Due to the anatomical and functional complexity of the region, craniofacial tumor removal requires some of the most challenging surgical approaches, often complemented with advanced chemo-radiotherapy techniques. However, these modern therapies often lead to sequelae that can drastically reduce the quality of life for the surviving patients. Recent advances in the field of regenerative medicine opened new avenues for craniofacial reconstruction following head and neck cancer treatment. One of the most promising recent strategies relies on the use of autologous fat transplant. In this mini review, we briefly present some of the fat’s biological properties that make it an ideal tissue for craniofacial reconstruction following cancer treatment. We then outline the recent advances that led to a better understanding of the detailed anatomy of the craniofacial fat depots. Furthermore, we provide a succinct review of the methods used for fat harvesting, processing and engrafting in the craniofacial area after head and neck tumor removal, discussing their main applications, advantages and limitations.
BackgroundLimited information is available about the involvement of human papillomavirus (HPV) in head and neck squamous cell carcinomas (HNSCCs) in Romanian patients.ObjectiveTo evaluate the HPV-attributable fraction in HNSCCs collected in Northeastern Romania.Materials and methodsIn total, 189 formalin-fixed paraffin-embedded tissue samples (99 oral cavity tumors, 28 oropharynx, 48 pharynx, and 14 larynx/hypopharynx) were analyzed for HPV DNA and RNA using Luminex-based assays, and for overexpression of p16INK4a (p16) by immunohistochemistry.ResultsOf the 189 cases, 23 (12.2%) were HPV DNA-positive, comprising half of the oropharyngeal cases (14/28, 50.0%) and 9/161 (5.6%) of the non-oropharyngeal cases. HPV16 was the most prevalent HPV type (20/23, 86.9%), followed by HPV18 (5/23, 21.7%) and HPV39 (1/23, 4.3%). Only two (2/189, 1.1%) HNSCC cases were HPV-driven, i.e. positive for both HPV DNA and RNA.ConclusionA very small subset of HNSCC cases within this cohort from Northeastern Romania appeared to be HPV-driven.
This paper aims to synthesize the main categories of biomaterials (bone substitutes, collagen membranes) used in the reconstruction of oral bone defects and alveolar augmentation by guided bone regeneration technique. The review of literature data shows that guided bone regeneration technique offers reliable and predictable results in the implant-prosthetic treatments.
The present study aimed to determine the frequency of herpesviruses in gingival fluid samples in patients with periodontitis HIV compared to HIV-negative subjects. Gingival crevicular fluid samples were obtained from 28 patients with HIV-positive periodontitis and from 14 patients with HIV seronegative periodontitis. Herpesviruses have been identified by PCR amplification methods. In HIV-positive patients, the most prevalent herpes virus was HCMV, followed by HHV-6 and HHV-7. In non-HIV-related periodontitis, HCMV was identified in 11 samples and EBV-1 in 8 samples, followed by HSV (7 samples). HIV seropositive samples showed an average of 4.0 herpesviruses and HIV-seronegative individuals averaging 1.4 herpesviruses. EBV-2 and HHV-8 were detected exclusively in subgingival samples from HIV-positive patients. HIV-induced activation of herpes viruses may be a stimulating factor for rapid periodontal destruction. Patients with severe immunosuppression may experience herpesvirus-mediated gingival necrosis. The hypothesis that HIV periodontitis is the result of a combined infection of herpesviruses and bacterial pathogens should be studied further.
Dental pathology is commonly described among patients with systemic sclerosis (SSc), a multisystem autoimmune disorder, and assumed to be multifactorial. We aimed to evaluate the periodontal status and to identify potential relation with SSc-specific parameters as well as serum lipid profile in a cross-sectional study on consecutive SSc. Standard assessments comprised dual, rheumatologic (disease subtype, clinical spectrum, inflammatory, immunological, lipid metabolism - total cholesterol and fractions, triglycerides), and dental evaluation (plaque index, bleeding on probing, pocket depth, clinical attachment level). 70.96% SSc developed oral manifestations, 51.61% periodontal disease, while one third severe aggressive periodontitis, particularly in diffuse SSc (p[0.05). Abnormal lipid pattern (low serum HDL- and high LDL-cholesterol, increased serum triglycerides, without significant modification in total cholesterol level) significantly correlated with diffuse SSc and skin involvement, disease duration, anti-topoisomerase 1 positivity, SSc activity and severity, as well as periodontitis (p[0.05). Our results clearly define an association between the presence and severity of periodontal disease and lipid anomalies in SSc, suggesting a potential link with early atherosclerosis via gingival inflammation and altered lipid metabolism.
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