Papers by Michel El-hakim
Le Journal dentaire du Québec
L’ostéonécrose des maxillaires associée aux bisphosphonates (ONAB) est définie comme étant « une ... more L’ostéonécrose des maxillaires associée aux bisphosphonates (ONAB) est définie comme étant « une exposition osseuse des mâchoires chez un patient ayant reçu ou ayant été exposé aux bisphosphonates, et n’ayant pas été exposé à la radiothérapie dans cette même région. L’os exposé doit être présent depuis huit semaines après avoir été identifié par un professionnel de la santé. »1 Puisque des millions de gens reçoivent des bisphosphonates pour diverses raisons, il est important que les dentistes généralistes puissent identifier les patients présentant des risques de développer une ONAB. Récemment, certaines associa- tions professionnelles, dont l’American Dental Association et l’American Society for Bone and Mineral Research, ont mis sur pied des groupes de travail afin d’évaluer les données disponibles sur le sujet, et publier des articles1, 2 recommandant la prise en charge dentaire des patients traités aux bisphosphonates. L’objectif du présent texte, qui est basé en grande partie s...
Bisphosphonates Delay Jawbone Healing Following Tooth Extractions in Rats
Objectives: This study aimed to evaluate the effect of the administration of bisphosphonates on t... more Objectives: This study aimed to evaluate the effect of the administration of bisphosphonates on the healing of jawbones and the onset of bisphosphonate-related osteonecrosis of the jaw-like disease (BRONJ-like) after tooth extractions (EXO) in rats. Methods: A total of 16 retired breeder female Sprague-Dawley rats were divided into two groups: experimental (EX) and control (CT). The EX group (n=10) received a combination of zoledronic acid (ZA: 125 µg/kg, twice/week) and dexamethasone (DX: 5 mg/kg body weight, weekly). The CT group (n=6) did not receive any medications. After 3 weeks of drug administration, all rats had EXO of their left maxillary and mandibular first molars. Drug administration was continued for 9 additional weeks until euthanasia. In-vivo radiographs were taken at EXO, 3 and 10 days, 3, 6 and 9 weeks post-EXO. After euthanasia, the mandible and maxilla were removed and processed for micro-computer tomography (µCT) and histological analyses. Results: In-vivo radiog...
Fracture of the anterior segment of the atrophic mandible related to dental implants
International journal of oral and maxillofacial surgery, 2012
Implant placement in an anterior atrophic mandible is not an uncommon procedure. Fracture seconda... more Implant placement in an anterior atrophic mandible is not an uncommon procedure. Fracture secondary to such implant placement is a rare complication. The authors discuss a case referred to their surgical centre and discuss the management approaches found in the English literature.
Oral and Maxillofacial Surgery Cases, 2015
Nodular fasciitis is a benign soft tissue neoplasm of mesenchymal origin. It is usually character... more Nodular fasciitis is a benign soft tissue neoplasm of mesenchymal origin. It is usually characterized by rapid growth, infiltrative behavior, and heterogeneous histopathology, which can make diagnosis difficult and lead to delayed management. It has a 15%-20% occurrence rate in the head and neck and occurs rarely intraorally. In this report, we discuss an unusual case of nodular fasciitis originating in the masticator space and destroying the ascending ramus of the mandible. The treatment involved complete resection of the lesion and reconstruction with a temporomandibular joint prosthesis. At 24 months after surgery, the patient showed a return to normal function with no signs of recurrence.
