Editorial Board/Reviewing Committee

doi : 10.1016/S0901-5027(21)00193-4

Volume 50, Issue 7, July 2021, Page i

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Mandibulotomy access to tumour sites: fewer complications for postoperative compared with preoperative radiotherapy

K.Carlwig12P.Fransson23M.Bengtsson23M.Gebre-Medhin24J.Sj?vall12aL.Greiff12a

doi : 10.1016/j.ijom.2020.11.004

Volume 50, Issue 7, July 2021, Pages 851-856

The purpose of this study was to compare complication rates at the mandibulotomy site between patients receiving preoperative radiotherapy (RT) and those receiving postoperative RT during treatment for oral and oropharyngeal cancer where the surgical procedure required a mandibular osteotomy to gain access to the tumour. Sixty-four consecutive patients treated during the period 2000–2015 were available for analysis. Their medical records were reviewed retrospectively. All patients were followed for at least 1 year postoperatively. A subgroup of patients received RT on several occasions or long before the mandibulotomy, therefore the statistical comparisons focused on the two groups of patients receiving RT on one occasion and within 6 months prior to or following surgery. Seventeen patients presented a total of 29 complications, yielding an overall complication rate of 27%. Orocutaneous fistula was the most common complication. Patients who received RT preoperatively presented a higher complication rate (9/15; 60%) when compared to those who received RT postoperatively (2/31; 6.5%) (odds ratio 21.8, P < 0.001). This study demonstrated fewer complications in the mandibulotomy area exposed to postoperative RT compared with preoperative RT. It is therefore suggested that, when possible, RT should be given postoperatively if combination treatment with RT and surgery, including a mandibulotomy, is planned.

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High level of CD10 expression is associated with poor overall survival in patients with head and neck cancer

Q.LiY.WangL.XuL.WangY.GuoC.Guo

doi : 10.1016/j.ijom.2020.07.037

Volume 50, Issue 7, July 2021, Pages 857-864

CD10 is a common zinc-dependent metalloid protease that is expressed in numerous tissues, including malignant cells. Genomic alterations of CD10 are frequently observed in haematopoietic and non-haematopoietic tumours. In the present study, we analysed the CD10 expression in head and neck squamous cell carcinoma (HNSCC) and its association with tumour prognosis using bioinformatic analysis and explored the potential of a CD10-driven signalling pathway in a tumour-immune microenvironment. Briefly, data mining analysis showed strengthened CD10 expression in HNSCC patients. High CD10 expression was associated with unfavourable overall survival (OS) and recurrence-free survival (RFS). In addition, the correlation between CD10 expression and interleukin (IL)-6/IL-8-mediated M1 macrophage activity could potentially explain the poor prognosis of HNSCC. Among 692 genes co-expressed with CD10 in HNSCC, Rap1 signalling pathway, regulation of actin cytoskeleton, protein digestion and absorption, proteoglycans in cancer, PI3K-Akt signalling pathway, focal adhesion and extracellular matrix–receptor interaction were the candidate signalling pathways driven by the CD10 gene. Further investigation of immune-associated signalling pathways regulated by CD10 may be beneficial to improve the prognosis of HNSCC patients by immunotherapy.

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Using the Patient Concerns Inventory in the identification of fatigue following treatment for head and neck cancer

S.N.Rogers12C.J.Semple34G.M.Humphris5D.Lowe6A.Kanatas7

doi : 10.1016/j.ijom.2020.11.001

Volume 50, Issue 7, July 2021, Pages 865-872

Fatigue has a profound impact on health-related quality of life (HRQOL). The aim of this study was to describe the clinical characteristics and HRQOL of head and neck cancer patients who raised the issue of fatigue on the Patient Concerns Inventory (PCI) at their review consultation. Eight consultants were randomized to use the PCI as part of a cluster-controlled trial. Patients also completed the University of Washington Quality of Life version 4 (UWQOL), EQ-5D-5L (EuroQol Group), and Distress Thermometer questionnaires. The study included 140 patients who attended clinics at a median of 108 (interquartile range 70–165) days after the end of treatment. The PCI item ‘fatigue’ was the sixth most commonly selected, by 29% (n = 40). Those with advanced tumours were more likely to have selected the item (30/84, 36% vs 10/56, 18%; P = 0.02), as were those treated with radiotherapy ± chemotherapy (34/87, 39% vs 6/53, 11%; P < 0.001). The PCI fatigue group reported significantly worse overall quality of life, social–emotional and physical function composite scores (UWQOL), Distress Thermometer, and EQ-5D-5L. PCI fatigue was common in those with sleeping, nausea, mood, depression, mobility, breathing, and energy level concerns. In conclusion, given the problems associated with fatigue, it is appropriate to screen and seek interventions that might help patients address this.

