Design, clinical applications and post-surgical assessment of bioresorbable 3D-printed craniofacial composite implants.

This study details the design, fabrication, clinical trials' evaluation, and analysis after the clinical application of 3D-printed bone reconstruction implants made of nHAp@PLDLLA [nanohydroxyapatite@poly(L-lactide-co-D,L-lactide)] biomaterial. The 3D-printed formulations have been tested as bone reconstruction Cranioimplants in 3 different medical cases, including frontal lobe, mandibular bone, and cleft palate reconstructions. Replacing one of the implants after 6 months provided a unique opportunity to evaluate the post-surgical implant obtained from a human patient. This allowed us to quantify physicochemical changes and develop a spatial map of osseointegration and material degradation kinetics as a function of specific locations. To the best of our knowledge, hydrolytic degradation and variability in the physicochemical and mechanical properties of the biomimetic, 3D-printed implants have not been quantified in the literature after permanent placement in the human body. Such analysis has revealed the constantly changing properties of the implant, which should be considered to optimize the design of patient-specific bone substitutes. Moreover, it has been proven that the obtained composition can produce biomimetic, bioresorbable and bone-forming alloplastic substitutes tailored to each patient, allowing for shorter surgery times and faster patient recovery than currently available methods.

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer.

The aim of this study was to identify and assess the impact of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients of the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital in Wroclaw for whom oncological treatment was planned by a cancer case board between March 2018 and February 2022. We analysed the medical records of 625 patients. In order to verify whether the relationships between the analysed features were statistically significant, the chi-square test of independence and the Student's t-test for independent samples were used (p < 0.05). Our analysis showed that the impact of the pandemic on the organization of health service delivery to HNC patients was not uniform. The largest difference in the number of formulated treatment plans was observed at the beginning of the pandemic (22.1% reduction compared with the year before the pandemic). During the pandemic, the proportion of patients admitted on the basis of a DILO (diagnosis and oncological treatment) card issued by a primary care physician, instead of a regular referral to hospital, issued also by a primary care physician, was significantly higher compared with the that during the pre-pandemic period. The majority of cancer patients with a oncological treatment planned during the pandemic lived in urban areas. During the pandemic, the number of patients with more-advanced-stage cancer, assessed on the basis of the type of planned treatment (radical vs. palliative), did not increase compared with that during the pre-pandemic period. However, our follow-up period was quite short. It is necessary to intensify activities aimed at promoting health and increasing health awareness in people living in rural areas and setting long-term priorities and objectives for health policies at the national, regional and local levels, with particular focus on this group of people.

Genetic Factors of Teeth Impaction: Polymorphic and Haplotype Variants of PAX9, MSX1, AXIN2, and IRF6 Genes.

In recent research, there has been a growing awareness of the role of genetic factors in the positioning and eruption of teeth in the maxilla and mandible. This study aimed to evaluate the potential of specific polymorphic markers of single nucleotide polymorphisms (SNPs) located within the PAX9, MSX1, AXIN2, and IRF6 genes to determine the predisposition to tooth impaction. The study participants were divided into two groups: the first group consisted of individuals with at least one impacted secondary tooth. In contrast, the second group (control group) had no impacted teeth in their jaws. To analyze the genes, real-time PCR (polymerase chain reaction) and TaqMan probes were utilized to detect the selected polymorphisms. The findings suggest that disruptions in the structure and function of the mentioned genetic factors such as polymorphic and haplotype variants of PAX9, MSX1, AXIN2, and IRF6 genes, which play a direct role in tooth and periodontal tissue development, might be significant factors in tooth impaction in individuals with genetic variations. Therefore, it is reasonable to hypothesize that tooth impaction may be influenced, at least in part, by the presence of specific genetic markers, including different allelic variants of the PAX9, AXIN2, and IRF6 genes, and especially MSX1.

Oral cancer awareness among patients at 3 university hospitals in Poland and Germany: A survey research.

BACKGROUND: The epidemic of cancer (including oral cancer) is a growing public health and economic problem in the European societies. A high percentage of patients who come for the appropriate treatment are in the late stages of advancement, often with nodal and/or distant metastases. The literature on the public oral cancer awareness in Poland and Germany is limited. OBJECTIVES: To investigate the levels of public awareness about the early symptoms and risk factors of oral cancer, and to analyze the findings in the context of the socioeconomic profiles of the subjects. MATERIAL AND METHODS: The survey consisted of a 20-item questionnaire divided into 4 sections: socioeconomic and demographic factors, the awareness of oral cancer, symptoms of oral cancer, and its risk factors. It was distributed to 465 adult patients in Poland (Wroclaw and Lódz) and Germany (Dresden). RESULTS: The response rate was 97.6%. Most of the respondents (65.4%) had heard of oral cancer. The sources of information were mainly the traditional mass media and the Internet, with only 23.8% of the respondents indicating doctors as a source of information about oral cancer. What is worrying, only about 1/5 of the participants in each of the 3 centers had an oral cancer examination last year. The awareness of oral cancer correlated positively with the age of the respondents and negatively with the size of the place of residence. Education level had no significant impact on declared knowledge. CONCLUSIONS: The results of this survey do not only show unsatisfactory levels of patients' awareness of the risk factors and symptoms of oral cancer but also emphasize the need to improve the level of healthcare concerning this disease, including screening programs.

Expression of syndecan-1 in oral cavity squamous cell carcinoma.

