Management of atypical occlusal discrepancy after condylar resection: A clinical report

This clinical report describes the prosthetic management of occlusion for a patient who had received condylar resection as part of cancer treatment. Previous reports have identified that patients with unrepaired segmental resection of the mandible experienced a frontal plane rotation of the mandible toward the nonsurgical side. In contrast, because of preservation of temporomandibular muscles and their attachments, the mandible rotated toward the surgical side, and occlusal contacts were limited to a pair of molars on that side. Manual manipulation and instructions for muscular stretching and massages were provided to reduce muscular tension. A mandibular guidance prosthesis was fabricated and gradually adjusted to guide the mandible progressively toward a normal position. These treatments helped improve general comfort, mastication, occlusion, and the gradual rotation of the mandible toward a normal position.

The effects of zinc on radiation-induced dysgeusia: a systematic review and meta-analysis

PURPOSE

Many head and neck cancer patients who receive radiation therapy experience radiation-induced dysgeusia (RID), which has no standard treatment. The only supplement controlled clinical trials have evaluated for the treatment of RID is zinc. However, the results of these and other studies investigating the use of zinc for RID have been inconsistent. To assess the validity of zinc as a treatment for RID, we conducted a systematic literature search and performed a meta-analysis to determine the extent to which zinc affects RID incidence and the degree to which ongoing RID responds to zinc.

METHODS

We searched the Ovid MEDLINE, Ovid Embase, PubMed, and Cochrane Library databases to identify studies investigating the use of zinc-based therapy for RID in head and neck cancer patients treated with radiation that were published between January 1, 2003, and November 9, 2017. Using American Society of Clinical Oncology criteria, we selected studies with a high level of evidence for inclusion in the meta-analysis.

RESULTS

Of the 32 full-text articles eligible for inclusion, three were included in the final review and meta-analysis. The meta-analysis showed that, compared with placebo, zinc reduces the incidence of RID (risk ratio, 0.72; 95% confidence interval, 0.67-0.92) but does not improve taste acuity more rapidly following radiation therapy (risk ratio, 2.58; 95% confidence interval, 0.97-6.88).

CONCLUSION

Our findings indicate that zinc-based therapy reduces the incidence of RID but has a minimal effect on ongoing RID. Our findings also highlight the need for additional evidence-based research on this topic.

Prosthodontic treatment of a patient with Ewing sarcoma of the left maxillary sinus: A clinical report

This clinical report describes the prosthodontic rehabilitation of a 22-year-old woman with a substantial treatment history of Ewing sarcoma of the left maxillary sinus. The patient was diagnosed with Ewing sarcoma at the age of 7 years and went through chemotherapy, radiation, surgical resection, and free-flap reconstruction, initially without prosthodontic rehabilitation. The patient aged 22 years was referred to the oral oncology clinic at The University of Texas MD Anderson Cancer Center for prosthodontic treatment. The patient's prosthetic rehabilitation with dental implants and a definitive maxillary obturator prosthesis is presented in detail.