Preliminary study of the impact of loss of part of the face and its prosthetic restoration

STATEMENT OF PROBLEM: Loss of a part of the face or having a congenitally missing ear, nose, or eye is likely to have both a social and a psychologic impact on those affected. The nature and extent of this impact has not been explored previously. The provision of facial prostheses is an increasingly viable and beneficial treatment option, but the psychologic and social adjustment to the prosthesis has not been described. PURPOSE: This study performed a preliminary investigation of patients' responses to loss of part of the face, and their perceptions of the prosthetic restoration of their missing facial part. METHODS: Nine individuals who had experienced prosthetic replacement of an ear, nose, or eye were interviewed. Interviews were semistructured, each respondent was interviewed individually and the interviewer followed a predetermined interview schedule. Themes emerging in the interviews were identified. RESULTS: The main themes relating to the loss of the facial part were the importance of the story of the loss, coping through bargaining, and the impact of the loss on relationships. The important themes identified in regard to the prosthesis were issues in the maintenance of the prosthesis and the reactions of other people to the prosthesis. CONCLUSION: Loss of part of the face requires great adjustment. The reactions of other people were marked. Provision of a facial prosthesis can assist in the process of adjustment.     

Dentistry in Taiwan, Republic of China: national health insurance reforms, illegal dentistry and plans for peer review quality control

The dental health care system in Taiwan, Republic of China is described in terms of demographics, structure, context of treatment and historical development of the dental health care payment system. A notable characteristic of the system is the existence of trade dentists, who operate without licensure. Their popularity and price advantage has maintained a political base that affects policy decisions. Health care reforms of March, 1995 with a comprehensive national health insurance, as well as ambitious plans for systematic peer review quality control of dentists' work are unique health care developments worthy of the attention of health care policy makers in other countries who are studying health care reform processes.     

A removable oral prosthetic appliance for Bell's palsy: report of case.

An intra-extraoral removable prosthetic appliance permitted the patient, a victim of Bell's palsy, to carry on daily activities with a minimum of facial distortion, pain, speech difficulty, and emotional trauma. Perhaps thousands of other victims of Bell's palsy and strokes would benefit from such a device.     

Excision of buccal hemangioma by carbon dioxide laser beam.

The carbon dioxide laser beam was used successfully to extirpate a large buccal hemangioma in a child. No hemostats were required, as this new surgical modality affords a practically bloodless operative field. Tissue necrosis occurs only minimally at the borders of the incision. Operative intervention with the carbon dioxide laser beam in cases of hemangioma and other tumors of the oral cavity is advocated.     

Activation of the complement system by some gram-positive oral bacteria.

Actinomyces viscosus 19246, T₁₄V and T₁₄AV, Streptococcus mutans and Streptococcus sanguis consumed complement in vitro. Complement (C) profile analysis revealed that C₄ and C_3–9 were consumed concomitantly in unadsorbed human serum. In serum from which naturally occurring agglutinating antibodies had been removed, the same microorganisms caused C_3–9 consumption in the absence of a demonstrable loss of C₄ activity. Congenitally C₄-deficient guinea-pig serum (C₄D) supported a similar consumption of C_3–9. The Gram-positive plaque microorganisms tested activated serum complement by the classical as well as the alternate pathways. Dental plaque microorganisms may cause a similar activation of gingival crevicular fluid complement in vivo, thus resulting in complement-mediated inflammatory processes.     

Ultrastructural features of the verruciform xanthoma

The verruciform xanthoma, a rare lesion of the oral cavity, was studied by light and electron microscopy. The major cell type associated with the lesion was shown to contain appreciable amounts of lipid and was characterized as a macrophage. It was characteristic of the endothelial cells associated with subepithelial capillaries to exhibit multiple basal laminae. A rather unusual observation was the migration of lipid-filled cells into the stratum germinativum of the overlying epithelium.