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Abtahi, Jahan
Publications (10 of 16) Show all publications
Abtahi, J., Henefalk, G. & Aspenberg, P. (2019). Impact of a zoledronate coating on early post-surgical implant stability and marginal bone resorption in the maxilla-A split-mouth randomized clinical trial.. Clinical Oral Implants Research, 30(1), 49-58
Open this publication in new window or tab >>Impact of a zoledronate coating on early post-surgical implant stability and marginal bone resorption in the maxilla-A split-mouth randomized clinical trial.
2019 (English)In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 30, no 1, p. 49-58Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The objective of this clinical study was to evaluate the effect of a bisphosphonate coating on a titanium implant on the implant stability quotient (ISQ) and the radiographic marginal bone levels at implants during early healing (2-8 weeks).

MATERIALS AND METHODS: In a randomized double-blind trial with internal controls, 16 patients received a dental implant coated with zoledronate and one uncoated implant as a control. The coated and uncoated implants which were visually indistinguishable were bone level titanium implants with a moderately rough surface and a microthreaded neck. ISQ values were obtained at insertion and at 2, 4, 6, and 8 weeks. Radiographs were obtained at insertion and at 8 weeks. The primary outcome was the difference in ISQ values between the coated implants and the control implants at 4 and 6 weeks, corrected for insertion values. The secondary outcome was loss of marginal bone level from insertion to 8 weeks.

RESULTS: Implant stability quotient values remained largely constant over the 8 weeks, and there was no significant difference between coated and uncoated implants at any time point. There was 0.12 (SD 0.10) mm marginal bone loss at the control implants and 0.04 (SD 0.08) mm at the coated implants. The difference was 0.17 mm; SD 0.14; p < 0.006). On blind qualitative scoring, 13 of the 15 control implants and two of 15 coated implants showed small marginal bone defects (p = 0.003).

CONCLUSIONS: There were no statistically significant differences observed in ISQ values between the coated and uncoated implants during the early healing. There was less marginal bone loss at the coated implants.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
dental implant, fibrinogen, maxilla, radiography
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-153634 (URN)10.1111/clr.13391 (DOI)000456748800004 ()30565741 (PubMedID)
Available from: 2019-01-06 Created: 2019-01-06 Last updated: 2019-02-27
Abtahi, J., Malakuti, I. & Ajan, A. (2019). Surgical Management of Granular Cell Tumor of the Orbit: Case Report and Literature Review. Open Dentistry Journal, 13, 33-40
Open this publication in new window or tab >>Surgical Management of Granular Cell Tumor of the Orbit: Case Report and Literature Review
2019 (English)In: Open Dentistry Journal, ISSN 1874-2106, E-ISSN 1874-2106, Vol. 13, p. 33-40Article in journal (Refereed) Published
Abstract [en]

Introduction: Granular Cell Tumors (GCTs) of the orbit are rare-entity soft-tissue tumors, and few reports have been published in the literature. The treatment of the choice is total excision. Early diagnosis prior to surgery is valuable for the distinction of malignant from benign tumor.

Case presentation: We report a case of a 55-year-old woman with a solitary slow-growing mass in the right orbit with the involvement of the rectus inferior muscle, and present a review of the recent literature. The lesion had a diameter of 1 cm and was noticed 2 years before the examination. Excisional biopsy confirmed the diagnosis of GCT. The tumor was resected through a retroseptal transconjunctival approach. The final histological examination revealed findings characteristic of GCT, including positive reaction for protein S-100, SOX10, and calcitonin and negative reaction for desmin, myogenin, Smooth Muscle Antigen (SMA), Melan-A, and HMB-45. There were no signs of malignancy in this sample. Disturbance of motility was not noted by the patient after surgery.

Conclusion: GCT should be included in the differential diagnosis of intraorbital lesions, particularly those that involve the orbit muscles. A biopsy is recommended before surgical resection, to exclude malignancy and prevent radical resection.

