The influence of mouth breathing on skeletal and dental features of splanchnocranium.

OBJECTIVE: This study was performed to investigate changes in dentofacial characteristics associated with mouth breathing (MB) and adenoidectomy. BACKGROUND: MB is considered to be an etiological factor of malocclusion. Adenoidectomy is supposed to have the ability to prevent the development of dentofacial deformities. METHODS: This retrospective study included 123 patients, namely 57 nose breathers, 19 former mouth breathers, who have undergone adenoidectomy, and 47 mouth breathers. The groups were compared according to their skeletal and dental characteristics. The measurements of each individual were obtained from lateral cephalograms and dental casts. The comparison was done using one-way ANOVA, Bonferroni post-hoc, Mann-Whitney U and Kruskal-Wallis tests. The statistically significant difference was defined as p<0.05. RESULTS: The MB group showed an increase in ArGoMe (p=0.02) angle. No difference was found in the sagittal parameters among the groups. Upper dental arch compression was positively correlated with MB(p=0.00), even in adenoidectomy cases (p=0.01). CONCLUSION: MB alters the vertical and transverse growth of the craniofacial complex. It is associated with longer lower anterior facial height and decreased maxillary intermolar distance. However, it does not influence the sagittal parameters. Airway clearance via adenoidectomy promotes the normalization of vertical parameters (Tab. 1, Fig. 2, Ref. 20).

Human race as indicator of 3D planning of soft tissue of face and multidisciplinary approach.

OBJECTIVE: The aim of this study was to determine the optimal parameters for 3D soft tissue planning for ortognatic treatment by gender and increases the effectiveness of multidisciplinary cooperation. METHODS: Craniofacial parameters which were analysed: nose breadth (al-al), bi-entocanthion breadth (en-en), bi-zygomatic breadth (zy-zy), bi-gonial breadth (go-go), total facial height (n-gn), mouth breadth (ch-ch), morphologic face height (sn-gn), upper-lip height (Ls-Stm), lower-lip height (Stm-Li) and pupils - mid-face (right). The statistically significant level was determined at p values < 0.05. RESULTS: We have determined the optimal parameters of chosen proportions for men and women as the common goal for ortodontist and maxilofacial surgeon. The gender and age influenced the variability of following parameters: bi-gonial breadth, total facial height and morphologic face height. CONCLUSION: The soft tissue values for craniofacial parameters can be used to identify the surgical-orthodontic goal for patient - europoid race. Due to the immigration and the mix of races it is necessary to take this fact into account (Tab. 3, Fig. 1, Ref. 41).

Role of human papilloma virus infection and oral-genital contact in oral cancer ethiopathogenesis.

Head and neck squamous cell carcinoma and especially oropharyngeal squamous cell carcinoma is a very significant cause of morbidity and mortality. The majors risk factors of these tumors are tobacco smoking, chewing and alcohol consumption. But there is a group, non-drinking and non-smoking, patients with oropharyngeal squamous cell carcinoma. In these patients may be oral-genital contact and human papillomavirus infection the major risk factor for oral carcinogenesis. Aim of this review is to point out this fact in correlation with clinical studies and clinical conclusion for medical practice (Fig. 1, Ref. 32).

Mesenchymal stem cells - a promising perspective in the orofacial cleft surgery.

Autologous bone grafts provide the golden standard for closure of oronasal fistulas in the cleft palate. Augmentation may be performed also by homografts and various xenogenic or alloplastic materials to prevent morbidity at the donor site but they may cause many problems (transmission of infections, immune response etc.). All the mentioned approaches also often reveal recurrences of the fistulas and prolong suffering of the cleft patients. Combination of mesenchymal stem cells (MSCs) and so called "platelet gel" seems to be a perspective method in this way. The platelet gel contains hydroxyapatite particles mixed with platelet rich plasma coagulated under effect of the calcium ions. The MSCs from the pelvic bone marrow aspirate are cultivated on a scaffold (collagen membrane) for 3-4 weeks before placement into the cleft defect. The method provides promising results in the alveolar clefts. Authors document a successful case of the secondary surgery in 25-year-old man with the unilateral complete cleft (Fig. 5, Ref. 10).

