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Sample records for buccal mucosa flaps

  1. Fibrolipoma of buccal mucosa

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    Monika Khubchandani

    2012-01-01

    Full Text Available The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors.

  2. Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU rectourethral fistula [version 2; referees: 2 approved

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    Shrikant Jai

    2017-02-01

    Full Text Available High intensity focused ultrasound (HIFU has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. Management of these fistulas has been described by Vanni et al. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the “first chance is the best chance”.

  3. Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU) rectourethral fistula.

    Science.gov (United States)

    Jai, Shrikant; Ganpule, Arvind; Singh, Abhishek; Vijaykumar, Mohankumar; Bopaiah, Vinod; Sabnis, Ravindra; Desai, Mahesh

    2016-01-01

    High intensity focused ultrasound (HIFU) has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. Management of these fistulas has been described by Vanni et al. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the "first chance is the best chance".

  4. Laparoscopic creation of neovagina and neocervix, followed by their reconstruction with polytetrafluoroethylene graft/buccal mucosa and pudendal artery perforator flap

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    Yi-Chieh Li

    2015-11-01

    Full Text Available Congenital cervical agenesis of is a rare Müllerian anomaly that may be associated with partial or complete vaginal aplasia and renal anomalies. Symptoms such as amenorrhea and abdominal pain usually develop shortly after menarche, when the absence or obstruction of the cervical canal results in blood accumulation in the uterus and fallopian tubes, and finally in the peritoneal cavity. Physical examination sometimes reveals normally developed external sex organs. Delayed diagnosis and treatment may potentially result in extensive endometriosis, which may potentially cause severe adhesion and damage to reproductivity. Such consequences could complicate further the management of the disease. Traditionally, hysterectomy has been the treatment of choice in these cases because of the high failure rate of canalization procedures and risk of serious ascending infection. With advanced laparoscopic techniques, conservative management seems feasible and has been recommended. We herein present a patient with complete cervical and vaginal agenesis. Creation of a neovagina and uterovaginal anastomosis were performed first under the guidance of laparoscopy (Figure 1. A neocervix was composed of a polytetrafluoroethylene graft and a piece of oral mucosa retrieved from the buccal area. The neovagina was reconstructed with an external pudendal artery perforator flap. A cervical Fr 16 size Foley was left in place as a stent. The patient had uneventful postoperative recovery and fair wound healing at the outpatient follow-up. Congenital agenesis of the uterine cervix and vagina can be differentiated accurately and reconstructed laparoscopically. Using mesh-buccal mucosa composite and pudendal perforator flap is a practical way to reconstruct neocervix and neovagina after their creation.

  5. LYMPHANGIOMA OF THE BUCCAL MUCOSA

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    Shashidevi HARANAL

    2013-12-01

    Full Text Available Lymphangiomas are uncommon congenital hamarto‑ mas of the lymphatic system, usually diagnosed in infancy and early childhood. Most lymphangiomas are present at birth (60% and, by the age of 2 years, 80% to 90% are present. Tongue, palate, gingiva, lip, alveolar ridge and buccal mucosa are the most commonly affected sites in the oral cavity. Various methods have been tried for the treat‑ ment of lymphangioma, including surgery, radiation, laser therapy, sclerotherapy and radiofrequency ablation. This paper reports a case of lymphangioma in a 28 year-old female patient.

  6. Speech and swallowing outcomes in buccal mucosa carcinoma

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    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  7. BUCCAL MUCOSA URETHROPLASTY FOR BULBAR URETHRAL

    African Journals Online (AJOL)

    tients (90%) had no evidence of recurrent stric- ture. Randomized studies comparing the dorsal and ventral approaches for buccal mucosa graft urethroplasty have not been published so far. Andrich et al.9 treated 71 patients with bul- bar urethral strictures with buccal mucosa patch urethroplasty. The approach was dorsal.

  8. [Urethral reconstruction using buccal mucosa transplants].

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    Engel, O; Ahyai, S; Rink, M; Eichelberg, C; Dahlem, R; Fisch, M

    2013-05-01

    Buccal mucosa is the ideal material for urethral reconstruction because it is easy to harvest, is accustomed to permanent moisture and can be used at any location in the urethra. Stricture length and local conditions of the urethra have to be considered to decide which technique is required to reconstruct the urethra. Open urethroplasty with buccal mucosa has a success rate over 85% and should be used after unsuccessful internal urethrotomy and primarily in longer strictures.

  9. How to harvest buccal mucosa from the cheek

    African Journals Online (AJOL)

    G. Barbagli

    2015-12-02

    Dec 2, 2015 ... Buccal mucosa;. Cheek;. Surgical technique;. Urethroplasty;. Complications. Abstract. The paper provides the reader with the step by step of our current technique of harvesting ... suggested a new technique for harvesting buccal mucosa from the ..... The use of buccal mucosa patch graft in the management.

  10. A disguised tuberculosis in oral buccal mucosa.

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    Nanda, Kanwar Deep Singh; Mehta, Anurag; Marwaha, Mohita; Kalra, Manpreet; Nanda, Jasmine

    2011-01-01

    Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.

  11. Buccal Mucosa Elasticity Influences Surgical Margin Determination in Buccal Carcinoma Resection.

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    Tsai, Pai-Tai; Shieh, Yi-Shing; Wu, Chi-Tsung; Lee, Shiao-Pieng; Chen, Yuan-Wu

    2016-09-01

    Little is known about whether buccal mucosa elasticity influences the determination of surgical margins for buccal carcinomas. This study investigated whether there is a difference in elasticity of the buccal mucosa in patients with buccal carcinoma compared with controls without the disease. A case-and-control study comprised of patients with buccal carcinoma and controls without the disease was conducted. In each patient, 2 gutta-percha points were attached to the buccal mucosa horizontally and examined twice by lateral cephalometry, once with the mouth closed and once during maximal mouth opening (MMO). Changes in distance between the gutta-percha points were used as a measurement of buccal elasticity. Information on age, alcohol consumption, betel nut chewing, smoking habits, oral submucosa fibrosis (OSF), temporomandibular joint (TMJ) subluxation, and interincisal distance at MMO (IDMMO) was collected. The results were analyzed using independent-sample and paired-sample t tests. Ten patients with buccal carcinoma and another 11 patients without buccal carcinoma were enrolled in this study. There was a significant increase in magnification percentage in patients with carcinoma (32.35%; P elasticity; magnification was 29.20% (P = .013). Magnification was significantly higher in patients with TMJ subluxation (54.50%; P = .041) than in the controls. Age, alcohol consumption, smoking, OSF, and IDMMO did not affect buccal mucosa elasticity. Buccal mucosa elasticity increased considerably at MMO in patients with buccal carcinoma. This elasticity should be taken into account when calculating adequate surgical margins for transoral resection of buccal carcinoma. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Pedicled buccal fat pad flap for intraoral malignant defects: A series of 29 cases.

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    Chakrabarti, Jayanta; Tekriwal, Rohit; Ganguli, Arun; Ghosh, Saradindu; Mishra, Pranay K

    2009-01-01

    A buccal fat pad (BFP) as a flap for reconstruction of defects in the oral cavity has been described for a variety of benign conditions. We describe the indications, advantages, and complications of the BFP flap and report our clinical experience with the flap for intraoral reconstruction after tumor removal. From 2005 to 2008, we analyzed 29 patients in the age range of 32 to 82 years old who underwent a pedicled BFP flap reconstruction for oral defects after intraoral tumor removal. Postoperative wound healing and complications including any recurrence was followed-up prospectively. Most of the patients had an uneventful immediate postoperative period with signs of buccal fat pad epithelialization by the end of the first week and complete epithelialization at the end of the first month. On continued follow-up, a linear band of fibrous tissue under the epithelialized mucosa replaced the once reconstructed buccal fat pad. Three patients had varying degrees of hemorrhage: one of them had hematoma that healed with severe fibrosis and of the remaining two, one had a partial flap loss and one had a complete flap loss. Judicious use of buccal fat pad reconstruction offers a simple, convenient, and reliable way to reconstruct small to medium defects of the oral cavity with low morbidity, even in older patients who would not be able to tolerate time-consuming flap reconstruction procedures.

  13. Autologous buccal mucosa graft augmentation for foreshortened vagina.

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    Grimsby, Gwen M; Bradshaw, Karen; Baker, Linda A

    2014-05-01

    Vaginal foreshortening after pelvic surgery or radiotherapy may lead to dyspareunia and decreased quality of life. Unfortunately, little literature exists regarding treatment options for this debilitating problem. Autologous buccal mucosal grafting has been previously reported for creation of a total neovagina and the repair of postvaginoplasty vaginal stenosis. Autologous buccal mucosa offers several advantages as a replacement material for vaginal reconstruction. Vaginal and oral buccal mucosa are both hairless, moist, nonkeratinized stratified squamous epithelia. Buccal mucosa has a dense layer of elastic fibers, imparting both elasticity and strength, and acquires a robust neovascularity with excellent graft take. The graft material is readily available and donor site scars are hidden in the mouth. A 60-year-old woman had vaginal foreshortening to 4.5 cm 15 years after radical hysterectomy and brachytherapy for endometrial cancer. She was unable to have intercourse despite attempted vaginal dilation. Her foreshortened vagina was successfully augmented with autologous buccal mucosa grafting at the apex, increasing her vaginal length to 8 cm and permitting pain-free intercourse. Even in the face of an altered surgical field after radical hysterectomy and radiation, autologous buccal mucosa is an option for vaginal reconstruction for vaginal foreshortening.

  14. [The extended free lateral arm flap for buccal soft tissue reconstruction after buccal cancer].

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    Chen, Yong; Yang, Xu-Dong; Li, Wei; Chen, Xiu-Juan; Hu, Qin-Gang

    2013-01-01

    To summary the application of the extended free lateral arm flaps for buccal soft tissue reconstruction after buccal cancer. From January to August 2011, three patients underwent the operation of buccal defect reconstruction using the extended free lateral arm flap in one-stage. PRCA was identification with the Doppler probe. According to the mark of PRCA, size and shape of defects, the flaps were designed and extended to the lateral epicondyle of humerus. The flap size ranged from 9 cm x 5 cm to 10 cm x 6 cm with a pedicle of 10 cm in length. The wounds at donor sites were closed directly. Vascular crisis happened in one case due to local negative pressure, which resolved after emergency management. All the flaps survived completely. The patients were followed up for 6 to 10 months with no recurrence. Both the esthetic and functional results were satisfactory. Two cases suffered from numb feeling in donor sites which alleviated six months later. The extended free lateral arm flap has reliable blood supply with appropriate thickness. It is an optional method for reconstruction of buccal defects after ablation of buccal cancer.

  15. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... steroids, topical or systemic, can control the disease and prevent progression. Surgical ... flexible cystoscopy [14] and ultrasonography [15]. The depth and ... In pursuit for the best graft material, bladder mucosa and buccal mucosal grafts .... and manual handling, resistance to infection, compatibility with a.

  16. Review: How to harvest buccal mucosa from the cheek | Barbagli ...

    African Journals Online (AJOL)

    The paper provides the reader with the step by step of our current technique of harvesting buccal mucosa from the cheek. We describe how to prepare the patients, the use of the Kilner-Doughty mouth retractor, the Stensen duct identification, the size and the shape of the graft. We discuss how to repair the donor site and ...

  17. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... Association. skin [2]. Again the results were unsatisfactory till 1995, when Duck- ett et al. successfully used buccal mucosa for urethral reconstruction ... subdivided into three categories (based on function and histology);. Masticatory, Lining and ... anatomy should be accurately determined. The location and ...

  18. Dorsal onlay graft bulbar urethroplasty using buccal mucosa ...

    African Journals Online (AJOL)

    It can be used for penile urethral stricture repair and different types of dorsal onlay graft urethroplasty for bulbar urethral stricture repair. The current paper describes, step by step, Barbagli technique of dorsal onlay graft bulbar urethroplasty using buccal mucosa. The preoperative patient evaluation and postoperative course ...

  19. Initial experience of buccal mucosa urethroplasty in Tanzania ...

    African Journals Online (AJOL)

    Objective: To present the experience with the use of buccal mucosa graft urethroplasty. Patients and methods: This was a retrospective review of 53 consecutive patients who presented with urethral strictures seen by the author from January 2002 to December 2003 and were managed with different forms of urethral ...

  20. Ventral onlay graft bulbar urethroplasty using buccal mucosa ...

    African Journals Online (AJOL)

    Objective: To assess the ongoing role of ventral onlay oral mucosa free graft in the treatment of bulbar urethral stricture. Methods: Detailed review of technical consideration and outcomes from the author's institution along with review of other peer reviewed literature. Results: Of 62 patients undergoing ventral onlay buccal ...

  1. Human vaginal mucosa as a model of buccal mucosa for in vitro permeability studies: an overview.

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    van der Bijl, Pieter; van Eyk, Armorel D

    2004-04-01

    The buccal cavity is attractive for noninvasive, controlled transmucosal delivery of both local and systemic therapeutically active compounds. Administering drugs via this route is advantageous due to the rich vasculature of the oral mucosa, and the absence of gastrointestinal and "first-pass" hepatic degradation. Moreover, the barrier properties of the oral mucosa against noxious substances and its role in disease require further investigation. However, the scarcity of sizeable specimens of human oral mucosa for in vitro experimental studies has hampered research on this tissue. For this reason we developed a model in which human vaginal mucosa is used as a substitute for buccal mucosa. In this article the quality and predictive value of the human vaginal/buccal in vitro model with respect to a number of drugs and other chemical compounds differing widely in molecular size and lipophilicity, including water, arecoline, arecaidine, benzo[a]pyrene, 17beta-estradiol, sumatriptan, vasopressin and dextrans, are reviewed. In addition some applications of the model for investigating the effect of areca nut extract on epithelial barrier properties, temperature effects on water and 17beta-estradiol flux rates, and cyclosporin diffusion through mucosal membranes are described. The permeability characteristics of vaginal mucosa, as a model of buccal mucosa, are compared with those of other human tissue, including mucosae from the small intestine and colon.

  2. Carcinoma of buccal mucosa: A site specific clinical audit.

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    Singhania, V; Jayade, B V; Anehosur, V; Gopalkrishnan, K; Kumar, N

    2015-01-01

    Carcinoma of buccal mucosa is the most common cancer of the oral cavity in India. Treatment of oral cancer poses unique reconstructive challenges, owing to the dynamic architecture of the oral cavity. Despite current progress in various treatment modalities, over the past 50 years survival rates have not improved drastically. Although, philosophy on treatment of buccal mucosa carcinoma remains well-established, due to the relative paucity of reported data, retrospective reviews of institutional experiences are of prime importance. This study provides a detailed insight on this site specific cancer of the oral cavity in the Indian population. The aim of this study is to analyze our experience with the management of carcinoma of buccal mucosa; associated clinical presentation, outcomes and prognostic factors. A retrospective chart review was performed of all cases of primary buccal mucosa carcinoma treated surgically between years 2008 and 2012 in SDM Craniofacial Unit, Karnataka, India. All cases were analyzed based on patient characteristics, clinical presentation, surgical and adjuvant therapy rendered and treatment outcomes. A retrospective chart review was carried out using the hospital's data base for the same. Kaplan-Meier methods were used for analyzing disease free survival (DFS). Univariate analysis of prognostic factors was performed with log rank test. The significant variables in univariate analysis were: Overall stage, T-stage (T1/T2 vs. T3/T4) and nodal status (N0 vs. N+). We found that staging, tumor size and nodal status were significant prognostic factors for DFS. The strong influence of overall disease stage, tumor size, nodal status, final histopathological report and habits of tobacco/betel quid chewing, on prognosis; emphasizes the importance of early diagnosis and prevention of carcinoma of buccal mucosa in the Indian population.

  3. Nicotine permeability across the buccal TR146 cell culture model and porcine buccal mucosa in vitro

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, Margrethe Rømer

    2002-01-01

    comparable for bi-directional and uni-directional transport in the presence of a transmembrane pH gradient. Nicotine concentrations between 10(-5) and 10(-2) M were applied to the apical side of the TR146 cell culture model or the mucosal side of porcine buccal mucosa. Buffers with pH values of 5.5, 7...

  4. An adult juvenile xanthogranuloma in the buccal mucosa

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    Ching-Yi Chen

    2015-09-01

    Full Text Available Juvenile xanthogranulomas (JXGs are a type of non-Langerhans cell histiocytosis that commonly affects infants and children. Adult oral JXGs are very rare. A 32-year-old Taiwanese male presented with the chief complaint of a solitary, firm, painless, non-tender swelling over the right buccal mucosa for about 2 weeks. An excisional biopsy of the lesion revealed a mixture of histiocytes, inflammatory cells, and Touton giant cells, and immunohistochemical positivity for CD68 and negativity for S-100 and CD1a confirmed the diagnosis of a JXG. Therefore, the current case report documents, to our knowledge, the first occurrence of an adult oral JXG in the buccal mucosa. It is also the first case of an adult oral JXG to be reported from Taiwan. The clinical characteristics of adult oral JXGs are also briefly reviewed.

  5. Buccal mucosa urethroplasty in a reoperative and reconstructive challenge hypospadias: A case report

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    Hayrettin Ozturk

    2014-01-01

    Full Text Available Buccal mucosa graft is usually used in a second operation. A buccal mucosa graft from the lower lip was used for large fistula reconstruction in one patients. The patient previously had been operated on several times at another center. The use of the buccal mucosa graft for urethral reconstruction in complex urethroplasties is a successful method with a low incidence of complications.

  6. One-stage and two-stage penile buccal mucosa urethroplasty ...

    African Journals Online (AJOL)

    The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa ...

  7. Myoepithelial carcinoma of buccal mucosa: A rare tumor

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    Jeevan Lata

    2014-01-01

    Full Text Available Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for < 1% of all salivary gland tumors. The most common sites of involvement are major salivary glands mainly parotid gland. Intraorally, it can arise from minor salivary glands; palate is the most common site of occurrence. It also occurs in nasopharynx, paranasal sinuses, nasal cavity and larynx in head and neck region. Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  8. One-stage and two-stage penile buccal mucosa urethroplasty

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    G. Barbagli

    2016-03-01

    Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

  9. Raman mapping of oral buccal mucosa: a spectral histopathology approach

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    Behl, Isha; Kukreja, Lekha; Deshmukh, Atul; Singh, S. P.; Mamgain, Hitesh; Hole, Arti R.; Krishna, C. Murali

    2014-12-01

    Oral cancer is one of the most common cancers worldwide. One-fifth of the world's oral cancer subjects are from India and other South Asian countries. The present Raman mapping study was carried out to understand biochemical variations in normal and malignant oral buccal mucosa. Data were acquired using WITec alpha 300R instrument from 10 normal and 10 tumors unstained tissue sections. Raman maps of normal sections could resolve the layers of epithelium, i.e. basal, intermediate, and superficial. Inflammatory, tumor, and stromal regions are distinctly depicted on Raman maps of tumor sections. Mean and difference spectra of basal and inflammatory cells suggest abundance of DNA and carotenoids features. Strong cytochrome bands are observed in intermediate layers of normal and stromal regions of tumor. Epithelium and stromal regions of normal cells are classified by principal component analysis. Classification among cellular components of normal and tumor sections is also observed. Thus, the findings of the study further support the applicability of Raman mapping for providing molecular level insights in normal and malignant conditions.

  10. Filariasis of the buccal mucosa: A diagnostic dilemma

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    Seema Kurup

    2013-01-01

    Full Text Available Filariasis is an endemic disease in tropical and subtropical countries. Filarial nematodes can infect humans through vectors, commonly mosquitoes. Human infection can manifest as lymphatic filariasis, subcutaneous or pulmonary nodules and with eye involvement. Intra-oral presentation is very rare and often poses a diagnostic dilemma to the dentist. We report a case of intra-oral Dirofilaria repens infection in a 54-year-old female patient, involving the buccal mucosa. History was unremarkable and on clinical examination, a diffuse swelling with no significant signs and symptoms was seen. Laboratory investigations and radiographs were non-contributory to diagnosis. Ultrasound findings revealed a hypo-echoic lesion in the muscular layer of the left cheek. Differential diagnoses considered were minor salivary gland tumor, parotid sialolith, and cysticercosis among others. The presence of a Dirofilaria worm in the excised nodule confirmed the diagnosis. Medical awareness of the risk of intra-oral nematode infection is essential. A detailed travel history, awareness of endemic status of certain diseases, proper diagnosis and management helps in better prognosis for the patient.

  11. Enhanced delivery of ketobemidone through porcine buccal mucosa in vitro via more lipophilic ester prodrugs

    DEFF Research Database (Denmark)

    Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.

    1992-01-01

    The in vitro penetration of ketobemidone and various ester prodrugs through porcine buccal mucosa in a modified Ussing chamber was investigated in order to support the selection of a prodrug derivative with optimal buccal absorption. The nine esters studied included carboxylic acid and carbonate...... a plateau or a slight decrease occurred. No toxic effects of ketobemidone or the prodrugs on the buccal membrane were observed as judged from monitoring of the electrical properties of the membrane....

  12. Fibrolipoma of the Buccal Mucosa: A Case Report and Review of the Literature

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    Masayasu Iwase

    2016-01-01

    Full Text Available Lipomas are common benign soft tissue neoplasms derived from mature adipose tissue. However, they rarely arise in the oral cavity. Fibrolipoma is a histological variant of lipoma that mainly affects the buccal mucosa and causes functional and cosmetic issues. This article describes the case of a 71-year-old male with a fibrolipoma of the left buccal mucosa and a review of previous articles about fibrolipoma.

  13. PREPARATION AND IN VITRO ASSESSMENT OF VARIOUS MUCOSA-ADHESIVE FILMS FOR BUCCAL DELIVERY

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    SEYED-AL1REZA MORTAZAVI REZA ABOOFAZELI

    2000-07-01

    Full Text Available The aim of this study was to examine various polymers considered to have mucosa-adhesive properties for the preparation of buccal-adhesive films and their in vitro evaluation. A number of materials, such as cellulose derivatives, carbopols and natural polymers, were employed for the preparation of buccal-adhesive films. Aqueous solutions containing the mucosa-adhesive polymer and a plasticizer were prepared and used to prepare films by the "solvent cast" method. Prepared films were then evaluated in terms of their physical appearance and film forming ability, in vitro mucosa-adhesive strength and duration of mucosa-adhesion. Results showed that among the various materials examined, sodium carboxymethyl cellulose (CMC formed very flexible films with the greatest mucosa-adhesive strength. Further studies showed that the combination of carbopols and CMC, along with glycerin as the plasticizer, resulted in the formation of films with desirable appearance and a relatively stronger mucosa-adhesive strength than films containing CMC alone. In vitro studies showed that films containing carbopol 934P, CMC and glycerin gave the greatest mucosa-adhesive strength and longer mucosa-adhesion. In conclusion, this formulation is proposed as a good base for the preparation of buccal-adhesive films and patches. Furthermore, it is suggested that in the development of buccal-adhesive drug delivery systems, and in particular films and patches, duration of mucosa-adhesion determined by in vitro experiments is a critical factor in the selection of the ultimate formulation.

  14. Adenoid cystic carcinoma of the buccal mucosa: A case report and review of the literature

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    Vidya Ajila

    2012-01-01

    Full Text Available Adenoid cystic carcinomas are deceptive malignancies that show slow growth and local invasion with recurrences seen many years after diagnosis. Upto 50% of these tumors occur in the intraoral minor salivary glands usually in the hard palate. Buccal mucosal tumors are relatively rare. We determined the incidence of buccal mucosal adenoid cystic carcinoma by reviewing the number of reported cases in the literature. This is the first article to analyze the occurrence of adenoid cystic carcinomas in the buccal mucosa through a review of 41 articles. Our review revealed 178 buccal mucosal adenoid cystic carcinomas among a total of 2,280 reported cases. We present a case of adenoid cystic carcinoma occurring in the left buccal mucosa of a 45-year-old female.

  15. Lateral Oropharyngeal Wall Coverage with Buccinator Myomucosal and Buccal Fat Pad Flaps

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    Bok Ki Jung

    2015-07-01

    Full Text Available BackgroundReconstruction of oropharyngeal defects after resection of oropharyngeal cancer is a significant challenge. The purpose of this study is to introduce reconstruction using a combination of a buccinator myomucosal flap and a buccal fat pad flap after cancer excision and to discuss the associated anatomy, surgical procedure, and clinical applications.MethodsIn our study, a combination of a buccinator myomucosal flap with a buccal fat pad flap was utilized for reconstruction after resection of oropharyngeal cancer, performed between 2013 and 2015. After oropharyngectomy, the defect with exposed vital structures was noted. A buccinator myomucosal flap was designed and elevated after an assessment of the flap pedicle. Without requiring an additional procedure, a buccal fat pad flap was easily harvested in the same field and gently pulled to obtain sufficient volume. The flaps were rotated and covered the defect. In addition, using cadaver dissections, we investigated the feasibility of transposing the flaps into the lateral oropharyngeal defect.ResultsThe reconstruction was performed in patients with squamous cell carcinoma. The largest tumor size was 5 cm×2 cm (length×width. All donor sites were closed primarily. The flaps were completely epithelialized after four weeks, and the patients were followed up for at least six months. There were no flap failures or postoperative wound complications. All patients were without dietary restrictions, and no patient had problems related to mouth opening, swallowing, or speech.ConclusionsA buccinator myomucosal flap with a buccal fat pad flap is a reliable and valuable option in the reconstruction of oropharyngeal defects after cancer resection for maintaining functionality.

  16. Effect of cryoprotectants for maintaining drug permeability barriers in porcine buccal mucosa

    DEFF Research Database (Denmark)

    Marxen, Eva; Axelsen, Mary Carlos; Pedersen, Anne Marie Lynge

    2016-01-01

    if permeability barriers for small molecules (nicotine and diazepam) were maintained after freezing porcine buccal mucosa with cryoprotectants to -80°C. Combinations of dimethyl sulfoxide, bovine serum albumin, glycerol and sucrose were used as cryoprotectants. The permeability of nicotine and diazepam across...... tissue. Freezing with or without cryoprotectants did not significantly affect the flux of diazepam compared to fresh tissue. Only minor histological changes were seen in frozen/thawed porcine buccal mucosa compared to fresh tissue. In conclusion, permeability barriers for nicotine and diazepam were...

  17. Hypoxic regulation of plasminogen activator inhibitor-1 expression in human buccal mucosa fibroblasts stimulated with arecoline.

