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Recent advances in molecular-targeted therapy for oral cancer
Abstracts have here their limitation and are for such reconstruction until today not an alternative due to their poor regeneration potential. Autogenous bone graft harvested from intraoral sites, especially the retromolar area of the mandible, and used following the split bone block (SBB) technique is offering many possibilities for intra operative facilities and stable long-term results. Splitting the thick cortical block to 2 or 3 thin blocks is augmenting the number of blocks allowing the reconstruction of larger atrophic crest and giving a better adaptation to the recipient site with individual determination of the width and the volume of the grafted area. Filling the space and gaps between the thin block and the remaining crest with particulate bone chips is reducing the time needed for revascularisation of the graft improving its vitality compared to the original thick block. Many studies demonstrate that the reconstruction of horizontal and vertical atrophied crest with thin mandibular blocks in combination with particulate bone grafts, without any biomaterial or membrane, offer over years, through the high vitality of the grafted and regenerated bone, a stable periimplant bone level. 15 years results on more of 1300 grafting procedure for horizontal and vertical bone augmentation present a low complication rate and showed that changes of the volume of the grafted bone occurred up to one year after the grafting procedures and stays stable for more than 15 years. Limited bone resorptions were observed, especially when the bone block was grafted outside the bone contours, but without negative influence on the definitive treatment. Implants inserted in this grafted bone presented similar osseointegration as implants placed in non-grafted bone. http://dx.doi.org/10.1016/j.ijom.2017.02.099 Development of biodegradable future suture S.G. Kim Gangneung-Wonju National University, Gangwon-do, Republic of Korea Silk suture material is mainly composed of silk fibroin, which is produced by silkworm Bombyx mori. Silk suture is regarded as non-resorbable material and it is slowly degraded by proteolysis when it is implanted into body. 4-Hexylresorcinol (4HR) is well known antiseptics. In this study, the biodegradability of the 4HR incorporated silk suture was compared to those of untreated silk suture and polyglactin 910 suture which is commercially available resorbable suture. Silk fibroin disc contained 4HR showed anti-septic property and this property was maintained after autoclaving. Matrix metalloproteinase (MMP) can digest wide spectrum of protein including collagens. 4HR increased MMP-2, -3, and -9 expression in RAW264.7 cells. MMP-2, -3, and -9 could digest not only silk fibroin but also silk suture in in vitro experiments. The inhibitor of MMPs could prevent proteolysis of silk fibroin by MMPs. As a consequence, 4HR incorporated silk suture was rapidly biodegraded compared to untreated silk suture and with the similar rate to polyglactin 910 in the animal model. Expression of MMP-2, -3 and -9 was high in the 4HR incorporated silk suture implanted site at 12 weeks after implantation. In conclusion, 4HR-treated silk suture showed similar level of bio-degradation to polyglactin 910 suture via higher expression of MMP-2, -3, and -9 in macrophage. http://dx.doi.org/10.1016/j.ijom.2017.02.100
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Revised protocol for the management of medication-related osteonecrosis of the jaw S.J. Kim Ewha Womans University, Seoul, Republic of Korea Medication-related osteonecrosis of the jaw (MRONJ) has been reported in patients undergoing treatment with bisphosphonates for osteoporosis, and because of the 10-year half-life of bisphosphonates, there is a need for further studies of this extensive population. This presentation provides revised protocol based on several case reports to show the contrast in treatment outcomes and morbidity in patients with MRONJ. The cases involved diagnostic imaging modalities commonly used in the practice of dentistry: panoramic radiography and computed tomography and bone scan. This case reports demonstrate the usefulness of dental diagnostic imaging in the detection and management of MRONJ, corroborate the increasing number of reports regarding high levels of morbidity associated with various MRONJ treatments, and underscore the danger of performing invasive dental procedures for patients receiving bisphosphonate therapy. This report provides information on the high levels of morbidity associated with various MRONJ treatments, and underscores the danger of performing even simple procedures, such as denture delivery for patients receiving bisphosphonate therapy. Once osteonecrosis of the mandible begins, it is nearly