Our results indicate that PD-L1-expressing dysplastic epithelial and recruited subepithelial cells in oral precancerous legions may evade the host immune system, and that the inhibition of PD-1/PD-L1 pathway may potentially prevent malignant transformation of oral precancerous legions as well as can treat advanced cancers.
ObjectiveThe effect of direct oral anticoagulants (DOACs) on the risk of bleeding after tooth extraction remains unclear. This study aimed to evaluate the incidence of postextraction bleeding among patients who received DOAC and vitamin K antagonists (VKAs), such as warfarin.DesignThis study was a retrospective cohort analysis. Incidence rates and propensity score-matched regression models were used to compare the risks of bleeding after tooth extractions involving DOACs and VKAs.SettingThe study took place in a single university hospital in Japan.ParticipantsBetween April 2013 and April 2015, 543 patients underwent a total of 1196 simple tooth extractions.Primary outcome measureThe primary outcome measure was the occurrence of postextraction bleeding, which was defined as bleeding that could not be stopped by biting down on gauze and required medical treatment between 30 min and 7 days after the extraction.ResultsA total of 1196 tooth extractions (634 procedures) in 541 patients fulfilled the study criteria, with 72 extractions (41 procedures) involving DOACs, 100 extractions (50 procedures) involving VKAs and 1024 extractions (543 procedures) involving no anticoagulants. The incidences of postextraction bleeding per tooth for the DOAC, VKA and no anticoagulant extractions were 10.4%, 12.0% and 0.9%, respectively. The incidences of postextraction bleeding per procedure for DOACs, VKAs and no anticoagulants were 9.7%, 10.0% and 1.1%, respectively. In comparison to the VKA extractions, the DOAC extractions did not significantly increase the risk of postextraction bleeding (OR 0.69, 95% CIs 0.24 to 1.97; p=0.49).ConclusionsThe risk of postextraction bleeding was similar for DOAC and VKA extractions.
A case of dilated odontoma in the second molar region of the mandible was reported. The patient was a 14-year-old female. Panoramic X-ray and CT examination revealed an oval ring-shaped radiopaque lesion accompanying a radiolucent area in the center at the left second molar region of the mandible. The left second molar and all third molars were not found. The lesion was diagnosed as odontoma and extirpated under general anesthesia. The lesion was a spherical mass of 12x9mm. Histologically, the mass was composed of dentin arranged in an oval ring shape with dentinal tubules. Inside the dentin, immature enamel was present. The central area of the mass was filled with fibrous tissue with a small nest of bone and cementum. Bone tissue was also observed in contact with the immature enamel layer. These morphological and histological features are compatible with those of a dilated odontoma.
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