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Superficial versus deep system single venous anastomosis in the radial forearm free flap: a meta-analysis

Y.Xie1T.Feng2Y.Ou3Y.Lin1W.Gong1Y.Wang2

doi : 10.1016/j.ijom.2020.11.007

Volume 50, Issue 7, July 2021, Pages 873-878

The selection of the superficial or deep drainage system for use with the radial forearm free flap (RFFF) remains controversial. The aim of this study was to identify the optimal drainage system for single venous anastomosis. A systematic review and cumulative meta-analysis was performed to assess superficial and deep system single venous anastomosis for use with the RFFF in postoperative reconstruction of the head and neck. This study included 1073 flaps (495 superficial system-based flaps, 578 deep system-based flaps) reported in six studies. The outcomes assessed in the studies selected for this meta-analysis included venous compromise, flap failure, and the salvage success rate. Venous compromise was more common in the superficial system group (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.36–3.86, P = 0.002). The rate of successful salvage was higher with the superficial system (OR 8.19, 95% CI 1.75–38.3, P = 0.008). The rate of flap failure was lower in the superficial system group (OR 0.30, 95% CI 0.04–2.48, P = 0.27). Although the deep system showed a lower risk of venous compromise, the evidence provided by the meta-analysis was insufficient to determine which type of drainage system is more suitable for single venous anastomosis in RFFF. All included studies were cohort studies; therefore, findings must be interpreted with caution.

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Surgical anatomy of the submental artery perforator flap and assessment for application in postoperative reconstruction following oral cancer surgery: a prospective clinical study

X.BinabX.WuaL.HuangaY.ZhouacF.Guoa

doi : 10.1016/j.ijom.2020.07.038

Volume 50, Issue 7, July 2021, Pages 879-886

The submental artery perforator flap (SMAPF) has an elongated pedicle, allowing good cosmetic outcomes to be achieved following oral reconstruction surgery. The improper dissection of perforators often leads to a vascular flap crisis. To avoid this, some surgeons choose to carry amounts of connective tissue around the pedicle. However the inclusion of connective tissue on the pedicle raises concerns about oncological safety. A surgical anatomical study of the submental vessel patterns and subdivisions of the cervical level I lymph nodes was conducted on 33 patients with primary oral cancer who underwent reconstruction with a SMAPF after tumour resection. The variations in vessels and cervical level I lymph nodes observed during SMAPF harvesting were recorded and analyzed. Two patterns of submental artery perforators and three patterns of submental veins were identified. The different characteristics of the lymph node distribution were elucidated for five subdivisions. All SMAPFs survived (n = 33, 100%); however, two SMAPFs exhibited partial losses. The 3-year survival rate of patients was 84.5 ± 6.4%, and there were no suspected flap-related recurrences. With detailed anatomical information on the vascular system and lymph node subdivision, SMAPFs are a reliable choice for postoperative reconstruction following oral cancer surgery, meeting the standards for oncological safety.

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Third-generation modular mandible endoprosthesis in Macaca fascicularis

