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Aim: With the increasing number of older people worldwide, dentists have more opportunities to manage patients whose oral health requires attention. Such patients often need to undergo minor dental surgery to restore their oral function; however, they usually experience post‐treatment complications that directly reduce their quality of life. This study aimed to comprehensively evaluate the frequency of complications occurring after minor dental surgery and identify predictors of delayed healing (one of the most frequent complications) among patients aged over 65 years. Methods: Patients who visited the Department of Oral Diagnosis and Medicine at Hokkaido University Hospital from 2015 to 2022 were selected and classified into the non‐delayed (n = 87) and delayed (n = 19) healing groups. The clinical backgrounds of these patients were compared between the two groups. Results: Among 106 patients aged over 65 years, delayed healing (17.9%) was the most frequent complication after minor dental surgery. Serum albumin levels (odds ratio: 10.0; 95% confidence interval: 2.15–46.6) significantly differed between the delayed and non‐delayed healing groups. Multivariate logistic regression analysis revealed that a serum albumin level of <3.5 g/dl (odds ratio: 10.1; 95% confidence interval: 1.83–56.2) was significantly associated with delayed healing. Conclusion: This study proposed that serum albumin level is a potential predictor of delayed healing in patients aged over 65 years who undergo minor dental surgery. In clinical practice, dentists are required to evaluate and improve nutritional status of older patients even before minor dental surgery. [ABSTRACT FROM AUTHOR]

The study aimed to introduce the closure technique using palatal island flap with or without hinge flap for oroantral or oronasal fistula. We explained the surgical methods, assessed the efficacy of these techniques and compared with other closure methods. This study included nine patients who were diagnosed with oroantral or oronasal fistula and underwent treatment; closure technique using palatal island flap with hinge flap (double flap closure) or that without hinge flap (single flap closure) between 2000 and 2022. Etiological factors included malignant tumors, benign tumors, cyst, and trauma. Double flap closure was performed in five cases, wherein primary closure was achieved with hinge flap created using surrounding palatal mucosa and secondary closure was achieved with palatal island flap. Single flap closure was performed in four cases. All nine patients were treated successfully, and follow-up showed no evidence of flap necrosis or major postoperative complications. The main advantages of this double flap closure technique include effective primary closure with hinge flap, which can prevent perforation into the nasal cavity and/or sinus even if the secondary flap (palatal island flap) becomes loose due to palatal mucosa irritation, and rich blood supply in the palatal island flap from the greater palatine artery. These factors confirm the validity of this technique. Secure closure with single palatal island flap was achieved; however, more secure closure can be achieved by using double flap closure technique. Therefore, it is important to choose single or double flap closure technique depending on the case. [ABSTRACT FROM AUTHOR]

Aim: Oral candidiasis is often complicated by other oral diseases, and long‐term follow‐up is essential because oral candidiasis often recurs. Failure to provide appropriate treatment for oral candidiasis will lead to persistence of the fungal cell in the oral cavity and increase the risk of severe oral candidiasis and recurrence of infection. We hypothesized that various inflammatory cytokines are involved in the pathogenesis and progression of oral candidiasis. Methods: We measured cytokine levels in the saliva samples of candida‐negative and candida‐positive patients. Results: Saliva interleukin (IL)‐17 concentrations were significantly lower in patients with oral candidiasis than in healthy individuals. Saliva IL‐17A concentrations were significantly lower in candida‐positive patients than in candida‐negative patients. However, the levels of tumor necrosis factor‐α, IL‐2, IL‐4, IL‐5, and IL‐6 showed no significant differences between the two groups of patients. Conclusion: Saliva IL‐17A levels were significantly lower in patients with severe oral candidiasis, providing a potentially highly useful indicator for the pathogenesis and progression of severe oral candidiasis. [ABSTRACT FROM AUTHOR]

