The effects of ultrasonic scaling with oral hygiene education on the distribution of pathological pockets using CPITN diagnostic standards

Thirty-three subjects aged 20-44 years, selected from Japanese company employees who had been given CPITN Codes of 3 or 4, received a treatment of ultrasonic scaling to investigate any changes in the distribution of pathological pockets after this treatment using CPITN diagnostic standards. A pathological pocket was defined as a pocket with a depth of 4 mm or deeper as described in the CPITN system. The results demonstrate that the number of teeth with pathological pockets was significantly reduced from 6.2 to 3.4 (45 per cent reduction) after scaling with an ultrasonic instrument requiring at most 30 minutes per subject. The reduction in pathological pockets was attributed to an improvement in shallow pockets rather than deep pockets. These results imply that as far as shallow pockets are concerned, one episode of scaling with ultrasonics is effective in reducing the extent of periodontal disease. Comparison between the number of sextants with shallow pockets before and after scaling further revealed that more improvements were observed in the subjects aged 20-29 years than in those aged 30-44 years. These results suggest that subjects aged 20-29 years with shallow pockets should be given first priority for scaling programmes in an adult population. The results also indicate that the CPITN diagnostic standards, in which the probe measures what is 'normal' and 'abnormal', is appropriate for the evaluation of periodontal status in an epidemiological study.     

Pathological fracture of the mandible resulting from osteomyelitis successfully treated with only intermaxillary elastic guiding

Treatment of mandibular pathological fractures differs according to etiology. Closed reduction with intermaxillary fixation is usually performed when fractures occur as a result of osteomyelitis. Here is reported a case of pathological fracture of the mandible resulting from osteomyelitis that was successfully treated with intermaxillary elastics only.     

Tumour volume estimated by computed tomography as a predictive factor in carcinoma of the tongue

This retrospective study evaluated tumour volume, estimated by computed tomography (CT), as a predictive factor in carcinoma of the tongue. Tumour volume was measured from pretreatment CT scans of 20 consecutive patients, followed up for at least 3 years, and this measurement was compared with tumour volume estimated from pathological specimens. T-stage and CT-derived tumour volume were compared with the clinical and pathological status of the nodes, and with the outcome of treatment.The measurement of tumour volume derived from CT correlated well with measurements derived from pathological examination, and tumour volume also predicted overall treatment failure. The disease-specific survival rate was 100% for patients with low-volume tumours (<13 cc) compared with 79% for those with stage T1 and T2 tumours.CT is a reliable way of measuring the volume of tumours in carcinoma of the tongue, and tumour volume is useful adjunct to the clinical tumour-node-metastases staging system.     

Bilateral investigation of the temporomandibular joint. An autopsy study of edentulous individuals

Investigations concerning normal and pathological anatomy of the temporomandibular joint (TMJ) have shown that pathological reactions such as deviations of the shape of the condyle, disc thinnings, disc perforations and osteoarthrotic changes are fairly common, particularly in the elderly population. Autopsy studies of the TMJ describe pathological findings respective to their location in different age groups, but most authors describe their findings for removed joints of one side only. The specific aim of this study was therefore to investigate the intra-individual relationships between the degenerative changes and deviations concerning the articular surfaces of the TMJs and the topographical distributions of these findings. In this investigation both joints of 22 edentulous individuals between 58 and 95 years of age were studied. Correlations were found between the right and left joints with respect to the anatomical location of the pathological findings.     

白斑及鳞癌9p微卫星位点改变及与病理的关系

目的:探讨口腔白斑及鳞癌染色体9p上4个微卫星位点改变的状况及其与临床病理诊断的关系。方法:选择微卫星位点D9S171、D9S175 2、D9S1748和IFNA ,应用聚合酶链式反应-变性聚丙烯酰胺凝胶电泳-银染方法,检测3 9例口腔白斑及12例鳞癌,分析其微卫星不稳定(MSI)及杂合性缺失(LOH)状况。结果:不同病理组别间4个位点MSI及LOH总的检出率有显著性差异(P <0 .0 1)。其中LOH检出率在不同临床病理组别之间有显著性差异(P <0 .0 5 ) ;而MSI的检出率在不同临床病理组别之间无显著性差异(P >0 .0 5 )。不同病理组别间单个位点的MSI及/或LOH无显著性差异(P >0 .0 5 )。结论:口腔癌的发生是多阶段多基因共同作用的结果。4个微卫星位点附近可能存在与口腔鳞癌发生发展相关的抑癌基因。MSI在口腔癌前病变癌变早期即已发生,而LOH发生频率则随口腔癌前病变癌变的发生发展逐渐增高     

