This study aimed to identify anatomical areas where resections of oral squamous cell carcinomas (... more This study aimed to identify anatomical areas where resections of oral squamous cell carcinomas (OSCC) are significantly associated with close or positive margins. This retrospective study included 330 patients with a primary OSCC from 2010 to 2015. Patient and tumour data were categorised into three groups by R-status (R0 [clear], ≥ 5 mm, 185 patients [56.06%]; R1 [positive], < 1 mm, 24 patients [7.27%]; and R0 [close], 1-5 mm, 121 patients [36.67%]). Areas where resections were significantly associated with close or positive margins were the hard palate (p < 0.001), buccal mucosa (p = 0.03), floor of the mouth (p = 0.004), lower alveolar ridge (p = 0.01), retromolar triangle (p = 0.005), and dorsal tongue (p = 0.02). Anatomical areas were identified in the oral cavity where it is challenging to resect OSCCs with an adequate safety margin. These results may enable surgeons to achieve a postulated safe distance during tumour resection, leading to a survival benefit for patients.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2018
The current surgical techniques used in cleft repair are well established, but different centers ... more The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.
International Journal of Clinical and Experimental Pathology, 2012
Oncocytic lipoadenoma is a rare salivary gland tumour composed of adipose tissue and oncocytic ep... more Oncocytic lipoadenoma is a rare salivary gland tumour composed of adipose tissue and oncocytic epithelial cells in varied proportions. This tumour is still not included in the current WHO classification of salivary gland neoplasms. We herein report a further case of oncocytic lipoadenoma originating in the parotid gland of a 55-year-old woman. The tumour presented as a slowly growing asymptomatic left-sided parotid gland mass. The resected tumour measured 2.7 cm in maximum diameter and was composed of oncocytoma-like epithelial component admixed with mature adipocytes that made up 10% of the whole mass. Foci of sebaceous differentiation were seen. This rare variant of lipomatous salivary gland tumours is in need of more recognition and should be distinguished from other fat-containing salivary gland lesions, particularly lipomatous pleomorphic adenoma and myoepithelioma.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2016
The study aims to establish a peri-implant dehiscence-type bone defect in a diabetic animal model... more The study aims to establish a peri-implant dehiscence-type bone defect in a diabetic animal model of human bone repair and to quantify the influence of diabetes on peri-implant bone regeneration. Experimental diabetes was induced in three domestic pigs by streptozotocin. Three animals served as healthy controls. After 12 months four standardized peri-implant dehiscence bone defects were surgically created in the ramus mandibulae. The animals were sacrificed after 90 days. Samples were histologically analyzed to quantify new bone height (NBH), bone-to-implant-contact (BIC), area of newly formed bone (NFB), bone-density (BD), and bone mineralization (BM) in the prepared defect (-D) and in a local control region (-L). After 90 days, diabetic animals revealed a significantly lower BIC (p = 0.037) and BD (p = 0.041) in the defect area (-D). NBH and BM-D differences within the groups were not significant (p > 0.05). Significant more NFB was measured in the healthy control group (p = 0....
Even after adequate surgical and nonsurgical treatment, combined or isolated clefts often cause f... more Even after adequate surgical and nonsurgical treatment, combined or isolated clefts often cause functional disorders, such as speech disorders. Speech disorders vary widely in extent and can take the form, for example, of specific features of articulation, with altered nasal emission and shifted articulation, leading to reduced speech intelligibility. So far it has not been possible to describe the relationship between cleft type and intelligibility except subjective, categorical evaluation. Intelligibility of the speech as influenced by cleft palate in 58 children aged 9+/-2 was quantified objectively and numerically by means of automatic speech recognition technology in speech recordings for the PLAKSS test [test for psycholinguistic analysis of childhood speech impairments]. It was found that 33 children had a unilateral cleft lip and palate (CLP), 9, bilateral CLP, 10, isolated cleft palate, and 6, submucosal cleft palate. As a control group, 84 children aged 9+/-1 years and with physiological articulation were recruited from a mainstream school. Speech intelligibility is expressed as word accuracy, which means the percentage of correctly recognized words in a word sequence. Word accuracy levels in the control group were between 39% and 84% (mean 62%+/-10%), while the children with clefts achieved values between 0% and 73% (mean 42%+/-17%). There was no difference in intelligibility between children with isolated cleft palate and those with combined cleft type. Differences were, however, found between each group and the control group (p&amp;amp;lt;0.01). Speech intelligibility of children with isolated cleft palate does not significantly differ from that of children with combined cleft type including the palate, as has been objectively quantified for the first time by objective methods. In the presence of speech disorders, the need for diagnosis and therapy is just as great in children with isolated cleft palate as in children with combined cleft types.
