[Hypophosphatemic oncogenic osteomalacia]. / Hypophosphataemiával járó onkogén osteomalacia.

The first case of oncogen osteomalacia in Hungary is reported, to draw the attention of the medical profession to it and to present the new data about its pathomechanism. Pathological hip fracture caused by hypophosphataemic osteomalacia due to isolated renal phosphate wasting was found in a previously healthy 19 years old sportsman. In spite of daily 1.5 micrograms calcitriol treatment and phosphate supplementation, hypophosphataemia persisted for 13 years and he needed regular indometacin medication for his bone pain. During that time an 1.5 cm gingival tumour was found and radically removed. The serum phosphate level returned to normal in a few hours after the operation (preoperative 0.51, after 2, 4 and 8 hours 0.61, 0.68 and 0.79 mmol/l respectively), and remained normal without calcitriol. The histological examination showed epulis with fibroblast and vascular cell proliferation, which has never been previously reported in connection with oncogenic osteomalacia. The pain resolved after 3 months and the bone density became normal in one year. Oncogenic osteomalacia must be considered in every case presenting with atypical hypophosphataemic osteomalacia. Careful dental examination is needed also in the course of search for the underlying tumour. Every tumour-like growth, even the common epulis, has to be operated radically and serum phosphate monitored in the postoperative period in all such cases.

[Free-end reconstruction by dento-osseous autotransplantation]. / Sorvégi hiány pótlása dentoossealis autotransplantatum segítségével.

The authors describe an endosseal autotransplantation A tooth is extracted together with its parodontium and the surrounding bone. It is implanted into a different place where the bone had been prepared. Upper left unilateral free-end saddle cases were solved by removing the tooth No 24 into the place of No 27. A bridge was constructed after 6 weeks using the 23 as abutment. The metal-ceramic bridges have been used by the patients for 3 years without complaint.

[Extensive intraoral cicatrization treated by microsurgery]. / Kiterjedt intraoralis hegesedés kezelése mikrosebészeti módszerrel.

Extensive intra-oral burns are very rare injuries. The microstomia resulting from the advanced cicatrization of the mucosa makes it difficult for the patient to eat and impossible to take care of his teeth. The traditional operation for widening the oral orifice was not sufficient because of the extensive scarring of the bucca. In the first operation the authors substituted the mucosa of the lip and the bucca of one side with splitted jejunum. Because of the advancing scarring another operation was performed and the mucosa of the other side of the bucca and the angle of mouth was substituted with a forearm graft.

[Developing subcutaneous emphysema after dental care]. / Subcutan emphysema kialakulása fogorvosi kezelések során.

Subcutaneous emphysema is a rare but potentially dangerous complication of dental and maxillofacial surgical interventions. The authors present three such cases and give an overview on the diagnostic, therapeutic and preventive possibilities of the disease.

[Surgical repair of pharyngocutaneous defects resulting from actinomycosis]. / Actinomycosis talaján kialakult pharyngocutan defektus sebészi kezelése.

The pharyngo-cutan defect is a frequent complication of oropharynx and larynx operations. The not frequent serious actinomycotic inflammation of the neck, and in its treatment the repeated surgical incision was in the background of the defect. The authors review the possibilities of closing these defects, and they describe the method used.

[Mandibular fracture in an infant]. / Csecsemökorú gyermek állkapocstörése.

Maxillofacial fractures under 10 years of age are uncommon, with an occurrence of 7.3%. Isolated fractures of the mandible are even more rare, due to the fact that in young children the mandible is relatively small and resilient. Some authors suggest that the occurrence of this form of fracture is about 1-5%. Different methods have been described for treatment of fractures off the mandible in children. In the therapy since the introduction of titanium mini plates the trend has been to select surgical repositioning followed by osteosynthesis. This paper describes the management of a 7-month old boy with isolated mandibular fracture, using this method to avoid the damage of the tooth germs. This particular case raises the issue of child abuse, which is on the increase in Hungary as well. To find a kind of solution would be not only a task of dentists but also of society in general.

[Computer tomography in implantology]. / Komputertomográfiás vizsgálat az implantológiai diagnosztikában.

