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Abstract: This clinical report describes the successful management of a patient who underwent extensive resection of a maxillary cancer, by introduction of a maxillary obturator prosthesis using zygoma implants. The patient was a 57-year-old man with cancer of the upper anterior gingiva. The maxillary bone in the affected region had been extensively excised by radical surgery. Owing to loss of teeth retaining the denture, the existing prosthesis was unstable, and the patient experienced severe speech and mastication disorders. Four zygoma implants (two on each side), and two conventional dental implants (one each at both maxillary tuberosities) were used as denture retainers. The obturator prosthesis was stabilized by the implants, and the patient''s oral function improved. High-level compatibility between the implant and surrounding tissue was obtained by mucosal regeneration around the implant. The results suggest that the combination of zygoma and conventional dental implants improves postoperative oral function by facilitating retention of the obturator prostheses. [Copyright &y& Elsevier]

Abstract: Radiotherapy is commonly used to treat oral squamous cell carcinoma (OSCC), but its therapeutic effects are unpredictable. To determine which genes correlate with radiation resistance in oral cancer, the authors evaluated radiation sensitivity using a standard colony formation assay with a gene microarray system for seven OSCC cell lines. They found significant associations between dozens of gene-expression levels and radiation resistance of OSCC cell lines. Following analysis of the different radiosensitive cancer cell lines, the friend leukaemia insertion (Fli)-1 gene was selected as a prediction marker gene for OSCC radiotherapy resistance. Fli-1 expression was associated with radiation resistance in OSCC patients. These data help to predict the effects radiation therapy has on OSCC, in turn contributing to the development of alternative radiation therapies. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to measure the bone volume necessary for secondary bone grafting in the alveolar cleft using surgical simulation software based on three-dimensional computed tomography (CT) scan data, to compare this measurement with the actual volume of the bone graft, and to evaluate consistency. The subjects were 13 patients with cleft lip and palate who underwent CT using a cone-beam CT unit (CB-CT) 1 month before surgery, followed by bone grafting with particulate cancellous bone and marrow (PCBM) to close the cleft. The bone volume necessary for grafting was measured based on the CB-CT scan data. Correlation analysis, a test of the population mean between two samples, and Wilcoxon''s signed rank test were conducted between these measurements and the actual bone volume (PCBM volume) used for grafting. SPSS was used for statistical analysis, and the level of significance was set below the 5% level. The results showed a significant correlation, with no significant differences between the two in all tests. These results suggest that measuring and preoperatively calculating the bone volume necessary for bone grafting with surgical simulation software using CB-CT scan data is beneficial. [Copyright &y& Elsevier]

Abstract: This study analyzed the results of speech intelligibility tests in patients with tongue cancer who had undergone resection with the aim of making surgical recommendations for flap design and inset, to improve speech function. A total of 126 patients, enrolled from 13 Japanese institutions, were classified into 3 groups according to the resected site: lateral, anterior, and combined. The lateral group was further divided into 3 subgroups and the anterior group into 2 subgroups according to the size of resection. The speech intelligibility score was analyzed based on articulatory site and mode: 5 articulatory sites (linguodentoalveolar, linguopalatal, linguovelar, and their intermediates); and 7 articulatory modes (plosives, fricatives, affricatives, grids, nasals, vowels and semivowels). Low speech intelligibility scores were recorded at sites where flaps contribute directly to the pronunciation in the lateral and combined groups and at the anterior part of the reconstructed tongue in the anterior group. Plosives and glides displayed low values in general. A radial forearm flap had higher function in the lateral group than other flaps. The type of flap had no effect in the anterior and combined groups. Surgical techniques and flap selection to improve functional status in each type of resection are discussed. [Copyright &y& Elsevier]

Abstract: This report describes mandibular reconstruction using a 2-step bone transport technique in a cancer patient with type 2 diabetes mellitus (DM) who received radiotherapy before ablative surgery. The bone, measuring 90mm in length with the mandibular curvature and good alveolar form, was regenerated using a plate-guided method. Three implants were placed 21 months after completion of the first distraction and 14 months after the second distraction. These implants integrated successfully and have remained stable more than 2 years after loading. The results suggest that mandibular reconstruction using bone transport is possible after segmental osteotomy in irradiated cancer patients with DM, although a long treatment period is required. [Copyright &y& Elsevier]