Quintessence Publicacion Internacional De Odontologia, Nov 1, 2011
En odontologia, el tratamiento farmacologico del dolor de intensidad leve a moderada se basa en f... more En odontologia, el tratamiento farmacologico del dolor de intensidad leve a moderada se basa en farmacos como ibuprofeno, paracetamol y metamizol. En el paciente cronico, la obtencion de una anamnesis exhaustiva sienta las bases para un tratamiento analgesico sin complicaciones. En pacientes con hepatopatias, nefropatias y asma asi como en pacientes tratados con anticoagulantes se evitara la administracion de antiinflamatorios no esteroideos (AINE) como ibuprofeno. El paracetamol esta contraindicado tambien en las hepatopatias. En los pacientes sometidos a tratamiento anticoagulante, el paracetamol y el metamizol son buenas alternativas. Conviene limitar la duracion del tratamiento analgesico al minimo imprescindible en los pacientes con enfermedades cronicas. La administracion de metamizol a largo plazo exige controles estrechos del hemograma para detectar precozmente una posible leucopenia. Las interacciones generadas por la administracion de analgesicos en un paciente polimedicado pueden ser muy complejas. En estos casos se recomienda consultar con el medico de cabecera.
The International Journal of Oral Maxillofacial Implants, 2003
Purpose: Osseointegration of implants depends on time and the local bone conditions regarding qua... more Purpose: Osseointegration of implants depends on time and the local bone conditions regarding quality and quantity. This led to the bone classification by Lekholm and Zarb. The aim of the present study was to enhance osseointegration of implants through conditioning of the bone bed and to compare in this context the efficacy of bone condensation, an osteoinductive collagen (Colloss), and platelet-rich plasma (PRP). Materials and methods: Porcine frontal skull bone was used for the preparation of Identical-size implant beds. Before placement of the implants (Ankylos, 3.5 x 4 mm), the implant beds were untreated (control) or conditioned with condensation, Colloss, or PRP. The animals were sacrificed after 2, 4, and 8 weeks. The specimens were then compared and analyzed by microradiography, and statistical analysis was performed using the Wilcoxon signed rank test. Results: At the early observation times, significant effects on the sites of topical bone conditioning in comparison to the control group could be seen regarding the implant-bone interface (2 weeks: control 31%, Colloss 60%, condensation 73%, PRP 47%; 4 weeks: control 39%, Colloss 51%, condensation 40%, PRP 42%) and peri-implant bone density (2 weeks: control 31%, Colloss 48%, condensation 59%, PRP 39%; 4 weeks: control 47%, Colloss 53%, condensation 41%, PRP 50%). A leveling of the results between groups was found at 8 weeks (implant-bone interface: control 51%, Colloss 58%, condensation 55%, PRP 62%; peri-implant bone density: control 50%, Colloss 55%, condensation 51%, PRP 51%). Discussion: Overall, bone condensation and Colloss apparently influenced bone formation process from the onset, but over the entire 8-week healing period, differences in bone formation were not significant Conclusion: It can be stated that, in the initial healing phase, an effect of topical bone conditioning may be achieved by the different described methods.