The use of optical magnifying devices in periradicular microsurgery.

Microsurgery is a more precise modification of present procedures with less operative trauma and improved healing. The basic risk with traditional periradicular surgery arises from potential damage to major vessels or nerve bundles. These potential problems can be fixed using optical magnifying tools such as dental operating microscopes and endoscopes. Instruments have been also designed to take the full advantage of increased visibility. The higher magnification and illumination is favorable in all phases of periradicular surgery. The article focuses mainly on the advantages of optical magnifying devices by root-end resection (Tab. 1, Ref. 22).

Root-end resection.

AIM: The aim of the retrospective clinical study was to analyse a complex of patients who underwent a root end resection in the Department of Dentistry and Maxillofacial Surgery, Comenius University, St. Elisabeth Hospital, Bratislava, Slovakia between January 2006 and December 2009 on the small surgery court. PATIENTS: A total number of 285 patients who underwent root end resection. METHODS: Factors examined include sex, patients age structure, total number of resected teeth and their position in upper or lower jaw and the 10 most resected teeth. RESULTS: From 285 patients 103 (36.14 %) were males and 182 (63.86 %) were females. A total number of 378 root end resections was performed, 55 (14.55 %) in the lower jaw and 323 (85.45 %) in the upper jaw. The most resected teeth are from the first and second quadrant. CONCLUSION: There is a decrease trend by the number of patients who underwent root end resection and teeth which were resected in the timeline between 2006-2009. This process is positive and matches the worldwide trend, by making better and successfull endodontic treatment which results in healing of periapical pathology without the need of root end resection (Tab. 2, Fig. 2, Ref. 20). Full Text in PDF www.elis.sk.

Recurrent malignant epitheloid schwannoma of the lower lip.

The authors describe a case of recurrent malignant epitheloid schwannoma of the lower lip. Histologically, the tumor was composed of fibroblast-like spindle cells in compact fascicles and areas of epitheloid growth, combined with demonstration of S-100, GFAP and NF positivity, which is characteristic for this type of tumor. The therapy consisted of a combination of surgery and radiotherapy and the patient was followed-up since the disease was diagnosed. A local re-operation had to follow the first surgical intervention consisting of a radical excision of tumor in the lower lip together with suprahyoid neck dissection six months later. After the first operation, the patient received a radiation therapy with a total dosage of 12 Gy in seven fractions to the tumor area of the lower lip. After the second operation, an external radiotherapy with total dosage of 50 Gy was applied. Despite the complex intensive therapy, the patient died of metastases into lungs, liver and spine 37 months after the initiation of the therapy (Fig. 2, Ref. 17). Full Text (Free, PDF) www.bmj.sk.

Squamous cell carcinoma of the oral cavity.

OBJECTIVES: A number of treatment modalities are available in the management of oral cavity cancer. These are surgery (operation OP), irradiation (radiotherapy RT), chemotherapy (CHT), or complex therapy performed as a combination of the later three methods with various survival rates. A multidisciplinary team approach in every individual case is required. BACKGROUND AND METHODS: Authors analysed retrospectively a group of 622 patients (553 men, 69 women), mean age 58.6 years (range 23-88 years) hospitalised in the Department of Oral and Maxillofacial Surgery, Faculty Hospital and Faculty of Medicine Comenius University in Bratislava within the years 1992-2001 with primary untreated histologically confirmed squamous cell carcinoma of oral cavity (beside cancer of the lip and salivary glands). Gender, age, location and TNM staging of the disease, clinical and histopathological evaluations of the neck lymph nodes and relationship to the treatment modalities were recorded. The authors compared some parameters of the results obtained during their previous study within the years 1977-1986 (453 patients). RESULTS: The number of cases with squamous cell carcinoma of oral cavity increased by 37.31% in total as well as that of cases with advanced disease, especially stage IV (318 patients = 56.6%) increased by 7.6%. In the studied group there occurred cases that were clinically falsely negative by NO (11.04%) as well as falsely positive by N1 (39.1%) when examined by palpation of lymph nodes. The overall 5-year survival rate remained at the same level (55.4 %), the early and late stages did not change the survival rate at the 5th year (I = 75.1%, II = 69.9%, III = 47.5%, IV = 25.1%). Regarding the complexity of treatment, the best 5-year survival rates showed the complex three-modal therapy (CHT + OP + RT = 23.5%), comparing to the dual (OP + RT or CHT + RT = 19.4%) and mono-modal therapy (OP or RT alone = 17.2%). In the complex therapy, the mean disease-free interval improved (30.2 vs 39.4 months) due to a change in the sequence of therapy modalities. CONCLUSION: The increase in the number of cases with advanced disease has a warning trend. The reasons of this trend remain unclear. In spite of the fact that the overal 5-year survival was found not to improve, the quality of life regarding the mean disease-free interval in the group of patients under the complex treatment is considered to be a positive result (Tab. 3, Fig. 4, Ref. 27). Full Text (Free, PDF) www.bmj.sk.