Syndecan-1 (SDC1) belongs to heparan sulfate proteoglycans which may interact with different growth factors, cytokines, morphogens and promote tumor growth and invasion. The aim of the present study was to assess the immunohistochemical expression of syndecan-1 in oral squamous cell carcinoma (OSCC) and oral cysts. Evaluation of the staining pattern with the clinico-histological characteristics of patients was performed. A total of 42 OSCC and 23 oral cysts tissue samples were examined. Statistical tests were used for the significance analysis. The positive expression of syndecan-1 was significantly higher in OSCC compared to cyst located in the oral cavity. Moreover, the results indicate that the intensity of the expression correlated with grading score (p = 0.046). The data indicate that syndecan-1 is altered in OSCC and its excessive amount relates in a predictive manner to neoplastic transformation. As such, SDC1 expression may be used as an adjunctive biomarker in molecular diagnostics of oral squamous cell carcinoma.

Oral cancer: The first symptoms and reasons for delaying correct diagnosis and appropriate treatment.

BACKGROUND: The first symptoms of oral cancer are nonspecific. They raise suspicions of other, less serious conditions. Treatment of oral cancer is challenging, and the time of its detection and the implementation of appropriate therapy affect the prognosis. OBJECTIVES: To identify predisposing factors, symptoms, time of, and reasons for delays in the diagnosis and appropriate treatment of oral cancer. MATERIAL AND METHODS: This retrospective analysis includes patients who were hospitalized with a diagnosis of carcinoma at the Clinical Department of Maxillofacial Surgery at the 4th Military Clinical Hospital and Polyclinic in Wroclaw, Poland, between 2008 and 2018, and at the Department of Maxillofacial Surgery at Wroclaw Medical University Hospital between 2010 and 2018. The analysis took into account the data obtained from the patients' medical records. RESULTS: This study comprised 305 patients (112 female; 36.7% and 193 male; 63.3%). The most frequent diagnosis was squamous cell carcinoma (N = 294; 96.4%). The floor of the mouth was the most frequent primary site (N = 103; 33.8%), followed by the anterior 2/3 of the tongue (N = 94; 30.8%) and lower gingiva (N = 43; 14.1%). A significant percentage were reported at an advanced stage (73.5% in stages III and IV combined). The reasons for the late-stage diagnoses depended on the patients (40.6%), the doctors (24.9%) or both (10.8%). Only 47.5% of patients reported because of the initial symptom noticed. Nearly half of the patients reported after 3-6 months of observing symptoms, usually to a general practitioner (GP; 35.7%) or a dentist (31.8%). CONCLUSIONS: The oncological awareness of patients and healthcare professionals is an essential issue. Doctors often recommend inappropriate treatment, sometimes without monitoring its effectiveness. Dentists should consider cancer in the differentiation of clinical manifestations of other oral disorders.

A comparative study of osteopontin expression, Ki67 index and prognosis in squamous cell carcinoma and cysts of the oral cavity.

BACKGROUND: Recent studies have shown a strong relationship between the expression of osteopontin and oral carcinogenesis. Osteopontin (OPN) has been shown to play a major role in regulating the aggressiveness of cancer cells and promote tumor growth. Odontogenic cysts are an essential aspect of oral and maxillofacial pathology. They are relatively frequent lesions with different clinical behavior. Some of them may have a proliferative pattern of growth and neoplastic nature. Evaluation of osteopontin expression with Ki-67 index may help examine clinical behavior and recurrence of oral squamous cell cancer and radicular cyst patients. METHODS: A total of 44 oral cavity cancer cases and 21 cysts samples were analyzed by immunohistochemical staining. Data used for analysis were derived from medical records. The following information was obtained from all patients' medical records: survival, age, sex, lymph node status, tumor size, and location, as well as grade and histologic type of tumor. Expression status of OPN and Ki-67 was statistically assessed. RESULTS: Our data demonstrated that for summary immunoreactive scores of OPN and Ki-67 expressions in OSCC vs. RC patients statistical significance was found for both markers' between OSCC and RC groups. Moreover, osteopontin is significantly higher expressed in larger OSCC tumors. CONCLUSIONS: In conclusion, the role of OPN expression both in oral squamous cancer cells and radicular cyst and possible correlation with demographic and clinicopathological features remain undetermined in some aspects, further high-powered studies to develop a more standardized assessment of Ki-67 and osteopontin expression in OSCC and are needed.

[IL-1beta and PGE2 production in whole blood and gingival fluid in women with periodontitis and preterm low birth weight]. / Stezenie IL-beta i PGE2 w krwi pelnej i plynie dziaslowym u kobiet z zapaleniem przyzebia oraz niska masa urodzeniowa noworodka wynikajaca z przedwczesnego zakonczenia ciazy.

DESIGN: The aim of the investigation was to evaluate of IL-1beta and PGE2 concentrations in gingival fluid, whole blood as well as IL-1beta, PGE2 production after Escherichia coli lipopolysaccharide stimulation in whole blood in women with preterm low birth weight (PLBW), as compared to the control group. MATERIAL AND METHODS: A case-control study of 88 postpartum women aged 17 to 39 was performed. The case group consisted of 52 women with PLBW and the control group consisted of 36 women giving birth in time. Concentration of inflammatory mediators in gingival fluid, blood serum and IL-1beta, PGE2 production in whole blood after bacterial lipopolysaccharide stimulation were determined by means of immunoenzymatic method. RESULTS AND CONCLUSIONS: The levels of IL-1beta and PGE2 in gingival fluid were significantly higher in all PLBW mothers (also PLBW primiparous) than in the control group. In addition in the primiparous with PLBW group significantly higher PGE2 concentration in blood serum was found compared to the primiparous controls. There were no significant differences between women with PLBW and the controls together with a significantly higher production of IL-1beta and PGE2 in whole blood after LPS stimulation in women with periodontitis and gingivitis compared to subjects with healthy periodontium. Such findings suggest that inflammatory mediator synthesis is mainly result of specific cells exposition to bacterial products. Therefore it seems that more frequent occurrence of the phenotype of hyperactive cells that synthesise these mediators is not responsible for PLBW.