Pharyngeal pack placement in minor oral surgery: A prospective, randomized, controlled study.

We conducted a prospective, randomized, controlled study to investigate the influence of pharyngeal pack placement on postoperative nausea, vomiting, and throat pain after minor oral surgery. Our study group was made up of 80 patients-45 men and 35 women, aged 19 to 52 years (mean: 27.3)-who underwent a minor oral surgical procedure under general anesthesia. Patients were randomly assigned to one of three groups: 20 patients who received a pharyngeal pack under videolaryngoscopic guidance (video guidance group), 20 who had a pack placed blindly (blind insertion group), and 40 patients who received no pack at all (control group). Postoperative nausea occurred in only 4 patients (20%) in the blind insertion group (p < 0.007). No patient experienced postoperative vomiting. Postoperative throat pain occurred in all 20 video guidance patients (100%), in 17 of the blind insertion patients (85%), and in 20 of the controls (50%). The difference between the controls and each of the two pack groups was statistically significant (p < 0.006); the difference between the two pack groups was not significant.

The importance of ctokeratins in the early detection of oral squamous cell carcinoma.

BACKGROUND: Oral cancer is usually diagnosed at advanced stages. The pattern of keratin expression in normal epithelia and the change in their expression in premalignant lesions and carcinomas have suggested the possibilities of improving diagnosis. The aim of this study is to determine the use of acidic cytokeratins (CKs) as biomarkers of histopathological progression in oral carcinogenesis. MATERIALS AND METHODS: A total of 50 paraffin blocks of histological specimens diagnosed as hyperplastic epithelium, dysplastic epithelium, well-differentiated squamous cell carcinoma (SCC) and poorly-differentiated SCC (10 specimens each) were included in this study, in addition to 10 normal oral mucosal samples. All samples were stained immunohistochemically with CKs (10-ab1, 14, 16-ab1, 18-dc10 and 19-abs10) using Ventana Medical Systems (Arizona-USA). The expression of CKs antigen was evaluated as absent, mild, moderate and severe. RESULTS: CK10-ab1 was found to be positive in the suprabasal layers of all specimens in normal and hyperplastic epithelium, while it was moderate in dysplastic epithelium and mild in well-differentiated SCC. CK10-ab1 was negative in all samples with poorly-differentiated SCC (P < 0.005). CK14 was positive in all specimens of all groups whereas CK16-ab1 was negative in all specimens of all groups. The stain of CKs 18-dc10 and 19-abs10 was restricted to the basal cells only in normal, hyperplastic and dysplastic epithelium, while it was mild in well-differentiated and poorly-differentiated SCC (P < 0.01). CONCLUSION: CK10-ab1 disappeared gradually with the progression of malignant changes of squamous cells whereas CKs 18-dc10 and 19-abs10 increased gradually at the same time. Such changes in the protein mapping of squamous cells need more investigation for a better understanding of oral SCC.

Should Surgical Burs Be Used as Single-Use Devices to Avoid Cross Infection? A Case-Control Study.

OBJECTIVE: The purpose of this study was to evaluate and compare the rate of bacterial contamination of reused and new unused burs after different sterilization sessions. MATERIALS AND METHODS: The test group consisted of 40 used fissure burs, and the control group of 40 unused new fissure burs (total n = 80). The burs from both groups were precleaned according to standard protocols and then subjected to two sterilization sessions (high- and low-steam pressure autoclaving). After each sterilization session, the burs were transferred into incubation tubes which contained thioglycollate culture medium and were monitored daily for a period of 48 h to detect any bacterial growth. Data were collected and statistical analysis was done using Fisher's exact test. RESULTS: Of the 40 burs of the test group, 2 burs (5%) showed positive bacterial growth, whereas no bur from the control group showed any sign of bacterial growth after high-pressure autoclaving. The colony structure and Gram staining were compatible with the growth of Staphylococcus epidermis. After a second sterilization session at low-pressure steam autoclaving, no bacterial growth was observed for the test group, but 1 bur (2.5%) from the control group showed bacterial growth and Gram-positive staining matched well with the growth of Brevibacterium species. CONCLUSIONS: The new and unused burs were 100% sterile after high-pressure steam autoclaving, whereas 5% of the reused burs appeared positive with bacterial contamination. After low-pressure steam autoclaving, reused burs were 100% sterile, but 1 new bur demonstrated bacterial contamination.

Effect of Video Triggering During Conventional Lectures on Final Grades of Dental Students in an Oral Biology Course: A Two-Year Retrospective Study.

