Bacterial colonization of microbial biofilms in oral squamous cell carcinoma

Objectives

The purpose of this prospective clinical study was to identify the bacterial spectra on the surface of oral squamous cell carcinomas (OSCC) in comparison to oral mucosa of patients with a higher risk to emerge an OSCC and a control group to determine their susceptibility to various common antibiotics.

Material and methods

Swabs from 90 patients, 30 patients of each group, were cultured on media for aerobes and anaerobes and tested with agar diffusion and Etest.

Results

The predominant pathogens of the normal healthy oral mucosa were aerobes. The ratio between aerobes and anaerobes was 2:1, balanced in risk patients and inverted in the OSCC group. Altogether, 1,006 isolates were cultured. The most frequent strains were 47 viridans streptococci, 30 Staphylococcus species, 14 Enterococcus faecalis, 36 Neisseria species, 14 Escherichia coli, and 23 other aerobes, 66 Peptostreptococcus species, 39 Fusobacterium species, and 34 Prevotella species. The resistance rates in the OSCC group were penicillin 40 %, ampicillin 57 %, doxycycline 23 %, clindamycin 47 %, and amoxicillin/clavulanic acid 20 %, but up to 100 % of pathogens were susceptible to azithromycin, telithromycin, levofloxacin, and moxifloxacin.

Conclusion

Gram-negative anaerobes play a decisive role in the development of postoperative infections in patients with OSCC. This tumor special type of colonization does not agree with the normal flora of the oral cavity. Clinical relevance: Biofilms on OSCC surfaces provide an important reservoir for anaerobic bacteria. As a consequence, a proposal for an antibiotic prophylactic regime should be given.     

Prognostic value of histamine H1 receptor expression in oral squamous cell carcinoma

Objectives

Overexpression of the histamine H1 receptor (H1R) has been described in a variety of tumor models, but experience in oral squamous cell carcinomas (OSCC) is not available. Current adjuvant treatment options for OSCC can be improved by the identification of new targets of therapy. Herein, we evaluated H1R expression in a large patient cohort of OSCC.

Materials and methods

H1R immunoexpression was evaluated in 191 cases of OSCC and two OSCC cell lines BICR56 and BICR3. Scanned images were digitally analyzed using ImageJ and the immunomembrane plug-in. The combined score of computer-assisted semiquantitative analysis was correlated with manually counted percentages of tumor cells by Kendall’s tau (т) correlation coefficient. Disease-free survival times were estimated using the Kaplan–Meier method and were compared by using the log-rank test. Multivariate analyses were performed using the Cox proportional hazards model.

Results

H1R was rarely expressed in OSCC but significantly related with advanced tumor stages (n?=?21/191, mean expression 63.5 % of cancer cells in positive tumor samples, 95 % confidence interval of the mean 53.5 to 73.6 %, p?=?0.006). Following univariate analysis, patients with H1R expression showed a significant poorer prognosis (p?=?0.0004). Multivariate analysis revealed H1R expression as an independent prognostic factor (p?=?0.0164). Expression of H1R in cancer cell lines was confirmed by specific staining of OSCC cell lines BICR56 and BICR3.

Conclusion

This is the first study focusing on H1R expression showing a significant poorer DFS rate in the H1R+ patient cohort. Based on these data, H1R activation may promote carcinogenesis in OSCC.

Clinical relevance

Investigation of H1R regulation and its antagonists shows a clear rationale for future supportive anticancer therapies in OSCCs.     

Evaluation of a biomarker based blood test for monitoring surgical resection of oral squamous cell carcinomas

Introduction

The potential use of determination of biomarkers in blood for the monitoring of surgical removal of oral squamous cell carcinomas (OSCC) was evaluated using the epitope detection in monocytes (EDIM) technology.

Materials and methods

In tumor specimen, elevated Apo10 and transketolase-like 1 (TKTL1) expression was analyzed by immunohistochemistry. Apo10 and TKTL1 biomarkers have been used prospectively for EDIM blood test in patients with primary and/or recurrent OSCC (n = 92) before surgery and after curative tumor resection (n = 45).

