Based on the finding that VEGF-receptor kinase inhibition impaired collagen degradation pathways, Flt-1 may represent a candidate for therapeutic approaches in periodontitis.
A prolonged period of oral surgery is a potential risk factor of postoperative mental disorders although no such report has been published to date. We retrospectively studied perioperative features in 36 patients who underwent prolonged (10 hours or more) of oral surgery. Patients were categorized as pre-delirium (Pre-D) when they manifested 1 or 2 symptoms and delirium (D) when they showed more than 2 symptoms, according to the modified International Classification of Diseases, 10th edition. Of the 36 patients who returned to a normal mental state without drug therapy, 13 were classified as D and 14 were Pre-D. A number of patients had moderate complications preoperatively, and massive hemorrhaging occurred during the operation in some Pre-D and D patients. Age was greater in D (62.0 +/- 9.9 years) than in Pre-D (56.0 +/- 13.8 years) patients. Propofol-based general anesthesia was most commonly employed. The time prior to appearance of pre-delirium was significantly shorter in D (30.0 +/- 16.7 hours) than in Pre-D (55.0 +/- 35.0 hours) group patients. Our results indicate that, in general, patients predisposed to postoperative mental disorders have moderate complications preoperatively, are generally older than 50-years-old, receive propofol-based general anesthesia and/or experience a massive hemorrhage during the operation.
To better understand the clinical features of mass lesions of the tongue, we retrospectively evaluated frequency, recurrence rate, and complications in 296 patients who had undergone surgery for such lesions. The diagnoses were fibroma (43.6%), mucous cyst (14.2%), papilloma (11.8%), hemangioma (7.8%), granuloma (6.4%), lipoma (1.4%), schwannoma (1.0%), ectopic tonsil (0.7%), and other (13.2%). Recurrence was noted in two patients (0.7%). Twentytwo patients (7.4%) developed surgical complications, including lingual nerve paralysis (6.4%), glossodynia (0.6%), and postoperative infection (0.3%). Lingual nerve paralysis was observed in the ventral portion (42.1%) of the tongue, apex (36.8%), lateral border (10.5%), and dorsum (10.5%). When all sites were considered together, there was no significant difference in the number of patients presenting with lingual nerve paralysis (P = 0.075). However, there were significant differences in lingual nerve paralysis at the lateral border (P < 0.05), apex (P < 0.05), and dorsum (P < 0.001) but not at the ventral portion (P > 0.05) in the size of the patients with versus without it which suggests that the risk of lingual nerve paralysis is higher at the ventral tongue, regardless of tumor size. These results shed light on the clinical features of mass lesions of the tongue.
We recently encountered an interesting tumour, containing both a diffuse sclerotic border and calcified bodies, which was eventually diagnosed as a central odontogenic fibroma. The patient was a 40-year-old man with a painless radiolucent area in the crown area of the unerupted left lower third molar shown by panoramic radiography. Clinically, the lesion was thought to represent an odontogenic tumour involving a calcified body, i.e. calcifying cystic odontogenic tumour, calcifying epithelial odontogenic tumour or ossifying fibroma. Diagnosis by radiographic findings was extremely difficult.
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