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Mouth rehabilitation calls for the greatest skills we possess as dentists. We have a moral and professional responsibility to our patients to do what is best for them. This can only be achieved by careful checking and cross-checking of our procedures during fabrication. Transitional prostheses, therefore, may serve as a valuable adjunct toward the achievement of success in mouth rehabilitation.
The extraordinarily rich blood supply of the tongue makes it possible to use a variety of pedicled tongue flaps: 1. Defects of the dorsum of the tongue can be covered either with island flaps from the margin or with flaps crossing the midline. 2. Medial defects can be covered by flaps taken from both sides or from the centre of the dorsum. 3. Defects of the tip of the tongue or the front of the floor of the mouth can be filled by island flaps taken from one or both sides of the tongue. Large defects can be crossed by a triangular island flap pulled through a tunnel. 4. For defects in the lateral floor of the mouth an oval shaped flap from the middle of the tongue is pulled through a tunnel into the defect.
Six healthy young men breathed room air or one of nine hot humid air conditions on separate days for one hour while walking on a treadmill (40% VO2 max). Inspired wet bulb temperatures ranged from 18.9 (room air) to 49.3 degrees C. Tissue temperatures in the mouth were measured by means of thermocouples placed on the tongue and hard palate. Analysis of variance on repeated measures showed significant increases in both tongue and hard palate tissue temperatures (p less than 0.001) as a result of increasing wet bulb temperatures; however, core temperature and heart rate were not affected (p greater than 0.05). Ratings of subjective discomfort increased proportionally with increases in wet bulb temperature of the inspired air. It was concluded that wet bulb temperature of inspired air is a valuable measure to uses in studying temperature responses of mouth tissues when inhaling hot humid air, particularly when investigating human tolerance levels in order to recommend federal standards for the design of breathing apparatus.
The virus of foot and mouth disease causes severe epizootics in animals and infrequently evokes painful, but transient, clinical signs in man. Adults in certain occupational groups and young children are particularly exposed to risk. Infected persons may disseminate virus for up to about 14 days. The virus can be transmitted from animals to animals, from animals to man, from man to animals and, probably, from man to man. Evidence for transfer of the disease between human and animal populations is reviewed in detail and modern methods of diagnosis are described. Predisposing factors play an important role in the development of overt foot and mouth disease in man. Subclinical infection occurs. The possibility of aerial transfer of the virus between man and domestic livestock constitutes a hazard, especially to the latter. Attention is directed to the need for sophisticated diagnostic techniques, to requirements for adequate precautions in the handling and disposal of affected animals, and to hygienic measures for disease control.
The effectiveness and tolerance of the new semisynthetic acylureidopenicillin 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen) were investigated in 10 patients with bone and soft tissue infections of the mouth and jaw. The antibiotic was given in doses of 2 to 10 g/d. Indications for treatment were osteomyelitis of the jaw and/or phlegmon of the floor of the mouth and abscesses of the soft palate. 9 out of 10 infections could be cured. Due to the short treatment period one case was not assessable. In 6 patients 9 causative aerobic and anaerobic organisms were isolated which were eliminated. The clinical and laboratory control examinations did not reveal any adverse reactions.
Wild-coloured Zebra Finch nestlings with fully developed mouth markings were compared with white mutants, which lack the markings, with respect to the ability of these markings to release the feeding response of both wild-coloured and white parents. In more than 80 nestlings, the wild-coloured ones proved to have a higher survival rate, to grow faster, to be given more food, and to have piority to the first feedings in the day. Within the colour groups greater relative age was as advantageous as mouth markings were between groups.
Pigs infected with foot-and-mouth disease virus by different routes of exposure were air-sampled individually, first as 'intact' (I-) pigs and then as 'intubated' (T-) pigs, using an endotracheal tube. Irrespective of the route of infection it was found that during the early stages of disease more virus was recovered from I-pigs than from T-pigs. Most of the virus from I-pigs during incubation and early disease was associated with large and medium sized particles. T-pigs infected by direct or indirect contact excreted a range of particle sizes at this time but T-pigs infected by inoculation only excreted small particles. During advanced disease all sizes of particle were excreted by I- and T-pigs. Greater amount of airborne virus were recovered at this time from I-pigs than T-pigs infected by indirect contact but I-pigs infected by intravenous or intradermal inoculation excreted less infectivity than T-pigs. The results show that the respiratory tract is involved during the early stages of foot-and-mouth disease in pigs infected by either natural or experimental routes of exposure and suggest that upper respiratory infection precedes lower.
