Numerical analysis of displacements of mandible bone parts using various elements for fixation of subcondylar fractures.

The paper presents an analysis of the distribution of dislocations in the case of fixation of a mandible low subcondylar fracture. Three types of elements have been used for fixation: NiTi shape-memory staples, miniaturized titanium plates and the Synthes compression plate, also called the Synthes zygomatic plate. The analysis was conducted using the finite element method. The degree of the mobility of the fractures was analysed as well as the tendency towards their separation on the basis of value analysis and the distribution of dislocation areas. The results obtained allowed a preliminary assessment of predicted healing effects and the possibility of being able to predict developing complications after osteosynthesis with the use of the elements analysed.

The influence of chronic periodontitis on serum TNF-alpha, IL-6 and hs-CRP concentrations, and function of graft and survival of kidney transplant recipients.

OBJECTIVE: The aim of the study is to analyze whether chronic periodontitis (CP) influences serum tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) concentrations in renal transplant recipients and patients or graft survival. BACKGROUND: CP is associated both with higher serum concentrations of cytokines and CRP and high cardiovascular risk. METHODS: One hundred and seventeen patients with a transplanted kidney (Tx) were divided according to the Community Periodontal Index of Treatment Needs (CPITN) into two subgroups: TxP+: severe CP (CPITN 3-4) and TxP-: no or moderate CP (CPITN 0-2). The control group (C) consisted of 36 subjects with no kidney disease and with no or moderate CP (CPITN 0-2). RESULTS: hs-CRP concentration was higher in TxP+ than in TxP- patients [2.0 mg/L (0.7-4.4) vs. 0.9 mg/L (0.3-1.9), p = 0.006]. There were no differences in serum TNF-alpha and IL-6 between TxP+ and TxP-. Significant positive correlation between CPITN score and hs-CRP concentration was found both in Tx and C. The hazard ratio of death was 7.17 (1.4-76.4) for TxP+ patients. CP status did not increase the risk of graft loss or doubling of serum creatinine. CONCLUSIONS: Severe CP is associated with increased serum hs-CRP concentration in patients after kidney transplantation. Severe periodontitis seems to increase the risk of patients' death after kidney transplantation.

Modeling of scaphocephaly using superelastic titanium-nickel rings: a preliminary report.

As long as resection of sagittal suture eliminates craniostenosis it leads to desired cranium broadening and shortening solely in the case of children under six months of age. In the majority of cases, especially in older children, boat-shaped cranium remains rather unchanged and its effective modeling requires extensive dissection and osteotomy of the whole cranium vault (e.g., frontal, occipital and parietal bones). Lauritzen's method is an alternative solution. It consists of distraction of cranium vault bones with the aid of steel springs. In order to simplify and improve the efficacy of treatment since 2002, the authors originated the application of titanium-nickel rings to model the cranium. After the sparing excision of cranium vault sutures in the shape of letter "H" the compressed ring is given in the sagittal axis oval shape and in this form it is fixed to osseous margins. The ring's expansion at the same time broadens and shortens the cranium vault. Material was analyzed from 7 children (range, 9 months to 4 years of age), who were treated in the years 2002-2006 because of sagittal craniostenosis. Observations made so far and good treatment results indicate purposefulness of discussed treatment continuation.

Panoramic radiographic predictors of mandibular third molar eruption.

OBJECTIVE: Third molar (M3) eruption can be problematic. According to some orthodontic surgeons, the teeth are capable of aggravating the average crowding level in the dental arch. The question is whether it might be possible to give a prognosis for ultimate M3 position in the arch and make an early decision to extract or retain them. The purpose of the study was to determine which measurements made on panoramic tomograms might facilitate prognosis for M3 position in the dental arch over the years. STUDY DESIGN: The investigation involved 64 patients who had been enrolled to the study group 10 years earlier, ie, in 1993, when an analysis had been carried out regarding M3 effect on dental arch crowding. At that time panoramic tomograms had been taken, and dental casts made. The procedures were repeated in 2003. The following measurements were taken at baseline (1993) and at the end of the study (2003): (1)/the retromolar space to lower third molar crown width, (2) third molar angulation to the base of the mandible, and (3) third molar to second molar inclination. RESULTS: At some defined values of the Ganss ratio, and M3 inclination to mandibular base and second molar, it is possible to predict potential lower third molar alignment in the dental arch using a panoramic radiograph.

Mucociliary clearance and sense of smell following management of Le Fort maxilla fractures.

