Oral cavity as a potential source of infections in recipients with diabetes mellitus.

Our previous observations showed alterations of oral cavity status among hemodialyzed patients and kidney allograft recipients as well as differences in the prevalence and composition of microorganisms occurring in the mouths of patients. In the present work, we analysed the results of oral cavity examinations, the identification of microorganisms, and the assessment of their importance to kidney allograft recipients or hemodialyzed patients with diabetes mellitus, in comparison with nondiabetic recipients, dialyzed patients, and control patients.

Smoking, alcohol, diet, dentition and sexual practices in the epidemiology of oral cancer in Poland.

The effect of smoking, drinking, diet, dental care and sexual habits on the risk of oral and pharyngeal cancer was investigated in a case-control study conducted in Warsaw, Poland. The study comprised 122 patients (including 44 females) aged 23-80 years with histologically confirmed cancer of oral cavity and pharynx. Controls were 124 subjects (including 52 females) admitted to the hospital for different non-neoplastic conditions unrelated to tobacco and alcohol consumption, with frequency matched to cases by age and sex. Smoking and drinking were strongly associated with an increased risk of oral cancer. Among consumers of both products, risks of oral cancer tended to combine in a multiplicative fashion and were increased more than 14-fold among those who consumed more than 15 cigarettes and seven or more drinks per day. Cessation of smoking was associated with reduced risk of this cancer. The risks varied by type of cigarettes smoked, being lower among those consuming filtered cigarettes only (OR = 1.6) than nonfilter (OR = 6.5) or mixed (OR = 4.2) cigarettes. High fruit intake was associated with significantly decreased risk (OR = 0.4) with the strongest significant inverse association found for fruit juices and citrus fruits ( < 0.01). After adjustment for tobacco smoking and alcohol drinking, poor dentition as evidenced by missing teeth, frequency of dental check-ups and frequency of teeth brushing emerged as a strong risk factor. Number of missing teeth and frequency of dental check-ups and frequency of tooth brushing showed increased ORs of 9.8, 11.9 and 3.2, respectively. Denture wearing did not affect oral cancer risk. No differences were detected in sexual practices (including oral sex and intercourse with prostitutes). In terms of attributable risk, smoking accounted for 57% of oral cancer cases in Poland, alcohol for 31% and low fruit intake for 12%. Attributable risks for low frequency of tooth brushing and dental check-ups were 56% and 47%, respectively. In conclusion, smoking and drinking cessation and increase of fresh fruit intake are likely to be effective preventive measures against oral cancer. These findings indicate also that poor oral hygiene may be an independent risk factor.

Host--protozoans--bacteria--fungi interrelations in the mouths of patients with systemic illnesses.

The aim of this work was to study clinical changes and microorganisms in mouths of three patient groups: with congenital disorders (Cd), dialyzed (D) and control (C). Fifty five patients, 20 to 62 years old were assessed. Swabs and samples of periodontal tissue were used for microscopical study to detect of protozoans and for bacterial and fungal cultures. E. gingivalis and T. tenax were found in all groups. Three out of Cd patients were infected with Acanthamoeba sp.. Fecal bacteria were more often found in D than Cd. In all 30-40 years old D patients, fecal bacteria and various strains of C. albicans occurred. We found that systemic diseases favour instabilities in mouths changing interrelations between protozoa, bacteria and fungi. It may increase risk of clinical complications.

Abnormalities in T cell interactions with the extracellular matrix proteins in a patient with Wegener's granulomatosis.

T cell interactions with the extracellular matrix proteins and cultured human endothelium were studied in a patient with Wegener's granulomatosis and other cases of vasculitis. Markedly enhanced costimulation of T-lymphoproliferative responses mediated by collagen and fibronectin were found in patients with severe forms of vasculitis, particularly with necrotizing changes. In addition, enhanced adhesion to collagen IV was found in the Wegener patient. T cell adhesion to resting and inflamed endothelium varied from normal to increased.

[Results of treatment of upper gingiva and palate carcinomas]. / Ocena wyników leczenia raków dziasla górnego i podniebienia.

From 1981 to 1986 in the Department of Maxillofacial Surgery, Institute of Stomatology, Medical Academy in Warsaw 85 patients were treated for carcinoma of the upper gingiva and palate. The follow-up of the patients after treatment was from 3 to 7 years. The obtained results of the treatment were analysed depending on the degree of differentiation of neoplasms and their biological aggressiveness and the therapeutic method used. It was found that the results of the treatment of upper gingiva carcinoma were not satisfactory. The best results were obtained using surgical treatment followed by radiotherapy. A positive result of the treatment without symptoms of recurrence was achieved in 21 cases (24.7%).