Delayed healing of the extraction socket is not uncommon when tooth extraction is performed on patients taking prednisolone. This study aimed to identify specific dosage of prednisolone and factors associated with delayed healing of the extraction socket in patients taking prednisolone. This single-center retrospective study included 80 patients who underwent tooth extraction under local anesthesia and were taking prednisolone orally. Patients were divided into the nondelayed healing group (n = 50) and delayed healing group (n = 30), and their background and dosage of prednisolone were compared. The dosage of prednisolone was significantly higher in the delayed healing group than in the nondelayed healing group. A receiver operating characteristics curve analysis resulted in moderate accuracy when the cutoff value was set at 8.0, with 67% sensitivity, 76% specificity, and 0.765 area under the curve. The multivariate logistic regression analysis revealed that prednisolone dosage >8.0 mg/day (odds ratio [OR], 10.8; 95% confidence interval [CI], 2.79–41.6) and osteosclerotic changes beyond the alveolar bone around the tooth to be extracted (OR, 10.3; 95% CI, 2.81–37.8) in X-ray imaging had significant effects on delayed healing. The results of this study suggested that delayed healing following tooth extractions in patients taking prednisolone was related to a dosage of 8.0 mg/day or higher and osteosclerotic changes. [ABSTRACT FROM AUTHOR]

The global prevalence of oral squamous cell carcinoma (OSCC) has been increasing. OSCC at the advanced stage tends to resist conventional treatment and causes local recurrence and distant metastasis, resulting in poor prognosis. Therefore, detecting this cancer at an early stage and performing early intervention are important. Promising biomarkers to detect OSCC have yet to be established; however, microRNAs (miRNAs/miRs) serve a crucial role in OSCC tumorigenesis and may be potential biomarkers. In the present case report, the availability of salivary miRNAs as a therapeutic and prognostic marker for patients with OSCC was assessed. The patient was a 33-year-old woman who was diagnosed with advanced OSCC of the tongue, and their miRNA profile isolated from a saliva sample at each clinical course was evaluated. Microarray analysis of the salivary samples revealed changes in the levels of four miRNAs (hsa-miR-6798-5p, miR-6803-5p, miR-6805-5p and miR-6845-5p) in accordance with the clinical course. Neoadjuvant chemotherapy and surgical procedure decreased the levels, whereas the levels increased when the patient was diagnosed with lung metastasis. Furthermore, tongue and lung metastatic lesion specimens exhibited expression of the vascular endothelial growth factor receptor-2, which is regulated by the four miRNAs. Accordingly, the present report proposed that salivary miRNAs could be a therapeutic and prognostic biomarker for OSCC. [ABSTRACT FROM AUTHOR]

Tumor blood vessels play important roles in tumor progression and metastasis. Targeting tumor endothelial cells (TECs) is one of the strategies for cancer therapy. We previously reported that biglycan, a small leucine‐rich proteoglycan, is highly expressed in TECs. TECs utilize biglycan in an autocrine manner for migration and angiogenesis. Furthermore, TEC‐derived biglycan stimulates tumor cell migration in a paracrine manner leading to tumor cell intravasation and metastasis. In this study, we explored the therapeutic effect of biglycan inhibition in the TECs of renal cell carcinoma using an in vivo siRNA delivery system known as a multifunctional envelope‐type nanodevice (MEND), which contains a unique pH‐sensitive cationic lipid. To specifically deliver MEND into TECs, we incorporated cyclo(Arg–Gly–Asp–D–Phe–Lys) (cRGD) into MEND because αVβ3 integrin, a receptor for cRGD, is selective and highly expressed in TECs. We developed RGD‐MEND‐encapsulating siRNA against biglycan. First, we confirmed that MEND was delivered into OS‐RC‐2 tumor‐derived TECs and induced in vitro RNAi‐mediated gene silencing. MEND was then injected intravenously into OS‐RC‐2 tumor‐bearing mice. Flow cytometry analysis demonstrated that MEND was specifically delivered into TECs. Quantitative RT‐PCR indicated that biglycan was knocked down by biglycan siRNA‐containing MEND. Finally, we analyzed the therapeutic effect of biglycan silencing by MEND in TECs. Tumor growth was inhibited by biglycan siRNA‐containing MEND. Tumor microenvironmental factors such as fibrosis were also normalized using biglycan inhibition in TECs. Biglycan in TECs can be a novel target for cancer treatment. [ABSTRACT FROM AUTHOR]

