.1701/1315.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Bone is the third common site of distant metastases in cancer patients. Bone metastases may have implications for prognosis, quality of life, and local and systemic therapy. Numerous imaging modalities may be used to detect bone metastases. The two main anatomical modalities are computed tomography (CT) and magnetic resonance imaging (MRI), with many variants proposed for the MRI procedure, including diffusion-weighted imaging. The two main functional modalities are scintigraphy and PET/CT, also with many variants in the radiopharmaceuticals. Aim of our paper is to review the most important radio-compounds that can be successfully used to detect and/or characterize bone metastases.
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Santagata M, Tozzi U, Tartaro G, Santillo V, Giovanni C, Lamart E, Itro A, Colella G, D'Amato S. Maxillary Sinus Augmentation with Autologous and Heterologous Bone Graft: A Clinical and Radiographic Report of Immediate and Delayed Implant Placement. J Maxillofac Oral Surg 2013. [PMID: 26225003 DOI: 10.1007/s12663-013-0569-5] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate cumulative survival rate of implants placed on augmented maxillary sinus using a mixture of autologous bone harvested from the maxillary tuberosity and bovine-derived HA and to assess the height of the grafted material through radiographic evaluation. METHODS Thirty-five patients were treated with maxillary sinus augmentation and 93 implant fixtures were installed. The height of the augmented sinus and the gain of bone volume were measured by Cone Beam CT Scan and intraoral radiographs immediately after augmentation and up to 48 months subsequently. Changes in the height of the sinus graft material were calculated radiographically. RESULTS The cumulative survival rate was 98.92 % in all 93 implants. Additionally, normal healing process without any complication was observed in all patients. The original sinus height was a mean of 4.52 mm (range 2.0-6.4 mm) and the augmented sinus height was a mean of 14.1 mm (range 12.0-16.5 mm) after the surgery. The bone volume gain was a mean 9.613 mm (range 7-13 mm). CONCLUSIONS Within the limitations of this study, it would appear from the clinical and radiographic results that the sinus lift procedure with autologous bone graft harvested from the maxillary tuberosity combined with deproteinized bovine bone allows for a predictable outcome regarding the amount of bone formation in sinus floor augmentation and the immediate placement of implants, when possible, is recommended.
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Affiliation(s)
- Mario Santagata
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy ; Piazza Fuori Sant'Anna, 17, 81031 Aversa, Italy
| | - Umberto Tozzi
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Vincenzo Santillo
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Corrado Giovanni
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Ettore Lamart
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Angelo Itro
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
| | - Salvatore D'Amato
- Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU-SUN (Second University of Naples), Naples, Italy
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Cappabianca S, Capasso R, Cirillo M, Santagata M, Tartaro G, Colella G. Dynamic evaluation of benign neoplasm of parotid glands with multidetector row CT. Minerva Stomatol 2013; 62:95-106. [PMID: 23588210] [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: 06/02/2023]
Abstract
AIM The aim of this paper was to evaluate the role of net-enhancement (NE) of benign salivary glands with multiphase multidetector row CT (MDCT). METHODS Forty-eight patients (M=27, F=21), aged 35-76 years old (mean =57) with benign parotid neoplasms were examinated with 4 MDCT, at 20'', 40'', 70'' e 9' after intravenous administration of contrast medium. NE was calculated after subtracting precontrast phase to postcontrast phases. Final data were compared to the histopathology. RESULTS Thirty-six cases were pleomorphic adenomas (PA), 24 Warthin (WT). PA had a medium NE values of 23 HU, 74 HU, 53 HU e 34 HU at 20'', 40'', 70'' e 9' respectively. WT had a medium NE of 52 HU, 54 HU, 40 HU e 39 HU respectively at the same times. After subtracting precontrast phase to the delayed phase, with NE at 9' and cut-off of 34 HU, we have differenziate PA from WT and normal gland with specifity (SP) 87%, sensibility (SE) 60%, positive predictive value (PPV) and negative predictive value (NPV) of 75% and 59%; with NE at 20'' and cut-off of 54HU we have distingueshed WT from AP with SP 83%, SE 50%, PPV 75% and NPV 63%. CONCLUSION The study of NE can allow the characterization of benign parotid gland tumors.