Y.Liu12R.Lim1N.Chanchareonsook123X.F.Walboomers4J.A.Jansen4S.E.Saffari5B.T.Goh123

doi : 10.1016/j.ijom.2020.09.020

Volume 50, Issue 7, July 2021, Pages 887-894

The aim of this study was to develop a third-generation modular mandible endoprosthesis that would experience less stress concentration at its stems compared to earlier generations, thereby minimizing micromotion and achieving long-term stability. In this three-piece modular design, different degrees of movement were incorporated between the endoprosthesis module interfaces. It was hypothesized that this unique feature would minimize stress concentration at the stems and hence promote osseointegration during the early phase of implantation. The endoprosthesis system was made of commercially pure grade 4 titanium, machined and surface-treated, then sterilized and implanted in segmental mandible defects of nine Macaca fascicularis. Clinical, radiological, histological, and histomorphometric evaluations were performed 4 months post-implantation. The endoprosthesis systems with a degree of movement incorporated, exhibited superior performance compared to the rigid system: 30.9–34.8 times higher percentage bone–implant contact (P <  0.0001) and 3.4–4.1 times higher percentage bone area (P < 0.0001), with osseointegration noted at the posterior stems. However, fibrous tissue encapsulation was noted around the majority of the anterior stems in all groups. Although the degree of movement was favourable for improving bone healing and stability of the endoprosthesis system, more work needs to be done to investigate other strategies to further reduce loading on the endoprosthesis to achieve predictable osseointegration at the stems.

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Differential diagnosis of immunoglobulin G4-related sialadenitis and Kimura’s disease of the salivary gland: a comparative case series

W.-X.Zhu1Y.-Y.Zhang1Z.-P.Sun2Y.Gao3Y.Chen3G.-Y.Yu1

doi : 10.1016/j.ijom.2020.05.023

Volume 50, Issue 7, July 2021, Pages 895-905

The aim of this study was to investigate key points for the differential diagnosis of immunoglobulin G4-related sialadenitis (IgG4-RS) and Kimura’s disease (KD) involving the salivary glands. The clinical, serological, radiological, histological, and immunohistochemical features of 85 IgG4-RS cases and 52 KD cases were evaluated comparatively. Seventy-two IgG4-RS cases had enlargement of multiple salivary and/or lacrimal glands; 67 patients had bilateral submandibular gland (SMG) involvement. Unilateral parotid gland involvement (59.6%) and comorbid skin lesions (61.5%) were common in KD. Serum IgG4 was elevated in 94.1% of IgG4-RS cases versus 19.0% of KD cases (cut-off value = 266.5 mg/dl). KD was more commonly associated with elevated eosinophil counts (86% vs 23.1%) and elevated IgE concentrations (95.5% vs 76.6%). Storiform fibrosis, irregular lymphoid follicles, and increased IgG4-positive cells (112.9 ± 37.6/high-power field (HPF)) were common in IgG4-RS. Acellular fibrosis, regular lymphoid follicles, IgE-positive reticular networks, increased IgE-positive cells (43.4 ± 26.7/HPF), and tryptase-positive mast cells (29.7 ± 13.3/HPF) were usually detected in KD. Computed tomography showed that 85.7% of KD cases involved subcutaneous fat tissue. A superficial hypoechoic and reticular pattern with multiple hypoechoic foci were the sonographic features of the SMG in IgG4-RS. Despite numerous overlapping manifestations, histopathological examination showed meaningful differences in the types of fibrosis, eosinophils, and IgG4-positive cell counts. Comprehensive evaluation of clinical, serological, radiological, and histopathological features are crucial for the differential diagnosis.

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Oral management with polaprezinc solution reduces adverse events in haematopoietic stem cell transplantation patients

M.Tsubura-Okubo12Y.Komiyama12R.Kamimura1Y.Sawatani1H.Arai3K.Mitani3Y.Haruyama4G.Kobashi4H.Ishihama5D.Uchida16H.Kawamata1

doi : 10.1016/j.ijom.2020.10.004

Volume 50, Issue 7, July 2021, Pages 906-914

The aim of this study was to analyse the effects of gargling with and then swallowing PPAA (polaprezinc in polyacrylic acid solution), in addition to regular oral management, on patients with a haematopoietic neoplasm scheduled for haematopoietic stem cell transplantation (HSCT). A total of 120 patients scheduled for HSCT during the years 2006–2016 were recruited. Patient background, oral adverse events, the incidence and severity of systemic adverse events (sepsis/septic shock, acute graft-versus-host disease (GVHD) after transplantation), and outcomes (survival/death) were compared between groups treated with and without PPAA. The severities of oral adverse events (oral mucositis, oral pain, and dysgeusia) were significantly lower in patients treated with PPAA. There was no significant difference in the incidence of febrile neutropenia (P = 0.622) or sepsis/septic shock (P = 0.665) as systemic adverse events. The severity of allograft-induced acute graft-versus-host disease (GVHD) was significantly lower in the PPAA group (P = 0.011). There was no significant difference in outcome between the two groups (P = 0.285). Within the limitations of the study design, it may be concluded that oral management with PPAA reduces adverse events in HSCT. Oral management with concomitant use of PPAA decreased oral adverse events and reduced the systemic complication of GVHD.

