Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg)

Publications in this journal

• Article: An Orthodontic Technique for Minimally Invasive Extraction of Impacted Lower Third Molar.

  Zhi-Gui Ma, Qian-Yang Xie, Chi Yang, Guang-Zhou Xu, Xie-Yi Cai, Jie-Yan Li
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  ABSTRACT: PURPOSE: To present a novel orthodontic approach for minimally invasive extraction of impacted mandibular third molars (M3s) close to the inferior alveolar nerve (IAN). PATIENTS AND METHODS: Eight patients (8 M3s) requiring extraction of M3s were included in this study; there were 2 cases of horizontal impaction, 4 of mesioangular impaction, and 2 of vertical impaction. Cone-beam computed tomogram showed that the roots of impacted M3s in 2 cases interrupted the cortices of the mandibular canal, and those in the other 6 cases were very close to the IAN. Orthodontic treatment was performed in this study. The crowns of 5 impacted teeth were surgically exposed before the application of the orthodontic device, whereas bonding was performed directly to the occlusal surface of the other 3 M3s, which had partially erupted. The opposing maxillary M3s were removed in 3 cases. One-step orthodontic extraction was applied to vertically impacted M3s and 2-step treatment was applied to horizontally or mesioangularly impacted M3s. Success was defined as the separation of the impacted tooth from the IAN as visualized on cone-beam computed tomogram. RESULTS: After orthodontic treatment, all impacted M3s were extruded and separated from the IAN (mean, 6.6 months; range, 4 to 10 months), without any neurologic consequences. The average time of extraction was 5 minutes. In all 8 cases, new bone formation occurred distal to the adjacent second molar. CONCLUSION: This orthodontic technique may be a minimally invasive approach for the extraction of impacted M3s adjacent to the IAN, with a decreased risk of paresthesias and with osteoperiodontal advantages.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2013;
• Article: Clinical Trial Registration: Implications for Stakeholders.

  James R Hupp
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2013; 71(6):985-987.
• Article: Increased Levels of Interleukin-6 in Synovial Lavage Fluid From Patients With Mandibular Condyle Fractures: Correlation With Magnetic Resonance Evidence of Joint Effusion.

  Shinnosuke Nogami, Tetsu Takahashi, Wataru Ariyoshi, Daigo Yoshiga, Yasuhiro Morimoto, Kensuke Yamauchi
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  ABSTRACT: PURPOSE: The aim of the present study was to investigate the relation between magnetic resonance (MR) evidence of joint effusion and concentrations of proinflammatory cytokines, including interleukin (IL)-1β and IL-6, in washed-out synovial fluid samples obtained from patients with mandibular condyle fractures. PATIENTS AND METHODS: Twenty-five joints in 23 patients with mandibular condyle fractures were examined. Computed tomography was used to determine the position of the fracture and MR examination was performed in all cases. Twenty-five joints underwent temporomandibular joint (TMJ) irrigation before surgical treatment for the fractures. The detection rates and concentrations of the tested cytokines were determined, and their relations to evidence of joint effusion and positions of the condylar fractures were analyzed. RESULTS: Six TMJ fractures were found in the head, 10 in the upper neck, 4 in the lower neck, and 5 in the subcondyle. MR evidence of joint effusion was observed in 17 of 25 TMJs (68.0%). The detection rate and concentration of IL-6 were significantly higher in patients with MR evidence of joint effusion and those with high condylar fractures. Moreover, there was a correlation between joint effusion grade and IL-6 concentration. CONCLUSIONS: The present findings showed a correlation between MR evidence of joint effusion and concentration of IL-6 in washed-out synovial fluid samples collected from patients with mandibular condyle fractures. These results may provide support for arthrocentesis as a reasonable treatment modality for high condylar fractures.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2013; 71(6):1050-1058.
• Article: Neck Hairline Incision for Simultaneous Harvesting of Temporal and Mastoid Fasciae: A Technical Note.