This study aimed to identify anatomical areas where resections of oral squamous cell carcinomas (... more This study aimed to identify anatomical areas where resections of oral squamous cell carcinomas (OSCC) are significantly associated with close or positive margins. This retrospective study included 330 patients with a primary OSCC from 2010 to 2015. Patient and tumour data were categorised into three groups by R-status (R0 [clear], ≥ 5 mm, 185 patients [56.06%]; R1 [positive], < 1 mm, 24 patients [7.27%]; and R0 [close], 1-5 mm, 121 patients [36.67%]). Areas where resections were significantly associated with close or positive margins were the hard palate (p < 0.001), buccal mucosa (p = 0.03), floor of the mouth (p = 0.004), lower alveolar ridge (p = 0.01), retromolar triangle (p = 0.005), and dorsal tongue (p = 0.02). Anatomical areas were identified in the oral cavity where it is challenging to resect OSCCs with an adequate safety margin. These results may enable surgeons to achieve a postulated safe distance during tumour resection, leading to a survival benefit for patients.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2018
The current surgical techniques used in cleft repair are well established, but different centers ... more The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.
International Journal of Clinical and Experimental Pathology, 2012
Oncocytic lipoadenoma is a rare salivary gland tumour composed of adipose tissue and oncocytic ep... more Oncocytic lipoadenoma is a rare salivary gland tumour composed of adipose tissue and oncocytic epithelial cells in varied proportions. This tumour is still not included in the current WHO classification of salivary gland neoplasms. We herein report a further case of oncocytic lipoadenoma originating in the parotid gland of a 55-year-old woman. The tumour presented as a slowly growing asymptomatic left-sided parotid gland mass. The resected tumour measured 2.7 cm in maximum diameter and was composed of oncocytoma-like epithelial component admixed with mature adipocytes that made up 10% of the whole mass. Foci of sebaceous differentiation were seen. This rare variant of lipomatous salivary gland tumours is in need of more recognition and should be distinguished from other fat-containing salivary gland lesions, particularly lipomatous pleomorphic adenoma and myoepithelioma.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2016
The study aims to establish a peri-implant dehiscence-type bone defect in a diabetic animal model... more The study aims to establish a peri-implant dehiscence-type bone defect in a diabetic animal model of human bone repair and to quantify the influence of diabetes on peri-implant bone regeneration. Experimental diabetes was induced in three domestic pigs by streptozotocin. Three animals served as healthy controls. After 12 months four standardized peri-implant dehiscence bone defects were surgically created in the ramus mandibulae. The animals were sacrificed after 90 days. Samples were histologically analyzed to quantify new bone height (NBH), bone-to-implant-contact (BIC), area of newly formed bone (NFB), bone-density (BD), and bone mineralization (BM) in the prepared defect (-D) and in a local control region (-L). After 90 days, diabetic animals revealed a significantly lower BIC (p = 0.037) and BD (p = 0.041) in the defect area (-D). NBH and BM-D differences within the groups were not significant (p > 0.05). Significant more NFB was measured in the healthy control group (p = 0....
Even after adequate surgical and nonsurgical treatment, combined or isolated clefts often cause f... more Even after adequate surgical and nonsurgical treatment, combined or isolated clefts often cause functional disorders, such as speech disorders. Speech disorders vary widely in extent and can take the form, for example, of specific features of articulation, with altered nasal emission and shifted articulation, leading to reduced speech intelligibility. So far it has not been possible to describe the relationship between cleft type and intelligibility except subjective, categorical evaluation. Intelligibility of the speech as influenced by cleft palate in 58 children aged 9+/-2 was quantified objectively and numerically by means of automatic speech recognition technology in speech recordings for the PLAKSS test [test for psycholinguistic analysis of childhood speech impairments]. It was found that 33 children had a unilateral cleft lip and palate (CLP), 9, bilateral CLP, 10, isolated cleft palate, and 6, submucosal cleft palate. As a control group, 84 children aged 9+/-1 years and with physiological articulation were recruited from a mainstream school. Speech intelligibility is expressed as word accuracy, which means the percentage of correctly recognized words in a word sequence. Word accuracy levels in the control group were between 39% and 84% (mean 62%+/-10%), while the children with clefts achieved values between 0% and 73% (mean 42%+/-17%). There was no difference in intelligibility between children with isolated cleft palate and those with combined cleft type. Differences were, however, found between each group and the control group (p&amp;amp;lt;0.01). Speech intelligibility of children with isolated cleft palate does not significantly differ from that of children with combined cleft type including the palate, as has been objectively quantified for the first time by objective methods. In the presence of speech disorders, the need for diagnosis and therapy is just as great in children with isolated cleft palate as in children with combined cleft types.