Bisphosphonates inhibit bone remodeling in the jaw bones of rats and delay healing following tooth extractions
Oral Oncology, 2014
This study aimed to evaluate the impact of concurrent administration of clinically relevant doses... more This study aimed to evaluate the impact of concurrent administration of clinically relevant doses of zoledronic acid (ZA) and dexamethasone (DX) on bone healing after tooth extraction (EXO). Forty-four Sprague-Dawley rats (6-8 month old) were randomized into five groups: ZA + DX = weekly injection of ZA with DX for 7 weeks; WD = ZA with DX for 3 weeks then DX alone for 4 weeks; C = control saline for 7 weeks; ZA = ZA alone for 7 weeks and DX = DX alone for 7 weeks. ZA was administered at 0.13 mg/kg/week and DX at 3.8 mg/kg/week and body weights recorded at the time of injection. All rats underwent extraction (EXO) of the mandibular and maxillary first molars at 3 weeks and were euthanized at 7 weeks. The extracted and non-extracted sides of both jaws were harvested for micro-CT analyses. All rats, particularly those injected with ZA, exhibited weight gain till EXO followed by decline then recovery. ZA + DX group demonstrated highest fractional bone to tissue volume (BV/TV) in the non-extracted side. ZA + DX rats exhibited also highest volume and surface of sequestra. Only sequestra volume was statistically higher in the WD group compared to C group. Combined treatment with ZA and DX over a prolonged period inhibits bone remodeling and increased sequestra formation to a greater extent than either drug alone. Trauma caused by these sequestra cutting through the mucosa could play a key role in the development of BRONJ by potentially facilitating infection. ZA withdrawal may promote bone-remodeling reactivation following EXO.
Journal of Oral and Maxillofacial Surgery, 2004
Journal of Oral and Maxillofacial Surgery, 2014
Purpose: The aim of the present study was to assess patients' quality of life (QOL) after mandibu... more Purpose: The aim of the present study was to assess patients' quality of life (QOL) after mandibular resection and reconstruction with the free fibula flap (FFF).
Gingival carcinoma-retrospective analysis of 74 patients
British Journal of Oral and Maxillofacial Surgery, 2008
Gingival carcinoma: retrospective analysis of 72 patients and indications for elective neck dissection
British Journal of Oral and Maxillofacial Surgery, 2011
Gingival squamous cell carcinoma (SCC) is relatively uncommon, and little is known about its meta... more Gingival squamous cell carcinoma (SCC) is relatively uncommon, and little is known about its metastatic pattern. We retrospectively reviewed 864 consecutive patients with oral SCC who were seen at the University of Maryland Department of Oral and Maxillofacial Surgery (1991-2005), and identified 111 cases of gingival SCC. Inclusion criteria were fulfilled in 72 patients (mean duration of follow up 49 (1-153) months). Mean (range) age was 72 (45-93) years; 41 patients were women and 31 men. Distribution was almost equal: mandible 35 and maxilla 37. Forty (56%) were in the early stages (pI/II) and 32 (44%) in the later stages (pIII/IV). Twenty-nine patients had primary neck dissections, of whom 7/21 had clear, and 6/8 invaded, cervical nodes. The total number of occult nodal metastases was 9/29 (31%) in the mandible and 14/35 in the maxilla (one patient with initially clear nodes had both invaded nodes at neck dissection and a recurrence in the neck). The number of early compared with late stage occult metastases was 4 of 20 patients (20% T1/T2) and 5 of 9 patients (55% T3/T4) in the mandible and 2 of 22 patients (9% T1/T2) and 2 of 13 patients (15% T3/T4) in the maxilla. Two of 9 patients developed occult nodes within T2 maxillary gingival SCC. Bony invasion was identified in 17 patients (24%) occurring in 8 of 19 patients (42%) with invaded nodes compared with 9 of 53 patients (17%) with clear nodes. Overall survival at 2 and 5 years was 53 of 72 patients (74%) and 27 of 72 patients (38%) respectively. Elective neck dissection is indicated for all stages of mandibular gingival tumours and T3/T4 carcinomas of the maxillary gingiva. T2 maxillary SCC should be considered for elective neck dissection. Overall disease-free survival was worse among those with cervical metastases (p=0.004) and those who had had marginal resections (p=0.04).
Archives of Oral Biology, 2013
Severe unilateral cross-bite secondary to tumour of the mandibular condyle
Journal (Canadian Dental Association), 2014
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Papers by Michel El-hakim