  Shahriar Nazari, Behnam Bohluli, Rozina Besharatizadeh, Pooyan Sadr-Eshkevari, Ashkan Rashad
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  ABSTRACT: Fasciae are known reservoirs of ideal graft material. The temporalis and mastoid fasciae are 2 of the most important graft reservoirs used by plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons. The temporalis fascia is harvested predominantly by plastic surgeons, whereas otolaryngologists often prefer the mastoid fascia. In either case, graft harvesting might be accompanied by donor-site complications, such as hair loss, bleeding, hematoma, and scar formation, which can limit its application. To gain access to the temporal and mastoid fasciae simultaneously, the authors combined conventional techniques to develop a modified single-approach incision line that would minimize most donor-site complications.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Comparison Between p16(INK4A) Immunohistochemistry and Human Papillomavirus Polymerase Chain Reaction Assay in Oral Papillary Squamous Cell Carcinoma.

  Prokopios P Argyris, Deepak Kademani, Stefan E Pambuccian, Reyna Nguyen, Konstantinos I Tosios, Ioannis G Koutlas
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  ABSTRACT: PURPOSE: Oral papillary squamous cell carcinoma (OPSCC) is a histologic variant of SCC with a growth pattern suggesting human papillomavirus (HPV) infection. The aim of this study was to investigate the presence of HPV genotypes in OPSCC. MATERIALS AND METHODS: All cases with a histologic diagnosis of OPSCC from 1993 through 2008 were retrieved and confirmed. Immunohistochemical evaluation for the surrogate marker p16(INK4A) and HPV polymerase chain reaction were performed in tissue and DNA derived from formalin-fixed paraffin-embedded tissue. RESULTS: Forty-four patients with confirmed OPSCC (mean age, 71.96 yr; female-to-male ratio, 1.75:1) comprised the study population. The most common site of involvement was the gingiva followed by the palate and buccal mucosa. Forty cases exhibited an invasive component, 1 was noninvasive, and in 3 cases invasion could not be confirmed owing to suboptimal thickness of the biopsy. Paraffin tissue blocks were available in 41 cases. Twenty-three cases (56.1%) exhibited positive p16(INK4A) staining, which was primarily weak to moderate with a generally focal pattern. Polymerase chain reaction assays were negative for HPV DNA in all cases. CONCLUSIONS: In this study, there was a clinical predilection of OPSCC in older women, with most cases occurring in the masticatory mucosa. Weak to moderate and focal p16(INK4A) staining was appreciated in contrast to reported staining properties in genital and oropharyngeal PSCC. Failure of the polymerase chain reaction assay to exhibit transcriptionally active HPV genotypes suggests that HPV is not associated with OPSCC tumorigenesis.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Cytogenetics of Central Giant Cell Granuloma of the Mandible.

  Esther Manor, Leonid Kachko, Peter A Brennan, Lipa Bodner
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  ABSTRACT: PURPOSE: Central giant cell granuloma is a benign entity that commonly occurs in the mandible and maxilla. It is usually treated by surgical excision, varying from curettage to en bloc resection. Because the entity is more common in diseases such as neurofibromatosis, a genetic element may be involved in its pathogenesis. Cytogenetic studies of central giant cell granuloma affecting bone are rare, and to the authors' knowledge, there are none reported in the literature for central giant cell granuloma of the mandible. MATERIALS AND METHODS: The authors investigated the cytogenetic profile of a case occurring in the mandible. Fresh biopsy tissue was minced and cultured in RPMI-1640 medium. Cells were fixed and stained, and cytogenetic analysis was performed according to standard procedures. RESULTS: A clone with t(1;17;18) and other random numerical chromosomal changes was found. CONCLUSIONS: The significance of these findings in diagnosis and prognosis is currently unclear and further karyotyping studies are needed to more fully understand this tumor.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Does Elastic Therapeutic Tape Reduce Postoperative Swelling, Pain, and Trismus After Open Reduction and Internal Fixation of Mandibular Fractures?