    Science.gov (United States)

    Tsai, Chung-Hung; Lee, Shiuan-Shinn; Chang, Yu-Chao

    2015-10-01

    Oral submucous fibrosis (OSF) is regarded as a pre-cancerous condition with fibrosis in oral subepithelial connective tissue. Hypoxia-inducible factor (HIF)-1α regulates a wide variety of profibrogenic genes, which are closely associated with tissue fibrosis. The aim of this study was to compare HIF-1α expression in normal buccal mucosa tissues and OSF specimens and further explore the potential mechanisms that may lead to the induction of HIF-1α expression. Twenty-five OSF specimens and six normal buccal mucosa were examined by immunohistochemistry. The expression of HIF-1α from fibroblasts cultured from OSF and normal buccal mucosa was measured by Western blot. Arecoline, a major areca nut alkaloid, was challenged to normal buccal mucosa fibroblasts (BMFs) to elucidate whether HIF-1α expression could affect by arecoline. In addition, the effects of arecoline on plasminogen activator inhibitor (PAI)-1 expression were evaluated in environmental hypoxia. HIF-1α expression was significantly higher in OSF specimens and expressed mainly by fibroblasts, epithelial cells, and inflammatory cells. Fibroblasts derived from OSF were found to exhibit higher HIF-1α protein expression than BMFs (P oral submucosa leading to fibrosis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits

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    Geovanne F. Souza

    2008-06-01

    Full Text Available PURPOSE: Buccal mucosa is a widely accepted tissue for urethroplasty. The exact healing and tissue integration process, mainly the histological characteristics of dorsal buccal mucosa graft urethroplasty when used dorsally to reconstruct the urethral plate has not previously been assessed, and thus we developed an experimental model to address this question. MATERIALS AND METHODS: In 12 New Zealand rabbits (weight 2.5 kg we surgically created a dorsal penile urethral defect. A buccal mucosa graft was sutured to the corpora and tunica albuginea, and the ventral urethra anastomosed to this new urethral plate. The animals were divided in three groups and sacrificed 1, 3 and 6 weeks after surgery (groups 1, 2 and 3. A retrograde urethrogram was obtained at autopsy in the last group and the penis analyzed histologically with hematoxylin-eosin and Masson's staining. RESULTS: The urethrograms showed no evidence of fistula or stricture. In group 1 the histopathological analysis showed submucosal lymph-mononuclear inflammatory edema, numerous eosinophils and squamous epithelium integrated into the adjacent urothelium. In group 2 there was no evidence of an inflammatory response but rather complete subepithelial hyaline healing, which was more marked in group 3. CONCLUSION: Healing of buccal mucosa grafts to reconstruct the urethral plate can be achieved by total integration of the squamous epithelium with the urothelium, maintaining the original histological properties of the graft with no fibrosis or retraction.

  19. Ex Vivo Correlation of the Permeability of Metoprolol Across Human and Porcine Buccal Mucosa

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Marxen, Eva; Pedersen, Anne Marie Lynge

    2014-01-01

    The pH partition theory proposes a correlation between fraction of unionized drug substance and permeability. The aim of this study was to compare the permeability of metoprolol and mannitol in ex vivo human and porcine buccal mucosa models at varying pH to validate whether the porcine permeability...... model is predictive for human buccal absorption. Human (n = 9-10) and porcine (n = 6-7) buccal mucosa were mounted in a modified Ussing chamber, and the kinetics of metoprolol and mannitol transport was assessed for a period of 5.5 h with the pH values of donor medium set at 7.4, 8.5, and 9...

  20. A Foreign Body Granuloma of the Buccal Mucosa Induced by Honeybee Sting

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    Kazuhiko Yamamoto

    2017-01-01

    Full Text Available A foreign body granuloma of the buccal mucosa induced by honeybee sting was reported. The patient was an 82-year-old female who presented with a submucous mass at the right buccal mucosa. The mass was 20 mm in diameter, elastically firm, partly mobile without pain or tenderness, and covered with almost normal mucosa. MR image did not delineate the lesion clearly. Under clinical diagnosis of a benign tumor, the lesion was excised under local anesthesia. The excised lesion was 14×11×9 mm in size and solid and yellowish in cut surface. Histologically, the lesion consisted of granulomatous tissue with a few narrow, curved, eosinophilic structures compatible with decomposed fragments of a honeybee sting and was diagnosed as a foreign body granuloma, although the patient did not recall being stung.

  1. Adenomatoid hyperplasia of the minor salivary glands on the buccal mucosa: A rare case report.

    Science.gov (United States)

    Dereci, Omür; Cimen, Emre

    2014-01-01

    Adenomatoid hyperplasia of the minor salivary glands is a hyperplastic oral lesion which may be seen on minor salivary gland bearing areas on all oral mucosa, especially on soft and hard palate. This study reports a rare case of buccal adenomatoid hyperplasia of the minor salivary glands and discusses the clinical significance. 48 year old male patient presented with a complaint of a swelling on his left cheek. Clinical examination revealed a bluish mass on the buccal mucosa. A provisional diagnosis of salivary gland neoplasm was made and the lesion was excised under local anesthesia. The histological diagnosis was adenomatoid hyperplasia of the minor salivary glands. Buccal localization of the adenomatoid hyperplasia of the minor salivary glands is quite uncommon in the literature. There are two cases in the English literature for our knowledge. In the clinical examination, the nodular and protuberated appearance of the lesion resembles buccal minor salivary gland tumors and vascular lesions. Histological analysis is fundamental to achieve correct diagnosis. The differential diagnosis of buccal nodular, exophytic and colored mucosal lesions should include adenomatoid hyperplasia of the minor salivary glands. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Aloin delivery on buccal mucosa: ex vivo studies and design of a new locoregional dosing system.

    Science.gov (United States)

    De Caro, Viviana; Scaturro, Anna Lisa; Di Prima, Giulia; Avellone, Giuseppe; Sutera, Flavia Maria; Di Fede, Olga; Campisi, Giuseppina; Giannola, Libero Italo

    2015-01-01

    Chemoprevention of potential malignant disorders or cancerous lesions that affect oral mucosae requires extended duration of treatment. Locoregional delivery of natural products could represent a promising strategy for this purpose. To investigate the aptitude of aloin to permeate through, or accumulate in, the buccal mucosa and to develop a new prolonged oro-mucosal drug delivery system. Permeation/accumulation of aloin from Curacao Aloe (containing 50% barbaloin) was evaluated ex vivo, using porcine buccal mucosa as the most useful model to simulate human epithelium. Oro-mucosal matrix tablets were prepared by dispersing aloin (10% w/w) in Eudragit® RS 100 as, biocompatible, low permeable, pH-independent, and non-swelling polymer. The prepared tablets were evaluated for drug-polymer compatibility, weight variation, drug uniformity content, diameter, thickness, hardness, friability, swelling, mucoadhesive strength, and drug release. Aloin has low tendency to cross buccal mucosa, permeation is marginal, and high drug amounts remain entrapped into the epithelium. Matrix tablets characteristics were in agreement with pharmacopoeial requirements. Drug release showed highly reproducible Higuchian profile. Delivery through matrix tablets promoted drug accumulation in the mucosal tissue. Following application of matrix tablets on porcine buccal mucosa, the amount of discharged drug recovered in the tissue should be sufficient to produce the desired effects, providing therapeutic drug levels directly at the site of action. Aloin-loaded tablets are valid candidates for prevention/treatment of potentially malignant disorders and oral cancer and could potentially lead to clinically relevant drug delivery system as coadjuvant of conventional chemotherapy/radiation therapy.

  3. The cytological status of the nasal mucosa and the buccal epithelium in coal miners

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    L.T. Bazeliuk; B.M. Salimbaeva

    2006-11-15

    Sixty-four persons were examined. The examination was undertaken to study the cytomophological parameters of the cells of the nasal mucosa and the buccal epithelium in coal miners. Group 1 consisted of 18 donors without contact with industrial dust; Group 2 comprised 24 apparently healthy miners; Group 3 included 22 workers (drift miners) with Stage 1 anthracosilicosis, grade 1 respiratory failure. The patients with Stage 1 anthracosilicosis had noticeably worse morphofunctional characteristics of the epithelium that displayed extensive fields with pronounced structural changes, such as destruction and desquamation of the integumentary epithelium of the nasal mucosa. Nasal mucosal atrophic changes were observed in 50% of the examined miners. Examination of the buccal epithelium in apparently healthy miners (code 0) and in workers with Stage I anthracosilicosis revealed the increased proportion of microfloral (Streptococcus) contamination by 79% and 3.7 times, respectively.

  4. Verruciform xanthoma of buccal mucosa: A case report with review of literature

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    Sudhir Bhalerao

    2012-01-01

    Full Text Available Verruciformxanthoma (VX is an uncommon benign mucocutaneous lesion of unknown etiology. It appears as a papule or single plaque with verrucous or papillomatous surface and variable color from reddish pink to gray. It occurs primarily in the masticatory mucosa. Histologically, VX is characterized by the presence of parakeratinized epithelium with thin rete ridges and connective tissue papillae extending up to the surface. The papillae characteristically consist of foam cells, also called xanthoma cells. We report a case of VX in the buccal mucosa and discuss their clinical and histopathological findings.

  5. The role of tobacco as an etiological agent for oral cancer: Cytomorphometrical analysis of the buccal mucosa in tobacco users

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    Megha Singh

    2014-01-01

    Conclusion: The results confirmed that tobacco chewing and smoking influenced the cytomorphology of normal appearing buccal mucosa and the degree of these changes were found to be greater in chewers as compared to smokers.

  6. Buccal mucosa carcinoma: surgical margin less than 3 mm, not 5 mm, predicts locoregional recurrence

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    Chiou Wen-Yen

    2010-09-01

    Full Text Available Abstract Background Most treatment failure of buccal mucosal cancer post surgery is locoregional recurrence. We tried to figure out how close the surgical margin being unsafe and needed further adjuvant treatment. Methods Between August 2000 and June 2008, a total of 110 patients with buccal mucosa carcinoma (25 with stage I, 31 with stage II, 11 with stage III, and 43 with Stage IV classified according to the American Joint Committee on Cancer 6th edition were treated with surgery alone (n = 32, surgery plus postoperative radiotherapy (n = 38 or surgery plus adjuvant concurrent chemoradiotherapy (n = 40. Main outcome measures: The primary endpoint was locoregional disease control. Results The median follow-up time at analysis was 25 months (range, 4-104 months. The 3-year locoregional control rates were significantly different when a 3-mm surgical margin (≤3 versus >3 mm, 71% versus 95%, p = 0.04 but not a 5-mm margin (75% versus 92%, p = 0.22 was used as the cut-off level. We also found a quantitative correlation between surgical margin and locoregional failure (hazard ratio, 2.16; 95% confidence interval, 1.14 - 4.11; p = 0.019. Multivariate analysis identified pN classification and surgical margin as independent factors affecting disease-free survival and locoregional control. Conclusions Narrow surgical margin ≤3 mm, but not 5 mm, is associated with high risk for locoregional recurrence of buccal mucosa carcinoma. More aggressive treatment after surgery is suggested.

  7. Early postoperative healing following buccal single flap approach to access intraosseous periodontal defects.

    Science.gov (United States)

    Farina, Roberto; Simonelli, Anna; Rizzi, Alessandro; Pramstraller, Mattia; Cucchi, Alessandro; Trombelli, Leonardo

    2013-07-01

    This study aims to evaluate the early postoperative healing of papillary incision wounds and its association with (1) patient/site-related factors and technical (surgical) aspects as well as with (2) 6-month clinical outcomes following buccal single flap approach (SFA) in the treatment of intraosseous periodontal defects. Forty-three intraosseous defects in 35 patients were accessed with a buccal SFA alone or in combination with a reconstructive technology (graft, enamel matrix derivative (EMD), graft + EMD, or graft + membrane). Postoperative healing was evaluated at 2 weeks using the Early Wound-Healing Index (EHI). EHI ranged from score 1 (i.e., complete flap closure and optimal healing) to score 4 (i.e., loss of primary closure and partial tissue necrosis). SFA resulted in a complete wound closure at 2 weeks in the great majority of sites. A significantly more frequent presence of interdental contact point and interdental soft tissue crater, and narrower base of the interdental papilla were observed at sites with either EHI > 1 or EHI = 4 compared to sites with EHI = 1. No association between EHI and the 6-month clinical outcomes was observed. At 2 weeks, buccal SFA may result in highly predictable complete flap closure. Site-specific characteristics may influence the early postoperative healing of the papillary incision following SFA procedure. Two-week soft tissue healing, however, was not associated with the 6-month clinical outcomes.

  8. Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy.

    Science.gov (United States)

    Ahyai, Sascha A; Schmid, Marianne; Kuhl, Marie; Kluth, Luis A; Soave, Armin; Riechardt, Silke; Chun, Felix K-H; Engel, Oliver; Fisch, Margit; Dahlem, Roland

    2015-08-01

    We evaluated stricture-free survival and functional outcomes of buccal mucosa graft urethroplasty in patients with urethral stricture disease after radiotherapy. We reviewed our urethroplasty database for patients with a radiotherapy history who underwent buccal mucosa graft urethroplasty between January 2009 and October 2013. We reviewed patient charts and the institutional, standardized, nonvalidated questionnaires administered to each patient postoperatively. Study end points included 1) the success rate, 2) continence status, 3) erectile function and 4) patient satisfaction postoperatively. Success was defined as stricture-free survival. Of 38 men included in the study prostate cancer was the most common indication for radiotherapy in 35 (92.1%). External beam radiotherapy was performed in 24 cases (64.9%), brachytherapy was done in 8 (21.6%) and a combination of the 2 treatments was performed in 6 (13.5%). Strictures were in the bulbar/bulbomembranous urethra and had a median length of 3.0 cm (range 1.0 to 8.0). The overall success rate was 71.1% at a median followup of 26.5 months (range 1.0 to 50.0). Median time to stricture recurrence was 17.0 months (range 3.0 to 44.0). De novo urinary incontinence was observed in 4 patients (10.5%). Erectile function remained mostly unchanged compared to preoperative status. Study limitations include the small sample size and the lack of validated questionnaires. At short-term to mid-term followup the success rate of ventral onlay buccal mucosa graft urethroplasty in patients with radiotherapy history seems acceptable. However, patients must be counseled about the increased risk of urinary incontinence. Longer followup is warranted to address long-term outcomes. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Carcinoma Buccal Mucosa Underlying a Giant Cutaneous Horn: A Case Report and Review of the Literature

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    Sunil Kumar

    2014-01-01

    Full Text Available Cutaneous horn is a conical, dense, and hyperkeratotic protrusion that often appears similar to the horn of an animal. Giant cutaneous horns are rare; no incidence or prevalence has been reported. The significance of cutaneous horns is that they occur in association with, or as a response to, a wide variety of underlying benign, premalignant, and malignant cutaneous diseases. A case of giant cutaneous horn of left oral commissure along with carcinoma left buccal mucosa is reported here as an extremely rare oral/perioral pathology.

  10. Spindle Cell Lipoma Occurring in the Buccal Mucosa: An Unusual Location of This Benign Lipomatous Neoplasm

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    Noala Vicensoto Moreira Milhan

    2015-01-01

    Full Text Available Spindle cell lipoma is a benign lipomatous neoplasm, which rarely occurs in the oral cavity. The aims of this paper are to report a case of spindle cell lipoma located in buccal mucosa and discuss the main clinical, histological, and immunohistochemical findings of this entity. Thus, we report a 4-year history of an asymptomatic smooth surface nodule in an elderly Caucasian man with clinical hypothesis of fibroma. The histopathological examination showed spindle cells, mature adipose tissue, and many mast cells in a stroma of connective tissue presenting ropey collagen fibers bundles. After immunohistochemical analysis, the final diagnosis was spindle cell lipoma.

  11. Single-flap approach with buccal access in periodontal reconstructive procedures.

    Science.gov (United States)

    Trombelli, Leonardo; Farina, Roberto; Franceschetti, Giovanni; Calura, Giorgio

    2009-02-01

    New surgical techniques have been developed to optimize primary closure as well as to minimize the surgical trauma in the reconstructive procedures of periodontal intraosseous defects. Recently, we proposed a minimally invasive procedure, the single-flap approach (SFA), specifically indicated when the defect extension is prevalent on the buccal or oral side. The basic principle of the SFA is the elevation of a flap to access the defect only on one side (buccal or oral), leaving the opposite side intact. The present case series reports preliminary data on the clinical effectiveness of SFA with buccal access in conjunction with a collagen membrane and a hydroxyapatite (HA)-based biomaterial in the reconstructive treatment of deep periodontal intraosseous defects. Ten intraosseous defects in 10 patients were accessed with a buccal SFA and treated with a collagen membrane and an HA-based graft biomaterial. The follow-up period following the regenerative procedure ranged from 6 to 14 months (mean: 10.0 +/- 3.0 months). Clinical attachment level (CAL) decreased from 11.2 +/- 2.6 mm presurgery to 6.4 +/- 1.9 mm post-surgery. Probing depth was 9.0 +/- 2.8 mm before surgery and 3.8 +/- 1.5 mm post-surgery. Gingival recession increased from 2.2 +/- 1.9 mm presurgery to 2.6 +/- 1.3 mm post-surgery. Challenging intraosseous defects, surgically accessed with a buccal SFA and treated with a combined graft/guided tissue regeneration technique, may heal with a substantial CAL gain. Limited postsurgical recession indicates that SFA may represent a suitable option to surgically treat defects in areas with high esthetic demands.

  12. A case report on buccal mucosa graft for upper ureteral stricture repair

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    Vilas Pandurang Sabale

    2016-01-01

    Full Text Available Management of ureteric stricture especially long length upper one-third poses a challenging job for most urologists. With the successful use of buccal mucosa graft (BMG for stricture urethra leads the foundation for its use in ureteric stricture also. A 35-year-old male diagnosedcase of left upper ureteric stricture, postureteroscopy with left percutaneous nephrostomy (PCN in situ. Cysto-retrograde pyelography and nephrostogram done simultaneously suggestive of left upper ureteric stricture of 3 cm at L3 level. On exploration, diseased ureteral segment exposed, BMG harvested and sutured as onlay patch graft with supportive omental wrap. The treatment choice for upper ureteric long length stricture is inferior nephropexy, autotransplantation, or bowel interposition. With PCN in situ, inferior nephropexy becomes technically difficult, other two are morbid procedures. Use of BMG in this situation is technically better choice with all the advantages of buccal mucosa. Onlay BMG for ureteral stricture is technically easy, less morbid procedure and can be important choice in future.

  13. [Anterolateral thigh flap for reconstruction of defects after en bloc resection of buccal cancer : a retrospective study of 23 cases].

    Science.gov (United States)

    Deng, Zhi-Yuan; Fang, Xiao-Dan; Pan, Hao; Hu, Yan-Jia; Tang, Zhan-Gui

    2017-04-01

    This study was aimed to observe the effects of anterolateral thigh flap for reconstruction of tissue defects after en bloc resection of buccal cancer. Twenty-three patients with soft tissue defects after en bloc resection of buccal cancer underwent simultaneous reconstruction with anterolateral thigh flap from May, 2013 to May, 2015 were observed. Anterolateral thigh flaps were designed and harvested in form of single or multiple islands to restore the defect in buccal region after surgery. The appearance and function of both the oral and maxillofacial region and the donor site were recorded and evaluated. All the 23 flaps survived. Only 3 of them experienced vascular crisis within 24 hours after surgery, and recovered gradually after salvage. The success rate was 100%. One to three years of follow-up showed satisfying morphology and function for both the receipt sites and the donor sites. Buccal abscess was observed in 1 patient and recovered after rinsing and drainage. Two patients died of recurrence. Good effects can be achieved using anterolateral thigh flap to reconstruct buccal defects after en bloc resection of cancer, which is suitable for application in clinical practice.

  14. Adenoid Cystic Carcinoma of the Buccal Mucosa with Rare Delayed Frontal Bone Metastasis: A Case Report

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    Zohreh Dalirsani

    2016-10-01

    Full Text Available Adenoid cystic carcinoma (AdCC is a malignant neoplasm, which accounts for 5-10% of all salivary gland tumors (1. About 50% of these tumors originate from intraoral minor salivary glands usually in the hard palate (1. Three clinically obvious characteristics of AdCC include slow growth rate, perineural invasion and high incidence of distant metastasis (1. The most commonly-affected sites of distant metastasis are bone, liver and brain, followed by lungs (2. Lymph node metastases are rare;  The most common sites  involved by hematogenous spread are lungs (2.  This is a report about a patient with a rare form of AdCC on buccal mucosa with an unusual metastasis to the frontal region after a two-year follow up.

  15. Internal urethrotomy in patients with recurrent urethral stricture after buccal mucosa graft urethroplasty.

    Science.gov (United States)

    Rosenbaum, Clemens M; Schmid, Marianne; Ludwig, Tim A; Kluth, Luis A; Reiss, Philip; Dahlem, Roland; Engel, Oliver; Chun, Felix K-H; Riechardt, Silke; Fisch, Margit; Ahyai, Sascha A

    2015-09-01

    To determine the success rate of direct vision internal urethrotomy (DVIU) in the treatment of short stricture recurrence after buccal mucosa graft urethroplasty (BMGU). Patients who underwent DVIU for the treatment of short, "veil-like" recurrent urethral strictures (<1 cm) after BMGU between October 2009 and 2013 were retrospectively identified within our urethroplasty database. Stricture recurrence was defined as maximum flow rate (Q max) <15 ml/s and a consecutively verified stricture in a combined retro- and antegrade voiding cystography or cystoscopy at a follow-up visit. The success rate of DVIU was assessed by Kaplan-Meier analysis. Univariable Cox regression analyses evaluated risk factors for stricture recurrence following DVIU. Forty-three patients underwent DVIU for short stricture recurrence after BMGU for bulbar (81.3 %), penile (14.0 %) and membranous (4.7 %) strictures. Relapse had occurred proximally to the buccal mucosa graft in 28 (65.1 %) and distally in 12 (27.9 %) patients, respectively. At a mean follow-up of 11.7 (±9.7) months, stricture recurrence was observed in 48.8 % of our patients. Stricture recurrence was significantly associated with weak urinary stream (9.3 ml/s vs. no recurrence 19.5 ml/s) and patient dissatisfaction (66.7 % vs. no recurrence 18.1 %; both p < 0.001). The overall success rate was 60.5 % 15 months after DVIU. The main limitations of this study are its retrospective design, the small sample size and the short follow-up. DVIU after BMGU showed a moderate success rate and therefore might be a viable treatment option in selected patients with very short strictures after BMGU. However, longer follow-up is warranted to prove long-term effectiveness.

  16. Buccal Mucosa Carcinoma: A Comparative Relative Risk Analysis between Tobacco and Non Tobacco Users.

    Science.gov (United States)

    Padma, Ramasamy; Kalaivani, Amitkumar; Paulraj, Sathish; Sundaresan, Sivapatham

    2017-06-01

    In South India, buccal mucosa carcinoma is common cancer due to widespread use of tobacco in different form. Recently, areca nut (non tobacco) chewing habits have increased among young adults resulting in high morbidity and mortality. Thus, there is need to understand role of aetiology and risk of disease. To analyse relative risk of tobacco users and non tobacco users in buccal mucosa carcinoma. This prospective comparative study was conducted in Regional Cancer Centre, Kanchipuram, between 2013 and 2016. The subjects were divided as tobacco users and non tobacco users in order to evaluate the Relative Risk (RR) in these groups based on demographic and clinical characteristics by Chi-square analysis and Kaplan-Meier (log-rank test) applied for survival difference. All statistics considered at 95 % CI, pusers and 30 (25.7%) non tobacco users. In the study, demographic characteristics of gender [RR=0.365 (0.150-0.886), p=0.023] and age groups {RR=2.026 (0.905-4.996), p=0.04} showed significant difference in both study groups. Similarly, clinical characteristics of TNM (tumour node and metastasis) stage {RR=1.57 (0.338-3.31), p=0.024}, nodal status {RR=2.014 (0.412-4.454), p=0.017}, Grade of tumour {RR=1.293 (0.581-2.878), p=0.015}, perineural invasion {RR=2.601 (0.806-5.32), p=0.012} and extracapsular invasion {RR=1.627 (0.533-2.824), p=0.045} showed significant association. The estimated overall survival was 50%; tobacco users (44%) showed lower survival than non tobacco users (57%) with significant difference (p=0.042, pusers than non tobacco users. Hence, the study concluded that the tobacco consumption in different form is more aggressive than non tobacco consumption.

  17. An electron microscopic study on the effects of irradiation on the buccal mucosa of rat

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    Choi, Syng Kyu; Lee, Sang Rae [Dept. of Oral Dental Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    1987-11-15

    The author studied the acute reaction of cobalt-60 irradiation to buccal mucosa in rats and difference of the effects of single versus fractionated exposure. 195 Sprague Dowley strain rats, weighing about 120 gm, were used in this experiment. 3 rats served as controls and the remaining 192 rats were divided into six groups of 32 rats each. Experiment group I, II, III were received a single does of 15 Gy, 16.5 Gy 18 Gy and group IV, V, VI were received two equal sized fractionated does of 9 Gy, 9.75 Gy, 10.5 Gy at 4 hour intervals, respectively. The experimental groups were irradiated with cobalt-60 teletherapy unit, Picker model 4M 60(Field size, 12 x 5 cm, SSD, 50 cm, Dose rate, 222 cGy/min, Depth, 1 cm). The animals were sacrificed at 1, 2, 3, 6, 12 hours, 1, 3, 7 days after irradiation and the changes of the irradiated buccal mucosa were observes by electron and light microscopy. The results were as follows: 1. A single exposure was more damaging than fractionated exposure, and as the radiation dose increased, the changes of cell organelles became faster, but the healing of radiation-induced damage in fractionated exposure was faster than in single exposure. 2. The radiation-induced changes of the basal cells were the most prominent in 18 Gy-single exposure group, and the least in 18 Gy-fractionated exposure group. 3. Electron-microscopically, there appeared nuclear changes, swelling of mitochondria and rough endoplasmic reticulum, decrease of free ribosome, presence of vesicles, widening of intercellular space, and loss of basal lamina. The early remarkable changes were partly loss of nuclear membrane and swelling of mitochondria. 4. Light-microscopically, derangement and pyknosis of basal cells, hydropic changes of spinous cells, enlargement of granular cells, indistinctness of basement membrane, and proliferation of epithelium were observed.

  18. Immunoperoxidase detection of polycyclic aromatic hydrocarbon-DNA adducts in mouth floor and buccal mucosa cells of smokers and nonsmokers

    NARCIS (Netherlands)

    Besaratinia, A.; Besarati Nia, A.; van Straaten, H. W.; Godschalk, R. W.; van Zandwijk, N.; Balm, A. J.; Kleinjans, J. C.; van Schooten, F. J.