We report a clinical technical note of a patient for whom open surgery of temporomandibular joint (TMJ) mobilization was performed for treating bilateral TMJ ankylosis where the temporoparietal fascia flap (TPFF) was found to be useful. We infer that using such biological tissues prevents postoperative readhesion of the TMJ. The TPFF is often used in craniofacial reconstructive surgery and has been found to be useful in covering wounds and filling dead spaces. Our patient was a female in her 70s, and she was earlier diagnosed with bilateral osteoarthritis of the TMJ and underwent bilateral TMJ release surgery at different hospital. However, she had not received enough mouth opening training exercises after surgery. She was referred to our hospital, where we established a diagnosis of bony ankylosis in bilateral TMJ. After performing open surgery of TMJ mobilization, we completed the surgery by performing reconstruction with filling of the TPFF. She then had a favorable course after 19 days of surgery and was discharged from the hospital. This technical note recommends the need for continuous postoperative mouth opening exercises and periodic follow-up by computed tomography to prevent readhesion of the incision by bone hyperplasia in patients with TMJ ankylosis. [ABSTRACT FROM AUTHOR]

Medication‐related osteonecrosis of the jaw (MRONJ) has been commonly known as a adverse side effect of antiresorptive or antiangiogenic agents for the treatment of osteoporosis patients. Although there is considerable evidence on the occurrence of MRONJ in the literature, the number of studies focusing on Stage 3 MRONJ attributable to oral administration of bisphosphonates (BPs) in patients with osteoporosis is limited. The patient had exposed necrotic bone in the mandible and pus discharge through an extraoral fistula attributed to an oral BPs for the treatment of steroidal osteoporosis. She was diagnosed with Stage 3 MRONJ. She had no other identifiable cause of mandible necrosis. Given the severity and risk of pathological fractures of the mandibular bone, an extensive surgical therapy was performed after failure of compressive conservative therapy. Our surgical treatment satisfied the patient with regard to esthetics, leading to a dramatic improvement in her quality of life for 5 years after surgery. We report a case of Stage 3 MRONJ associated with BP administration for steroid‐induced osteoporosis and discuss esthetically successful reconstruction of the mandible using mandibular reconstruction plates following segmental mandibulectomy. To prevent such severe complications, it is important to develop appropriate medical and surgical treatment strategy for immunosuppressed patients with osteoporosis. [ABSTRACT FROM AUTHOR]

Tracing the movements of foreign bodies is challenging after they aberrantly migrate into the soft tissues. Oral soft tissues are extremely mobile and move in a coordinated and highly complex manner during mastication, deglutition, and phonation. This report presents three cases of aberrantly migrated foreign bodies within the soft tissues of the oral cavity. In the first case, a fractured broach used for root canal treatment entered the oral cavity and moved within the soft tissues, making it difficult to identify its position. In the second case, the tip of a chopstick was embedded within the tissues in the palate, and in the third case, a broken needle was embedded in the left maxilla. It was possible to locate and remove the objects in Cases 1 and 2 (broach and chopstick, respectively); however, attempts to remove the object in Case 3 were unsuccessful due to its location behind the maxillary tuberosity. Foreign bodies that enter into the soft tissues migrate in response to the complex and frequent movements of the oral cavity and, ultimately, get embedded at locations away from their original point of entry. Therefore, dentists need to exercise caution while using instruments such as endodontic file and dental needle, and be completely aware of the difficulties involved in removing migrated and embedded foreign bodies. [ABSTRACT FROM AUTHOR]