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Affiliation(s)
- S Cappabianca
- Department of Internal Clinical and Experimental Medicine, Second Università of Naples, Naples, Italy.
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Prisco R, Santagata M, Vigolo P. Effect of Aging and Porcelain Sintering on Rotational Freedom of Internal-Hex One-Piece Zirconia Abutments. Int J Oral Maxillofac Implants 2013; 28:1003-8. [DOI: 10.11607/jomi.2997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Santagata M, Guariniello L, D'amato S, Tozzi U, Rauso R, Tartaro G. Augmentation of atrophic posterior maxilla by short implants and osteotome technique. Stomatologija 2012; 14:85-88. [PMID: 23128490] [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: 06/01/2023]
Abstract
UNLABELLED INTRODUCTION. Edentulous ridge in the posterior maxilla is often compromised by reduced bone volume. This anatomical condition limits the implant placement of 10 mm in length without sinus augmentation. The use of shorter implants with osteotome technique minimizes the need of more extensive sinus floor elevation, thus reducing the duration and morbidity of the treatment. MATERIALS AND METHODS. A prospective study was conducted of all patients treated between Nov 2007 and Nov 2008 who received endosseous implants that were less than 10 mm in length. Patient age, gender, height bone residual of posterior maxilla, location of implants, number and type of implants and Albrektsson criteria for success were assessed. RESULTS A total of 25 implants of 8 mm in length were placed with primary stability in 11 patients. Cumulative survival rates for implants were 100%. CONCLUSION. This simplified treatment modality can make implant rehabilitation of the atrophic posterior maxilla more accessible.
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Affiliation(s)
- Mario Santagata
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, University Hospital(AOU) – Second University of Naples, Naples, Italy.
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Santagata M, Guariniello L, Tartaro G. A Modified Edentulous Ridge Expansion Technique for Immediate Placement of Implants: A Case Report. J ORAL IMPLANTOL 2011; 37 Spec No:114-9. [DOI: 10.1563/aaid-joi-d-10-00035.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This case report is focused on the possibility of treating atrophic ridge with a reduced number of surgical procedures and a reduced healing time. A 43-year-old female patient affected by edentulism associated with horizontal resorption of the ridge was treated by means of a sagittal osteotomy and expansion of the ridge with the new modified edentulous ridge expansion (MERE) technique to obtain a wider bony base for ideal implant placement. In the same procedure 2 implants were placed and connective tissue graft, covering the bony wound, was placed to achieve keratinized mucosa. The implants were placed immediately after the split crest of the ridge and covered by a connective tissue graft. Postoperative recovery was uneventful. Within the limits of this case report, the MERE technique appeared to be reliable and simple, and it reduced morbidity compared with other techniques such as autogenous bone grafts and guided bone regeneration.
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Affiliation(s)
- Mario Santagata
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
| | - Luigi Guariniello
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
| | - Gianpaolo Tartaro
- Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy
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Santagata M, Guariniello L, Rauso R, Tartaro G. Immediate loading of dental implant after sinus floor elevation with osteotome technique: a clinical report and preliminary radiographic results. J ORAL IMPLANTOL 2010; 36:485-9. [PMID: 20553132 DOI: 10.1563/aaid-joi-d-09-00105] [Citation(s) in RCA: 11] [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: 11/22/2022]
Abstract
Edentulous ridges in the posterior maxilla are often compromised by reduced bone volume. This anatomic condition often limits dental implant placement of 10 mm in length without prior or simultaneous sinus augmentation. The osteotome technique is an alternative and conservative technique for sinus floor augmentation and immediate implant placement in the posterior region of the maxillary jaw. According to the relevant literature, the osteotome technique appears to be a predictable and safe method for augmenting bone at the sinus floor and to improve bone density and quality of the implant site sufficiently so that immediate loading is possible. A 46-year-old male patient was referred to the authors to replace the single upper premolar with an implant-supported crown restoration without interfering with the integrity and topography of the adjacent gingival tissues. Only one clinical study analyzed minimally invasive implant and sinus lift surgery with immediate loading. In that case report, the osteotomy was widened to its final diameter using a series of incrementally larger twist drills. In our clinical case, a series of incrementally larger diameter osteotomes improved bone density. This simplified treatment modality can make single tooth implant rehabilitation of the atrophic premolar maxilla region more accessible, and immediate loading is facilitated by improved bone density.