    2000-01-01

    Tobacco smoking is a major risk factor for oral cancer; mouth floor and buccal mucosa are among the most and least cancer-prone subsites, respectively, in the oral cavity. We investigated the applicability of immunohistochemistry of smoking-induced DNA adducts in oral cells for assessing the

  19. Intra oral reconstruction with buccal fat pad: Recent applications of autologous tissue transplantation as a local flap

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    Khaleque Hasibul

    2016-12-01

    Full Text Available Intra oral reconstruction with buccal fat pad (BFP is an identical procedure during reconstructive head and neck surgery. It has a successful outcome in restoring both soft and hard tissues for more than 3 decades. The purpose of this study was to represent a series of cases and review of the recent diversified application of BFP in intra-oral region during reconstruction. The Authors are presenting 12 cases (Male – 8/66.7%; Female – 4/33.33%, mean age – 66.33 years of BFP reconstruction from small to medium sized defect in oral cavity. The diameter of the BFP graft was between 10 mm and 55 mm. Only one case was restored in mandible while others were in maxillary region. All patients were recovered within a short time. The yellow fat tissues were turned into reddish color within 1 week. Patient recovered with almost normal mucosa before 4th week. BFP reconstruction had considered as a quick and easy to restore flap during most intra-oral reconstruction. Rapid healing without any complications added additional advantage. High blood supply and easy access make it as a first consideration. We also evaluated the merits, demerits, distance between host and donor site, size of defect and site of reconstruction.

  20. Immunohistochemical analysis of blood vessels in peri-implant mucosa: a comparison between mini-incision flapless and flap surgeries in domestic pigs.

    Science.gov (United States)

    Lazić, Zoran; Golubović, Mileta; Marković, Aleksa; Šćepanović, Miodrag; Mišić, Tijana; Vlahović, Zoran

    2015-07-01

    The aim of this experimental study is to compare the effect of mini-incision flapless versus flap technique of implant placement on the amount of vascular structures and blood vessel elements in peri-implant soft tissue, using immunohistochemical analysis. The experiment was conducted on five domestic pigs. Each animal received six implants in mandible according to the split-mouth design. On one randomly chosen jaw side, mini-incision flapless surgery was performed, whereas on the opposite jaw side, flap was raised. After 3 months of implant healing through submerged approach, the experimental animals were sacrificed and samples for immunohistochemical analyses were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The study outcome was the presence of vascular structures and elements of the blood vessels in the peri-implant mucosa per microscopic field, estimated through ordinal scores from 0 to 2. Effects of surgical approach, site of implantation, and their interaction on vascular scores of peri-implant mucosa were assessed by Brunner and Langer nonparametric analysis of longitudinal data. Statistically significant effect of surgical approach on vascularity of peri-implant mucosa has been revealed in the second mucosal layer, where flapless approach provided higher vascularity compared with flap approach (P = 0.002). In the remaining two layers, surgical approach did not affect mucosal vascularity significantly (layer 1: P = 0.071; layer 3: P = 0.433). The flapless surgical implant placement approach using mini-incision provides better vascularization of peri-implant mucosa after 3 months of healing compared with flap surgery. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Giant Panda (Ailuropoda melanoleuca) Buccal Mucosa Tissue as a Source of Multipotent Progenitor Cells.

    Science.gov (United States)

    Prescott, Hilary M A; Manning, Craig; Gardner, Aaron; Ritchie, William A; Pizzi, Romain; Girling, Simon; Valentine, Iain; Wang, Chengdong; Jahoda, Colin A B

    2015-01-01

    Since the first mammal was cloned, the idea of using this technique to help endangered species has aroused considerable interest. However, several issues limit this possibility, including the relatively low success rate at every stage of the cloning process, and the dearth of usable tissues from these rare animals. iPS cells have been produced from cells from a number of rare mammalian species and this is the method of choice for strategies to improve cloning efficiency and create new gametes by directed differentiation. Nevertheless information about other stem cell/progenitor capabilities of cells from endangered species could prove important for future conservation approaches and adds to the knowledge base about cellular material that can be extremely limited. Multipotent progenitor cells, termed skin-derived precursor (SKP) cells, can be isolated directly from mammalian skin dermis, and human cheek tissue has also been shown to be a good source of SKP-like cells. Recently we showed that structures identical to SKPs termed m-SKPs could be obtained from monolayer/ two dimensional (2D) skin fibroblast cultures. Here we aimed to isolate m-SKPs from cultured cells of three endangered species; giant panda (Ailuropoda melanoleuca); red panda (Ailurus fulgens); and Asiatic lion (Panthera leo persica). m-SKP-like spheres were formed from the giant panda buccal mucosa fibroblasts; whereas dermal fibroblast (DF) cells cultured from abdominal skin of the other two species were unable to generate spheres. Under specific differentiation culture conditions giant panda spheres expressed neural, Schwann, adipogenic and osteogenic cell markers. Furthermore, these buccal mucosa derived spheres were shown to maintain expression of SKP markers: nestin, versican, fibronectin, and P75 and switch on expression of the stem cell marker ABCG2. These results demonstrate that giant panda cheek skin can be a useful source of m-SKP multipotent progenitors. At present lack of sample numbers

  2. Giant Panda (Ailuropoda melanoleuca Buccal Mucosa Tissue as a Source of Multipotent Progenitor Cells.

    Directory of Open Access Journals (Sweden)

    Hilary M A Prescott

    Full Text Available Since the first mammal was cloned, the idea of using this technique to help endangered species has aroused considerable interest. However, several issues limit this possibility, including the relatively low success rate at every stage of the cloning process, and the dearth of usable tissues from these rare animals. iPS cells have been produced from cells from a number of rare mammalian species and this is the method of choice for strategies to improve cloning efficiency and create new gametes by directed differentiation. Nevertheless information about other stem cell/progenitor capabilities of cells from endangered species could prove important for future conservation approaches and adds to the knowledge base about cellular material that can be extremely limited. Multipotent progenitor cells, termed skin-derived precursor (SKP cells, can be isolated directly from mammalian skin dermis, and human cheek tissue has also been shown to be a good source of SKP-like cells. Recently we showed that structures identical to SKPs termed m-SKPs could be obtained from monolayer/ two dimensional (2D skin fibroblast cultures. Here we aimed to isolate m-SKPs from cultured cells of three endangered species; giant panda (Ailuropoda melanoleuca; red panda (Ailurus fulgens; and Asiatic lion (Panthera leo persica. m-SKP-like spheres were formed from the giant panda buccal mucosa fibroblasts; whereas dermal fibroblast (DF cells cultured from abdominal skin of the other two species were unable to generate spheres. Under specific differentiation culture conditions giant panda spheres expressed neural, Schwann, adipogenic and osteogenic cell markers. Furthermore, these buccal mucosa derived spheres were shown to maintain expression of SKP markers: nestin, versican, fibronectin, and P75 and switch on expression of the stem cell marker ABCG2. These results demonstrate that giant panda cheek skin can be a useful source of m-SKP multipotent progenitors. At present lack of

  3. Comparison of lingual mucosa and buccal mucosa grafts used in inlay urethroplasty in failed hypospadias of pre-pubertal boys in a Chinese group.

    Directory of Open Access Journals (Sweden)

    Jin Hongyong

    Full Text Available The purpose of this study was to compare the outcomes of the buccal mucosa and lingual mucosa used in children who received multiple failed hypospadias surgeries.We conducted a retrospective study of 62 children who received buccal or lingual mucosa graft urethroplasty in our hospital between 2012 and 2015. The ages ranged from 3.5-11 y. All cases included multiple failed hypospadias procedures, and the subjects received previous operations 2-3 times. All patients underwent one-stage operations. Thirty-three cases were treated with lingual mucosa grafts. The patient ages ranged from 3.5 to 11 y (median 7.5 y, and they had previous operations 2-3 times (mean 2.8±0.7. Grafts ranged from lengths of 2-6 cm (mean 5.1±0.46 cm and widths of 0.5-1.5 cm (mean 1.2± 0.16 cm. Our follow-up was 5 to 12 m (mean 8.3±1.2 m. Twenty-nine cases were treated with buccal mucosa grafts. The patient ages ranged from 4 to 9.2 y (median 7.0 y, and they had previous operations 2-3 times (mean 2.5±0.2. Grafts ranged from lengths of 2-5.3 cm (mean 4.9± 0.28 cm and widths of 0.5-1.5 cm (mean 1.0±0.11 cm. Our follow-up was 5 to 12 m (mean 7.9±0.5 m. The results were tested with SPSS 18.0. The rates of complications were compared by a chi-square test, and pre-operative conditions were compared by t test.For the outcomes of the two groups, there was no significant difference between the groups in terms of age, preoperative surgery time, and the length and width of the grafts (p>0.05. For the lingual mucosa graft group, fistula: 2/33 (6.0%, stricture: 1/33(3.0%, ventral curvature: 2/33(6.0%, complications: 5/33(15.0%, success rate: 28/33(84.8%, Hose score: 14.34±0.95, peak flow: 6.5 ml/s-12.0 ml/s, and mean peak flow: 9.3±0.4 ml/s. For the buccal mucosa graft group, fistula: 2/29(6.8%, stricture: 2/29(6.8%, ventral curvature: 1/29 (3.4%, complication rate: 5/29(17.0%, success rate: 24/29 (83.0%, Hose score: 14.28±1.03, peak flow: 6.5 ml/s-12.0 ml/s, and mean peak

  4. Redo buccal mucosa graft urethroplasty: success rate, oral morbidity and functional outcomes.

    Science.gov (United States)

    Rosenbaum, Clemens M; Schmid, Marianne; Ludwig, Tim A; Kluth, Luis A; Dahlem, Roland; Fisch, Margit; Ahyai, Sascha

    2016-11-01

    To determine the success rate, oral morbidity and functional outcomes of redo buccal mucosa graft urethroplasty (BMGU) for treatment of stricture recurrence after previous BMGU. We included 50 patients who underwent redo BMGU between February 2009 and September 2014. Patients' charts and non-validated questionnaires were reviewed. The primary endpoint was success rate, defined as stricture-free survival. Stricture recurrence was defined as any postoperative claims of catheterization, dilatation, urethrotomy or repeat urethroplasty, or a maximum urinary flow rate <15 mL/s, and a stricture was consecutively verified in a combined cysto-urethrogram or cystoscopy at annual follow-up visit. The secondary endpoint was oral morbidity. Additional endpoints were erectile function, urinary continence and patients' satisfaction. Redo BMGU was performed for bulbar (71.4%) or penile (28.6%) recurrent strictures. The mean (median; range) follow-up was 25.6 (15.5; 3-70) months. Stricture recurrence occurred in 18.0% of patients within a mean (median; range) of 13.8 (9.0; 3-36) months. Stricture-free survival at 12, 24 and 36 months was 91.2, 86.2 and 80.8%, respectively. The majority of the patients (97.0%) reported no or only mildly changed salivation or problems in opening of the mouth. Severe or very severe oral numbness occurred in 13.5% of patients. Oral problems in daily life were a moderate or severe burden to 13.6 and 2.7% of the patients, respectively, while 75.0% of the patients reported improved quality of life compared with preoperative status. The success rate and oral morbidity of redo BMGU are almost the same as outcomes of primary BMGU. Oral numbness was the most frequently reported oral disorder. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  5. Pediatric Robot-assisted Redo Pyeloplasty With Buccal Mucosa Graft: A Novel Technique.

    Science.gov (United States)

    Ahn, Jennifer J; Shapiro, Michael E; Ellison, Jonathan S; Lendvay, Thomas S

    2017-03-01

    To report a novel approach of pediatric robot-assisted redo pyeloplasty with buccal mucosa graft (BMG). An Institutional Review Board-approved retrospective review of all patients undergoing robot-assisted redo pyeloplasty with BMG at our institution was performed. For all patients, the following ports were used: one 8.5 mm camera, two 8 mm robotic, and one 5 mm assistant. Initial dissection was performed laparoscopically and robotically, and the ureter was incised longitudinally along the anterior surface. The robot was undocked, and BMG was harvested from the inner cheek. The robot was then redocked, and grafts were delivered via the 8 mm robotic port and anastomosed as anterior onlay grafts using 5-0 or 6-0 absorbable monofilament suture. Omentum was quilted over the graft as a vascular backing. Ureteral stents were placed intraoperatively and left in situ for 8 weeks. Foley catheters were removed on postoperative day 3. All patients received intravenous ampicillin and gentamicin preoperatively, with antibiotics discontinued within 24 hours. Three patients underwent robot-assisted redo pyeloplasty with BMG. Patient characteristics are seen in Table 1. Mean number of prior surgeries for ureteropelvic junction obstruction repair was 2 (1-3), and mean length of stricture was 4.3 cm (2.5-6). At a median follow-up of 10 months (5-26), all patients are asymptomatic with stable or improved ultrasound. Robot-assisted redo pyeloplasty with BMG is safe and feasible in the pediatric population. Long-term follow-up is needed to determine the durability of these grafts. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Clinicopathological study of surgical margins in squamous cell carcinoma of buccal mucosa

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    S.M. Azeem Mohiyuddin

    2016-03-01

    Full Text Available Objective: To evaluate the margins of resected specimen of oral squamous cell carcinoma (SCC and to document the surgical margin (measured at the time of resection and margins at the time of pathological examination (after immersion of the specimen in formalin. Methods: Patients who were diagnosed and confirmed with squamous carcinoma of buccal mucosa were included in the study. Patients underwent resection of the tumor with a margin of 1 cm. Soon after resection, the distance between outermost visible margin of the tumor and the margin of the specimen was measured and documented. Specimens were fixed in 10% formalin and submitted for gross and histopathological examination. The closest histopathologic margin was compared with the in situ margin (10 mm to determine and document any shrinkage of the margin and the percentage of discrepancy if any. Results: A total of 52 specimens were collected from patients between January 2014 and December 2014. All specimens were obtained from the oral cavity (n = 52 of which 43 (82.7% were squamous cell carcinoma and 9 (17.3% were verrucous variant of squamous cell carcinoma. The average decrease in tumor margins measured after fixation in formalin was found to be statistically significant (P < 0.05 in 65% of cases. Conclusion: Tumor margin shrinks significantly after formalin fixation by about 25%. The operating surgeon and pathologist should be well aware of such changes while planning for further management thereby ensuring adequate margin of resection and adjuvant treatment wherever required to prevent possible local recurrence of the disease. Keywords: Oral squamous cell carcinoma, Formalin fixation, Margin of resection, Recurrence

  7. Fentanyl Buccal Tablet for the Treatment of Breakthrough Pain: Pharmacokinetics of Buccal Mucosa Delivery and Clinical Efficacy

    Directory of Open Access Journals (Sweden)

    Mona Darwish

    2010-06-01

    Full Text Available The treatment of breakthrough pain (BTP, a transitory exacerbation of pain that occurs on a background of otherwise-controlled, persistent pain, requires an opioid formulation and/or method of administration that can provide rapid and extensive systemic exposure. Fentanyl buccal tablet (FBT; FENTORA®, Cephalon, Inc. employs OraVescent® drug delivery technology, which enhances the rate and extent of fentanyl absorption. OraVescent technology enhances the oral dissolution and buccal absorption of fentanyl, which facilitates rapid uptake of fentanyl into the bloodstream, reducing gastrointestinal absorption and minimizing extensive first-pass metabolism. The resulting pharmacokinetic profile of FBT is characterized by greater bioavailability and a higher early systemic exposure compared with the earlier oral transmucosal fentanyl citrate formulation. In clinical studies of opioid-tolerant patients with cancer-related and noncancer- related BTP, FBT has provided consistent and clinically relevant improvements in pain intensity and pain relief relative to placebo, with a safety and tolerability profile that is generally typical of that observed with other potent opioids. The pharmacokinetic properties of FBT allow for meaningful clinical efficacy, with an onset of action that closely matches the onset of BTP.

  8. Exfoliative cytological assessment of apparently normal buccal mucosa among quid chewers using argyrophilic nucleolar organizer region counts and Papanicolaou staining.

    Science.gov (United States)

    Mohan, Bhavna C; Angadi, Punnya V

    2013-01-01

    Quid chewing is associated with an increased risk of oral cancer. This study aims to analyze argyrophilic nucleolar organizer region (AgNOR) counts along with Papanicolaou (PAP) staining in exfoliative smears of quid chewers and non-chewers to correlate quid chewing habits with possible early cytological changes in apparently normal buccal mucosa. Exfoliative smears were obtained from normal buccal mucosa of 30 male quid chewers and non-chewers. The smears were stained using the AgNOR silver staining technique to evaluate the proliferative activity and PAP for cytological appearance. Statistically higher AgNOR counts were observed in chewers as compared to non-chewers. The difference in the mean percentage of nuclei having ≥5 AgNORs in both groups was statistically significant (p = 0.001). In chewers, PAP showed 77% with class I and the remaining 23% were class II, while the non-chewers showed only class I cytology. AgNOR counts between chewers and non-chewers having class I cytological appearance demonstrated a greater mean AgNOR count in chewers (p = 0.0001). Quid chewing seems to have a definite role in promoting proliferative activity of apparently normal buccal mucosal cells. Exfoliative cytological assessment of a combination of AgNOR counts and PAP has the potential for prediction of early quid-associated cellular changes before the appearance of clinical premalignant and malignant lesions. Copyright © 2013 S. Karger AG, Basel.

  9. Micronuclei and other nuclear anomalies in normal human buccal mucosa cells of oral cancer patients undergoing radiotherapy: a field effect.

    Science.gov (United States)

    Tak, A; Metgud, R; Astekar, M; Tak, M

    2014-08-01

    We evaluated micronuclei and other nuclear anomalies in exfoliated epithelial cells of the oral cavity on the side opposite the lesion targeted by radiotherapy and correlated them with radiation doses. Buccal smears were obtained from oral cancer patients undergoing radiotherapy with a cumulative dose of at least 1000 rad for 3 weeks and from controls matched for age, gender and habits. The exfoliated cells from the mucosa were collected using a cytobrush; smears were prepared, fixed in 80% methanol and stained using the Feulgen plus fast green method. The mean number of micronuclei and other nuclear anomalies/1000 cells was significantly greater in patients undergoing radiotherapy treatment, but the differences were not significant compared to radiation doses. It appears that radiotherapy has a potent clastogenic effect on buccal mucosal cells of oral cancer patients.

  10. [Hypopharynx reconstruction of defects after operation on advanced pyriform sinus cancer with remaining laryngeal mucosa flap and pectoralis major myocutaneous flap].

    Science.gov (United States)

    Hu, Guohua; Wei, Lianzhi; Zhu, Jiang

    2004-07-01

    To explore the outcome of hypopharynx reconstruction by using remaining laryngeal mucosa flap and pectoralis major myocutaneous flap in advanced pyriform sinus cancer. Twelve patients with pyriform sinus cancers underwent hemilaryngectomy and partial pharyngectomy, two patients underwent cervical esophagectomy at the same time. The defects were reconstructed by remaining laryngeal mucosa flap. Four cases were involved in the bilateral larynx, received total laryngectomy and were repaired by pectoralis major myocutaneous flap. There was no operative fatal case and all flaps survived. Only one suffered from postoperative pharyngocutaneous fistulas, whose defect was reconstructed by remaining laryngeal mucosa flap and had radiotherapy. All patients could swallow ordinary food and had no benign esophagostenosis and pharyngostenosis after operation. Out of 16 patients, 1 case died of general metastasis; 3 cases died of local tumor relapse, tumor relapse of cervical lymphonode and lung metastasis respectively within 1 year after operation; the other 12 cases survived over 2 years. The advantage of hypopharynx reconstruction with remaining laryngeal mucosa flap is simple and convenient with less trauma and complication. The reconstruction should be completed by using the pectoralis major myocutaneous flap when the bilateral larynx are involved in.

  11. In vitro, ex vivo and in vivo examination of buccal absorption of metoprolol with varying pH in TR146 cell culture, porcine buccal mucosa and Göttingen minipigs

    DEFF Research Database (Denmark)

    Holm, René; Meng-Lund, Emil; Andersen, Morten B.

    2013-01-01

    This work studied the buccal absorption of metoprolol in vitro, ex vivo and in vivo as a function of buffered pH at 7.4, 8.5, 9.0 and 9.5. Permeability studies showed a correlation (r(2)=0.92) between in vitro TR146 cell culture and ex vivo porcine buccal mucosa in a modified Ussing chamber...

  12. Tenonplasty Combined With Free Oral Buccal Mucosa Autografts for Repair of Sclerocorneal Melt Caused by Chemical Burns.

    Science.gov (United States)

    Wang, Shuangyong; Tian, Ying; Zhu, Haifeng; Cheng, Yan; Zheng, Xuan; Wu, Jie

    2015-10-01

    To describe a surgical technique for repair of an intractable sclerocorneal melt caused by a serious chemical burn. This study includes a technique description and review of 3 representative cases. The combination of tenonplasty with a free oral buccal mucosa autograft was used in 3 patients with sclerocorneal melts caused by chemical burns. Promising results were found in each of them. The area of the sclerocorneal melt healed successfully after surgery, and the integrities of the eyeballs were salvaged. This technique provides a new method for surgical repair of an intractable sclerocorneal melt caused by a chemical burn.

  13. Optimization of piribedil mucoadhesive tablets for efficient therapy of Parkinson's disease: physical characterization and ex vivo drug permeation through buccal mucosa.

    Science.gov (United States)

    Çelik, Burak; Özdemir, Samet; Barla Demirkoz, Aslı; Üner, Melike

    2017-11-01

    The aim of this study was optimization of buccal piribedil (PR) mucoadhesive tablets to improve its low bioavailability and provide controlled release for the treatment of Parkinson's disease. Buccal tablets were prepared by direct compression method using carbomer (CP), carboxymethyl cellulose (CMC), and hydroxypropyl methylcellulose (HPMC) as mucoadhesive polymers. Physical properties of powder mixtures and buccal tablets were evaluated. Physicochemical compatibility between ingredients was investigated with infrared spectroscopy and differential scanning calorimetry analysis. In vitro dissolution profiles and drug release kinetics of buccal tablets were investigated. Mucoadhesion and ex vivo permeation studies were performed using sheep buccal mucosa. Powder mixtures demonstrated sufficient flow properties and physical characteristics of all tablet formulations were within compendia limits. Tablet ingredients were absent of any chemical interactions. CP tablets displayed slower drug release compared to HPMC tablets with zero order release, while CMC tablets lost their integrity and released entire drug after 6 h following Higuchi model. All formulations displayed adequate mucoadhesion and steady state flux of PR through buccal mucosa were higher with HPMC compared to CP-containing tablets. Overall, HPMC was found to combine desired controlled release and mucoadhesion characteristics with sufficient pharmaceutical quality for optimization of buccal tablets. Piribedil mucoadhesive buccal tablets designed for the first time may introduce a new alternative for the treatment of Parkinson's disease.

  14. Raman spectroscopy of oral buccal mucosa: a study on age-related physiological changes and tobacco-related pathological changes.

    Science.gov (United States)

    Sahu, Aditi; Deshmukh, Atul; Ghanate, A D; Singh, S P; Chaturvedi, Pankaj; Krishna, C Murali

    2012-12-01

    Biophysical techniques play an important role in detecting physiological alterations during pathogenesis. Raman spectroscopy has shown immense potential in identifying several diseased conditions, including oral cancers. Classification of normal, inflammatory, premalignant and malignant conditions has been demonstrated using ex vivo Raman spectroscopy. Feasibility of recording in vivo spectra in clinically implementable time has also been shown. Translation of this technology to clinics requires extensive validation of methodologies, building of robust models and testing the same under stringent conditions as well as on diverse populations. In this context, the ability of Raman spectroscopy in identifying subtle changes in oral mucosa with increasing age, and the influence of these aging related changes on classification with tobacco-related pathological changes was evaluated. A total of 451 spectra from 62 subjects were recorded from buccal mucosa of healthy subjects of 4 different age groups (aged 20-60 years). Also, 478 spectra from 85 subjects belonging to 4 different categories, tobacco exposed mucosa, contralateral normal (opposite side of tumor), premalignant patches and tumors on buccal mucosa were recorded using fiber optic probe-coupled commercial Raman spectrometer. Differences in spectra were explored by unsupervised Principal Component Analysis (PCA) and supervised Linear Discriminant Analysis (LDA), followed by Leave one out cross validation. Results indicate feasibility of classifying early and late age groups. Also, clear classification is observed between healthy and pathological groups, thus inherent heterogeneity in healthy groups seems to have no bearing on classification of normal with abnormal conditions. Findings of the study indicate high sensitivity of Raman spectroscopy in detecting subtle mucosal changes, further supporting efficacy of Raman spectroscopic approaches in oral cancer applications. Prospectively, more vigorous validation

  15. In vivo Raman spectroscopy of oral buccal mucosa: a study on malignancy associated changes (MAC)/cancer field effects (CFE).

    Science.gov (United States)

    Singh, S P; Sahu, Aditi; Deshmukh, Atul; Chaturvedi, Pankaj; Krishna, C Murali

    2013-07-21

    Occurrence of metachronous and synchronous secondary tumors in oral cavities has been associated with poor prognosis and decreased 5-year disease-free survival rates. The origin of secondary tumors in the oral cavity has been primarily attributed to cancer field effects (CFE) or malignancy-associated changes (MAC) in uninvolved areas. Classification of normal, cancerous and pre-cancerous oral lesions by in vivo Raman spectroscopy (RS) has already been demonstrated. In the present study, MAC/CFE in oral buccal mucosa were explored. In vivo Raman spectra from 84 subjects (722 spectra) under five categories - cancer and contralateral normal (opposite side of tumor), healthy controls (no tobacco habit, no cancer), habitués healthy controls (tobacco habit, no cancer) and non-habitués contralateral normal (no tobacco habit with cancer) were acquired. Mean and difference spectra suggest that loss of lipids and additional features representing proteins and DNA are characteristics of all pathological conditions, with respect to healthy controls. Spectral data were analyzed by PC-LDA followed by leave-one-out cross-validation. Results suggest that Raman characteristics of mucosa of healthy controls are exclusive, while those of habitués healthy controls are similar to those of contralateral normal mucosa. It was observed that the cluster of non-habitués contralateral normal mucosa is different from habitués healthy controls, suggesting that malignancy associated changes can be identified and also indicating that transformation of uninvolved oral mucosa due to tobacco habit or malignancy is different. The findings of the study demonstrate the potential of RS in identifying early transformation changes in oral mucosa and the efficacy of this approach in oral cancer applications.