impossible to eradicate the condition. Exposed bone, the hallmark of MRONJ, will remain and may even progress to fracture. Therefore, prevention of infection and avoiding the need for surgery form the cornerstone of treatment. To reach the exact conclusion, long-term follow-up studies and systemic studies are needed. The work was supported by the Ewha Global Top5 Grant 2013 of Ewha Womans University. http://dx.doi.org/10.1016/j.ijom.2017.02.101 Recent advances in molecular-targeted therapy for oral cancer M. Kioi Yokohama City University Graduate School of Medicine, Japan Although the surgery is standard therapy for oral cancer in many cases, advanced oral cancer is deadly and disfiguring disease for which better systemic therapy is enormously sought to improve the mortality and to avoid dysfunction and cosmetic disorder. Despite recent advances in multimodality therapies for the treatment of oral squamous cell carcinoma (OSCC), survival rates, functional outcomes and toxicities of therapy remain poor. The development of targeted therapies potentially decreased toxicities and increased selectivity may represent significant improvement for the efficacy and also as treatment options. Targeted agents currently approved or under investigation for OSCC include epidermal growth factor receptor (EGFR) monoclonal antibodies, EGFR tyrosine kinase inhibitors, vascular endothelial growth factor receptor inhibitors and various inhibitors of other targets including immune-checkpoint. In this talk, the recent advances in targeted therapy for OSCC will be presented, and also our clinical outcome of several targeted therapies using cetuximab and local therapy will be introduced. http://dx.doi.org/10.1016/j.ijom.2017.02.102
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Revised protocol for the management of medication-related osteonecrosis of the jaw S.J. Kim Ewha Womans University, Seoul, Republic of Korea Medication-related osteonecrosis of the jaw (MRONJ) has been reported in patients undergoing treatment with bisphosphonates for osteoporosis, and because of the 10-year half-life of bisphosphonates, there is a need for further studies of this extensive population. This presentation provides revised protocol based on several case reports to show the contrast in treatment outcomes and morbidity in patients with MRONJ. The cases involved diagnostic imaging modalities commonly used in the practice of dentistry: panoramic radiography and computed tomography and bone scan. This case reports demonstrate the usefulness of dental diagnostic imaging in the detection and management of MRONJ, corroborate the increasing number of reports regarding high levels of morbidity associated with various MRONJ treatments, and underscore the danger of performing invasive dental procedures for patients receiving bisphosphonate therapy. This report provides information on the high levels of morbidity associated with various MRONJ treatments, and underscores the danger of performing even simple procedures, such as denture delivery for patients receiving bisphosphonate therapy. Once osteonecrosis of the mandible begins, it is nearly impossible to eradicate the condition. Exposed bone, the hallmark of MRONJ, will remain and may even progress to fracture. Therefore, prevention of infection and avoiding the need for surgery form the cornerstone of treatment. To reach the exact conclusion, long-term follow-up studies and systemic studies are needed. The work was supported by the Ewha Global Top5 Grant 2013 of Ewha Womans University. http://dx.doi.org/10.1016/j.ijom.2017.02.101 Recent advances in molecular-targeted therapy for oral cancer M. Kioi Yokohama City University Graduate School of Medicine, Japan Although the surgery is standard therapy for oral cancer in many cases, advanced oral cancer is deadly and disfiguring disease for which better systemic therapy is enormously sought to improve the mortality and to avoid dysfunction and cosmetic disorder. Despite recent advances in multimodality therapies for the treatment of oral squamous cell carcinoma (OSCC), survival rates, functional outcomes and toxicities of therapy remain poor. The development of targeted therapies potentially decreased toxicities and increased selectivity may represent significant improvement for the efficacy and also as treatment options. Targeted agents currently approved or under investigation for OSCC include epidermal growth factor receptor (EGFR) monoclonal antibodies, EGFR tyrosine kinase inhibitors, vascular endothelial growth factor receptor inhibitors and various inhibitors of other targets including immune-checkpoint. In this talk, the recent advances in targeted therapy for OSCC will be presented, and also our clinical outcome of several targeted therapies using cetuximab and local therapy will be introduced. http://dx.doi.org/10.1016/j.ijom.2017.02.102