The significance of perineural spread in adenoid cystic carcinoma of the major and minor salivary glands

Patient survival, local recurrence and distant metastasis were studied in relation to the pathological finding of perineural spread in 37 patients with adenoid cystic carcinoma of the major and minor salivary glands. All patients underwent a combined surgical and radiotherapeutical treatment. The overall incidence of perineural invasion in primary resection specimens was 52.6%. The 5-year actuarial survival rate for patients with perineural invasion was significantly lower (p less than 0.001) than for those without (36.9% versus 93.8%). In 26 patients with resection margins free of tumour, recurrences developed in 9/11 (81.8%) of the patients with perineural invasion as opposed to 4/15 (26.7%) of the patients without perineural invasion (p = 0.005). In the same group with resection margins free of tumour, distant metastasis developed after the primary treatment in 4/10 (40.0%) of the patients with perineural invasion, while none of the 14 patients without perineural invasion experienced distant metastasis (p less than 0.0002). The incidence of perineural invasion increased with a higher stage of the primary tumour.     

In-vitro adherence of oral streptococci in the presence of sucrose and its relationship to cariogenicity in the rat

Streptococcus sanguis I gave a significantly greater percentage coverage (cell-pellicle attachment) of saliva-coated glass in the presence of sucrose than did Strep. sanguis II (p less than 0.025), and both these gave greater percentage coverages than the other species tested, between which no significant differences were noted. There was a large number of significant differences in clump size (cell-cell attachment) between species-pairs. Among the mutans streptococci, there were significant differences in the percentage coverage between Streptococcus rattus/Streptococcus mutans (p less than 0.05) and Strep. rattus/Streptococcus sobrinus (p less than 0.01), and in clump size between all species-pairs with the exception of Streptococcus cricetus or Strep. sobrinus and Strep. mutans. The rank order of species in relation to fissure caries was mutans streptococci greater than Streptococcus salivarius greater than Streptococcus milleri greater than Strep. sanguis greater than Streptococcus faecalis greater than Streptococcus mitis greater than Streptococcus lactis. There was a significant correlation between percentage coverage in vitro and fissure caries in vivo for strains of Strep. sanguis (p less than 0.05) and pooled strains of Strep. mitis and Strep. sanguis (p less than 0.01). On comparing data for adherence in the presence or the absence of sucrose, the sugar had no effect on the percentage coverage of the seven species tested, but significantly increased the clump size of the mutans streptococci (p less than 0.01) and Strep. sanguis (p less than 0.05).     

The fit of gold-alloy full-crown castings made with ceramic casting ring liners.

Measurements were made of the fit of gold-alloy full-crown castings produced with dry ceramic ring liners. When used with vacuum investing, these liners absorb relatively large amounts of water from the investment mix (thereby reducing its original W/P ratio) and then function as wet liners, thus increasing the investment's potential expansion and giving castings which are consistently larger than when air investing is used. With four of the five liners tested, investing in air produced many castings which were unacceptably undersized (inaccuracy worse than -0.2%). The fifth liner, an industrial material 2 mm thick, gave only one casting out of 12 which was outside this limit, although all castings were undersized to a lesser extent. Vacuum investing gave improved casting accuracy; with four of the five liners, the improvement was highly significant (p < 0.001), and with the fifth, probably significant (p < 0.05). Even with vacuum investing, however, with only two of the liners did all castings show inaccuracies within +/- 0.2%. With the other three liners, some castings (ranging from 2/10 to 7/9) had inaccuracies worse than -0.2%. With both air and vacuum investing, changing from one liner to another caused changes in relative casting accuracy which were often significant (p < 0.01) or highly significant (p < 0.001). In casting techniques where a ceramic ring liner is used, the choice of specific lining material and the choice between investing in air or under vacuum are important factors which can have a major effect on the fit of castings.     

Studies of fluoride retention by oral soft tissues after the application of home-use topical fluorides.