  16. Buccal Mucosa Exfoliative Cell Prussian Blue Stain Co-Relates with Iron Overload in β-Thalassemia Major Patients.

    Science.gov (United States)

    Gajaria, Pooja K; Maheshwari, Ujwala M; Borkar, D B; Dhar, Reeta; Pancholi, Varsha

    2017-12-01

    Thalassemics require regular blood transfusion therapy leading to iron overload in the body tissues, which is a major cause of morbidity and mortality in these patients. We hereby attempted to measure this iron overload by means of exfoliative cytology, a non-invasive and inexpensive technique. The aims and objectives of our study were: 1. To detect iron overload by oral exfoliative cytology using Perl's Prussian blue stain in β-thalassemia major patients. 2. To correlate staining positivity with serum ferritin levels. Smears were obtained from buccal mucosa of 50 β-thalassemia major patients (who had taken more than 12 transfusions) and 25 healthy subjects of the same age group as controls. Smears were stained with Perl's Prussian blue. Blood samples were taken from the study group for estimation of serum ferritin levels. Grading criteria were defined for assessing the Prussian blue positivity. Perl's positivity was observed in 49 out of 50 of thalassemic patients (98%). 1 patient had Grade 0, 7 patients had Grade I, 5 had Grade II, 12 had Grade III, 14 had Grade IV while 11 patients had Grade V positivity. Spearman Rank's Correlation Co-efficient was 0.38, signifying a weak positive correlation between positivity of buccal smears for Perl's Prussian blue staining and respective serum ferritin levels. Perl's Prussian blue staining of exfoliated cells from buccal mucosa can be used to assess iron overload in β-thalassemia major patients, as a screening as well as diagnostic tool. With the grading system we can give a semi-quantitative assessment of the same.

  17. Lip buccal mucosa traumatic overgrowth due to sucking habit - a 10-year follow-up of a non-surgical approach: a combination of behavioural and myofunctional therapy.

    Science.gov (United States)

    Aizenbud, Dror; Gutmacher, Zvi; Teich, Sorin T; Oved-Peleg, Efrat; Hazan-Molina, Hagai

    2014-11-01

    Traumatic lesion of the lip buccal mucosa may develop due to a repetitive lip sucking habit, secondary to a dental space which opened in the dental in adult patients. The non surgical treatment approach is based on increasing of patient's awareness to the sucking habit along with the creation of a change in the oral and dental surrounding tissues. The following case included a failure to identify a traumatic habit of lower lip sucking, resulting in a buccal mucosa overgrowth. Combined conservative periodontal and orthodontic approach will be presented to address this clinical issue without any need for surgical intervention. 56 year old female patient presented with a complaint of unaesthetic appearance of the intraoral right buccal mucosa of the lower lip at rest position due to an intensive repetitive sucking habit of the right lower lip segment. We initiated a non surgical treatment approach including increasing the patient's awareness to the sucking habit, controlling the periodontal disease and orthodontic treatment to align and level the dental arch and to close the residual space. The soft tissue overgrowth on the lip buccal mucosa almost completely subsided spontaneously as a result of conservative dental and behavioral management without the need for any oral surgery intervention. A 10 years follow-up revealed no repetitive oral mucosa overgrowth, no spaces reopening and no sucking habit redevelopment. Implementation of a morphological correction will assist the patient in breaking the habit and creating an environment that may effectively prevent the reoccurrence of the habit.

  18. Urethroplasty with dorsal buccal mucosa graft. Is it still the method of choice in long term urethral stenosis?

    Directory of Open Access Journals (Sweden)

    Carlo Pavone

    2017-03-01

    Full Text Available The aim of our work was to evaluate the long-term changes in symptoms (median 42 months and to analyze data for any negative predictive factors for the application of the procedure, in patients who underwent to urethroplasty with dorsal buccal mucosa graft. During the period from 2010 to 2015 27 patients were examined. Than they underwent urethroplasty using dorsal buccal mucosa graft (graft of 4 x 2.5 cm. The evaluation of symptoms has been addressed through the application of the IPSS Quality of Life Questionnaire (International Prostatic Symptoms Score and the evaluation of urinary flow has been carried out by a comparative analysis between the pre- and post-operative uroflowmetry. As our study has shown, data obtained by the screening tests in the post-operative follow-up indicate that there is an increase in the maximum flow of urine until 1 month after surgery. The results in the long-term follow-up are different because they show a partial reduction of the maximum flow although it is maintained around an average value of 23 ml/s being still higher than the maximum flow in the pre-operative period. According to our results it follows that there is a low failure rate of the procedure after a median of 42 months. Only in patients with urethral stenosis longer than 2 cm, a lower long term success is achieved. From what we could observe, this length of the stenosis seems to be the only negative predictive factor for long-term maintenance of a good Quality of Life in patients undergoing the procedure. The results obtained from our study confirm literature data according to which, the gold standard for 2-cm long bulbar urethral stricture whose lumen is well preserved with circumferential spongiofibrosis limited to 1-2 mm is the dorsal graft urethroplasty with buccal mucosa that in our study showed success rates higher of 80% after a median follow up of 42 months and a percentage of relapse-free patients of 82.1% ( median 3.5 years.

  19. Induction of micronuclei in buccal mucosa on chewing a mixture of betel leaf, areca nut and tobacco.

    Science.gov (United States)

    Sellappa, Sudha; Balakrishnan, Mythili; Raman, Sangeetha; Palanisamy, Subashini

    2009-06-01

    Betel quid containing areca nut and chewing tobacco is used in many parts of India. In this study we evaluated the micronuclei (MN) in buccal mucosa of healthy individuals from southern India, who were regularly chewing a mixture of betel leaf, areca nut and tobacco. A total of 44 subjects were examined. The study population included 15 chewers, 14 chewers with smoking habit and 15 controls with the mean age of 38.57 +/- 0.54, 34.50 +/- 0.95, and 33.28 +/- 0.89 years, respectively. The mean percentage of MN was 1.90 +/- 1.03 in chewers, 2.00 +/-1.12 in chewers with smoking habits and 0.81 +/- 0.66 in controls. There was no significant difference between the mean percentages of the two experimental groups. It can be concluded that a mixture of betel leaf, areca nut, and tobacco is unsafe for oral health.

  20. Lower lip reconstruction using a skin-mucosa Abbe-Estlander flap after squamous cell carcinoma excision.

    Science.gov (United States)

    Husein-ElAhmed, Husein; Armijo-Lozano, Rafael

    2017-01-01

    Lips are structures that play an essential role in aesthetics and in different functions such as nutrition and speech. The complex anatomy of the lips - with three different layers composed of skin, mucosa, and muscles - makes surgical management of this area a therapeutic challenge. The use of flaps for the reconstruction of large defects with low risk of necrosis is possible given the abundant blood supply of the lips. We report a case of surgical reconstruction of the lower lip after the excision of a severe squamous cell carcinoma using a skin-mucosa Abbe-Estlander flap with a satisfactory final outcome.

  1. Effects of ethanol and extract of cigarette smoke on the rabbit buccal mucosa.

    Science.gov (United States)

    Bor-Caymaz, Canan; Bor, Serhat; Tobey, Nelia A; Abdulnour-Nakhoul, Solange; Orlando, Roy C

    2011-01-01

    The combination of smoking and drinking alcohol has a high association with diseases of squamous epithelium within the human oral cavity. Therefore, a study was done to assess the impact of these agents alone or in combination on the squamous epithelium using as model the buccal epithelium from rabbit oral cavity. Buccal epithelium was mounted in Ussing chambers to monitor electrical parameters during exposure to ethanol (5-40%) or to Ringer extract of cigarette smoke (EOCS) from one to six cigarettes dissolved in 10 ml Ringer either alone or with combination. Exposure to EOCS reduced in a dose dependent manner above 2 cigarettes/10 ml transmural electrical potential difference (PD), short-circuit current (I(sc)), increased transmural electrical resistance (R). Morphology showed from generalize tissue edema to patchy necrosis with the increasing concentrations. Ethanol alone raised PD, I(sc) and R at lower concentrations (5%) and lowered PD, I(sc) and R at higher concentrations (40%). The combination of 5% ethanol, EOCS-1cigarette/10 ml reduced PD, I(sc) by 58% and increased R by 29%. Unlike exposure to 5% EtOH and EOCS-1, 10% EtOH combined with EOCS-1 produces a harmful effect by dropping PD and I(sc). Both, simultaneous, and sequential, use of these agents enhanced their negative impact on these parameters. The enhancement of these effects are not due to solubulization of additional tobacco products by EtOH or by or by EtOH enhancing smoking noxious effect. Histopathologic damage needs higher concentrations of ethanol and EOCS combination and changes were more profound compared to the sum of the isolated effects of both agents. © 2010 John Wiley & Sons A/S.

  2. Role of tissue engineered buccal mucosa for treatment of urethral stricture

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    Vaddi S

    2013-10-01

    next challenge awaiting researchers in the urogenital tissue engineering field. Genitalia reconstruction is also possible with cell therapy. Engineered penile prosthesis can be reconstructed by culturing autologous chondrocytes which are seeded onto a Poly-glycolic acid scaffold and then implanting the scaffold into the corporal space of penis [6]. Microencapsulated Leydig cells in animal studies have been used to replace or supplement testosterone in testicular failure [7]. Cell therapy techniques are also used for treatment of urinary incontinence, vesicoureteric reflux by injecting cultured myoblasts or adipocytes [5]. The major limitation in engineering solid organs is the vascularisation of the regenerated tissue. Recent developments in angiogenesis research [8] may provide answer to this complex problem and accomplish the goal. Most of the research to date in urological tissue engineering is done in animals. Before these engineering techniques can be applied to humans, further studies need to be performed. Buccal Mucosal Epithelium for repair of the short segment urethral stricture: Urethral stricture is the narrowing of the lumen of the urethra which occurs as a terminal event secondary to many etiologies. Patients present with difficulty in voiding urine. There are endoscopic and open surgical reconstructive procedures to treat this disorder. Endoscopic treatment is often temporary and eventually results in recurrence of the disease. Many open surgical procedures have been described but none of the procedures offer permanent cure. The use of buccal mucosal grafts for stricture repair is in practice [9,10] with considerable success. However the donor site morbidity and complications like stricture recurrence with the present techniques [11,12] warrant the advent of novel techniques. The use of buccal mucosal cells which can be obtained by harvesting a 2mm x 2mm tissue bit compared to that of 5-6cm tissue usually harvested in conventional techniques for a graft

  3. DNA damage in buccal mucosa cells of pre-school children exposed to high levels of urban air pollutants.

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    Elisabetta Ceretti

    Full Text Available Air pollution has been recognized as a human carcinogen. Children living in urban areas are a high-risk group, because genetic damage occurring early in life is considered able to increase the risk of carcinogenesis in adulthood. This study aimed to investigate micronuclei (MN frequency, as a biomarker of DNA damage, in exfoliated buccal cells of pre-school children living in a town with high levels of air pollution. A sample of healthy 3-6-year-old children living in Brescia, Northern Italy, was investigated. A sample of the children's buccal mucosa cells was collected during the winter months in 2012 and 2013. DNA damage was investigated using the MN test. Children's exposure to urban air pollution was evaluated by means of a questionnaire filled in by their parents that included items on various possible sources of indoor and outdoor pollution, and the concentration of fine particulate matter (PM10, PM2.5 and NO2 in the 1-3 weeks preceding biological sample collection. 181 children (mean age ± SD: 4.3 ± 0.9 years were investigated. The mean ± SD MN frequency was 0.29 ± 0.13%. A weak, though statistically significant, association of MN with concentration of air pollutants (PM10, PM2.5 and NO2 was found, whereas no association was apparent between MN frequency and the indoor and outdoor exposure variables investigated via the questionnaire. This study showed a high MN frequency in children living in a town with heavy air pollution in winter, higher than usually found among children living in areas with low or medium-high levels of air pollution.

  4. Extract of haruan (Channa striata extract increasing reepithelialisation count in wound healing process on wistar rat’s buccal mucosa

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    Devintha Ayu Mellyana Tamales

    2016-04-01

    Full Text Available Haruan is Kalimantan’s indigenous fish which has the potency to accelerate wound healing. Haruan extract has substantial properties such as albumin, Zn, Cu, and Fe to accelerate wound healing. The aim of this study was to examine the effect of haruan extract on reepithelialization of wistar rats’ buccal mucosa wound healing on day 3, 5, 7, and 10 histopathologically. This study was true experimental with posttest with control design. Samples were divided in 16 treatment groups, haruan extract 25%, 50%, 100% treatment groups and aquadest treatment group as negative control, each treatment was performed for 10 days. Epithelial thickness count reached its peak on day 10. Mean epithelial thickness scoring of each group was 50.40 µm; 56.85 µm; 62.81 µm; 38.28 µm respectively. Two way Anova and Post Hoc LSD tests presented there was a significant difference between negative control and haruan extract groups. Haruan extract treatment significantly increases epithelial thickness count in wound healing process.

  5. Assessment of cervical lymph node metastasis for therapeutic decision-making in squamous cell carcinoma of buccal mucosa: a prospective clinical analysis

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    Essig Harald

    2012-11-01

    Full Text Available Abstract Background Cervical metastasis has a tremendous impact on the prognosis in patients with carcinomas of the head and neck and the frequency of such spread is greater than 20% for most squamous cell carcinomas. With emerging evidence, focus is shifting to conservative neck procedures aimed at achieving good shoulder function without compromising oncologic safety. The purpose of this study was to analyze the pattern of nodal metastasis in patients presenting with squamous cell carcinoma of buccal mucosa. Materials and methods This was a prospective clinical analysis of patients who were histologically diagnosed with squamous cell carcinoma of the buccal cavity and clinically N1 and had not received treatment anywhere else. Patients were analyzed for age and sex distribution, tumor staging, location, and metastasis. Results The incidence of metastatic lymph node in T4 (n=44 was the highest, that is, level I was 100% (44/44, level II was 43.18% (19/44, level III was 15.90% (7/44, and level IV was 4.5% (2/44. Level V was free of metastasis. Among T3 (n=10 lesions, incidence of metastasis in level I was 100% (10/10, level II was 20% (2/10, and level III, IV, and V were free of metastasis. Among T2 (n=6 lesions, incidence of lymph node metastasis in level I was 100% (6/6 and all other levels of lymph nodes were found free of metastasis. Conclusion Lymphatic spread from carcinoma of the buccal mucosa is low. Involvement of level IV is seen in only 3% of patients. A more conservative approach to the neck in patients with carcinoma of the buccal mucosa is recommended.

  6. The Folded Buccal Musculomucosal Flap for Large Palatal Fistulae in Cleft Palate

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    Shinji Kobayashi, MD

    2014-02-01

    Conclusion: The f-BMMF is able to cover both sides without a raw surface and a mucosal graft even in cases of large fistula closure, although BMMF cannot usually cover both oral and nasal sides of a fistula. The advantages of this procedure are that it does not require second surgery to release the pedicle and that its distal island mucosa can be used to monitor engraftment. This proposed method seems to be an appealing alternative.

  7. The role of tobacco as an etiological agent for oral cancer: Cytomorphometrical analysis of the buccal mucosa in tobacco users.

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    Singh, Megha; Sircar, Keya; Tandon, Ankita; Chowdhry, Aman; Popli, Deepika Bablani

    2014-11-01

    Histopathological diagnosis of lesions arising from the intake of tobacco is based on subjective evaluation of morphological alterations within the lesional tissue. Oral exfoliative cytology is a non-invasive diagnostic technique for early detection of oral premalignant and malignant lesions. Morphometric techniques have been advocated as objective and reproducible methods of detecting changes before they are visible by routine microscopy and can facilitate differentiation of normal and abnormal epithelium. This study was conducted to assess the morphometric parameters (cell diameter, nuclear diameter and nuclear cytoplasmic ratio [N:C ratio]) in tobacco smokers and chewers and to evaluate the variations, if any. The study was conducted on cytological smears obtained from oral lesions of patients with habit of tobacco smoking (Group B) and tobacco chewing (Group C). Group A comprised of subjects free from oral lesions and not using tobacco in any form. Patients with both the habits were excluded. The smears were stained using Papanicoloaou staining method. For morphometric analysis, Microimage 3.0 image analysis software was employed. The statistical test employed was an analysis of variance and P < 0.05 was considered as significant. The results of this study showed that the cellular diameter was progressively reduced and nuclear diameter progressively increased from Group A to Group B to Group C. The N:C ratio also showed a progressive increase from Group A to Group C. The results confirmed that tobacco chewing and smoking influenced the cytomorphology of normal appearing buccal mucosa and the degree of these changes were found to be greater in chewers as compared to smokers.

  8. Use of Botox (OnabotulinumtoxinA) for the Treatment of Parotid Sialocele and Fistula After Extirpation of Buccal Squamous Cell Carcinoma With Immediate Reconstruction Using Microvascular Free Flap: A Report of 3 Cases.

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    Melville, James C; Stackowicz, Daniel J; Jundt, Jonathon S; Shum, Jonathan W

    2016-08-01

    Buccal squamous cell carcinoma is an aggressive form of oral carcinoma with a high recurrence rate. Injury to the parotid duct is often unavoidable when surgically treating buccal squamous cell carcinoma because of the intimate anatomic relation among the buccal mucosa, Stensen duct, and parotid gland. It is often difficult to achieve negative margins and preserve the integrity of the parotid duct. Sialocele formation is a frequent and untoward complication owing to extravasation of saliva into the surgical defect, which delays healing, creates fistulas, and produces painful facial swelling. Currently, no consensus exists regarding the management of a parotid sialocele. Multiple investigators have described different modalities of treatment, such as repeated percutaneous needle aspiration, pressure dressings, antisialagogue therapy, radiotherapy, botulinum toxin, and surgical techniques, including duct repair, diversion, ligation, drain placement, and parotidectomy. With approval from the institutional review board of the University of Texas Health Sciences Center at Houston, 3 cases of parotid sialocele and nonhealing fistulas successfully treated with Botox (onabotulinumtoxinA) after tumor extirpation, neck dissection, and reconstruction with a microvascular free flap are presented. At the University of Texas Health Sciences Center at Houston, the radiation oncologist prefers not to start adjunctive radiation treatment with a nonhealing wound or a drain in the field of radiation. Ideally, a standard timing of adjuvant radiotherapy is 6 to 8 weeks after surgery and 60 cGy should be completed before 7 months. With the use of Botox, the nonhealing wound resolved and the drain was removed at least 2 weeks before the initiation of adjunctive radiotherapy, thus minimizing the delay in adjuvant treatment. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva.

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    Chang, Chris; Liu, Sean S Y; Roberts, W Eugene

    2015-11-01

    To compare the initial failure rate (≤4 months) for extra-alveolar mandibular buccal shelf (MBS) miniscrews placed in movable mucosa (MM) or attached gingiva (AG). A total of 1680 consecutive stainless steel (SS) 2 × 12-mm MBS miniscrews were placed in 840 patients (405 males and 435 females; mean age, 16 ± 5 years). All screws were placed lateral to the alveolar process and buccal to the lower first and second molar roots. The screw heads were at least 5 mm superior to the soft tissue. Loads from 8 oz-14 oz (227 g-397 g, 231-405 cN) were used to retract the mandibular buccal segments for at least 4 months. Overall, 121 miniscrews out of 1680 (7.2%) failed: 7.31% were in MM and 6.85% were in AG (statistically insignificant difference). Failures were unilateral in 89 patients and bilateral in 16. Left side (9.29%) failures was significantly greater (P placement in MM or AG. Failures were more common on the patient's left side and in younger adolescent patients. Having 16 patients with bilateral failures suggests that a small fraction of patients (1.9%) are predisposed to failure with this method.

  10. Evaluation of Various Nuclear Cytological Changes in Normal Buccal Mucosa and Peritumoural Area in Patients with Oral Squamous Cell Carcinoma Receiving Concomitant Chemoradiotherapy

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    Sadia Minhas

    2016-01-01

    Full Text Available Objectives. To evaluate the role of serial cytological assay in calculating the nuclear response of contralateral normal buccal mucosa and peritumoural area of squamous cell carcinoma of oral cavity in patients receiving fractionated radiotherapy (RT and chemotherapy. Materials and Methods. This prospective, nonrandomized study was comprised of 76 histologically confirmed cases of oral squamous cell carcinoma on cyclical chemoradiation treatment. Chemoradiosensitivity was evaluated using serial scrape smears taken before and after immediate exposure to CCRT, at 17th day of CCRT (mid of treatment, and at the end of treatment. The nuclear changes, such as multinucleation, micronucleation, karyorrhexis, karyolysis, nuclear budding, prominent nucleoli, and binucleation occurring in both irradiated cancer cells and contralateral normal buccal mucosa, had a statistically significant dose related increase with concomitant chemoradiotherapy (p<0.05. Conclusion. We recommend regular use of serial cytological assay during CCRT as it may prove to be a valuable tool for assessment of chemoradiosensitivity and persistence of tumour/dysplastic cells after radiotherapy.

  11. Five-Year Follow-Up of Concomitant Accelerated Hypofractionated Radiation in Advanced Squamous Cell Carcinoma of the Buccal Mucosa: A Retrospective Cohort Study

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    Hassan Iqbal

    2015-01-01

    Full Text Available In resource limited settings, induction chemotherapy with Gemcitabine and Cisplatinum and concurrent hypofractionated chemoradiation for locally advanced carcinoma of buccal mucosa (BMSCC are a cost effective option but remain under reported. The objective of this study was to report long term survival outcome after concurrent hypofractionated radiotherapy in locally advanced BMSCC. Between February 2005 and 2009, 63 patients received treatment. Induction chemotherapy (IC regimen consisted of two drugs: Gemcitabine and Cisplatin. All patients received 55 Gy of radiation in 20 fractions with concurrent single agent Cisplatin (75 mg/m2. Five-year overall survival (OS, disease-free survival (DFS, and progression-free survival (PFS were determined. Based on AJCC staging, 7 (11% patients were stage III, 31 (49% stage IV a, and 25 (40% stage IVb at presentation. After IC, 8 (18% patients had complete radiological response, 33 (73% had partial response, and 4 (9% had stable disease. After concurrent hypofractionated chemoradiation, thirty-nine (62% patients were complete responders and 24 (38% had stable disease. With a minimum follow-up of 60 months, 5-year OS, DFS, and PFS were 30%, 49%, and 30%, respectively. In locally advanced buccal mucosa squamous cell carcinoma, concurrent hypofractionated chemoradiation results in acceptable survival and regimen related toxicity.

  12. Two-piece customized mold technique for high-dose-rate brachytherapy on cancers of the buccal mucosa and lip.

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    Matsuzaki, Hidenobu; Takemoto, Mitsuhiro; Hara, Marina; Unetsubo, Teruhisa; Yanagi, Yoshinobu; Katsui, Kuniaki; Katayama, Norihisa; Yoshio, Kotaro; Takenobu, Toshihiko; Kuroda, Masahiro; Kanazawa, Susumu; Asaumi, Jun-Ichi

    2012-01-01

    High-dose-rate (HDR) brachytherapy using a customized mold is a minimally invasive treatment for oral cancer; however, it is difficult to use this technique for buccal and lip cancers involving the commissura labiorum, owing to its anatomic form. The purpose of this study was to introduce an improved customized mold consisting of 2 pieces to allow the fixation of molds to these sites. Five patients with buccal carcinoma and 1 patient with lip carcinoma were treated with this technique after external beam radiotherapy. One patient with neck metastasis underwent both neck dissection and partial tumor resection before HDR brachytherapy. At the end of the follow-up period, 5 patients had no tumor recurrence, and 1 patient had suffered local recurrence. Our technique is a viable therapeutic option for patients with buccal and lip carcinomas for whom the therapeutic modalities are limited by age, performance status, and other factors. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. SINGLE STAGE VENTRAL ONLAY BUCCAL MUCOSAL GRAFT URETHROPLASTY BASED ON TUNICA VAGINALIS FLAP FOR BALANITIS XEROTICA OBLITERANS RELATED URETHRAL MEATAL AND NAVICULAR FOSSA STRICTURES

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    Sathish Kumar G

    2017-07-01

    Full Text Available BACKGROUND Balanitis Xerotica Obliterans (BXO, also known as lichen sclerosus of penis is a chronic, progressive disease of the glans and prepuce that leads to phimosis and stricture of the urethra that can extend from the meatus and glanular urethra to the prostatic urethra. Urinary and sexual functions are affected and there is a severe reduction in quality of life. Many patients have been initially treated with tacrolimus or circumcision, when the disease has involved the prepuce and glans superficially, but conservative management has a limited role in this condition. Once stricture develops, surgical intervention in the form of grafts or flaps becomes necessary. We present our results with single-stage Ventral Onlay Buccal Mucosal Graft Urethroplasty (VOBMGU based on tunica vaginalis flap for BXO related strictures of meatus and fossa navicularis. MATERIALS AND METHODS From July 2014, six patients who underwent single stage Ventral Onlay Buccal Mucosal Graft Urethroplasty Graft (VOBMGU based on tunica vaginalis flap for BXO related strictures of urethral meatus and navicular fossa were included in the study. Patients presenting with BXO were clinically assessed for the extent of involvement as having BXO affecting the foreskin, glans, meatus, penile shaft, urethra and scrotum. They were radiologically assessed with a retrograde urethrogram and ultrasound abdomen. Outcome was assessed in terms of uroflowmetry, cosmetic appearance, stricture recurrence and complications. RESULTS Patients were reviewed every three months for over one year and six monthly. Only one patient had mild stenosis of the urethral meatus, as evidenced by change in flow, which was treated successfully with dilatation. One patient reported moderate splaying of urine, but this was mild in all other cases. All patients had a normal slit-like meatus, satisfactory voiding and sexual functions. CONCLUSION Isolated involvement of fossa navicularis and meatal stenosis stricture

  14. Oxidative Stress on Buccal Mucosa Wound in Rats and Rule of Topical Application of Ethanolic Extracts of Mauli Banana ( Musa acuminata Stem

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    Wenda Fitriati Noora

    2015-05-01

    Full Text Available The present study was undertaken to evaluate the effect of a topical application of ethanolic extracts of Mauli banana stem on oxidative status in buccal mucosa wounds of rats. The sets involved three groups, P0 was the negative control; P1 was treated with alocair topically; and P2 was treated with ethanolic extracts of Mauli banana stem topically, respectively, 24h after wound creation for 3 days. The oxidative stress status was evaluated by monitoring the SOD, CAT activity, MDA and CC levels. Ethanolic extracts of Mauli banana stem showed significantly increased in SOD activity, decreased in MDA levels, and no significant change both in CAT activity and CC levels compared to negative control. These results showed that The ethanolic extracts of Mauli banana stem might affect the oxidative stress status during wound healing process.

  15. Comparison of ATR-FTIR spectra of porcine vaginal and buccal mucosa with ear skin and penetration analysis of drug and vehicle components into pig ear.