  Oliver Ristow, Bettina Hohlweg-Majert, Victoria Kehl, Steffen Koerdt, Lilian Hahnefeld, Christoph Pautke
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  ABSTRACT: PURPOSE: The aim of the present study was to investigate whether the application of elastic therapeutic tape (Kinesio Tape [KT]) prevents or decreases swelling, pain, and trismus after open reduction and internal fixation of mandibular fracture, thus improving patients' postoperative morbidity. MATERIALS AND METHODS: To address the research purpose, the investigators designed and implemented an open-label, monocentric, parallel-group, randomized clinical trial. Patients were prospectively assigned for treatment of unilateral mandibular fractures and randomly allocated to receive treatment with or without KT application. KT was applied directly after surgery and maintained for 5 days postoperatively. Facial swelling was quantified using a 5-line measurement at 6 specific time points. Pain score was assessed using a 10-level visual analog scale; mouth opening was measured. In addition, all patients were asked to evaluate overall satisfaction and swelling (2 groups) and the effect of the tape on movement and comfort (KT group only). RESULTS: The study included 26 patients (11 female and 15 male; mean age, 43 yr; standard deviation, 18.5 yr). Application of KT after surgery for mandibular fracture had a statistically significant influence on tissue reaction and swelling, decreasing the incidence of swelling and turgidity by more than 60% during the first 2 days after surgery. Although KT had no significant influence on pain control, patients in the KT group perceived significantly lower morbidity. CONCLUSION: The present results showed that KT after open reduction and internal fixation of mandibular fracture is a promising, simple, less traumatic, and economical approach for managing postoperative swelling that is free from systemic adverse reactions, thus improving patients' quality of life.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Single-Step Resection and Reconstruction Using Patient-Specific Implants in the Treatment of Benign Cranio-Orbital Tumors.

  Giovanni Gerbino, Francesca Antonella Bianchi, Emanuele Zavattero, Fulvio Tartara, Diego Garbossa, Alessandro Ducati
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  ABSTRACT: PURPOSE: The aim of this study was to evaluate surgical outcomes using patient-specific prostheses produced by computer-aided design and manufacturing for primary reconstruction in patients with benign cranio-orbital tumors. Polyetheretherketone was used to manufacture the implants. MATERIALS AND METHODS: The present study included 3 patients who underwent fronto-orbito-pterional craniotomy using individual custom-made surgical guides. Patient-specific polyetheretherketone prostheses were used for reconstruction during the same surgery. All patients underwent esthetic examination (facial and orbital symmetry, globe projection and position), ophthalmologic examination (diplopia with the Hess-Lancaster test, visual field and acuity), and radiologic evaluations (computed tomography and magnetic resonance imaging) during the preoperative and follow-up periods. Operating time and short- and long-term complications were recorded. RESULTS: The immediate and long-term morphologic results were satisfactory; in particular, ocular globe position and projection were correct. After 25 to 31 months, none of the patients developed implant-related complications, such as infection, extrusion, or malposition. Two-year postoperative computed tomograms and magnetic resonance images showed no recurrences. CONCLUSION: Single-step resection and reconstruction with computer-aided designed and manufactured implants is a challenging new technique that decreases operative time and morbidity. The implants adequately restore an anatomically complex area with satisfactory cosmetic results.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Effects of Allogenous Periosteal-Derived Cells Transfected With Adenovirus-Mediated BMP-2 on Repairing Defects of the Mandible in Rabbits.

  Mingxia Sun, Wanye Tan, Ketao Wang, Zuoqing Dong, Huahai Peng, Fengcai Wei
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  ABSTRACT: PURPOSE: This report describes the effect of periosteal-derived cells transfected with adenovirus-mediated bone morphogenetic protein-2 (BMP-2) on the repair of mandibular defects in rabbits. MATERIALS AND METHODS: Periosteal-derived cells were transfected with a replication-defective adenoviral vector encoding BMP-2, and the expression of BMP-2 was examined in transfected cells using in situ hybridization and enzyme-linked immunosorbent assay. In addition, the proliferation ability and activity of alkaline phosphatase of transfected cells were examined using the 3-[4,5-dimethylthiazol-2-Yl]-2,5-diphenyltetrazolium bromide method and enzymology, respectively. In vitro critical-size defects (about 10 × 6 mm) were made bilaterally in each rabbit mandible, and individual sites were implanted with tissue-engineered bone modified with an adenovirus construct encoding the recombinant human BMP-2 gene (Ad-BMP-2), tissue-engineered bone without modification, single bioactive glass ceramic, or no implants (control). New bone formation was evaluated by histochemical stain. RESULTS: BMP-2 expression in the supernate of infected cells was detected from the first day after Ad-BMP-2 transfection and remained at a high level for at least 2 weeks. Alkaline phosphatase expression in transfected cells was significantly greater than in uninfected cells. The group of Ad-BMP-2-modified periosteal-derived cells formed more new bone than the other group at any time point. CONCLUSION: Gene-modified tissue-engineered bone grafts have greater osteogenic potential than single tissue-engineered bone and single bioactive glass ceramic graft. Ex vivo Ad-BMP-2 transfer to periosteal-derived cells can increase bone formation in critical-size bone defects. Further studies are needed to determine if modified engineered cells can be developed for safe and effective clinical applications.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Odontogenic Infection Due to Aerococcus viridans: A Case Report.