Results

There were highly significant (p < 0.0001) correlations found between EDIM blood scores and the tissue expression of both biomarkers measured by immunohistochemistry (Apo10: n = 89/92, 97 %; TKTL1: n = 90/92, 98 %). EDIMApo10 and EDIM-TKTL1 scores were positive in 92 % (EDIM-Apo10: n = 85/92) and 93 % (EDIM-TKTL1: n = 86/92), respectively, in patients with OSCC before surgery. The combined score EDIM-Apo10/EDIM-TKTL1 increased significantly the detection rate of tumors to 97 % (n = 89/92). After surgery, the EDIM-TKTL1 and EDIMApo10 scores significantly decreased in 75.6 and 86.7 % of the patients (p < 0.0001), respectively, in the aftercare.

Conclusions

The correlation of TKTL1 and Apo10 immunohistochemistry with the blood test results indicates that the EDIM blood test could serve as a non-invasive diagnostic tool (liquid biopsy) to assess surgical removal of OSCC by determination of two biomarkers.

Clinical relevance

This is the first study that has been demonstrated a reliable and successful monitoring of OSCC cancer patients by a blood test. The specific and significant decrease of EDIM-TKTL1 and EDIM-Apo10 scores after surgery could serve as a new tool for monitoring surgical removal of OSCC.

     

In vitro fracture load of monolithic lithium disilicate ceramic molar crowns with different wall thicknesses

Objectives

The objective of this in vitro study was to assess the effect of wall thickness on the fracture loads of monolithic lithium disilicate molar crowns.

Material and methods

Forty-eight extracted molars were prepared by use of a standardized preparation design. Lithium disilicate crowns (e.max CAD, Ivoclar/Vivadent, Schaan, Liechtenstein) of different wall thicknesses (d?=?0.5, 1.0, and 1.5 mm; n?=?16 for each series) were then constructed and milled (Cerec MC-XL, Sirona, Bensheim, Germany). After placement of the teeth in acrylic blocks (Technovit, Heraeus Kulzer, Hanau, Germany), the crowns were adhesively luted (Multilink, Ivoclar Vivadent). In each series, eight crowns were loaded without artificial aging whereas another eight crowns underwent thermocycling (10,000 cycles, THE-1100, SD Mechatronik) and chewing simulation (1.2 million cycles, Willytec CS3, SD Mechatronik, F _max?=?108 N). All specimens were loaded until fracture on one cusp with a tilt of 30° to the tooth axis in a universal testing machine (Z005, Zwick/Roell). Statistical assessment was performed by use of SPSS 19.0.

Results

Crowns with d?=?1.0 and 1.5 mm wall thickness did not crack during artificial aging whereas two of the crowns with d?=?0.5 mm wall thickness did. The loads to failure (F _u) of the crowns without aging (with aging) were 470.2?±?80.3 N (369.2?±?117.8 N) for d?=?0.5 mm, 801.4?±?123.1 N (889.1?±?154.6 N) for d?=?1.0 mm, and 1107.6?±?131.3 N (980.8?±?115.3 N) for d?=?1.5 mm. For aged crowns with d?=?0.5 mm wall thickness, load to failure was significantly lower than for the others. However, differences between crowns with d?=?1.0 mm and d?=?1.5 mm wall thickness were not significant.

Conclusions

Fracture loads for posterior lithium disilicate crowns with 0.5 mm wall thickness were too low (F _u?<?500 N) to guarantee a low complication rate in vivo, whereas all crowns with 1.0 and 1.5 mm wall thicknesses showed appropriate fracture resistances F _u?>?600 N.

Clinical relevance

The wall thickness of posterior lithium disilicate crowns might be reduced to 1 mm, thus reducing the invasiveness of the preparation, which is essential for young patients.     

