The 8th AJCC classification is inferior to a new neck stage based on intraparotid lymph node in parotid gland cancer.

BACKGROUND: Lymph node (LN) status is an important prognostic factor for parotid gland cancer (PGC). This study aimed to analyze the impact of extranodal extension (ENE) of intraparotid LN and LN metastasis burden on survival in PGC. METHODS: Patients with surgically treated PGC and at least one metastatic cervical LN were retrospectively enrolled. Primary outcome variables were distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS). The impact of ENE and LN metastasis burden was assessed using the Cox model. RESULTS: A total of 292 patients were included. ENE in cervical or intraparotid LN was not associated with DMFS, DSS, or OS. Intraparotid LN metastasis had a significant impact on prognosis, and the presence of only one metastatic intraparotid LN offered an approximately 1.5-fold risk of distant metastasis. Prognostic models based on the number of positive LNs (1 vs. 2-3 vs. 4+) were superior to the AJCC N stage in terms of DMFS, DSS, and OS. CONCLUSIONS: ENE of cervical or intraparotid LN has a limited effect on the prognosis of PGC, and the number of positive LNs is better than the AJCC N stage in LN status evaluation.

Engineered Biomaterials Trigger Remineralization and Antimicrobial Effects for Dental Caries Restoration.

Dental caries is the most prevalent chronic disease globally, significantly impacting individuals' quality of life. A key reason behind the failure of implanted restorations is their biological inactivity, meaning they are unable to form crosslinks with the surrounding tooth structures, thus making patients susceptible to implant loss and recurrent tooth decay. For the treatment of caries, antibacterial medicine and remineralization are effective means of treating the recurrence of caries. Owing to the rapid progression in the biomaterials field, several biomaterials have been reported to display antimicrobial properties and aid in dentin remineralization. Bioactive materials hold considerable potential in diminishing biofilm accumulation, inhibiting the process of demineralization, enabling dentin remineralization, and combating bacteria related to caries. Bioactive materials, such as fluoride, amorphous calcium phosphate, bioactive glass, collagen, and resin-based materials, have demonstrated their effectiveness in promoting dentin remineralization and exerting antibacterial effects on dental caries. However, the concentration of fluoride needs to be strictly controlled. Although amorphous calcium phosphate can provide the necessary calcium and phosphorus ions for remineralization, it falls short in delivering the mechanical strength required for oral mastication. Resin-based materials also offer different advantages due to the complexity of their design. In this review, we delve into the application of advanced bioactive materials for enhancing dentin remineralization and antibacterial properties. We eagerly anticipate future developments in bioactive materials for the treatment of dental caries.

Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma.

To evaluate the relationship between factors of metastatic intraparotid lymph node (IPLN) and distant metastasis in parotid adenoid cystic carcinoma (ACC). Patients with surgically treated parotid ACC were retrospectively enrolled, and primary outcome variable was distant metastasis free survival (DMFS). The effect of factors of metastatic IPLN on DMFS was evaluated using Cox model. In total, 232 patients were included. Extranodal extension of IPLN and cervical lymph nodes did not impact the DMFS, and the 7th but not 8th AJCC N stage was associated with DMFS. Groups of 0 and 1 metastatic IPLN had comparable DMFS, but presence of 2+ positive IPLN was related to increased worse DMFS (p = 0.034, HR 2.09). A new N stage (0 vs 1-2 vs 3+) based on total positive lymph node number exhibited better C-index than traditional N stage. IPLN metastasis increased the risk of distant metastasis, and the impact was mainly determined by the number of metastatic IPLN. Our proposed N stage provided better DMFS prediction than the 8th AJCC N classification.

Oral Health Status of 12-Year-Old Hani Children in the Yunnan Province of China: A Cross-Sectional Study.

BACKGROUND: The aim of this cross-sectional study was to investigate the oral health status of Hani 12-year-old children in Yunnan, a province in Southwest China. METHOD: This study employed a multistage sampling method to recruit children from local primary schools. Two calibrated dentists examined the status of dental caries, gingival bleeding and dental fluorosis by adopting the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed. The chi-square test and multivariate logistic regression were conducted. RESULTS: This study invited 480 Hani children, and recruited 413 children (52% boys) (response rate: 86%). The dental caries prevalence was 52%, and the caries experience associated with the mean (standard deviation) decayed, missing and filled teeth (DMFT) score was 1.10 (1.46). Gingival bleeding was diagnosed in 252 children (61%), and dental fluorosis was found in two children (0.5%). The results of the regression model indicated the prevalence of dental caries were associated with sugary snacking habits (p = 0.002). The prevalence of gingival bleeding was related to the mother's education level as well as the child's monthly pocket money (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Hani children in the Yunnan province in China. Dental fluorosis was uncommon.

Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study.

BACKGROUND: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan. METHOD: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis. RESULTS: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The gingival-bleeding prevalence was associated with the mother's education level, the child's monthly-pocket money and daily toothbrushing frequency (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.

Planning Minimal Access Incisions in Resectioning Benign Parotid Tumors.

BACKGROUND: Traditional parotid surgery leaves visible submaxillary cicatrices, unaesthetic results from incisions, and a high incidence of postoperative complications. This study aimed to examine the feasibility of newly designed incisions for the removal of benign parotid lesions. METHODS: The authors randomly assigned patients (n = 48) with benign parotid lesions admitted to our department from November 2016 to April 2019. In the study group, an aesthetic incision was designed through a preoperative examination combined with a medical history and physical examination. Half of the patients (n = 24) underwent surgery with the new incision design, while the patients in the control group (n = 24) received conventional surgery. The therapeutic effects and outcomes of the two groups were compared. RESULTS: The postoperative complication rate of the study group (n = 6) was significantly lower than that of the control group (n = 15). Compared to conventional surgery, patients who received the hidden incisions had less total drainage volume, decreased length of incision, and fewer days of postoperative hospitalization (P < 0.05). On an average follow-up of 20 months, no recurrence was found in any patient. CONCLUSIONS: Minimal access incisions, aided with loupe magnification, greatly improve the surgical safety, patient outcomes, and final scar appearance. The described technique is worth further study and utilization.

Dental caries status of Lisu preschool children in Yunnan Province, China: a cross-sectional study.

BACKGROUND: Dental caries is still considered a major public health concern for human beings, especially minority groups and those living in disadvantaged communities. The Lisu is a minority group in China of more than 702,000 people located primarily in Yunnan Province. The present study was aimed at studying the status of dental caries status, as well as its risk factors, among Lisu children aged 5 years in Yunnan Province, China. METHODS: A multistage cluster sampling method was employed for participants' recruitment. Two calibrated dentists carried out the clinical examination with dental mirrors and CPI probes under an LED headlight. The dental caries experience was assessed by the dmft index. Oral hygiene status was evaluated using the visible plaque index (VPI). Information on the child's socio-demographic characteristics and oral health-related practices were collected using a parental questionnaire. A zero-inflated negative binomial regression (ZINB) was employed to analyse the associations between the dental caries status and the children's social-demographic status and their oral health-related behaviours. RESULTS: In all, 470 Lisu children aged 5 were invited, and 404 were examined. Their mean dmft (±SD) and caries prevalence were 5.6 ± 4.8 and 80%, respectively. Their mean VPI scores were 58% ± 21%. Lisu children who brushed their teeth at least once daily had higher dmft scores, and children from high-income families were more likely to have dental caries. CONCLUSION: The prevalence of dental caries among Lisu children aged 5 years in Yunnan, China was high, and their caries status was severe, with a majority of carious teeth untreated. The dental caries experience of Lisu children aged 5 was related to their brushing frequency and families' economic backgrounds.

Evaluation of the efficacy and safety of propranolol, timolol maleate, and the combination of the two, in the treatment of superficial infantile haemangiomas.

Our aim was to compare in a prospective study the clinical effects and safety of propranolol given orally, timolol maleate applied locally, and the combination of the two, in the management of superficial infantile haemangiomas. Thirty-nine patients with superficial infantile haemangiomas were randomised into three equal groups of 13 each: the first given timolol maleate applied topically together with propranolol given orally, the second given only propranolol orally, and the third given only timolol maleate topically. Photographs were taken before, and periodically after, starting treatment. A minimum of 50% improvement was considered to be effective. The maximum duration of treatment was planned for 6 months, and the patients were followed up for 3-12 months. The overall rate of clinical effectiveness for the three groups was 11/13, 9/13, and 8/13, respectively. The two drugs together had a shorter effective response time than when they were given separately. There were no serious adverse effects. We therefore conclude that timolol maleate given topically together with propranolol given orally is safe and effective in the treatment of superficial infantile haemangiomas. Compared with simple medication, this method is more rapid, has an appreciable effect, takes a shorter time, and has fewer adverse reactions. It could be used as a first-line treatment, particularly if the lesion is potentially disfiguring or functionally threatening such as large periocular superficial haemangiomas.