  Xiaowen Jiang, Shoukang Yang, Guoliang Sun
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Oral Myiasis-A Case Report.

  Vikas Singla
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  ABSTRACT: Myiasis, a term introduced by William Hope in 1840, refers to the invasion of tissues and organs of animals and human wounds and certain body cavities by the dipteran larvae, which manifests as subcutaneous furunculoid or boil-like lesions. Oral myiasis is a rare pathology and a risk to the patient's life. A higher incidence is seen in rural areas, affecting the tropical and subtropical zones of Africa and America. It can be secondary to medical or anatomic conditions, such as cancrum oris, neglected mandibular fracture, cerebral palsy, mouth breathing, anterior open bite, incompetent lips, and use of mechanical ventilation. Myiasis also has been described after tooth extraction. All these conditions more easily allow the infestation of human tissues. Myiasis affecting the orodental complex is rare. This case report describes oral myiasis in a 25-year-old male patient who was a gardener by profession. The lesion was treated with turpentine oil, which forced the larvae out, and irrigated with normal saline solution.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Multiple-Parameter Evaluation Demonstrates Low Donor-Site Morbidity After Submental Flap Harvesting.

  Jih-Chin Lee, Wen-Sen Lai, Chuan-Hsiang Kao, Chiang-Hung Hsu, Yueng-Hsiang Chu, Yaoh-Shiang Lin
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  ABSTRACT: PURPOSE: The objective of this study was to implement a scoring system to analyze the authors' experience of donor-site morbidity after harvesting a submental flap for the reconstruction of surgical defects at the head and neck region after oncologic resection. MATERIALS AND METHODS: A retrospective case series study was conducted of patients who underwent reconstruction with a submental flap at the Tri-Service General Hospital (Taipei, Taiwan) from 2008 through 2012. Five parameters representing donor-site morbidity (whistling, smiling, neck extension, beard change, and esthetic outcome) were evaluated with a scoring system developed by a blinded panel of 2 clinicians and the patients. Scores were analyzed and compared between patient subgroups. RESULTS: Twenty-two patients (20 men and 2 women; mean age, 56 yr) underwent reconstruction with a submental flap after head and neck tumor ablation. Primary lesion sites included the oral cavity (13 patients), pharynx (6 patients), larynx (1 patient), neck (1 patient), and sinus (1 patient). The means of all 5 parameters evaluated were higher than 8 on a scale of 0 to 9 (whistling, 8.7; smiling, 8.7; beard change, 8.9; neck extension, 8.2; esthetic outcome, 8.2), showing that submental flap harvesting led to low donor-site morbidity. CONCLUSIONS: Donor-site morbidity after submental flap harvesting was evaluated with a scoring system measuring 5 parameters, namely whistling, smiling, beard change, neck extension, and esthetic outcome. In general, donor-site morbidity was very low. This implemented system and these findings will be helpful in future reconstructive surgical planning and management.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Acronym Acrimony.

  Thomas B Dodson
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013; 71(5):829.
• Article: Response to "Oral and Maxillofacial Surgery Residents Have Poor Understanding of Biostatistics"

  Jonathon S Jundt
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013; 71(5):831.
• Article: Functional Effects of Local Administration of Thyroid Hormone Combined With Chitosan Conduit After Sciatic Nerve Transection in Rats.

