Vasilios Thomaidis

Application of PRP gel alone or in combination with guided bone regeneration does not enhance bone healing process: An experimental study in rabbits

INTRODUCTION The aim of this study was to assess the hypothesis that application of platelet-rich plasma (PRP) gel in mandibular defects in rabbits, alone or in combination with guided bone regeneration (GBR) techniques, could enhance the bone healing process. MATERIALS AND METHODS Thirty New Zealand white rabbits were used. Three groups of 10 animals each were assigned, and the animals were sacrificed after 12 weeks. During the operation, a rotating trephine bur was used to create circular defects 10-mm in diameter in the region anterior to the jaw angles. In group human fascia lata (HFL), a human fascia lata membrane was used. In group PRP, PRP gel was used to fill the defect, and in group HFL+PRP, PRP was used to fill the defect which after that was covered with a human fascia lata membrane. RESULTS In general, none of the control sides and the PRP treated sides had full development of bone or filling of the defect through bone bridging. Conversely, the sides on which the fascia lata membrane or the combination of membrane and PRP had been applied were characterized mostly by development of newly formed bone that bridged the gap. CONCLUSIONS Our results suggest that the application of PRP gel alone or in combination with GBR does not enhance bone healing process.

Epidemiology of Surgical Treatment of Nonmelanoma Skin Cancer of the Head and Neck in Greece

BACKGROUND Nonmelanoma skin cancer (NMSC) constitutes the most common malignancy in Caucasians. Epidemiological data derive, mainly, from studies in the United States, Australia, and Northern Europe, whereas data from Mediterranean Europe are scarce. OBJECTIVE To provide information on the epidemiology of surgically treated NMSC of the head and neck in the region of Thrace, Northern Greece, and to evaluate the surgical treatment given. METHODS A retrospective review of patients surgically treated from 2004 to 2006 was conducted. Data on demographics, histology and skin cancer characteristics, and treatment efficacy and recurrence rate were extracted and analyzed. RESULTS One hundred seventy‐nine NMSCs of the head and neck were excised and histopathologically confirmed in 160 patients, with the majority (58.7%) classified as Fitzpatrick skin type III. Histology included 125 basal cell carcinomas (BCCs) and 54 squamous cell carcinomas (SCCs). The mean age was 70.6 ± 10.1 (range 38–97). Tumor size ranged between 2 and 50 mm. Excision with 5‐mm margins was performed in every case, and the defects were closed mainly using local flaps. Incomplete excision was limited to 3.9% of cases, and the recurrence rate was 1.7%. The study revealed similar characteristics between BCC and SCC regarding age and sex but significant differences in terms of location and size. CONCLUSIONS Surgical resection achieves a satisfactory NMSC clearance rate in the head and neck. The authors have indicated no significant interest with commercial supporters.

Lack of periradicular healing and gradually increasing swelling two years after intentional extrusion of calcium hydroxide into periapical lesion: report of a case.

A 40-year-old female patient with noncontributory medical history presented to the postgraduate clinic of the Department of Endodontology, Aristotle University of Thessaloniki, Greece. Her chief complaint was a gradually increasing swelling in the left side of her maxilla, during the preceding 2 months. After clinical examination, the radiologic and computerized tomographic scan examinations revealed the presence of a radiopaque foreign material in contact with the apex of tooth #22, confined within the limits of a radiolucent area. On dental anamnesis and after communication with her dentist, it was concluded that calcium hydroxide was deliberately extruded for the healing of the large lesion. The patient was scheduled for periapical surgery. The histopathologic features of the lesion revealed the presence of a periapical cyst and the absence of foreign body giant cells. After an observation period of 1 year, healing was uneventful.

Bisphosphonate-induced osteonecrosis of the jaw in patients with bone metastatic, hormone-sensitive prostate cancer. Risk factors and prevention strategies.

AIMS AND BACKGROUND Evidence from the literature suggests that osteonecrosis of the jaw is emerging as a serious complication of treatment with bisphosphonates for patients with advanced prostate cancer. METHODS AND STUDY DESIGN This study is a series of 60 patients with osseous metastases from prostate cancer under complete androgen deprivation therapy. All patients also received bisphosphonates intravenously every 3 to 4 weeks. Over a period of 3 and a half years, we recorded the incidence, presenting signs and symptoms of osteonecrosis of the jaw among those patients and the diagnostic workup required. RESULTS Nine of the 60 patients with metastatic prostate cancer were found to be affected with osteonecrosis of the jaw secondary to bisphosphonate administration at the Urology Department at the University Hospital of Alexandroupolis between January 2006 and August 2009. For diagnostic reasons, all 9 patients underwent computed tomography scan and magnetic resonance imaging of the maxillary region, as well as a three-phase whole body bone scan. CONCLUSIONS; There is evidence that administration of bisphosphonates in patients with advanced prostate cancer may increase the risk of osteonecrosis of the jaw. Guidelines regarding the diagnosis and management of those patients are needed.

A record of skin creases and folds

The skin creases of the human body are features of great anatomical, morphological, and surgical interest and important for the maintenance of the contour of each anatomic area. In the literature, when referring to a skin crease, there is variation of terms used other than “crease,” such as “fold” and “sulcus,” but these terms do not accurately reflect their histology structure nor their function. In the review of literature, a record of the creases of the human body for each anatomic area, including the synonyms that are used for each crease in the literature, has been attempted. The skin crease as a fixed and permanent line, according to their histology, is related to connective tissue attachments with the underlying structures or extensions of the underlying muscle fibers in the dermis of the crease site. The skin fold is characterized by skin redundancy that is responsible partly, often in combination with connective tissue attachments, for the skin crease. It is essential to use appropriate terms that accurately reflect the anatomic structure and histology when referring to the skin lines.

Lips and Chin

The area surrounding the mouth is constituted by two anatomically and surgically related subunits: the lips and the chin. The lips are important structures that dominate in facial aesthetics but are also valuable in function being a motile organ. Its shape and thickness differs between the upper and lower lip and varies significantly from individual to individual. Structurally each lip is composed of the orbicularis muscle that is invested extraorally by the skin and subcutaneous tissue, intraorally by mucosa and submucosa, and over its free edge by the vermilion. The chin is the round-shaped area just inferior to the lower lip and corresponds to the osseous chin. Its skin, the subcutaneous tissue, and the chin muscles structure the chin. The perioral area provides flaps that mainly reconstruct only the lips and the chin. These flaps are largely based on an arterial circle that surrounds the mouth.

Scalp and Temple

Five distinct layers structure the scalp: the skin, the connective subcutaneous tissue, the galea aponeurotica and the muscles, the loose areolar tissue, and the pericranium. In the temporal region, the layers increase in number and the fascial anatomy becomes more complex. The scalp and the temple are supplied by the superficial temporal, the supraorbital, the supratrochlear, the posterior auricular, and the occipital vessels. The rich vascular network that is formed allows for the design of a great number of versatile, random, or axial pattern flaps. Robust, predominantly rotation and transposition, flaps can be derived and used for the reconstruction of even the largest defects with safety.