Removal of an oral squamous cell carcinoma including parts of osseointegrated implants in the marginal mandibulectomy. A case report

Purpose

The incidence of oral squamous cell carcinomas (OSCC) arising around dental implants will increase because of the rising popularity of dental implants. In this case, a novel surgical treatment of an OSCC in the vicinity of endosseous implants is reported.

Materials and methods

In a 69-year-old woman, a recurrent OSCC (cT₂N₀M₀) developed in the floor of the mouth extending to the attached keratinized peri-implant mucosa of both interforaminal-placed dental implants. Radiographically, no bone invasion could be observed.

Results

To radically remove the tumor, a marginal mandibulectomy was performed including the cranial parts of both dental implants by cutting them into two parts. Three years after tumor resection and one year after reimplantation, the patient is disease free and has a good oral function.

Conclusions

In case of an OSCC, traditional bone and soft margins for oncologic safety are 1.0 cm. If a dental implant is present within this safety zone, on condition, there is no massive bone invasion, and the original mandible has sufficient vertical height; a marginal mandibulectomy including part of the implants can be considered.     

Nachweis von TP53-Mutationen mittels Exfoliativzytologie (brush biopsy) oraler Leukoplakien

Objective. The aim of this study was to determine the prevalence of mutations of the tumour suppressor gene TP53 in oral leukoplakias. Material and method. Brush biopsy specimens of 43 oral leukoplakias, 26 oral squamous cell carcinomas (OSCC) for reference, and the oral mucosa of 4 clinically normal volunteers were collected. DNA of the critical exons 5–8 was analysed by temperature gradient gel electrophoresis (TGGE). Results. The prevalence of mutations was 57.7% in OSCC, 39.5% in leukoplakias and 0% in controls. The highest frequency of mutations was found in exon 5 (46.2%) in OSCC and in exon 6 (23.3%) in leukoplakia. More than one mutation was detected in 26.9% of OSCC and 7% of leukoplakia specimens. At least one mutation was found in 37.5% of T1 OSCC and 100% of T4 OSCC specimens and in 37.1% of the L1 leukoplakia and 100% of L3 leukoplakia specimens. Conclusions. TP53 mutations could be a useful prognostic indicator in precancerous oral lesions. Although the brush biopsy technique appears simple clinically, further investigations are necessary to specify the implications of genetic analysis.     

CCND1 amplification and cyclin D1 immunohistochemical expression in head and neck squamous cell carcinomas

Objectives

Gene products, which show a significant association to cell proliferation and cell cycle control, are of high scientific interest, because genes as well as gene products could be possible targets for a specific therapeutic approach and eventually be prognostic markers.

Materials and methods

Cyclin D1 expression and amplification as well as the Ki-67 expression status were examined in a two tissue microarray analysis for head and neck squamous cell carcinoma (HNSCC) including 546 patients. A tumour site-specific analysis and a survival analysis of 222 oral squamous cell carcinoma (OSCC) patients were performed. Cyclin D1 amplification status was examined with fluorescence in situ hybridisation analysis, while cyclin D1 expression and Ki-67 expression status were examined with IHC.

Results

Amplification of the CCND1 gene and immunohistochemical expression of cyclin D1 and Ki-67 were examined in 546 tumours of the head and neck region in two tissue microarrays. CCND1 amplification was significantly more frequent in pharyngeal carcinomas (63 %) than in laryngeal (37 %) and oral (25 %) carcinomas. Among the 222 cases of OSCCs, both CCND1 amplification and cyclin D1 expression were significantly associated with overall survival of the patients (p?=?0.0127 and p?=?0.0004, respectively). Ki-67 expression was significantly associated with cyclin D1 expression and with amplification of the CCND1 gene (p?=?0.0002 and p?=?0.0015, respectively) but not with patient overall survival.

Conclusion

Our results suggest the prognostic value of CCND1 amplification and cyclin D1 expression for patients with OSCC and highlight the genetic differences in HNSCC of different subanatomic localisation.

Clinical relevance

Cyclin D1 expression and CCND1 amplification seem to have a prognostic value for OSCC. Further studies of HNSCC should always consider subanatomic genetic differences.     