OBJECTIVE: To assess mucociliary transport and olfaction in patients after Le Fort fractures. STUDY DESIGN: Forty-one patients were enrolled who had sustained a Le Fort fracture during the preceding five years. Control group consisted of students. Olfaction and mucociliary transport were examined in all subjects. A capillary with saccharine was placed on the inferior nasal concha, and time was recorded in which the subject tasted sweetness in the mouth. Results were subject to statistical analysis. Patients with allergy, sinus disease and smokers were excluded from the examination. RESULTS: Disturbance of mucociliary transport and olfaction turned out to be statistically dependent on the type of fracture and management. CONCLUSIONS: Le Fort fracture might be complicated by compromised mucociliary clearance and olfactory disturbances.

[Malignant lymphoma or inflammation? Diagnostic and treatment difficulties--2 cases report]. / Chloniak zlosliwy czy stan zapalny? Trudnosci diagnostyczno-lecznicze--opis dwóch przypadków.

Soft and hard tissue in the oral cavity can be the first coexisting place of systemic diseases manifestation. The aim of this study was to report the diagnostic and treatment difficulties in two patients with malignant lymphomas. The first case was a 66-year-old woman who had undergone surgery procedures connected with radiotherapy and chemotherapy because of malignant lymphoma in nasal cavity in 2001 year. In 2002 she was treated in our department after finding tumor in oral cavity, also diagnosed as malignant lymphoma. The second patient was a 58-year-old man who had undergone an operation (surgery) by reason of maxillary inflammation tumor in 2002 year. On the next year he underwent an operation of removal cervical lymp nodes because of malignant lymphoma. In 2004 year he underwent surgery on account of maxillary tumor suspected by malignant lymphoma, which was diagnosed as inflammation. Conclusions. In differentiation tumors of head and neck one should take an account of lymphoma malignant. The similar clinic and radiological symptoms and laboratory results of malignant lymphomas and inflammations of head and neck can cause the late diagnosis and aggravate the prognosis of this severe disease.

Characteristics of maxillofacial injuries resulting from road traffic accidents--a 5 year review of the case records from Department of Maxillofacial Surgery in Katowice, Poland.

BACKGROUND: In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005. METHODS: The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident). RESULTS: The traffic accidents were the cause of 19.93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22.21%), followed by tooth and alveolar process injuries (20.71%) and mandibular fractures (18.69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. CONCLUSION: Our results exhibit that road traffic accidents remain among the main reasons of maxillofacial injuries following the traumas resulting from assaults and interpersonal violence. This succession of etiologic factors is in accordance with the data from the most developed countries. The relatively high incidence of injuries resulting from traffic accidents indicates the necessity to reinforce legislation aimed to prevent road traffic crashes and thus to reduce maxillofacial injuries among children and adults.

[Oral hygiene in haemodialyzed patients with chronic renal failure]. / Higiena jamy ustnej u hemodializowanych chorych na przewlekla niewydolnosc nerek.

UNLABELLED: The present study aimed to assess the oral hygiene in haemodialyzed patients with chronic renal failure (CRF). MATERIAL AND METHODS: 44 haemodialyzed patients with CRF were analyzed (18 F and 26 M, mean age 47.4 +/- 1.6). In all patients a stomatological examination and dental panoramic x-ray were performed. The presence of chronic periodontal disease (CP) and an approximal plaque index (API) were assessed. RESULTS: Chronic periodontitis was found in 17 patients (39%), whereas in 27 (61%) patients periodontal disease was not present. Oral hygiene assessed by API was not satisfactory in 50%, while very good only in 11% haemodialyzed patients. Patients with periodontal disease were characterized by worse API than patients without periodontitis. CONCLUSION: Oral hygiene status is unsatisfactory in most of haemodialyzed uremic patients.

[Epidemiology of maxillofacial injuries in athletes]. / Epidemiologia obrazen czesci twarzowej czaszki u sportowców.

The general enthusiasm connected with sports activities causes that we often forget about threat connected with careless sports activities. The aim of this paper was the evaluation of causes and frequencies of maxillofacial injuries in hospitalized athletes in the Department of Maxillofacial Surgery in Katowice. Period between 1992-2002 was analyzed. Material consisted of 59 patients in whom injury required hospitalization. In studied material the frequency and causes of maxillofacial injuries in athletes in eleven-year period was examined. Male and female patients were divided in two groups: I--team sports and II--individual sports. In analyzed material injuries of upper part of facial skull were not affirmed. Injuries of upper facial massif overweighed its bottom massif injuries.

[Effect of passive smoking on the level of selected metals in deciduous teeth]. / Wplyw biernego narazenia na dym tytoniowy na wystepowanie wybranych metali w zebach mlecznych.