Salivary gland tumours treated in the stomatological clinics in Bratislava.

During the period of 1951-1996 a group of 1021 patients (484 men and 537 women, mean age 53 years, range 2-87 years) with salivary gland tumours were analysed retrospectively. The mean follow-up period was 8 years (range 10 months-25 years). The frequency of benign tumours was 74% (n = 755) and malignant tumours 26% (n = 266). Lesions were sited in the parotid gland 83% (n = 847), in the submandibular gland 10.8% (n = 110), in the sublingual gland 3.2% (n = 33) and in the minor salivary glands 3% (n = 31). The most common benign tumours were pleomorphic adenoma in 53.9% (n = 550) and Warthin's tumour 9.7% (n = 99). Of the malignancies, the adenoid cystic carcinoma was most common (6.4% of cases, n = 65) and mucoepidermoid carcinoma occurred in 5.2% (n = 53). The predominant therapy was surgery alone or in combination with postoperative radiotherapy in 93.7% (957 cases), radiotherapy alone after fine needle aspiration biopsy for 4.7%, and 19 patients remained untreated.

[Treatment of salivary gland tumors in the past and at the present time at the 1st and 2nd Stomatology Clinics of the Charles University Medical School in Bratislava]. / Liecba nádorov slinných zliaz v minulosti a súcasnosti na I. a II. stomatologickej klinike LFUK v Bratislave.

The retrospective study analyzes a group of 1021 patients (484 men and 537 women) with salivary gland tumours treated at the 1st and 2nd Departments of Stomatology in Bratislava within the years 1951-1996. This time period is divided into the past (1951-1980) and recent (1981-1996) periods. The trends in the diagnosis and treatment with the main emphasis on surgical procedures are mentioned. The most common operation were lateral parotidectomy (409 cases = 40.1%) and conservative parotidectomy (105 cases = 10.2%), enucleations were indicated rarely. Authors stress the necessity of team approach and cooperation of maxillofacial surgeons, radiologists, histopathologists, otorhinolaryngologists and oncologists. (Tab. 1, Fig. 2, Ref. 6.)

[Carcinoma of the oral cavity--analysis of local metastases and results of therapy]. / Karcinóm ústnej dutiny--analýza lokálneho metastazovania a výsledkov liecby.

A series of 453 patients admitted to the 2nd Clinic of Stomatology in Bratislava over the ten-year period from 1977-1986 was statistically evaluated. The series comprised patients with the diagnosis of epidermoid carcinoma of the oral cavity, with the exception of carcinoma of the lip. The condition of the regional lymphatic apparatus at the first examination and over the succeeding period was studied. The relationship between the treatment used, clinical stage and prognosis of tumorous disease in the orofacial region was evaluated. The possibilities of different types of cervical dissection are discussed along with the histological findings recorded. In the light of the survival period a direct relationship between the clinical stage of the disease at the onset of treatment and prognosis has been confirmed.

[Immunotherapy and its possible application in malignomas of the orofacial region. Review]. / Imunoterapia a moznosti vyuzitia u malignómov orofaciálnej oblasti. Súborný referát.

The authors give an account of the types of active and passive immunotherapy in malignomas. Based on data in the literature they evaluate its possibilities in clinically used and perspective methods. For practical use in the orofacial region they emphasize the necessity to follow up tumour markers.