Closed versus open reduction of mandibular condylar fractures in adults: a meta-analysis.

PURPOSE: A review of the literature shows a difference of opinion regarding whether open or closed reduction of condylar fractures produces the best results. It would be beneficial, therefore, to critically analyze past studies that have directly compared the 2 methods in an attempt to answer this question. MATERIALS AND METHODS: A Medline search for articles using the key words "mandibular condyle fractures" and "mandibular condyle fracture surgery" was performed. Articles that compared open and closed reduction were selected for further evaluation. Additional articles were obtained from reference lists in the Medline-selected articles. Of the 32 articles identified, 13 met the final selection criteria. These contained data on at least one of the following: postoperative maximum mouth opening, deviation on opening, lateral excursion, protrusion, asymmetry, and joint or muscle pain. RESULTS: Numerous problems were found with the information presented in the various articles. These included lack of patient randomization, failure to classify the type of condylar fracture, variability within the surgical protocols, and inconsistencies in choice of variables and how they were reported. However, the results from the meta-analyses were explored in a general sense. CONCLUSIONS: Because of the great variation in the manner in which the various study parameters were reported, it was not possible to perform a reliable meta-analysis. There is a need for better standardization of data collection as well as randomization of the patients treated in future studies to accurately compare the 2 methods.

A retrospective, cohort study of the prevalence and risk factors of oral burning in patients with dry mouth.

OBJECTIVES: The aims of this study were to evaluate the prevalence of oral burning in a dry mouth cohort of patients and to determine associated factors. STUDY DESIGN: A retrospective cohort study was conducted by reviewing the charts of 170 patients who presented to Carolinas Medical Center's Department of Oral Medicine from January 2004 to June 2009. Information collected from their charts was extensive. RESULTS: Forty percent (68 of 170) of dry mouth patients had a concomitant complaint of oral burning. Sixty-four were female and 4 were male. The mean age was 61.1 years (range 25-89). Cofactors associated with oral burning included age (OR 1.03, CI 1.00-1.05, P = .028) and use of herbal medications (OR .26, CI .10-.67, P = .005). CONCLUSIONS: Oral burning is often concomitant with oral dryness. Targeting factors associated with oral dryness may help alleviate an oral burning complaint in select populations.

Molecular methodology to assess the impact of cancer chemotherapy on the oral bacterial flora: a pilot study.

OBJECTIVE: This pilot study determined the profile of the oral bacterial flora in an outpatient cancer population before and after chemotherapy using molecular techniques. STUDY DESIGN: We recruited 9 newly diagnosed breast cancer patients scheduled for induction chemotherapy. All were seen immediately before chemotherapy, and 7 to 14 days later. At both visits, we performed oral evaluations and obtained mucositis grading (with the World Health Organization [WHO] scale), absolute neutrophil counts (ANC), and bacterial samples from the buccal mucosa. Bacterial DNA was isolated, and 16S ribosomal RNA gene clonal libraries were constructed. Sequences of genes in the library were used to determine species identity by comparison to known sequences. RESULTS: After chemotherapy, WHO scores of 0 and 1 were in 3 and 6 patients, respectively, and mean ANC (+/-SD) dropped from 3326 +/- 463 to 1091 +/- 1082 cells/mm(3). From pre- and post-chemotherapy samples, 41 species were detected, with a predominance of Gemella haemolysans and Streptococcus mitis. More than 85% of species have not been previously identified in chemotherapy patients. Seven species appeared exclusively before chemotherapy and 25 after chemotherapy. After chemotherapy, the number of species per patient increased by a mean of 2.6 (SD = 4.7, P = .052). CONCLUSION: We identified species not previously identified in chemotherapy patients. Our results suggest a shift to a more complex oral bacterial profile in patients undergoing cancer chemotherapy.