[Histopathological evaluation of bone regeneration using human resorbable demineralized membrane].

BACKGROUND/AIM: Filling a bone defect with bone substitution materials is a therapy of choice, but the infiltration of connective tissue from the mucoperiostal flap may compromise a healing of bone substitutions with bony wall defects. Application of membrane as a barrier is indicated as a solution to this problem. The aim of this study was to show a pathohistological view of bone regeneration and the significance of human resorbable demineralized membrane (HRDM), 200 microns thick in bone regeneration regarding mandibular defects in an experiment on dogs. METHODS: The experiment was performed on six dogs. Bone defects were created in all six dogs on the right side of the mandible after the elevation of the mucoperiostal flap. One defect was filled with human deproteinised bone (HDB), and in between HDB and soft tissue RHDM of 200 microns thick was placed. In the second defect, used as a control one, only HDB without RHDM was placed. Two dogs were sacrificed two months after the surgery, another two dogs four months after the surgery and the last two dogs six months after the surgery. After that, samples of bone tissue were taken for histopathological analysis. RESULTS: In all the six dogs with defects treated with HDB and RHDM the level of bone regeneration was much higher in comparison with the control defects without RHDM. CONCLUSION: Membrane, as a cover of bony defect, is useful and benefits bone regeneration. Bony de fects covered with RHDM show better bony healing despite the fact that bone regeneration was not fully complete for as long as six months after the RHDM implantation.

[Significance of confirming Epstein-Barr virus nuclear antibody as tumor marker].

BACKGROUND/AIM: Study of the association between Epstein-Barr virus (EBV) and the tumors of the nasopharynx renders an opportunity to introduce causal treatment Already have been proven the anti-EBV (anti-Epstein-Barr nucleus antigene) antibodies in the blood serum of the patients infected with EBV, while over 91% of the patients with nasopharyngeal malignant tumors also have a detectable anti-EBV marker. The aim of this research was to determine if there were anti-EBV antibodies in the serum of the patients with the already verified nasopharyngeal malignant tumors, and, if there were, to determine the quantitative ratio to the values in the serum of the healthy controls. METHODS: The study involved 74 individuals in the period from 1994-2001 divided into four groups: group A counting 11 patients with undifferentiated carcinome of nasopharyngeal type (UCNT); group B counting 25 patients with UCNT X-ray treated at least three years before the onset of the study; group C including 28 healthy subjecets (blood donors), and the group D with 10 patients with planocellular nasopharyngeal carcinoma. Serologic diagnostics of the patients serum was performed using the techniques of Reedman and Klein for the detection of anti-EBV antibodies in the serum. RESULTS: The presence of the statistically significantly higher values of the mean geometric titer (MGT) of the anti-EBNA antibodies was determined in 36 patients with histologically verified UCNT as compared with the control groups including 10 patients with planocellular carcinomas of the nasopharynx and 28 blood donors. Presented were anti-EBNA titers with 95% confidence interval for any participants according to the Hoo clinical classification of nasopharyngeal tumors, as well as according to the fact if they had been radiotreated within the previous three years. CONCLUSION: The results of this study confirm the conclusions of the recent literature on the possible etiopathogenesis of nasopharyngeal tumors and the use of viral anti-EBNA antibodies as viral markers in the diagnostics of UCNT diseases.

[Oral surgery as risk factor of odontogenic maxillary sinusitis].

In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most common cause of the condition, i.e. in 40% of cases. It may be concluded that odontogenic sinusitis is the complication of the oral cavity surgery in 85% of patients, what should be taken into consideration in prevention.

[Possibilty of the lower third molar eruption--radiographic analysis].

BACKGROUND/AIM: To assess the possibility of the eruption of the lower third molar on the basis of the measured parameters: retromolar space, mesiodistal crown width of a molar and the third molar angulation. METHODS: The investigation included 104 patients both sexes (43 boys, and 61 girls), 16 to 25 years old (mean age, 18 years). It was performed using the orthopanthomographic radiographs analysis of those patients. Each radiograph was covered by tracing paper, and the contoures of the following anatomic details were drawn: a) the crown and root contours of third molars, upper and lower central incisors, distal molars in occlusion, anterior edge of ramus mandible, b) lines: 1. the occlusal plane, 2. the line of retromolar space, 3. the mesiodistal crown width of third molar, 4. the axial shaft of the third molar and the distal angle between occlusal plane and the axial shaft of the third molar. The values were measured with an orthodontic caliper: the diameter of retromolar space, diameter of mesiodistal width, the value of distal angle between occlusal plane and axial shaft of molar. RESULTS: A favourable angulation of the lower third molar (more than 60 degrees) was found in, boys (left 27.90%, right 32.55%), girls (left 39.34%, right 37.77%). A favourable relationship between the diameters of mesiodistal width of the third molar and retromolar space was found in, boys, (left 13.59%, right 16.27%), girls, (left 8.19%, right 14.75%). A favourable relationship between the diameters of mesiodistal width of the third molar and the retromolar space and the angulation was found in boys, (left 9.30%, right 11.62%), girls, (left 6.56%, right 9.83%). CONCLUSION: There was not any statistically significant difference found between the relation of the retromolar value, third molar mesiodistal diameter, or of the third molar angulation to the left and the right side nor of their mutual relations in comparing boys and girls. A favourable prognosis was found in 9.33% of the patients.