Place, publisher, year, edition, pages
Sharjah, United Arab Emirates: Bentham Open, 2019
Keywords
Granular cell tumor, Orbit, Protein S-100, Inferior rectus muscle, Magnetic resonance imaging, Biopsy
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-154508 (URN)10.2174/1874210601913010033 (DOI)
Available from: 2019-02-19 Created: 2019-02-19 Last updated: 2019-02-26Bibliographically approved
Abtahi, J. & Ajan, A. (2018). Malignant Transformation of Ossifying Fibroma into Parosteal Osteosarcoma with High-grade Component: Presentation of an Unusual Case and Review of the Literature. The Open Dentistry Journal, 12, 1059-1068
Open this publication in new window or tab >>Malignant Transformation of Ossifying Fibroma into Parosteal Osteosarcoma with High-grade Component: Presentation of an Unusual Case and Review of the Literature
2018 (English)In: The Open Dentistry Journal, E-ISSN 1874-2106, Vol. 12, p. 1059-1068Article in journal (Refereed) Published
Abstract [en]

Background: Parosteal Osteosarcoma of the Jaw (POSJ) is a rare entity that is associated with a high survival rate. Several case reports and case series of POSJ have been published in the literature, but few authors have described development of this tumor by possible transformation from a fibro-osseous neoplasm. Objective: We present a rare occurrence of parosteal osteosarcoma with involvement of the posterior maxilla, orbit floor, and infra-temporal fossa in a 20-year-old man. Furthermore, we performed a literature review regarding clinical, radiological, and histological features; treatment strategies; and etiology/pathophysiology. Methods: A PubMed search yielded a total of 74 articles and the articles were sorted according to their corresponding key area of focus. Results: This was a case of POSJ with high-grade component in the maxillofacial region of a 20-year old male. Co-expression of MDM2 and CDK4 was confirmed. At 2.5-year follow-up, the patient had died. The literature review revealed 18 articles including 20 cases of POSJ. Four cases represent the possible development of this tumor by transformation from a fibro-osseous neoplasm: Two cases of fibrous dysplasia, one case of cemento-ossifying fibroma, and the case of Ossifying Fibroma (OF) in the present study. Conclusion: In conclusion, we found an unusual case of POSJ of the midface in a patient with a previous diagnosis of OF in the same region. To our knowledge, there have been no previous reports of development of POSJ in OF. Furthermore, this is the first described case of high-grade surface osteosarcoma in the craniofacial region.

Place, publisher, year, edition, pages
Bentham Open, 2018
Keywords
Facial bone;Jaw, Malignant tumor;Neoplasm;Osteosarcoma;Parosteal
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-153632 (URN)10.2174/1874210601812011059 (DOI)
Available from: 2019-01-06 Created: 2019-01-06 Last updated: 2019-01-06
Alstad, V. & Abtahi, J. (2017). Surgical removal of keratocystic odontogenic tumours via a Le Fort I osteotomy approach: a retrospective study of the recurrence rate. International Journal of Oral and Maxillofacial Surgery, 46(4), 434-439
Open this publication in new window or tab >>Surgical removal of keratocystic odontogenic tumours via a Le Fort I osteotomy approach: a retrospective study of the recurrence rate
2017 (English)In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 46, no 4, p. 6p. 434-439Article in journal (Refereed) Published
Abstract [en]

The keratocystic odontogenic tumour (KCOT) is one of the most aggressive odontogenic cysts and has a high recurrence rate. The treatment of these tumours is the subject of debate. A KCOT in the posterior maxilla with sinus involvement is rare. Few reports have been published in the literature. The purpose of this study was to evaluate the recurrence rate after surgical removal of maxillary KCOTs via a Le Fort I osteotomy. A search was performed to identify patients with a follow-up time of at least 5 years. Nine patients were included in the study. The following clinical variables were analyzed: age at surgery, sex, symptoms, site and size of the tumour, surgical approach, and recurrence rate. The surgical approaches were curettage (n=6) and enucleation (n=3). Recurrence was seen in three patients (33%); all had multilocular tumours. No recurrence was seen in patients with unilocular tumours. The Le Fort I osteotomy approach allows direct visualization and ensures wide excision, minimizing the risk of recurrence. In this series, cases with a multilocular KCOT showed a higher risk of recurrence due to the difficulty of removing the tumour in total. All recurrences took place within 2 years of the intervention; a 5-year follow-up is recommended.

