Davide Sozzi - Academia.edu (original) (raw)
Papers by Davide Sozzi
PubMed, Nov 1, 2009
Aims: Epithelial-myoepithelial carcinoma (EMC) is a rare malignant salivary gland neoplasm that m... more Aims: Epithelial-myoepithelial carcinoma (EMC) is a rare malignant salivary gland neoplasm that most commonly occurs in the parotid gland, but can also arise in the minor salivary glands. Three cases are reported of epithelial-myoepithelial carcinoma of the minor salivary glands, with the goal of better defining this entity. Patients and methods: All three cases showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. All parts of each tumor were surrounded by a myoepithelial cell rim and there was evidence of invasion. Results: Immunohistochemical analysis showed the tumor cells to be weakly positive for S100, cytokeratin (CK) CK5/6, CK7, CKAE-1/AE-3 and strongly positive for epithelial membrane antigen (EMA) and p63; they were focally positive for calponin and acute lymphoblastic leukemia antigen (CD10). The tumor cells were negative for vimentin, alpha-smooth muscle actin (SMA) (except one case), glial fibrillar acid protein (GFAP) and MIB1. The tumors were resected completely with wide margins and no recurrence or metastasis had occurred from 6 to 15 months after surgery. Conclusion: Three cases of minor salivary gland tumors are described and the differential diagnosis underlined in relation to benign myoepithelioma. The characteristic morphological and immunohistochemical features aided diagnosis of these biphasic tumors.
Annali di stomatologia, 2017
Aim. The purpose of this research is to investigate whether and how the adhesive bond failure sit... more Aim. The purpose of this research is to investigate whether and how the adhesive bond failure site varied in relation to the material used for the orthodontic bonding and debonding technique applied. Materials and methods. Two different methods of orthodontic debonding were included in our survey; cutters for orthodontics and debonding plier. Three different materials for the adhesion of the bracket: composite light curing, self-curing composite and glass ionomer cement. The remaining amount of adhesive on the tooth surface is an important parameter that gives information on how the location of the posting site varied during the debonding. 60 dental elements, maxillary and mandibular, previously extracted for orthodontic reasons, as well as periodontal, were included in our research. We investigated a possible significant correlation between different variables (debonding technique and materials for membership) and the ARI index. Conclusions. The use of orthodontic cutters or debonding pliers does not affect the adhesive bond failure site and both techniques have a tendency to leave a significant amount of adhesive on the surface enamel. In the resin-reinforced glass ionomer cements, detachment occurs at the interface enamel-adhesive and this pattern of detachment increases the risk of the enamel damage during debonding. In both types of composite resins (photopolymerizable or self-curing), the detachment occurs at the interface bracketing adhesive. In this case the amount of remaining adhesive material on the tooth must be removed with further methods, which in addition, increase the risk of iatrogenic injury as well as the working hours.
PubMed, Apr 1, 2014
Necrotizing fasciitis is a rare polymicrobial, infection, characterized by a rapid and destructiv... more Necrotizing fasciitis is a rare polymicrobial, infection, characterized by a rapid and destructive spread within the subcutaneous tissue and along the superficial fascial planes, initially not affecting underlying muscles but with a common systemic involvement. Necrotizing fasciitis confined to the cervico-facial region is extremely rare (10% of cases) and is characterized by a high mortality rate due to airway compromise and to involvement of the supra-aortic vessels. The prognosis for survival is based on the severity of the necrotizing fasciitis, on the patient's systemic condition and on the prompt diagnosis and adequate surgical and medical management. We discuss a case of cervico-facial necrotizing fasciitis in a 25-year-old patient beginning with an odontogenic abscess, resistant to antibiotic therapy, rapidly progressing into an important right-sided swelling of the neck with worsening dyspnea and dysphagia. Because of his worsened general condition, the patient was transferred to the operating room for an emergency treatment. Under general anesthesia, the right cervical and left buccal purulent material was drained via right lateral cervicotomy an aggressive debridement of necrotic tissue, a disruption and excision of the all-necrotic fascia and a removal of the right submandibular gland. Thus, a portable mini-VAC device was applied. The early intervention with a specific diagnostic and therapeutic protocol and the wound treatment by means of vacuum assisted closure therapy allowed to obtain a quick healing, preventing the systemic involvement, minimizing morpho-esthetic outcome and limiting the costs of post-operative wound care.