Eosinophils may predict occult lymph node metastasis in early oral cancer

Objective

The aim of this study was to investigate whether tumor-associated tissue eosinophilia (TATE) in early oral squamous cell carcinoma (OSCC) would aid in predicting occult lymph node metastasis.

Patients and methods

Seventy-one patients undergoing elective neck dissection for T1 and T2 OSCC were evaluated for clinical features, prognosis, and TATE. The degree of TATE in OSCC was statistically analyzed in relation to the clinicopathological features, tumor invasion, occult lymph node metastasis, and survival using χ ² test and Kaplan–Meier method.

Results

Statistical analysis revealed that intense TATE was a significant feature (p?=?0.004) to predict occult lymph node metastasis in patients with early OSCC. All regional recurrences of the OSCC occurred in patients showing intense TATE.

Conclusions

These results suggest that intense TATE can be clinically used as a predictive factor for occult lymph node metastasis.

Clinical relevance

The presence of intense TATE is an adjunctive histopathological marker to reinforce the indication of elective neck dissection of the patients with early OSCC.     

Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on dental side effects

Objectives

This study aimed to assess possible dental side effects associated with long-term use of an adjustable oral appliance compared with continuous positive airway pressure (CPAP) in patients with the obstructive sleep apnea syndrome and to study the relationship between these possible side effects and the degree of mandibular protrusion associated with oral appliance therapy.

Materials and methods

As part of a previously conducted RCT, 51 patients were randomized to oral appliance therapy and 52 patients to CPAP therapy. At baseline and after a 2-year follow-up, dental plaster study models in full occlusion were obtained which were thereupon analyzed with respect to relevant variables.

Results

Long-term use of an oral appliance resulted in small but significant dental changes compared with CPAP. In the oral appliance group, overbite and overjet decreased 1.2 (±1.1) mm and 1.5 (±1.5) mm, respectively. Furthermore, we found a significantly larger anterior–posterior change in the occlusion (?1.3?±?1.5 mm) in the oral appliance group compared to the CPAP group (?0.1?±?0.6 mm). Moreover, both groups showed a significant decrease in number of occlusal contact points in the (pre)molar region. Linear regression analysis revealed that the decrease in overbite was associated with the mean mandibular protrusion during follow-up [regression coefficient (β)?=??0.02, 95 % confidence interval (?0.04 to ?0.00)].

Conclusions

Oral appliance therapy should be considered as a lifelong treatment, and there is a risk of dental side effects to occur.

Clinical relevance

Patients treated with the oral appliance need a thorough follow-up by a dentist or dental-specialist experienced in the field of dental sleep medicine.     

Investigation of trefoil factor expression in saliva and oral mucosal tissues of patients with oral squamous cell carcinoma

Objectives

The aims of our study were to determine levels of trefoil factor (TFF) peptides in saliva and oral mucosal tissues from patients with oral squamous cell carcinoma (OSCC), and to evaluate whether individual members of TFFs (TFF1, TFF2, and TFF3) might act as biomarkers of disease.

Materials and methods

Saliva samples were from 23 healthy subjects and 23 OSCC patients. Tissue samples were collected from 32 normal oral mucosa (NOM) and 32 OSCC biopsy specimens. ELISA and immunohistochemical methods were used to evaluate the expression of TFF1, TFF2, and TFF3 in saliva and oral mucosal tissues, respectively.

Results

Expression of TFF2 and TFF3 in oral mucosal tissues of OSCC patients was strongly downregulated when compared to healthy subjects (p?<?0.001 and p?=?0.002, respectively). However, there were no differences in levels of salivary TFF concentrations between OSCC patients and healthy subjects.

Conclusions

The present study extends previous observations, demonstrating the reduction of TFF2 and TFF3 expression in oral mucosal tissues of OSCC patients.

Clinical relevance

These findings suggest the clinical significance of TFF2 and TFF3 molecules as negative markers of tumor progression in OSCC. Quantification of TFF levels in saliva may not be optimal in terms of diagnostic or predictive value for OSCC derived from oral mucosa.     

Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process

Objectives

The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla.

Patients and methods

A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0?±?8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels.

Results

The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively.

Conclusion

These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.     

Effect of seating forces on cement–ceramic adhesion in microtensile bond tests

Objectives

The aim of this study was to evaluate the effect of different seating forces during cementation in cement–ceramic microtensile bond strength (μTBS).

Materials and methods

Forty-five blocks (5?×?5?×?4 mm³) of a glass-infiltrated alumina-based ceramic (In-Ceram Alumina) were fabricated according to the manufacturer’s instructions and duplicated in resin composite. Ceramic surfaces were polished, cleaned for 10 min in an ultrasonic bath, silica coated using a laboratory type of air abrasion device, and silanized. Each treated ceramic block was then randomly assigned to five groups (n?=?9) and cemented to a composite block under five seating forces (10 g, 50 g, 100 g, 500 g, and 750 g) using a dual-cured resin cement (Panavia F). The ceramic–cement–composite assemblies were cut under coolant water to obtain bar specimens (1 mm?×?0.8 mm²). The μTBS tests were performed in a universal testing machine (1 mm/min). The mean bond strengths values were statistically analyzed using one-way ANOVA (α?≤?0.05).

Results

Different seating forces resulted in no significant difference in the μTBS results ranging between 13.1?±?4.7 and 18.8?±?2.1 MPa (p?=?0.13) and no significant differences among cement thickness.

Conclusions

Excessive seating forces during cementation seem not to affect the μTBS results.

Clinical relevance

Excessive forces during the seating of single all-ceramic restorations cementation seem to display the same tensile bond strength to the resin cement.     

Radiologic bone loss in patients with bisphosphonate-associated osteonecrosis of the jaws: a case–control study

Objectives

Most patients with bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) report a previous tooth extraction at the necrosis site before the diagnosis was made. At older ages, most teeth are extracted due to periodontal disease, which is per se another BP-ONJ trigger factor. The aim of this study was to evaluate the periodontal status of BP-ONJ patients using panoramic radiographs compared to a control.

Materials and methods

All patients treated for BP-ONJ up to January 1, 2010 comprised the study. The very first panoramic radiograph was analyzed. The number of remaining teeth and the radiographic bone loss from the cemento-enamel junction to the crestal bone were measured. For each patient, one control was analyzed (matching for gender and age).

Results

One hundred twenty-nine BP-ONJ panoramic radiographs and 129 controls were analyzed (68 women, 61 men; 67.3?±?9.7 years; osteoporosis [n?=?11], breast cancer [n?=?33], multiple myeloma [n?=?61], prostate cancer [n?=?24]). The average number of remaining teeth was 12.9?±?8.4 for BP-ONJ and 16.4?±?9.4 for the control (p?=?0.02). The average radiographic bone loss was 5.5?±?2.3 mm for BP-ONJ and 3.1?±?1.1 mm for the control (p?<?0.001); 96.6 % of BP-ONJ and 77.5 % had radiographic bone loss of more than 5 mm. Radiographic bone loss in the molar region was the highest for both groups (BP-ONJ 6.0?±?2.3 mm; control 3.6?±?1.4 mm).

Conclusion

Prevalence and severity of periodontal disease in patients with BP-ONJ is higher compared to healthy controls.

Clinical relevance

Patients with periodontal disease might be at a higher risk of developing BP-ONJ; therefore, periodontal disease therapy in patients who are about to receive bisphosphonates should be undertaken.     

Cervical metastases of squamous cell carcinoma of the maxilla: a retrospective study of 25 years

Objectives

Squamous cell carcinomas (SCCs) of the maxilla are relatively rare; therefore, only little data is available regarding the frequency of cervical metastasis (CM) and therapy strategies. Most authors only undertake clinical observation of the lymph nodes. The aim of this retrospective study was to evaluate the manner of metastasis in SCC of the maxilla.

