Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.     

口腔颌面-头颈部胚胎型横纹肌肉瘤临床诊治探讨

目的:探讨头颈部胚胎型横纹肌肉瘤的临床特点、诊断、治疗及预后.方法:回顾性分析上海交通大学医学院附属第九人民医院2000-09--2010-10收治的12例头颈部胚胎型横纹肌肉瘤患者的临床资料.结果:12例患者中9例获得随访.5例术前化疗患者中3例短期疗效达到PR,1例达到MR,化疗有效率达到60%;8例患者行手术治疗...     

Assessment and comparison of phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non-smokers

OBJECTIVES

Tobacco use is one of the most important public health problems worldwide. It is also linked to impairment of normal immunologic surveillance and defence mechanism of polymorphonuclear leukocytes. Tobacco smoke and its components have been seen to affect the phagocytic ability and viability of polymorphonuclear leukocytes suggesting the pathogenesis of tobacco induced oral diseases. Aim of this study was to assess and compare the phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non smokers.

DESIGN

The study comprised of 35 smokers and 35 non-smokers, age matched. Saliva was collected by rinsing method and the polymorphonuclear leukocytes were separated. Phagocytic activity was determined by using latex spheres as targets. Cell viability was measured using trypan blue stain.

RESULTS

Salivary polymorphonuclear leukocytes in smokers showed significant reduction in the phagocytic activity by ingesting few latex spheres when compared to the non-smokers. The viability of these cells in saliva of smokers was significantly reduced.

CONCLUSIONS

The present study revealed reduced phagocytic activity and viability of salivary polymorphonuclear leukocytes in smokers compared to non-smokers. These findings indicate that smokers are more prone to gingival, periodontal and other oral diseases. Thus indicating that the health care professionals should encourage smoking cessation as an aid in preventing oral diseases.     

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牙拔除术是一种常见的外科手术,术后因机体对拔牙创伤的生理反应会不可避免地引起局部出现程度不一的疼痛、肿胀,这种由手术创伤引起的疼痛、肿胀虽然是正常手术的继发过程,但会导致患者术后生活质量下降,并可使很多由于恐惧而不敢拔牙的患者延误了最佳治疗时机。本文就拔牙术后疼痛和肿胀的发生原因、临床表现、治疗方法和预防措施进行阐述,为临床上如何避免或减轻拔牙术后的疼痛和肿胀提供帮助。     

Colour and translucency of opaque-shades and body-shades of resin composites

The purpose of this study was to evaluate the optical properties--not only the translucency but also the colours--of opaque-shade resin composites. The CIELAB parameters (L*, a* and b*) of disks of A2 and opaque A2 (OA2) shades of Charisma (Heraeus-Kulzer), Solare (GC) and Filtek Supreme (3M) were evaluated on backings of black, white and the material itself to calculate the translucency parameter (TP) and the colour differences (delta E*) between A2 and OA2. A two-way analysis of variance (anova) for the TP indicated a less statistically significant TP value in the OA2 shade than the A2 shade for all products. As for the products, Charisma showed a statistically greater TP value than the other two products. Regarding the delta E* between A2 and OA2, all the products revealed clinically perceptible colour differences (delta E* > 3.3). Hence, we must take the colour differences of opaque-shade resin composites into consideration, as well as the translucency of the materials, for a clinically acceptable colour match of the restoration.     

种植体周围炎与牙周炎的类比探究

种植体周围炎症是种植失败的主要原因之一,包括种植体周围黏膜炎和种植体周围炎。种植体周围炎的发生、发展及治疗和预防与牙周炎存在一定的相似性,本文将种植体周围炎和牙周炎的流行病学、组织病理表现、始动因素、危险因素、治疗和预防等方面进行类比,探讨如何更好地预防和治疗种植体周围炎。     

Effects of zinc and copper on adhesion and hemagglutination of Prevotella intermedia and Prevotella nigrescens

This study investigated the mechanism of protein attachment to the surface of the putative periodontal pathogens Prevotella intermedia and Prevotella nigrescens in artificial gingival crevicular fluid, and ways to increase protein attachment to the bacterial cells. The effects of cations on protein attachment, bacterial adhesion, and hemagglutination were examined, and cation-binding components on both bacterial species were identified. The presence of cations, especially zinc, copper and cerium, increased attachment of human serum proteins to both bacterial species. In contrast, the presence of hydrophobic inhibitors or sugars had little effect. Protein attachment was reduced by heat treatment of the bacterial cells. Pretreatment of bacteria with human serum proteins inhibited adhesion of both species to buccal epithelial cells and hemagglutination. These effects were enhanced by the presence of zinc and copper during pretreatment. Using a chelating column, specific zinc- and copper-binding proteins were identified on the surfaces of both bacterial species.     

