Primary intra-osseous carcinoma involving the maxilla

Primary intra-osseous carcinoma, especially in the maxilla, is a rare sub-type of odontogenic carcinoma. The authors describe a recurrent case with maxillary involvement. In 1981, an intra-osseous maxillary tumour was excised from a 33 year-old male. There were two recurrences (in 1983 and 1984). Extra-osseous sites for the origin of the tumour were excluded. The histopathological appearance of the tumour was that of a primary intra-osseous carcinoma. At the age of 22 years, the patient had an osteosarcoma of the radius and at the age of 31 years, pulmonary tuberculosis. The differential diagnosis of primary intra-osseous carcinoma is discussed.     

Peripheral squamous odontogenic tumour

Squamous odontogenic tumour (SOT) is a rare, benign epithelial tumour of odontogenic origin. A recurrent case of SOT with peripheral occurrence is described. In 1971, a tumour from the anterior maxillary palatal mucosa of an 11-year-old female was excised. In 1984, when the patient was 24 years old, a recurrent tumour was found in the same area. The histopathological appearance of the lesion, which was found to be identical with the primary tumour, was that of an SOT. Both the clinical and radiographic features supported the extra-osseous involvement of both tumours. The SOT is further evaluated and its origin is discussed.     

Comparison of postoperative skeletal stability of maxillary segments after Le Fort I osteotomy,using patient-specific implant versus mini-plate fixation

BackgroundThree-dimensionally (3D) designed osteotomies and customised osteosynthesis are rapidly becoming standard in maxillofacial reconstructive and deformity surgery. Patient-specific implants (PSIs) have been in use for a few years in orthognathic surgery as well. In Le Fort I osteotomy, wafer-free fixation of the maxillary segment can be performed by individually manufactured cutting and drill guides together with PSIs.AimThis retrospective study was performed to compare the postoperative skeletal stability of the maxillary segment fixed by patient-specific implants versus mini-plates after Le Fort I osteotomy.PatientsFifty-one patients were divided into subgroups according to the fixation method and the advancement of the sub-spinal point. The postoperative skeletal stability of the maxillary segment was evaluated from lateral cephalometric radiographs one year postoperatively.ResultsNo statistically significant differences were found between the postoperative skeletal stability of the PSI and mini-plate fixed maxillae. Prospective studies, possibly with 3D fusion analysis, are warranted to confirm the results.ConclusionThe choice between the two fixation methods does not seem to affect the postoperative skeletal stability of the maxillary segments.     

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — Up to 3-year follow-up

The use of individually designed osteotomies, combined with individually manufactured osteosynthesis material, is rapidly becoming a standard for more challenging maxillofacial surgery. The benefits of patient-specific implants (PSI) in orthognathic surgery are clear in complex cases. PSIs can enhance precision and ease up the surgical protocol. We previously reported on the benefits of PSIs as reposition and fixation systems during Le Fort I osteotomy. The aim of this study was to evaluate a cohort of 28 patients, treated with bilateral sagittal split osteotomy (BSSO) and PSIs for fixation, with regard to healing for up to 3 years. A retrospective cohort of 48 patients with conventional mini-plate repositioned mandibles was also collected for statistical analysis. No statistically significant differences were found with regard to infection, soft tissue problems, or reoperations between these two groups.     

Current treatments and advances in pain and anxiety management

In light of preoperative and postoperative mortality and morbidity, continued advancement in pain and anxiety management would benefit millions. Although significant strides have been made in the past few decades, it is imperative that research and development continue. This article discusses types of pain and anxiety, the relationship between pain and anxiety, the physiology of pain and anxiety, and current trends in pain and anxiety management.     

Age and gender-related differences in premolar and molar functional areas

The aim of the present study was to underline the difference in premolar-molar functional areas according to both age and gender in a human adult population. Premolar and molar series were marked manually on opposed casts with articulating paper and functional areas were evaluated by quantification of these markings. It was noticed that on average larger functional areas were displayed by the older group (19 individuals, mean age 71.2 years, minimum 68 years, maximum 73 years) in comparison with the younger one (24 individuals, mean age 27.4 years, minimum 22 years; maximum 33 years). It was also observed that the average total functional area (4 hemiarches) was larger in the male subgroup (n: 23; mean age 45; young adults, 14; old adults, 9) compared with the female one (n: 20; mean age 49; young adults, 10; old adults, 10). Nevertheless, this gender difference in premolar-molar functional areas was related to the individual occlusal areas. As a matter of fact, when the individual occlusal area was taken into account for each series in the form of a ratio (functional area/occlusal area), the values obtained were not different between both gender subgroups studied. When comparing premolar and molar functional ratios (functional area/occlusal area) between age groups, it appears that the values obtained were slightly higher for the premolar series (ratios for young and older adults, respectively: Premolar series: 23.6+/-7.5%, 30+/-6.5%; Molar series: 23.1+/-6.8%, 27.3+/-6.7%). This difference was interpreted in relation to the reference (occlusal area) chosen.     

Oral infections related to radiation and immunosuppressive therapy

Abstract. The frequency of oral infection complications after cytotoxic chemotherapy andradiochemotherapy is significant, often contributing to serious septic infectious complications. Generally, the more intense the cytotoxic therapy, the more common are the oral infection complications. In the present review, the spectrum of oral infections related to radiation and immunosuppressive therapy are evaluated and the different local and systemic treatment modalities are presented.     