龋源性牙髓病的组织病理学研究

目的 :研究龋源性牙髓病的病变类型、范围和程度。方法 :收集 2 0 0例龋源性牙髓病牙的临床和病理资料 ,观察其组织病理变化。结果 :2 0 0例龋源性牙髓病牙的病理学改变中慢性炎症 14 8例 ( 74.0 % ) ,其中又以部分性单纯性牙髓炎为大多数 ( 96例 ,64 .9% )。结论 :龋源性牙髓病牙的病理变化与感染途径有关 ,越靠近龋洞或穿髓点处的牙髓病变越重。     

Schwannoma of the inferior alveolar nerve in association with the organ of Chievitz

Abstract A benign neural sheath neoplasm arising from the investing tissues of the inferior alveolar nerve and presenting as a facial swelling is described. Of interest and importance was the associated finding of the so-called organ of Chievitz within the initial biopsy specimen. Its recognition as a vestigial structure and not a pathological entity is emphasized.     

牙齿病理性磨损充填治疗的临床效果研究

目的观察尚未出现牙髓症状的牙齿病理性磨损充填治疗的临床效果。方法选择牙列完整、后牙骀面有病理性磨损且具有充填空间的患者10例，患牙48颗，均无牙髓症状。使用后牙树脂充填后，比较治疗前、治疗后3个月和1年时，患者主观感觉和咀嚼功能（咬合力、咀嚼效率和咬肌肌电活动）的变化，观察树脂充填的临床效果（美国公共健康部评价系统）。结果患牙经充填治疗后患者临床症状消失，咬合力增加（P〈0．05），咀嚼效率明显提高（P〈0．01），治疗前后下颌息止位、大力咬合时、咀嚼运动时，颞肌前束和咬肌的活动强度、活动对称性及用力方式差异均无统计学意义（P〉0．05）；治疗后3个月和1年时复查，48颗后牙树脂充填体各项指标A级率为100％。结论对后牙骀面尚未出现牙髓症状的病理性磨损用树脂进行充填是一种有效的治疗方法，可以解除患者的临床症状，减缓磨损的发展，增加咀嚼效率及患牙咬合力。     

Usefulness of contrast-enhanced CT in the evaluation of depth of invasion in oral tongue squamous cell carcinoma: comparison with MRI

Objectives

There is currently no standardized approach for assessing the depth of invasion (DOI) of oral tongue squamous cell carcinoma via diagnostic imaging. We investigated the usefulness of contrast-enhanced computed tomography (CECT) for estimating the pathological DOI of oral tongue squamous cell carcinoma by evaluating the correlation of pathological DOI with the DOIs on CECT and magnetic resonance imaging (MRI).

Methods

We retrospectively reviewed 21 of 139 patients who underwent radical surgery for primary oral tongue squamous cell carcinoma between 2009 and 2018. The 21 cases were evaluable, without dental artifacts on CECT. DOIs on CECT and MRI, and pathological DOI were measured.

Results

The median pathological DOI was 9 mm, that on CECT was 10.9 mm, that on T2-weighted MRI was 14.2 mm, and that on contrast-enhanced T1-weighted MRI was 13.1 mm. The DOIs on CECT and on MRI were larger than the pathological DOI (p?=?0.003 to <?0.001). The absolute value of the difference between pathological DOI and DOI on CECT was smaller than that between pathological DOI and DOI on MRI (p?=?0.01 and 0.003). DOIs on CECT and on MRI correlated with pathological DOI (r?=?0.74–0.66, all p?<?0.001). Spearman’s correlation coefficient between DOI on CECT and pathological DOI was greater than that between DOI on MRI and pathological DOI.