补体与牙周炎发生发展及其治疗

在牙周炎这一慢性炎症反应过程中,补体不仅可以调解机体防御反应,保护宿主,还可直接作用于免疫细胞或通过调控信号转导通路,协助病原菌进一步感染和破坏牙周组织,最终导致免疫病理性的损伤反应。在免疫炎症反应中,补体不仅可刺激白细胞分泌白细胞介素、肿瘤坏死因子和粒细胞-巨噬细胞集落刺激因子,调节辅助性T细胞和巨噬细胞,促进细胞免疫和T细胞依赖的抗体分泌,增强免疫效应的调节,提高机体免疫力;亦可引起的炎症反应可对组织造成损伤,引起牙周炎。以补体受体拮抗剂干扰补体受体-Toll样受体信号转导通路,有利于机体清除病原菌,达到防治牙周炎的目的。理解补体在牙周炎发生发展中的作用,可为牙周炎治疗探索新途径。     

Combined effects of NaF and SLS on acid- and polysaccharide-formation of biofilm and planktonic cells

Bacteria grow preferentially attached to surfaces embedded in an exopolysaccharide matrix to form biofilms. In this mode of growth, bacteria often show reduced susceptibility to antimicrobials. The aim of this study was to investigate whether the combination of NaF and the detergent sodium lauryl sulphate (SLS) could result in additive effects on acid formation by planktonic and biofilm cells, as well as on extracellular polysaccharide formation. An additive inhibitory effect on Streptococcus mutans acid formation was observed, both in planktonic and biofilm cells. In dental biofilms, SLS alone and in combination with NaF reduced acid formation. Extracellular polysaccharide formation by S. mutans and saliva was reduced by SLS alone and in combination with NaF. In dentifrices and mouthrinse solutions, NaF and SLS are often present in combination. It remains to be determined whether an additive effect on acid formation may also occur in dental biofilms under different concentrations from those used in the present study, and whether the effects may be selective for certain bacterial species.     

Impact of moderate and severe hypodontia and amelogenesis imperfecta on quality of life and self-esteem of adult patients

ObjectivesThe objective of this study was to investigate the impact of moderate and severe hypodontia and amelogenesis imperfecta on the quality of life and self-esteem of affected adult patients.MethodsForty one adult patients (aged 18–45 years) with clinical and radiological diagnoses of moderate to severe hypodontia and twenty seven patients diagnosed with amelogenesis imperfecta were age and gender matched with a control group of patients attending for routine dental care. Subjects completed the Oral Health Impact Profile [OHIP-49] and Rosenberg Self Esteem Scale. A paired t-test was used to analyse data; the test alpha level was set at P ≤ 0.05.ResultsThe results for hypodontia patients were significantly different from controls in six out of the seven OHIP-49 domains, the exception being the Handicap domain. Total scores were also significantly different between the two groups (P = 0.003). Self-esteem was not significantly different between the two groups (P = 0.98).For amelogenesis imperfecta patients the results were significantly different from control patients in four out of the seven domains of the OHIP-49 and also in the total scores (P = 0.01). When self-esteem was investigated there was no significant differences between the two groups (P = 0.92).ConclusionsModerate to severe hypodontia and amelogenesis imperfecta have marked negative impacts on the Oral Health Related quality of life of this patient population relative to controls. However, self-esteem was not significantly affected.     

