Dental Implants Installed in Irradiated Jaws – A Systematic Review

Source: Journal of Dental ResearchPublished: October 24, 2013By: 1. L. Chambrone12. J. Mandia Jr23. J.A. Shibli34. G.A. Romito1,*5. M. Abrahao21. 1Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil 2. 2Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil 3. 3Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, SP, Brazil 1. ↵*garomito@usp.br  Abstract The aim of this study was to assess the survival rate of titanium implants placed in irradiated jaws. MEDLINE, EMBASE, and CENTRAL were searched for studies assessing implants that had been placed in nongrafted sites of irradiated patients. Random effects meta-analyses assessed implant loss in irradiated versus nonirradiated patients and in irradiated patients treated with hyperbaric oxygen (HBO) therapy. Of 1,051 potentially eligible publications, 15 were included. A total of 10,150 implants were assessed in the included studies, and of these, 1,689 (14.3%) had been placed in irradiated jaws. The mean survival rate in the studies ranged from 46.3% to 98.0%. The pooled estimates indicated a significant increase in the risk of implant failure in irradiated patients (risk ratio: 2.74; 95% confidence interval: 1.86, 4.05; p < .00001) and in maxillary sites (risk ratio: 5.96; 95% confidence interval: 2.71, 13.12; p < .00001). Conversely, HBO therapy did not reduce the risk of implant failure (risk ratio: 1.28; 95% confidence interval: 0.19, 8.82; p = .80). Radiotherapy was linked to higher implant failure in the maxilla, and HBO therapy did not improve implant survival. Most included publications reported data on [...]

2013-10-31T17:53:12-07:00October, 2013|Oral Cancer News|

Dental hygienist, consultant detects own oral cancer

Source: www.dentistryiq.com Author: Shelli Castor Dental hygienist and practice-management consultant Barbara Boland discovered at the young age of 41 that she had oral cancer. Boland is now a 10-year cancer survivor, and she hopes her story and experiences will serve to start a continuing dialogue about oral cancer, especially among dental professionals. Boland graduated from Temple University in Pennsylvania in 1982 and has been working as a practice-management consultant for 24 years. In December 2002, she discovered a peculiar white spot on her tongue that she knew she hadn’t noticed before. She kept an eye on the spot for a month, and because it was changing, she showed her tongue to a head and neck surgeon. The surgeon responded that it couldn’t be cancer for various reasons: she didn’t smoke or drink, she was female, and she was “too young” — there was no way the spot could be cancer. While such an almost flippant response to a patient’s concerns seems wildly out of place and unexpected today, Boland notes that 10 years ago, dental and medical professionals were not well-educated on the signs, symptoms, and risk factors of oral cancer. For dental and medical professionals 10 years ago, the most common risk factors included tobacco and alcohol use, age, and the fact that males had a higher incidence of oral cancer than females. Boland fit none of those categories, and so her concerns were not seen as pressing. Still, the spot on her tongue “didn’t feel right” to her. [...]

Michael Douglas: ‘Throat cancer’ was really tongue cancer

Source: cnn.com Author: Jen Christensen, CNN Michael Douglas never had throat cancer, as he told the press in 2010. The actor now says he had tongue cancer. Douglas said he hid the diagnosis at the urging of his doctor to protect his career. "The surgeon said, 'Let's just say it's throat cancer,' " Douglas told fellow actor Samuel L. Jackson for a segment that ran on British television as a part of Male Cancer Awareness Week. Douglas says that the doctor told him if they had to do surgery for tongue cancer, "it's not going to be pretty. You could lose part of your tongue and jaw." When Douglas first talked about his cancer diagnosis in the summer of 2010, he was on a worldwide publicity tour for the movie "Wall Street: Money Never Sleeps." Douglas and Jackson joked that could have been the end of his acting career. Douglas said if he had surgery he could see the director saying, "What's your good side? I've got no side over here." "There really is no such thing as throat cancer per se," explained Brian Hill, an oral cancer survivor and the founder of the Oral Cancer Foundation. Douglas has taped a public service announcement to raise awareness about oral cancer for Hill's foundation. "Throat" cancer and tongue cancer are both colloquial terms that fall under the oral cancer umbrella. Throat cancer usually refers to cancerous tumors that develop in your pharynx, voice box or tonsils. Tongue cancer refers to cancerous [...]

Positive results for Acacia in cancer drug trials

Source: http://www.businessweekly.co.uk/ Author: staff Positive results from a Phase II study of APD515 – a drug to treat xerostomia (dry mouth) in advanced cancer patients – have been reported by Cambridge UK medical technology business Acacia Pharma. The study showed that APD515 significantly reduced the symptoms of dry mouth compared to placebo. Dr Julian Gilbert, Acacia Pharma’s CEO said: “Dry mouth is a common and distressing issue in advanced cancer patients that is significantly under-recognised. “It is associated with a wide range of oral and systemic complications and can contribute to a greatly reduced quality of life. Our market research indicates that a locally delivered, liquid formulation of a suitable salivary stimulant would be of major benefit to many cancer sufferers, and these data indicate that APD515 should meet this profile.” The trial was conducted in 11 centres in the UK and Denmark and enrolled 32 patients with advanced cancer and a persistently dry mouth http://kodu.ut.ee/~roma1956/images/phocagallery2/gallery/generic-cialis.html. The study met its primary endpoint of a significant improvement in the subjective scoring of mouth dryness after one week of treatment with APD515 compared to placebo. Dr. Gabriel Fox, Acacia Pharma’s chief medical officer, added: “This was a robust trial, whose cross-over design allowed us to compare the effects of APD515 and placebo in the same patient. “The study has shown an unequivocal benefit for APD515 in advanced cancer patients suffering with a dry mouth. APD515 is the first product opportunity to be developed in this hitherto poorly managed patient group.” Initially, Acacia [...]

