Feasibility, Safety and Acceptance of Buccal Mucosa Harvest Under Local Anesthesia for Substitution Urethroplasty:Prospective Observational Study in a Tertiary Centre.

Background Urethral stricture is a challenging condition with significant socioeconomic impacts, often requiring surgical intervention such as urethroplasty. Buccal mucosa grafts (BMG) are a popular choice for substitution urethroplasty due to their favorable outcomes. This study evaluates the feasibility, safety, and acceptance of harvesting buccal mucosa grafts under local anesthesia. Objective To assess feasibility, safety and acceptance of Buccal mucosa harvest under local anesthesia. Method A prospective observational hospital based study to evaluate outcomes of substitution urethroplasty using buccal mucosa grafts (BMG) under local anesthesia. Result Of the 40 patients, 28 had unilateral graft harvests, while 12 had bilateral procedures. The mean graft length obtained was 5.65 cm. Postoperatively, patients experienced a quick recovery, with full mouth opening achieved within an average of 2.78 days and resumption of normal eating within 2.6 days. Minor complications included oral swelling in 15% of cases and food residue in 12.5%. Although 87.5% of patients reported pain at the perineal wound site, the overall pain score averaged 3.58, indicating manageable discomfort. Importantly, 92.5% of patients expressed a willingness to undergo the procedure again if necessary. Conclusion These findings suggest that buccal mucosa graft harvest under local anesthesia is both feasible and well-tolerated. The procedure appears to be a safe alternative to regional or general anesthesia, with minimal complications and a high level of patient acceptance. Future randomized controlled trials comparing local anesthesia to regional or general anesthesia could provide additional insights and further validate these findings. This study contributes to the growing body of evidence supporting the use of local anesthesia in urethral stricture surgery, offering a practical approach to managing this condition effectively.

Multi-ancestry Genome-Wide Association Study of Early Childhood Caries.

Early childhood caries (ECC) is the most common non-communicable childhood disease. It is an important health problem with known environmental and social/behavioral influences that lacks evidence for specific associated genetic risk loci. To address this knowledge gap, we conducted a genome-wide association study of ECC in a multi-ancestry population of U.S. preschool-age children (n=6,103) participating in a community-based epidemiologic study of early childhood oral health. Calibrated examiners used ICDAS criteria to measure ECC with the primary trait using the dmfs index with decay classified as macroscopic enamel loss (ICDAS ≥3). We estimated heritability, concordance rates, and conducted genome-wide association analyses to estimate overall genetic effects; the effects stratified by sex, household water fluoride, and dietary sugar; and leveraged the combined gene/gene-environment effects using the 2-degree-of-freedom (2df) joint test. The common genetic variants explained 24% of the phenotypic variance (heritability) of the primary ECC trait and the concordance rate was higher with a higher degree of relatedness. We identified 21 novel non-overlapping genome-wide significant loci for ECC. Two loci, namely RP11-856F16 . 2 (rs74606067) and SLC41A3 (rs71327750) showed evidence of association with dental caries in external cohorts, namely the GLIDE consortium adult cohort (n=∼487,000) and the GLIDE pediatric cohort (n=19,000), respectively. The gene-based tests identified TAAR6 as a genome-wide significant gene. Implicated genes have relevant biological functions including roles in tooth development and taste. These novel associations expand the genomics knowledge base for this common childhood disease and underscore the importance of accounting for sex and pertinent environmental exposures in genetic investigations of oral health.

Reproduction of intra-radicular surface anatomy of extracted human teeth: comparison of three different materials using injection technique.

This in vitro study compared the reproduction of intra-radicular surface anatomy of extracted human teeth taken by silicon, inlay casting wax and acrylic resin using an injection technique to determine which material produced fewer voids. Twenty impressions/patterns using this technique were made for each material and compared with each other on the basis of number, location and size of voids. Length of each dowel impression/ pattern was also compared. The percentage of void free surfaces using silicon, inlay casting wax and acrylic resin were 90%, 100% and 85% respectively. Most of the voids were less than 1mm in size and situated in the middle third of the impression/pattern. There was no significant difference in the length of the impression/ pattern taken by the three materials. Using the injection technique to reproduce the intra-radicular anatomy of the dowel space, all three materials will show predictably good results.

Stimulation of in vivo calcification using collagen membranes cultured with osteoblastic cells in vitro: a preliminary report.

