Examination Of Oral Cavity Research Articles

Occult mucosal injuries with radiofrequency ablation of the palate

Objective: To determine the true incidence of mucosal injury after radiofrequency ablation of the palate (RFAP) for snoring and mild obstructive sleep apnea, and to evaluate the consequences of this injury. Study Design and Setting: A prospective, nonrandomized analysis of RFAP was undertaken at Stanford University Hospital. Endoscopic examinations of the nasal surface of the palate and of the posterior pharyngeal wall were performed to supplement the routine oral cavity examinations in the postoperative period. Visual analog scales of pain were completed by the patients. Twenty-three patients underwent a total of 54 RFAP procedures using the Somnus system at the recommended level of energy (600 J in the midline palate, and 300 J to each lateral palate). Results: Fourteen of the 23 first stage procedures were associated with a total of 16 mucosal injuries representing an incidence of 60.9%. Mucosal injury at the 1st stage prompted a reduction in energy at the 2nd stage to 500 J in the midline and 250 J laterally; there were 4 injuries among 19 2nd stage procedures (21.1%). The overall incidence of mucosal injury, including stage 3 and 4 procedures, was therefore 42.6%; 37% of these were “occult” (only visualized endoscopically). Conclusions and Significance: RFAP, although intended to be mucosa-sparing, is nevertheless associated with a high incidence of mucosal injuries, many of which are occult. The occurrence of these mucosal ulcers is usually associated with only a trivial degree of increased pain postoperatively. (Otolaryngol Head Neck Surg 2001; 125:468-72.)

Evaluation of documentation practices of sexual assault nurse examiners

Evaluation of documentation practices of sexual assault nurse examiners

A patient initiated computer program improved breast cancer screening practices in primary care

Williams RB, Boles M, Johnson RE. A patient-initiated system for preventive health care. A randomized trial in community-based primary care practices. Arch Fam Med1998 Jul/Aug; 7 : 338 –45 [OpenUrl][1][CrossRef][2][PubMed][3][Web...

Stomatitis, pharyngitis and tonsillitis caused byMalassezia pachydermatisin a dog

A case of oropharyngitis caused byMalassezia pachydermatisin a 3‐year‐old male Cocker Spaniel is reported. Recurrent episodes of pharyngitis were treated with antibacterial antibiotics; when a final treatment after tooth extraction was unsuccessful, the dog was admitted to the clinic at the Department of Microbiology and Infectious Diseases at the Veterinary Faculty, University of Zagreb. Bacteriological culture of enlarged tonsils revealed a mixed culture ofStreptococcussp.,Staphylococcussp. andPasteurellasp. During antibacterial treatment with amoxicillin plus clavulanic acid and metronidazole, lesions appeared in the oral cavity and mycological examination of the lesions and enlarged tonsils revealed a pure culture ofM.pachydermatis. The patient was treated with ketoconazole, 10 mg kg−1twice daily for 7 days when the lesions resolved.M. pachydermatisstrains from the mouth and from various sites on the dog’s body had identical protein patterns and DNA profiles which differed from strains from other animals.

Caries dental en escolares del Distrito Federal

To estimate the prevalence and severity of dental caries and the dental treatment necessities of school children in Mexico City. The studied population was surveyed for dental caries in 1988 to obtain data necessary for the National Program of Salt Fluoridation in Mexico. The population was selected with a sample frame based on a list of Kindergartens and primary schools registered at the Ministry of Public Education in 1988. The oral cavity examination was based on diagnostic criteria marked by the World Health Organization. A total of 4475 scholars of 5 to 12 years of age were included in the study. Dental caries prevalence in the population reached 90.5%. The index of treatment necessities was high (79.6%). The mean of caries index in scholars of 12 years of age was DMFT = 4.42 (SD = 3.2) and DMFS = 6.53 (SD = 4.8). Results emphasize the pertinence of a widely reaching preventive program of such as salt fluoridation. Additionally, strategies to improve access of the school children population to dental services must be elaborated.

179 Prevention of oral mucositis in head and neck radiation therapy

The purpose is to evaluate the effectiveness of a protocol to prevent oral mucositis, an usual complication of head and neck radiotherapy. This protocol consists of a previous oral cavity examination, mouth hygienization, infectious focuses remotion and administration of chlorhexidine, sucralfate and benzydamine mouthwashes. A retrospective study was made on 45 patients that received radiotherapy, 19 of them started without prevention and the others 26 were controlled since the beginning. Mucositis level was evaluated every week following the OMS criteria. U-Mann-Whitney test was used to compare the two groups. Statistical significant differences were found between both (<i>P</i>=0.000l). Median value mucositis in the prevention protocol (PPG) and no prevention protocol groups were 0 and 1 respectively. The differences were more important between the 3th and 5th weeks. Tolerance treatment was better in PPG.