Incidence rates by income level were computed for squamous cell carcinomas of the gum and mouth, larynx, and esophagus and for squamous cell carcinoma, small cell carcinoma, and adenocarcinoma of the lung in white males and females aged 35--64 years, with the use of data for the nine geographic areas of the Third National Cancer Survey and the 1970 U.S. census. Within sex, age, and geographic area groups, patterns of cancer incidence by income level were analyzed by use of a nonparametric statistical method. Higher rates for males than for females were found for every histologic type studied, and the ratio of male-to-female rates increased with age (especially for squamous cell carcinomas of the larynx and lung). A strong inverse relation to income level was found for all of the histologic types studied in males and for squamous cell carcinomas of the gum and mouth and esophagus and small cell carcinoma of the lung in females. These findings are discussed with reference to patterns of smoking and alcohol use by sex and social class.
To better understand the frequency of appearance, the density of growth, and the most common sites in which female patients harbor Candida albicans, a study was initiated of all patients receiving a pelvic examination for any reason at a solo family practice office. From February 1980 to November 1981, 341 pelvic examinations were accompanied by cultures and colony counts of the vagina, rectum, and mouth. A semiquantitative method adapted to Microstix-Candida (Ames Company) was utilized. Only 39 percent of all examinations had negative cultures in all three sites. Twenty-three percent of the positive cultures for C albicans were found from the vagina, 41 percent from the rectum, and 34 percent from the mouth. Incidence of colonization in any site did not vary significantly from 16 to 75 years of age. Negative rectal colonization was associated with lower vaginal colony counts and less frequent vaginal symptomatology. Relatively high vaginal colony count was associated with symptomatic vaginal candidiasis.
The acceptable state of the art for commissure electric burns of the mouth in children in the past was to advocate conservative treatment, allowing spontaneous healing to be followed by reconstructive procedures. These statements were made because of the difficulty of assessing the degree of initial injury, the loss of valuable normal tissue in early excision and reconstruction, and the minor role played by infection in healing of local electric burns particularly in this anatomic area. Most authors feel that maximum tissue preservation and functional restoration could best be achieved by delay of surgery until the eschar had separated and the scar had softened. Another school of surgeons believe that scarring, distortion, and secondary infection can be circumvented by timely, early surgical intervention. More recently the fabrication and use of a "dynamic microstomia prevention splint" appears to be beneficial in eliminating the need for or decreasing the degree of surgery in children with electric burns of the commissure of the mouth.
The treatment of carcinomas of oropharynx and oral cavity has changed rapidly over the last 15 years due to the progress of surgical technics and of oncological knowledge. As far as natural history and therapy are concerned, there are two opposing types of cancer: 1. Carcinomas developing from a mucous membrane covering a lymphoid tissue (cancers of the tonsil, some cancers of the palate and the base of tongue). Treatment is usually by radiotherapy, and surgery is mainly resorted to if radiotherapy fails. Therapeutic trials of chemotherapy are in progress. 2. Carcinomas developing from a mucous membrane covering muscles (cancers of the tongue, floor of the mouth and interval cheek) or bone of the mandible (carcinomas of the gingiva, floor of the mouth and gingiva, and retro-alveolar area). The therapy is described. The principles of treatment of the regional lymph nodes are also described.
Sixteen autopsy cases of the primary sarcomas of the mouth and jaws were reviewed, which included 1 chondrosarcoma, 3 osteosarcomas, 1 leiomyosarcoma, 7 rhabdomyosarcomas and 4 histiocytic lymphoma (reticulum cell sarcoma). Although the case materials studied were too small, the pattern of the spread of the sarcomas of the mouth and jaw was likely to be divided into two groups, localized and generalized. The former is comprised of chondrosarcoma osteosarcoma, leiomyosarcoma and pleomorphic rhabdomyosarcoma. The latter is comprised of alveolar rhabdomyosarcoma and histiocytic lymphoma. Embryonal rhabdomyosarcoma belongs to either depending on the case. The former, being resistant to local therapy, tended to recur with a contiguous spread but was slow to metastasize. Metastases were limited to the lung and pleura through the hematogenous route. The primary sarcoma of the latter group were not so extended in local spread and occasionally cured with therapy. However, metastases, both hematogenous and lymphogenous, were generalized.
