Ioannis Dimitrakopoulos - Academia.edu (original) (raw)
Papers by Ioannis Dimitrakopoulos
Balkan Journal of Stomatology, 2003
Many studies have been made in the past in an effort to understand the pathogenetic factors that ... more Many studies have been made in the past in an effort to understand the pathogenetic factors that are involved in the development of fibrous dysplasia and McCune-Albright syndrome. Recently, with the aid of cellular and molecular biology, the implication of G protein mutations have been demonstrated to be a crucial etiopathogenetic factor for the manifestations of these disorders. In this paper, we present the most recent data regarding the etiology of monostotic and polyostotic fibrous dysplasia, as well as of McCune-Albright Syndrome, and discuss different sights of the above disorders associated with molecular changes.
Oral and Maxillofacial Surgery, Apr 6, 2010
Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spr... more Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spreads into the surrounding tissues by direct infiltration whereas spread by hematogenous dissemination is relatively unusual, and most commonly involves the lung, bone, and liver. The involvement of oral and maxillofacial region is extremely rare in gynecological cancer. In this paper, we present an unusual case of a metastatic squamous cell carcinoma originating in the infratemporal fossa of a 37-year-old woman who had underwent a subtotal hysterectomy, for squamous cell carcinoma of the cervix, 22 months earlier. A whole-body CT scan revealed a mass of enlarged lymph nodes in the mediastinum as well. The patient, who had presented for evaluation of a rapidly increasing trismus associated with deep intermittent facial pain and temporal swelling had initially been treated for a TMJ dysfunction and later for an infratemporal fossa abscess for long before a definite diagnosis was made. A high index of suspicion is possible to make an early diagnosis, which when coupled with an aggressive management can improve survival and quality of life.
Balkan Journal of Stomatology, 2010
Conservative and surgical methods utilized so far to treat temporomandibular disorders have demon... more Conservative and surgical methods utilized so far to treat temporomandibular disorders have demonstrated inconsistent results. Tissue engineering is a new, rapidly expanding, multidisciplinary field aiming to generate tissue and organ substitutes in vitro. Stem cells have already shown the potential to form multiple tissue types. Thus, their ability could be incorporated in contemporary paradigms to reconstruct the temporomandibular joint disc, though such attempts are rare. This review points out the unique histological and biomechanical character of the disc, trying to delineate the basic parameters that need to be considered in this process. In fact, the histological character of the disc cannot be defined as hyaline cartilage but fibro-cartilage. Particularly, the type I fibrillar collagen prevalence and relatively low glucosamino-glycan content, along with their specific topographic arrangement and distribution, correspond to the cellular content and correlate to the biomechanical characteristics of the disc, which mirror its functional role. Here, the various biomaterials, biochemical and biomechanical stimuli utilized for the reconstruction of hyaline cartilage are explored, since the experience and knowledge from these research fronts offer a useful guideline for the reconstruction of the temporomandibular joint disc. The cross-talk between these advancing scientific fields, together with a deeper comprehension of the physiology and pathophysiology of the temporomandibular complex can act as a catalyst, elevating the prospects of the disc's regeneration to new heights.
Clinical advances in periodontics, May 1, 2017
Introduction: Aggressive periodontitis (AgP), according to the diagnostic criteria set by the Ame... more Introduction: Aggressive periodontitis (AgP), according to the diagnostic criteria set by the American Academy of Periodontology, is an infrequent periodontal disease. However, certain cases originally diagnosed as AgP due to young age and the involvement of first molars, when not responding to therapy, can diagnostically involve more severe systemic conditions such as the rare disorder Langerhans cell histiocytosis (LCH).Case Presentation: A 25‐year‐old white male, with no known systemic diseases, was referred to the Postgraduate Clinic of the Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece. Clinical and radiographic examination and comparison with a previous evaluation revealed a rapidly progressive lesion involving the molar region in all quadrants, although the patient had been treated by a periodontist during the last 2 years. Molars were extracted and biopsies taken, which demonstrated morphologic and immunohistochemical characteristics leading to the diagnosis of LCH. The patient was referred to a hematology clinic, where he received a comprehensive examination and chemotherapy. The patient did not further comply with his proposed medical treatment and therefore 2 years later appeared with a progressing lesion in the molar area. He was re‐treated by further extractions and closure of a sinus perforation. He was persuaded to continue the treatment plan and received supportive periodontal treatment every 3 months. Regular medical and periodontal checkups show that his condition remains stable during the last 5 years.Conclusion: Periodontists should be aware of rare systemic conditions mimicking AgP and immediately refer the patient accordingly.