Conclusions

Compared to the DOI determined on an MRI scan, the DOI determined on a CECT scan correlated with and better approximated pathological DOI. Therefore, CECT can be useful for preoperative staging of patients with oral tongue squamous cell carcinoma.

     

34例下颌骨中心性癌临床、病理及预后分析

目的： 回顾分析下颌骨中心性癌的临床、病理以及预后特点。方法： 纳入2010—2015年于我院口腔颌面-头颈肿瘤科接受手术治疗的下颌骨中心性癌患者的基本信息、临床治疗信息、影像学信息、病理学信息、随访记录,采用SPSS17.0软件包对数据进行统计学分析。结果： 最终纳入36例患者,其中34例随访信息完整。随访患者中,男22例,女12例;年龄31~60岁23例,>60岁11例;有既往吸烟史13例,有既往酗酒史4例。瘤体最大直径中位值为4 cm,瘤体最大直径≤4 cm 21例,瘤体最大直径>4 cm 13例。病理报告提示9例存在同期淋巴结转移,所有术区切缘均为阴性。28例接受术后放疗,9例在随访期间死于肿瘤局部复发或肿瘤远处转移。结论： 手术是治疗下颌骨中心性癌的主要措施。瘤体位于下颌骨体部以外,同期肿瘤淋巴结转移的患者具有较高的术后肿瘤局部复发几率。既往酗酒史对肿瘤术后远处转移有一定促进作用,瘤体最大直径>4 cm的患者,总体预后较差。     

安氏Ⅲ类错(牙合)畸形患者翼外肌MRI研究

目的 通过MRI观察安氏Ⅲ类错(牙合)畸形患者翼外肌结构,探讨Ⅲ类错(牙合)畸形导致颞下颌关节紊乱病的潜在危险性.方法利用MRI对24例安氏Ⅲ类错(牙合)畸形患者(Ⅲ类错(牙合)组)和10名健康对照者(健康对照组)进行翼外肌成像研究.观察两组翼外肌病理结构及Ⅲ类错(牙合)组病理结构与颞下颌关节紊乱病体征的关系.结果Ⅲ类错(牙合)组翼外肌存在肌肉肥大、挛缩和萎缩等病理改变(36侧),并与健康对照组翼外肌病理改变(2侧)的差异有统计学意义(P＜0.01).安氏Ⅲ类错(牙合)畸形患者有翼外肌的病理改变,但多不伴颞下颌关节紊乱病的临床症状.结论安氏Ⅲ类错(牙合)畸形比正常(牙合)可更多地引起翼外肌的病理改变,有发生颞下颌关节紊乱病的潜在危险.     

左侧腮腺区软骨肉瘤1例

发生于颌面部的软组织软骨肉瘤极为罕见。本文报道1例左侧腮腺区高分化软骨肉瘤,并结合文献对该肿瘤的临床病理特征、诊断、治疗及预后进行探讨。     

颌骨黏液瘤临床与病理研究

目的:总结颌骨黏液瘤临床、病理特点。方法:对29例颌骨黏液瘤的临床表现、X线影象及病理特征等进行回顾性分析。结果:29例中男9例,女20例,平均年龄31.8岁;病变位于下颌骨17例,上颌骨12例;临床多以颜面部肿胀而就诊。X线常表现为边界不清的多房性泡沫状透光影,其中间杂有不透光区。该瘤的组织病理学特征,主要是在黏液样基质中散在分布一些星芒状、梭形、三角形的瘤细胞。镜下依据胶原纤维的含量分为(纤维)黏液瘤(15例)和黏液纤维瘤(14例)2种类型。结论:临床上颌骨黏液瘤与其他一些颌骨病变很难鉴别,最后确诊仍需病理检验。通过分析表明,该瘤预后相对较好,但由于其具有局部浸润性,黏液纤维瘤型及保守性手术如刮治术不彻底可复发。     

Critical issues of ageing: the dentist as a supervisor of the general health of the elderly

The importance of the dentist's role in monitoring the general health of the ageing patient is described and its value is stressed. The quality of life and the health of an elderly patient is very closely linked with oral health, whilst the reverse is also true. The use of oral photography is described in this age group as an aid to diagnosis, review of possible pathological changes, patient motivation and as an educational resource.     