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    Schwarz, Julia C; Pagitsch, Elisabeth; Valenta, Claudia

    2013-12-18

    In the present study, porcine buccal and vaginal mucosae were successfully characterised by ATR-FTIR for the first time and compared to porcine ear skin. By analysing typical bands of the spectra, the structure of proteins and the lipid matrix were elucidated. According to the body site, differences in membrane permeability were detected when analysing the CH2-stretching and -scissoring vibrations. The results indicated a higher permeability for porcine vaginal and buccal tissue compared to skin. Furthermore, the influence of a lecithin-based microemulsion on the barrier properties of the above mentioned tissues was investigated by ATR-FTIR; the results revealed structural changes in all tissues. In addition, the ATR-FTIR technique was employed to semi-quantitatively analyse compounds directly on skin. To this end, tape stripping experiments were performed with a deuterated liposomal drug delivery system containing the model drug flufenamic acid. While the amount of penetrated deuterated liposomes was determined directly on skin samples by ATR-FTIR, the drug amount was analysed by HPLC after extraction of the tape strips since higher sensitivity was achieved in this fashion. Thus, it was possible to monitor the skin penetration of drug and vehicle simultaneously. Interestingly, the results indicated an independent drug penetration after release from the liposomal carrier system. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Daily rhythm variations of the clock gene PER1 and cancer-related genes during various stages of carcinogenesis in a golden hamster model of buccal mucosa carcinoma.

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    Ye, Hua; Yang, Kai; Tan, Xue-Mei; Fu, Xiao-Juan; Li, Han-Xue

    2015-01-01

    Recent studies have demonstrated that the clock gene PER1 regulates various tumor-related genes. Abnormal expressions and circadian rhythm alterations of PER1 are closely related to carcinogenesis. However, the dynamic circadian variations of PER1 and tumor-related genes at different stages of carcinogenesis remain unknown. This study was conducted to investigate the daily rhythm variation of PER1 and expression of tumor-related genes VEGF, KI67, C-MYC, and P53 in different stages of carcinogenesis. Dimethylbenzanthracene was used to establish a golden hamster model of buccal mucosa carcinogenesis. Hamsters with normal buccal mucosa, precancerous lesion, and cancerous lesion were sacrificed at six different time points during a 24-hour period of a day. Pathological examination was conducted using routine hematoxylin and eosin staining. PER1, VEGF, KI67, C-MYC, and P53 mRNAs were detected by real-time reverse transcriptase polymerase chain reaction, and a cosinor analysis was applied to analyze the daily rhythm. PER1, VEGF, C-MYC, and P53 mRNA exhibited daily rhythmic expression in three carcinogenesis stages, and KI67 mRNA exhibited daily rhythmic expression in the normal and precancerous stages. The daily rhythmic expression of KI67 was not observed in cancerous stages. The mesor and amplitude of PER1 and P53 mRNA expression decreased upon the development of cancer (Pclock gene PER1 and tumor-related genes VEGF, KI67, C-MYC, and P53 correlate with the development of cancer. Additional studies might provide new insights and methods to explore carcinogenic mechanisms and cancer treatment.

  17. Genotoxic and mutagenic effects of passive smoking and urban air pollutants in buccal mucosa cells of children enrolled in public school.

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    Cavalcante, Deborah Navit de Carvalho; Sposito, Juliana Caroline Vivian; Crispim, Bruno do Amaral; Nascimento, André Vieira do; Grisolia, Alexeia Barufatti

    2017-06-01

    Nuclear abnormalities (micronuclei and meta-nuclear changes) have been used as biomarkers to identify cell damages. As children are more vulnerable to the adverse effects of pollution when compared to adults, assessing genetic damage caused by environmental influences is of great interest. As such, the objective was to determine metanuclear (karyolysis, pycnosis, karyorrhexis, binucleated cells, chromosome bridges and micronuclei) in cells from the oral mucosa of children associated with the school environment, gender, exposure to cigarette smoke and vehicular traffic. Analyses of nuclear abnormalities were performed in exfoliated buccal cells of children from two public schools located in Dourados - MS. The data were analyzed through Kruskal-Wallis test considering a significance level of 5% (p mutagenic and genotoxic agent, suggesting that such contaminants are related to clastogenic and aneugenic effects on DNA. Moreover, female children had higher amounts of nuclear abnormalities when compared to male children. With regards to the school environment, the study results indicated statistical differences in of term chromosomal abnormalities for schools A and B. Thus, it was possible to determine that children exposed to cigarette smoke are susceptible to further genetic damage than unexposed children, and female children may be more susceptible to genotoxic and mutagenic agents. This study contributes to the current knowledge on the mutagenic characteristics of human cells, supporting the adoption of preventive Public Health measures.

  18. Oral mucosa grafts for urethral reconstruction

    African Journals Online (AJOL)

    [33]. First report on the use of tongue mucosa. Figure 1: Histology of buccal mucosa[60]. Figure 2: Microvasculature of buccal mucosa[60]. Surgical Anatomy of Oral Mucosa. The morphology of oral mucosa varies from region to region being related to the functional demands placed upon it. These regional differences exist in.

  19. Nuclear abnormalities in buccal mucosa cells of patients with type I and II diabetes treated with folic acid.

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    Gómez-Meda, B C; Zamora-Perez, A L; Muñoz-Magallanes, T; Sánchez-Parada, M G; García Bañuelos, J J; Guerrero-Velázquez, C; Sánchez-Orozco, L V; Vera-Cruz, J M; Armendáriz-Borunda, J; Zúñiga-González, G M

    2016-02-01

    Diabetes mellitus (DM) is characterized by high blood glucose. Excessive production of free radicals may cause oxidative damage to DNA and other molecules, leading to complications of the disease. It may be possible to delay or reduce such damage by administration of antioxidants such as folic acid (FA). The objective of this study was to determine the effect of FA on nuclear abnormalities (NAs) in the oral mucosa of patients with DM. NAs (micronucleated cells, binucleated cells, pyknotic nuclei, karyorrhexis, karyolysis, abnormally condensed chromatin, and nuclear buds) were analyzed in 2000 cells from 45 healthy individuals (control group) and 55 patients with controlled or uncontrolled type I or II DM; 35 patients in the latter group were treated with FA. Samples were taken from the FA group before and after treatment. An increased rate of NAs was found in patients with DM in comparison with that of the control group (Pabnormally condensed chromatin, karyolysis, and nuclear buds produced by FA supplementation in DM patients (P<0.02) are consistent with the idea that free radicals are responsible for the increased frequency of NAs in DM patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Comparative evaluation of genotoxicity by micronucleus assay in the buccal mucosa over comet assay in peripheral blood in oral precancer and cancer patients.

    Science.gov (United States)

    Katarkar, Atul; Mukherjee, Sanjit; Khan, Masood H; Ray, Jay G; Chaudhuri, Keya

    2014-09-01

    Early detection and quantification of DNA damage in oral premalignancy or malignancy may help in management of the disease and improve survival rates. The comet assay has been successfully utilised to detect DNA damage in oral premalignant or malignancy. However, due to the invasive nature of collecting blood, it may be painful for many unwilling patients. This study compares the micronucleus (MN) assay in oral buccal mucosa cells with the comet assay in peripheral blood cells in a subset of oral habit-induced precancer and cancer patients. For this, MN assay of exfoliated epithelial cells was compared with comet assay of peripheral blood leucocytes among 260 participants, including those with oral lichen planus (OLP; n = 52), leukoplakia (LPK; n = 51), oral submucous fibrosis (OSF; n = 51), oral squamous cell carcinoma (OSCC; n = 54) and normal volunteers (n = 52). Among the precancer groups, LPK patients showed significantly higher levels of DNA damage as reflected by both comet tail length (P cancer patients was OLP oral habits, it was multiple habits > cigarette + khaini > cigarette smokers > areca + khaini > areca. There was no significant difference in the comet length and MNi frequency between males and females who had oral chewing habits. An overall significant correlation was observed between MNi frequency and comet tail length with r = 0.844 and P oral exfoliated epithelial cells, and MNi frequency can be used with the same effectiveness and greater efficiency in early detection of oral premalignant conditions. © The Author 2014. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. The use of autologous platelet rich plasma gel in bulbar and penile buccal mucosa urethroplasty: Preliminary report of our first series

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    Marcello Scarcia

    2016-12-01

    Full Text Available Objective: The Buccal Mucosa (BM UrethroPlasty (UP is one of the preferred treatments for long or compli-cated urethral strictures. We propose the use of autologous Platelet Rich Plasma gel (aPRPg in order to enhance to vascularization of BM graft and reduce the fibrous spongy. We report the outcome of our ten cases of bulbar and penile UP and the safety of this technique. Materials and metods: Ten patients underwent to BM UP with use of aPRP gel. Median age was 46. Stricture etiology was idiopathic, failed hypospadias and flogistic. Average stricture length was 3.7 cm. All patient were preoperatively evaluated with uroflowmetry , retrograde urethrography, cystoscopy and questionnaire. The harvesting of the aPRP was performed in blood bank from peripheral venous sample. Catheter was usually removed after 3 weeks and urethrography was performed after 6 weeks. Results: All patients reported no problem on the donor site. At time of follow-up (median 20 month, 12-34 all patients refer no problem and a good uroflowmetry. No re-strictures at the anastomotic sites were demonstrated in any of the patients. Conclusion: However in our experience the follow-up is limited and no definitive conclusion or comparison can be made with the original BM UP. The use of aPRP gel seems feasible and safe. In our opinion it is important to continue investigating this procedure for its advantages in case of complex urethral strictures complicated by fibrous spongy, above all in penile urethral strictures post hypospadia repair.

  2. Cell proliferation in lichen planus of the buccal mucosa with special regard to a therapy with an aromatic retinoid (RO 10-9359). Proliferationsverhalten des oralen lichen planus unter besonderer Beruecksichtigung einer Therapie mit aromatischem Retinoid (RO 10-9359)

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, G.

    1982-01-01

    The proliferative activity of buccal mucosa epithelium in 16 patients suffering from oral lichen planus was studied by using (/sup 3/H)-thymidine labelling technique in vitro and histometric methods. Autoradiographic sections of two groups of lesions (12 with atrophic and 4 with acanthotic epithelium) were compared with the buccal mucosa of 19 healthy controls investigated in the same way. Determinations comprised separate and combined labelling indices of the basal and suprabasal progenitor compartment (LIsub(bas), LIsub(sbas), LIsub(total)) in relation to basal cells as well as to surface of the epithelium. The following results were obtained. The values of LIsub(total) per 100 basal cells were increased in both groups of lesions, whereby the relation of LIsub(bas):LIsub(sbas) shifted markedly to LIsub(bas), in particular in the atrophic lesions. When relating the total of labelled nuclei to surface length, however, an increase could be confirmed only in acanthotic lesions, whereas most atrophic lesions showed a decrease. This indicates an impaired capacity of the atrophic epithelium to maintain regenerative steady state. This imbalance could also be confirmed by counting the total of basal cells per surface length, which were significantly lowered in atrophic lesions as compared with acanthotic ones as well as normal mucosa. From the results it can be concluded that the renewal activity of the epithelium in atrophic lesions of lichen planus mucosae becomes virtually deficient, though determination of LIsub(total) referred to basal cells simulates a slight increase. Thus, for detecting intrinsic imbalances in the proliferative equilibrium of squamous epithelium, correlation of progenitor compartment labelling to external surface as the site of continuous cell loss is required.

  3. Prelaminated temporal fascia free flap for reconstruction of the floor of the mouth

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    Vojko Didanovič

    2011-03-01

    Conclusion: There is no ideal replacement for the oral mucosa. Scar as a result of healing by secondary intention prevents tongue mobility. The quantity of mucosa available for local flaps is limited. Oral cavity environment is not ideal for healing of split-thickness skin grafts and skin transferred into oral cavity is never accustomed to the local conditions. With buccal mucosa prelaminated temporal fascia, microvasculary transferred into the oral cavity, offers a valuable method of reconstruction of medium-size mucosal defects of the oral cavity in selected, motivated patients.

  4. Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck.

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    Canhua Jiang

    Full Text Available The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14-23 cm and the mean width was 4.9 (range: 2.5-7 cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

  5. The Role of Buccal Epithelial Cells Properties to Adhesion of Candida albicans and Influence on It of Regulatory Cytokines During Infectious Process in Patients with Candidiasis of the Mucosa of the Upper Digestive Tract

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    I.V. Kushnirenko

    2016-10-01

    Full Text Available The role of buccal epithelial cells in candidiasis development and the interrelation with peculiarities of cytokine balance in patients with candidiasis of the upper digestive tract continues to be studied today. The aim of the investigation. To study levels of cytokines interleukin‑1β (IL‑1β, IL‑4, IL‑6, IL‑8 and tumor necrosis factor α (TNF-α in gastroenterological patients with candidiasis of the upper digestive tract and to compare obtained data with indices of buccal epithelial cells ability to the adhesion of reference strain of Candida albicans depending on the depth of the damage of the mucosa. Materials and methods. The study was done on buccal epithelial cells from 66 patients, who were divided into three groups according to the results of microbiological investigation of the scrape from the tongue and biopsy materials of the esophagus and the stomach. The first group (1 — 31 patients with oropharyngeal candidiasis and superficial growth of fungi in biopsy materials, of them 1А subgroup — 8 people with superficial growth, the second group (2 — 25 patients with fungi invasion in the mucos, the third group (3 — 10 individuals without oropharyngeal candidiasis and without the growth of fungi. Results. It was demonstrated that the average index of adhesion of buccal epithelial cells was 1.3 and 1.6 higher in group 2 compared with subgroup 1 and 1A (р < 0.05 and р < 0.05 correspondingly. Examined patients had a significantly decreased level of IL‑4 (р < 0.001, on the background of which in groups 1 and 2 there was a significant increase of IL‑8 level (р < 0.01 and р < 0.001, and in group 1 — of IL‑1β (р < 0.05. Patients of the 1А subgroup had a significantly higher level of IL‑6 and TNF-α as compared to group 2  (р < 0.05 and р < 0.05 respectively. The increase of buccal epithelial cells ability to adhesion of Candida albicans has the direct correlation with the level of IL

  6. Biological width following immediate implant placement in the dog: flap vs. flapless surgery.

    Science.gov (United States)

    Blanco, Juan; Alves, Célia Coutinho; Nuñez, Vanesa; Aracil, Luis; Muñoz, Fernando; Ramos, Isabel

    2010-06-01

    To assess the marginal soft tissue healing process after flap or flapless surgery in immediate implant placement in a dog model. This study was carried out on five Beagle dogs. Four implants were placed in the lower jaw in each dog immediately after tooth extraction. Flap surgery was performed before the extraction on one side (control) and flapless on the other (test). After 3 months of healing, the dogs were sacrificed and prepared for histological analysis. Ten implants were placed in each group. Two failed (one of each group). The length of the junctional epithelium in the flapless group was 2.54 mm (buccal) and 2.11 mm (lingual). In the flap group, the results were very similar: 2.59 mm (buccal) and 2.07 mm (lingual), with no significant differences observed between the groups. The length of the connective tissue in the flapless group was 0.68 mm (buccal) and 0.54 mm (lingual), and 1.09 mm at the buccal and 0.91 mm at the lingual aspect in the flap group, with no significant differences between groups. The difference between the mean distance from the peri-implant mucosa margin to the first bone-implant contact at the buccal aspect was significant between both groups (3.02 mm-flapless and 3.69 mm flap group). However, this difference was mostly due to the Pm3 group (flapless: 2.95/flap: 3.76) because no difference could be detected in the Pm4 group. Both groups showed minimal recession, with no significant differences between groups (flapless group - 0.6 mm buccal and 0.42 mm lingual; flap group - 0.67 and 0.13 mm). The clinical evaluation of immediate implant placement after 3 months of healing indicated that buccal soft tissue retraction was lower in the flapless group than in the flap group, without significant differences. The mean values of the biological width longitudinal dimension at the buccal aspect were higher in the flap group than in the flapless group, this difference being mostly due to the Pm3, probably because of a thinner biotype in this

  7. Ridge alterations following immediate implant placement in the dog: flap versus flapless surgery.

    Science.gov (United States)

    Blanco, Juan; Nuñez, Vanesa; Aracil, Luis; Muñoz, Fernando; Ramos, Isabel

    2008-07-01

    To assess the healing process after flap or flapless surgery in immediate implant placement. This study was carried out on five Beagle dogs. Four implants were placed in the lower jaw in each dog immediately after tooth extraction. Flap surgery was performed before the extraction on one side (control), and flapless on the contrary (test). After 3 months of healing, the dogs were sacrificed and prepared for histological analysis. Ten implants were placed in each group. Two failed (one of each group). The percentage of bone-implant contact was very similar in both groups: 64.8% and 65.1% for the flap and the flapless group, respectively. The difference between the mean distance from the peri-implant mucosa margin to the first bone-implant contact at the buccal aspect was statistically significant between both groups (3.02 mm. flapless and 3.69 mm. flap group). The mean first bone-implant contact at the buccal aspect was located in relation to the sand-blasted and acid-etched level at 0.82 mm for the flapless group and 1.33 mm for the flap group. This difference was not statistically significant. Flapless immediate implant surgery produces a significant reduction in the vestibular biologic width and a minor reduction in buccal bone plate resorption.

  8. Galeal flap based on superficial temporal vessels for oral cavity and pharynx reconstruction: an anatomical study

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    Fabio Pinto

    2008-01-01

    Full Text Available PURPOSE: Despite the advances in microvascular free tissue transfer for intraoral reconstruction, this surgery is not recommended for all patients. In specific cases, the pedicled temporoparietal galeal flap may be an option for reconstructive procedures in the head and neck regions. The objective of this paper is to present the anatomical aspects of a galeal flap based on the superficial temporal vessels and to test its potential for reconstructing diverse sites of the oral cavity and pharynx. METHODS: We performed 40 dissections on 34 fresh adult cadavers. The flap vascular anatomy was studied by injecting latex into the superficial temporal vessels. A standardized square-shape flap measuring 10 x 10 cm², pedicled on the superficial temporal vessels, was raised. Oral cavity and oropharynx reconstruction simulations were performed after flap transposition into the mouth by passing it under the zygomatic arch. Hypopharyngeal reconstruction was tested by transposing the flap to the neck under the facial nerve. RESULTS: After latex injection, a rich vascular network over the temporoparietal galea was observed directly from the superficial temporal artery, and a well-vascularized flap based on this vessel was raised. In the reconstruction simulations, the flap was shown to be suitable for the coverage of hypothetical defects in most oral cavity and pharyngeal sites, mainly the retromolar trigone, tonsil area, and buccal mucosa. CONCLUSIONS: A galeal flap based on the superficial temporal vessels presents favorable anatomical characteristics for oral cavity and pharyngeal reconstruction.

  9. Daily rhythm variations of the clock gene PER1 and cancer-related genes during various stages of carcinogenesis in a golden hamster model of buccal mucosa carcinoma

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    Ye H

    2015-06-01

    Full Text Available Hua Ye, Kai Yang, Xue-Mei Tan, Xiao-Juan Fu, Han-Xue LiDepartment of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaBackground: Recent studies have demonstrated that the clock gene PER1 regulates various tumor-related genes. Abnormal expressions and circadian rhythm alterations of PER1 are closely related to carcinogenesis. However, the dynamic circadian variations of PER1 and tumor-related genes at different stages of carcinogenesis remain unknown. This study was conducted to investigate the daily rhythm variation of PER1 and expression of tumor-related genes VEGF, KI67, C-MYC, and P53 in different stages of carcinogenesis.Materials and methods: Dimethylbenzanthracene was used to establish a golden hamster model of buccal mucosa carcinogenesis. Hamsters with normal buccal mucosa, precancerous lesion, and cancerous lesion were sacrificed at six different time points during a 24-hour period of a day. Pathological examination was conducted using routine hematoxylin and eosin staining. PER1, VEGF, KI67, C-MYC, and P53 mRNAs were detected by real-time reverse transcriptase polymerase chain reaction, and a cosinor analysis was applied to analyze the daily rhythm.Results: PER1, VEGF, C-MYC, and P53 mRNA exhibited daily rhythmic expression in three carcinogenesis stages, and KI67 mRNA exhibited daily rhythmic expression in the normal and precancerous stages. The daily rhythmic expression of KI67 was not observed in cancerous stages. The mesor and amplitude of PER1 and P53 mRNA expression decreased upon the development of cancer (P<0.05, whereas the mesor and amplitude of VEGF, KI67, and C-MYC mRNA increased upon the development of cancer (P<0.05. Compared with the normal tissues, the acrophases of PER1, VEGF, and C-MYC mRNA occurred earlier, whereas the acrophases of P53 and KI67 mRNA lagged remarkably in the precancerous lesions. In the cancer stage, the acrophases

  10. Microvascular free flap reconstruction for head and neck cancer in a resource-constrained environment in rural India

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    Nirav P Trivedi

    2013-01-01

    Full Text Available Introduction: Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialised procedure and is not routinely performed in the resource-constrained environment of certain developing parts of India. Materials and Methods: This article focuses on the practice environment in a cancer clinic in rural India. Availability of infrastructure, selection of the case, choice of flap, estimation of cost and complications associated with treatment are evaluated and the merits and demerits of such an approach are discussed. Results: We performed 22 cases of free flaps in a six-month period (2008-2009. Majority (17 of the patients had oral cancer. Seven were related to the tongue and eight to the buccal mucosa. Radial forearm free flap (RFF: 9 and anterolateral thigh flap (ALT: 9 were the most commonly used flaps. A fibula flap (1 was done for an anterior mandible defect, whereas a jejunum free flap (1 was done for a laryngopharyngectomy defect. There were six complications with two re-explorations but no loss of flaps. Conclusion: Reconstruction with microvascular free flaps is feasible in a resource-constrained setup with motivation and careful planning.

  11. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue.

    Science.gov (United States)

    Al-Juboori, Mohammed Jasim

    2016-01-01

    Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

  12. Raman microspectroscopic study of oral buccal mucosa

    Science.gov (United States)

    Behl, Isha; Mamgain, Hitesh; Deshmukh, Atul; Kukreja, Lekha; Hole, Arti R.; Krishna, C. Murali

    2014-03-01

    Oral cancer is the most common cancer among Indian males, with 5-year- survival-rates of less than 50%. Efficacy of Raman spectroscopic methods in non-invasive and objective diagnosis of oral cancers and confounding factors has already been demonstrated. The present Raman microspectroscopic study was undertaken for in-depth and site-specific analysis of normal and tumor tissues. 10 normal and 10 tumors unstained sections from 20 tissues were accrued. Raman data of 160 x 60 μm and 140 x 140 μm in normal and tumor sections, respectively, were acquired using WITec alpha 300R equipped with 532 nm laser, 50X objective and 600 gr/mm grating. Spectral data were corrected for CCDresponse, background. First-derivitized and vector-normalized data were then subjected to K-mean cluster analysis to generate Raman maps and correlated with their respective histopathology. In normal sections, stratification among epithelial layers i.e. basal, intermediate, superficial was observed. Tumor, stromal and inflammatory regions were identified in case of tumor section. Extracted spectra of the pathologically annotated regions were subjected to Principal component analysis. Findings suggest that all three layers of normal epithelium can be differentiated against tumor cells. In epithelium, basal and superficial layers can be separated while intermediate layer show misclassifications. In tumors, discrimination of inflammatory regions from tumor cells and tumor-stroma regions were observed. Finding of the study indicate Raman mapping can lead to molecular level insights of normal and pathological states.

  13. Buccal Mucosa Urethroplasty for Bulbar Urethral Strictures ...

    African Journals Online (AJOL)

    After the bulbar urethra is exposed, we perform a dorsal endoscopic cold knife urethrotomy until the urethra is fully opened. After measurement of the defect, the graft is harvested from the lower lip and sutured to the urethra and to the corpora cavernosa. A transurethral grooved catheter and suprapubic drainage are left for 7 ...

  14. Freqüência e atividade enzimática de Candida albicans isoladas da mucosa bucal de crianças de uma creche da prefeitura de Fortaleza Frequency and enzymatic activity of Candida albicans isolated from the buccal mucosa of children of a day-care center of the city hall of Fortaleza, Ceará, Brazil

    Directory of Open Access Journals (Sweden)

    Everardo Albuquerque Menezes

    2005-02-01

    Full Text Available As candidíases bucais (também chamadas sapinhos que ocorrem em crianças são causadas por uma deficiência imunológica, bem como por outros fatores tais como má higiene bucal e esterilização inadequada dos utensílios utilizados pelas mesmas, que potencializam a ocorrência dessa infecção fúngica. Considerando esse fato, foram avaliadas a freqüência e a atividade enzimática de Candida sp. isoladas em crianças de uma creche pública (Aprisco na cidade de Fortaleza, Ceará. Foram coletadas amostras da mucosa bucal de 364 alunos de 1 a 5 anos de idade. Elas foram semeadas em ágar Sabouraud dextrose com cloranfenicol, incubadas por 72 horas a 37ºC e identificadas por testes micológicos. Verificou-se que 67 (18% apresentaram leveduras do gênero Candida. A Candida albicans foi a mais freqüente, com 30 isolados (45%, seguida pelas C. tropicalis (31%, C. guilliermondii (17%, C. glabrata (4,5% e C. stellatoidea (1,5%. Com relação às atividades enzimáticas das cepas de Candida albicans, 20% produziram a enzima proteinase e 33%, a fosfolipase. As Candida albicans isoladas da mucosa bucal de crianças dessa creche da prefeitura apresentaram uma fraca atividade enzimática. Assim, conclui-se que essas cepas parecem ter uma baixa virulência.Immunedefficiency is one of the main causes of buccal candidiasis, also called thrush, in children. Other factors like inadequate mouth hygiene and inappropriate sterilization utensils potentialize this fungal infection. Considering these facts, Candida sp. frequency and enzymatic activity were evaluated in 364 stocks from mouth mucous of one to five year-old children from a public day care center in Fortaleza, Ceará (Brazil. The samples were cultured in dextrose Sabouraud with chloranfenicol agar and incubated for 72 hours at 37°C. They were identified by mycological tests. It was verified that 67 samples (18% presented Candida sp. and the most frequent genus was Candida albicans (30

  15. Versatility of radial forearm free flap for intraoral reconstruction

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    Jeremić Jelena V.

    2015-01-01

    Full Text Available Introduction. The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. Objective. The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. Methods. This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5% or delayed (2 patients, 9.5% reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases, buccal mucosa (5 cases, lip (1 case and a retromolar triangle (2 cases defects, or after hemiglossectomy (7 cases. In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. Results. An overall success rate was 90.5%. Flap failures were detected in two (9.5% patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis. The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. Conclusion. The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies. [Projekat Ministarstva nauke Republike Srbije, br. 41006

  16. Cytologic and cytometric analysis of oral mucosa in Alzheimer's disease.

    Science.gov (United States)

    de Oliveira, Raquel Mazzilli Toscano; Lia, Erica Negrini; Guimarães, Renato Maia; Bocca, Anamélia Lorenzetti; Cavalcante Neto, Florêncio Figueiredo; da Silva, Tarcília Aparecida

    2008-04-01

    To analyze cytomorphologically the buccal mucosa of patients with Alzheimer's disease (AD). Brush biopsies were obtained from 10 patients with AD and 9 age-matched controls without neurologic symptoms from 3 distinct oral sites. A significant reduction in partially keratinized intermediate (red) cells was observed in the buccal mucosa of the AD group. In the AD group, parabasal cells from the floor of the mouth (p = 0.017) and buccal mucosa (p = 0.058) and red cells,from the tongue dorsum (p = 0.013) and buccal mucosa (p = 0.002), exhibited significantly greater nuclear areas. With regard to the nuclear to cytoplasmic (N:C) ratio, intermediate (red) cells from the buccal mucosa and tongue dorsum of AD individuals showed a decrease in this parameter (p <0.0001), while superficial (yellow) cells (from buccal mucosa) (p= 0.042) and parabasal (blue) cells (from the tongue dorsum) (p = 0.003) exhibited an increased N:C ratio. No significant differences were detected in the cells from the floor of the mouth. Our findings indicate that cytologic and cytometric changes were detectable in the exfoliative cytology of the buccal mucosa and tongue in the AD group.

