Risk assessment of bisphosphonate-related osteonecrosis of the jaw based on CBCT scans / A biszfoszfonátkezelés állcsontnekrózist eloidézo kockázatának megítélése CBCT-felvételek alapján.

INTRODUCTION: Bisphosphonate-related osteonecrosis of the jaw is a condition that severely affects the quality of life, therefore an early diagnosis is of utmost importance (both from a general and a surgical point of view), alongside with an accurate assessment of the risk of emergence of the disease. AIM: Estimation of the prognosis is not resolved; among several radiological options those used in dentistry seem the most fit for the purpose, with cone-beam computed tomography (CBCT) being superior in this task. Assessment of the risk of BRONJ developed following orally applied bisphosphonate is unemphatic in most case studies - these focus more on the intravenous application carrying a greater risk of BRONJ. METHOD: In contrast with the studies published so far, we performed our measurements on preoperative CBCT scans, thereby directly studying the possibility of risk assessment. Our measurements were conducted through evaluating CBCT scans. We chose the frontal section in the midline of the mental foramen as the representative area. We measured density and thickness of the cortical bone on several given points; the diameter of the mental foramen was also measured. In the first group, we examined patients suffering from osteoporosis who had developed BRONJ following oral bisphosphonate treatment. In the second group, we looked at patients suffering from osteoporosis, who had received oral bisphosphonate therapy for this condition but did not develop BRONJ after oral surgery. As control group, we chose patients suffering from osteoporosis who had not received any of the medications known to cause BRONJ. RESULTS: Based on our results, it is clear that there is no significant difference in the bone density of those patients who developed BRONJ and those who did not, examining the preoperative CBCT scans. CONCLUSIONS: Using CBCT scans (and thereby submitting the patient to radiation exposure) in order to estimate the possibility of BRONJ following oral bisphosphonate treatment for osteoporosis is not recommended. It is important not to expose patients to more radiation than strictly necessary to predict BRONJ following oral bisphosphonate treatment in accordance with the ALARA (as low as reasonably achievable) principle. Orv Hetil. 2020; 161(21): 867-872.

[Calcifications in the maxillofacial area]. / Meszesedések a maxillofaciális régióban.

Among patients presenting for dental treatment we could reveal various calcifications on panoramic x-rays or on cone beam computed tomography (CBCT) Calcifications is more likely to occur in vessels, ligaments, glandular tissues and is usually associated with chronic inflammation or scarring. The purpose of this article is to describe the imaging characteristics of commonly observed calcifications of the maxillofacial area with presenting our own cases such as: tonsilloliths, calcified lymph nodes, elongeated styloid process (calcified stylohyoid chain), phleboliths, carotid atheromas, calcified laryngeal cartilage.

Decreased oral cancer risk by moderate alcohol consumption in non-smoker postmenopausal women.

OBJECTIVE: Alcohol consumption is a strong risk factor for oral cancer however; an ambiguous biphasic impact of moderate and excessive alcohol intake on the risk of upper aerodigestive tract cancers has also been published. The aim of the present study was to clarify the dose-related risk of alcohol consumption for oral cancer, in male and female cases. MATERIALS AND METHODS: Six-hundred and eight non-smoker patients (466 males and 142 females) with squamous cell oral carcinomas (OCs) and 406 non-smoker tumor free controls (264 males and 142 females) were included into the study. Data of three groups; abstinent cases, moderate and excessive alcohol consumers were recorded according to the drinking habits of both OC cases and their controls. Blood glucose levels in male and female cases and menopausal state of women were also registered. RESULTS: Mean age of female patients was significantly higher than of male cases (p<0.01). Excessive alcohol consumption was a strong risk factor for both sexes, however moderate alcohol intake proved to be an OC risk for men (OR: 1.4) and decreased the OC risk for women (OR: 0.7). Elevated blood glucose level proved to be an OC risk factor for the predominantly postmenopausal women (OR: 1.6), whereas did not affect the OC risk among men. CONCLUSION: The presented findings are controversial to the hypothesis that women are more vulnerable to alcohol-induced carcinogenesis as compared with men. Increased insulin sensitivity and higher estrogen levels are advantageous systemic effects of moderate ethanol intake and they might reduce the risk for OC in postmenopausal women.

[Current issues of anticoagulation therapy in the course of dental treatment and oral surgery]. / Véralvadásgátló gyógyszerek alkalmazásának aktuális kérdései a fogorvosi és szájsebészeti kezelések során.

More and more patients receiving anticoagulant therapy or other drugs modifying the coagulation mechanism require dental or oral surgical treatment nowadays. The reason is that in Hungary the various forms of thrombosis are on the first place of morbidity and mortality lists. More than 50 per cent of all the mortality is due to thromboembolism. In view of all this it is not surprising that in the past years the indications, application and dosage of anticoagulant and platelet aggregation inhibitor drugs have changed. Decades-old principles have been modified. It is important for dentists and oral surgeons to know the risk of interventions in patients receiving anticoagulant or platelet inhibitory therapy.

[Changes in the indications for oral surgical implants based on statistical analysis]. / Az implantációs sebészeti beavatkozások indikációs területének változása a statisztikai vizsgálatok tükrében.

Journals, books and lectures on oral implantology are concerned less and less with the various fields of indication and their changes. The reason for this is in part that from a surgical point of view we consider the lack of contraindication as the indication of dental implant placement, while from a prosthetic point of view implant supported prosthetic work can be done in any prosthetic situation. Despite of this it is an interesting question, how the ratios of the various fields of indication have changed in view of the age groups and genders in Hungary in the past twenty years. In the present study a part of the patients reporting to the outpatient clinic of the Department of Oral and Maxillofacial Surgery and Dentistry of Semmelweis University for dental implant placement in the past 22 years were analyzed using statistical methods. Various age groups, genders and types of implants were compared in view of the indication of placement. The results were compared to data published in international literature.

[Gardner syndrome. Case reports]. / Gardner-szindróma. Esetismertetés.

The authors discuss 3 cases of Gardner-syndrome, outlining malignized large intestine polyposis, multiplex osteomas and the different skin tumours as the main features. The earliest symptoms suspecting the clinical picture are usually dental and/or mandibular lesions and draw the attention to the highly malignant polyposis.