The aim of this study was to analyze the effect of the inclusion of video triggers in conventional face-to-face lectures on the final grades of dental students in an oral biology course. The study consisted of two groups of students taking the course in two academic years at a dental school in Saudi Arabia: group 1, 2013-14 (control); and group 2, 2014-15. The total sample comprised 163 students (n=163; group 1: 71 and group 2: 92). Group 1 received lectures without any videos, whereas group 2 received lectures that included two to three videos of one to five minutes in duration with triggering effect (a video was shown every 10-15 minutes into the lecture). The final examination grades of the students were accessed retrospectively, and the data were compared with a chi-square test. The results confirmed that a higher number of students who received video triggering during lectures (group 2) performed better than their counterparts who did not receive video triggers (group 1); the difference was statistically significant (p<0.05). Among the group 2 students, 26% achieved a grade of A, and 37% achieved a grade of B. In contrast, only 7% of the group 1 students obtained a grade of A, and 31% achieved a grade of B. These results suggest that video triggers may offer an advantage over conventional methods and their inclusion in lectures can be a way to enhance students' learning.

Desmoplastic fibroma of the mandible: report of a misdiagnosed case.

Several odontogenic and non-odontogenic tumors and related lesions affecting the jaws share clinical presentation and imaging appearance. However, all cases have to be approached and treated on an individual basis, based on a reliable anatomic pathology diagnosis. The present paper describes a case of a desmoplastic fibroma, which was misdiagnosed as an odontogenic keratocyst, and spotlights the potential benefit and conclusive role of a second opinion in oral and maxillofacial pathology diagnosis. A brief review of the literature is also provided.

Lateral wall sinus floor elevation for implant placement: revisiting fundamentals and the surgical technique.

Sinus floor augmentation procedure is indicated to reconstruct the posterior maxilla with a sufficient amount of bone to allow for successful implant placement. This paper reviews the contemporary lateral wall technique, the related anatomy and some concepts and properties concerning graft materials currently available.

Desmosomal adhesion and pemphigus vulgaris: the first half of the story.

Pemphigus vulgaris (PV) is a paradigm of autoimmune disease affecting intercellular adhesion. The mechanisms that lead to cell-cell detachment (acantholysis) have crucial therapeutic implications and are currently undergoing major scrutiny. The first part of this review focuses on the classical view of the pathogenesis of PV, which is dominated by the cell adhesion molecules of the desmosome, namely desmogleins (Dsgs). Cloning of the DSG3 gene, generation DSG3 knock-out mice and isolation of monoclonal anti-Dsg3 IgG have aided to clarify the pathogenic mechanisms of PV, which are in part dependent on the fate of desmosomal molecules. These include perturbation of the desmosomal network at the transcriptional, translational, and interaction level, kinase activation, proteinase-mediated degradation, and hyper-adhesion. By the use of PV models, translational research has in turn helped shed light into the basic structure, function, and dynamics of assembly of desmosomal cadherins. The combined efforts of basic and applied research has resulted in tremendous advance into the understanding of epidermal adhesion and helped debunk old myths on the supposedly unique role of desmogleins in the mechanisms of cell-cell detachment in PV.

Allograft for maxillary sinus floor augmentation: a retrospective study of 90 cases.

PURPOSE: The aim of this study is to demonstrate the clinical applicability and efficacy of an allograft for maxillary sinus augmentations in patients requiring placement of dental implants. PATIENTS AND METHODS: Sixty consecutive patients underwent a total of 90 sinus augmentations. Twenty-nine were women and 31 men, with a mean age of 54 years. Twenty-six patients received a bilateral procedure and 34 unilateral. All cases were treated with the lateral wall technique. Allograft consisted of demineralized freeze-dried blocks in 6 cases, particulate in 82 cases, and a combination of both in 2 cases. In 30 patients, it was combined with platelet-rich plasma. A total of 84 implants were inserted. Bone samples of grafted areas were obtained in two patients for histological examination. RESULTS: Seventy-three implants were clinically successful at the reentry time. Eleven implants in seven patients were removed between 15 days and 6 months after their placement. Seven of these implants were replaced and received prostheses as well, for an overall postloading success rate of 95.2%. Follow-up for all patients after final restoration was between 12 and 96 months. Specimen's histological evaluation revealed bone formation and evidence of inflammatory infiltrate. CONCLUSIONS: Based on the findings of this study, it can be suggested that the use of the demineralized freeze-dried bone allograft from the Banco de Huesos y Tejidos Fundación Cosme y Damian for sinus augmentation is effective and constitutes a feasible therapeutic alternative for implant placement.