  17. Treatment of Crohn's disease-related high perianal fistulas combining the mucosa advancement flap with platelet-rich plasma: a pilot study.

    Science.gov (United States)

    Göttgens, K W A; Smeets, R R; Stassen, L P S; Beets, G L; Pierik, M; Breukink, S O

    2015-08-01

    Healing rates after surgical closure for high perianal fistula in patients with Crohn's disease are even more disappointing than in patients with cryptoglandular fistulas. The objective was to improve healing rates by combining the well-known mucosal advancement flap with platelet-rich plasma. A prospective pilot study was conducted in one tertiary referral centre. Consecutive patients with primary or recurrent Crohn's disease-related high perianal fistulas, defined as involving the middle and/or upper third parts of the anal sphincter complex, were included. A staged procedure was performed with non-cutting seton treatment for 3 months first, followed by a mucosal advancement flap with injection of platelet-rich plasma into the fistula tract. Ten consecutive patients were operated on between 2009 and 2014. Half (50%) of the patients had undergone previous fistula surgery. Mean follow-up was 23.3 months (SD 13.0). Healing of the fistula was 70% (95% confidence interval, 33-89%) at 1 year. One (10%) patient had a recurrence, and in two (20%) patients, the fistula was persistent after treatment. An abscess occurred in one (10%) patient. The median post-operative Vaizey score was 8.0 (range 0-21), indicating a moderate to severe continence impairment. The results of combining the mucosal advancement flap with platelet-rich plasma in patients with Crohn's disease-related high perianal fistulas are moderate with a healing rate of 70%. Further investigation is needed to determine the benefits and risks on continence status for this technique in this patient population.

  18. Buccal alterations in diabetes mellitus

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    Negrato Carlos

    2010-01-01

    Full Text Available Abstract Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a increased concentration of mucin and glucose; b impaired production and/or action of many antimicrobial factors; c absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d bad taste; e oral candidiasis f increased cells exfoliation after contact, because of poor lubrication; g increased proliferation of pathogenic microorganisms; h coated tongue; i halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a tongue alterations, generally a burning mouth; b periodontal disease; c white spots due to demineralization in the teeth; d caries; e delayed healing of wounds; f greater tendency to infections; g lichen planus; h mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present.

  19. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, M R

    1999-01-01

    (app)) of the hydrophilic marker mannitol due to exposure to solutions with pH values or osmolality values different from the physiological values was studied. As in studies with solutions of either taurocholate (TC), glycocholate (GC) or glycodeoxycholate (GDC) the results were compared to the increase in P......(app) of mannitol obtained in analog studies using porcine buccal mucosa in an Ussing chamber. The effect of the exposure on the electrical resistance of the TR146 cell culture model and the porcine buccal mucosa was measured, and the degree of protein leakage due to GC exposure was investigated in the TR146 cell...... culture model. The porcine buccal mucosa was approximately ten times less permeable to mannitol than the TR146 cell culture model. The P(app)TC. Increased P(app) values correlated with a decrease in the electrical resistance of the TR146 cell culture model and the porcine buccal mucosa. GC was shown...

  20. Cierre de una fístula oroantral usando cemento óseo y un colgajo de mucosa yugal Closure of an oroantral fistula using bone cement and a jugal mucosa flap

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    Beatriz Ágreda Moreno

    2012-03-01

    Full Text Available Una fístula oroantral es una solución de continuidad patológica entre el seno maxilar y la cavidad oral, producida frecuentemente tras una extracción dentaria, en la mayoría de los casos, del primer o segundo molar. El síntoma más común que provoca es una sinusitis aguda, que evolucionará a la cronicidad si la fístula permanece. El diagnóstico se realiza mediante endoscopia transalveolar, ortopantografía o tomografía computarizada dental. Su cierre quirúrgico es necesario cuando la fístula tiene más de 3 mm, o no sella por sí misma en 3 semanas. Existen, para ello, varias técnicas, usando distintos materiales y colgajos, cuyo fin es ocluir, tanto el defecto óseo, como el mucoso, para solucionar así a la vez la fístula y el problema sinusal.The oroantral fistula is a solution of pathological continuity between the maxillary sinus and the oral cavity, frequently produced after a teeth extraction in most of cases of the first or second molars. The commonest symptom provoked is an acute sinusitis evolving to chronicity if the fistula remains. The diagnosis is made by transalveolar, orthopantography or dental computerized tomography. Its surgical closure is necessary when the fistula has more than 3 mm or not seal by itself in three weeks. For it, there are some techniques using different materials and flaps where its objective is to occlude the bone defect as well as the mucous one thus solving the fistula and the sinus problem.

  1. Oral Mucoadhesive Buccal Film of Ciprofloxacin for Periodontitis ...

    African Journals Online (AJOL)

    This method records the time required for complete erosion or dislodgement of the film from the mucosal surface (segments of porcine buccal mucosa glued on a .... Sitzman C. Evaluation of a hydrophilic gingival dental sealant in beagle dogs. J Vet Dent. 2013; 30(3):150155. 6. Agarwal S, Venkatesh M, Udupa N. Controlled ...

  2. Microemulsion containing triamcinolone acetonide for buccal administration.

    Science.gov (United States)

    Padula, C; Telò, I; Di Ianni, A; Pescina, S; Nicoli, S; Santi, P

    2018-03-30

    The aim of the present work was to investigate the potential of microemulsions for the buccal administration of triamcinolone acetonide. Microemulsions were developed by the construction of pseudoternary phase diagrams, using the aqueous titration method. Among all microemulsions prepared and tested for stability, three were selected and submitted to characterization and in vitro permeation/retention experiments, using pig esophageal epithelium, an accepted model of the buccal mucosa. Furthermore, one microemulsion was added of excipients (stearylamine, CTAB and chitosan) able to alter the charge of droplets. The results obtained show that the permeation of triamcinolone acetonide across pig esophageal epithelium was not influenced by the droplet size nor by the composition, but only by the presence of chitosan, polysaccharide able to increase the transport across mono and stratified epithelia. The determination of the permeation parameters allowed us to show that chitosan acts on the diffusion parameter across the tissue and not on the partitioning parameter; for the same reason the tissue retention of triamcinolone acetonide was not modified. Triamcinolone flux (2.6 μg cm -2  h -1 ) was too low to make systemic administration feasible (dose required 2.5 to 60 mg/day). The amount of triamcinolone acetonide recovered in the mucosa after only 10 min. of microemulsion application was much higher than after overnight application of the commercial paste Omicilon® A. This suggests that triamcinolone acetonide microemulsions can be an interesting alternative to the commercial formulation to treat diseases of the buccal mucosa. Owing to the fast uptake by the tissue, the formulation can be used as a mouthwash. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Reconstruction of the bulbar urethra using dorsal onlay buccal mucosal grafts: New concepts and surgical tricks

    Directory of Open Access Journals (Sweden)

    Guido Barbagli

    2006-01-01

    Full Text Available Buccal mucosa onlay graft urethroplasty represents one of the most widespread methods for the repair of strictures in the bulbar urethra, because of its thick and highly vascular spongiosum tissue. Recently the location of the patch has become a contentious issue, since we described our original techniques of dorsal onlay graft urethroplasty. The design rationale for this approach was based on the concept that the corporeal body remains a healthy host for receiving a free transplanted tissues. Moreover, graft fixation onto a defined surface may decrease graft shrinkage and sacculation. The success rate using buccal mucosa grafts for the repair of bulbar urethral strictures has generally been high with dorsal or ventral onlay grafts or using an augmented roof-strip anastomotic urethroplasty. We describe here the fundamental concepts of the bulbar urethra reconstruction using buccal mucosal grafts, presenting a new surgical technique of dorsal onlay buccal mucosa graft urethroplasty using fibrin glue.

  4. Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs.

    Science.gov (United States)

    Vlahovic, Zoran; Markovic, Aleksa; Golubovic, Mileta; Scepanovic, Miodrag; Kalanovic, Milena; Djinic, Ana

    2015-11-01

    The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Azone® decreases the buccal mucosal permeation of Diazepam in a concentration-dependent manner via a reservoir effect

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Jacobsen, Jette; Jin, Liang

    2014-01-01

    The purpose of this study was to examine concentration-dependent effects of Azone® (AZ) on the buccal absorption of diazepam (DIAZ). Porcine buccal mucosa was placed in modified Ussing chambers and pretreated with 10 μL of 0%, 5%, 20%, and 50% (w/v) AZ in ethanol. DIAZ was administered to the donor...

  6. Buccal bone loss after immediate implantation can be reduced by the flapless approach

    Directory of Open Access Journals (Sweden)

    ARTHUR BELÉM NOVAES JR

    2011-10-01

    Full Text Available Aim: The aim of this study was to evaluate the buccal bone remodeling after immediate implantation with flap or flapless approach. Material and Methods: The mandibular bilateral premolars of 3 dogs were extracted and immediately three implants were placed in both hemi-arches of each dog. Randomly, one hemi-arch was treated with the flapless approach, while in the contra lateral hemi-arch tooth extractions and implant placement were done after mucoperiosteal flap elevation. Non-submerged healing of 12 weeks was provided for both groups. Histomorphometric analysis was done to compare buccal and lingual bone height loss, bone density and bone-to-implant contact in the groups. Fluorescence analysis was performed to investigate the dynamic of bone remodeling in the different groups. Results: There was a significant association between the surgical flap and the extent of bone resorption around immediate implants. The loss of buccal bone height was significantly lower in the flapless group when compared to the flap group (0.98 mm x 2.14 mm, respectively, p<0.05. The coronal and apical buccal bone densities of the flap group were significantly higher when compared to the lingual components, showing anatomical differences between the bone plates. Fluorescence analysis showed no major differences in bone healing between the flap and flapless groups, supporting that the higher loss of buccal bone height is linked to the anatomic characteristics of this plate and to the negative influence of the detachment of the periosteum in immediate implant therapy. Conclusion: The flapless approach for immediate post-extraction implants reduces the buccal bone height loss.

  7. Fentanyl Buccal Soluble Film: A Review in Breakthrough Cancer Pain.

    Science.gov (United States)

    Garnock-Jones, Karly P

    2016-05-01

    Fentanyl buccal soluble film (Onsolis(®), Breakyl(®), Painkyl™) comprises two layers: a mucoadhesive layer containing the active drug, and an inactive layer with the aim of preventing the diffusion of fentanyl into the oral cavity. It is approved in several countries worldwide, including the USA and those of the EU, for the management of breakthrough cancer pain in opioid-tolerant, adult patients with cancer. This article reviews the pharmacological properties of fentanyl buccal soluble film and its clinical efficacy and tolerability in these patients. Fentanyl buccal soluble film provides an additional option for transmucosal delivery of fentanyl, with approximately half of the dose undergoing an initial, rapid absorption via the buccal mucosa (accounting for its high bioavailability). In clinical trials, fentanyl buccal soluble film was associated with significant improvements in pain intensity scores versus placebo and was generally well tolerated. The most common adverse events were typical opioid-associated adverse events, such as nausea and vomiting. Fentanyl buccal soluble film is a useful option for the treatment of breakthrough cancer pain in opioid-tolerant patients.

  8. Effect of buccal dwell time on the pharmacokinetic profile of fentanyl buccal tablet.

    Science.gov (United States)

    Darwish, M; Kirby, M; Jiang, J G

    2007-09-01

    The time fentanyl buccal tablet (FBT) takes to completely dissolve after placement on the buccal mucosa (i.e., 'dwell time') could exceed the time to onset of analgesia. To examine the relationship between FBT dwell time and fentanyl pharmacokinetic parameters. This was a post hoc exploratory analysis of data from two randomized, open-label, crossover, pharmaco-kinetic studies that were designed to assess dose proportionality within the anticipated therapeutic dose range. Healthy adults received single FBT doses of 200-1080 microg in Study 1 (n = 28) and 270-1300 microg in Study 2 (n = 42). Assessments included buccal dwell time, defined as the duration of FBT presence in the oral cavity, and the following pharmacokinetic measures: maximum serum concentration (C(max)), time to C(max) (T(max)) and area under the concentration-time curve (AUC; exposure) from 0 minutes to median T(max) adjusted for the dose (T(max')) (AUC(0 T(max'))). Spontaneously reported adverse events were recorded. Mean buccal dwell time for FBT across the dose range varied from 14 to 25 minutes (range 3 - 62 minutes). There was no evidence of an association between FBT dwell time and values for T(max) (medians 45 - 60 minutes), dose-normalized C(max) (means 0.42-0.66 pg/ml/200 microg) or dose-normalized AUC(0 T(max')) (means 0.24-0.38 pg x h/ml/200 microg) over the range of FBT doses delivered. All adverse events reported were mild to moderate; none were unexpected or serious. The pharmacokinetic parameters of FBT did not appear to be related to its buccal dwell time.

  9. Buccal delivery of metformin

    DEFF Research Database (Denmark)

    Sander, Camilla; Nielsen, Hanne Mørck; Jacobsen, Jette

    2013-01-01

    The oral cavity is considered an attractive site of drug administration. Metformin is currently, used in oral diabetes treatment. The aim of the current study was to study the feasibility of metformin, to permeate the buccal epithelium applying a bioadhesive and permeation enhancing drug delivery...... system. The in vitro TR146 cell culture model was used to study the effect of drug concentration (5-100mM) and the impact of a bioadhesive chitosan formulation (discs) and chitosan in solution (0-20mg/mL) acting as a permeation enhancer. The permeation of metformin occurred by passive diffusion via......, suggest that in vivo absorption of therapeutic doses of metformin needs to take place as a combination of buccal and intestinal absorption as metformin therapy requires the use of high doses....

  10. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Mørck Nielsen, H; Rømer Rassing, M; Nielsen, Hanne Mørck

    2000-01-01

    The objective of the present study was to characterise the TR146 cell culture model as an in vitro model of human buccal mucosa with respect to the enzyme activity in the tissues. For this purpose, the contents of aminopeptidase, carboxypeptidase and esterase in homogenate supernatants of the TR146...... cell culture model, and human and porcine buccal epithelium were compared. The esterase activity in the intact cell culture model and in the porcine buccal mucosa was compared. Further, the TR146 cell culture model was used to study the permeability rate and metabolism of leu-enkephalin. The activity...... of the three enzymes in the TR146 homogenate supernatants was in the same range as the activity in homogenate supernatants of human buccal epithelium. In the TR146 cell culture model, the activity of aminopeptidase (13.70+/-2.10 nmol/min per mg protein) was approx. four times the activity of carboxypeptidase...

  11. Cytokeratin expression in human fetal tongue and buccal mucosa

    Indian Academy of Sciences (India)

    Our earlier studies on CK expression in human oral tumours and pre-cancerous lesions have shown specific changes in CK expression. ... Cancer Research Institute, Parel, Mumbai 400 012, India; Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai 400 012, India; Nowrosjee Wadia Maternity Hospital, Parel, ...

  12. Dorsal onlay graft bulbar urethroplasty using buccal mucosa

    African Journals Online (AJOL)

    G. Barbagli

    2015-12-02

    Dec 2, 2015 ... arated parts so that two surgical teams can work simultaneously. Each team has its own set of surgical instruments. One team har- vests and prepares the oral graft, while the second team exposes the urethra. Pre-operative urethroscopy is performed using a 7F rigid ureteroscope to evaluate the stricture ...

  13. Ventral onlay graft bulbar urethroplasty using buccal mucosa

    African Journals Online (AJOL)

    H. Wessells

    2016-01-21

    Jan 21, 2016 ... long-term consequence of this practice pattern will be to increase the length of strictures, rendering some unsuitable ... urological interventions in the aging male across the world. This paper reviews the diagnostic ..... can overcome severely compromised urethral pathology. The grand challenges of urethral ...

  14. Cytokeratin expression in human fetal tongue and buccal mucosa

    Indian Academy of Sciences (India)

    Unknown

    distinct subfamilies, type I – acidic and type II – basic or neutral (Eichner et al 1986). These are expressed in ... chea, breast, lung, stomach, intestinal epithelium, skin, and enamel organs and were found to be different ... temperature and the sections were then incubated with. FITC conjugated goat anti-mouse IgG for 1 h at ...

  15. Balanitis Xerotica Obliterans: An experience with Buccal Mucosa ...

    African Journals Online (AJOL)

    Background: Balanitis Xerotic obliterans (BXO) or Penile Lichen Sclerosus is a dermatological condition affecting the genitalia and associated with chronic, progressive, sclerosing inflammatory dermatosis of unclear etiology. It was first described by Stuhmer in 1928, as being a rare condition but causes severe tissue ...

  16. Ventral onlay graft bulbar urethroplasty using buccal mucosa

    African Journals Online (AJOL)

    H. Wessells

    2016-01-21

    Jan 21, 2016 ... web page of the journal www.ees.elsevier.com/afju · www.sciencedirect.com. Review. Ventral onlay graft bulbar urethroplasty using ..... use and increase probability of long term success in patients with compromised urethras. Conflict of interest. No conflict of interest. References. [1] Santucci RA, Joyce GF, ...

  17. Review: Non-transecting bulbar urethroplasty using buccal mucosa ...

    African Journals Online (AJOL)

    Augmentation urethroplasty using oral mucosal graft has become the standard surgical treatment of long bulbar strictures. In very tight strictures the urethral plate is narrowed to the extent that an almost circumferential substitution with oral graft is necessary, with suboptimal results. If the obliterative segment within a longer ...

  18. Non-transecting bulbar urethroplasty using buccal mucosa

    African Journals Online (AJOL)

    S. Bugeja

    2015-12-02

    Dec 2, 2015 ... Augmentation urethroplasty using oral mucosal graft has become the standard surgical treatment of long bulbar strictures. .... complications [14]. The legs are supported in Allen® Yellofin® stir- rups. Anti-thromboembolic stockings and pneumatic intermittent calf compression devices are used routinely.

  19. Introduction to the special issue of Buccal Mucosa Graft Urethroplasty

    African Journals Online (AJOL)

    Ismail Khalaf Editor-in-Chief

    African Journal of Urology. Official journal of the Pan African Urological Surgeon's Association web page of the journal www.ees.elsevier.com/afju ... The Editorial Board of the AFJU express their deep apprecia- tion, thankfulness and gratitude to the following expert faculty: Prof. Guido Barbagli, Director of the Center for ...

  20. Closure of oro-antral fistula with pedicled buccal fat pad. A case ...

    African Journals Online (AJOL)

    This article demonstrates the use of BFP in the repair of chronic oro-antral fistula. Methods: A case of a chronic oro-antral fistula of 5- year duration in a 56- year old man successfully repaired with pedicled buccal fat pad after unsuccessful several attempts with other local flaps is presented. A review of relevant literature ...

  1. The oral mucosa graft: a systematic review.

    Science.gov (United States)

    Markiewicz, Michael R; Lukose, Melissa A; Margarone, Joseph E; Barbagli, Guido; Miller, Kennon S; Chuang, Sung-Kiang

    2007-08-01

    We provide the reader with a critical, nonbiased, systematic review of current and precedent literature regarding the use of oral mucosa in the reconstruction of urethral defects associated with stricture and hypospadias/epispadias. We reviewed pertinent English literature from January 1966 through August 1, 2006 via the databases MEDLINE/PubMed, the Cochrane Library, and EMBASE Drugs and Pharmacology regarding the use of oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with stricture and hypospadias/epispadias. Bibliographies of pertinent articles were explored for additional important literature. Data were stratified among studies that only used oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with stricture, and those that used oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with hypospadias/epispadias. Recipient site success in the reconstruction of defects associated with stricture was significantly associated with the location of graft placement (ventral vs dorsal, p oral mucosa harvest (labial vs buccal, p oral mucosa is a viable source of donor tissue displaying many characteristics of the ideal urethral graft. There are numerous variations of the oral mucosa graft urethroplasty technique. Herein comparisons are made.

  2. Regional Myocutaneous Flaps for Head and Neck Reconstruction ...

    African Journals Online (AJOL)

    Department of Oral and Maxillofacial Surgery, Regional Head and Neck Cancer Division, LASUCOM/LASUTH, Lagos,. Nigeria. ABSTRACT ... head and neck reconstruction: Experience of a head and neck cancer unit. Niger J Surg 2015 .... The PMMC flaps were used to reconstruct mucosa only in five cases; mucosa and ...

  3. SUCCESSFUL ANAESTHETIC MANAGEMENT OF A PATIENT WITH PARADOXICAL VENTRICULAR SEPTAL MOTION (PVSM POSTED FOR MODIFIED RADICAL NECK DISSECTION WITH RADIAL FREE FLAP

    Directory of Open Access Journals (Sweden)

    Amruta

    2015-04-01

    Full Text Available BACKGROUND : Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION : We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck disse ction with radial free flap. CONCLUSION : Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri - operative perio d. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the p aradoxical ventricular septal motion

  4. Chemokine production by buccal epithelium as a distinctive feature of pediatric Crohn disease

    NARCIS (Netherlands)

    Damen, GM; Hol, J; de Ruiter, L.; Bouquet, J; Sinaasappel, M; van der Woude, J; Laman, JD; Hop, WCJ; Buller, HA; Escher, JC; Nieuwenhuis, EES

    Objectives: Inflammatory bowel diseases (IBD) represent an aberrant immune response by the mucosal immune system to luminal bacteria. Because the oral mucosa harbors the first epithelial cells that interact with microorganisms, we assessed the immunologic activity of buccal epithelium in children

  5. Periodontal responses to augmented corticotomy with collagen membrane application during orthodontic buccal tipping in dogs.

    Science.gov (United States)

    Lee, Dong-Yeol; Ahn, Hyo-Won; Herr, Yeek; Kwon, Young-Hyuk; Kim, Seong-Hun; Kim, Eun-Cheol

    2014-01-01

    This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.

  6. Periodontal Responses to Augmented Corticotomy with Collagen Membrane Application during Orthodontic Buccal Tipping in Dogs

    Science.gov (United States)

    Herr, Yeek; Kwon, Young-Hyuk; Kim, Seong-Hun; Kim, Eun-Cheol

    2014-01-01

    This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface. PMID:25276824

  7. Bilayered buccal films as child-appropriate dosage form for systemic administration of propranolol.

    Science.gov (United States)

    Abruzzo, Angela; Nicoletta, Fiore Pasquale; Dalena, Francesco; Cerchiara, Teresa; Luppi, Barbara; Bigucci, Federica

    2017-10-05

    Buccal mucosa has emerged as an attractive site for systemic administration of drug in paediatric patients. This route is simple and non-invasive, even if the saliva wash-out effect and the relative permeability of the mucosa can reduce drug absorption. Mucoadhesive polymers represent a common employed strategy to increase the contact time of the formulation at the application site and to improve drug absorption. Among the different mucoadhesive dosage forms, buccal films are particularly addressed for paediatric population since they are thin, adaptable to the mucosal surface and able to offer an exact and flexible dose. The objective of the present study was to develop bilayered buccal films for the release of propranolol hydrochloride. A primary polymeric layer was prepared by casting and drying of solutions of film-forming polymers, such as polyvinylpyrrolidone (PVP) or polyvinylalcohol (PVA), added with different weight ratios of gelatin (GEL) or chitosan (CH). In order to achieve unidirectional drug delivery towards buccal mucosa, a secondary ethylcellulose layer was applied onto the primary layer. Bilayered films were characterized for their physico-chemical (morphology, thickness, drug content and solid state) and functional (water uptake, mucoadhesion, drug release and permeation) properties. The inclusion of CH into PVP and PVA primary layer provided the best mucoadhesion ability. Films containing CH provided a lower drug release with respect to films containing GEL and increased the amount of permeated drug through buccal mucosa, thanks to its ability of interfering with the lipid organization. The secondary ethylcellulose layer did not interfere with drug permeation, but it could limit drug release in the buccal cavity. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Buccal midazolam spray as an alternative to intranasal route for conscious sedation in pediatric dentistry.

    Science.gov (United States)

    Chopra, Radhika; Mittal, Meenu; Bansal, Kalpana; Chaudhuri, Payal

    2013-01-01

    To evaluate the acceptance of midazolam spray through buccal route as compared to intranasal route and compare the efficacy of the drug through both the routes. 30 patients aged 2-8 years with Grade I or II Frankl's Behaviour Rating Scale were selected who required similar treatment under local anesthesia on two teeth. Midazolam spray was administered randomly through buccal or intranasal routes for the two appointments. Scoring was done for the acceptance of drug and Houpt's score was recorded for the behaviour of patients during the treatment. Acceptance of drug through buccal route was significantly better than the intranasal route (p 0.05). Midazolam spray can be effectively used through the buccal mucosa in children who give poor compliance with the intranasal administration.

  9. Overview and Future Potential of Buccal Mucoadhesive Films as Drug Delivery Systems for Biologics.

    Science.gov (United States)

    Montenegro-Nicolini, Miguel; Morales, Javier O

    2017-01-01

    The main route of administration for drug products is the oral route, yet biologics are initially developed as injectables due to their limited stability through the gastrointestinal tract and solubility issues. In order to avoid injections, a myriad of investigations on alternative administration routes that can bypass enzymatic degradation and the first-pass effect are found in the literature. As an alternative site for biologics absorption, the buccal route presents with a number of advantages. The buccal mucosa is a barrier, providing protection to underlying tissue, but is more permeable than other alternative routes such as the skin. Buccal films are polymeric matrices designed to be mucoadhesive properties and usually formulated with permeability enhancers to improve bioavailability. Conventionally, buccal films for biologics are manufactured by solvent casting, yet recent developments have shown the potential of hot melt extrusion, and most recently ink jet printing as promising strategies. This review aims at depicting the field of biologics-loaded mucoadhesive films as buccal drug delivery systems. In light of the literature available, the buccal epithelium is a promising route for biologics administration, which is reflected in clinical trials currently in progress, looking forward to register and commercialize the first biologic product formulated as a buccal film.

