[OralCDx brush biopsy--a tool for early diagnosis of oral squamous cell carcinoma]. / CDx-Bürstenbiopsie--Ein Hilfsmittel zur Früherkennung des Mundhöhlenkarzinoms.

Aim of the present study was an evaluation of the OralCDx brush biopsy (CDx Laboratories Germany, D-72764 Reutlingen) as a screening method for apparently benign lesions of the oral mucosa which due to their harmless clinical appearance previously would not have been subjected to incisional biopsy. One hundred and eighteen brush biopsies from 100 patients were analyzed. Ninety-three brush biopsies from 79 patients revealed a negative result. All OralCDx "atypical", "positive" and "inadequate" results were referred for conventional scalpel biopsy and examined by conventional histology. In six patients (seven OralCDx tests) with the result "positive" and in 14 patients with the result "atypical" by histological examination, carcinoma (4), severe dysplasia (4), moderate dysplasia (1) and mild dysplasia (4) were detected. The OralCDx brush biopsy proved to be a valuable new minimally invasive method for early detection and surveillance of oral dysplasia and of oral squamous cell carcinoma of innocuous appearance.

Bioabsorbable root analogue for closure of oroantral communications after tooth extraction: a prospective case-cohort study.

OBJECTIVE: To assess the clinical capacity of a bioabsorbable root analog to close oroantral perforations after extraction. STUDY DESIGN: In this prospective case-cohort study, 20 consecutive patients with oroantral communications greater than 2 mm were treated with a bioabsorbable root analog (RootReplica). Patients were followed up clinically and radiographically for 3 months to monitor the healing process. RESULTS: Root replicas could be placed in 14 patients, whereas 6 patients required the socket to be covered with a buccal sliding flap. In the latter cases, fragmentary roots or overly large defects prohibited replica fabrication or accurate fitting of the analog, respectively. Healing was uneventful in all patients, and epistaxis, swelling, or pain was observed only in patients treated with flaps. CONCLUSIONS: The method described is a valuable alternative method with which to close oroantral communications but cannot be performed in all patients because of technical limitations.

[Therapy and course of recurrent odontogenic keratocyst. A case report]. / Therapie und Verlauf der rezidivierenden odontogenen Keratozyste. Ein Fallbericht.

Recurrence following the surgical treatment of keratocysts of the jaws may present a major problem to the oral surgeon. The surgical treatment of patients with odontogenic keratocysts is concerning the high recurrence rate demanding and difficult. It has been suggested that recurrence is a consequence of technical of microcysts in the mucosa overlying the recurrent lesions. Attemps have been made to reduce this high recurrence rate by improved surgical techniques, such as removal of superadjacent mucosa, smoothing of the osseous wall of the cystic cavity, resection of neighboring parts of the mandible, tanning of the epithelial lining of the cyst with Carnoy's solution and marsupialisation. On the basis of a case report it was the aim of the authors to present the surgical treatment of odontogenic, recurrent keratocysts at the Clinic for Maxillo-Facial Surgery, University Hospital Zurich, from the primary operation following the Brosch-procedure in 1971 up to the latest cystectomy in 2004.

[Pain management after third molar extraction. Observations of the use of mefenamic acid and rofecoxib in the treatment of postoperative pain in the dental office]. / Schmerzbehandlung nach Weisheitszahnentfernung. Anwendungsbeobachtung von Mefenaminsäure und Rofecoxib in der Schmerzbehandlung nach operativen Zahnextraktionen unter Praxisbedingungen.

Pain monitoring is often inadequate in the ambulant field to assure therapy results. Today NSAID take the centre in acute pain and inflammation control in dental interventions. Compared to conventional non-selective NSAID modern selective Cyclooxygenase-2 inhibitors (COX-2) provide the potential for improved compatibility and simplified medication with heightened effectiveness in acute postoperative toothaches. The aim of this study was to compare the effect of selective COX-2 inhibitors with NSAID after operative wisdom tooth extraction in 30 ambulant patients. The pain curve under mefenamine acid showed a significant increase during the first 48 hours after extraction. With rofecoxib a continuous pain decrease with the lowest stand 48 hours after intervention was registered. One week after extraction the patient's satisfaction was in favour of rofecoxib, which showed a clearly prolonged analgetic effect over 24 hours. Additionally rofecoxib as a COX-2 selective inhibitor doesn't bear the risk for severe non-anticipatable gastrointestinal side effects or prolonged bleeding after surgical intervention.

Ciliated epithelium-lined radicular cysts.

OBJECTIVE: This report describes 3 cases of ciliated epithelium-lined radicular cysts among 256 apical periodontitis lesions and also illustrates the occurrence of an Actinomyces-infected periapical cyst. STUDY DESIGN: Serial and step serial sections of 256 plastic-embedded root apices with attached apical periodontitis lesions that were prepared for a previous investigation were reviewed for the presence of ciliated epithelium-lined radicular cysts. The lesions that were found to have such epithelial lining were examined in a transmission electron microscope to elaborate the fine structure of the ciliated cells. RESULTS: A total of 3 ciliated columnar epithelium-lined cysts was found among the 256 apical periodontitis lesions examined. Two of the lesions also contained stratified squamous epithelium. All 3 lesions affected maxillary premolars. One of the lesions was a true cyst, and the other 2 were periapical pocket cysts. The lumen of 1 of the latter revealed the presence of typical "ray-fungus" actinomycotic colonies. CONCLUSION: Although the stratified squamous component of the epithelia that lined the radicular cysts reported here may be derived from the cell rests of Malassez, the ciliated epithelial cells may be of sinus origin. Microbial agents from diseased root canals can advance into radicular cysts, particularly in pocket cysts, with the possible threat of such infection in upper posterior teeth spreading into the maxillary sinus.