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Affiliation(s)
- Mario Santagata
- Department of Head and Neck Pathologies, Second University of Naples, Naples, Italy.
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Rauso GM, Nesi N, Fragola L, Santagata M, Santillo V, Rauso R. Ostheosynthesis plates, screws, xenogenic graft and resorbable barriers for preimplant and peri-implant surgery. Minerva Stomatol 2010; 59:315-324. [PMID: 20588218] [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: 05/29/2023]
Abstract
AIM The guided bone regeneration (GBR) procedure allows the regeneration of bone in implant surgery. A variety of GBR procedures to provide the bony-support for implant placement have been described and a variety of devices to perform this procedures have been used. The authors have carried out a retrospective study on the use of ostheosynthesis plates, screws, xenogenic bone grafting material and resorbable barriers for implant and preimplant surgery. METHODS Fourteen partially edentulous patients were treated by a single surgeon in a private dental clinic in Italy. Patients age ranged between 28 and 52 years old. Every patients was treated with GBR technique performed with the use of ostheosynthesis plate and screws, xenogenic bone grafting material and resorbable barriers in staged or simultaneous implant placement. RESULTS Twenty-one implants were placed and no-one failed, all planned prostheses were delivered. In all the cases a complete bone regeneration was obtained. CONCLUSION The outcomes of the study allow to state that the GBR technique performed with ostheosynthesis plates, screws, xenogenic graft and resorbable barriers is a safe alternative to the others well established GBR procedure.
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Rauso R, Santagata M, Colella G, Nesi N, Gherardini G, Tartaro G. Can occlusal devices prolong the effect of botulinum toxin type A in the contouring of the lower face? Eur J Plast Surg 2010. [DOI: 10.1007/s00238-009-0375-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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Rauso R, Santagata M, Tartaro G, Filipi M, Colella G. Chondroid syringoma: a rare tumor of orofacial region. Minerva Stomatol 2009; 58:383-388. [PMID: 19633639] [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: 05/28/2023]
Abstract
Chondroid syringoma is a rare tumor arising from the major and minor salivary glands. The incidence of chondroid syringoma is reported to be <0.01% among the primary skin tumors. Eighty percent of the chondroid syringomas are seen in older patients , commonly on head and neck region and mostly on the cheek and nose. The authors report a case discussing the surgical management of a chondroid syringoma and pointing out the importance of including this tumor in the differential diagnosis of small subcutaneous nodules in the head and neck region, in middle-age male patients.
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Affiliation(s)
- R Rauso
- Department of Head and Neck Pathology, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Naples, Italy.
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Santagata M, Guariniello L, D'Andrea A, Tartaro G. A Modified Crestal Ridge Expansion Technique for Immediate Placement of Implants: A Report of Three Cases. J ORAL IMPLANTOL 2008; 34:319-24. [DOI: 10.1563/1548-1336-34.6.319] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
Atrophic edentulous jaws can pose a significant challenge to successful oral rehabilitation with endosseous dental implants. Although ridge augmentation can help to restore ridge volume, grafting procedures can significantly increase patient morbidity, costs, and treatment time, depending on the case, before dental implants can be placed. This article reports on an alternative technique used in 3 patients to expand ridge volume and place dental implants in a single procedure. A partial-thickness flap was elevated to expose the alveolar crest, and conventional implant osteotomies were partially prepared. Along the crest of the ridge, a furrow with terminal vertical releases 1 to 3 mm deep were created, and a bone chisel was used to deepen the furrow. Osteotomes were used to complete preparation of the implant receptor sites, and the implants were placed. Bony plates were stabilized through the use of resorbable sutures. Furrows more than 2 mm deep between the plates were augmented with a xenograft. Collegen membranes were placed over the sites, and soft tissue was sutured. Healing was unremarkable, and all implants were successfully restored. For these patients, the ridge expansion technique resulted in substantial bone reconstruction with little or no grafting. Long-term, prospective studies on this procedure are required before definitive conclusions can be drawn.
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