PubMed, Mar 1, 1991
An extensive hemangioma of the lower face is discussed as an example illustrating the use of ther... more An extensive hemangioma of the lower face is discussed as an example illustrating the use of therapeutic--particularly preoperative--arterial embolization in the treatment of extensive facial hemangiomas. In this procedure a thrombusinducing material is inserted into the lumen of a blood vessel to occlude this vessel, and thus to reduce blood flow to the lesion. This promising technique opens up new possibilities in the treatment of extensive hemangiomas of the maxillofacial region. It may be used either as a definite therapy or as pretreatment procedure enabling a safer and simpler surgical approach.
Oral Oncology Supplement, Jul 1, 2009
Oral Oncology Supplement, 2005
Introduction: Tongue cancer In young adults under tile age of 45 years has been specially studied... more Introduction: Tongue cancer In young adults under tile age of 45 years has been specially studied due to the fact that it arises early at patients who have not been exposed or shghtly exposed to mutation t~actors, suggesting a more aggressive behavior. Purpose of this work as to study the literature for this theoretically possible dafferent biological behavior of tongue cancer in young patients and to present 10 new cases Materials and Methods: During the period 1999-2003, 141 pataents suffering from squanlous cell carclnonla of tile oral cavity were treated. Thirty five of them had tongue cancer. Ten of those were under the age of 45 years. The mean age of this latter group was 38.1 years old. Eight of them were staged as T1, 1 as T2 and 1 as T4. Nine had negative neck for enlarged nodes and 1 was staged as N3. All of them were surgically treated with wide local excision of the primary ~inor combined with neck dissection. Results: In 64.17% of all patients with cancer the tumor occurred at the tongue. 7.10'0 of all patients had tongue cancer and were under tile age of 45 years old. Tile final pTNM staging revealed 2 patients being of N1 stage. Four patients received adjuvant radiotherapy. The mean follow up period was 31.9 inonti~s. All of ten are ahve. Nine are free of disease. One presented with recurrence 14 months after and underwent combined radlo-chelnotherapy and salvage operation. She is free of disease for 5 years. Conclusion: Tile survival rates of young patients suffering from tongue cancer are slrmlar to those of older patients. There time Interval between the lmtlal therapy and the recurrence is wider among the young patients. However, according to large series, we agree that there is no need for more aggressive treatment as m our group occurred.
Journal of Oral and Maxillofacial Surgery, 2008
Purpose: To present a treatment plan for localized mucosa-associated lymphoid tissue lymphoma of ... more Purpose: To present a treatment plan for localized mucosa-associated lymphoid tissue lymphoma of the orbit in order to preserve vital structures and function from the side effects of radiotherapy. Materials and Methods: Study of 2 clinical cases by means of clinical and radiologic examination, with 2 and 3 years follow-up, respectively. Results: Immediate remission of the disease after 6 cycles of chemotherapy, with no signs of recurrence after 2 and 3 years. Clinical examination of the oculomotor mechanism and visual activity gave excellent results. Conclusion: Although radiotherapy is preferable for localized lymphoproliferative lesions, chemotherapy should also be considered as an effective treatment that preserves the integrity and function of the ocular adnexa.
British Journal of Oral & Maxillofacial Surgery, Sep 1, 2016
Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defec... more Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defects in terms of postoperative complications, recovery of sensitivity, and quality of life. We organised a retrospective cohort study of 49 patients who had had intraoral reconstruction with nasolabial pedicled (n-= 13) and island (n = 36) flaps. Twenty-two patients filled in a validated quality-of-life (QoL) questionnaire and we did sensitivity tests (sharp discrimination with the aid of a Semmes-Weinstein TM aesthesiometer). Descriptive and bivariate statistics were computed and probabilities of 0.05 were accepted as significant. There were 11 flap-related complications (22%), and the flap was totally necrotic in three patients (6%), all of whom had island flaps. There was a significant association between flap-related complications and the use of reconstruction plate p = 0.001, 95% CI 2.36 to 11.37) and advanced stage (T3 and T4 p = 0.01, 95% CI 1.45 to 5.26). Skin sensitivity recovered in both island and pedicled flaps. Patients treated with island flaps had significantly more problems with prosthetic rehabilitation than those treated with pedicled flaps. The relatively low morbidity and adequate functional and aesthetic results make the pedicled nasolabial flap a viable technique. Deepithelialisation of the pedicle in island flaps permits coverage of defects with unilateral flaps in a one-stage reconstruction. However, the pedicle may be excessively stretched, leading to ischaemic complications.
