口腔鳞状细胞癌角蛋白A_(575)表达的病理学特征

运用免疫组化技术ＡＢＣ法观察４３例口腔鳞状细胞癌角蛋白Ａ５７５表达的病理学特征，并对Ａ５７５角蛋白表达与口腔鳞癌的组织学分级、淋巴结转移、临床分期的关系进行了探讨。结果表明，口腔鳞癌组织学分化越低，Ａ５７５角蛋白表达的强度越低。表达强度在以上的Ⅰ级鳞癌为９４．４％；Ⅱ级鳞癌为７８．６％；Ⅲ级鳞癌为３６．４％。Ａ５７５角蛋白表达强度在以上的口腔鳞癌中，有淋巴结转移者为３０％，无转移者为８７．９％，表明Ａ５７５角蛋白表达强度越低，口腔鳞癌转移的可能性越大。Ａ５７５角蛋白表达强度在以上的早晚期口腔鳞癌中分别为９１．７％、５２．６％（Ｐ＜０．０１）。表明临床分期越高，Ａ５７５角蛋白表达强度越低。     

p16和细胞周期蛋白D1蛋白在口腔鳞癌中的表达及其意义

目的　研究口腔鳞癌组织中p16及细胞周期蛋白D1(cyclin D1)表达以及与临床生物学特性和细胞增殖的关系。方法　采用免疫组化方法检测49例原发性口腔鳞癌组织及20例正常口腔黏膜组织中p16及cyclin D1蛋白的表达水平，Ki-67作为细胞增殖活性的指标也被检测。结果　p16在口腔鳞癌中阳性表达率显著低于正常口腔黏膜组织(P<0.05)，cyclin D1蛋白和Ki-67在口腔鳞癌中阳性表达率显著高于正常口腔黏膜组织(P<0.05) ；cyclin D1蛋白过表达与临床分级及淋巴结转移有关(P值分别<0.05)，p16缺失表达与淋巴结转移有关(P<0.05)；p16负表达和cyclin D1过表达与细胞增殖评价因子Ki-67呈负相关(r=-0.598和-0.658, P<0.05)。结论　在鳞癌的发生发展过程中，p16的缺失表达和cyclinD1的过表达两者可能单独或共同参与。p16的缺失可能还与口腔鳞癌细胞的分化、转移及增值和预后有关。     

伴有全身多发性损伤的颅颌面骨折同期与延期手术的疗效比较

目的：探讨颅颌面部骨折伴有全身其他部位多发性损伤的患者采用同期或延期手术治疗的临床效果差异。方法85例颅颌面部骨折伴有全身其他部位多发性损伤的患者,根据患者本人、家属意愿及实际情况,将患者按照颅颌面部骨折与全身其他部位是否同期治疗分为2组,同期组48例行同期手术治疗;延期组37例行延期手术治疗。比较2组伴有颅脑损伤患者的神经功能缺损程度、术后咬合、张口度、住院时间及术后并发症的差异。结果根据神经外科评分标准,2组术后3个月的格拉斯哥预后评分（Glasgow outcome scale,GOS）分布差异无统计学意义（Z=?1.545,P=0.122）;术后同期组患者的咬合优良率（93.75%）高于延期组患者（75.68%）（c2=5.630,P=0.018）;术后同期组患者的张口度（34.5±3.6）mm高于延期组（28.9±3.3）mm （c2=7.370,P<0.001）;同期组住院时间（28.5±5.2）d,短于延期组（40.1±5.7）d（c2=9.778,P<0.001）;术后同期组手术并发症发生率为8.33%,低于延期组24.32%（c2=4.124,P=0.042）。结论在患者创伤严重程度适宜的情况下,对于颅颌面部骨折伴多发性损伤患者可以采取多科室联合手术治疗,可缩短住院时间、有利于患者颌面部外观及功能恢复。     

A survey of mouth pain and dryness in patients with advanced cancer

 An 11-item face-to-face survey was conducted in 99 consecutive patients with advanced cancer to determine the prevalence, intensity, reporting and treatment, presumed cause(s), and importance of mouth pain and dryness. Sixteen of the 99 patients (16%) reported experiencing mouth pain at a mean intensity corresponding to 5.5±SD 2.21 on a 0 (no pain) to 10 (worst possible pain) numerical scale, and 88 (88%) patients reported dry mouth at a mean intensity corresponding to 6.2±SD 2.21. Nine (56%) of the 16 patients with mouth pain and 39 (44%) of the 88 patients with mouth dryness reported these symptoms to their attending physician(s). Sixty-nine percent (27/39) of patients who reported having a dry mouth were advised by their physician(s) to pursue one or more treatments. The most common treatments recommended (and frequencies) were drinking water/taking sips of fluid (13), gargling with bicarbonate mouthwash (4), using an artificial saliva spray (4), and using an oral fungal suspension for thrush (4). The most common findings on oral examination included: possible thrush (53 patients), upper and lower dentures (33 patients), and multiple dental restorations (23 patients). The causes most frequently assumed to be responsible were ill-fitting dentures for mouth pain, and medications and possible oral fungal infections for mouth dryness. The mean values given for the importance of the symptoms of mouth pain and dryness relative to other symptoms or problems experienced by the patients were 4.4±SD 1.84 and 3.6±SD 1.67, respectively, on a Likert scale ranging from 1 (not important) to 7 (great importance). Mouth dryness was more frequently reported than mouth pain. The mean rating for the intensity of mouth pain was higher than that for mouth dryness, although both were of moderate importance to patients relative to other symptoms or problems experienced at the time. Patients tended to underreport mouth pain and dryness, and physicians tended to address such complaints inadequately. Published online: 3 August 2000     