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Functional outcomes in patients with facial dysostosis and severe upper airway obstruction

P.P.J.M.van der Plas1aS.Yang2aM.Streppel3B.Pullens3S.L.Versnel2M.J.Koudstaal1E.B.Wolvius1I.M.J.Mathijssen2K.F.M.Joosten4

doi : 10.1016/j.ijom.2020.11.018

Volume 50, Issue 7, July 2021, Pages 915-923

An increased risk of upper airway obstruction (UAO) is seen in up to 95% of patients with facial dysostosis. Secondary to respiratory problems are feeding difficulties and increased nutritional requirements. Little has been described regarding these outcomes in this patient population. Hence, a retrospective cohort study was performed to gather data on functional outcomes. Eighteen patients with facial dysostosis and severe UAO were included. The median follow-up time was 3.42 years. A tracheostomy tube was placed in 13 patients, of whom 10 subsequently underwent mandibular distraction. Three of the five patients without a tracheostomy underwent mandibular distraction as the primary surgical treatment; the remaining two patients were treated conservatively with oxygen supplementation. At presentation, 13 patients had feeding difficulties. Overall malnutrition was present in 16 patients during follow-up. At the end of follow-up, severe UAO was present in 12 patients, feeding difficulties in seven patients, and malnutrition in four patients, while two patients died. In conclusion, patients with facial dysostosis have a high prevalence of severe UAO, feeding difficulties, and malnutrition. Importantly, mandibular distraction has limited success in treating severe UAO in these patients. Close follow-up by a specialized craniofacial team is of paramount importance to manage the long-term consequences.

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Growth patterns of the airway in Crouzon syndrome patients with different types of cranial vault suture synostosis

X.Lu1A.J.Forte2A.Wilson1K.E.Park1O.Allam1M.Alperovich1D.M.Steinbacher1C.Tonello3N.Alonso4J.A.Persing1

doi : 10.1016/j.ijom.2020.11.023

Volume 50, Issue 7, July 2021, Pages 924-932

The severity of obstructive respiratory difficulty varies among affected Crouzon syndrome patients. The aim of this study was to investigate the correlation between the restricted airway volume in Crouzon syndrome and the associated type of cranial vault suture synostosis. Computed tomography scans of 68 unoperated Crouzon syndrome patients and 89 control subjects were subgrouped into four types: type I, bilateral coronal synostosis; type II, sagittal synostosis; type III, pansynostosis; type IV, perpendicular combinations of synostoses. Measurements were made using Mimics software. Of type I Crouzon patients, 42% had a restricted nasal airway (P = 0.002), while the pharyngeal airway volume was not significantly reduced. Type II Crouzon patients grew normal segmental airway volumes. Crouzon patients of type III developed simultaneously reduced nasal and pharyngeal airway volumes in infancy, by 38% (P = 0.034) and 51% (P = 0.014), respectively. However, the nasal airway achieved a normal volume by 2 years of age without any intervention, while the pharyngeal airway remained significantly reduced up to 6 years of age, by 42% (P = 0.013), compared to controls. Type IV Crouzon patients developed a reduced nasal airway volume (32%, P = 0.048) and a non-significant restricted pharyngeal airway (18%, P = 0.325). Airway compromise in Crouzon syndrome is variable when associated with different craniosynostosis fusion patterns. Type II (sagittal synostosis) Crouzon patients grew a normal nasopharyngeal airway volume. Those with types I (bicoronal synostosis) and IV (perpendicular synostoses) had significantly restricted nasal airways and a tendency towards a reduced pharyngeal volume. Type III (pansynostosis) Crouzon infants had the worst restriction of both airways, although there was some improvement with age.