Journal of Oral and Maxillofacial Surgery, May 1, 1997
PubMed, Apr 1, 2008
Background: Although several studies have examined use of collagen membranes in guided bone regen... more Background: Although several studies have examined use of collagen membranes in guided bone regeneration (GBR), none has examined the use of human fascia temporalis as a bioabsorbable barrier. The majority of studies related to GBR have examined critical size defects. We sought to assess the human fascia temporalis and other well-documented membranes applied for GBR in mandibular osseous defects beyond critical size. Material/methods: Fifty adult male New Zealand white rabbits were used in this study. Five groups of 10 animals each were used: HFL (human fascia lata membrane), HP (human pericardium), HFT (human fascia temporalis), BP (bovine pericardium), and PTFE (expanded polytetrafluoroethylene). Animals were killed 10 weeks after membrane application. In each animal, 9-mm circular mandibular defects were created bilaterally. On 1 side of the jaw, the defect was covered with 1 of the test membranes; the defect on the other side served as a control. Harvested specimens were examined histologically. Results: Membranes were significantly superior to the controls in all animals (P<0.001). Paired comparisons showed that groups HFL, HP, BP, and PTFE were significantly superior to HFT (P<0.05). Conversely, comparisons of HFL-HP, HFL-BP, HFL-PTFE, HP-BP, HP-PTFE, and BP-PTFE, showed no significant differences (P>0.05). Conclusions: According to our results, the fascia temporalis is not recommended for GBR techniques. The fascia lata, human pericardium, bovine pericardium, and e-PTFE advance bone regeneration and can be successfully used as GBR membranes for osseous defects beyond the critical size.
Balkan Journal of Stomatology, 2006
... Balkan Journal of Stomatology. 2006, vol. 10, br. 1, str. 48-52. jezik rada: engleski prikaz ... more ... Balkan Journal of Stomatology. 2006, vol. 10, br. 1, str. 48-52. jezik rada: engleski prikaz slučaja. ... Suba, ZS, Nemeth, ZS, Gyulai-Gaal, SZ, Ujpal, M., Szende, B., Szabo, GY (2003) Malignant myoepithelioma. Clinicopathological and immunohistochemical characteristics. ...
Quintessence International, Jun 1, 2008
Ameloblastic fibroma (AF) is an uncommon benign odontogenic mixed tumor. A case of an AF associat... more Ameloblastic fibroma (AF) is an uncommon benign odontogenic mixed tumor. A case of an AF associated with unerupted and missing teeth is presented. A 13-year-old girl was referred for evaluation of a painless swelling of her right mandible. The most remarkable finding was the resorption of the proximal root of the permanent first molar. The lesion was completely enucleated. Follow-up showed satisfactory bony healing, and the resorbed root was completely surrounded by a continuous layer of intact lamina dura. In most cases, the patient presents to the clinician complaining of an unerupted tooth at the posterior area of the mandible. The most remarkable finding in our case, however, was the coexisting root resorption. This finding could indicate a more aggressive form of AF. AF has a very good prognosis. Malignant transformation is extremely rare.