During the planning of implantation the CT method helps in determining the location of the implant and aids in choosing the right implant. It provides the following measurable information about the jaw-bones: height and width; exact location of bone deficiencies; the orovestibular shape of the alveolar process; the course of the mandibular canal; the location of the mental foramen; the location and size of the canalis incisivus; the area of the nasal cavity and the maxillary sinus; the quality of the bones and the relationship between cortical and spongious bone. In comparison to the X-ray examinations possession of these informations increase significantly the safety of planning before surgery.

[Use of antibiotics at the Department of Oral and Maxillofacial Surgery of the Debrecen Medical University in the last 10 years (1989-1998)]. / Antibiotikum alkalmazás a DOTE stomatológiai Klinika Szájsebészeti Osztályán az elmúlt 10 év során (1989-1998).

Just like in other areas of the medical science antibiotics are widely used in oral surgery, too. The aim of the present study is to give a retrospective survey of the use of antibiotics between the years 1989-1998 in the Section of Oral surgery of the Stomatological Department of the Medical and Health Science Centre of Debrecen University. Examined in the study was the antibiotic therapy of patients admitted to the ward, since that was accessible for follow-up unequivocally. The data were obtained from the case records. The study involves the number of antibiotically treated patients in relation to the total number of patients, the age dependence, the length of the treatment and that of the febrile condition. Also examined were the antibiotics chosen, the frequency and results of cultures, in the case of hypersensitivity, the application of alternative drugs. In a final summary, all these were broken down to years and the most frequent diseases. The most frequent disorders involved in the study were: fractures, abscess, cysts, periostitis, antroalveolar fistula--chronic sinusitis. On examining the quantitative parameters of use, it was found that use decreased as a whole and in its proportions, but there was a continuous increase in the number of patients in the course of the years. In the case of the fractures the duration of treatment decreased in the course of the years (from 9 to ca. 6 days). The antibiotic first administered was penicillin, whereas in 1998 the most frequently used drug was a broad-spectrum penicillin derivative (Augmentin) combined with a lactamase inhibitor. In the treatment of abscesses the most effective drug was Amoxycillin (length of treatment ca. 3 days, 1-day febrile condition). The days of treatment decreased with cysts, too, (from 15 days to 5). In their therapy., after the prevalence of Amoxycillin, Augmentin won the first place. The drugs of choice were Augmentin and Ampicillin in periostitis, too (secondary choice were cephalosporins). With antroalveolar fistulas the choice was similar (Augmentin, Aktil). One must take into consideration that added to the total consumption in the last years, were the antibiotic drugs applied for systemic surgical prophylaxis. In view of the prescription of antibacterial drugs used in oral surgery we can see quantitative and qualitative changes can be observed in the period under study.

[Correlation between meteorologic factors and periostitis of dental origin in Debrecen]. / Idöjárási jelenségek és dentális eredetü periostitisek összefüggéseinek vizsgálata Debrecenben.

Correlation between bioclimatical and meteorological factors is well documented. The aim of this study was to investigate the correlation between dental periostitis and meteorological fronts, cyclon and anticyclon. We found a positive, statistically significant correlation between occurrence of warm meteorological front, cyclon, anticyclon and prevalence of dental periostitis. It could have important implications in organizing the work of dental teams.

[Analysis of secretion into the saliva of cefoxitin (Mefoxin), imipenem (Tienam) and meropenem (Meronem)]. / Cefoxitin (Mefoxin), imipenem (Tienam) és meropenem (Meronem) nyálba történö kiválasztódásának vizsgálata.

The salivary excretion of cefoxitin (Mefoxin), a second-generation beta-lactam antibiotic of the cefalosporin group, which shows enhanced anti-anaerobic effect was investigated in oral surgery patients. In animal experiments the saliva levels of imipenem (Tienam) and meropenem (Meronem), which also belong to the betalactam carbapenem group were studied. The antibiotics were administered parenterally in single therapeutic doses, then blood samples were taken first after half an hour then hourly, and mixed saliva was collected for 6 hours. Cefoxitin was found to reach top level in the 1st hour, then this level decreased rapidly, and in the 4th hour it was no longer measurable. Out of the carbapenems imipenem showed highest level in the 2nd hour and in the 4th hour its concentration in the saliva was minimal. Meropenem reached a higher level in the saliva (1,5-2 times higher than the serum level) in the 2nd hour after administration, which persisted even in the 6th hour. The experimental results justify the administration of these antibiotics in dentistry and oral surgery.