面颈部13例钙化上皮瘤临床分析

目的:探讨钙化上皮瘤的临床特点及辅助检查结果,以提高术前正确诊断率。方法:对兰州大学第一医院口腔颌面外科2008～2011年收治的13例钙化上皮瘤患者作一临床分析。结果:结合文献发现钙化上皮瘤为单一的局部皮下硬结,大小在5cm以下不等,成菱形或类圆形,可隆起于皮肤表面,表面皮肤色泽正常或有局部发红出现,有时肿瘤与皮肤紧密粘连。B超及CT可提供肿瘤内部结构特点。结论:根据如上临床特点结合B超及CT检查结果可明显提高钙化上皮瘤术前正确诊断率。     

口腔颌面颈部恶性淋巴瘤46例临床分析

目的:回顾性分析口腔颌面颈部恶性淋巴瘤的流行病学状况、临床特点、常见误诊原因以及提高临床早期诊断的要点.方法:对46例经病理确诊的口腔颌面颈部恶性淋巴瘤的临床资料进行回顾性分析.结果:46例恶性淋巴瘤中非霍奇金淋巴瘤39例(84.8%),霍奇金淋巴瘤7例(15.2%).首发症状依次为无痛性包块、疼痛性包块、感染、溃疡.首发部位依次为颈部、颌下、颏下、口腔、腮腺区.不伴发全身症状者40例(87%).首诊诊断不明者38例(82.6%).1次病理诊断的确诊率为84.8%.治疗主要为手术 化疗.患者5年生存率58%.结论:结外型恶性淋巴瘤的临床表现呈多样化,容易被临床误诊.应提高对其认识,对高度怀疑为该病的患者应反复多次病检加免疫组化检查以明确诊断.     

口腔颌面颈部恶性淋巴瘤56例临床分析

目的：探讨头颈部恶性淋巴瘤的发病特点、临床表现以及预后的相关性分析。方法：搜集56例头颈部恶性淋巴瘤病例,采用HE染色法进行观察,分析临床特点及预后情况。结果：56例头颈部恶性淋巴瘤患者中非霍奇金恶性淋巴瘤和霍奇金恶性淋巴瘤患者分别为47例（83.93%）和9例（16.07%）,常见临床体征是包块（痛性及无痛性）,感染溃疡。49例回访,7例失访。在回访中,22例（44.90%）复发,经分析表明复发率与患者的年龄及累计部位的差异具有统计学意义（P〈0.05）。发病部位依次为颈部、颌下、颏下。仅有头颈部症状者48例（85.71%）。初次诊断不明确者46例（82.14%）。1次病理诊断的确诊率为84.8%。治疗主要为手术＋化疗。患者5年生存率58%。结论：结外型恶性淋巴瘤的临床表现及组织学形态多样化,容易与临床上其他疾病相混淆。应通过病理检查及免疫组织化学检查以明确诊断。累犯≥2个部位和年龄〉50岁头颈部恶性淋巴瘤患者的复发率较高。     

Development of the clinical use of distant flaps for head and neck reconstruction

The reconstruction of hard and soft tissue defects, mainly after ablative oncologic surgery in the head and neck area, is an evolving field. The use of free flaps for reconstruction of the head and neck is considered to be the surgical standard. In our analysis of more than 1000 free flaps we give an overview of the development of the use of different types of free tissue transfer to the head and neck area over the last 25 years. We show that the evolving field of head and neck reconstruction raises new possibilities with new types of flaps, whereas other types of flaps disappear in the everyday clinical use. The spectrum of reconstruction possibilities broadens with the number of different flap types available to the head and neck surgeon.     

口腔科常用医疗器械清洗消毒效果的评价

目的评价口腔科医疗器械常规清洗消毒的效果。方法选择2013年7月～12月口腔科使用过的非一次性医疗器械（拔牙钳、车针）共36669件,消毒供应室清洗消毒处理前后,对物体表面口腔常见的变形链球菌、白色念珠菌、金黄色葡萄球菌以及乙肝病毒进行检测,并用目测法分析清洗的质量,测评临床的满意度。结果（1）器械清洗消毒质量的合格数为35395件,合格率达到96．52％;（2）细菌和病毒检测结果显示,除了工作室桌子有10次细菌不达标以外,其余均未检出细菌和病毒;（3）紫外照射与高压的消毒效果差距较大,未高压的灭菌消毒效果低于高压的灭菌消毒效果;（4）临床使用满意度达到95．83％。结论经规范化清洗消毒与管理,基本能确保口腔器械的卫生安全,所采用的清洗消毒措施,在一定程度上能有效控制医院感染的发生。     

1.2 Cognition and learning

This theme is concerned with the relevance and efficacy of educational methods adopted in dental schools while recognizing the influence of geopolitical issues in different countries and regions. Particular emphasis will be given to examples of best practices and innovations. Cognition and learning are dealt with in many different research areas such as education, psychology, cognitive sciences, brain research, neurolinguistics, gender, etc. and comprise the theoretical foundation for the philosophies, principles and methods underlying the dental education system. Educational methods are many and mixed. This group has used existing knowledge, personal experiences and current literature together with some of the material from the DentEd visits.     

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...