Quintessence Publicacion Internacional De Odontologia, Nov 1, 2011
En odontologia, el tratamiento farmacologico del dolor de intensidad leve a moderada se basa en f... more En odontologia, el tratamiento farmacologico del dolor de intensidad leve a moderada se basa en farmacos como ibuprofeno, paracetamol y metamizol. En el paciente cronico, la obtencion de una anamnesis exhaustiva sienta las bases para un tratamiento analgesico sin complicaciones. En pacientes con hepatopatias, nefropatias y asma asi como en pacientes tratados con anticoagulantes se evitara la administracion de antiinflamatorios no esteroideos (AINE) como ibuprofeno. El paracetamol esta contraindicado tambien en las hepatopatias. En los pacientes sometidos a tratamiento anticoagulante, el paracetamol y el metamizol son buenas alternativas. Conviene limitar la duracion del tratamiento analgesico al minimo imprescindible en los pacientes con enfermedades cronicas. La administracion de metamizol a largo plazo exige controles estrechos del hemograma para detectar precozmente una posible leucopenia. Las interacciones generadas por la administracion de analgesicos en un paciente polimedicado pueden ser muy complejas. En estos casos se recomienda consultar con el medico de cabecera.
The International Journal of Oral Maxillofacial Implants, 2003
Purpose: Osseointegration of implants depends on time and the local bone conditions regarding qua... more Purpose: Osseointegration of implants depends on time and the local bone conditions regarding quality and quantity. This led to the bone classification by Lekholm and Zarb. The aim of the present study was to enhance osseointegration of implants through conditioning of the bone bed and to compare in this context the efficacy of bone condensation, an osteoinductive collagen (Colloss), and platelet-rich plasma (PRP). Materials and methods: Porcine frontal skull bone was used for the preparation of Identical-size implant beds. Before placement of the implants (Ankylos, 3.5 x 4 mm), the implant beds were untreated (control) or conditioned with condensation, Colloss, or PRP. The animals were sacrificed after 2, 4, and 8 weeks. The specimens were then compared and analyzed by microradiography, and statistical analysis was performed using the Wilcoxon signed rank test. Results: At the early observation times, significant effects on the sites of topical bone conditioning in comparison to the control group could be seen regarding the implant-bone interface (2 weeks: control 31%, Colloss 60%, condensation 73%, PRP 47%; 4 weeks: control 39%, Colloss 51%, condensation 40%, PRP 42%) and peri-implant bone density (2 weeks: control 31%, Colloss 48%, condensation 59%, PRP 39%; 4 weeks: control 47%, Colloss 53%, condensation 41%, PRP 50%). A leveling of the results between groups was found at 8 weeks (implant-bone interface: control 51%, Colloss 58%, condensation 55%, PRP 62%; peri-implant bone density: control 50%, Colloss 55%, condensation 51%, PRP 51%). Discussion: Overall, bone condensation and Colloss apparently influenced bone formation process from the onset, but over the entire 8-week healing period, differences in bone formation were not significant Conclusion: It can be stated that, in the initial healing phase, an effect of topical bone conditioning may be achieved by the different described methods.
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Papers by Emeka Nkenke