Journal of Oral and Maxillofacial Surgery, Dec 1, 2012
Approximately one third of non-Hodgkin lymphomas (NHLs) arise in tissues other than the lymph nod... more Approximately one third of non-Hodgkin lymphomas (NHLs) arise in tissues other than the lymph nodes. The purposes of this study are to evaluate the clinical outcome of NHLs of the oral cavity and maxillofacial region in a group of 58 patients who were diagnosed in our clinic and to discuss the clinical, histologic, and immunohistochemical features of these malignant neoplasms, as well as the prognosis. The study included 58 patients with extranodal NHLs of the oral cavity and maxillofacial region. There were 32 male and 26 female patients. The patients&amp;amp;amp;amp;amp;amp;amp;#39; ages ranged from 7 to 81 years. The most frequent sites of occurrence were the salivary glands (24 patients) and intraoral mucosa (21 patients). Other sites were the paranasal sinus (3 patients), Waldeyer ring (4 patients), bone of the jaws (3 patients), and orbit (3 patients). The histologic subtype was extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) in 21 patients, diffuse large B-cell lymphoma (DLBCL) in 19, chronic lymphocytic leukemia in 10, mantle cell lymphoma in 4, follicular lymphoma in 2, Burkitt lymphoma/leukemia in 1, and B-cell acute lymphocytic leukemia (B-ALL) in 1. Of the DLBCL cases, 13 were stage IIE and 6 were stage IE. All the MALT lymphomas were stage IE. The mean follow-up was 5 years after the initial diagnosis. A better prognosis was found in patients with MALT lymphomas (19 of 21 patients are alive) compared with those with DLBCLs (10 of 19 patients are alive). MALT lymphomas have a more favorable outcome (about 90%) in comparison with DLBCLs. Careful examination of the oral cavity and neck by the maxillofacial surgeon is essential for the diagnosis and staging of lymphomas.
Australian Dental Journal, Mar 1, 1999
Chondrosarcoma (CHS) is an uncommon malignant tumor of unknown etiology, which is characterized b... more Chondrosarcoma (CHS) is an uncommon malignant tumor of unknown etiology, which is characterized by the production of cartilaginous tissue and the absence of production of bone tissue. Maxillary and mandibular localizations of CHS are extremely rare and have a poor prognosis. Usually, the lesion presents as a slow growing painless swelling, firm to palpation, frequently associated with paraesthesia and loosening of teeth. Radiographically, CHS is characterized from radiopaque and radiolucent areas, either alone or in combination. The most acceptable treatment is wide local resection with a tumor-free margin of 2 to 3 cm. This article presents the case of an 80-year-old woman with a large tumor mass that had originated in the mandible, resulting in facial asymmetry, and speech and feeding difficulties. The clinical course and characteristics with the radiopaque features of the tumor and the final microscopic examination of the specimen set the diagnosis of a mandibular CHS. The epidem...
Annals of dentistry
Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. ... more Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. We present the clinical features and outcomes of four cases in minor salivary glands and of 69 additional cases previously reported in the literature. The tumor occurs most frequently in the sixth and seventh decades of life with a 3.8:1 male preponderance. The prognosis is dismal. Sixty-one percent of patients were dead within 5 months to 10 years (mean 25 months) and the rate of lymph node metastasis was 60%. Twenty-eight percent of patients were without evidence of the disease for 13 months to 9 years (mean 33 months). The histologic features, differential diagnosis, and origin of SDC are discussed.
Dentistry Journal
The purpose of this article is to present four new cases of peripheral osteoma of the mandibular ... more The purpose of this article is to present four new cases of peripheral osteoma of the mandibular condyle and the literature review. A retrospective study of files from our Department of Oral and Maxillofacial Surgery over the last 6 years revealed four cases of peripheral osteomas located in the area of the mandibular condyle. Diagnostic procedure included clinical, radiographic, and histologic criteria. Gardner’s syndrome was excluded from patient history and clinical evaluation. One patient had only an aesthetic disturbance, with facial swelling, and the other three patients presented disturbances of the mandibular function, including deviation during mouth opening along with malocclusion. Three of the patients were male and one was female; all were of middle age (45–65 years old). The proposed surgical treatment was accepted by half of the patients, while the remaining half declined the operation after a confirmation of the diagnosis. Peripheral osteomas of the maxillofacial regi...
Journal of Oral and Maxillofacial Surgery, May 1, 2007
Purpose: The purpose of this study was to access the reliability and use of the superiorly based ... more Purpose: The purpose of this study was to access the reliability and use of the superiorly based platysma flap for reconstruction of small and medium oral defects. Patients and Methods: This case series consists of 5 patients who were reconstructed with a superiorly based platysma flap for defects of the following oral region: buccal mucosa, floor of the mouth, and lateral gingiva. The flaps were monitored for complications, including skin loss and ischemia in the postoperative period. Results: Three patients (60%) had some skin sloughing in the recipient site. None of the patients had complications in the donor site. Conclusion: The superiorly based platysma flap can survive after the facial artery has been ligated, which is the normal procedure during neck dissection. If skin sloughing occurs, it is usually inconsequential for intraoral reconstruction because the underlying muscle remains viable and undergoes epithelialization.