[Significance of ultrasound and ultrasound-guided fine-needle aspiration for the detection of laryngeal occult metastases].

BACKGROUND/AIM: To evaluate ultrasound criteria based on a node size, shape, vascularity and cytology findings with respect to their value for the comparative determination of metastatic lymph nodes in laryngeal carcinoma. METHODS: A prospective study included 30 patients with laryngeal squamous cell carcinoma without node enlargement on computerized tomography, at the Department of Otorhinolaryngology, the University Hospital, Zemun. Thirty-six neck lymph nodes were evaluated sonographically and aspirated with an ultrasound-guided fine-needle. They were examined cytologically and/or histopathologically and compared to the sonographic assessment of their malignancy. RESULTS: Of the 36 neck lymph nodes evaluated cytologically, the 13 were found to be with a metastatic deposit. The assessment of a lymph node malignancy using the parameter of size had the senzitivity of 84%, the specificity of 70%, and the reliability of 75%. Using the criteria of a lymph node shape for the assessment of malignancy, the sensitivity of 61%, specificity of 65%, and the reliability of 64% were achieved. The evaluation of a lymph node vascularity by the use of the effect of Doppler showed the sensitivity of 69%, the specificity of 95%, and the reliability of 86%. CONCLUSION: Ultrasound and ultrasound-guided fine-needle aspiration citology should be always used for the preoperative staging and for the postoperative follow-up of the status of the neck with cancer of the larynx becouse of their high accuracy, availability and semiinvasivity, and in order to enhance the reliability of the evaluation of the malignant disease progression.

[Possibility of the use of serological method for the determination of immunoglobuline A antibody against early antigene of Epstein-Barr virus as a marker in the diagnosis of nasopharyngeal tumors].

BACKGROUND/AIM: According to the data from immunological, biological and molecular researches, there is a close association between the undifferentiated carcinoma of nasopharyngeal type (UCNT) and Epstein-Barr virus (EBV). To use IgA EA antibody as a serological marker in our patients with nasopharyngeal carcinoma from a clinical viewpoint. METHODS: 91 patients were followed in the period from 1989-1998. In 11 of the patients the antibody titre serum for the early antigen of EBV virus were determinated before the treatement, and in 24 of the patients 3 years after the treatement. There were three control groups of patients: 20 voluntary blood donors, 26 patients with squamocellular laryngeal carcinoma, and 10 patients with squamocellular nasopharyngeal carcinoma. RESULTS: In the group of 11 patients with UCNT before the treatment, the value of anti-EA IgA titre was 31.09, and in the patients after the treatement anti-EA IgA antiody titre was 14.56. In the control groups of patients the results were: in the blood donors 5.00; in the group with the diagnosis of squamocellular laryngeal carcinoma, the titre was 5.00; in the patients with squamocellular nosopharyngeal carcinoma, the titre anti-EA IgA was 5.36. CONCLUSION: These results were statisticly highly significant (p < 0.01). Our research clearly showed that anti-EA IgA EBV marker could be useful in diagnosing, differential diagnosing and prognosing as well.

[The most often causes of odontogenic maxillary sinusitis]. / Najcesci uzroci dentogenih maksilarnih sinuzitisa.

In the period 2000-2002, 40 patients with odontogenic sinusitis were examined at the Institute for ENT and Maxillofacial Surgery, Clinical Centre of Serbia. Oroantral communication was detected in 40% of the patients, oroantral fistula in 35%, sinus foreign bodies in 15% and other conditions in 10% of the cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% of the cases. Given the specific tooth, the first upper molar was the most often cause of the condition, i.e., in 40% of cases. Odontogenic sinusitis as the complication of the oral cavity surgery was found in 85% of the patients.