口腔颌面部肿瘤化疗方案药物敏感性试验

尊文以人舌鳞癌细胞系Ｔｃａ８１１３为对象，利用ＭＴＴ法对口腔颌面部肿瘤化疗常用的八种药物和七种方案进行了药敏试验，ＡＤＭ、５－Ｆｕ、ＣＤＤＰ等抗肿瘤作用较强；而ＰＹＭ、ＭＴＸ、ＶＣＲ单用对Ｔｃａ８１１３细胞无明显作用。化疗方案中以ＭＭＢＤ、ＰＦ、ＰＶＰ方案为佳，卡铂与顺铂在此疗方案中的作用无明显差异。实验结果提示：肿瘤化疗不能只凭经验用药，应注意化疗的耐药性问题。     

Coupling electrical and mechanical outputs of human jaw muscles undertaking multidirectional bite-force tasks

Previous studies have identified both linear and curvilinear relations between increasing bite-force magnitude and the integrated electromyogram (EMG) of jaw-closing muscles. In an attempt to explain the discrepancy, bite forces of incrementally increasing magnitude were produced on the right-hand side in five specified directions by eight humans. Linear regression lines were fitted to normalized EMG activities of the left and right masseter and temporalis muscles against increasing bite-force magnitude in each direction. The grand mean of linear correlation coefficients was 0.79 (±0.11 SD), suggesting an overall linear relation. Each set of individual data was fitted with polynomial lines up to the third order. The ‘best’ fit was selected by statistical significance of coefficients and the least-square analysis of the sum of residues for each fitted line; 62% of individual data-sets were best fitted with linear regression lines, 31% with quadratic lines and the remaining 7% with cubic lines. Repeated analysis of residue variance of the pooled data showed that either a linear or quadratic line fitted every data set except one, for which a cubic line had the best fit. Working-side muscles had significantly larger linear correlation coefficients than corresponding balancing-side muscles for most bite-force directions. Analysis of variance of linear correlation coefficients revealed that the degree of linearity often depended upon the roles played by a muscle in producing forces in different directions. It appears that linearity or non-linearity of the EMG-force relation is a determinant, among other variables, of the direction of the resultant force.     

Granulocyte elastase in gingival crevicular fluid: improved monitoring of the site-specific response to treatment in patients with destructive periodontitis

Abstract In 13 patients with severe destructive periodontitis. the response to periodontal therapy was estimated by granulocyte elastase level in gingival crevicular fluid (GCF). 62 sites were classified according to changes of probing depths (PD) and quantitative bone height (BH%) before and after 5–year regular maintenance treatment: (i) 17 consistently healthy sites with no changes of PD and BH%; (ii) 6 initially healthy sites with deterioration in PD and BH%; (iii) 14 diseased sites with improvement in PD and BH%; (iv) 25 diseased sites with no improvement in PD and BH%. GCF was collected by an intracrevicular washing system. The released elastase in the supernatants (EA-S) and the cell-bound elastase in the pellets (EA-P) were determined with a low molecular weight substrate specific for granulocyte elastase. The ratio of EA-S and EA-P (S/P-ratio) was used as a relative measure of elastase released by the granulocytes present. The sites classified as diseased with no improvement or initially healthy but deteriorating, had significantly higher EA-S, EA-P and S/P-ratios than the consistently healthy sites or diseased but improving sites (p < 0.01). Both EA-S and S/P-ratio showed strongly positive correlations with the current levels of gingival inflammation and periodontal destruction (p < 0.001). The present study suggests that increased elastase level is associated with disease progression, and may be used to monitor the response to longitudinal maintenance therapy.     

Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing

Oral submucous fibrosis (OSF) is a high risk precancerous condition, predominantly affecting Indians. Consumption of chilli was hypothesized as an etiologic factor on the basis of ecological observations and a solitary animal experimental study. Subsequent epidemiologic studies that included case-series reports, large cross-sectional surveys, case-control studies, cohort and intervention studies have identified areca nut as the major etiologic agent. Tissue-culture studies involving human fibroblasts, areca nut extracts and areca nut alkaloids supported this etiologic hypothesis by showing fibroblastic proliferation and increased collagen formation. Currently, the role of genetic susceptibility and that of autoimmunity are receiving attention. The influence of nutritional factors, if any, remains unclear.     

FRCSEd (Oral and Maxillofacial Surgery): a milestone in the history of Oral and Maxillofacial Surgery in the United Kingdom

The British Association of Oral and Maxillofacial Surgeons (BAOMS) and the Royal College of Surgeons of Edinburgh (RCSEd) have had leading roles in organisation, assessment and improvement of surgical training in the United Kingdom. This was particularly well illustrated by the establishment of the fellowship examination in Oral and Maxillofacial Surgery (FRCSEd, OMFS).     