Methods to determine airway resistance - pulmonary function tests - have been recommended for the measurement of nasal resistance. Using the "oscillation method", you can demonstrate in some patients a source of error: Some mouth breathers can have an additional regulative resistance. By means of direct write-out tracings it is demonstrated that the simple subtraction of the resistances (during mouth and nose breathing respectively) is not a reliable method to determine nasal resistance. But the source of error can be recognized using a more luxurious measuring technique.
Our present experience with Stage III disease suggests that the most effective means of treating advanced carcinoma of the floor of the mouth and tongue are with initial chemotherapy given as basal treatment by intra-arterial infusion followed by planned radiotherapy or operation, or both. Early carcinoma of the floor of the mouth and tongue can be managed effectively with conventional techniques using surgical treatment or radiotherapy, or both, and probably does not justify the increased time and increased problems of management involved in the use of chemotherapy regimens. Our experience in comparing the two programs of treatment in patients classified as having Stage IV lesions is too small to justify valid comparisons to be made at this stage, although we currently have under investigation similar management programs for these patients.
Gnathostoma of larvae of the chigger mite N. pomeranzevi is situated terminally on the trunk. The base of the gnathostoma is gnathocoxa represented by conglutinated coxae of pedipalps. Gnathocoxa narrows apically and passes into hypostome protruding up to the cheliceral blades. Lateral borders of the hypostome are bent dorsally thus forming a groove in which cheliceral blades are located. The cheliceral blades have a small groove in their internal surface. Larval chelicerea are free because their tactum is missing. Cheliceral apodemes which serve for the insertion of muscles, elevators of chelicerae, are jointed to the base of inner walls of basal cheliceral joints. Lateral gnathostoma bears five-jointed palps which have strong three-apical claws on tibia. Palps do not take part in the attachment of larvae to the host. The dorsal wall of gnathostoma is formed by the epistoma and caudal subcheliceral plate which further is branched into two cheliceral apodemes. Subcheliceral plate and apodemes serve as an attachment place of muscles, dilatators of the pharynx. The mouth opening is situated not far from the apical end of hypostome and goes into a large pharynx passing along the bottom of gnathosoma. On the whole, the mouth parts of larvae are adapted well for sucking liquid food.
A study on contacts between livestock holdings was conducted in a geographically defined area of 4 by 6 km in the Netherlands. The farmers were asked to record all contact on and off farm during a period of 2 weeks. The number of contacts in the 2 week period was high, on average 91.8 contacts per farm. The risk of spreading foot-and-mouth disease on or off the farm was greater for cattle farms than for swine farms. Relatively more people had contact with the animals while visiting cattle farms, thereby causing the higher risk. Most contacts occurred over short distances. Almost 50% of the contacts were within the research area. This finding confirms the importance of restricted areas around farms with foot-and-mouth disease infections.
The incidence of physical injury to the head, face, mouth, and neck of 266 suspected cases of child abuse was studied at Texas Children's Hospital in Houston, Texas, from January 1993 through December 1994. While there was an even distribution of physical abuse by gender, 74.8 percent of the children were under the age of three. A hospital physician performed every examination. The most frequently occurring injury was contusion or ecchymosis of soft tissue, while the face was the part of the body injured most often. Although 66.2 percent of the children reviewed had some type of injury to the head, face, mouth, or neck, only seven cases (2.6 percent) of intraoral injury were mentioned. These results point out the need for dentists to become active participants on multidisciplinary child maltreatment teams.
OBJECTIVE: To compare two methods of obtaining the anteroposterior (AP) open mouth view. DESIGN: Radiological evaluation of the occiput-C1/C1-C2 structures, as visualized on radiographs obtained using two different radiographic position set-ups. SETTING: The Anglo-European College of Chiropractic Clinic. PATIENTS: A total of 60 patients. Each method used on 30 patients. CRITERIA ASSESSED: Visualization of: (a) occiput-C1 joints, (b) atlantoaxial joints, (c) lateral masses C1 and (d) odontoid process. RESULTS: The visualization of the occiput-C1 joints was increased almost 100% using method 2. The atlantoaxial joints were seen in 7% more cases using method 2 and the lateral masses were seen in 10% more cases. The only structure seen more consistently using method 1 was the odontoid process, which was seen in 7% more cases using that method. CONCLUSION: This study shows that there is an easier and more consistent method of obtaining the AP open mouth view than that traditionally used in many institutions.