Balkan Journal of Stomatology, 2003
Many studies have been made in the past in an effort to understand the pathogenetic factors that ... more Many studies have been made in the past in an effort to understand the pathogenetic factors that are involved in the development of fibrous dysplasia and McCune-Albright syndrome. Recently, with the aid of cellular and molecular biology, the implication of G protein mutations have been demonstrated to be a crucial etiopathogenetic factor for the manifestations of these disorders. In this paper, we present the most recent data regarding the etiology of monostotic and polyostotic fibrous dysplasia, as well as of McCune-Albright Syndrome, and discuss different sights of the above disorders associated with molecular changes.
Oral and Maxillofacial Surgery, Apr 6, 2010
Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spr... more Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spreads into the surrounding tissues by direct infiltration whereas spread by hematogenous dissemination is relatively unusual, and most commonly involves the lung, bone, and liver. The involvement of oral and maxillofacial region is extremely rare in gynecological cancer. In this paper, we present an unusual case of a metastatic squamous cell carcinoma originating in the infratemporal fossa of a 37-year-old woman who had underwent a subtotal hysterectomy, for squamous cell carcinoma of the cervix, 22 months earlier. A whole-body CT scan revealed a mass of enlarged lymph nodes in the mediastinum as well. The patient, who had presented for evaluation of a rapidly increasing trismus associated with deep intermittent facial pain and temporal swelling had initially been treated for a TMJ dysfunction and later for an infratemporal fossa abscess for long before a definite diagnosis was made. A high index of suspicion is possible to make an early diagnosis, which when coupled with an aggressive management can improve survival and quality of life.
Balkan Journal of Stomatology, 2010
Conservative and surgical methods utilized so far to treat temporomandibular disorders have demon... more Conservative and surgical methods utilized so far to treat temporomandibular disorders have demonstrated inconsistent results. Tissue engineering is a new, rapidly expanding, multidisciplinary field aiming to generate tissue and organ substitutes in vitro. Stem cells have already shown the potential to form multiple tissue types. Thus, their ability could be incorporated in contemporary paradigms to reconstruct the temporomandibular joint disc, though such attempts are rare. This review points out the unique histological and biomechanical character of the disc, trying to delineate the basic parameters that need to be considered in this process. In fact, the histological character of the disc cannot be defined as hyaline cartilage but fibro-cartilage. Particularly, the type I fibrillar collagen prevalence and relatively low glucosamino-glycan content, along with their specific topographic arrangement and distribution, correspond to the cellular content and correlate to the biomechanical characteristics of the disc, which mirror its functional role. Here, the various biomaterials, biochemical and biomechanical stimuli utilized for the reconstruction of hyaline cartilage are explored, since the experience and knowledge from these research fronts offer a useful guideline for the reconstruction of the temporomandibular joint disc. The cross-talk between these advancing scientific fields, together with a deeper comprehension of the physiology and pathophysiology of the temporomandibular complex can act as a catalyst, elevating the prospects of the disc's regeneration to new heights.
Clinical advances in periodontics, May 1, 2017
Introduction: Aggressive periodontitis (AgP), according to the diagnostic criteria set by the Ame... more Introduction: Aggressive periodontitis (AgP), according to the diagnostic criteria set by the American Academy of Periodontology, is an infrequent periodontal disease. However, certain cases originally diagnosed as AgP due to young age and the involvement of first molars, when not responding to therapy, can diagnostically involve more severe systemic conditions such as the rare disorder Langerhans cell histiocytosis (LCH).Case Presentation: A 25‐year‐old white male, with no known systemic diseases, was referred to the Postgraduate Clinic of the Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece. Clinical and radiographic examination and comparison with a previous evaluation revealed a rapidly progressive lesion involving the molar region in all quadrants, although the patient had been treated by a periodontist during the last 2 years. Molars were extracted and biopsies taken, which demonstrated morphologic and immunohistochemical characteristics leading to the diagnosis of LCH. The patient was referred to a hematology clinic, where he received a comprehensive examination and chemotherapy. The patient did not further comply with his proposed medical treatment and therefore 2 years later appeared with a progressing lesion in the molar area. He was re‐treated by further extractions and closure of a sinus perforation. He was persuaded to continue the treatment plan and received supportive periodontal treatment every 3 months. Regular medical and periodontal checkups show that his condition remains stable during the last 5 years.Conclusion: Periodontists should be aware of rare systemic conditions mimicking AgP and immediately refer the patient accordingly.