[Comparison of the effectiveness of conventional methods of radiological examinations and computed tomography in the diagnosis of lower gingiva tumours]. / Porównanie skutecznosci konwencjonalnych metod badania radiologicznego oraz tomografii komputerowej w rozpoznawaniu guzów dziasla dolnego.

In 22 patients aged 34 to 87 years treated in the Department of Maxillofacial Surgery, Institute of Stomatology, Medical Academy in Warsaw for malignant tumours of the lower gingiva the usefulness was assessed of the conventional radiological methods and computed tomography for the evaluation of malignant infiltrations. Computed tomography was found to be an auxiliary radiological method determining best the morphology and syntopy of malignant neoplasms of the lower gingiva infiltrating the soft tissues of the oral floor.

[The effectiveness of selected surgical methods in the treatment of zygomatico-maxillary fractures]. / Ocena skutecznosci wybranych metod chirurgicznych w leczeniu zlaman jarzmowo-szczekowych.

In a period of 3 years, from 1984 to 1986 in the Department of Maxillofacial Surgery, Institute of Stomatology, Medical Academy in Warsaw 442 patients were treated for zygomatico-maxillary fractures, in 101 cases the treatment was conservative, and 341 were treated surgically by various operative methods. The aim of the study was assessment of late effectiveness of the surgical methods used most frequently in zygomatico-maxillary fractures with reposition of skeletal fragments either with one-pronged hook introduced percutaneously or from the side of the lumen of the maxillary sinus. The criterion of effectiveness of both methods was accepted to be functional assessment of the visual system and the stomatognathic system, and the condition of sensory function in the area of innervation by the suborbital nerve. Control examinations were done 2-5 years after operations confirming the both methods were successful in 90% of the treated group. A more detailed analysis of these methods is not possible since the qualification for these operations differentiated essentially both groups of patients.

[Late results of treatment of maxillary fractures]. / Odlegle wyniki leczneia zlaman szczeki.

In the period of 3 years, from 1984 to 1986 in the Department of Maxillofacial Surgery, Institute of Stomatology, Medical Academy in Warsaw 230 patients were treated for maxillary fractures. Late results of this treatment were assessed in 102 patients coming for control examinations in 1988. In the assessment of the therapeutic results the following features were considered: facial symmetry, proportions of three facial segments, functions of the visual system and stomatognathic system, nasal patency, and sensory disturbances in the area innervated by the infraorbital nerves. On the basis of this late assessment of the results of treatment of these fractures it was found that the definite morphological-functional and aesthetic results were unsatisfactory in cases of Le Fort III and II type maxillary fractures. This points out that the therapeutic methods used as yet are not sufficiently satisfactory and other methods should be evolved.

[Analysis of surgical-orthopaedic treatment of mandibular fractures in patients treated in the period 1984-1986]. / Ocena chirurgiczno-ortopedycznego leczenia zlaman zuchwy u osób operowanych w latach 1984-1986.

During 3 years 1246 patients were treated for mandibular fractures, 828 of them were treated by conservative-orthopaedic methods while in 418 patients the displaced mandibular fragments were reduced and fixed surgically using various methods. The purpose of the assessment was a group of 319 patients in whom the fragments were reduced and fixed with ossous sutures. A good result of treatment was achieved after this operation in 291 cases (91.2%). In 28 patients (8.8%) postoperative complications developed requiring reoperation.

[Late results of treatment of mandibular fractures]. / Ocena odleglych wyników leczenia zlaman zuchwy.

In a group of 1246 patients treated in the Department of Maxillofacial Surgery-Institute of Stomatology, Medical Academy in Warsaw, in a period of 3 years (1984-1986) late results of treatment of mandibular fractures were assessed. In the assessment the range of mandible abduction, function of temporomandibular joints, occlusal abnormalities, the sensory function in the area innervated by the mental nerves and the condition of posttraumatic scars changing the morphology and aesthetic appearance of the face were considered. Limitation of mandibular abduction after treatment was found in 39 cases. Functional disturbances of temporomandibular joints developed in 58 cases, and various occlusal complications were found in 130 out of 1246 patients. In 56 patients various sensory loss was noted in the innervation area of the mental nerves. Posttraumatic scars in 89 patients affected in various degree facial morphology and aesthetic appearance.

[The method of examination and clinical application of magnetic nuclear resonance in the diagnosis of facial skeleton]. / Metoda badania i zastosowanie kliniczne magnetycznego rezonansu jadrowego w diagnostyce czesci twarzowej czaszki.

On the basis of modern literature the present state of knowledge on MNR and the diagnostic effectiveness of this method in various diseases of the facial skeleton are discussed. The diagnostic effectiveness of MNR is compared to that of computed tomography.