Previous studies have focused on enamel and plaque as the primary sites of fluoride (F) retention in the mouth. The present study was undertaken to evaluate the role of oral soft tissue as a site of F retention by comparing an edentulous subject panel (n = 9) with a fully dentate panel (n = 10). Unstimulated whole saliva samples were collected by having subjects pool saliva for two min. Samples were collected over a 24-hour period after application of a placebo dentifrice (PD; 0.4 ppm F), fluoride dentifrice (FD; 1100 ppm F), fluoride rinse (FR; 226 ppm F), or fluoride gel (FG; 5000 ppm F) delivered in custom trays. There was no statistically significant difference in salivary flow rate between the two panels for any of the treatments. The edentulous panel had higher salivary F levels than the dentate panel, which reached statistical significance (p less than 0.05) for the FD and FG treatments. In a separate study involving the same treatments, F levels at specific soft-tissue sites were measured over a one-hour period by use of absorbent discs placed in different soft-tissue areas of the mouth. The tongue and lower posterior vestibule retained the highest F levels, followed by the upper posterior buccal vestibule and upper anterior labial vestibule, with the lowest F levels retained in the lower anterior vestibule and the floor of the mouth. There was a strong-to-moderate correlation between whole saliva F concentration and F levels at specific soft-tissue sites. This study establishes the importance of oral soft tissue as the major site of F retention in the mouth.     

Habilitation of patients with clefts: parent and child ratings of satisfaction with appearance and speech.

This study examined ratings regarding satisfaction with facial appearance and speech performance from 495 parent-child pairs. Data were obtained from school-aged children (5-18 years old) and their parents using standardized independent interviews. Results revealed that 54 percent of the children with cleft lip (CL) or cleft lip and palate (CLP) were very pleased with their appearance, and 62 percent of the cleft palate or CLP subjects were very pleased with speech. Low, but statistically significant correlations exist between the female subjects and their parents in satisfaction with appearance. Although older cleft lip and/or palate patients reported increased satisfaction with speech, no age differences in patient satisfaction with appearance were observed in subjects with CL/CLP. Parents of females expressed more concern about their daughters' appearance than parents of males, while parents of males were more concerned about speech. Implications for craniofacial habilitation teams and research suggestions are discussed.     

Immunohistochemical localization of CEA,EMA and keratin in salivary mucoepidermal carcinoma]

Localizations of CEA,EMA and keration in 19 cases of mucoepidermal carcinomas were investigated using the indirect immunoperoxidase technique.The results showed CEA was negative in normal salivary glands and showed faint reaction in glands near carcinoma tissue.Keratin and EMA were localized in some myoepithelial cells.The positive rates in carcinoma tissue were 78.9%,89.5% and 84.2%,respectively.The positive rates and staining intensity of CEA and EMA in carcinoma tissue gradually decreased with the decline of tumor differentitation,but that of keratin showed no variation.the author consider that CEA and EMA could become good indices in clinically diagnosing mucoepithelial carcinoma and determining tumor differentiation type cell in mucoepidermal carcinoma and have a potential to multiply express the tumor elements of epithelium and/or mesenchyma.     

Acute airway obstruction following tooth extraction in hereditary angioedema

Life threatening airway obstruction occurred following a single tooth extraction in a patient who had hereditary angioedema, despite preoperative administration of FFP and danazol. Emergency intubation was performed in the operating room, and assisted respiration was required during the acute attack. The clinician should be aware that an acute attack of HAE may occur even though recommended medical management regimens are followed and should be prepared for emergency airway control.     

Dental education at The University of Adelaide: an evaluation

A bstract — Dental students, staff, and practitioners participated in an evaluation of the dental curriculum at The University of Adelaide between 1978 and 1981. The need for curriculum reform was expressed by all three groups, especially with respect to the teaching of basic sciences, some biomedical subjects, behavioural science, and practice management. Dental staff and practitioners have also indicated serious misgivings about the quality of clinical skills of new graduates. Proposals for reform are directed to resolving these and other curriculum problems revealed in the evaluation.