PubMed, Mar 1, 1991
An extensive hemangioma of the lower face is discussed as an example illustrating the use of ther... more An extensive hemangioma of the lower face is discussed as an example illustrating the use of therapeutic--particularly preoperative--arterial embolization in the treatment of extensive facial hemangiomas. In this procedure a thrombusinducing material is inserted into the lumen of a blood vessel to occlude this vessel, and thus to reduce blood flow to the lesion. This promising technique opens up new possibilities in the treatment of extensive hemangiomas of the maxillofacial region. It may be used either as a definite therapy or as pretreatment procedure enabling a safer and simpler surgical approach.
Oral Oncology Supplement, Jul 1, 2009
Oral Oncology Supplement, 2005
Introduction: Tongue cancer In young adults under tile age of 45 years has been specially studied... more Introduction: Tongue cancer In young adults under tile age of 45 years has been specially studied due to the fact that it arises early at patients who have not been exposed or shghtly exposed to mutation t~actors, suggesting a more aggressive behavior. Purpose of this work as to study the literature for this theoretically possible dafferent biological behavior of tongue cancer in young patients and to present 10 new cases Materials and Methods: During the period 1999-2003, 141 pataents suffering from squanlous cell carclnonla of tile oral cavity were treated. Thirty five of them had tongue cancer. Ten of those were under the age of 45 years. The mean age of this latter group was 38.1 years old. Eight of them were staged as T1, 1 as T2 and 1 as T4. Nine had negative neck for enlarged nodes and 1 was staged as N3. All of them were surgically treated with wide local excision of the primary ~inor combined with neck dissection. Results: In 64.17% of all patients with cancer the tumor occurred at the tongue. 7.10'0 of all patients had tongue cancer and were under tile age of 45 years old. Tile final pTNM staging revealed 2 patients being of N1 stage. Four patients received adjuvant radiotherapy. The mean follow up period was 31.9 inonti~s. All of ten are ahve. Nine are free of disease. One presented with recurrence 14 months after and underwent combined radlo-chelnotherapy and salvage operation. She is free of disease for 5 years. Conclusion: Tile survival rates of young patients suffering from tongue cancer are slrmlar to those of older patients. There time Interval between the lmtlal therapy and the recurrence is wider among the young patients. However, according to large series, we agree that there is no need for more aggressive treatment as m our group occurred.
Journal of Oral and Maxillofacial Surgery, 2008
Purpose: To present a treatment plan for localized mucosa-associated lymphoid tissue lymphoma of ... more Purpose: To present a treatment plan for localized mucosa-associated lymphoid tissue lymphoma of the orbit in order to preserve vital structures and function from the side effects of radiotherapy. Materials and Methods: Study of 2 clinical cases by means of clinical and radiologic examination, with 2 and 3 years follow-up, respectively. Results: Immediate remission of the disease after 6 cycles of chemotherapy, with no signs of recurrence after 2 and 3 years. Clinical examination of the oculomotor mechanism and visual activity gave excellent results. Conclusion: Although radiotherapy is preferable for localized lymphoproliferative lesions, chemotherapy should also be considered as an effective treatment that preserves the integrity and function of the ocular adnexa.
British Journal of Oral & Maxillofacial Surgery, Sep 1, 2016
Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defec... more Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defects in terms of postoperative complications, recovery of sensitivity, and quality of life. We organised a retrospective cohort study of 49 patients who had had intraoral reconstruction with nasolabial pedicled (n-= 13) and island (n = 36) flaps. Twenty-two patients filled in a validated quality-of-life (QoL) questionnaire and we did sensitivity tests (sharp discrimination with the aid of a Semmes-Weinstein TM aesthesiometer). Descriptive and bivariate statistics were computed and probabilities of 0.05 were accepted as significant. There were 11 flap-related complications (22%), and the flap was totally necrotic in three patients (6%), all of whom had island flaps. There was a significant association between flap-related complications and the use of reconstruction plate p = 0.001, 95% CI 2.36 to 11.37) and advanced stage (T3 and T4 p = 0.01, 95% CI 1.45 to 5.26). Skin sensitivity recovered in both island and pedicled flaps. Patients treated with island flaps had significantly more problems with prosthetic rehabilitation than those treated with pedicled flaps. The relatively low morbidity and adequate functional and aesthetic results make the pedicled nasolabial flap a viable technique. Deepithelialisation of the pedicle in island flaps permits coverage of defects with unilateral flaps in a one-stage reconstruction. However, the pedicle may be excessively stretched, leading to ischaemic complications.