The cigarette smoke is a significant source of heavy metals, which after being absorbed into the human organism, may be accumulated in a calcified tissue. The accumulation process may be also a result of a passive exposure to the cigarette smoke. As the hard tissues of deciduous teeth are relatively stable in chemical composition, they are widely used as the indicators of the exposure to heavy metals in children. This project is aimed to estimate the effect of passive smoke on the levels of selected toxic and essential elements in deciduous teeth. The research material consisted of 386 deciduous teeth. Out of this, 205 teeth were from the children exposed to the cigarette smoke in the apartments. The levels of cadmium, copper, iron, manganese, lead, zinc, calcium and magnesium were determined using atomic absorption spectrometer with flame atomization. It was concluded that the exposure to the cigarette smoke in children is a factor producing the changes in the levels of selected toxic and essential elements in deciduous teeth. This particularly results in the higher levels of cadmium, copper, lead and zinc, which are the permanent constituents of the cigarette smoke, and the lower levels of manganese, calcium and magnesium. Moreover, the disturbed gradient of lead levels dependent on the tooth type is observed in the children exposed to the cigarette smoke in the apartments.

Association between chronic periodontal disease and left ventricular hypertrophy in kidney transplant recipients.

Periodontal disease (PD) may cause a systemic inflammatory reaction and contribute to left ventricular hypertrophy (LVH) in hypertensive subjects. This study aimed to assess whether chronic PD may contribute to LVH in patients after kidney transplantation. The study analyzed 99 patients divided according to Community Periodontal Index of Treatment Needs (CPITN) score into patients with advanced PD (CPITN 3-4) and patients without or with moderate periodontal lesions (CPITN 0-2). Patients with CPITN 3 to 4 were characterized by a significantly higher plasma high-sensitivity C-reactive protein (HS-CRP) concentration (6.2+/-2.2 vs. 1.7+/-0.3 mg/L, P<0.05) and left ventricular mass index (LVMI) (150+/-7 vs. 111+/-3 g/m, P<0.001) in comparison with patients with CPITN 0 to 2. In the multiple regression model, LVMI was dependent on CPITN (P<0.001), HS-CRP (P<0.05), serum cholesterol (P<0.05), and creatinine concentration (P<0.05). In conclusion, it appears that advanced PD in patients after kidney transplantation is associated with LVH.

Long-term outcome in the treatment of mandibular condylar fractures.

Background. Fractures of the condylar process of the mandible, whether isolated or coexisting with other injuries, are often difficult to manage. Treatment outcome in patients with mechanical injuries of the temporomandibular joints and fractures of mandibular condylar process, which is an element of this joint, depends mostly when and how treatment is initiated. The goal of our study was to assess functional abnormalities in patients following fractures of the condylar process of the mandible in relation to the treatment method used. Material and methods. We analyzed patient documentation and the results of follow-up examinations of 147 patients hospitalized for fractures of the condylar process. This material included both isolated fractures of the condylar process and those accompanied by fractures of the body of the mandible. All mandibular body fractures were managed by means of multiplate osteosynthesis. Fractures of the condylar process were treated in a conservative-orthopedic manner or surgically, depending on the degree of shortening of the mandibular ramus. Anamnesis regarding pain and a functional examination of mandibular kinetics and audible effects gave a basis for assessing the function of temporomandibular joints following treatment. The Helkimo Dysfunction Index was used to assess changes in masticatory function and disorders in the temporomandibular joint. Results. Functional disturbances of the temporomandibular were observed in 38.1% of the examined patients. The most frequently observed symptoms of dysfunction were periodic pain and crackles on mandibular abduction, subluxation, deviation of the mandible, and slight limitation of jaw opening. The intensity depended mainly on when rehabilitation was commenced, and to a less degree on the type of treatment used. No joint dysfunctions were observed in patients of developmental age who sustained isolated condylar process fractures.

[Influence of smoking tobacco on the condition of dentition and occurence of periodontal diseases in patients of the Clinic of Maxillo-Facial Surgery at the Silesian Medical Academy in Katowice]. / Wplyw palenia tytoniu na stan uzebienia i wystepowania chorób przyzebia wsród pacjentów Kliniki Chirurgii Szczekowo- Twarzowej SAM w Katowicach.