牙周病与肺感染相关性实验动物模型的建立

目的：建立牙周病与肺感染的实验动物模型，以排除临床各种干扰因素来探讨两者的关系。方法：通过钢丝结扎＋黏性高糖饮食法，建立不同程度的大鼠牙周病模型，各组均采用气管灌注（第2亚组）或口腔喂饲铜绿假单胞菌悬液（第3亚组）两种途径使大鼠肺脏感染，且设立不接触菌液的对照组（第1亚组）。观察不同牙周病程度及不同感染途径叠加后对牙周炎和肺炎的影响。结果：大鼠平均牙周袋深度及牙槽骨吸收总量：重度牙周病组（C组）〉轻度牙周病组（B组）〉牙周正常组（A组）。中性粒细胞分类百分数：各组中第2亚组〉第3亚组〉第1亚组；且C2组〉B2组与A2组，C3组〉B3组与A3组。25％的B3组大鼠及75％的C3组大鼠牙周袋内龈下菌斑中可检出铜绿假单胞菌。结论：钢丝结扎＋黏性高糖饮食法2周时可建立大鼠轻度牙周病模型，4周则可建立重度牙周病模型。经口腔喂饲铜绿假单胞菌可导致大鼠肺感染，但严重程度不如气管灌注途径。牙周炎症越重的大鼠深牙周袋内越易定植呼吸道致病菌，且合并的肺感染更为严重。     

富血小板血浆与富血小板纤维蛋白联合冻干法研究进展

手术使用的浓缩血小板是再生医学的创新材料,富血小板血浆(PRP)是第一代富含血小板的浓缩物,已广泛应用于促进软硬组织愈合。富血小板纤维蛋白(PRF)是由法国学者Choukroun等首次提出的新一代血小板浓缩物,较传统富血小板血浆更具有应用优势。冻干法是保存生物制品的常规方法,也是控制支架空隙大小并保存其原有成分的有效手段。本文就于富血小板血浆和富血小板纤维蛋白结合冻干法应用于组织发育与再生作一综述。     

Ten years of observations and demographics of hemimandibular hyperplasia and elongation

Introduction

The full epidemiology and etiology of hemimandibular hyperplasia (HH) has not yet been clarified. In most cases it starts before puberty and results in various forms of dento-alveolar and skeletal discrepancies. This study is the first attempt at evaluating and describing some of the authors' key experiences, clinical philosophical approach, and gathered demographic data on hemimandibular hyperplasia and hemimandibular elongation (HE) among the Polish population.

Signs and symptoms of temporomandibular disorders and the incidence of tinnitus

In a cross-sectional analysis of data from the Study of Health in Pomerania (SHIP 0), temporomandibular disorders (TMD) were the strongest predictors for tinnitus beside headache. The aim of this study was to investigate whether signs and symptoms of TMD can be identified as risk factors for developing tinnitus. The SHIP 1 is a population-based 5-year longitudinal study intended to systematically describe the prevalence of and risk factors for diseases common in the population of Pomerania in northern Germany. A total of 3300 subjects (76% response) were reevaluated after 5 years for tinnitus and signs and symptoms of TMD using the same questionnaires and examination tools as baseline. To estimate the relative risk (RR) appropriately, a modified Poisson regression was used. After exclusion of prevalent cases with diagnosed tinnitus, 3134 subjects were analysed. Among the 191 exposed subjects with palpation pain in the temporomandibular joint (TMJ), 24 subjects (12·6%) received diagnosed tinnitus after 5 years, whereas among the 2643 unexposed subjects 142 subjects (5·8%) received tinnitus yielding a risk difference of 7·7% (95% confidence interval [CI]: 3·0%-12·5%) and a risk ratio of 2·60 (95% CI: 1·7-3·9). The risk ratio was 2·4 (95% CI: 1·6-3·7) after adjustment for gender, age, school education and frequent headache. Pain on palpation of the TMJ, however, did not worsen the prognosis for tinnitus in prevalent tinnitus cases (RR = 0·8, P = 0·288). Signs of TMD are a risk factor for the development of tinnitus.     

Comparison of Dentists'' Treatment and Management of Normal and Handicapped Patients

Forty-eight of 120 dentists (40%) responded to a survey using a two-questionnaire time-series design. Responding dentists with a median age of 36 years and 9.5 years in practice had received education in care of the handicapped mainly in dental school (42%) and continuing education (40%). They were asked to make the same treatment and practice management decisions for both normal and handicapped patients. No significant differences were found between normal and handicapped patients in the amount of time dentists spend on diagnosis, treatment, planning, or recall (p less than 0.05). For both normal and handicapped patients, the dentists as a group always chose the same option as treatment of choice for both normal and handicapped patients most frequently from a list of treatment or management options. Individual dentist consistency between normal and handicapped patients in treatment and management was good, with four out of five dentists choosing the same first treatment of choice for both normal and handicapped patients for similar circumstances. Only about one out of six dentists maintained a consistent priority sequence for both normal and handicapped patients when asked to rank a list of four or five possible treatment or management choices.     

