A retrospective screening and epidemiological study of oncological and other diseases in the oral and maxillofacial region at the University of Szeged, Department of Oral Medicine (1960-2014).

The Department of Oral Medicine at the University of Szeged was responsible for the stomato-oncological care of the population of three counties (with a population of 1,7 M at an average) in the period 1960-201 4. The present report summarizes the incidence of oral medicine diseases during this period. The overall number of new out-patients at the Department of Oral Surgery between 1960 and 2014 was 338,200. These patients were dental and oral surgical patients who presented spontaneously or were referred from the general practice, or stomato-oncological patients referred from general dental practices in-the three counties. Of the 338,200 new cases, 9,482 (2.8%) were benign tumors, 5438 (1.6%) premalignancies and 5,145 (1.5%) malignant tumors. This means a total of 20,065 tumor cases (5.9%) in the examined period, of which 10,579 (3.1 %) were premalignancies and malignancies. 14,446 patients presented with other diseases of the oral mucous membrane (5.8%, data available from 1974). Data on the number of stomato-oncological control patients in any given year are available from 1970 on. In the period 1970-2014, the total number of check-up patients was 117,268, this is the 76,97% of the departments overall number of patients. As for the tendencies, in the representative period of 1960-2004, the number of new benign tumors 15-fold, premalignancies 30-fold, and malignant tumors exhibited an 25-fold increase, while the number of other conditions affecting the oral mucosa showed a 14-fold increase.

Inhibition of microflora associated with oral malignancy.

Changes in the microflora on oral carcinoma surfaces may lead to both local and systemic infections, which may complicate the morbidity of the patient suffering from oral malignant neoplasms. Thus, anticancer therapy, irradiation, chemotherapy or surgery impairs the defence mechanism of the oral mucosa and is accompanied by proliferation of the mucosal biofilm with overgrowth of yeast and bacteria. This study investigates the inhibition of the biofilm present on the surface of oral squamous cell carcinomas. Biofilm samples were obtained from the central surface (1 cm2) of each lesion in 10 patients (eight male, two female; mean age: 47.6 years; SD +/- 7.6) before any antibiotherapy or tumour treatment. Patients were randomly divided into two groups and were rinsed with Meridol mouthrinse (amine fluoride) or placebo (saline solution) for 7 days. Samples were repeatedly taken from the same site after rinsing. Samples were transported in pre-reduced brain heart infusion broth and cultured within 1 h of removal, using aerobic and anaerobic complete and selective media. Total aerobic and anaerobic counts were determined and isolated bacteria were identified. The median counts of colony forming units (CFU/ml) after rinsing with Meridol were significantly lower for both aerobes and anaerobes than before rinsing with Meridol. (For aerobes before rinsing: 1.35 x 10(6), after rinsing: 7.55 x 10(5); p = 0.025; for anaerobes before rinsing: 1.39 x 10(6), after rinsing: 7.15 x 10(5); p = 0.011. Rinsing with placebo: no significant difference was found. Aerobe median counts before rinsing: 1.17 x 10(6), after rinsing: 1.03 x 10(5), and for anaerobes: before rinsing 1.75 x 10(6), after rinsing: 1.51 x 10(6); p > 0.05 [Wilcoxon test].) It was concluded that 7-days (three times a day) Meridol rinsing significantly reduced the surface biofilm of oral carcinoma compared to rinsing with placebo. Clinical examination indicated no irritation of the mucosa. The mouthrinse was well tolerated by the patients, who commented on a reduction in burning sensation and bad breath. Besides routine oral hygiene, rinsing itself could reduce patient morbidity. The findings of the present study indicate that in addition to any other oral focus, the lesion itself, when ulcerated, should receive direct antimicrobial treatment so as to reduce patient morbidity and enhance quality of life.

The microflora associated with human oral carcinomas.

Both local and systemic infections may complicate the morbidity of patients with oral malignant neoplasms, particularly those presenting intraorally. This study investigated the microbial contents of the biofilms present on the surfaces of oral squamous cell carcinomas. Biofilm samples were obtained from the central surface of the lesions in 21 patients (20 male, 1 female) aged 52.8 (+/- 8.2) years, and from contiguous healthy mucosa, before any antibiotic therapy or any tumour treatment. All lesions were keratinising squamous cell carcinomas with surface ulceration. Samples were transported in reduced brain heart infusion (BHI) broth and cultured within 1 h of removal, using aerobic and anaerobic complete and selective media. The median number of anaerobic colony forming units (CFU/ml) at the tumour sites (1.6 x 10(8)) was significantly higher than for the healthy (control) mucosa (3.0 x 10(7); P = 0.0001, Wilcoxon); the same was true for aerobes at the tumour sites (1.51 x 10(8)) relative to the controls (2.8 x 10(7); P = 0.0008, Wilcoxon). The species isolated in increased numbers at tumour sites were Veillonella, Fusobacterium, Prevotella, Porphyromonas, Actinomyces and Clostridium (anaerobes), and Haemophilus, Enterobacteriaceae and Streptococcus spp. (aerobes). Candida albicans was found at eight of the 21 tumour sites, but never at control sites. It was concluded that human oral carcinoma surface biofilms harbour significantly increased numbers of aerobes and anaerobes as compared with the healthy mucosal surface of the same patient. Candida albicans can also be present in these biofilms. These findings must be considered in relation to the known predisposition of such patients to systemic infections, and to the unpleasant complications of oral morbidity due to infected lesions.

[20 years' experience in stomato-oncology]. / Húsz éves tapasztalataink a stomatoonkológiában.

Between 1970 and 1988, 8,657 out of 102,113 out-patients at the Clinics of Dentistry and Oral Surgery of Szeged had stomatooncological illness. Documentation of the patients is carried out on data-forms suitable for computer processing. One of the most important tasks of stomatooncology consists in effecting screening test in which the basic dental care has a decisive role. It is a deficiency sign of the oncological view that even the precancerous oral cavity conditions and conspicuous tumors don't get timely into the centres, and, also, treatments are carried out without histological biopsy. Since 1973, 4,038 patients have been treated with cryotherapeutic methods and such method did deemed primary independent treatment in case of well selected patient stocks. The oncological complex therapy has to be followed by looking after. Yearly 1,500 to 2,000 check ups are effected.

[Rehabilitation of patients with head and neck tumors, with special attention to psychotherapy]. / Fej-nyak daganatos betegek rehabilitációja, kiemelt figyelemmel a pszichés gondozásra.

Few people are more severely handicapped than patient with facial deformities. The face forms a centre point of attention in human relationships with particular emphasis placed on cosmetic acceptance. Surgical ablation of head and neck cancer often creates significant functional and aesthetic problems. In addition to the numerous physiologic problems that can befall the patient, devastating changes in appearance may occur with serious psychologic sequel. Our purpose here is to discuss the numerous physiologic and psychological problems occurring after major ablative surgery of the head and neck. A team effort is essential to the effective treatment of those patients, including: surgeon, oncologist, radiotherapist, prosthodontist and last but not least psychologist, who has a main role in strengthening the patients and helping them to lead an acceptable quality of life.

[Microbial study of the surface of malignant tumors of the oral cavity]. / Rosszindulatú szájüregi daganatfelszínek mikrobiológiai vizsgálata.

Malodour and other infection sequelae may increase the morbidity, compromise the oral well-being of the patient suffering from maxillo-facial neoplasia. The purpose of our study was to evaluate the differences of the oral bacterial flora attached to the tumor and the contra lateral sound surfaces. Swabs were obtained and samples were microbiologically cultured. It was concluded, that carcinoma surface biofilm harbors increased levels of both aerobs and anaerobs.