[Histological investigations in ambulatory oral surgery practice]. / Szövettani vizsgálatok az ambuláns szájsebészeti gyakorlatban.

In the practice of oral surgery correspondence with the pathologist is required in order to identify the lesions in question by histologic examination. By current legal regulations the histological evaluation of removed tissues is mandatory. In the presentation the authors process the data obtained in their Department since 2008. Coincidence of the clinical and histological diagnosis is analysed statistically such is the occurrence of various types of oral mucosa lesions and cysts. In cases of presumed malignancy the biopsies were carried out in a department with adequate oncological background. In indications of autoimmun deseases mainly in cases of Sjögren's syndrome the Department has been requested to carry out minor salivary gland biopsies. Statistical analysis of the findings of the minor salivary gland biopsies will also be discussed. The histological diagnoses have been provided by Prof. Zsuzsanna Suba MD, DMD, PhD of the Semmelweis University, Department of Oral and Maxillofacial Surgery, Oral Pathology Unit. In order of prevalence the most common histologically verified lesions were: radicular cyst, fibromas and granulation tissue. In 84.5% of the cases the histological findings confirmed the clinical diagnoses. In 44,5% of the cases Sjögren's syndrome was verified by the minor salivary gland biopsy. Although in most cases the histological examination supported the clinical diagnoses, close cooperation of the oral surgeon and pathologist is essential.

Decreased oral cancer risk by moderate alcohol consumption in non-smoker postmenopausal women.

OBJECTIVE: Alcohol consumption is a strong risk factor for oral cancer however; an ambiguous biphasic impact of moderate and excessive alcohol intake on the risk of upper aerodigestive tract cancers has also been published. The aim of the present study was to clarify the dose-related risk of alcohol consumption for oral cancer, in male and female cases. MATERIALS AND METHODS: Six-hundred and eight non-smoker patients (466 males and 142 females) with squamous cell oral carcinomas (OCs) and 406 non-smoker tumor free controls (264 males and 142 females) were included into the study. Data of three groups; abstinent cases, moderate and excessive alcohol consumers were recorded according to the drinking habits of both OC cases and their controls. Blood glucose levels in male and female cases and menopausal state of women were also registered. RESULTS: Mean age of female patients was significantly higher than of male cases (p<0.01). Excessive alcohol consumption was a strong risk factor for both sexes, however moderate alcohol intake proved to be an OC risk for men (OR: 1.4) and decreased the OC risk for women (OR: 0.7). Elevated blood glucose level proved to be an OC risk factor for the predominantly postmenopausal women (OR: 1.6), whereas did not affect the OC risk among men. CONCLUSION: The presented findings are controversial to the hypothesis that women are more vulnerable to alcohol-induced carcinogenesis as compared with men. Increased insulin sensitivity and higher estrogen levels are advantageous systemic effects of moderate ethanol intake and they might reduce the risk for OC in postmenopausal women.

[Etiology and diagnostics of upper canine tooth retention]. / A felsô szemfog retenció etiológiája és diagnosztikája.

Upper canines have significant esthetical and functional roles in the dental arch. Upper canine retention is a frequent anomaly as the germ develops rather far from its final place. Moreover, the neighboring teeth may narrow the place of the canine because of its late eruption. Impacted canines without treatment may cause severe complications. Impaction of canines can be diagnosed early by clinical and radiological findings, which enables the clinician to perform a complete rehabilitation by successful surgical and orthodontic treatment.

[Surgical-orthodontic treatment of the upper canine retention]. / Az attörésben visszamaradt felso szemfogak szájsebészeti-orthodonciai ellátása.

Combined surgical and orthodontic treatment of upper canine retention showed thorough development during the past decade. Depending on the axial position of the unerupted canine there are three methods for their alignment. When the axis of the unerupted canine is near vertical making a mucosal window is enough for deliberation of the crown. When the unerupted canine is covered by bone a palatinal or buccal corticotomy is necessary for the accessibility of the crown. When the unerupted tooth is positioned near horizontally redressment force or removal is advisable. Combined surgical and orthodontic method for alignment of unerupted canine may achieve excellent cosmetical and functional results.

[Oral cancer: morbus Hungaricus in the 21st century]. / Szájüregi rák: Morbus Hungaricus a 21. században.

Hungary is the leader both in oral cancer morbidity and mortality among the European countries. Oral cancer mortality had increased dramatically in Hungary to near fourfold between 1975 and 2002 both among the male and female populations. The increased oral cancer morbidity among the non-smoker, non-drinker elderly women and young adults, suggest that factors other than tobacco and alcohol consumption may also have important role in the pathogenesis of oral cancer. To reveal the epidemiological changes oral cancer cases and tumor-free controls were studied in the Department of Oral and Maxillofacial Surgery of the Semmelweis University in two phases between 1985-1986 and 2004-2005. In the 1st phase of the study, 460 cases with histologically confirmed oral squamous cell cancer and 350 tumor-free control cases were included. In the 2nd phase data of 550 oral cancer cases and 450 tumor-free controls were examined. Location of the tumors, alcohol consumption, and smoking habits of the male and female patients were separately evaluated. Among the oral cancer cases and their controls the ratio of smokers showed a significantly decreasing tendency in the examined period. Both the male oral cancer patients and their controls showed a significant decrease in the ratio of regular drinkers, whereas among the female tumor cases and controls the ratio of alcohol consumers were similarly low in both phases. The high male to female ratio of oral cancer cases significantly decreased over the examined period. Among elderly women (>60 yrs) oral cancer morbidity conspicuously increased. Among male cases the primacy of lower lip cancer had been taken over by sublingual cancer during the examined period. Among female patients, gingival tumor location was the most frequent in both phases. Our data suggest that the extraordinarily rapid increase in oral cancer morbidity and mortality in Hungary is not reasonable simply on the basis of excessive tobacco and alcohol consumption habits. Changes in the male to female ratio of oral cancer after 20 years, the older age of female patients as compared with males and the gender related difference of the prevalent tumor sites suggest some role of gender specific, systemic risk factors for oral cancer.

[Role of hormonal risk factors in oral cancer development]. / Hormonális kockázati tényezok szerepe a szájüregi rák kialakulásában.

Male: female ratio of oral cancer cases (OC) is fairly high. Lower rate of female cases as compared with males suggests that some endocrine factors may play role in the development of tumors. The aim of the present study was to clarify the differences of risk factors for OC among male and female cases. In the Oral and Maxillofacial Department of Semmelweis University 2660 OC (2130 males and 530 females) patients were included into the study. Ratio of smoking, alcohol consumption, elevated serum glucose level and menopausal data of the female patients were registered. Concordant to the literary data, smoking and excessive alcohol consumption proved to be an important risk factor for OC both among male and female patients. However, moderate alcohol consumption was a weak risk factor among male and no risk factor among female cases. Elevated serum glucose level was not significant OC risk among male cases, but was a high risk factor among female patients, especially in gingival cancer cases. The female OC cases were near exclusively postmenopausal, and the term between the time of menopause and clinical OC diagnosis was fairly long (average: 17 year). These results suggest that estrogen-deficiency may play an important role in the initiation of OC. In the female OC cases menopause appeared in significantly younger age, and the rate of hysterectomy was also significantly higher as compared with the tumor-free control cases. These data also support the estrogen-deficiency theory of cancer initiation. In postmenopausal female patients both estrogen-deficiency and elevated fasting glucose proved to be risk factors for OC. These results reveal new aspects concerning the etiology of OC and give a possible explanation how smoking-associated tumors may develop even without smoking.