Survival of patients who needed salvage surgery for recurrence after radiotherapy for oral carcinoma

Objective: To find out how long patients with oral carcinoma survived after the primary tumour had been treated by radiotherapy and who required salvage surgery for recurrence; to see if there were any significant differences in age, sex, site, size, and histology of the tumours in relation to survival; and to see if the time of the recurrence had any effect on the survival. Design: Retrospective analysis of case notes. Setting: Teaching Hospital, Scotland. Subjects: 370 consecutive patients, 187 (51%) of whom were initially treated by radiotherapy; 58 of the 187 (31%) developed a recurrence that was considered suitable for salvage surgery. Results and conclusions: 43/58 patients had died and 15 patients were still alive at the time of the study, the median (range) survival of the groups was 21 (6–89) months compared with 72 (19–212) months, respectively (P = 0.0001). Other significant differences included age at presentation for men (P = 0.004), and the increased likelihood of survival if the initial site of the tumour was the tongue (P = 0.02). There was also a highly significant correlation between time to recurrence and survival amongst those who died (P = 0.002). A short recurrence time may suggest a less radical surgical salvage option if reduced survival is likely. Why there should be such an association is unknown.     

Glomus tumour of the palate: case report and review of the literature

Glomus tumours are benign vascular tumours, usually located in the skin. Intra-oral glomus tumours are rare. A glomus tumour of the palate is reported, only the fifth such case out of a total of 14 intra-oral glomus tumours in the world medical literature.     

Reducing the incidence of palatally impacted maxillary canines by extraction of deciduous canines: a useful preventive/interceptive orthodontic procedure. Case reports

The early detection of palatally impacted permanent maxillary canines is stressed. Appropriate radiographs to determine impactions are suggested and removal of deciduous canines to eliminate impactions in patients who have good dental arches with no space deficiency is recommended. Two case histories are presented to illustrate the method.     

Fine needle aspiration cytology in the diagnosis of amyloid in the submandibular gland

This paper describes how fine needle aspiration cytology (FNAC) was used to diagnose amyloid in a patient who had multiple myeloma and had developed xerostomia and submandibular salivary gland enlargement.     

Experience with ITI osseointegrated implants at five centres in the UK

Experience with the two-part ITI titanium implant system at five centres in the UK is reported. A total of 461 implants were inserted in 176 patients, who received 189 prostheses. Criteria for the assessment of success following implantation are listed. Results over a 3-year period showed a success rate of 94% when implants were used for mandibular overdentures and crown and bridge prosthetics. A lower success rate in the edentulous maxilla was recorded.     

Restoration longevity in an Australian Defence Force population

Replacement of restorations comprises a considerable portion of the work of most dentists. Consequently, factors that affect restoration longevity can influence the pattern of dental practice in a given community. Based on the results of research into treatment provision in the General Dental Service in Scotland, it was considered possible that factors such as the frequency with which patients were examined, and the frequency with which they changed dentists, might influence restoration longevity in other populations. Therefore, the present study was initiated to investigate the effects of these two factors in a population of 100 long-term members of the Royal Australian Air Force. No statistically significant relationship could be found between examination frequency, or frequent changes in dental practitioner, and restoration longevity. It is proposed that the large differences found in restoration longevity between this study and the Scottish study upon which it was based, may be due in part to the differing modes of remuneration of the dentists in the two studies.     

The Role of Imaging and Surgery in the Management of Vascular Tumors of the Masseter Muscle

PURPOSE: Intramuscular vascular malformations are uncommon lesions in the head and neck that may mimic salivary gland disease. This study reports on the use of various imaging modalities and recommends a surgical approach in the management of vascular malformations of the masseter muscle. PATIENTS AND METHODS: This is a retrospective study of 7 consecutive patients with vascular tumors of the masseter muscle treated in one unit between 1995 and 2004. The age, gender, signs and symptoms, imaging methods, and surgical outcome are reported. A previously unreported surgical approach is described. RESULTS: All patients had atypical swellings in and around the parotid region that were difficult to diagnose on plain radiography and computed tomography. Magnetic resonance imaging provides accurate three-dimensional images and provisional diagnosis of lesions within the masseter muscle. Six of the 7 patients underwent surgery by the recommended approach. No patients developed permanent facial weakness following modified parotidectomy. No recurrence of the vascular tumors occurred when the recommended approach is used. CONCLUSIONS: Magnetic resonance imaging remains the imaging modality of choice for the management of tumors of the masseter muscle. The extended parotidectomy approach gives good and safe surgical access in the management of these uncommon lesions.     

Perceptions of the value of hospital residency and clinical medicine in dental education

A survey of the outlook of 81 participating dental undergraduates concerning the value of a general hospital residency programme has been compared with the perceptions of 240 graduate health professionals (dental and medical practitioners, registered nurses and others). There is convincing statistical evidence of pan-professional support for such a general hospital residency. Better medical preparation of the dental student prior to residency is strongly favoured. Closer links between medicine and dentistry are inevitable as well as being essential for both professions and the community.     

The modified Le Fort III osteotomy in the correction of mid-facial deficiency. Case reports

Maxillary hypoplasia is a common diagnosis in the spectrum of dentofacial deformities and is usually corrected by a Le Fort I maxillary advancement osteotomy. The modified Le Fort III osteotomy enables correction of mid-face hypoplasia where the maxillary hypoplasia is associated with infraorbital and zygomatic deficiency. This procedure is described and illustrated in two case reports. It is considered to be a superior technique to the maxillary osteotomy and onlay procedure and is recommended for use in selected patients.