  Rahim Mohammadi, Keyvan Amini, Alireza Yousefi, Mehdi Abdollahi-Pirbazari, Abolfazl Belbasi, Farzaneh Abedi
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  ABSTRACT: PURPOSE: To assess the local effect of triiodothyronine (T3) on peripheral nerve regeneration in a rat model of sciatic nerve transection. MATERIALS AND METHODS: Forty-five male healthy white Wistar rats were divided randomly into 3 experimental groups (n = 15): sham operation, control (CHIT), and T3 treatment (CHIT/T3). In the sham-operated group, the left sciatic nerve was exposed under anesthesia through a gluteal muscle incision and the muscle was sutured after homeostasis. In the CHIT group, the left sciatic nerve was exposed the same way and transected proximal to the tibioperoneal bifurcation, leaving a 10-mm gap. Each proximal and distal stump was inserted into a chitosan conduit, which was filled with phosphate buffered solution 10 μL. In the CHIT/T3 group, the defect was bridged using a chitosan conduit filled with T3 10 μL. Each group was subdivided into 3 subgroups of 5 animals each and studied 4, 8, and 12 weeks after surgery. Data were analyzed statistically by factorial analysis of variance and the Bonferroni test for pairwise comparisons. RESULTS: Behavioral testing and sciatic nerve function study confirmed a faster and better recovery of regenerated axons in the CHIT/T3 group than in the CHIT group (P < .05). Gastrocnemius muscle mass was significantly larger in the CHIT/T3 group than in the CHIT group. Morphometric indices of regenerated fibers showed that the number and diameter of the myelinated fibers were significantly larger in the CHIT/T3 group than in the CHIT group. Immunohistochemistry showed that the locations of reaction to S-100 were clearly more positive in the CHIT/T3 group than in the CHIT group. CONCLUSIONS: The response to local treatment showed that thyroid hormone influenced and improved the functional recovery of peripheral nerve regeneration.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Computational Fluid Dynamic Analysis of the Posterior Airway Space After Maxillomandibular Advancement for Obstructive Sleep Apnea Syndrome.

  Somsak Sittitavornwong, Peter D Waite, Alan M Shih, Gary C Cheng, Roy Koomullil, Yasushi Ito, Joel K Cure, Susan M Harding, Mark Litaker
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  ABSTRACT: PURPOSE: This study evaluated the soft tissue change of the upper airway after maxillomandibular advancement (MMA) using computational fluid dynamics. MATERIALS AND METHODS: Eight patients with obstructive sleep apnea syndrome who required MMA were recruited into this study. All participants underwent pre- and postoperative computed tomography and then MMA by a single oral and maxillofacial surgeon. Upper airway computed tomographic datasets for these 8 patients were created with high-fidelity 3-dimensional numerical models for computational fluid dynamics. The 3-dimensional models were simulated and analyzed to study how changes in airway anatomy affect the pressure effort required for normal breathing. Airway dimensions, skeletal changes, apnea-hypopnea index, and pressure effort of pre- and postoperative 3-dimensional models were compared and correlations were interpreted. RESULTS: After MMA, laminar and turbulent air flows were significantly decreased at every level of the airway. The cross-sectional areas at the soft palate and tongue base were significantly increased. CONCLUSIONS: This study showed that MMA increased airway dimensions by increasing the distance from the occipital base to the pogonion. An increase of this distance showed a significant correlation with an improvement in the apnea-hypopnea index and a decreased pressure effort of the upper airway. Decreasing the pressure effort will decrease the breathing workload. This improves the condition of obstructive sleep apnea syndrome.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: Sudden Hearing Loss After Dental Treatment.