国内外口腔颌面外科教育培训体系对比

口腔颌面外科的范围除了基础的牙及牙槽外科之外,还包括各种复杂的颅颌面手术,因此对口腔颌面外科医生的知识背景要求就不仅限于牙科。虽然其在世界范围的很多地方被归为牙科专业,但也有许多国家会要求从业者获得临床医学和牙科学的双重学位。不同国家和地区的口腔颌面外科教育培训路径各有不同,文章将进行对比分析,并浅谈对于口腔颌面外科医师培养的一些思考。     

Adherence and hydrophobicity of invasive and noninvasive strains of Porphyromonas gingivalis

The adherence of Porphyromonas gingivalis to cell surfaces of periodontal tissues may play an important role in its pathogenicity. In this study, 12 strains of P. gingivalis , including both invasive and noninvasive strains, were investigated for adherence to gingival ligament components. The test strains of P. gingivalis adhered to collagen, fibronectin, and laminin to significantly different degrees. An overall positive correlation was noted between hydrophobicity and the number of cells that attached to collagen coated on hydroxyapatite beads. Invasive strains had low hydrophobicity and bound less to collagen than did noninvasive strains that possessed strong hydrophobic properties. ³H-fimbriae extracted from P. gingivalis were found to attach to collagen-coated hydroxyapatite. The fimbriae extracted from noninvasive strains bound strongly to collagen, whereas invasive strains' fimbriae with low hydrophobicity bound weakly to collagen or saliva-coated hydroxyapatite. These data suggest that 1) fimbriae play an important role in colonization through their hydrophobic activity; 2) fimbriae of noninvasive strains are associated with the major adhesin for attachment to gingival tissue, whereas fimbriae of invasive strains are weakly involved in adherence; and 3) there is no correlation between colonization and the invasiveness of P. gingivalis.     

牙本质和牙骨质的仿生修复与再生

牙体硬组织缺乏完善的自我修复的能力。在牙本质和牙骨质中,羟基磷灰石(hydroxyapatite,HA)可同时存在于胶原纤维内外。如何在胶原纤维存在的情况下,修复或再生出具有高度有序的定向排列的HA是牙本质和牙骨质修复和再生的难点。目前牙本质和牙骨质的仿生矿化主要从模仿其生物形成过程和其生理结构两个方面来进行,分为源于纤维矿化机制的仿生矿化体系和以HA为主要成分的仿生矿化体系。应用的材料有脱矿牙本质(demineralized dentin matrix,DDM)、煅烧牛骨羟基磷灰石(bovine hydroxyapatite,BHA)等天然材料和聚合物诱导液体前体(polymer-induced liquid precursor,PILP)、合成HA等合成材料。未来应通过将天然材料与合成材料相结合,应用再矿化溶液-HA释放磷酸钙离子仿生矿化的方式来促进牙本质和牙骨质的修复与再生。     

成釉细胞瘤、颌骨囊肿中E-cadherin、vimentin的表达及意义

目的通过免疫组化双染技术检测成釉细胞瘤(ameloblastomas,AM)、颌骨囊肿中E-cadherin、vimentin的表达情况,探索AM中是否存在上皮间充质转化(epithelial-mesenchymal transition,EMT)现象。方法选择37例不同分型的AM、5例颌骨囊肿为研究对象,用免疫组化双染技术检测E-cadherin、vimentin的表达情况,通过计数分析二者共同表达细胞的分布情况。单因素方差分析AM与颌骨囊肿、实性型与单囊型AM的EMT。结果 AM中存在EMT现象,EMT发生特点在实性型与单囊型AM之间、AM与颌骨囊肿之间均无统计学差异。结论 EMT与成釉细胞瘤的侵袭性生物学行为无相关性,EMT存在于AM中可能为肿瘤组织中间质细胞的来源之一。