Materials and methods

All patient records from 1987 to 2011 were scanned for SCC of the maxilla. Patients with SCC limited to the maxilla were comprised. The cases were analyzed regarding tumor node metastasis staging system and any special occurrences in the follow-up time such as tumor recurrence, metastasis, and exitus letalis. Classification and staging were performed according to the 2003 UICC system.

Results

One hundred thirty-eight patients were comprised of 36 % females and 64 % males (average age, 66 years; women, 71 years; men, 63 years). The average follow-up time was 43 months (range, 0–195). Fifty-eight percent smoked or declared regular consumption of alcohol. About 50 % of the patients had an advanced tumor stage (III–IV). At the time of the primary diagnosis, 38 % of the patients had CM. There is an increased risk for CM occurrence with increasing tumor size and grading and a tumor localized in the postcanine region. Contralateral CM arises frequently in T4 tumors and tumors localized in the postcanine region.

Conclusion

The data exhibit aggressive regional metastatic behavior of SCC of the maxilla.

Clinical relevance

Therefore, surgical treatment of the draining lymphatic system as a primary management strategy is recommended for patients with SCC of the maxilla.     

The use of lithium as a marker for the retention of liquids in the oral cavity after rinsing

Objective

The aim of this study was to validate the use of lithium as a marker to indicate the retention of simple liquids in the oral cavity and use this to determine how much liquid is retained in the oral cavity following 30 s of rinsing.

Materials and methods

This is a validation study in which saliva was spiked with known concentrations of lithium. Twenty healthy participants then rinsed their mouths with either water or a 1 %?w/v carboxymethylcellulose (CMC) solution for 30 s before expectorating into a collection cup. Total volume and concentration of lithium in the expectorant were then measured, and the percentage of liquid retained was calculated.

Results

The mean amount of liquid retained was 10.4?±?4.7 % following rinsing with water and 15.3?±?4.1 % following rinsing with 1 %?w/v CMC solution. This difference was significant (p?<?0.01).

Conclusions

Lithium was useful as a marker for the retention of liquids in the oral cavity, and a value for the amount of water and 1 %?w/v CMC solution remaining in the oral cavity following a 30-s rinse was established.

Clinical relevance

The present study quantifies the retention of simple fluids in the oral cavity, validating a technique that may be applied to more complex fluids such as mouth rinses. Further, the application of this method to specific population groups such as those with severe xerostomia may assist in developing effective saliva substitutes.     

Accuracy of cone-beam computed tomography to assess the configuration and extent of ligature-induced peri-implantitis defects. A pilot study

Purpose

This is a pilot study which aims to evaluate the accuracy of cone-beam computed tomography (CBCT) to assess the configuration and extent of ligature-induced peri-implantitis defects.

Materials and methods

Radiographic evaluation of advanced ligature-induced peri-implantitis defects (n?=?9) in canine was performed using CBCT (central cross-sections) and compared with the corresponding histomorphometrical measurements of the respective site serving as a validation method. Deviations were calculated for the supracrestal (SC), and intrabony (IC) defect components, as well as defect width (DW) assessed at both vestibular (v) and oral (o) aspects.

Results

Mean differences between CBCT and histological analyses were ?0.53?±?1.48?mm (SC), +0.49?±?1.18?mm (IC), and +0.18?±?0.54?mm (DW) at vestibular aspects, and ?0.13?±?0.44?mm (SC), ?0.05?±?0.62?mm (IC), and +0.15?±?0.48?mm (DW) at the oral aspects (P?>?0.05; paired t test, respectively).

Conclusion

CBCT may represent an accurate diagnostic tool to estimate the histological extent of advanced peri-implantitis defects.     

Utility of superiorly based platysma myocutaneous flap for reconstruction of intraoral surgical defects: our experience

Purpose

Various surgical modalities have been advocated for the soft tissue reconstruction of oral cavity with variable results. This prospective study evaluates the utility of platysma myocutaneous flap (PMF) in the reconstruction of surgical defects followed by treatment of oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) in terms of healing and functional outcomes.