  10. Closure of oroantral fistula with rotational palatal flap technique

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2007-03-01

    Full Text Available Oroantral fistula is one of the common complications following dentoalveolar surgeries in the maxilla. Closure of oroantral fistula should be done as early as possible to eliminate the risk of infection of the antrum. Palatal flap is one of the commonly used methods in the closure of oroantral fistula. A case is reported of a male patient who had two oroantral communication after having his two dental implants removed. Buccal flap was used to close the defects, but one of them remained open and resulted in oroantral fistula. Second correction was performed to close the defect using buccal fat pad, but the fistula still persisted. Finally, palatal rotational flap was used to close up the fistula. The result was good, as the defect was successfully closed and the donor site healed uneventfully.

  11. Ketobemidone prodrugs for buccal delivery

    DEFF Research Database (Denmark)

    Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.

    1992-01-01

    As part of studies aiming at developing a ketobemidone prodrug suitable for buccal or sublingual administration, the potential impact of saliva enzyme-catalyzed hydrolysis of various ester prodrugs was assessed. The hydrolysis of three ketobemidone esters in human whole saliva, obtained under...... at pharmacologically relevant prodrug concentrations, degradation of the esters by saliva enzymes was predicted to occur to only a minor extent (1-6%) under conditions similar to those prevailing in vivo after administration of buccal or sublingual tablets of the esters. The mode of administration of tablets for use...... in the mouth and their rate of disintegration were shown to have some influence on the rate of saliva secretion and hence on saliva esterase activity but not to an extent compromising the efficient buccal or sublingual delivery of the ketobemidone prodrugs....

  12. Micronuclei assay of exfoliated oral buccal cells: Means to assess the nuclear abnormalities in different diseases

    Directory of Open Access Journals (Sweden)

    Bina Kashyap

    2012-01-01

    Full Text Available The micronuclei assay (MA in exfoliated buccal cells is an innovative genotoxicity technique, which holds promise for the study of epithelial carcinogens. Micronuclei are suitable internal dosimeters for revealing tissue-specific genotoxic damage in individuals exposed to carcinogenic mixtures. This article reviews the MN assay with respect to oral buccal mucosa, which has been used since the 1980s to demonstrate cytogenetic effects of environmental and occupational exposures, lifestyle factors, dietary deficiencies, and different diseases along with the characteristics of micronuclei and other nuclear abnormalities.

  13. The fate of buccal bone around dental implants. A 12-month postloading follow-up study.

    Science.gov (United States)

    Merheb, Joe; Vercruyssen, Marjolein; Coucke, Wim; Beckers, Ludovic; Teughels, Wim; Quirynen, Marc

    2017-01-01

    Buccal bone thickness is considered to be an important factor during implant surgery. Its resorption might have an effect on the soft tissue stability and eventually on implant survival. This study aimed to investigate the resorption of the buccal bone over the first 12 months after implant loading. Twenty-four subjects (47 implants) were included. The buccal bone thickness was measured during implant surgery at several distances from the implant shoulder using a specifically designed device which allows buccal bone thickness measurements without the elevation of a muco-periostal flap. These measurements were repeated after 12 months of loading. Sixteen implants were placed flapless and 31 with the elevation of a flap. Of the latter, 19 were placed following a one-stage protocol and 12 following a two-stage protocol. The mean reduction in buccal bone thickness, when all groups pooled, was 0.26, 0.36, 0.35 and 0.27 mm at the shoulder and 2, 4 and 6 mm apically. Implants with initial bone thickness flapless procedure leads to less bone resorption compared to an open-flap procedure (P = 0.03). However, the number of surgeries (one stage vs. two stages) did not influence the rate of bone resorption (P = 0.23). Within the limitations of this study, one might question the necessity of having a thick bone plate at the vestibular site of the implant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Lipoma in oral mucosa: Two case reports

    Directory of Open Access Journals (Sweden)

    Ali Tavakoli Hoseini

    2010-01-01

    Full Text Available Lipoma is a common tumor of soft tissue. Its location on the oral mucosa is rare, representing 1% to 5% of benign oral tumors although it is the most mesenchymal tumor of the trunk and proximal por-tions of extremities. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, and floor of the mouth are among the common locations. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumor. Other benign connective tissue lesions such as granular cell tumor, neurofibroma, traumatic fibroma and salivary gland lesions (mucocele and mixed tumor might be included in differential diagnosis. We present two cases of oral lipoma in unusual locations: one in junction of soft and hard palate and the other in tongue. Both were rare in the literature.

  15. Effect of novel mucoadhesive buccal patches of carvedilol on isoprenaline-induced tachycardia

    Directory of Open Access Journals (Sweden)

    Navneet Verma

    2014-01-01

    Full Text Available The main aim of the study was designed to develop bioadhesive buccal patches of carvedilol (CR and evaluate for isoprenaline-induced tachycardia. Buccal patches of carvedilol were prepared by using chitosan (CH, sodium salt of carboxy methyl cellulose (NaCMC, and polyvinyl alcohol (PVA as mucoadhesive polymers. The solvent evaporation method was used for the preparation of buccal patches. The patches were evaluated for their physical characteristics like patch thickness, weight variation, content uniformity, folding endurance, surface pH, residence time, in vitro drug release, and in vivo pharmacodynamic study. The swelling index of the patches was found to be proportional to the polymer concentration, whereas surface pH of all the formulated bioadhesive patches was found to lie between neutral ranges. In-vitro release study shows that 94.75% drug was release in 8 hours from the patch, which containing 2% w/v chitosan. The folding endurance result shows good elasticity in all the patches.Application of buccal patches on buccal mucosa of rabbit shows a significant result in % inhibition of isoprenaline-induced tachycardia. Prepared buccal patches of chitosan, NaCMC, and PVA containing Carvedilol meet the ideal requirement for the delivery of cardiovascular drugs and inhibit the isoprenaline tachycardia.

  16. Vertical platysma myocutaneous flap reconstruction for oral defects using three different incision designs: experience with 68 cases.

    Science.gov (United States)

    Huang, L; Gao, X; Su, T; Jiang, C-H; Jian, X-C

    2018-03-01

    This study evaluated the effects of three different incision designs for the vertical platysma myocutaneous flap (VPMF): apron, MacFee, and T-shaped. This flap was used for the reconstruction of intraoral defects following cancer ablation in selected patients. Sixty-eight cases of VPMF reconstruction were assessed: the apron incision was used in 28, MacFee incision in 22, and T-shaped incision in 18. With regard to postoperative outcomes, there were 26 cases of flap survival and two of partial necrosis with the apron incision; 20 of survival and two of partial necrosis with the MacFee incision; 15 of survival and three of partial necrosis with the T-shaped incision. Success rates were 92.9%, 90.9% and 83.3%, respectively, for VPMF with the apron, MacFee, and T-shaped incisions. A wound healing disturbance in the neck was seen in three cases of VPMF with the apron incision and one case with the MacFee incision. The MacFee incision had the best aesthetic effect, and the postoperative neck scar was more obvious for the T-shaped incision. It is recommended that VPMF with the MacFee or apron incision be used for the reconstruction of larger buccal mucosa and floor of the mouth defects, while VPMF with the T-shaped incision should be used for smaller intraoral defects, especially tongue defects of the lateral surface. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. The expression profile of filaggrin-2 in the normal and pathologic human oral mucosa.

    Science.gov (United States)

    Makino, Teruhiko; Mizawa, Megumi; Inoue, Sayaka; Noguchi, Makoto; Shimizu, Tadamichi

    2016-04-01

    The epithelial cells of the oral cavity show a remarkable degree of regional variation with respect to their morphology and keratinization status. In the oral cavity, the tongue and palate contain keratinizing stratified epithelia, while the buccal mucosa contains non-keratinizing stratified epithelia. We herein examined the expression of filaggrin-2, a member of the S100 fused-type protein family, in the oral mucosa. Filaggrin-2 was weakly expressed in the normal epithelium of the palate, but not in the buccal mucosa or tongue, although filaggrin protein was observed in the epithelium of the buccal mucosa and the palate. We next examined the expression of filaggrin-2 in the oral mucosa of subjects with hyperkeratotic diseases. The expression of filaggrin-2 was markedly increased in the epithelium of the oral mucosa in patients with lichen planus, leukokeratosis and leukoplakia. Filaggrin-2 positivity was observed in granules, some of which were co-localized with those of filaggrin. These results indicate that filaggrin-2 was expressed in the oral mucosa under certain pathological conditions, demonstrating that an aberrant protein expression, together with filaggrin, indicates the altered differentiation program including hyperkeratosis that occurs in these diseases.

  18. Mucoadhesive buccal tablets containing silymarin Eudragit-loaded nanoparticles: formulation, characterisation and ex vivo permeation.

    Science.gov (United States)

    El-Nahas, Amira E; Allam, Ahmed N; El-Kamel, Amal H

    2017-08-01

    Eudragit-loaded silymarin nanoparticles (SNPs) and their formulation into buccal mucoadhesive tablets were investigated to improve the low bioavailability of silymarin through buccal delivery. Characterisation of SNPs and silymarin buccal tablets (SBTs) containing the optimised NPs were performed. Ex vivo permeability of nominated SBTs were assessed using chicken pouch mucosa compared to SNPs and drug suspension followed by histopathological examination. Selected SNPs had a small size (77%) with drug release of about 90% after 6 h. For STBs, all physicochemical parameters were satisfactory for different polymers used. DSC and FT-IR studies suggested the presence of silymarin in an amorphous state. Ex vivo permeation significantly emphasised the great enhancement of silymarin permeation after NPs formation and much more increase after formulating into BTs relative to the corresponding drug dispersion with confirmed membrane integrity. Incorporation of SNPs into BTs could be an efficient vehicle for delivery of silymarin.

  19. Nasal Floor Mucosa: New Donor Site for Mucous Membrane Grafts.

    Science.gov (United States)

    Morgan, Payam V; Suh, Jeffrey D; Hwang, Catherine J

    2016-01-01

    Mucous membrane grafts are used for various indications in oculoplastics. The authors report the use of nasal floor mucosa as a new donor site for mucous membrane grafts. Following adequate anesthesia and vasoconstriction, the nasal floor is visualized with a 30° endoscope. Next, the interior turbinate is medialized, and the nasolacrimal duct is identified and preserved. Anterior, posterior, medial, and lateral incisions are made through the nasal mucosa to the nasal bone. The mucosa is dissected off the nasal bone with a periosteal elevator. Nasal saline irrigation is used postoperatively to aid healing. Histologic analysis of the harvested graft and mucosa from the inferior and middle turbinates were analyzed histologically for the number of mucin-producing cells per high power field and compared. Nasal floor mucosa provides ample tissue for grafting with little donor site morbidity. The surgery is technically easy to learn and perform. There is less risk for blood loss compared with harvesting tissue from the turbinates and less postoperative discomfort compared with buccal mucosal grafts. The grafts have been used in 9 different patients for a variety of ocular indications. Histologically, the nasal floor mucosa contains statistically more mucin-secreting cells than other nasal site, which can be helpful especially in cases of ocular surface disease. In 1 case, biopsy of the grafted tissue at postoperative year 2 showed survival of the respiratory mucin-secreting cells under histologic examination. Nasal floor mucosa should be considered a donor site when a mucous membrane graft is needed. The surgery is safe, easy to perform, and has less morbidity than either a nasal turbinate graft or a buccal mucosal graft.

  20. A study of complexity of oral mucosa using fractal geometry

    Directory of Open Access Journals (Sweden)

    S R Shenoi

    2017-01-01

    Full Text Available Background: The oral mucosa lining the oral cavity is composed of epithelium supported by connective tissue. The shape of the epithelial-connective tissue interface has traditionally been used to describe physiological and pathological changes in the oral mucosa. Aim: The aim is to evaluate the morphometric complexity in normal, dysplastic, well-differentiated, and moderately differentiated squamous cell carcinoma (SCC of the oral mucosa using fractal geometry. Materials and Methods: A total of 80 periodic acid–Schiff stained histological images of four groups: normal mucosa, dysplasia, well-differentiated SCC, and moderately differentiated SCC were verified by the gold standard. These images were then subjected to fractal analysis. Statistical Analysis: ANOVA and post hoc test: Bonferroni was applied. Results: Fractal dimension (FD increases as the complexity increases from normal to dysplasia and then to SCC. Normal buccal mucosa was found to be significantly different from dysplasia and the two grades of SCC (P < 0.05. ANOVA of fractal scores of four morphometrically different groups of buccal mucosa was significantly different with F (3,76 = 23.720 and P< 0.01. However, FD of dysplasia was not significantly different from well-differentiated and moderately differentiated SCC (P = 1.000 and P = 0.382, respectively. Conclusion: This study establishes FD as a newer tool in differentiating normal tissue from dysplastic and neoplastic tissue. Fractal geometry is useful in the study of both physiological and pathological changes in the oral mucosa. A new grading system based on FD may emerge as an adjuvant aid in cancer diagnosis.

  1. Use of the buccal fat [corrected] pad for vocal cord augmentation.

    Science.gov (United States)

    Tamura, Etsuyo; Fukuda, Hiroyuki; Tabata, Yasuhiko; Nishimura, Masaki

    2008-02-01

    We performed therapeutically successful intracordal injection of autologous fat harvested from the buccal fat pad. Autologous fat has been used increasingly for intracordal injection as vocal rehabilitation in patients with deficient glottal closure. Adipose tissues used have been harvested mostly from the lower abdomen. However, patients differ considerably in the amount of fat available from the lower abdomen, and it is often difficult to obtain sufficient fat in patients with a low body mass index (BMI). Moreover, the scar visible after harvesting can be cosmetically undesirable. As an alternative, we evaluated harvesting of the buccal fat pad, as in plastic surgery. From January to December 2005, intracordal buccal fat injection was performed for 10 patients, who were subsequently followed up for over 6 months. Buccal mucosa was incised under general anesthesia to expose and harvest the buccal fat pad. This fat was cut into small pieces and injected into the vocal cord. Maximum phonation time and glottal aerodynamics were evaluated pre- and postoperatively. Glottal closure and mucosal vibration were examined stroboscopically. Except in one patient, no postoperative complications such as swelling or infection followed either harvesting or injection. After injection, phonation showed notable improvement that was maintained throughout follow-up.

  2. Buccally Administered Intranasal Desmopressin Acetate for the Treatment of Neurogenic Diabetes Insipidus in Infancy.

    Science.gov (United States)

    Smego, Allison R; Backeljauw, Philippe; Gutmark-Little, Iris

    2016-05-01

    The treatment of neurogenic diabetes insipidus (DI) in infancy is challenging and complicated by fluid overload and dehydration. Therapy with subcutaneous (SC), intranasal (IN), or oral tablet desmopressin acetate (1-desamino-8-D-arginine vasopressin [DDAVP]) remains difficult to titrate in infants. Assess the efficacy and safety of buccally administered IN DDAVP for the management of infants with neurogenic DI. Retrospective review of clinical and laboratory data of 15 infants (mean age, 4.5 mo) with neurogenic DI treated at a tertiary care center. Treatment was with diluted IN DDAVP formulation (10 mcg/mL) administered buccally via a tuberculin syringe to the buccal mucosa. After initial DDAVP titration of 2-3 days, IN DDAVP doses ranged from 1 to 5 mcg twice daily given buccally. Mean serum sodium concentration at DI diagnosis was 159 ± 6.6 mmol/L (range, 151-178) and improved to 142 ± 3.5 mmol/L (range, 137-147) with the buccally administered IN DDAVP. Normal sodium concentrations were established without major fluctuations. Serum sodium was then maintained in the outpatient setting at a mean of 145.7 ± 4.8 mmol/L (mean duration of follow-up, 11 mo). Buccally administered IN formulation of DDAVP provides a practical and safe treatment alternative for neurogenic DI in infancy. Our approach avoided severe hypo- and hypernatremia during DDAVP titration and ongoing outpatient management of DI. The possibility for smaller dosage increments and ease of administration make IN DDAVP administered buccally preferable over other DDAVP treatment options in infants.

  3. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  4. Ex vivo comparative study on three sinus lift tools for transcrestal detaching maxillary sinus mucosa.

    Science.gov (United States)

    Li, Yanfeng; Hu, Pin; Han, Yishi; Fan, Jiadong; Dong, Xinming; Ren, Huan; Yang, Chunhao; Shi, Tingting; Xia, Dong

    2017-07-04

    The objective of this study was to comparatively evaluate 3 different sinus lift tools, namely umbrella-shaped sinus lift curette YSL-04, our recently designed probe-improved sinus lift curettes, and our newly invented elevator 014, using our previous developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time. Goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time were generated according to our previously developed protocol. The effectiveness for each tool was evaluated through the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions. The results showed that all 3 sinus lift tools could transcrestally detach the maxillary sinus mucosa and create extra space under the elevated sinus floor on the goat ex vivo sinus models. Moreover, our newly invented elevator 014 had advantages over the other 2 in term of the capability to detach the sinus mucosa. Our newly invented elevator 014 might be a promising tool for detaching maxillary sinus mucosa in transcrestal maxillary sinus floor elevation.

  5. Blood-group-related carbohydrates are expressed in organotypic cultures of human skin and oral mucosa

    DEFF Research Database (Denmark)

    Grøn, B; Andersson, A; Dabelsteen, Erik

    1999-01-01

    the function of cell-surface carbohydrates, we established organotypic cultures of skin and buccal mucosa. In these cultures, keratinocytes are grown at the air-liquid interface on a supporting matrix consisting of homologous fibroblasts embedded in a collagen type I gel. We examined the expression of blood...... cultures. The organotypic skin and oral mucosa cultures showed a histological differentiation pattern analogous to that of normal skin and buccal mucosa, and a tissue-specific expression of carbohydrate structures and cytokeratins. However, both types of organotypic cultures also expressed markers which......Cellular maturation and migration are usually associated with changes in cell-surface carbohydrates, but the relationship between these changes and cell behaviour is at present largely unknown. To investigate whether an organotypic culture system can be used as an in vitro model to study...

  6. Chromosomal Damage and Apoptosis in Exfoliated Buccal Cells from Individuals with Oral Cancer

    Directory of Open Access Journals (Sweden)

    Lavínia Tércia Magalhães Dórea

    2012-01-01

    Full Text Available This study aimed to investigate cytological abnormalities indicative of chromosome damage (micronuclei and apoptosis (karyorrhexis, pyknosis, and condensed chromatin in exfoliated cells from the buccal mucosa of patients with oral cancer and control subjects. The sample included twenty individuals with oral cancer and forty individuals with normal buccal mucosa. Material was collected from the cheek epithelium in areas with lesions and areas without abnormalities. A minimum of one thousand cells was analyzed. Micronuclei were found significantly more frequently in cells collected from lesions than in cells from normal areas, independent of the presence/absence of cancer (P<0.0001. They were also significantly more frequent in smokers and in mouthwash users (P<0.0001. Apoptosis occurred significantly less frequently in individuals with oral cancer (P<0.0001. These results show that oral cancer is associated with higher frequency of chromosomal damage and suggest that apoptosis is compromised in the buccal cells of individuals with this kind of neoplasia.

  7. Micronucleus frequency in exfoliated buccal cells from hairdresser who expose to hair products

    Directory of Open Access Journals (Sweden)

    Koh Hui Yee

    2015-06-01

    Full Text Available Background: Hairdresser is one of the fastest growing occupations in today’s society. Hairdresser help styling, cutting, colouring, perming, curling, straightening hair and various treatment to customer. Somehow, hairdresser are constantly exposed to chemical substances such as aromatic amines, hydrogen peroxide, thioglycolic acid, formaldehyde in hair products which can cause damage to human’s genome. Micronucleus is one of the effective biomarker for processes associated with the induction of DNA damage. Purpose: The aim of this study was to determine the micronucleus frequencies in buccal mucosa epithelial cells of hairdresser who were exposed to chemical of hair products. Method: This study was conducted on twenty female subjects, who were divided into 2 groups: exposed and non-exposed (control group. All subjects recruited were working in the same beauty salon. Buccal cells were obtained from each individual by using cytobrush. The cells were stained with modified Feulgen-Ronssenback method and counting of micronucleus per 1000 cell was done under light microscope. The data were analyzed using independent t-test and one-way Anova (p<0.05. Result: The result showed a significant difference in micronucleus frequency between 2 groups. There were a significantly increase of micronucleus frequency in hairdressers and increase of  micronucleus frequency with the longer duration of exposure. Conclusion: It concluded that the chemical substances of hair products had affected the micronucleus frequency ofthe epithelial cells in buccal mucosa of hairdressers.

  8. Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium

    Science.gov (United States)

    Al Shammari, Abdullah Faraj; Ibrahim, Ibrahim Khalil AL; Alaauldeen, Amjad Ibrahim; Merza, Randa Fouad; Ahmed, Hussain Gadelkarim

    2016-01-01

    Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer. PMID:27893201

  9. Formulation and evaluation of a bioadhesive patch for buccal delivery of tizanidine

    Directory of Open Access Journals (Sweden)

    Mohamed S. Pendekal

    2012-06-01

    Full Text Available Tizanidine hydrochloride (THCl is an antispasmodic agent which undergoes extensive first pass metabolism making it a possible candidate for buccal delivery. The aim of this study was to prepare a monolayered buccal patch containing THCl using the emulsification solvent evaporation method. Fourteen formulations were prepared using the polymers Eudragit® RS 100 or Eudragit® RL 100 and chitosan. Polymer solutions in acetone were combined with a THCl aqueous solution (in some cases containing chitosan by homogenization at 9000 rpm for 2 min in the presence of triethyl citrate as plasticizer and cast in novel Teflon molds. Physicochemical properties such as film thickness, in vitro drug release and in vitro mucoadhesion were evaluated after which permeation across sheep buccal mucosa was examined in terms of flux and lag time. Formulations prepared using a Eudragit® polymer alone exhibited satisfactory physicomechanical properties but lacked a gradual in vitro drug release pattern. Incorporation of chitosan into formulations resulted in the formation of a porous structure which did exhibit gradual release of drug. In conclusion, THCl can be delivered by a buccal patch formulated as a blend of Eudragit® and chitosan, the latter being necessary to achieve gradual drug release.

  10. Characterization of the contribution of buccal absorption to internal exposure to bisphenol A through the diet.

    Science.gov (United States)

    Guignard, Davy; Gauderat, Glenn; Gayrard, Véronique; Lacroix, Marlène Z; Picard-Hagen, Nicole; Puel, Sylvie; Toutain, Pierre-Louis; Viguié, Catherine

    2016-07-01

    The gavage route is often used for the toxicological evaluation of food contaminants. This route does not take into account absorption of the toxicants through the buccal mucosa, as evidenced in dogs for bisphenol A (BPA). Our goal was to determine the functional significance of buccal BPA absorption during dietary exposure. Four ewes received BPA by nasogastric gavage (100 mg/kg) and through food pellets (10 mg/kg), 13 days apart. The time course of serum concentrations of BPA and its main metabolite BPA-G was submitted to non-compartmental analysis. The dietary route led to 3-fold higher bioavailability as compared to gavage. The ratio of BPA-G to BPA concentrations varied greatly over time after the food administration, but not after gavage, suggesting a delayed metabolism of BPA after dietary exposure. The maximum entrance rate of BPA in the systemic circulation, determined by deconvolution analysis, was much higher after dietary administration than after gavage and a biphasic pattern of BPA entry was observed in 3 of the 4 ewes. Our results evidenced a dual mechanism of BPA absorption (buccal and digestive) after dietary exposure and highlight the necessity to take buccal absorption into account when evaluating food contaminants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Localization of gamma-glutamyl transpeptidase in hamster buccal pouch epithelium treated with 7,12-dimethylbenz(a)anthracene

    Energy Technology Data Exchange (ETDEWEB)

    Solt, D.B.

    1981-07-01

    The utility of gamma-glutamyl transpeptidase (GGT) was explored as a histochemical marker for chemical carcinogenesis in hamster buccal pouch mucosa. One or both buccal pouches of 18 noninbred male Syrian golden hamsters were treated topically with 0.5% 7,12-dimethylbenz(a)anthracene (DMBA) in mineral oil over 16 weeks to produce numerous epithelial lesions at various stages of neoplastic development. Both buccal pouches of 4 control animals were similarly treated with mineral oil alone. GGT activity was not detectable in untreated pouches or pouches treated with mineral oil alone. With this technique, multiple discrete GGT-stained areas were visible in wholemounts prepared at 1 and 6 weeks after the final application of DMBA. The experimental results were consistent with the hypothesis that the early GGT-stained cell populations are preneoplastic in nature.

  12. Oral buccal mucous membrane allograft with a corneal lamellar graft for the repair of Boston type 1 keratoprosthesis stromal melts.

    Science.gov (United States)

    Ziai, Setareh; Rootman, David S; Slomovic, Allan R; Chan, Clara C

    2013-11-01

    To describe a surgical technique to repair Boston type 1 keratoprosthesis (KPro)-related corneal melts. Technique description and review of 3 representative cases. After harvesting the buccal mucosa from the patient's inner lower lip, the exposed area of the KPro back plate is prepared for repair by adequate exposure and removal of necrotic tissue. The area is then covered with a lamellar patch of cornea secured in place with interrupted 10-0 nylon sutures, followed by a thin layer of buccal mucosa secured in place with interrupted 8-0 vicryl sutures. This technique provides surgeons with a method to repair KPro-related corneal melts when there is a conjunctival deficiency.

  13. Free anterolateral thigh flap

    Directory of Open Access Journals (Sweden)

    Zoran M. Arnež

    2006-05-01

    Full Text Available Background: For reconstruction of soft tissue defects in reconstructive microsurgery after ablation of tumors or following trauma flaps having following characteristics are being searched for: large surface, long vascular pedicle with large diameter of vessels, possibility of transfer of multiple tissues (skin, muscle, fascia, tendons, bone on the same nutrient vessels, independent movement of different components of the flap in space, harvesting in supine position and primary donor site closure. Many of these characteristics are being met by the radial forearm flap however its main dissadvantage remains donor site closure by split thickness skin grafts. This can be avoided by the use of the anterolateral thigh (ALT flap.Methods: The ALT flap is raised, like other perforator flaps, arround the septocutaneous perforator, which is located by Doppler ultrasound at midpoint on the line connecting anterior superior iliac spine and upper lateral border of patella or arround musculocutaneous perforators. Vascular pedicle can be made longer by harvesting of the descendent branch of the lateral circomflex femoral artery.Results: We report the first successfull free ALT flap transfer for soft tissue reconstruction of oral cavity and cheek after ablation of a recurrency of a malignant tumor in Slovenia.Conclusions: Because of its proprieties the ALT flap is suitable for reconstruction of defects on head and neck and extremities following tumor ablation or trauma. Because of its advantages it will replace also in our country the radial forearm flap which is the most popular flap in Slovenija for these indications.