Journal of Oral and Maxillofacial Surgery, May 1, 1997
PubMed, Apr 1, 2008
Background: Although several studies have examined use of collagen membranes in guided bone regen... more Background: Although several studies have examined use of collagen membranes in guided bone regeneration (GBR), none has examined the use of human fascia temporalis as a bioabsorbable barrier. The majority of studies related to GBR have examined critical size defects. We sought to assess the human fascia temporalis and other well-documented membranes applied for GBR in mandibular osseous defects beyond critical size. Material/methods: Fifty adult male New Zealand white rabbits were used in this study. Five groups of 10 animals each were used: HFL (human fascia lata membrane), HP (human pericardium), HFT (human fascia temporalis), BP (bovine pericardium), and PTFE (expanded polytetrafluoroethylene). Animals were killed 10 weeks after membrane application. In each animal, 9-mm circular mandibular defects were created bilaterally. On 1 side of the jaw, the defect was covered with 1 of the test membranes; the defect on the other side served as a control. Harvested specimens were examined histologically. Results: Membranes were significantly superior to the controls in all animals (P<0.001). Paired comparisons showed that groups HFL, HP, BP, and PTFE were significantly superior to HFT (P<0.05). Conversely, comparisons of HFL-HP, HFL-BP, HFL-PTFE, HP-BP, HP-PTFE, and BP-PTFE, showed no significant differences (P>0.05). Conclusions: According to our results, the fascia temporalis is not recommended for GBR techniques. The fascia lata, human pericardium, bovine pericardium, and e-PTFE advance bone regeneration and can be successfully used as GBR membranes for osseous defects beyond the critical size.
Balkan Journal of Stomatology, 2006
... Balkan Journal of Stomatology. 2006, vol. 10, br. 1, str. 48-52. jezik rada: engleski prikaz ... more ... Balkan Journal of Stomatology. 2006, vol. 10, br. 1, str. 48-52. jezik rada: engleski prikaz slučaja. ... Suba, ZS, Nemeth, ZS, Gyulai-Gaal, SZ, Ujpal, M., Szende, B., Szabo, GY (2003) Malignant myoepithelioma. Clinicopathological and immunohistochemical characteristics. ...
Quintessence International, Jun 1, 2008
Ameloblastic fibroma (AF) is an uncommon benign odontogenic mixed tumor. A case of an AF associat... more Ameloblastic fibroma (AF) is an uncommon benign odontogenic mixed tumor. A case of an AF associated with unerupted and missing teeth is presented. A 13-year-old girl was referred for evaluation of a painless swelling of her right mandible. The most remarkable finding was the resorption of the proximal root of the permanent first molar. The lesion was completely enucleated. Follow-up showed satisfactory bony healing, and the resorbed root was completely surrounded by a continuous layer of intact lamina dura. In most cases, the patient presents to the clinician complaining of an unerupted tooth at the posterior area of the mandible. The most remarkable finding in our case, however, was the coexisting root resorption. This finding could indicate a more aggressive form of AF. AF has a very good prognosis. Malignant transformation is extremely rare.