Temperatures in and around mandibular fractures

This study measured the temperature in and around mandibular fractures in 20 anaesthetized patients. A fine calibrated thermocouple attached to a digital thermometer was used to measure temperature at the bone surface margin of a mandibular fracture and 5 and 10 mm from the fracture; within the fracture against the bone at 5, 7 and 10 mm depths and at the base of 7 mm deep biopsy cavities 5 and 10 mm distant from the fracture line immediately after biopsy, then 1 and 2 min later. On the surface the temperature was approximately 1 degrees C warmer than at the 5 and 10 mm sites distant from the fracture. Temperature reduced at the 1 and 2 min readings after the biopsy cavity cutting. This study confirmed that the surface temperature is lower than internal bone temperatures.     

Dentoalveolar relations in children born with a unilateral cleft lip and palate (UCLP) in Western Australia.

OBJECTIVE: Our objective was to evaluate complete unilateral cleft lip and palate repair outcome in the Cleft Unit in Perth, Western Australia, by assessment of dentoalveolar relationships. DESIGN: This is a retrospective study. SETTING: Our subjects were individuals under the care of the cleft team in Perth, Western Australia. PARTICIPANTS: All patients with unilateral cleft lip and palate and available 6-year casts who had been born since January 1, 1985, were identified from the cleft unit's database. The nature of the cleft was verified by examination of birth study models and photographs. A total of 54 such patients were identified. MAIN OUTCOME MEASURES: Main outcome measures were identified through dental arch relationship grading of study models using the 5 Year Old Study Model Index. RESULTS: Interexaminer and intraexaminer agreement kappa statistics revealed good to very good agreement using this index. The results indicate that the surgical outcome was graded as excellent, good, or fair for 77% of patients and poor or very poor for 23% of patients. CONCLUSIONS: The results of the Western Australia study compare favorably to the overall U.K. outcome (the Clinical Standards Advisory Group study) but unfavorably to the results of some European centers, such as Oslo.     

A survey of postgraduate (specialist) orthodontic education in 23 European countries

This paper reports on a survey of the duration, funding, and assessment of postgraduate specialist orthodontic training, the requirement for postgraduate training prior to entering specialist orthodontic training and registration of specialist orthodontists in Europe. A questionnaire and explanatory letter were mailed to all members of the EURO-QUAL BIOMED II project. Answers were validated during a meeting of project participants and by fax, when necessary. Completed questionnaires which were subsequently validated, were returned by orthodontists from 23 countries. The results indicated that a period of postgraduate training, prior to entering specialist orthodontic training was required in 12 of the responding countries. Specialist orthodontic training was reported as lasting 2 years in three countries, 3 years in 17, and for 4 years in three. Part-time training was reported as a possibility in four countries. In 21 of the 23 countries specialist training was reported to take place in full or part within universities, with some training taking place in government clinics in four countries. In five countries some or all training was reported to take place in specialist practices. Training was said to be funded solely or partially by governments in 15 of the 23 countries, to be solely self-funded in five countries, and partly or solely funded by universities in six countries. A final examination at the end of specialist training was reported to be held in 21 of the 23 countries. The nature of this examination varied widely and there was no such examination in two countries. Twelve of the 23 countries reported that they had a specialist register for orthodontics; 11 that they had no register. In none of the countries surveyed was there a requirement for those on a register to undergo periodic reassessment of competence once they are on the register. It was concluded that there was wide diversity in all aspects of specialist orthodontic training and registration within the countries surveyed.     

Duration of orthodontic treatment involving orthognathic surgery

The purpose of this study was to analyze factors influencing the duration of treatment in a sample of patients treated by a combined orthodontic/orthognathic surgery approach. Presurgical and postsurgical treatment times were assessed for 315 patients processed through an orthognathic team over a 7-year period. The median total treatment duration for all patients was 21.9 months, the median presurgical duration was 15.4 months, and the median postsurgical duration was 5.9 months. Treatment involving extractions resulted in significantly increased presurgical and total treatment times. Treatments performed in the university clinic showed reduced presurgical duration and increased postsurgical duration compared to treatments carried out by specialists outside the university. Presurgical, postsurgical, and total treatment times were significantly reduced when the orthodontist had treated 10 or more patients during the period. An earlier regimen of orthodontic treatment did not appear to have a significant effect on treatment duration.