Guided tissue regeneration (GTR) is a useful modality in the management of periodontal disease and for bone augmentation around osseointegrated implants. This study evaluated the in vivo use of atelocollagen membrane (AC) on which osteoblastic cells (OBCs) were cultured in vitro, for application as a GTR membranous material. Osteoblastic cells isolated in our laboratory from mouse calvaria formed a thin film on the AC in vitro which was easily manipulated after 21 days in culture. The AC and OBCs complex material (ACOB) was subjected to freezing and thawing and implanted in mouse subcutaneous tissue for the study of histologic events surrounding the implanted ACOB. Histologic findings in the subcutaneous tissue showed calcification on the ACOB at 28 days postimplantation, while no such finding was evident at the control site, where only AC without OBCs were grafted. The present study suggests the possibility of membrane calcification for GTR through ACOB produced by OBCs on an AC in vitro.

Ameloblastoma--a clinical study of 13 cases.

Ameloblastoma is commonly encountered odontogenic tumour in Bangladesh. A clinical assessment of this tumour is presented in this paper with the particular attention to its age, and sex incidence, clinical presentation, and its management. Complete removal of the neoplasm is the treatment of choice regardless the method of accomplishment to obtain complete cure. Small lesion, particularly in young patients may by given chance to be managed by enucleation and curettage exposing the healthy surrounding tissue. However radical resection of the tumour is the most efficient treatment particularly in large tumours to avoid recurrence.

Expression of tenascin in odontogenic tumours.

We investigated the expression of tenascin in a series of odontogenic tumours (n = 63) of epithelial and epithelial-ectomesenchymal origin by using immunohistochemical methods. A heterogeneity of expression of tenascin was observed in odontogenic tumours. The heterogeneity was most prominent in odontogenic tumours not forming calcified tissues. In these ameloblastomas and adenomatoid odontogenic tumours, tenascin was mainly localised at the epithelial tumour cell-mesenchymal tissue interface. In the calcifying epithelial odontogenic tumour, ameloblastic fibroma and odontoma, a widespread stromal immunoreactivity was observed which was, however, unreactive in the calcified masses. The stellate reticulum-like cells and granular cells of ameloblastoma also showed a positive immunoreactivity for tenascin. The results of the present study suggest that expression of tenascin in the stromal tissue of odontogenic tumours differs according to the potential of forming calcified masses by the tumour cells irrespective of tumour cell morphology.

Epidermal growth factor receptor in odontogenic cysts and tumors.

The expression of epidermal growth factor receptor (EGFR) was investigated in 67 cases of odontogenic cysts and 35 cases of odontogenic tumors using monoclonal antibody to EGFR (Biomarker, Israel) to determine the presence and significance of this transmembrane growth factor receptor. The cystic epithelial cells of odontogenic cystic lesions (keratocyst 60%; primordial cyst 75%; radicular cyst 35%; and follicular cyst 47.4%) were positive to EGFR staining. Cytochemical characterization of EGFR in those cystic epithelium was cell membrane positive type as in the normal epithelium. No expression of EGFR was found in the odontogenic tumors. This diversity of EGFR represents no binding activity of EGF, or loss of EGFR in the tumor cell upon EGFR mediated growth in odontogenic tumors was suggested a different tumor cell growth factor status or microenvironment in cell proliferation mechanism at the cellular level in cysts and tumors of odontogenic origin.

Oral mucosal lesions associated with betel quid, areca nut and tobacco chewing habits: consensus from a workshop held in Kuala Lumpur, Malaysia, November 25-27, 1996.

A variety of betel/areca nut/tobacco habits have been reviewed and categorized because of their possible causal association with oral cancer and various oral precancerous lesions and conditions, and on account of their widespread occurrence in different parts of the world. At a recent workshop in Kuala Lumpur it was recommended that "quid" be defined as "a substance, or mixture of substances, placed in the mouth or chewed and remaining in contact with the mucosa, usually containing one or both of the two basic ingredients, tobacco and/or areca nut, in raw or any manufactured or processed form." Clear delineations on contents of the quid (areca nut quid, tobacco quid, and tobacco and areca nut quid) are recommended as absolute criteria with finer subdivisions to be added if necessary. The betel quid refers to any quid wrapped in betel leaf and is therefore a specific variety of quid. The workshop proposed that quid-related lesions should be categorized conceptually into two categories: first, those that are diffusely outlined and second, those localized at the site where a quid is regularly placed. Additional or expanded criteria and guidelines were proposed to define, describe or identify lesions such as chewer's mucosa, areca nut chewer's lesion, oral submucous fibrosis and other quid-related lesions. A new clinical entity, betel-quid lichenoid lesion, was also proposed to describe an oral lichen planus-like lesion associated with the betel quid habit.