Place, publisher, year, edition, pages
Elsevier, 2017. p. 6
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-135566 (URN)10.1016/j.ijom.2017.01.006 (DOI)000398009500005 ()28189375 (PubMedID)
Note

Funding agencies: Linkoping University Hospital; Department of Oral and Maxillofacial Surgery, Linkoping, Sweden

Available from: 2017-03-17 Created: 2017-03-17 Last updated: 2018-05-02
Tardast, A., Sjoman, R., Loes, S. & Abtahi, J. (2015). Bisphosphonate associated osteomyelitis of the jaw in patients with bony exposure: prevention, a new way of thinking. Journal of Applied Oral Science, 23(3), 310-314
Open this publication in new window or tab >>Bisphosphonate associated osteomyelitis of the jaw in patients with bony exposure: prevention, a new way of thinking
2015 (English)In: Journal of Applied Oral Science, ISSN 1678-7757, E-ISSN 1678-7765, Vol. 23, no 3, p. 310-314Article in journal (Refereed) Published
Abstract [en]

Objective: There is strong evidence of a link between the use of systemic bisphosphonates (BPs) and osteonecrosis of the jaw, especially in cancer patients. Among risk factors for BRONJ, tooth extraction and immune suppressive drugs seem to have significant role on bone healing. Therefore, the importance of these parameters in development of BRONJ was reviewed in this retrospective study in two maxillofacial surgery units. Material and Methods: From 2007 to 2012, 46 patients on bisphosphonate who had developed oral bony lesions participated in this study. The pharmacological exposure, comorbidities, maxillofacial findings, types of treatment and outcome data were collected from clinical and radiological records. Results: The most frequently used BP was alendronate (67%). Tooth extraction was reported in 61% of patients with BRONJ. Systemic corticosteroids were prescribed in 35 cases (76%) as an adjuvant for BP. Patients on corticosteroids had a lower probability of bony lesion healing (pless than0.05) than patients without corticosteroids. Of the 46 patients who underwent conservative treatments, only ten were completely healed (21%). Conclusions: Beside tooth extraction, corticosteroids were shown to be an implant risk factor for low rate of bone healing and hence the development of BRONJ. The outcome of conservative treatment was uncertain and this emphasizes the importance of prevention.

Place, publisher, year, edition, pages
University of S�o Paulo, 2015
Keywords
Bisphosphonates; Jaw; Bisphosphonate-associated osteonecrosis of the jaw; Oral health; Osteoporosis
National Category
Dentistry
Identifiers
urn:nbn:se:liu:diva-120752 (URN)10.1590/1678-775720140506 (DOI)000358785900010 ()26221926 (PubMedID)
Note

Funding Agencies|Departments of Oral; Department of Oral and Maxillofacial Surgery at the University of Linkoping; Department of Oral and Maxillofacial Surgery at the University of Bergen

Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2017-12-04
Berglund, C., Ekströmer, K. & Abtahi, J. (2015). Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases. Case Reports in Dentistry, 2015(152717)
Open this publication in new window or tab >>Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases
2015 (English)In: Case Reports in Dentistry, ISSN 2090-6447, E-ISSN 2090-6455, Vol. 2015, no 152717Article in journal (Refereed) Published
Abstract [en]

