Oral cancer is an aggressive malignancy with a survival rate below 50% in advanced stages due to low mutation rates, lack of molecular subtypes, and limited treatment targets. This study presents a pioneering approach to classifying oral cancer subtypes based on the morphology of patient-derived organoids (PDOs) and proposes a therapeutic strategy. We establish 76 cancer and 81 normal PDOs. For cancer PDOs, both manual classification and AI-based scoring are utilized to categorize them into three distinct subtypes: normal-like, dense, and grape-like. These subtypes correlate with unique transcriptomic profiles, genetic mutations, and clinical outcomes, with patients harboring dense and grape-like organoids exhibiting poorer prognoses. Furthermore, drug response assessments of 14 single agents and cisplatin combination therapies identify a synergistic treatment approach for resistant subtypes. This study highlights the potential of integrating morphology-based classification with genomic and transcriptomic analyses to refine oral cancer subtyping and develop effective treatment strategies.

Background and Objectives: The aim of this study was to evaluate the effects of the chewing exerciser (CE) on the functional recovery of the masticatory muscles after orthognathic surgery. Material and Methods: This randomized clinical trial was conducted in patients undergoing bimaxillary orthognathic surgery including bilateral sagittal split ramus osteotomy. Postoperative physiotherapy (PT) was performed for 3 weeks starting 3 weeks after the surgery. The patients were randomly divided into two groups: control (Con) (conventional PT) group and CE group (use of CE in addition to conventional PT). The masticatory function was evaluated based on three standards: bite force (BF), amount of mouth opening (MO), and surface electromyography (sEMG) of the anterior temporal muscle (TA), masseter muscle (MM), sternocleidomastoid muscle, and anterior belly of digastric muscle before, 3 weeks (before PT) and 6 weeks after the surgery (after PT). Results: Finally, 22 subjects participated in this study: 10 patients for Con group and 12 patients for CE group. In both groups, the BF, which was reduced significantly after the surgery, recovered after the PT similar to that before the surgery. In both groups, the MO was also significantly reduced by the surgery. However, it did not recover as much, as it was before the surgery after applying the PT. There was no difference in BF and MO between the two groups. All muscles did not show significant changes in sEMG by surgery and PT at both resting and clenching states. Conclusion: Applying CE as a PT after orthognathic surgery did not cause any harmful side effects. In both groups, the weakened muscle activity after orthognathic surgery (OGS) was adequately restored 6 weeks after the surgery. However, CE did not offer a statistically significant benefit to the masticatory function in the recovery process after OGS.

Seongji Cho, Buyanbileg Sodnom-Ish, Mi Young Eo, Ju Young Lee, Ik Jae Kwon, Hoon Myoung, Hye Jung Yoon, Soung Min Kim. JKAOMS 2022;48:249-58. https://doi.org/10.5125/jkaoms.2022.48.5.249

Kwon D, et al. Imaging Sci Dent. 2022 May;52:e24. https://doi.org/10.5624/isd.20220035

The oral microbiome is crucial for human health. Although oral dysbiosis may contribute to oral cancer (OC), the detailed relationships between the microbiome and OC remain unclear. In this case-control study, we aimed to elucidate the connection between the oral microbiome and mechanisms potentially involved in oral cancer. The study analyzed 1022 oral saliva samples, including 157 from oral cancer patients and 865 from healthy controls, using 16S ribosomal RNA (16S rRNA) sequencing and a Light Gradient Boosting Machine (LightGBM) model to identify four bacterial genera significantly associated with oral cancer. In patients with oral cancer, the relative abundance of Streptococcus and Parvimonas was higher; Corynebacterium and Prevotella showed decreased relative abundance; and levels of fatty acid oxidation enzymes, including Carnitine palmitoyltransferase 1A (CPT1A), long-chain acyl-CoA synthetase, acyl-CoA dehydrogenase, diacylglycerol choline phosphotransferase, and H+-transporting ATPase, were significantly higher compared to controls. Conversely, healthy controls exhibited increased levels of short-chain fatty acids (SCFAs) and CD4+T-helper cell counts. Survival analysis revealed that higher abundance of Streptococcus and Parvimonas, which correlated positively with interleukin-6, tumor necrosis factor-alpha, and CPT1A, were linked to poorer disease-free survival (DFS) and overall survival (OS) rates, while Prevotella and Corynebacterium were associated with better outcomes. These findings suggest that changes in these bacterial genera are associated with alterations in specific cytokines, CPT1A levels, SCFAs in oral cancer, with lower SCFA levels in patients reinforcing this link. Overall, these microbiome changes, along with cytokine and enzyme alterations, may serve as predictive markers, enhancing diagnostic accuracy for oral cancer.

An autonomous robot osteotomy using direct coordinate determination for registering was developed, and the accuracy of the designed osteotomy along the preprogrammed plan was evaluated. Furthermore, the accuracy of the robotic and manual osteotomy was compared in regard to cut position, length, angle and depth. A light-weight robot was used in this study, with an electric gripper. Twenty stone models were used to evaluate accuracy of osteotomy and sixteen mandible phantoms were used to simulate the ramal bone harvest osteotomy for comparison between robotic and manual surgery. In the stone model experiment, the absolute mean values for osteotomy errors for position, length, angle, and depth were 0.93 ± 0.45 mm, 0.81 ± 0.34 mm, 1.26 ± 1.35°, and 1.19 ± 0.73 mm, respectively. In the mandible phantom model experiment, the robotic surgery showed lower errors for position, length and angle (0.70 ± 0.34 mm, 0.35 ± 0.19 mm and 1.32 ± 0.96°) and somewhat higher errors for depth (0.59 ± 0.46 mm) than manual surgery (1.83 ± 0.65 mm, 0.62 ± 0.37 mm, 5.96 ± 3.47° and 0.40 ± 0.31 mm). This study may provide a basis for developing clinical application of an autonomous robot osteotomy.