Should physicians screen for oral disease?

To assess how well primary care clinicians select patients needing early referral to a dentist based on an oral cavity examination. Prospective comparison of the screening oral cavity examinations performed by primary care clinicians with that performed by a dentist. General medicine clinic and dental clinic of a Veterans Affairs Medical Center. A sample of 86 consecutive patients attending regularly scheduled appointments in a primary care medical clinic. Each patient was examined independently by two primary care clinicians and then one dentist. History and physical findings, clinical impression, and plan based on the oral cavity examination were recorded. The reference standard was the examination by a dentist blinded to the patient's history. The prevalences of lesions suspicious for premalignancy, periodontal disease, calculus, and caries were 23%, 37%, 54%, and 18%, respectively. When the primary care clinicians noticed a lesion suspicious for premalignancy, the likelihood that such a lesion was present increased significantly (LR+ = 2.7 to 6.6). However, a normal examination by the primary care clinicians did not significantly lower the likelihood of a premalignant lesion (LR- = 0.7 to 0.8). The primary care clinicians were more efficient at evaluating dental and gingival conditions (LR+ = 2.7 to 5.8, LR- = 0.2 to 0.7). Screening for oral disease by primary care clinicians is justified but should not replace routine screening by dentists.

口腔癌治療後，長期経過して口腔内に腫ようの再発をきたした症例の検討

Late recurrence of oral squamous cell carcinomas was investigated clinicopathologically. Recurrence of carcinomas was found in 89 (27.5%) out of 324 cases of oral carcinomas that were treated in our department from 1972 to 1986.Of these cases, 37 cases showed recurrence between 3 to 20 years after the first treatment The interval between the first and recurrent carcinoma was: 3 to 5 years in 12 cases, 5 to 10 years in 17 cases, and more than 10 years in 8 cases.Recurrence happened near the primary site in 22 cases, at a completely different site in 11 cases, and at the same site as the primary carcinoma in 4 cases. Regarding the first treatment, 26 of the 37 cases (70.3%) had radiotherapy and/or chemotherapy. Of 37 cases of recurrent carcinomas, 13 (35.1%) had a second recurrence. These results indicate that the following factors may play an important role in late recurrence:1. Multiple occurrence of oral carcinomas.2. Radiation-induced or related carcinomas.3. Regrowth of the remaining cancerous cells.4. Cancerous changes of remaining atypical epithelium near the carcinoma.5. Completely new oral carcinoma caused by the oral environment.These findings imply that long-term follow-up observations and careful examination of the whole oral cavity are necessary. Furthermore, it is important that early treatment should be carried out as soon as mucosal alterations such as leukoplakia, erosion, etc. are noticed.

Oral condyloma lesions in patients with extensive genital human papillomavirus infection

The incidence, location, and morphologic appearances of human papillomavirus oral lesions in patients with genital condylomatosis were investigated with clinical, colposcopic, and histologic examination as diagnostic procedures. The human papillomavirus types were also evaluated with filter in situ hybridization. One hundred one patients, 66 female and 35 male, with genital condyloma underwent an oral cavity examination. Ninety-nine (99%) practiced orogenital sex, and all were asymptomatic for oral lesions. Ninety-one underwent biopsy; histologic studies gave a diagnosis of condyloma in 48% of 101 specimens collected. In 8 of 91 (9%) oral lesions were suspected by naked-eye examination; they were confirmed histologically in all eight. Of 83 patients suspected of having oral condyloma on colposcopic examination, 38 (46%) were confirmed histologically. Thus 38 of 46 patients (83%) had oral condyloma not visible to the naked eye. Colposcopically, oral lesions appeared filiform (50%), moruloid (26%), and mixed (24%). Twenty cytologic oral samples were also collected for deoxyribonucleic filter in situ hybridization analysis. Human papillomavirus deoxyribonucleic genital types were observed in 45% (9/20) of all oral scrapings collected, and all were histologically confirmed. Our data indicate that genital human papillomavirus types are capable of establishing a local infection in the oral cavity and demonstrate a high incidence of human papillomavirus oral lesions in patients with genital condyloma.

The value of investigation for genetic counselling in tuberous sclerosis.

Forty sets of parents and 24 sibs of patients with tuberous sclerosis were investigated by an extensive protocol, including clinical examination of skin, hair, and oral cavity, direct and indirect ophthalmoscopy, cranial CT scan, renal ultrasound, and a radiological skeletal survey. None of the clinical examinations provided evidence that any of the subjects was affected. Similarly, the cranial CT scan, renal ultrasound, and skeletal survey failed to identify any occult gene carriers. All of these investigations showed abnormalities in some parents but none was diagnostic. This study shows the difficulties in interpretation that these investigations may produce with consequent problems for genetic counselling. The study does not support the routine use of these tests. There are published reports where the diagnosis of tuberous sclerosis has been made in adults exclusively on a CT scan and an argument can be made for including this investigation. There is no indication for performing renal ultrasound nor skeletal x rays in parents who have normal clinical examinations.