A woman died from throat cancer after doctors initially believed she had an eating disorder

Source: Wales Online Author: Liz Day A woman died from throat cancer after doctors initially believed her swallowing problems were caused by an eating disorder. Rosemary Young was 63 when she died five months after being admitted to hospital with depression following the suicide of her 33-year-old son Andrew Hillier. Sister Lynne Middleton said: “Her condition deteriorated dramatically until she could not swallow at all. She weighed 9st when she was admitted to hospital and less than 5st when she died. It was very distressing – every time we left the hospital, we were in turmoil.” Mrs Young, who lived in Blackwood and had two children and one grandchild, had complained of difficulty swallowing six weeks before she was admitted to the Ty Sirhowy mental health unit in September 2011. She had been due to see an ear, nose and throat specialist at the Royal Gwent Hospital, but missed the appointment due to her depression, prompting her family to ask for a referral during her admission. Mrs Middleton, who is a registered mental health nurse, said: “A week after she was admitted, I was very worried about her. She looked unkempt and was not eating, but the staff were adamant it was an eating disorder. “When they said it over and over again, I started to think they might be right, but it did not make any sense. My sister was a lady whose one joy in life was cooking. It was absolute nonsense. At dinner, they forced her to [...]

2013-10-10T10:06:41-07:00October, 2013|Oral Cancer News|

Differences in Imaging Characteristics of HPV-Positive and HPV-Negative Oropharyngeal Cancers: A Blinded Matched-Pair Analysis

Source: American Journal of Neuroradiology Please address correspondence to Dr Lawrence E. Ginsberg, Department of Diagnostic Imaging, Unit 1482, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030; e-mail: lginsberg@mdanderson.org Abstract BACKGROUND AND PURPOSE: Human papillomavirus–positive oropharyngeal cancers typically have younger age of onset, limited tobacco exposure, and more favorable prognosis than HPV-negative oropharyngeal cancers. We assessed whether HPV-positive and HPV-negative oropharyngeal cancers have consistent differences in pretreatment imaging characteristics. MATERIALS AND METHODS: A retrospective review of 136 pretreatment CT examinations of paired HPV-positive and HPV-negative oropharyngeal cancers matched for T stage, tumor subsite, and smoking status was performed with the reviewing radiologist blinded to HPV status and clinical stage. Demographic/clinical characteristics and imaging characteristics of primary lesions and metastatic nodal disease were compared by use of Fisher exact testing. The McNemar χ2 test was used for the matched-pair analysis. RESULTS: By imaging, HPV-negative tumors were more likely to demonstrate invasion of adjacent muscle (26% versus 6%, P = .013). HPV-positive primary tumors were more likely to be enhancing and exophytic with well-defined borders, whereas HPV-negative primary tumors were more likely to be isoattenuated and demonstrate ill-defined borders, though these results were not statistically significant. HPV-positive tumors were more likely to demonstrate cystic nodal metastases than HPV-negative tumors (36% versus 9%, P = .002). CONCLUSIONS: In this matched and blinded analysis of the imaging differences between HPV-positive and HPV-negative oropharyngeal cancers, HPV-positive carcinomas often had primary lesions with well-defined borders and cystic nodal metastases, whereas HPV-negative [...]

2013-10-10T09:51:39-07:00October, 2013|Oral Cancer News|

Carcinoma of the oral tongue in patients younger than 30 years: Comparison with patients older than 60 years

Source: oraloncology.comPublished Online" 07 August 2013.  Summary  Objectives The incidence of oral tongue squamous cell carcinoma is rising in young patients. This study evaluated the clinical, pathological, and prognostic characteristics of oral tongue squamous cell carcinoma in the under-30-year age group. Materials and methods The computerized database of the Department of Otolaryngology-Head and Neck Surgery of a tertiary, university-affiliated medical center was searched for all patients with oral tongue squamous cell carcinoma treated by glossectomy with curative intent in 1996–2012. Data were collected by chart review. Results Of the 113 patients identified, 16 (14%) were aged ⩽30years at presentation and 62 (55%) >60years. Mean follow-up time was 30months. Comparison by age group revealed no sex predilection and no differences in histologic grade or rates of advanced T-stage, perineural and vascular invasion, or nodal extracapsular extension. Rates of node-positive disease were 75% in the younger group and 19% in the older group (p<0.001). Kaplan–Meier analysis yielded no between-group difference in disease-free or overall survival. Recurrence was documented in a similar proportion of patients (38% and 29.9%, respectively), but half the recurrences in the younger group were distant versus none in the older group (p=0.01) All younger patients with recurrent disease died within 16months of its appearance compared to 50% 3-year disease-specific survival in the older group. Conclusions Oral tongue squamous cell carcinoma is more advanced at presentation in younger than in older patients, with higher rates of regional metastases and distant failure. Recurrent disease is more aggressive, with a fatality rate of [...]

2013-10-02T15:43:52-07:00October, 2013|Oral Cancer News|
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