Journal of Oral and Maxillofacial Surgery, Dec 1, 2012
Approximately one third of non-Hodgkin lymphomas (NHLs) arise in tissues other than the lymph nod... more Approximately one third of non-Hodgkin lymphomas (NHLs) arise in tissues other than the lymph nodes. The purposes of this study are to evaluate the clinical outcome of NHLs of the oral cavity and maxillofacial region in a group of 58 patients who were diagnosed in our clinic and to discuss the clinical, histologic, and immunohistochemical features of these malignant neoplasms, as well as the prognosis. The study included 58 patients with extranodal NHLs of the oral cavity and maxillofacial region. There were 32 male and 26 female patients. The patients&amp;amp;amp;amp;amp;amp;amp;#39; ages ranged from 7 to 81 years. The most frequent sites of occurrence were the salivary glands (24 patients) and intraoral mucosa (21 patients). Other sites were the paranasal sinus (3 patients), Waldeyer ring (4 patients), bone of the jaws (3 patients), and orbit (3 patients). The histologic subtype was extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) in 21 patients, diffuse large B-cell lymphoma (DLBCL) in 19, chronic lymphocytic leukemia in 10, mantle cell lymphoma in 4, follicular lymphoma in 2, Burkitt lymphoma/leukemia in 1, and B-cell acute lymphocytic leukemia (B-ALL) in 1. Of the DLBCL cases, 13 were stage IIE and 6 were stage IE. All the MALT lymphomas were stage IE. The mean follow-up was 5 years after the initial diagnosis. A better prognosis was found in patients with MALT lymphomas (19 of 21 patients are alive) compared with those with DLBCLs (10 of 19 patients are alive). MALT lymphomas have a more favorable outcome (about 90%) in comparison with DLBCLs. Careful examination of the oral cavity and neck by the maxillofacial surgeon is essential for the diagnosis and staging of lymphomas.
Australian Dental Journal, Mar 1, 1999
Chondrosarcoma (CHS) is an uncommon malignant tumor of unknown etiology, which is characterized b... more Chondrosarcoma (CHS) is an uncommon malignant tumor of unknown etiology, which is characterized by the production of cartilaginous tissue and the absence of production of bone tissue. Maxillary and mandibular localizations of CHS are extremely rare and have a poor prognosis. Usually, the lesion presents as a slow growing painless swelling, firm to palpation, frequently associated with paraesthesia and loosening of teeth. Radiographically, CHS is characterized from radiopaque and radiolucent areas, either alone or in combination. The most acceptable treatment is wide local resection with a tumor-free margin of 2 to 3 cm. This article presents the case of an 80-year-old woman with a large tumor mass that had originated in the mandible, resulting in facial asymmetry, and speech and feeding difficulties. The clinical course and characteristics with the radiopaque features of the tumor and the final microscopic examination of the specimen set the diagnosis of a mandibular CHS. The epidem...
Annals of dentistry
Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. ... more Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. We present the clinical features and outcomes of four cases in minor salivary glands and of 69 additional cases previously reported in the literature. The tumor occurs most frequently in the sixth and seventh decades of life with a 3.8:1 male preponderance. The prognosis is dismal. Sixty-one percent of patients were dead within 5 months to 10 years (mean 25 months) and the rate of lymph node metastasis was 60%. Twenty-eight percent of patients were without evidence of the disease for 13 months to 9 years (mean 33 months). The histologic features, differential diagnosis, and origin of SDC are discussed.
Dentistry Journal
The purpose of this article is to present four new cases of peripheral osteoma of the mandibular ... more The purpose of this article is to present four new cases of peripheral osteoma of the mandibular condyle and the literature review. A retrospective study of files from our Department of Oral and Maxillofacial Surgery over the last 6 years revealed four cases of peripheral osteomas located in the area of the mandibular condyle. Diagnostic procedure included clinical, radiographic, and histologic criteria. Gardner’s syndrome was excluded from patient history and clinical evaluation. One patient had only an aesthetic disturbance, with facial swelling, and the other three patients presented disturbances of the mandibular function, including deviation during mouth opening along with malocclusion. Three of the patients were male and one was female; all were of middle age (45–65 years old). The proposed surgical treatment was accepted by half of the patients, while the remaining half declined the operation after a confirmation of the diagnosis. Peripheral osteomas of the maxillofacial regi...
Journal of Oral and Maxillofacial Surgery, May 1, 2007
Purpose: The purpose of this study was to access the reliability and use of the superiorly based ... more Purpose: The purpose of this study was to access the reliability and use of the superiorly based platysma flap for reconstruction of small and medium oral defects. Patients and Methods: This case series consists of 5 patients who were reconstructed with a superiorly based platysma flap for defects of the following oral region: buccal mucosa, floor of the mouth, and lateral gingiva. The flaps were monitored for complications, including skin loss and ischemia in the postoperative period. Results: Three patients (60%) had some skin sloughing in the recipient site. None of the patients had complications in the donor site. Conclusion: The superiorly based platysma flap can survive after the facial artery has been ligated, which is the normal procedure during neck dissection. If skin sloughing occurs, it is usually inconsequential for intraoral reconstruction because the underlying muscle remains viable and undergoes epithelialization.