Utilidad de los enjuagues con povidona yodada y peróxido de hidrógeno en pacientes con COVID-19

IntroductionPovidone-iodine and hydrogen peroxide could be effective in against SARS-CoV-2.MethodsA “non-interventional trial” in 88 patients (43 ± 17 yrs, 55% men) with SARS-CoV-2 in nasopharyngeal swabs (RT-PCR). 31 received mouth rinses/gargling with povidone-iodine (every 8 h, two consecutive days), 17 with mouth rinses/gargling of hydrogen peroxide, and 40 controls. PCR were repeated at 3, 11 and 17 days.ResultsAfter intervention the viral load (Log 10 copies/ml) remained similar in povidone-iodine (4.3 ± 2.7 copies/ml), hydrogen peroxide (4.6 ± 2.9 copies/ml; p = 0.40) and controls (4.4 ± 3.0 copies/ml). The percentage of patients with a negative result in the second PCR was 27% in povidone-iodine group, 23% in hydrogen peroxide and 32% in controls; in the third PCR, 62%, 54% and 58% respectively; and in the fourth PCR, 81%, 75% and 81%.ConclusionOur results do not support the clinical usefulness of mouth rinses/gargling with povidone-iodine or hydrogen peroxide in patients with COVID-19.     

Can dentists contribute to early screening for developmental disorders in five-year-old children during health checkups?

AimThis study aimed to clarify the relationship between developmental disorders and oral function assessed using the mouth rinsing function test (MRFT).Materials and methodsA total of 1147 children who underwent health checkups between 2014 and 2017 were included. We divided the patients into two groups based on their MRFT findings: good and poor oral function. We analyzed the associations between the outcomes of MRFT and other assessments using the chi-squared test and multiple variable logistic regression analysis.ResultsOf the 1147 participants, 346 (30.2%) were suspected of having developmental disorders, 951 (82.9%) had good oral function, and 196 (17.1%) had poor oral function. Statistical analysis demonstrated significant differences in developmental disorders and oral function. Children suspected of having developmental disorders had significantly poor oral function.ConclusionsDentists can detect early signs of developmental disorders using MRFT owing to its convenient performed in dental clinics. Developmental disorders possess spectrums of symptoms and various accompanying conditions; therefore, collaboration with other professionals is crucial for early screening and child support during their development.     

Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients

This study was performed to evaluate the subjective and objective functional outcomes of patients who had undergone submandibular gland-sparing neck dissection. All data were obtained from patients treated in a single hospital. Seventy-seven patients who had undergone complete submandibular gland sparing (CSGS) were included in the study. Cancer prognosis items were recorded. The subjective outcomes included patient self-evaluation of mouth dryness and the evaluation of the presence of saliva secretion following the application of digital pressure. Saliva scintigraphy served as the objective test. Self-reported xerostomia was compared between the CSGS patients and a control group of patients who had undergone unilateral submandibular gland removal (USGR; n = 74). In the CSGS group, local recurrence occurred in 3.8% of the 80 cancer sites, and neck recurrence occurred in 5.9% of neck dissection sites. Regarding the subjective measurements, 7.0% of the CSGS patients reported xerostomia and 91.9% demonstrated saliva secretion by digital pressure. Scintigraphy revealed actively secreting glands, with 42.9% of them showing normal gland function; none of the patients had severe xerostomia. The relative risk of dry mouth was significantly higher in the USGR patients than in the CSGS patients (P < 0.001). Submandibular gland sparing during neck dissection was found to result in satisfactory saliva secretion, with a relatively small risk of local or neck recurrence.     

Unique Oral Presentations of Deep Fungal Infections: A Report of Four Cases

Deep fungal infections rarely involve the oral cavity and most commonly affect immunocompromised patients. Oral deep fungal infections typically manifest as chronic mucosal ulcerations or granular soft tissue overgrowths. Since these lesions are non-specific and can mimic malignancy, it is crucial to obtain a thorough clinical history and an adequate biopsy to render the appropriate diagnosis. We report four new cases of deep fungal infections, diagnosed as histoplasmosis, blastomycosis and chromoblastomycosis, exhibiting unique oral and perioral presentations. Awareness of these unusual entities can help dental and medical practitioners expedite proper multidisciplinary care and minimize morbidity and mortality.