Journal of Oral and Maxillofacial Surgery, Mar 1, 2016
To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases o... more To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases of an uncommon head and neck malignancy and compare these results with data in the literature. The medical histories of all patients treated in the Maxillofacial Surgery Unit in San Gerardo Hospital (Monza, Italy) for primitive intraosseous squamous cell carcinoma (PIOSCC) of the jaw were reviewed. All patients were considered suitable for inclusion in the study, specifically those whose oral mucosa had not been compromised and who did not have distant metastases. Six patients were included (4 male, 2 female). The odontogenic origin was histologically shown in only 2 patients. The male-to-female ratio was 2:1, and the malignancy occurred in the posterior mandible in 50% of cases. The most common symptoms were swelling and pain, but no sensory disturbances were observed. Radiologic findings indicated considerable variation in presentation, including small cystic lesions, which might complicate a pathologic diagnosis. All patients in the study were treated with surgery, and 2 patients received adjuvant radiotherapy. Cervical node metastases were present in 33% of patients. All patients are currently alive and free of disease. PIOSCC is a rare malignancy of the head and neck. Diagnosis can be difficult during the early stages of disease owing to a lack of clinical symptoms or radiologic presentation. Treatment is surgical and, like every other cancer, must be adequate to cure the cancer.
The Cleft Palate-Craniofacial Journal, Sep 1, 2003
Objective: To supply quantitative information about the facial soft tissues of adult operated pat... more Objective: To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate (CLP). Design, Setting, and Patients: The three-dimensional coordinates of soft tissue facial landmarks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP (11 males and 7 females aged 19 to 27 years) and 162 healthy controls (73 females and 89 males aged 18 to 30 years). From the landmarks, 15 facial dimensions and two angles were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects: the mean z-score (an index of overall facial size), and its SD, called the craniofacial variability index (an index of facial harmony). Results: In treated patients with CLP, facial size was somewhat smaller than in normal individuals, but in all occasions the mean z-score fell inside the normal interval (mean ؎ 2 SD). Almost all patients had a craniofacial variability index larger than the normal interval, indicating a global disharmonious appearance. Overall, in patients pronasale, subnasale, and pogonion were more posterior, the nose was shorter and larger, the face was narrower, and the soft tissue profile and upper lip were flatter than in the reference population. Conclusions: The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age, sex, and ethnic group. In this patient group, surgical corrections of CLP failed to provide a completely harmonious appearance, even if the deviations from the reference were limited. Further analyses of larger groups of patients are needed.
Italian journal of anatomy and embryology, Sep 1, 2017
Minerva stomatologica
A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures,... more A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good ...
Journal of Cutaneous and Aesthetic Surgery
Children
This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibul... more This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibular difference that considers the patient’s profile (soft tissue Wits appraisal: obtained by projecting points A and B on the occlusal plane and subsequently measuring the linear distance between the two points). This new measurement was compared to the conventional Wits appraisal obtained to diagnose sagittal jaw discrepancy. In total, 300 subjects (162 males, 138 females) aged between 6 and 50 years requiring orthodontic treatment were analyzed. The cephalometric tracings on the pre-treatment lateral cephalometric radiographs were obtained and the two measurements taken were the Wits appraisal and a new measurement which were both calculated and compared. The analysis of the linear correlations between the conventional Wits value and the measurement obtained on the soft-tissue were undertaken. The relevance was established at 5% (p < 0.05). The mean values were also calculated within...
Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ ... more Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ has traditionally been accomplished using vascularized free fibula flaps (FFF). But not all patients are candidates for FFF. A two-staged protocol (SPR) was developed taking into account the challenges of the surgical site and comorbidities of the patient utilizing custom prosthetics. Methods: This study retrospectively analyzed 16 patients (13 males, 3 females) who developed stage III ORNJ subsequent to radiation and molar extraction (FFF n=4, SPR n=12). Postoperative surgical complications, maximal incisal opening (MIO), Pain Visual Analog Scale (VAS) at the different end points for the SPR and FFF group were analyzed. Results: All patients demonstrated decrease in pain and increased mouth opening. Comparing Stage 1 SPR and FFF patients, there was a significant difference in pain, but not in function (1.89 ± 1.05 vs 0.25 ± 0.5, p<0.01 and 28.44 ± 8.10 vs 24.75 ± 1.26 p>0.20). Aft...
Journal of Clinical Medicine
Aim: the purpose of this work is to present an innovative protocol for virtual planning and surgi... more Aim: the purpose of this work is to present an innovative protocol for virtual planning and surgical navigation in post-oncological mandibular reconstruction through fibula free flap. In order to analyze its applicability, an evaluation of accuracy for the surgical protocol has been performed. Methods: 21 patients surgically treated for mandibular neoplasm have been included in the analysis. The Brainlab Vector Vision 3.0® software for surgical navigation has been used for preoperative surgical planning and intra-operative navigation. A post-operative accuracy evaluation has been performed matching the position of mandibular landmarks between pre-operative and post-operative CT scans. Results: the maximal discrepancy observed was included between −3.4 mm and +3.2 mm, assuming negative values for under correction and positive values for overcorrection. An average grade of accuracy included between 0.06 ± 0.58 mm and 0.43 ± 0.68 mm has been observed for every mandibular landmark exami...
Cancers
Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally... more Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, w...
PubMed, Nov 1, 2009
Aims: Epithelial-myoepithelial carcinoma (EMC) is a rare malignant salivary gland neoplasm that m... more Aims: Epithelial-myoepithelial carcinoma (EMC) is a rare malignant salivary gland neoplasm that most commonly occurs in the parotid gland, but can also arise in the minor salivary glands. Three cases are reported of epithelial-myoepithelial carcinoma of the minor salivary glands, with the goal of better defining this entity. Patients and methods: All three cases showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. All parts of each tumor were surrounded by a myoepithelial cell rim and there was evidence of invasion. Results: Immunohistochemical analysis showed the tumor cells to be weakly positive for S100, cytokeratin (CK) CK5/6, CK7, CKAE-1/AE-3 and strongly positive for epithelial membrane antigen (EMA) and p63; they were focally positive for calponin and acute lymphoblastic leukemia antigen (CD10). The tumor cells were negative for vimentin, alpha-smooth muscle actin (SMA) (except one case), glial fibrillar acid protein (GFAP) and MIB1. The tumors were resected completely with wide margins and no recurrence or metastasis had occurred from 6 to 15 months after surgery. Conclusion: Three cases of minor salivary gland tumors are described and the differential diagnosis underlined in relation to benign myoepithelioma. The characteristic morphological and immunohistochemical features aided diagnosis of these biphasic tumors.
