Assessment of the anterior loop of the inferior alveolar nerve using reformatted computed tomography: a retrospective study.

The anterior loop of the inferior alveolar nerve (IAN) is an important landmark in the anterior mandible that must be considered during the placement of dental implants. We measured the length and prevalence of loops of the IAN in 188 consecutive, dentate patients using reformatted computed tomography (CT). A total of 158/188 (84%) had at least one anterior loop; 111/188 (59%) had bilateral loops. The mean (SD) length of the loops in the third quadrant was 1.4 (0.7)mm; 95% CI 1.3 to 1.6; (range 0.3 - 4.0mm). The mean (SD) length of the loops in the fourth quadrant was 1.5 (0.9)mm; 95% CI 1.4 to 1.6; range 0.3 - 5.5mm. In total 42/188 (22%) had loops that were longer than 2mm in quadrants three and four. CT images that have been reformatted with specialised software may be useful to identify loops in the IAN, particularly when recent cone-beam CT images are not freely available. The prevalence of these loops is high while their length varies, which makes meticulous assessment necessary before the placement of implants.

Substance abuse among oral healthcare workers.

The abuse of both licit and illicit substances by the general population affects at least one in ten people. Research shows that the oral healthcare worker has at least the same prevalence of substance abuse, perhaps even higher. The emergence of prescription drug abuse is one of the most worrying and dangerous aspects for the healthcare worker, due to ease of access to such drugs. According to the United Nations, prescription drug abuse is amongst the top three practices of substance abuse. We have an obligation to incorporate the evidence of substance abuse among oral healthcare professionals in our undergraduate dental curricula in order to combat this phenomenon. As the stress of daily survival in single practitioner practices increase, so will the danger of substance abuse. This may lead to impairment of the healthcare worker and ultimately loss of registration. It will take a combined effort from organised dentistry and academic institutions to establish a national strategy to ensure we address this important issue at undergraduate level and provide support at practitioner level. This paper will deal with substance abuse and the implications of impairment it holds for the oral healthcare worker.

Substance abuse and oral health: an overview.

Substance abuse is a worldwide phenomenon. It is on the increase in most countries and claims the lives of millions every year. Substance abuse may involve licit and illicit drugs, with licit substances claiming more lives than illicit drugs. Illicit substance abuse is on the increase, especially with new drugs emerging on the world market every year. These new drugs appear faster than scientific studies can keep pace in determining their possible detrimental influences on health. Many abused drugs do have oral health complications. For this reason, it is important for dentists to have a thorough knowledge of the oral environment to be able to detect any abnormalities, regardless of what the underlying cause may be. Due to the nature of illicit substance abuse, reliable information and science is hard to come by. This overview will focus on the direct consequences for oral health, whilst acknowledging that substance abuse may also have direct and indirect influences on general health.

Aetiology of oral cancer.

The terms Oral cancer (OC) and oral squamous cell carcinoma (OSCC) are used interchangeably, as more than 95% of all OCs are OSCCs. Worldwide up to 275 000 new cases of OC are seen every year. Most of these cases are seen in developing countries such as South Africa. Up to 50% of all patients living with OC will die within five years, and this survival rate has not improved over the last few decades. Tobacco and alcohol usage account for up to 75% of all OC cases. As these causative factors can be avoided, all oral health workers should be aware of the aetiology of OC so that sound preventive advice may be given to their patients. Infections and nutrition play a lesser but still important role in the aetiology of OC. This article reviews the importance of the aetiology of OC, with the emphasis on tobacco and alcohol.

Enhanced activity of demineralised bone matrix augmented with xenogeneic bone morphogenetic protein complex in rats.

INTRODUCTION: Demineralised bone matrix (DBM) is an allograft material widely used as a bone filler and bone graft substitute. DBM contains bone morphogenetic proteins (BMPs), which induce and regulate bone formation during embryogenesis and in postnatal life. AIMS AND OBJECTIVES: To investigate the osteoinductivity of DBM augmented with xenogeneic BMP-complex at different doses. MATERIALS AND METHODS: Rat DBM was augmented with BMP-complex purified from porcine diaphyseal bone. RESULTS: Dorsal subcutaneous implantation of 25 mg rat allogeneic DBM augmented with 0, 3, 6 and 12 mg BMP-complex per gram of DBM resulted in dose dependant up-regulation of bone formation on day 21, as scored histologically and biochemically. CONCLUSIONS: Allogeneic DBM can be augmented with xenogeneically sourced BMP-complex to improve DBM performance in vivo. This work demonstrates the potential of BMP-complex augmented DBM to induce new bone formation with improved parameters of bone formation.

Epidemiology of oral squamous cell carcinoma.

The National Cancer Registry (NCR) of South Africa publishes the pathology-based cancer incidence in the country and is the main cancer data source. The data published by the NCR have been used extensively in the development of the draft national guidelines for cancer prevention and control as well as for cancer research. The list of contributing pathology laboratories is fairly inclusive. Data from the NCR and the University of Limpopo, Department of Oral Pathology for the five years 1997-2001 were combined and then filtered for sites in the oral and oropharyngeal region. Age-Standardised Incidence Rates (ASIR) and the Cumulative Lifetime Risk (LR) for males and females in the different population groups were determined. Comprehensive reporting of oral and oropharyngeal cancer incidence will influence the allocation of government resources for prevention and treatment of oral cancers.

Epidemiology of oral precancer and cancer.

Although a large number of lesions and conditions have been designated as premalignant, most of these diseases have a very low incidence. Furthermore, only a small percentage undergo malignant transformation. In this article, premalignant changes of the oral mucosa are described and contributory factors that enhance their malignant transformation are identified. The largest single risk factor is atrophy of the oral mucosa. Oral submucous fibrosis, tobacco use and iron deficiency anaemias enhance the risk of malignant transformation. The location of lesions is also considered, since certain sites display a greater predilection to malignant transformation. The epidemiology of oral squamous cell carcinoma among the South African populations is considered and compared with figures from other countries. The impact of urbanisation and changing habits have led to a gradual move towards equalization of the incidences for males and females. The tongue is the most commonly involved site in all South African racial groups. However, there are differences in site distribution. For instance, among whites there is a greater predilection for carcinoma of the floor of the mouth, while among blacks the palate is more frequently involved. The incidence is highest during the 7th decade.