The sternocleidomastoid muscle as a muscular or myocutaneous flap for oral and facial reconstruction

The sternocleidomastoid muscle may be used as a muscular or a myocutaneous flap to satisfy the need for viable soft tissue in the reconstruction of some cancer- and trauma-related deformities. The anatomic and technical bases of these flaps are discussed in the context of a single-stage pedicled transfer in oral and maxillofacial reconstructive surgery.     

Squamous cell carcinoma developing in conjunction with a mandibular staple bone plate

A case of squamous cell carcinoma has been observed in conjunction with a mandibular staple bone plate. Because minor complications such as chronic irritation and gingival hyperplasia can possibly lead to more major sequelae, continuous follow-up care and observation are of the highest importance to the clinician who is involved in placement of the staple bone plate.     

A recurrent ulcerating lymphohistiocytic lesion of the oral cavity

Large ulcerated lesions of the oral cavity may be benign or malignant, and often the oral and maxillofacial surgeon is asked to differentiate between the two. Biopsy is recommended in all suspected lesions. However, occasionally the original histologic impression of a malignant neoplasm is not confirmed by the clinical behavior of the lesion. This report describes such a case and emphasizes the role of light microscopy, immunohistochemistry, and electron microscopy in the evaluation of such lesions.     

Disc displacement without reduction: a retrospective study of a clinical diagnostic sign

Objective: The purpose of this retrospective study is to evaluate a clinical diagnostic sign for disc displacement without reduction (DDWR), the absence of additional condylar translation during opening compared with protrusion.

Method: Thirty-eight electronic axiographic and magnetic resonance imaging (MRI) examinations of the TMJ were analyzed in order to compare the opening/protrusion ratio of condylar translation between non-painful DDWR and non-DDWR.

Result: According to the Mann-Whitney U test, the opening/protrusion ratio in non-painful DDWR differs significantly from non-DDWR (p < 0.0001).

Discussion: Among non-painful DDWR, there is no additional condylar translation during opening in comparison with protrusion, and this is probably also the case for DDWR without limited opening, which is a subtype that has not been validated by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Comparative condylar palpation can analyze this sign, and therefore, further comparative investigations between MRI and clinical examination are needed to validate the corresponding clinical test.     

Cynical hostility as a determinant of toothbrushing frequency and oral hygiene

AIM: Our aim was to investigate whether cynical hostility, self-reported toothbrushing frequency and objectively assessed levels of oral hygiene were associated. MATERIAL AND METHODS: The present study sample consisted of 4156 30-64-year-old dentate Finns. The questionnaire and the home interview included information about socioeconomic and sociodemographic factors and behavioural variables, such as toothbrushing frequency, dental attendance, smoking and cynical hostility. The level of oral hygiene was assessed during a clinical oral examination. The chi(2) test and ordinal logistic regression analyses were used. RESULTS: After controlling for sociodemographic and socioeconomic factors, smoking habits and reported dental attendance, the subjects belonging to the lowest cynical hostility level were found to brush their teeth significantly more often and to have better oral hygiene compared with those belonging the highest cynical hostility level. Toothbrushing frequency was adjusted when oral hygiene was used as the outcome variable. The association of cynical hostility with toothbrushing frequency and the oral hygiene seems to be partly dependent on the level of education. CONCLUSIONS: Cynical hostility is a psychosocial risk marker for the frequency and quality of toothbrushing and it could be a connecting trait between general health behaviour and oral health behaviour.     

Management of oral Kaposi's sarcoma and a proposal for clinical staging

Kaposi's sarcoma (KS) is the most common neoplastic disease in patients with disease due to human immunodeficiency virus (HIV), and oral KS (OKS) is the commonest oral neoplasia. OKS has been managed by local excision, intralesional chemotherapy regional radiotherapy, and systemic chemotherapy. Comparison between studies is difficult as the severity of oral involvement is not well defined in most studies. This paper reviews the approach to the management of OKS and also presents a proposal for the clinical staging of OKS. Clinical staging of OKS will facilitate comparisons of outcomes of treatment of OKS and improve our understanding of the natural history of the neoplasia, which has varied presentation and rates of progression.     

Is there a need for a common framework of dental specialties in Europe?

