Salivary levels of TNF-α and IL-6 in patients with oral premalignant and malignant lesions.

The aim of this study was to determine the salivary concentrations of tumour necrosis factor α (TNF-α) and interleukin 6 (IL-6) in patients with premalignant and malignant lesions. The study involved 57 patients who were examined between 2008 and 2010 at the Department of Oral Medicine and Department of Oral and Maxillofacial Surgery of the Medical Faculty, University of Rijeka, Croatia. They were divided into three groups: 19 patients with oral premalignant lesions, 19 with oral squamous cell carcinoma and 19 healthy control volunteers. Whole saliva was collected and investigated for the presence of TNF-α and IL-6 by enzyme immunoassay at the Department of Dentistry and Maxillofacial Surgery, Medical Faculty, University of Graz, Austria. All groups had statistically significant differences in values of TNF-α and IL-6 (P < 0.001). The results suggest that these proinflammatory cytokines are elevated in the saliva of patients with oral squamous cell carcinoma and oral premalignant lesions as compared to controls, which may have diagnostic and/or prognostic significance.

The influence of war stress on the prevalence of signs and symptoms of temporomandibular disorders.

The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders in patients with post-traumatic stress disorder (PTSD) occurring as a consequence of exposure to war stress. The examined group consisted of 100 male subjects, aged from 25 to 50 years, who had taken part in the War in Croatia, and in whom PTSD had previously been diagnosed. The control group comprised 100 subjects, without PTSD, of the same sex and age group, who had not taken part in the War. A functional evaluation of the stomatognathic system was performed using the Helkimo Anamnestic and Clinical Dysfunction Index. Eighty-two per cent of the group with PTSD had at least one symptom, and 98% at least one sign of dysfunction. Eight per cent reported mild symptoms and 74% severe symptoms. Twenty-eight per cent showed mild clinical signs, 22% had signs of moderate, and 48% of severe dysfunction. Twenty-four per cent of the control group of subjects had at least one symptom, and 52% at least one clinical sign of dysfunction. Twenty-two per cent reported mild and 2% severe symptoms. Mild clinical signs of dysfunction were found in 50% of subjects in the control group, moderate in 2% and none exhibited severe clinical signs. It is concluded that correlation exists between war stress and temporomandibular disorders.

Polymethyl-methacrylate implants in forehead and supraorbital arches reconstruction: retrospective study.

Frontobasal injuries and some other diseases of frontal sinuses sometimes require radical surgery with the obliteration of the sinus. A cosmetic correction of the forehead and supraorbital arches has to be performed after such a procedure. Nowadays, there is a wide choice of alloplastic materials on the market. We tried polymethyl methacrylate implants in correction of the exterior appearance of the forehead and supraorbital arches and followed the behaviour of the implants up to 25 years after surgery. The result was 18 (94.7%) successful implantations and one failure (5.3%) with a mild sagging of the borders of the implant. Polymethyl-methacrylate proved pliable for work and modelling, not invasive for the organism and stable. In conclusion, the cure of some frontobasal injuries and diseases with the first surgical step followed by cosmetic correction of the forehead and supraorbital arches (2nd surgical step) using this alloplastic material provides a safe, durable and aesthetically satisfactory solution for the patient.

Treatment of oroantral communications after tooth extraction. Is drainage into the nose necessary or not?

Seventy-six patients with oroantral communications after tooth extraction and chronic maxillary sinusitis were treated as follows: bacterial cultures were taken in all of them and maxillary sinuses were irrigated with an antibiotic from the cephalosporin group. Then, in 36 patients, drainage using the Caldwell Luc procedure was performed, including a naso-antral window. In all patients operations were completed by closing oroantral communications with flaps of the mucosa of the alveolar process close to the fistula. Antibiotics according to antibiogram were administered to all patients at least 10 days after surgery. Retrospective comparison between the results obtained in the first group and those in the second group 1, 3 and 6 months after operation was based on objective findings (condition of the oroantral communication, maxillary sinusitis), side effects (pain, numbness of the operated area, headache) and control radiographs (clear maxillary sinus or with mucosal thickening). The study suggests that transnasal drainage is not required in maxillary sinus surgery and in the closure of oroantral communications. Equally good results are achieved by treating with antibiotics and without drainage of the maxillary sinus into the nose.

[Personal experience in the treatment of war injuries of the jaw and face at the Clinical Hospital Center in Rijeka]. / Nasa iskustva u lijecenju ratnih ozljeda celjusti i lica u klinickom bolnickom centru Rijeka.

In this paper we have presented 38 cases of wounded persons who had sustained war injuries in maxillo-facial and neck region. All of them were injured in Croatia during the war period of 1991 and 1992, and treated at the Maxillo-Facial Surgery Department of the Clinical Hospital of Rijeka. The wounded persons were observed and monitored from the moment of their injury through the first aid on the spot, up to the surgical treatment of the wounds, subsequent primary and secondary reconstruction, and the final medical treatment. This paper describes for wounded persons with injuries of bones and soft tissue of the face. In two thirds of the wounded persons with the primary medical treatment and reconstruction, the cure terminated, while in one third it was necessary to provide for a secondary reconstructive operation. At the end of the treatment, all the wounded persons were successfully cured, functionally and aesthetically restored, so they were able to leave the Clinic to return to their everyday life and work. Such result has been particularly gratifying because they were mostly young men.

The radial forearm free flap: our experience in solving donor site problems.

Special attention is paid to the problems of the donor site (the forearm) in a series of 75 patients who underwent orofacial malignancy excision. An island skin flap from the ulnar aspect of the forearm, used in 15 patients, is reported to be an improvement of the surgical technique. No healing complications were observed, and the aesthetic and functional results were very good.