Temporomandibular arthropathies: A retrospective study with histopathological characteristics.

BACKGROUND: To investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics. MATERIAL AND METHODS: Temporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included. RESULTS: The mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes. CONCLUSIONS: The pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named.

[Retrospective multicenter study on carcinomas of the lips and oral cavity. The role of multiple malignancies]. / Multizentrische retrospektive Studie zum Lippen- und Mundhöhlenkarzinom. Untersuchung zur Rolle von Mehrfachmalignomen.

In a retrospective multicenter study the role of multiple cancer has been assessed in 2481 patients with carcinomas of the lips and oral cavity. In 3.2% of the cases the malignancies developed outside the maxillofacial area. In the majority of cases two malignant neoplasms were found. Most of them were histologically carcinomas. The bronchi and stomach were common localizations in patients with lip carcinomas, whereas patients with oral carcinomas exhibited mainly cancers of the breast, stomach and uterus. Sex-limited multiple cancers associated with oral carcinoma occurred predominantly in women. Surgery is the most common form of treatment. The prognosis for patients with lip carcinomas is significantly poorer when multiple cancers are present.

[Multicentric retrospective study on the carcinoma of lips and oral mucosa. Analysis of coherence between pre- and posttherapeutical categories of classification]. / Multizentrische retrospektive Studie zum Lippen- und Mundschleimhautkarzinom. Zusammenhangsanalyse zwischen prä- und posttherapeutischen Klassifizierungskategorien.

The coherence between prae- and posttherapeutical TNM findings had been checked up in a multicentrically registered patient material of 2,481 non-praetreated plate epithelium carcinomas of the lips and oral mucosa. Whereas the extension of the tumour has in the main been the same, the findings on lymph nodes had a trend showing essential deviations. In a two-dimensional examination of 851 histologically prepared preparations of lymph nodes, a prognostic relevance acc. to metastases had been registered for the characteristics palpation finding of the lymph node, tumour extension, tumour infiltration. Multidimensional analyses have to be realized.

[Initial results of high-dose-rate afterloading treatment of tumors in the head and neck region]. / Erste Ergebnisse der High-dose-rate-Afterloading-Behandlung von Tumoren im Kopf-Hals-Bereich.

First results of high-dose-rate afterloading therapy in the head-neck area are encouraging. The procedure is not very invasive and is suitable especially for older patients, not tolerating much, who can be hardly submitted another therapeutic method. The limited spatial dose distribution allows a careful treatment of the surrounding tissue in spite of the application of high single doses, however limits the size of tumors too, that the afterloading therapy is possible in (max. 2 cm). The method represents an alternative of the much more complicated procedure of the low-dose contact therapy, that affects the patients in a stronger way like interstitial therapy and moulage treatment. No tumor recurrences or metastasis were seen in our patients. Influence of alteration in fractionation rhythm and of application of sources with very high dose capacity will be the subject of further studies.

[Results of an analysis of waiting time at a maxillofacial surgery outpatient department of a university hospital]. / Ergebnisse einer Wartezeitanalyse in der Kieferchirurgischen Ambulanz einer Universitätsklinik.

Waiting periods in public health institutions not only stress the patients and the personnel, but they are also attended by considerable economic disadvantages. For this reason, the waiting periods of patients of a maxillofacial outpatient department in the various examination and treatment stations were analyzed with the help of accompanying leaflets. According to the results obtained, the sequence of examinations and treatments was verified and reorganized with regard to the three main processes: research, medical care, and education and training. The control by a second analysis evidenced a reduction of the total waiting period from 46.0 to 36.9 minutes per patient. Further possibilities of reducing the waiting periods are indicated, and reasons are given for the necessity for scientific work organization in public health institutions.

[Use of the intra-alveolar GR (gelatin-resorcinol) dressing after tooth extraction in patients with hemorrhagic diathesis]. / Die Anwendung des intraalveolären GR (Gelatine-Resorcin)-Verbandes nach Zahnextraktionen bei Patienten mit Blutungsneigung.

The suitability of an intra-alveolar gelatin-resorcinol dressing for controlling bleeding was tested in 118 tooth extractions on a total of 87 patients. Plain advantages of the dressing are: prompt haemostasis (which in most cases avoids hospitalization and substitution therapy), low cost, and easy application. The dressing is not always reliable in controlling bleeding after milk tooth extraction.

[Immunologic studies of lymph nodes in patients with maxillofacial tumors]. / Immunologische Untersuchungen von Lymphoknoten bei Patienten mit Tumoren im Kiefer-Gesichts-Bereich.

Starting from the basic concept that the regional lymph node, due to its important role in the defensive reaction to cancer, has a great value of information, the authors investigated 14 lymph nodes from patients with cancer in the maxillofacial region. The following immunological examinations were performed: T lymphocyte determination by means of the ovine erythrocyte rosette test; B lymphocyte determination by means of the mouse erythrocyte rosette test, with surface immunoglobulin estimation using the direct immunofluorescence technique; quantitative determination of immunoglobulins G, A and M in the lymph node extract. The results demonstrated that the determination of the absolute number of peripheral lymphocytes and of T rosettes as well as the immunoglobulin quantitation are very valuable. The decrease in T cells in the lymph node is obviously preceded by a similar development in the peripheral blood and seems to be a prognostic parameter. In lymph nodes in the maxillofacial region, a greater importance must be ascribed to IgA (as compared to the other immunoglobulins) than in other regions. The immunoreactivity against cancers in the maxillofacial region has a definite humoral component mainly determined by IgA. In addition to an increase in the number of samples examined by means of the aforementioned methods, parallel T cell determinations in the peripheral blood are advisable with regard to the evaluation by the influence of the cancer on the immunological system and for the purpose of prognostication.

[The orofacial manifestation of various hemoblastoses]. / Die orofaziale Manifestation einiger Hämoblastosen.

In everyday practice the stomatologist is sometimes confronted with symptoms that are indicative of malignant diseases. For malignant lymphoma, lymphogranulomatosis and myeloic leucosis, as examples, the authors present in tabular form orofacial symptoms such as bleedings, gingival hyperplasia, ulcerations and others, the occurrence of which requires diagnostic assessment.