Surface characterization and force relaxation of retrieved silk sutures.

AIM: To investigate the relaxation of as-received and retrieved silk sutures and characterize the compositional and structural changes occurred during service. MATERIALS AND METHODS: Silk sutures were tested in three conditions: (a) as-received, (b) retrieved from the oral cavity of patients, and (c) retrieved from extraoral sites of patients following 4 days. Specimens of the first group were fabricated by tying a knot on a plastic cable of 5 mm diameter. Specimens (n = 6) of groups (b) and (c) were placed in the appropriate surgical site and retrieved. Specimens were subjected to Fourier transform infrared spectroscopy for the characterization of molecular composition; low vacuum scanning electron microscopy (LV-SEM) to investigate the morphological variation; and energy dispersive X-ray microanalysis to assess the elemental composition of integuments formed onto the materials. To investigate the stress relaxation of elastics, a portable test assembly was developed to monitor the force exerted by a stretched suture for a period of 4 days. RESULTS: Retrieved specimens demonstrated absorption of proteinaceous matter comprising of amide I and II and alcohol, as well as precipitation of Mg, Si, Cl, and Ca for the extraorally aged specimens and additional K and P for the intraorally exposed sutures. Aged specimens showed swelling and disorganization and rupture of suture bundles. Stress relaxation data were indicative of no difference between the three groups, which relaxed at 30% of the initial value, whereas the curves showed similar slopes. SIGNIFICANCE: Significant relaxation was found for silk sutures, which seems to be independent of surgical site.

Solitary fibrous tumor of the tongue: case report and literature review.

Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm with unpredictable behavior. It was originally described in the pleura, but is now known to occur in various locations. SFT of the tongue is rare, with only four cases on record. An SFT of the anterolateral part of the left side of the tongue, which occurred in a 48 year-old man is recorded. The tumor was resected and the patient remains free of recurrence 3 years postoperatively.

Bisphosphonate-induced avascular osteonecrosis of the jaws: a clinical report of 11 cases.

Bisphosphonates are compounds used in the treatment of various metabolic and malignant bone diseases. In the last 2 years there has been a significant increase in referrals to the Department of Oral and Maxillofacial Surgery of patients with exposed necrotic jaw bone, diagnosed elsewhere as chronic refractory osteomyelitis of jaws, mostly after several teeth extractions. The only clinical feature in common for all the patients was the use of bisphosphonates in the treatment of bone diseases. A retrospective study was performed of 11 patients with necrotic bone lesions of the jaws of various extents referred to this Department from July 2003 to November 2004. The management of the patients included cessation of bisphosphonate therapy for 2-8 months and various surgical restorative procedures thereafter. Four patients (36%) presented with maxillary bone involvement, 6 (55%) had mandibular bone necrosis and 1 (9%) presented with necrosis at 3 quadrants. All patients had received bisphosphonate therapy for 6 months to 5 years. Biopsies from the necrotic lesions revealed no metastatic disease. One patient who was removed from bisphosphonate therapy for 8 months recovered completely, one other who was not removed from bisphosphonate therapy relapsed and for all the others, with cessation of bisphosphonate therapy for 2-6 months, the results were inconsistent. A new complication of bisphosphonate therapy administration, i.e. osteonecrosis of jaws, seems to be developing. The improved results after cessation of the medication should make clinicians reconsider the merits of the rampant use of bisphosphonates, while further investigation is needed to completely elucidate this complication.

Dermal psoriasis involving an oral split-skin graft. Case report.

Psoriasis is a chronic inflammatory skin disease which very rarely affects the oral cavity. It has many forms of expression on cutaneous and mucosal surfaces. This paper describes an unusual case of psoriasis with oral involvement affecting the skin graft used to reconstruct an oral mucosal defect. Diagnosis was based on clinical and microscopic findings and confirmed by the concurrent cutaneous disease.

Correction of the protruding ear with a modified anterior scoring technique.

PURPOSE: This article describes a modified anterior scoring technique to provide natural-looking results after correction of the protruding ear. The modified technique is described, and its advantages are compared with the conventional anterior scoring technique and with the other two basic techniques (Converse and Mustardé). PATIENTS AND METHODS: The modified technique was used to treat eight patients. In these cases, the use of transfixion mattress sutures placed through the perichondrium was very helpful in achieving a smooth curvature. RESULTS: Results up to 1 year showed no alteration in form when compared with the short-time results. CONCLUSION: The conventional anterior scoring technique for otoplasty is one of the most useful and reliable techniques, applicable in all cases of prominent ears. However, in some cases, it is difficult to control the cartilage bending completely. By using three adjusting mattress sutures (4-0 vicryl) through the perichondrium on the posterior side, combined with shallower scoring incisions, it is possible to create symmetry with the opposite ear and prevent "telephone ear" complication.

Primary malignant melanoma of the oral cavity. Report of an unusual case.

Primary malignant melanoma is only rarely found in the oral cavity (estimated at between 0.2 and 8 per cent of all melanomas) and occurs approximately four times more frequently in the oral mucosa of the upper jaw, usually on the palate or alveolar gingivae. A case is reported of a malignant melanoma in the mouth of a 74 year old male, which was originally diagnosed as reactive denture hyperplasia caused by a ill-fitting upper denture. Correction of the denture fault failed to stop the growth of the mass, which was therefore removed surgically. Histological examination revealed a melanin-producing tumour. A partial maxillectomy was performed and there was no evidence of recurrence over a three year follow-up period.

Clear cell carcinoma of the minor salivary glands. Report of a case.

Clear cell carcinoma is an extremely rare form of malignant salivary gland tumour. A case of clear cell carcinoma arising in the minor salivary glands is reported.

Acinic cell carcinoma of the maxillary sinus. A case report.

A case of acinic cell carcinoma of the maxillary sinus is presented. As can be assumed from the number of reported cases, this is an uncommon site for this tumor to occur.

Primary tuberculosis of the oral cavity.

Two cases of primary tuberculosis of the mouth are reported. Painless ulceration of long duration and enlargement of the regional lymph nodes that did not respond to conservative and antibiotic therapy were the main manifestations of the disease in both cases. In the first case the tubercle ulcer was located in the lower buccogingival sulcus of a 17-year-old girl. In the second case the lesion occurred as a chronic periodontal inflammation around the gingiva of the left lower second molar tooth. When the tooth was extracted, a painless ulceration appeared around the socket, which was filled by granulation tissue. Histopathologic examination; bacteriologic, serologic, and blood tests; and chest x-ray film confirmed the diagnosis. Predisposing factors that might favor primary inoculation of tubercle bacilli into oral mucosa are also discussed. Finally we emphasize that in such cases it is essential to attempt to locate a possible primary site elsewhere in the body before oral tuberculosis is considered the primary disease.

Congenital lipoma of the tongue. Report of a case.

A case of a congenital lipoma of the tongue in a 20-day old female infant is reported. The tumor was completely removed and follow-up showed excellent healing without recurrence.