Objective. Primary chronic osteomyelitis (PCO) of the jaws in children is associated with pain, trismus, and swelling. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. This paper presents two cases of mandibular PCO in children with the involvement of the collum mandibulae. In addition, a review of the literature regarding demographic data, histological, radiological, and laboratory findings, and treatment strategies of PCO was also performed. Material and Methods. Prospective analyses of two PCO cases. A PubMed search was used and the articles were sorted according to their corresponding key area of focus. Results. Review of the literature revealed twenty-four cases of PCO with two cases of mandibular condyle involvement. The mean age was 18 years; the male to female ratio was 1 : 3. Most of the patients were treated with anti-inflammatory drugs in combination with decortication. Clinical recurrence was seen in 7 cases. Conclusion. A combination of anti-inflammatory drugs and surgical intervention appears to be the first choice of treatment. However, surgical removal of necrotic tissue adjacent to collum mandibulae has its limitations in children. Further investigations are of utmost importance in order to increase our knowledge and understanding of this disease.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2015
National Category
Other Clinical Medicine Orthopaedics
Identifiers
urn:nbn:se:liu:diva-131071 (URN)10.1155/2015/152717 (DOI)26435856 (PubMedID)
Available from: 2016-09-07 Created: 2016-09-07 Last updated: 2018-04-03Bibliographically approved
Rasmusson, L. & Abtahi, J. (2014). Bisphosphonate associated osteonecrosis of the jaw: an update on pathophysiology, risk factors, and treatment.. International Journal of Dentistry, Article ID 71035.
Open this publication in new window or tab >>Bisphosphonate associated osteonecrosis of the jaw: an update on pathophysiology, risk factors, and treatment.
2014 (English)In: International Journal of Dentistry, ISSN 1687-8728, E-ISSN 1687-8736, article id 71035Article, review/survey (Refereed) Published
Abstract [en]

Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2014
National Category
Medical Materials Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-131045 (URN)10.1155/2014/471035 (DOI)25254048 (PubMedID)
Available from: 2016-09-06 Created: 2016-09-06 Last updated: 2017-11-21
Abtahi, J. (2013). Bisphosphonates and implants in the jaw bone. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Bisphosphonates and implants in the jaw bone
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Insertion of metal implants in bone is one of the commonest of all surgical procedures. The success of these operations is dependent on the fixation of the implants, which, in turn, depends on the strength of the bone that holds them. If the quality of the bone holding the implant could be improved locally, surgical procedures would become simpler and rehabilitation would become faster. Bisphosphonates are anti-resorptive drugs that act specifically on osteoclasts, thereby maintaining bone density and strength. Once released from the surface of a coated implant, bisphosphonates reduce osteoclast activity, thereby changing the balance of bone turnover in favor of bone formation, leading to a net gain in local bone density. During the last decades, the effects of bisphosphonate treatment on the stability of implants have been tested in several clinical and animal studies, but not in human jaws. This may be because it has been suggested that there is a link between the use of bisphosphonates (especially those given intravenously) and a condition called osteonecrosis of the jaw (ONJ). The pathophysiology and treatment of ONJ is controversial. The difficulty in treating ONJ has highlighted the importance of prevention.

The overall aim of the present thesis was to evaluate the effect of local and systemic use of bisphosphonates on bone tissue. Could a thin, bisphosphonate-eluting fibrinogen coating improve the fixation of metal implants in the human jaw? Would it be possible to reproduce ONJ and prevent the development of this condition in an animal model?

In two clinical studies, a total number of 96 implants were inserted in 21 patients. In a randomized trial with a paired design, one implant in each pair was coated with a thin fibrinogen layer containing two bisphosphonates (pamidronate and ibandronate). The bisphosphonate-coated implants showed better stability as measured by resonancefrequency analysis. Radiographic intraoral films also showed less bone loss. Three animal models were developed. In a study comparing local and systemic effects of bisphosphonates, zoledronate-coated screws inserted in rats showed better fixation in spite of a drug treatment that is known to induce ONJ-like lesions when given systemically. In another rat model, ONJ-like lesions were reproducibly induced at sites of tooth extraction whereas there were no signs of bone cell death in uninjured sites. Finally, rat experiments showed that the development of ONJ-like lesions after tooth extraction could be prevented by early mucoperiosteal coverage.