Popularity of smoking cigarettes in the Polish society is a widely known and discussed subject. Negative effects of smoking cigarettes as well as passive expose to the tobacco smoke are often described. Still, only a few publications focus on the frequency of a smoking habit among patients of clinics and facial and maxillary surgery wards as well as its influence on condition of their oral cavities. It is obvious that these people should particularly avoid smoking cigarettes due to the deterioration of the oral cavity hygiene, substantial differences in healing wounds and induction of neo-plastic changes. The goal of the survey was examining the frequency of the smoking habit among patients of the Departmental Outpatient Clinic of Maxillo-Facial Surgery at the Silesian Medical Academy in Katowice, the assessment of influence of the smoking habit on the oral cavity condition and hygiene. The survey covered 50 patients have been selected at random and they are all treated in the Departmental Outpatient Clinic of Maxillo-Facial Surgery at the Silesian Medical Academy in Katowice. The patients' age was from 21 to 64. In the group being surveyed, 17 patients (34% of the whole) admitted to the smoking habit. 7 patients, the so-called "heavy smokers", admitted to smoking more than 5 cigarettes a day (this group equalled 14% of the whole). Ten patients (20% of the whole) were moderate smokers who smoked fewer than 5 cigarettes a day. In spite of efforts of managing physicians, advertisements supporting a healthy lifestyle, and discouraging information on packets of cigarettes, fighting the habit is very difficult and it does not always lead to giving up smoking.

[Effect of cigarette smoking on coexistence of cadmium and zinc in retained wisdom teeth]. / Wplyw palenia papierosów na charakter wspólwystepowania kadmu i cynku w zatrzymanych zebach madrosci.

The change in coexistence pattern of elements (antagonism-synergism) in conditions of excessive level of toxic element is observed in many biological samples. The aim of this study was to establish the cadmium and zinc content in hard tissues of retained wisdom teeth of smokers and non-smokers and to find out if active exposure to cigarette smoke has an influence on coexistence of both metals in these tissues. Material consisted of 127 retained wisdom teeth (65 from smokers and 62 from non-smokers). Cadmium and zinc contents were determined by means of atomic absorption spectrometry. We found out that retained wisdom tooth from smokers exhibited higher cadmium and zinc contents compared to non-smokers' teeth. Moreover, coexistence pattern of cadmium and zinc in teeth depends on exposure to heavy metals and exhibits strong synergism in smokers.

[The effect of tobacco smoking on occurrence of precancerous lesions and cancers of oral cavity--literature reviews and own experiences]. / Wplyw palenia tytoniu na wyst powanie zmian przednowotworowych i nowotworów jamy ustnej--przeglqd pismiennictwa i doswiadczenia wlasne.

Tobacco smoking results in many serious health problems. It exhibits also significant influence on oral health and is linked with occurrence of oral precancers and cancers. In this paper, on the basis of literature review and own experiences, we tried to prove the close relationship between tobacco smoking and occurrence of oral precancers, their malignant transformations and therapeutic effects. We pointed out on significantly higher cancer occurrence in this region among smokers. We emphasized the role of physicians, whose professional interest was focused on oral health, in prophylaxis of oral cancers and advising patients smoking cessation.

[Cigarette smoking practices in patients with malignant neoplasms of the oral cavity and jaws]. / Palenie papierosów wsród pacjentów z nowotworami jamy ustnej i szczek.

The aim of this study was to estimate the cigarette smoking practices in patients with malignant neoplasms of the oral cavity and jaws, who were treated in the Outpatient Department of the Maxillofacial Department of Silesian Medical Academy in Katowice from january 2000 to june 2004. It was found that significant number of patients (100% of men and 72.72% of women) with oral squamous cell carcinoma had been smoking in the period of time preceding appearance of neoplasm. The men smoked more cigarettes a day and started smoking in a younger age than women. Gender factor did not influence significantly the period of time from starting of smoking practices to the appearance of neoplasm. The patients with the other types of neoplasms denied cigarette smoking.

[Lead and cadmium occurrence in deciduous teeth of children exposed to cigarette smoke in apartments]. / Wystepowanie olowiu i kadmu w zebach mlecznych dzieci dodatkowo narazonych w mieszkaniach na dym tytoniowy.

The aim of this study was to find out if children's exposure to tobacco smoke in the apartments influences the lead and cadmium content and the values of Pb/Ca and Cd/Ca ratios in hard tissues of their deciduous teeth. Material consisted of 71 shed deciduous teeth; 37 from children in the age of 6 to 13 years additionally exposed to tobacco smoke in the apartments and 34 from children in the same age, whose apartments were free of tobacco smoke. Lead, cadmium and calcium content was determined by means of flame atomic absorption spectrometry. Deciduous teeth of children additionally exposed to tobacco smoke in the apartments exhibited higher lead and cadmium content and higher values of Pb/Ca and Cd/Ca ratios, which indicated significant accumulation of these metals, when compared to deciduous teeth of children whose apartments were free of tobacco smoke.