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Surgical morbidities of sagittal split ramus osteotomy versus intraoral vertical ramus osteotomy for the correction of mandibular prognathism: a randomized clinical trial

Y.Y.LeungR.WangN.S.M.WongD.T.S.LiS.W.AuW.S.ChoiY.-x.Su

doi : 10.1016/j.ijom.2020.06.023

Volume 50, Issue 7, July 2021, Pages 933-939

The sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) are two common orthognathic procedures for the treatment of mandibular prognathism. This randomized clinical trial compared the surgical morbidities between SSRO and IVRO for patients with mandibular prognathism over the first 2 years postoperative. Ninety-eight patients (40 male, 58 female) with a mean age of 24.4 ± 3.5 years underwent bilateral SSRO (98 sides) or IVRO (98 sides) as part or all of their orthognathic surgery. IVRO presented less short-term and long-term surgical morbidity in general. The SSRO group had a greater incidence of inferior alveolar nerve deficit at all follow-up time points (P <  0.01). There was more TMJ pain at 6 weeks (P =  0.047) and 3 months (P =  0.001) postoperative in the SSRO group. The SSRO group also presented more minor complications, which were related to titanium plate exposure and infection. There were no major complications for either technique in this study. Despite the need for intermaxillary fixation, IVRO appears to be associated with less surgical morbidity than SSRO when performed as a mandibular setback procedure to treat mandibular prognathism.

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The correlation of maxillomandibular advancement and airway volume change in obstructive sleep apnea using cone beam computed tomography

W.Kongsong12P.D.Waite2S.Sittitavornwong2M.Schibler2F.Alshahrani23

doi : 10.1016/j.ijom.2020.11.017

Volume 50, Issue 7, July 2021, Pages 940-947

The purpose of this retrospective study was to evaluate the correlation of maxillomandibular advancement (MMA) and airway volume changes in patients with obstructive sleep apnea (OSA), and to determine the surgical skeletal movements necessary to achieve an increase in total airway volume (TAV) of ?70%. Thirty patients with OSA treated by MMA were evaluated. Pre- and postoperative cone beam computed tomography images were used to determine the horizontal distance and angular changes in surgical parameters and linear, area, and volumetric airway parameters. Postoperatively, the horizontal distance of surgical parameters (A-point, UI, B-point, pogonion, and menton) and craniofacial angulation (SNA and SNB) increased significantly, similar to total surface area, TAV, and minimum cross-sectional area of the airway (p < 0.0001). The total airway length decreased significantly (p < 0.0001). The mean increase in TAV was 67.2%. There were positive correlations between linear surgical changes and the percentage change in TAV. All surgical parameters were predictive of a change in TAV ?70%. The optimal surgical change was 6 mm for A-point, 7.9 mm for UI, 7.6 mm for B-point, 11.2 mm for pogonion, and 10 mm for menton. In conclusion, maxillary advancement of less than 10 mm was adequate in this study to obtain an increase in the TAV of at least 70%.

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Quality of life, chronic pain, insomnia, and jaw malfunction in patients after alloplastic temporomandibular joint replacement: a questionnaire-based pilot study

A.Zumbrunn Wojczy?ska1B.Steiger12C.S.Leiggener34D.A.Ettlin156L.M.Gallo1

doi : 10.1016/j.ijom.2020.09.022

Volume 50, Issue 7, July 2021, Pages 948-955

Studies of patients undergoing alloplastic total temporomandibular joint replacement seldom report on quality of life (QoL) and sleep. The aim of this pilot study was to assess these factors in such a patient cohort using validated psychometric questionnaires. Data were collected via online surveys comprising the following six questionnaires: Short Form-12 Health Survey (SF-12), Patient Health Questionnaire-15, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, Insomnia Severity Index, Graded Chronic Pain Scale, and Jaw Disability List. Pain intensity, limitation in nutrition, and treatment satisfaction were assessed using numerical rating scales. Mouth opening was measured at follow-up. The SF-12 Physical Composite Score was markedly lower than that of the age-matched general population, whereas the Mental Composite Score did not differ significantly. Participants indicated a low somatization level and low level of disability due to pain, but reduced QoL. Clinically relevant insomnia was reported by 36% of participants. In conclusion, the results of this pilot study indicate that QoL and sleep in patients with a total temporomandibular joint replacement differ from those in the general population, indicating the need for a comprehensive outcome assessment utilizing validated psychometric tools in accordance with the current biopsychosocial model of chronic disorders.