Methods

In this prospective study, 47 patients with OSMF and 15 of OSCC were evaluated and selected for PMF reconstruction. OSCC was selected under T₁N₀M₀ category only. Patients were operated under general anaesthesia followed by PMF grafting. In OSCC, ipsilateral and for OSMF, bilateral PMF was used.

Results

In 47 patients treated for OSMF, 46 were male and 1 female while 15 cases of OSCC, 10 were male and 5 females aged between 18 and 44 years. Intraoperative mouth opening was achieved up to 48 mm in OSMF followed by 42.5 mm postoperatively after 2 years. However, uneventful healing and acceptable scar on cervical region was noted in all the cases including OSCC. In OSMF, three cases of dehiscence, four partial necrosis at end of flap and in OSCC one case shows skin loss at flap and two partial necrosis at tip of flap and extraoral localised abscess at ipsilateral donor site in one case was noted. An uneventful healing, anatomical form and functional results were restored with acceptable scarring at donor site without any evidence of difficulty in neck movements were observed.

Conclusion

The PMF is simple, versatile and could be valued as a reconstructive alternative, with interesting visual qualities. It is a good therapeutic alternative tool for reconstruction of the buccal mucosa, especially for small- and medium-sized defects between 2 and 4 cm² of the oral cavity.

     

An early oral health care program starting during pregnancy—a long-term study—phase V

Objectives

Objective was to analyze the effects of a long-term prevention program on dental and oral health of adolescents.

Materials and methods

The entire study was subdivided into five phases. Phase I comprised an individual preventive care during pregnancy, phase II assessed mothers and their children until the age of 3, and in phase III until the age of 6. In phase IV, 13- to 14-year-old teenagers were investigated. In phase V, 18–19-year-old adolescents were examined (18.4?±?0.4 years, n?=?26). All phases consisted of an examination, education, and treatment based on the concept of an “early oral health care promotion.” The control group consisted of randomly selected adolescents of the same age (n?=?35). The following clinical parameters were assessed: DMF-T/DMF-S, HI, PBI, PSI, and Streptococcus mutans/lactobacilli concentration in saliva.

Results

The adolescents of the prevention group revealed a share of 92.3 % caries-free dentition. Mean DMF-T was 1.4?±?2.6. The control group showed a significantly higher mean DMF-T of 3.8?±?3.2 (p?<?0.05) and revealed 71.4 % of caries-free dentition. The prevention group showed a significant lower PSI of 1.2?±?0.8 compared to the control group (2.1?±?0.4) (p?<?0.05).

Conclusion

An “early oral health care promotion” starting during pregnancy may cause a sustained and long-term improvement of the oral health of young adults.

Clinical Relevance

Prevention programs starting during pregnancy may establish an improved health behavior. Caries, periodontitis, and dietary complications in mother and child can be avoided by improving maternal oral health and by a tooth-friendly diet.     

MR-Volumetrie der Zunge zur Abschätzung der individuellen Zungengröße

Aim

The purpose of this study was to determine the volume of the tongue using MRI. The correlation of the individual volume of the tongue and the size of the oral cavity was to be investigated.

Material and methods

To analyze the tongue volume we combined coronal and sagittal data acquisition, which divided the tongue virtually into two lateral and one medial part. This procedure helped to decrease artefacts by partial volume effect. In 20 probands (m/f 7/13, average age of 36.3 years) the volume of the tongue was determined. Imaging protocol: Magnetom 63 SP (Siemens, Erlangen), T1-weighted sequences (TR/TE 500 ms/10 ms), slice thickness 5 mm, matrix 256×256, FOV 250 mm.

Results

There was a significant linear regression between the tongue volume and height of the mouth cavity. This correlation can be used to calculate the normal volume of a patient’s tongue.

Discussion

Volumetry of the tongue can be carried out by means of MRI without application of injurious X-rays. It can be employed before as well as after tongue reduction surgeries for therapy control. The individual ideal tongue volume can be determined easily by determination of the height of the oral cavity.