Annali di stomatologia, 2017
Aim. The purpose of this research is to investigate whether and how the adhesive bond failure sit... more Aim. The purpose of this research is to investigate whether and how the adhesive bond failure site varied in relation to the material used for the orthodontic bonding and debonding technique applied. Materials and methods. Two different methods of orthodontic debonding were included in our survey; cutters for orthodontics and debonding plier. Three different materials for the adhesion of the bracket: composite light curing, self-curing composite and glass ionomer cement. The remaining amount of adhesive on the tooth surface is an important parameter that gives information on how the location of the posting site varied during the debonding. 60 dental elements, maxillary and mandibular, previously extracted for orthodontic reasons, as well as periodontal, were included in our research. We investigated a possible significant correlation between different variables (debonding technique and materials for membership) and the ARI index. Conclusions. The use of orthodontic cutters or debonding pliers does not affect the adhesive bond failure site and both techniques have a tendency to leave a significant amount of adhesive on the surface enamel. In the resin-reinforced glass ionomer cements, detachment occurs at the interface enamel-adhesive and this pattern of detachment increases the risk of the enamel damage during debonding. In both types of composite resins (photopolymerizable or self-curing), the detachment occurs at the interface bracketing adhesive. In this case the amount of remaining adhesive material on the tooth must be removed with further methods, which in addition, increase the risk of iatrogenic injury as well as the working hours.
PubMed, Apr 1, 2014
Necrotizing fasciitis is a rare polymicrobial, infection, characterized by a rapid and destructiv... more Necrotizing fasciitis is a rare polymicrobial, infection, characterized by a rapid and destructive spread within the subcutaneous tissue and along the superficial fascial planes, initially not affecting underlying muscles but with a common systemic involvement. Necrotizing fasciitis confined to the cervico-facial region is extremely rare (10% of cases) and is characterized by a high mortality rate due to airway compromise and to involvement of the supra-aortic vessels. The prognosis for survival is based on the severity of the necrotizing fasciitis, on the patient's systemic condition and on the prompt diagnosis and adequate surgical and medical management. We discuss a case of cervico-facial necrotizing fasciitis in a 25-year-old patient beginning with an odontogenic abscess, resistant to antibiotic therapy, rapidly progressing into an important right-sided swelling of the neck with worsening dyspnea and dysphagia. Because of his worsened general condition, the patient was transferred to the operating room for an emergency treatment. Under general anesthesia, the right cervical and left buccal purulent material was drained via right lateral cervicotomy an aggressive debridement of necrotic tissue, a disruption and excision of the all-necrotic fascia and a removal of the right submandibular gland. Thus, a portable mini-VAC device was applied. The early intervention with a specific diagnostic and therapeutic protocol and the wound treatment by means of vacuum assisted closure therapy allowed to obtain a quick healing, preventing the systemic involvement, minimizing morpho-esthetic outcome and limiting the costs of post-operative wound care.
Journal of Oral and Maxillofacial Surgery, Mar 1, 2016
To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases o... more To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases of an uncommon head and neck malignancy and compare these results with data in the literature. The medical histories of all patients treated in the Maxillofacial Surgery Unit in San Gerardo Hospital (Monza, Italy) for primitive intraosseous squamous cell carcinoma (PIOSCC) of the jaw were reviewed. All patients were considered suitable for inclusion in the study, specifically those whose oral mucosa had not been compromised and who did not have distant metastases. Six patients were included (4 male, 2 female). The odontogenic origin was histologically shown in only 2 patients. The male-to-female ratio was 2:1, and the malignancy occurred in the posterior mandible in 50% of cases. The most common symptoms were swelling and pain, but no sensory disturbances were observed. Radiologic findings indicated considerable variation in presentation, including small cystic lesions, which might complicate a pathologic diagnosis. All patients in the study were treated with surgery, and 2 patients received adjuvant radiotherapy. Cervical node metastases were present in 33% of patients. All patients are currently alive and free of disease. PIOSCC is a rare malignancy of the head and neck. Diagnosis can be difficult during the early stages of disease owing to a lack of clinical symptoms or radiologic presentation. Treatment is surgical and, like every other cancer, must be adequate to cure the cancer.
