[Distant metastases of malignant tumors of head and neck]. / Metastazele la distanta ale tumorilor maligne ale capului si gâtului.

The charts of 176 previously untreated patients with head and neck squamous cell carcinoma who completed treatment during 2006 in Oro-Maxillo-Facial Clinic, UMF "Carol Davila" Bucharest were reviewed. These patients had no evidence of distant metastases when initially evaluated. The overall incidence of distant metastases was 27.84%, varying from 10.52% for buccal mucosa to 63.63% for tongue and floor of the mouth (p < 0.05). 80% of the metastases were detected within two years after treatment. The rate also increased with the T and N classification; however, the N stage had greater influence on the rate of metastases than the T stage.

Oxidative stress markers in oral lichen planus.

Oral lichen planus (OLP) is a relatively common disorder whose cause is still unknown. Oral cancer is preceded in most cases by pre malignant lesions-leukoplasia, submucous fibrosis and lichen planus. Free radicals and reactive oxygen species play important roles in both pathogenesis of lichen planus and carcinogenesis. Thus monitoring systemic and saliva compounds important for the antioxidant defence (oxidative balance) could be important for the clinician's treatment strategy. Thorough medical management and early active treatment are necessary to improve symptoms and might also be a relevant prevention strategy from squamous cell carcinoma risk, although data to fully support this statement still need investigation. The principal aim of this study was to determine the systemic uric acid, GGT, and albumin levels as well as the levels of uric acid and albumin in 20 patients diagnosed with lichen planus and 20 controls. Extensive medline search failed to reveal any study of this type. Our results showed a significant decrease of saliva (p < 0.005) uric acid and an increase in serum gamma glutamyl transpherase (GGT) (p < 0.01) as well as in the total antioxidant capacity of saliva in patient group with respect to the control one. The preliminary conclusion of our study is that uric acid, the most important salivary antioxidant and GGT could be considered in the future as useful markers of oxidative stress for elaboration of treatment strategy and monitoring.

[Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker]. / Hemiartroplastia inferioara a articulatiei temporo-mandibulare cu proteza de condil articular articulata tip Stryker.

The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

Could constitute saliva the first line of defence against oxidative stress?

The oral cavity, a very complex and unique milieu due to its dual function, respiratory and digestive, is the only place in the body where the mineralized tissue is exposed to the external environment. In this environment there are complex interactions between various surfaces: host soft and hard tissues, food, air and microorganisms. Saliva is in the middle of this environment and tries to cope with an ever-changing milieu. It includes a large number of inorganic and organic compounds, which act as a "mirror of the body's health". In addition to its other functions, saliva could constitute the first line of defence against oxidative stress. The body contains a number of protective antioxidant mechanisms. Saliva is also rich in antioxidants. We review the current available data and from our laboratory concerning antioxidant capacity of saliva. Substantial data are available in literature on the role of reactive oxygen species and antioxidants in diseases, but few information is available on oral pathology. Due to its composition and functions, saliva could have a significant role in controlling and/or modulating oxidative damages in the oral cavity.

Salivary cortisol-marker of stress response to different dental treatment.

UNLABELLED: The measurement of salivary cortisol provides a stress-free, non-invasive collection procedure, which reflects the changes in the hormone plasma levels. The aims of the present study were to determine the level of stress displayed by healthy patients who underwent different types of routine dental treatment procedures and to detect a possible correlation between cortisol and oxidative stress in periodontal disease. MATERIAL AND METHODS: 36 subjects took part in this study. Patients received routine dental procedures or underwent oral surgery. The physiologic stress response was determined using salivary cortisol assessment. Total antioxidant capacity of saliva and uric acid was also measured. Salivary cortisol assessment was made in whole saliva by an ELISA extraction-free technique using a Serozyme Cortisol kit (ADALTIS, Italy) for serum and urine and adapted to saliva. Method's sensibility for saliva is 0.55 ng/mL. Uric acid was measured by uricase using a kit from Diamedix and the total antioxidant capacity (TAC) using the spectrophotometric assay, also called "Trolox equivalent antioxidant capacity" (TEAC). This method is an adaptation of the ABTS assay. RESULTS: Cortisol levels are influenced by the duration and types of treatment and anesthesia. The results indicate that saliva of healthy individuals is significantly more effective than that of patients with periodontal diseases in scavenging a wide variety of generated free radicals. CONCLUSIONS: Within the limits of this study, there is a relationship between salivary cortisol levels, time and intensity of various dental treatment procedures. Periodontal diseases are associated with oxidative stress and a defect in the total antioxidant activity of saliva.