  Leyla Kansu, Ismail Yilmaz
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  ABSTRACT: A 66-year-old man presented with impaired balance, tinnitus, sensation of blockage, and hearing loss in his left ear, which developed after dental treatment for dental pain 4 days previously. Treatment of the carious left upper second molar tooth had included pulp extirpation, canal expansion, and tooth filling under local anesthesia with articaine and epinephrine. Impaired balance decreased spontaneously within 3 days of dental treatment, but tinnitus and hearing loss persisted. Pure tone audiogram showed profound sensorineural hearing loss in the left ear, with a downslope from 40 to 100 dB, and an abnormal speech discrimination score (50%). Treatment included intravenous prednisolone, intratympanic dexamethasone, and oral betahistine and trimetazidine. The patient had improved hearing and resolution of tinnitus. Sudden hearing loss is rare after dental treatment, and awareness of this complication may prompt early referral for treatment and may improve recovery and prognosis.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: A Simple Modification to the Nasal Hood to Facilitate Capnographic Measurements: A Technical Note.

  Amir Laviv, Edward B Seldin, Thomas B Dodson
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013; 71(5):854-855.
• Article: 3-Dimensional Facial Simulation in Orthognathic Surgery: Is It Accurate?

  Stephen A Schendel, Richard Jacobson, Sadri Khalessi
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  ABSTRACT: PURPOSE: The purpose of this study was to measure the accuracy of 3D computer simulation of soft tissue changes after orthognathic surgery. MATERIALS AND METHODS: Consecutive patients who underwent orthognathic surgery were studied by photogrammetric facial scanning and cone-beam computed tomography before and after surgery. The photogrammetric scan was then fused to the cone-beam computed tomogram, creating a patient-specific image. The surgery was simulated in 3D form and the simulated soft tissue face was compared with the actual facial scan obtained 6 months postoperatively. Absolute millimeter differences between the simulated and actual postoperative changes in selected cephalometric skin markings were computed. RESULTS: The study was composed of 23 subjects (mean age, 31 yr; 13 women and 10 men). Eighteen different cephalometric landmarks were measured (total, 28). For 15 landmarks, the difference between actual and simulated measurements was smaller than 0.5 mm. Only 3 landmarks had a difference of 0.5 mm, and these were in the region of the labial landmarks. CONCLUSION: Based on the present study, 3-dimensional computer surgical simulation of the soft tissue of the face for routine orthognathic surgery is accurate enough for routine clinical use.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;
• Article: p16 Immunohistochemistry Can Be Used to Detect Human Papillomavirus in Oral Cavity Squamous Cell Carcinoma.

  Lisa D Duncan, Marcus Winkler, Eric R Carlson, R Eric Heidel, Eugene Kang, David Webb
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  ABSTRACT: PURPOSE: Human papillomavirus (HPV) is of etiologic significance in the development of oral squamous carcinoma and is noted to result in p16 overexpression. Identification of HPV is clinically important because the presence of HPV has prognostic and epidemiologic associations. Detection of HPV by polymerase chain reaction (PCR) is expensive and not widely accessible. The authors examined p16 immunohistochemistry (IHC) as a surrogate marker for high-risk HPV and its use as an alternative test to PCR. PATIENTS AND METHODS: A retrospective cohort of patients with oral squamous cell carcinoma underwent surgery and then analysis with p16 IHC and HPV PCR. The p16 IHC staining intensity was graded from 0 to 3+, and these results were compared with PCR. Descriptive and frequency statistics were performed by comparing HPV PCR results with p16 IHC, patient age, gender, and outcome. RESULTS: Eighty-one cases were included in the study. Forty-four study patients were men and 37 were women (mean age, 63.9 yr). Forty-five cases (55.6%) had 0 staining, 22 cases (27.2%) had 1+ staining, and 7 cases (8.6%) had 2+ staining. Seven cases (8.6%) had 3+ staining, all of which were positive for HPV serotype 16 by PCR. Three of 7 HPV PCR-positive cases had keratinization typical of an oral cavity location and not the basaloid growth of HPV oropharyngeal tumors. There was a statistical correlation (P < .001) among HPV PCR positivity, 3+ staining, and younger age. CONCLUSION: p16 3+ staining correlates with HPV PCR positivity. p16 IHC is a technically simple and widely available test, and this study establishes the use of p16 IHC as an alternative test to HPV PCR. Given the clinical significance of HPV in oral squamous carcinoma, p16 IHC should be performed in all cases and included in the pathology report.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2013;