Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography.

OBJECTIVES. To assess the presence of anatomic variations and pathology of the maxillary sinus using cone beam computed tomography (CBCT) of the maxilla where pre- implant surgery is planned. MATERIAL AND METHODS. This retrospective study evaluates a sample CBCT scans of 34 dental patients (68 sinuses). CBCT is used to assess maxillary sinus mucosa and outflow and prevalence of septa. The mucosal thickening was measured and the sinus outflow was classified as open or obstructed. RESULTS. Mucosal thickening was found in 48.5%, septa in 20.6% and total opacity in 2.9% of the sinuses. Maxillary sinus outflow was blocked in 26.5% of the scans. Strong association between radiological signs of maxillary sinus ostium blockage and thickened mucosa was observed. CONCLUSIONS. Anatomic variations and lesions of the maxillary sinus were common findings in CBCT examinations of the maxilla required for dental preprosthetic planning. Routine CBCT scans, including maxillary sinus ostium are recommended for risk assessment prior to surgery.

The stability of bilateral sagittal ramus osteotomy and vertical ramus osteotomy after bimaxillary correction of class III malocclusion.

INTRODUCTION: The purpose of this retrospective cephalometric study was to compare the stability of bilateral sagittal split osteotomy (BSSO) with extra-oral vertical ramus osteotomy (VRO) after correction of class III malocclusion by means of bimaxillary orthognathic surgery. METHODS: The sample comprised 51 consecutively treated patients, 38 females and 13 males, with a mean age of 19.1 years. All had a one-piece Le Fort I osteotomy with maxillary advancement and mandibular setback. VRO was performed in 30 cases, and BSSO was performed in 21 cases. Lateral cephalograms were obtained before surgery, within 1 week of surgery and 1 year after surgery. RESULTS: The mean forward movement of the maxilla was 5.6 mm in both groups (p<0.001). The mean horizontal surgical change in the VRO group was 4.4 mm (p<0.001), and in the BSSO group it was 5.4 mm (p<0.001). In the VRO group, the horizontal relapse was 1.2 mm (p<0.001), and in the BSSO group, it was 1.4 mm (p<0.001). CONCLUSION: There was no difference in the stability between the BSSO and VRO groups. The average relapse in the whole sample was 26% of the surgical movement.

Growth factors, apoptotic cells and barx1 gene in bone and soft tissue of skeletal class III patients.

UNLABELLED: Growth factors and growth stimulating genes are main signaling molecules for growth and development in ante- and postnatal period involved in cellular proliferation, differentiation and morphogenesis of tissues and organs during embryogenesis, postnatal growth and adulthood. The aim of this study was to evaluate TGF-beta (transforming growth factor-beta), BMP2/4 (bone morphogenetic protein 2/4), FGFR1 (fibroblast growth factor receptor one), barx1 gene and apoptosis from tissue samples of oro-maxillo-facial region in skeletal class III patients to reveal possible morphopathogenesis of severe skeletal anomalies. The study group included 9 patients with skeletal class III malocclusion. During orthognatic surgery tissue samples from tuber maxillae, ramus mandibulae anterior and posterior part, as well as gingiva from the lower jaw in region of second molar have been taken. Samples were stained with immunohistochemistry for TGF-beta, BMP2/4, FGFR1, apoptosis and barx1 gene. We used also the routine histological staining with haematoxyline and eosine. In tuber maxillae, ramus mandibulae anterior and posterior part staining for TGF-beta was the most relevant. Also BMP2/4, FGFR1 and barx1 showed the highest mean number of positive cells in tuber maxillae. Barx1 was equally expressed in ramus mandibulae, but BMP2/4 and FGFR1 mainly stained its posterior part cells. Apoptosis mostly affected ramus mandibulae anterior part. CONCLUSIONS: We suggest about more active stimulation of bone growth in tuber maxilla whereas ramus mandibulae. Apoptosis mainly affects ramus mandibulae anterior part that possibly connects to the lower expression of growth stimulating factors and may indicate lower bone remodelation ability.

5 year experience with lower lip cancer.

Retrospective study of 189 cases of lower lip cancer treated from 1996-2000 is done. There were 69% males and 31% females. Median age was 66.8 years. 84.4% of patients were with tumors stage I-II. Surgical treatment was performed in 83.6% of patients. In all operated cases was squamous cell carcinoma as verrucous tumor in 17.4%, as exophytic in 46% and as ulcerative in 36.6%. There were different methods of local excision, primary reconstruction and neck dissection depending from stage. In the patient group with clinically negative neck at the first attendance (170 patients) delayed cervical metastases developed in 6 patients (3.5%). Recurrence at the primary site developed in 11.3% of patients and was associated with large tumor size and low cancer differentiation. Survival rate at 5-year follow-up was 95% for patients with I stage, 89.7% for II stage and 37% for III and IV stage patients or mean for all group 83.7%. Diagnosis and treatment of actinic cheilitis also is discussed.

Treatment of parotid gland tumors in Latvian Oncological Center.

A total of 268 patients were treated for parotid gland lesions at department of Head and Neck Surgery of Latvian Oncological Center between 1996 and 2000, and the results were analyzed retrospectively. The objective was to analyze the incidence and factors associated with facial nerve dysfunction after different types of parotidectomies with facial nerve dissection and to compare the changing attitudes towards the pathology and surgical treatment in order to better define prevention and management of pleomorphic adenoma recurrences. Limited superficial parotidectomy was the commonest operation performed in 143 patients. Other procedures were complete superficial parotidectomy in 11%, total radical surgery in 10 patients and enucleation in 20 patients. Neck node dissection was done in 9 patients. In 4 patients (6%) paresis was observed after limited superficial parotidectomy, in 10 patients (16%) after complete superficial parotidectomy, in 18 cases (28%) after near - total (subtotal) parotidectomy and in 32 patients (50%) after total parotidectomy. Recurences after the surgical treatment of benign diseases were observed in 12 patients (5.2%). Overall 5-year survival for all stages and histologic types was 58 %.