The Cleft Palate-Craniofacial Journal, Sep 1, 2003
Objective: To supply quantitative information about the facial soft tissues of adult operated pat... more Objective: To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate (CLP). Design, Setting, and Patients: The three-dimensional coordinates of soft tissue facial landmarks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP (11 males and 7 females aged 19 to 27 years) and 162 healthy controls (73 females and 89 males aged 18 to 30 years). From the landmarks, 15 facial dimensions and two angles were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects: the mean z-score (an index of overall facial size), and its SD, called the craniofacial variability index (an index of facial harmony). Results: In treated patients with CLP, facial size was somewhat smaller than in normal individuals, but in all occasions the mean z-score fell inside the normal interval (mean ؎ 2 SD). Almost all patients had a craniofacial variability index larger than the normal interval, indicating a global disharmonious appearance. Overall, in patients pronasale, subnasale, and pogonion were more posterior, the nose was shorter and larger, the face was narrower, and the soft tissue profile and upper lip were flatter than in the reference population. Conclusions: The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age, sex, and ethnic group. In this patient group, surgical corrections of CLP failed to provide a completely harmonious appearance, even if the deviations from the reference were limited. Further analyses of larger groups of patients are needed.
Italian journal of anatomy and embryology, Sep 1, 2017
Minerva stomatologica
A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures,... more A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good ...
Journal of Cutaneous and Aesthetic Surgery
Children
This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibul... more This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibular difference that considers the patient’s profile (soft tissue Wits appraisal: obtained by projecting points A and B on the occlusal plane and subsequently measuring the linear distance between the two points). This new measurement was compared to the conventional Wits appraisal obtained to diagnose sagittal jaw discrepancy. In total, 300 subjects (162 males, 138 females) aged between 6 and 50 years requiring orthodontic treatment were analyzed. The cephalometric tracings on the pre-treatment lateral cephalometric radiographs were obtained and the two measurements taken were the Wits appraisal and a new measurement which were both calculated and compared. The analysis of the linear correlations between the conventional Wits value and the measurement obtained on the soft-tissue were undertaken. The relevance was established at 5% (p < 0.05). The mean values were also calculated within...
Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ ... more Background: Reconstruction of full thickness mandibular defects with disarticulation due to ORNJ has traditionally been accomplished using vascularized free fibula flaps (FFF). But not all patients are candidates for FFF. A two-staged protocol (SPR) was developed taking into account the challenges of the surgical site and comorbidities of the patient utilizing custom prosthetics. Methods: This study retrospectively analyzed 16 patients (13 males, 3 females) who developed stage III ORNJ subsequent to radiation and molar extraction (FFF n=4, SPR n=12). Postoperative surgical complications, maximal incisal opening (MIO), Pain Visual Analog Scale (VAS) at the different end points for the SPR and FFF group were analyzed. Results: All patients demonstrated decrease in pain and increased mouth opening. Comparing Stage 1 SPR and FFF patients, there was a significant difference in pain, but not in function (1.89 ± 1.05 vs 0.25 ± 0.5, p<0.01 and 28.44 ± 8.10 vs 24.75 ± 1.26 p>0.20). Aft...
Journal of Clinical Medicine
Aim: the purpose of this work is to present an innovative protocol for virtual planning and surgi... more Aim: the purpose of this work is to present an innovative protocol for virtual planning and surgical navigation in post-oncological mandibular reconstruction through fibula free flap. In order to analyze its applicability, an evaluation of accuracy for the surgical protocol has been performed. Methods: 21 patients surgically treated for mandibular neoplasm have been included in the analysis. The Brainlab Vector Vision 3.0® software for surgical navigation has been used for preoperative surgical planning and intra-operative navigation. A post-operative accuracy evaluation has been performed matching the position of mandibular landmarks between pre-operative and post-operative CT scans. Results: the maximal discrepancy observed was included between −3.4 mm and +3.2 mm, assuming negative values for under correction and positive values for overcorrection. An average grade of accuracy included between 0.06 ± 0.58 mm and 0.43 ± 0.68 mm has been observed for every mandibular landmark exami...
Cancers
Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally... more Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, w...