The influence of some anamnestic, demographic, and clinical variables on patient acceptance of new complete dentures.

Information obtained by the dentist during a conventional anamnesis and clinical investigation has been claimed to be important in predicting how new complete dentures will be accepted by the patient. The main purpose of the present paper was to test this hypothesis. Seventy-four experienced denture wearers with an average age of 66 years were included in the study. These patients were interviewed concerning their dental history and satisfaction with old and new complete dentures. In the clinical examination, anatomical and physiological conditions of the oral cavity, the quality of the old dentures, and the general health of the patients were assessed. Sixty-six per cent of the patients were dissatisfied with their old dentures. With regard to the new dentures, 15% of the patients were dissatisfied. The major prosthodontic problems during the period of adaptation were pain related to the mandibular dentures and difficulties with speech. Correlations between patient acceptance of new dentures and the anamnestic, demographic, and clinical variables were either statistically or practically/clinically insignificant and therefore poor predictors of how new dentures would be accepted by the patients.

Dental disease masquerading as suppurative lesions of the neck

Three female patients ages 16, 16, and 12, and an 8-yr-old male presented with neck pathology/2 with abscesses, 1 with a submandibular mass and 1 with a spontaneously draining abscess. In 2 instances, routine oral cavity examinations including percussion of the teeth, failed to reveal significant pathology. A detailed examination by a dentist, intraoral roentgenograms, and in the first child a sinogram, identified the etiology of the lesions as periapical infections. Review of the literature reveals that these patients characteristically receive multiple surgical procedures and courses of antibiotics prior to the recognition of intra-oral disease. Extraction, or root canal, is the definitive therapy that leads to involution of the sinus tract. These four typical cases are reported to illustrate the presentation and pathogenesis of this disease entity, and the importance of an adequate dental examination prior to surgery for a draining sinus of the neck.

GÖLGE HÜCRELİ ODONTOGEN KİST; Bir vaka bildirisi.

OZET Histolojik ozellikleri yonunden ilginc olan ve cok nadir gorulen bir golge hucreli odontogen kist vakasi bildirildi. Hasta 39 yasinda bir erkekti ve lezyon ustcene sol orta keserle ikinci kucukazi disleri arasindaki alanda yer aliyordu. SUMMARY [Ghost celled odontogenic or calcifying odontogenic cyst] A relatively rare in bone of maxilla of a 39 - year - old male patient was described. Examination of oral cavity revea'ed a smooth, somewhat fluctuant swelling that involved left maxillary ridge and mucobuccal fold from central incisor to second premolar area. Roentgenographs examination showed radiolucent lesions in left mexil'a (Fig. 1). These cysts were enucleated and curettaged under local anesthesia. Histologic examination of lesion showed typical appearence of ghost - celled odontogenic (Fig. 2 and 3). There were strands and islands of primitive odontogenic epithelium in connective tissue of wall (Fig. 4). Calcification of ghost cells was observed. Calcification of ghost cells is a frequent but not constant feature, and this kind of calcification is known as dystrophic type. Dystrophic calcification can be seen in some tumors (f. i. Chraniopharyngoima, Oligodendroglioma, thyroid and ovarian carcinomas), but ghost cells are principle structures of these cysts. Therefore, the ghost celled odantogenic cyst will be e better designation has over been proposed.

REPORT ON ORAL CAVITY EXAMINATION AND ORAL HYGIENIC CONDITIONS OF 7TH NATIONAL MOTHER AND CHILD DENTAL CONTEST WINNERS

Since the end of the War, dental hygiene for mothers and children has been taken up in the government policies, its significance is growing steadily along with their sanitary problems in general.Accordingly, the Contest has been yearly held throughout the country, under the joint auspieces of the Welfare Ministry, the Japan Dentists Association and the Yomiuri Press.Lucky enough, however, the author was able to carry out the oral cavity examination of the contest winners, Mrs. _??_ and her children who live in the same locality as the author's, (namely, the city of Yokkaichi, Mie Prefecture).The same mother and her eldest son _??_ won the second best prize for the 1937 National Contest, while for the 1958 National Contest, she and her eldest daughter _??_ gained the best prize.The author also availed himself of this opportunity to report on their healthy mouth cavities, hygienic mouth conditions and the hereditary factors there of in quite a different way from that of making a routine report on clinical researches.May the author here conclude hurriedly that the strong anticaries nature of the healthy teeth of the winning mother and children is largely due to their hereditary factors, besides an evidently favorable condition of their constantly taking in calcium from the sea weed?