This paper aims to promote discussion about dental specialties and post-graduate dental education in the European Union (EU). Previously, dental educators have concentrated their efforts of seeking Pan–EU convergence in undergraduate dental education. However, the impact of the enlargement of the EU, the new European Commission (EC) Directive of professional training and the Bologna Process all impact on post-graduate (specialist) just as much as on undergraduate dental education. The provisions of the new EC directive mean that, unlike new medical specialties, new Pan–EU dental specialties cannot be created purely because they exist in two-fifths of EU Member States. At present, some EU Member States recognise eight or more dental specialties, whereas others recognise none. It is suggested that changing needs and demands of patients, which reflect a general improvement in oral health, increased wealth and an aging population will place increasing demands on dentistry to provide more complex care and treatment and that the current undergraduate curriculum cannot be expanded to provide suitable training to meet these needs and demands. There is thus a need to expand dental specialist training in all EU Member States, to agree common standards for specialist education and to officially recognise a wider range of Pan–EU dental specialties. The paper concludes that in order to achieve these goals, there is a need of a better collaboration between competent authorities, including governments, universities, dental associations and the various Pan–European Scientific Specialist Organizations.     

The effect of a preventive programme on dental plaque, gingivitis and caries in schoolchildren. Results after one and two years

Abstract The effect on plaque, gingivitis and dental caries of regularly repeated professional mechanical tooth cleaning combined with topical application of monofluoro-phosphate was tested in a group of 192 schoolchildren, 7–14 years of age, during a 2-year trial. They were divided into test and control groups. A baseline examination revealed that the test and control groups had a very similar oral hygiene status, degree of gingival inflammation and caries experience. Once every second week during the 2-year period the children of the test groups were given professional oral prophylaxis including careful tooth cleaning and topical application of 5 % sodium mono-fluorophosphate. Once every month, the children of the control groups brushed their teeth at school, under supervision, using a 0.2 % sodium fluoride solution. The results after 1 and 2 years of experiment indicate that the test group children had low Plaque Index scores (～ 0.3), only negligible signs of gingivitis (～ 0.25) and very low caries increment (0.1 new carious surface per year). The control group children had higher Plaque Index scores (～ 1.0), showed signs of gingivitis (～ 0.75), and developed on an average 3.1 new carious surfaces per year. It is suggested that the efficacy of public health programmes, based on professional tooth cleaning and topical fluoride administration, should be tested in larger groups of children and adults.     

Dento-alveolar and maxillofacial injuries – a retrospective study from a level 1 trauma center in Israel

Abstract –  To evaluate the frequency and causes of dental and maxillofacial trauma in hospitalized patients. From January 1, 2000 to December 31, 2003, data from hospitalized trauma patients in a level 1 trauma center in Israel were analyzed according to age, gender, time, place, and cause of injury. Maxillofacial and tooth injuries were separated and further analyzed according to the above parameters. The analysis was based on data from the Israel Trauma Registry (ITR). Of all 14 040 trauma patients, 1038 (7.4%) involved maxillofacial or dental injuries. Common causes of injury were motor vehicle crashes (41%), falls (27%) and intentional injuries (23%). Fifty percent occurred on the street/road, 17% at home and 14% in public buildings. Surgery was required in 55.5% of all maxillofacial injuries. Males were hospitalized three times more than females, and young people, ages 19–28, were at greatest risk (30.2%). Oral and maxillofacial trauma is common, requiring dental health training for primary caregivers.     

Septicemia secondary to administration of a contaminated intravenous fluid

The clinical entities of bacterial contamination, septicemia, and septic shock have been discussed, and an unusual case of septic shock has been presented. The associated risks of intravenous delivery of drugs or fluids are stressed.     

Accuracy of stereolithography additive casts used in a digital workflow

Statement of problem

Despite the increasing demand for a digital workflow in the fabrication of indirect restorations, information on the accuracy of the resulting definitive casts is limited.

近中骨折端稳定的颧骨、颧弓骨折的简略复位固定技术

目的 颧骨、颧弓骨折通常需要冠状切口、下睑切口和口内切口进路,逐一进行裂开骨折段的复位固定。本文旨在探索一种简便而可靠的修复方法。方法 针对颧骨、颧弓骨折其内侧相邻的上颌骨结构稳定、颧骨的近中骨折端移位不明显的6例患者,采取半冠状切口,按顺序复位固定的方法,由后向前做颧弓骨折段的复位固定,核查眶外壁颧额缝和颧蝶缝的衔接无误,最后完成颧额缝处骨折的固定。不需做下眼睑、口内切口以及眶下缘颧上颌缝的固定和口内颧牙槽嵴的骨折固定。结果 本组6例病例均顺利完成骨折复位与固定。术后CT扫描显示各个骨折断端,包括上颌窦后外壁、眶外壁等,都获得精确的解剖复位和牢固固定。两侧面部宽度和颧骨突度基本对称,面形恢复满意。开、闭口功能正常。未发生颞下颌关节损伤、视力损害及面神经额支损伤。结论 应用近中骨折端稳定的颧骨骨折的简略复位固定技术,可恢复颧骨、颧弓的解剖位置。