Quantitative methylation analysis of resection margins and lymph nodes in oral squamous cell carcinoma

Resection is the preferred treatment for oral squamous cell carcinoma, and pathological staging of the resected specimen is crucial. The role of molecular biology in the diagnosis of minimal residual disease has not been fully investigated and may improve staging. Multiple adjacent specimens were taken from the tumour, the invasive front, the surgical margin, and the lymph nodes of 20 specimens from patients with oral cancer. Bisulphite-treated DNA from these specimens was assayed quantitatively with pyrosequencing methylation assays (PMA) of CpG islands within the gene promoters of the p16 and CYGB genes. Results were recorded with histopathological results, and compared with clinical outcome. Biological and technical replicates confirmed the reliability of the techniques. PMA upgraded 13 of the 20 surgical margins, 6 of which subsequently had a recurrent tumour. Not all of these recurrences were predicted and the effects of adjuvant treatment make firm conclusions difficult.     

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions.

Part 5 is the final part of a series of five articles reporting on an international, multicenter clinical audit of treatment outcome for complete UCLP. A number of recommendations for the methodology of future studies is made especially with respect to entry criteria, sample size, assumptions of homogeneity, and the reproducibility and validity of outcome measures. The findings of the present study regarding clinical procedures are presented tentatively, and improvement and extension of the methodology are required. It appears, however, that acceptable results can be achieved by different programs and ultimately clinical choices may be based on factors such as complexity, costs, and demands of treatment. Standardization, centralization, and the participation of high volume operators were associated with good outcomes, and nonstandardization and the participation of low volume operators with poor outcomes. Therapeutic factors associated with good outcomes were the employment of a vomer flap to close the anterior palate, and poor outcomes with primary bone grafting and with active presurgical orthopedics.     

The distribution of plaque and gingivitis and the influence of toothbrushing hand in a group of South Wales 11–12 year-old children

Numerous factors may affect the distribution of plaque and gingivitis in any individuals mouth. Of considerable importance must be the oral hygiene habits of each person, which will be influenced by compliance and dexterity with tooth cleaning methods. The pattern of gingivitis seen at a young age may, with time, reflect the eventual distribution of attachment loss. This in part, could explain the considerable variation in chronic periodontal disease seen between individuals and at different sites within the same mouth. This study reports the baseline data for the distribution of plaque and gingivitis in 1105, 11-12-year-old children in South Wales. The children were selected by disproportionate stratified random sampling and examined by a multidisciplinary group with the long-term aim of evaluating the importance of malocclusion to dental health and psychosocial variables. Toothbrushing frequency had a very low but significant correlation with the distribution of plaque and gingivitis, accounting therefore for only a small % of the variance in the group. For the total group and right-handed toothbrushers, buccal plaque and gingivitis was significantly increased on right contralateral teeth. No specific pattern for plaque and gingivitis distribution by side was seen for 100 left-handed toothbrushers. Plaque and gingivitis also showed significant differences dependent upon arch, tooth number, and surface. The population is being followed at 4-year intervals to monitor the pattern of periodontal disease with time and correlate changes with these baseline findings.