In conclusion, a thin, bisphosphonate-eluting fibrinogen coating can improve the fixation of dental implants in human bone. This may lead to new possibilities in orthopaedic surgery and dentistry. The pathophysiology of ONJ is strongly linked to bone exposure in combination with drugs that reduce resorption.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. p. 144
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1348
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89669 (URN)978-91-7519-724-1 (ISBN)
Public defence
2013-03-22, Berzeliussalen, hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-03-01 Created: 2013-03-01 Last updated: 2016-09-07Bibliographically approved
Abtahi, J., Agholme, F., Sandberg, O. & Aspenberg, P. (2013). Effect of Local vs. Systemic Bisphosphonate Delivery on Dental Implant Fixation in a Model of Osteonecrosis of the Jaw. Journal of Dental Research, 92(3), 279-283
Open this publication in new window or tab >>Effect of Local vs. Systemic Bisphosphonate Delivery on Dental Implant Fixation in a Model of Osteonecrosis of the Jaw
2013 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 92, no 3, p. 279-283Article in journal (Refereed) Published
Abstract [en]

Locally applied bisphosphonates may improve the fixation of metal implants in bone. However, systemic bisphosphonate treatment is associated with a risk of osteonecrosis of the jaw (ONJ). We hypothesized that local delivery of bisphosphonate from the implant surface improves the fixation of dental implants without complications in a setting where systemic treatment induces ONJ. Forty rats were randomly allocated to 4 groups of 10. All groups received a titanium implant inserted in an extraction socket. Group I received the implants only. Group II received dexamethasone (0.5 mg/kg). Group III received dexamethasone as above plus alendronate (200 µg/kg). Group IV received zoledronate-coated implants and dexamethasone as above. The animals were sacrificed 2 weeks after tooth extraction. All 10 animals with systemic alendronate treatment developed large ONJ-like changes, while all with local treatment were completely healed. Implant removal torque was higher for the bisphosphonate-coated implants compared with the other groups (p < 0.03 for each comparison). Micro-computed tomography of the maxilla showed more bone loss in the systemic alendronate group compared with groups receiving local treatment (p = 0.001). Local bisphosphonate treatment appears to improve implant fixation in a setting where systemic treatment caused ONJ.

Place, publisher, year, edition, pages
Sage Publications, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89667 (URN)10.1177/0022034512472335 (DOI)000314914100013 ()23264610 (PubMedID)
Available from: 2013-03-01 Created: 2013-03-01 Last updated: 2017-12-06Bibliographically approved
Abtahi, J., Agholme, F. & Aspenberg, P. (2013). Prevention of osteonecrosis of the jaw by mucoperiosteal coverage in a rat model. International Journal of Oral and Maxillofacial Surgery, 42(5), 632-636
Open this publication in new window or tab >>Prevention of osteonecrosis of the jaw by mucoperiosteal coverage in a rat model
2013 (English)In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 42, no 5, p. 632-636Article in journal (Refereed) Published
Abstract [en]

There is evidence for a link between the use of systemic bisphosphonates and osteonecrosis of the jaw (ONJ). This condition has the appearance of chronic osteomyelitis, and antibiotics prevent the development of ONJ in animal models. Clinically, ONJ can sometimes be successfully treated by mucoperiosteal coverage. If ONJ is indeed primarily caused by bacterial infection, immediate coverage of the extraction alveolus might reduce the risk of ONJ development in risk patients. Therefore, we studied whether immediate mucoperiosteal coverage after tooth extraction could prevent ONJ development in a rat model. Thirty rats were randomly allocated to three groups of 10. Group I (controls): extraction, no drug treatment; Group II (non-coverage): extraction, dexamethasone plus alendronate; Group III (coverage): dexamethasone plus alendronate, plus coverage by a mucoperiosteal flap. Rats were examined for macroscopic ONJ-like wounds after 2 weeks. All animals in the non-coverage group developed large ONJ-like changes. The coverage and control groups showed an intact overlying mucosa in all rats. Findings were confirmed with histology. Bisphosphonates and dexamethasone caused ONJ-like lesions after tooth extraction in a rat model. This was prevented by immediate mucoperiosteal coverage. The risk of ONJ in patients using bisphosphonates might be reduced by mucoperiosteal coverage after tooth extraction.

Keywords
Bisphosphonates, osteonecrosis, jaw, rat, mucoperiosteal flap, antibiotics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89668 (URN)10.1016/j.ijom.2013.02.007 (DOI)000318132600014 ()
Available from: 2013-03-01 Created: 2013-03-01 Last updated: 2017-12-06Bibliographically approved
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