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Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants

P.De Angelis1S.De Angelis2P.C.Passarelli1M.G.Liguori1G.Pompa3P.Papi3P.F.Manicone1A.D’Addona1

doi : 10.1016/j.ijom.2020.11.014

Volume 50, Issue 7, July 2021, Pages 956-963

Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P < 0.05). No statistically significant difference in pink aesthetic score (P = 0.379, 6 months postoperative) or marginal bone loss (P = 0.449 at 3 months postoperative, P = 0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P < 0.0001) and the time to complete the surgical procedure (P = 0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.

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Does osteoporosis increase marginal bone loss around dental implants in the posterior of the maxilla?

R.Tabrizi1F.Mousavi1S.Ghasemi2B.T.Ozkan3

doi : 10.1016/j.ijom.2020.12.001

Volume 50, Issue 7, July 2021, Pages 964-968

Osteoporosis is caused by an imbalance in bone remodelling. The aim of this study was to compare the marginal bone loss (MBL) around dental implants placed in the posterior maxilla between osteoporotic and non-osteoporotic female patients. This was a prospective cohort study. Female patients needing a dental implant restoration in the posterior maxilla were included. Dual-energy X-ray absorptiometry was performed and the T-score recorded. MBL was measured at 12 months after loading. The patients were assigned to one of two groups: group 1, osteoporotic (T-score ?2.5); group 2, non-osteoporotic (T-score <2.5). In this study, osteoporosis was the primary predictor variable and MBL was the outcome variable. The mean MBL was compared between the two groups using an independent t-test. Pearson’s correlation test was applied to identify any correlation between the T-score and MBL. Ninety female patients were studied, 44 in group 1 and 46 in group 2. The mean MBL was 1.20 ± 0.29 mm in group 1 and 0.87 ± 0.15 in group 2; this difference in mean MBL was statistically significant (P = 0.001). There was a correlation between T-score and MBL (P = 0.001). Despite the correlation between T-score and MBL, this study did not provide enough evidence to prove any causal relationship between MBL and osteoporosis.

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Augmented reality in craniomaxillofacial surgery: added value and proposed recommendations through a systematic review of the literature

M.Benmahdjoub12T.van Walsum2P.van Twisk1E.B.Wolvius1

doi : 10.1016/j.ijom.2020.11.015

Volume 50, Issue 7, July 2021, Pages 969-978

This systematic review provides an overview of augmented reality (AR) and its benefits in craniomaxillofacial surgery in an attempt to answer the question: Is AR beneficial for craniomaxillofacial surgery? This review includes a description of the studies conducted, the systems used and their technical characteristics. The search was performed in four databases: PubMed, Cochrane Library, Embase, and Web of Science. All journal articles published during the past 11 years related to AR, mixed reality, craniomaxillofacial, and surgery were considered in this study. From a total of 7067 articles identified using AR- and surgery-related keywords, 39 articles were finally selected. Based on these articles, a classification of study types, surgery types, devices used, metrics reported, and benefits were collected. The findings of this review indicate that AR could provide various benefits, addressing the challenges of conventional navigation systems, such as hand–eye coordination and depth perception. However, three main concerns were raised while performing this study: (1) it is complicated to aggregate the metrics reported in the articles, (2) it is difficult to obtain statistical value from the current studies, and (3) user evaluation studies are lacking. This article concludes with recommendations for future studies by addressing the latter points.

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Re: Preliminary experience with promethazine hydrochloride injection in the sclerotherapy of oral mucosa

A.Gangwar12D.Singh12

doi : 10.1016/j.ijom.2020.09.019

Volume 50, Issue 7, July 2021, Page 979

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Preliminary experience with promethazine hydrochloride injection in the sclerotherapy of oral mucocele

A.Chen

doi : 10.1016/j.ijom.2020.09.021

Volume 50, Issue 7, July 2021, Page 980

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