Pericoronal radiolucencies and the significance of early detection

Pericoronal radiolucencies are common radiographic findings encountered in general dental practice. They usually represent a normal or enlarged dental follicle that requires no intervention; alternatively they may represent a pathological entity that requires appropriate management and histopathological interpretation. A pericoronal space of greater than 2.5mm on an intraoral radiograph and greater than 3mm on a rotational panoramic radiograph should be regarded as suspicious. Although many pathological processes may present radiographically as pericoronal radiolucencies associated with unerupted teeth, the most common is the dentigerous cyst. These lesions may enlarge considerably if allowed to develop unchecked, and have the potential for pathological transformation. In this report we present four cases of large pericoronal radiolucencies associated with unerupted teeth, and highlight the importance of early detection and management of such lesions.     

Incidence of oral mucosa diseases in three populations in the province of Cracow

In three population groups in the Province of Cracow: in Cracow, Wieliczka and the villages of the Province a cross-sectional examination of oral mucosa was carried out in 180 subjects aged 35-44 years, 30 subjects in each group. Males and females were considered separately. In all, pathological changes were found in 22 subjects, that is 12.22%. The total number of pathological changes was 23, since in one man two disease entities were present. The frequency of mucosal changes was greater in males than females. In males the prevailing lesion was leucoplakia, in females candidiasis. The least number of lesions was found in the population in Wieliczka.     

The value of the different radiological examining methods in caries diagnosis]

This in vitro study compared the results of clinical examination (abbreviation CE) and the three radiological methods (i.e RVG-radiovisiography) on occlusal and proximal caries diagnosis,using pathological observation as the final standard.The results are:on occlusal caries diagnosis,CE provide the most accordant result to the pathological result.There are statistically significant differences between SR and CE,BW and CE.1st suggests that to occlusal caries diagnosis,CE is still a convenient and efficient way.On proximal caries diagnosis,there are statistically significant differences between SR and CE,BW and CE.BW has the most coincident result with pathological one.     

Aneurysmal bone cyst masquerading as unknown mandibular metastatic deposit causing pathological fracture

The following is a case presentation of an aneurysmal bone cyst (ABC) associated with a pathological fracture and coincidental finding of anaemia of unknown cause. The non-pathognomonic, extensive, mandibular, multilocular radiolucency, together with anaemia, raised the possibility of a neoplastic process. This case highlights clinical manifestations of ABC, as well as difficulties encountered in its diagnosis. The uncommon and potentially troublesome complication of a pathological fracture was treated by ensuring good reduction. Successful bone healing occurred despite the fixation period being significantly less than one month. Clinical Relevance: An awareness of the potential differential diagnoses of pathological mandibular fractures is important.     

不同放射线检查方法在龋病诊断中的价值

实验采用放射屏幕图像技术（简称ＲＶＧ）、根尖片、Ｈｅ翼片等放射摄片方法对邻面龋和咬Ｈｅ面龋进行检查，并与临床检查结果相对照，一病理磨片最后标准，结果是：对于咬Ｈｅ面龋的诊断，临床检查与病理结果最接近，并与根尖片，Ｈｅ翼片之间存在显著性差异，提示临床检查仍是简便而有效的手段；对邻面龋检查结果，根尖片和Ｈｅ翼片均与临床检查有显著差异，尤以Ｈｅ翼片与病理结果最为符合。     

多发性神经鞘瘤临床报告及文献复习

目的探讨多发性神经鞘瘤的临床、病理特点及鉴别要点。方法主诉颌面颈部及全身多处皮下肿物1例,其临床表现为多处散在皮下肿物,经手术切除病理检查及免疫组织化学检查明确诊断。结果临床表现、病理检查和免疫组织化学检查确诊为多发性神经鞘瘤。结论多发性神经鞘瘤为良性肿瘤,有完整的包膜,主要以手术治疗为主。