  14. Three-dimensional canine loop for management of buccally erupted canines

    Directory of Open Access Journals (Sweden)

    Praveen Mehrotra

    2015-01-01

    Full Text Available Maxillary canines are known as the cornerstones of mouth. They are considered to be important for esthetics and for functional occlusion. Any disturbance in the eruption process leading to an aberrant position will hamper esthetics as well as function. Orthodontic tooth movement of total buccally blocked-out canine is usually difficult as it is related with the problems of severe crowding, midline deviation, involvement of long root movement and risk of gingival recession. Such conditions can be treated orthodontically in various ways, but this clinical innovation helps to correct the buccally placed canines into the arch with a precise control of the canine in all the Three-dimensions (3D of space as well as providing maximum comfort to the patient by placing the canine loop on the palatal surface of the tooth, reducing soreness on the labial mucosa. It can be easily fabricated and activated at chairside for either simultaneous or sequential control in 3D.

  15. Rare carcinoma ex pleomorphic adenoma of the buccal minor salivary gland causing a therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Yogesh Kini

    2012-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA, as a group, constitutes 12% of malignant salivary gland tumors. We present a case of CXPA of the buccal mucosa in a 17-year-old patient. The buccal mass was of a size of 3.0 cm located in the right cheek. Pleomorphic adenoma was the provisional diagnosis. The tumor was excised under local anesthesia. Histopathological evaluation revealed a pre-existing pleomorphic adenoma. However, on magnification, certain areas showed islands of dysplastic epithelial cells′ invading the fibrous capsule and CXPA was diagnosed. The patient was recalled and secondary surgery of the site performed. No tumor tissue could be detected in the secondary resection specimen. There is no sign of recurrence since 2 years.

  16. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, H M; Rassing, M R; Nielsen, Hanne Mørck

    2000-01-01

    The objective of the present study was to evaluate the TR146 cell culture model as an in vitro model of human buccal epithelium. For this purpose, the permeability of water, mannitol and testosterone across the TR146 cell culture model was compared to the permeability across human, monkey...... (logD(oct; 7.4)) and capacity factor (k') and to their polar water accessible surface area (PWASA). For water, mannitol, testosterone and some of the beta-adrenoceptor antagonists, the permeability enhancement across the TR146 cell culture model in the presence of sodium glycocholate (GC......) was determined. The mannitol and testosterone permeability across the TR146 cell culture model could be related to the permeability across porcine and human buccal mucosa. The permeability of the beta-adrenoceptor antagonists across the TR146 cell culture model varied between 2.2 x 10(-6) cm/s (atenolol) and 165...

  17. Nuclear morphometric and morphological analysis of exfoliated buccal and tongue dorsum cells in type-1 diabetic patients.

    Science.gov (United States)

    Oz, Zehra Safi; Bektas, Sibel; Battal, Fatih; Atmaca, Hulusi; Ermis, Bahri

    2014-07-01

    Diabetes mellitus type 1 that results from immunologically mediated damage to the β-cells in the pancreas. Diabetes mellitus is characterized by recurrent or persistent hyperglycemia. Hyperglycemia can be associated with salivary gland dysfunction and alterations in the oral epithelial cells. The aim of this study was to evaluate the qualitative and quantitative changes in buccal and tongue dorsum epithelial cells using an exfoliative cytology method in type 1 diabetic patients. We performed light microscopic analysis of the buccal and tongue dorsum smears in thirty type 1 diabetic patients and thirty healthy individuals. The oral smears were stained using Papanicolaou method for cytological examination and nuclear morphometric analysis. In each case, the mean nuclear area, perimeter, length, breadth, and roundness factor were evaluated in each smear using the image analysis software (Q Win, Leica™). The nuclear area, length, breadth, and perimeters were significantly higher in the diabetic group from tongue dorsum smear than that of the control group (P cytological examination, karyorrhexis-karyolysis-karyopyknosis, binucleation, nuclear membrane irregularity, cytoplasmic polymorphism, perinuclear halo were observed in oral smears with type 1 diabetic patients. Binucleation (P = 0.002) and nuclear membrane irregularity (P = 0.024) were significantly more common in buccal smears of diabetic group. Furthermore, the sensitivity of buccal mucosa was significantly higher in the diabetic group (P = 0.006). The light microscopic and nuclear morphometric study indicates that type 1 diabetes can produce morphological and nuclear morphometric changes in the oral mucosa that are noticeable with exfoliative cytology.

  18. Evaluation of pemphigus cases involving oral mucosa.

    Science.gov (United States)

    Karagöz, Gizem; Bektaş-Kayhan, Kivanç; Ünür, Meral

    2014-09-01

    Pemphigus, defines a group of disorders in autoimmune etiology which could be life-threatening and clinical manifestations are mainly epithelial blistering affecting cutaneous and/or mucosal surfaces including oral mucosa. The aim of our study is to evaluate the clinical appearance of pemphigus with oral involvement by reported 15 pemphigus cases. This retrospective study of 15 cases of pemphigus obtained over a period of 7 years from 2006 to 2013 in Istanbul University, Dentistry Faculty, Oral Medicine and Surgery Department was designed. Age distribution of pemphigus was from 15 to 59 years with an average age of 41.3 years. Of the 15 patients, the male:female ratio was 1:2.75 (4 male, 11 female). The most common clinical various of pemphigus was pemphigus vulgaris, diagnosed in all patients. The buccal mucosa (34.3%) was the most commonly affected site followed by tongue (20%), gingiva (17.1%), palate (11.4%), lips (11.4%) and floor of mouth (5.7%). Our explanation of this conclusion, while speculative, is that socioeconomic situation related stress in males and hormonal changes like pregnancy and menostasis in females; systemic disease and using drugs; dental trauma and bruxism could be responsible for flare up in the disease.

  19. Evaluation of cytological alterations of oral mucosa in smokers and waterpipe users.

    Science.gov (United States)

    Seifi, Safoura; Feizi, Farideh; Mehdizadeh, Mohammad; Khafri, Soraya; Ahmadi, Behrang

    2014-01-01

    Oral mucosal epithelia of smokers and waterpipe users are more susceptible to malignant alterations. The aim of this study was morphometric evaluation of the effects of using waterpipe on normal oral mucosa. IN A CROSS SECTIONAL STUDY, CYTOLOGIC SMEAR SAMPLES FROM THE FOLLOWING THREE DIFFERENT AREAS: buccal mucosa, lateral surface of the tongue, and floor of the mouth (right) were taken from 40 smokers, 40 waterpipe users, and 40 normal individuals. They were then stained using Papanicolaou staining technique. Quantitative cytologic alterations such as nuclear and cytoplasmic size, nuclear-cytoplasmic (N/C) ratio, Feret ratio (FR), percent of karriorhexis, vacuolization of cytoplasm, two or multilobed nuclei, inflammation, and candida were evaluated. Quantitative evaluation was performed using MoticPlus 2 software, and 50 cells in each slide were studied. Practitioners were matched with age and sex in three groups. An increase in nuclear size, the N/C ratio, and F.R, while a decrease in cytoplasm size were observed in lateral surface of the tongue, buccal mucosa and floor of the mouth of smokers, waterpipe users and normal individuals, respectively (p≤0.001). No statistically significant differences were observed in percent of karriorhexis, vacuolization of cytoplasm, and two or multilobed nuclei in oral mucosa of smokers, waterpipe users (p=0.8), and normal individuals (p=0.9) in buccal mucosa, tongue, and mouth floor areas. However, the percentage of inflammation and candida in smokers (pnormal individuals. Smoking and using waterpipe are effective in creating some quantitative cytometric alterations in oral mucosa; however, smoking shows greater effect in the cytometric alterations than using waterpipe. Role of cytology in screening and detection of oral mucosa malignancies in smokers and waterpipe users needs further studies.

  20. Propeller TAP flap

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Bille, Camilla; Wamberg, Peter

    2013-01-01

    The aim of this study was to examine if a propeller thoracodorsal artery perforator (TAP) flap can be used for breast reconstruction. Fifteen women were reconstructed using a propeller TAP flap, an implant, and an ADM. Preoperative colour Doppler ultrasonography was used for patient selection...... to identify the dominant perforator in all cases. A total of 16 TAP flaps were performed; 12 flaps were based on one perforator and four were based on two. A permanent silicone implant was used in 14 cases and an expander implant in two. Minor complications were registered in three patients. Two cases had...... major complications needing additional surgery. One flap was lost due to a vascular problem. Breast reconstruction can be performed by a propeller TAP flap without cutting the descending branch of the thoracodorsal vessels. However, the authors would recommend that a small cuff of muscle is left around...

  1. Morphologic and cytomorphometric analysis of exfoliated buccal mucosal cells in diabetes patients

    Directory of Open Access Journals (Sweden)

    Prasad H

    2010-01-01

    Full Text Available Background : It is now known that the disease process of diabetes has effects on various tissues of the body. The following study was done to analyze the effects of diabetes on oral tissues. Aims : To study the morphology and cytomorphometry of the cells obtained in cytologic smears from the buccal mucosa of diabetic patients. Materials and Methods : Smears were obtained from clinically normal buccal mucosa of 50 randomly selected diabetic patients attending the diabetic clinic and the out-patient department and of five healthy subjects as control. Smears were stained using Papanicolaou method, and using a micrometer mean values of nuclear diameter (ND, cell diameter (CD, cytoplasmic diameter (CyD and nucleus: cytoplasm ratio (N: C ratio were obtained for each patient. Diabetic patients were divided into four groups based on the glycosylated hemoglobin (GHb values for comparison. Statistical analysis used : Student′s T-test and Fisher′s F-test. Results : Statistically significant increase in ND (P=0.0367 was found in diabetic patients compared to controls. Degree of glycemic control significantly affected ND (P=0.0042 and N: C ratio (P=0.0055. In general, as the severity of diabetes increases, ND and N: C ratio rise gradually. Conclusions : Diabetes produces definite morphologic and cytomorphometric changes in the buccal mucosa of patients. However, further research in this direction is indicated, to analyze the significance of these findings as a tool for diabetes detection, as well as to obtain deeper insights into its effects on various tissues.

  2. Pharmacokinetics of buprenorphine in a sodium carboxymethylcellulose gel after buccal transmucosal administration in dogs.

    Science.gov (United States)

    Krotscheck, Ursula; Boothe, Dawn Merton; Little, Amy A; Erb, Hollis N

    2010-01-01

    Alternatives to intravenous administration of opioids are needed in veterinary medicine. Previous research suggests that opioids can be administered through the buccal mucosa in dogs. This study reports the pharmacokinetics of buprenorphine HCl (0.05 mg/kg) administered transmucosally in six dogs compared with those of buprenorphine HCl (0.015 mg/kg) administered intravenously. The results suggest that the pharmacokinetics of buprenorphine HCl administered intravenously or transmucosally are similar and that transmucosal administration may be considered as a noninvasive alternative to intravenous administration.

  3. Efficacy and safety of fentanyl buccal for cancer pain management by administration through a soluble film: an update

    Directory of Open Access Journals (Sweden)

    Marvin Omar Delgado-Guay

    2010-11-01

    Full Text Available Marvin Omar Delgado-GuayDivision of Geriatrics and Palliative Medicine, The University of Texas, Medical School at Houston, Houston, TX, USAAbstract: More than half of patients receiving prescription medicine for cancer pain have been reported to experience inadequate pain relief or breakthrough pain. Buccal administration can deliver lipophilic opioids rapidly to the systemic circulation through the buccal mucosa, limiting gastrointestinal motility and first-pass metabolism. This review updates the safety and efficacy of fentanyl buccal soluble film (FBSF in patients with cancer pain. Literature was identified through searches of Medline (PubMed. Search terms included combinations of the following: cancer pain, fentanyl, fentanyl buccal soluble film, pharmacology, kinetics, safety, efficacy and toxicity. FBSF is an oral transmucosal form of fentanyl citrate developed as a treatment of breakthrough pain in opioid-tolerant patients with cancer. Studies have shown that it is well tolerated in the oral cavity, with adequate bioavailability and safety in cancer patients. Further studies are warranted to evaluate, in comparison with other short-acting opioids, its efficacy in the management of breakthrough cancer pain, its addictive potential and its economic impact in cancer patients.Keywords: fentanyl buccal soluble film, cancer pain

  4. MODIFIED SINGLE ROLL FLAP APPROACH FOR SIMULTANEOUS IMPLANT PLACEMENT AND GINGIVAL AUGMENTATION

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2017-09-01

    Full Text Available INTRODUCTION: The frequent result of tooth extraction is the resorption of the buccal alveolar wall and formation of I class (Siebert alveolar ridge defect. Another frequent problem in the implant surgery after the elevation of the standard full thickness flap is the choice of the exact vertical implant position to provide adequate biological width with 3mm keratinized soft tissue above a bone level implant. Nowadays the aim is to develop minimally invasive surgical approaches for other surgical applications. AIM: This presentation demonstrates the application of a newly modified, minimally invasive, single roll flap approach for simultaneous implant placement and gingival augmentation. MATERIALS AND METHODS: A 47 years old patient presented with fractured left central incisor. A new surgical technique for simultaneous implant placement and gingival augmentation was applied. Buccal partial thickness flap was prepared with de-epithelization and roll flap elevation of the crestal keratinized tissue, thus forming new papillae and ensuring implant placement in the exact vertical position. After one week of healing the final screw retained restoration was placed. RESULT: The application of this newly developed by the author modification of the surgical protocol allowed precise implant placement consistent with the biological width requirements and simultaneously achieving buccal gingival augmentation. CONCLUSION: The proposed new surgical approach provides an opportunity for minimally invasive implant placement without periosteal elevation. The modified roll flap preserves the keratinized tissues of the alveolar ridge using them to provide adequate buccal soft tissue volume. Furthermore, this approach ensures precise selection of the optimal implant depth, thus providing maximal functional and aesthetic result.

  5. Micronucleus Investigation in Buccal Mucosal Cells of Young Waterpipe Tobacco Smokers in Tehran

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    Sepideh Arbabi Bidgoli

    2017-12-01

    Full Text Available Waterpipe Tobacco Smoke(WTS is an unhealthy life style that may increase the risk of genotoxic responses and chronic diseases such as cancer. Micronucleus test is a successful and reliable method which is used for screening of genetotoxic responses of whole body and also for screening those people who had already exposed to genotoxic compounds. In this study, specific questionnaires were designed and used for studying the role of shisha smoking on the extent of genotoxic responses and cases were looked for MNs with this biomonitoring method. The study population was 20 young adults (12men and 8 women who born and lived in Tehran and had continuously smoked shisha more than 2 times weekly for more than 2 years . The associations between all recorded background, environmental and nutritional factors and increased incidence of Micronucleus in buccal cells of all cases were considered by statistical methods. In order to count Micronucleus levels, buccal cells were collected from buccal mucosa of these people with small-headed toothbrush and was placed the head of tooth brush into buccal cell buffer, slides were prepared and cells were stained with Schiff’s reagent and light green .Finally 1000 differentiated cells were recorded by optical microscope in each slide and the mean level of MN was determined for each volunteer . All steps were performed according to the buccal micronucleus cytome (BMCyt assay protocol. Increased incidence of Micronucleus was associated with the extent of shisha smoking per week (p=0.021, alcohol consumption ( p=0.021 and BMI ( p=0.027. The other effective factor in the occurrence of Micronucleus was gender/sex ( p=0.011 but nutritional factors didn’t change the level of Micronucleus in our cases. The relationship between other background and environmental factors were not significant too. It seems that long term consumption of shisha in both genders could increase the risk of genetic toxicity and occurrence of

  6. Microbial Contamination of Orthodontic Buccal Tubes from Manufacturers

    Directory of Open Access Journals (Sweden)

    Kok-Gan Chan

    2010-09-01

    Full Text Available This study aimed to test the sterility of new unused orthodontic buccal tubes received from manufacturers. Four different types of buccal tubes were used straight from the manufactures package without any additional sterilizing step. Of these buccal tubes tested, three genera of bacteria, implicated as opportunistic pathogens, namely Micrococcus luteus, Staphylococcus haemolyticus and Acinetobacter calcoaceticus were recovered from these buccal tubes. Our data showing microbial contamination on buccal tubes highlights the need of sterilization before clinical use. We also suggest that manufacturers should list the sterility state of orthodontic buccal tubes on their packaging or instructions stating the need for sterilization.

  7. Pedicled perforator flaps

    DEFF Research Database (Denmark)

    Demirtas, Yener; Ozturk, Nuray; Kelahmetoglu, Osman

    2009-01-01

    adequately to cover the defect. Defects measuring 3 x 3 cm up to 20 x 20 cm at diverse locations were successfully reconstructed in 20 of 21 patients with 26 flaps. Pedicled perforator flaps offer us reliable and satisfactory results of reconstruction at different anatomic territories of the body. It sounds...

  8. Basaloid Squamous Cell Carcinoma Involving the Alveolar Ridge, Buccal & Lingual Vestibule - A Case Report

    Directory of Open Access Journals (Sweden)

    Supriya Koshti

    2013-01-01

    Full Text Available Background: Basaloid squamous cell carcinoma of oral mucosa is a rare and aggressive variant of squamous cell carcinoma. They can be differentiated from squamous cell carcinomas by their distinct clinical and histopathological features. Methods: 45 year old female patient presented with extra oral exophytic mass and intra-oral ulcerative lesion on right buccal mucosa and vestibule. The patient was referred for routine blood examination and radiography followed by incisional biopsy. The biopsy specimen was fixed, processed and stained with Hematoxylin and Eosin for further microscopic examination. Results: On microscopic examination basaloid cells were seen proliferating along with dysplastic squamous cells in the connective tissue stroma. Conclusion: Based on the histopathological findings a diagnosis of ′Basaloid squamous cell carcinoma′ was made. The patient was referred to department of Oral and Maxillofacial Surgery for excision of the lesion followed by radiotherapy.

  9. Transmucosal Implant Placement with Submarginal Connective Tissue Graft in Area of Shallow Buccal Bone Dehiscence: A Three-Year Follow-Up Case Series.

    Science.gov (United States)

    Stefanini, Martina; Felice, Pietro; Mazzotti, Claudio; Marzadori, Matteo; Gherlone, Enrico F; Zucchelli, Giovanni

    2016-01-01

    The aim of the present case series study was to evaluate the short- and long-term (3 years) soft tissue stability of a surgical technique combining transmucosal implant placement with submarginal connective tissue graft (CTG) in an area of shallow buccal bone dehiscence. A sample of 20 patients were treated by positioning a transmucosal implant in an intercalated edentulous area. A CTG sutured to the inner aspect of the buccal flap was used to cover the shallow buccal bone dehiscence. Clinical evaluations were made at 6 months (T₁) and 1 (T₂) and 3 (T₃) years after the surgery. Statistically significant increases in buccal soft tissue thickness and improvement of vertical soft tissue level were achieved at the T₁, T₂, and T₃ follow-ups. A significant increase in keratinized tissue height was also found at T₃. No significant marginal bone loss was recorded. The submarginal CTG technique was able to provide simultaneous vertical and horizontal soft tissue increases around single implants with shallow buccal bone dehiscence and no buccal mucosal recession or clinical signs of mucositis or peri-implantitis at 1 and 3 years.

  10. Cerrobend shielding stents for buccal carcinoma patients

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    Karma Yangchen

    2016-01-01

    Full Text Available Buccal carcinoma is one of the most common oral malignant neoplasms, especially in the South Asian region. Radiotherapy, which plays a significant role in the treatment of this carcinoma, has severe adverse effects. Different types of prosthesis may be constructed to protect healthy tissues from the adverse effects of treatment and concentrate radiation in the region of the tumor mass. However, the technique for fabrication of shielding stent with Lipowitz's alloy (cerrobend/Wood's alloy has not been well documented. This article describes detailed technique for fabrication of such a stent for unilateral buccal carcinoma patients to spare the unaffected oral cavity from potential harmful effects associated with radiotherapy.

  11. Treatment of Bilateral Buccal Nonocclusion and Distalization

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    Nagarajan Sadhasivam

    2014-01-01

    Full Text Available Orthodontic treatment aims to improve esthetics, function and structural balance. In some rare circumstances, the clinician may not be able to achieve the ideal treatment goals because of complex multiple orthodontic problems, which may include significant mutilation of the dentition. Brodie bite, a complete buccal posterior crossbite is a problem, which confronts clinicians with often complex variable etiology. The following case report demonstrates treatment of bilateral buccal nonocclusion that is mainly due to a maxillary dental arch issue rather than mandibular retrognathism.

  12. Original article The Treatment of Complex Urethral Strictures Using ...

    African Journals Online (AJOL)

    Objectives: To compare the outcome of free onlay Buccal Mucosa Graft (BMG) with onlay penile Skin Island Flap (SIF) urethroplasty ... Key Words: Urethral stricture, Urethroplasty, Buccal mucosa graft, Skin island flap. Corresponding Author: Dr. .... Heinke et al, reported that BMG can be used as a ventral patch with favorable.

  13. Changes in Exfoliative Cell of Oral Mucosa in Kidney Transplant Patients.

    Science.gov (United States)

    Keles, M; Caglayan, F; Tozoglu, U; Kara, A; Cankaya, E; Dogan, H; Dogan, G E; Uyanik, A; Aydinli, B

    2015-06-01

    The aim of this study was to investigate quantitative cytologic changes in oral mucosal smears collected from kidney transplant patients by modern stereologic methods. We enrolled 32 kidney transplant patients. Smears were obtained from the buccal mucosa transplant patients before and 12 months after kidney transplantation. Smears from each individual were stained using the Papanicolaou method and were analyzed using a stereological method. Statistically, the nuclear volumes and cytoplasmic volumes in the cells of buccal mucosa were markedly higher after kidney transplantation (P < .05). There was a decreased positive cell density in the oral epithelial cells after kidney transplantation compared with before renal transplantation (P < .05). These findings suggest that there are alterations in the oral epithelial cells after kidney transplantation, which are detectable by microscopy and cytomorphometry. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Larva migrans in the oral mucosa: report of two cases.

    Science.gov (United States)

    Damante, José Humberto; Chinellato, Luiz Eduardo Montenegro; Oliveira, Fernando Toledo de; Soares, Cleverson Teixeira; Fleury, Raul Negrão

    2011-01-01

    Cutaneous Larva migrans is a very common disease in tropical regions. In the oral mucosa, the infection occurs in the same way as in the skin, but it is rarer. This report describes two cases of Larva migrans in the oral mucosa. The first case was in a 27-year-old woman who presented an erythematous plaque located on the buccal mucosa, extending to a posterior direction, following a linear pattern, to other areas of the mouth. After incisional biopsy of the anterior-most portion of the lesion, morphological details obtained in multiple examined sections suggested Necator or Ancylostoma braziliense larvae as the cause of infection. The second case was in a 35-year-old male who presented a fusiform erythematous plaque in the palatal mucosa. This area was removed and submitted to microscopic examination under a presumptive diagnosis of "parasite migratory stomatitis". The histological characteristics were suggestive of a larva pathway. In both cases the lesion disappeared after biopsy and the patients were symptom-free.

  15. Enhanced penetration of nitrosonornicotine across oral mucosa in the presence of ethanol.

    Science.gov (United States)

    Squier, C A; Cox, P; Hall, B K

    1986-05-01

    There is evidence for synergy between tobacco and alcohol in the etiology of oral cancer but the reason for such an effect is unclear. One possible explanation is that alcohol enhances the penetration of carcinogens through the oral lining. We measured the permeability in vitro of three regions of porcine oral mucosa to the tobacco associated carcinogen, nitrosonornicotine (NNN) alone and in the presence of 5% or 50% ethanol. 50% ethanol did not significantly alter the permeability of oral mucosa to NNN except for buccal mucosa, where it was reduced. However, there was a significant increase in the permeability of gingiva and floor of mouth mucosa (but not buccal mucosa) in the presence of 5% ethanol; this increase occurred after far shorter exposures for floor of mouth than for gingiva. These results accord well with studies showing that the floor of mouth is a "high risk area" for oral carcinoma and that there is an increased relative risk of oral cancer for heavy smokers and drinkers and, in particular, for those individuals who consume beverages with a low alcohol content.

  16. Buccal absorption of diazepam is improved when administered in bioadhesive tablets-An in vivo study in conscious Göttingen mini-pigs

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Jacobsen, Jette; Müllertz, Anette

    2016-01-01

    Buccal delivery may be clinically beneficial for compounds with a high gastrointestinal and hepatic first pass metabolism or in situations where a fast systemic absorption is desired. The delivery of a crystalline low soluble compounds, e.g. diazepam, may be limited due to the low volume of saliva...... available to facilitate solvation in order to drive the permeation of drug through the buccal mucosa. Therefore, the present study investigated the potential benefits of administering diazepam either as an amorphous or as a crystalline form in mucoadhesive tablets to conscious Göttingen mini...

  17. Biomechanics of oral mucosa

    Science.gov (United States)

    Chen, Junning; Ahmad, Rohana; Li, Wei; Swain, Michael; Li, Qing

    2015-01-01

    The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication. PMID:26224566

  18. The Use of Buccal Fat Pad in the Treatment of Oral Submucous Fibrosis: A Newer Method

    Directory of Open Access Journals (Sweden)

    K. Saravanan

    2012-01-01

    Full Text Available Purpose of the study. This study was to evaluate the use of buccal fat pad as an interpositioning material in surgical management of oral sub mucous fibrosis. Materials and methods. A series of 8 cases with proven oral sub mucous fibrosis, with mouth opening less than 20 mm, involving the buccal mucosa were treated surgically in the Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, Chennai. Pedicled buccal fat pad was used as an interpositioning material to cover the raw areas in the oral cavity after incision and release of fibrous bands. Results. In 8 patients, the range of pre operative mouth opening was 3–18 mm (mean 14 mm. As the result of the successful surgical procedure, the size of the intra operative mouth opening was ranged from 25–38 mm (mean 33.25 mm. The patients were discharged 5–7 days after the operation. The range of the mouth opening at this time was 25–36 mm (mean 30.63 mm. The results were evaluated using student’s t test and found to be statistically significant. The pedicled grafts took up uneventfull.

  19. Prediction of outcome in buccal cancers treated with radical radiotherapy based on the early tumor response

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    G V Giri

    2015-01-01

    Full Text Available Aim of the Study: Aim was to assess the clinical significance of the rate of tumor regression in carcinoma buccal mucosa undergoing radical radiotherapy. Materials and Methods: Sixty six patients were enrolled in the study with proven buccal cancers requiring radical radiotherapy, from 1990 to 1996. Radiotherapy was delivered using a combination of external beam and brachytherapy with preloaded cesium 137 needles. The response to the radiation was assessed at the completion of external beam radiation and 6 weeks after brachytherapy. An analysis correlating various parameters influencing the long term disease free survival and overall survival was done. Results: Response assessed at the end of external beam radiation correlated strongly with the overall survival and the disease free interval (P=0.000. No other factor influenced the survival. Conclusion: The rate of the tumor regression can predict the overall outcome in patients with buccal cancers treated with radiation. Completion of the planned course of radiation in patients who do not show a substantial reduction in size by 4.5 weeks of conventional radiation does not improve the results.

  20. Translocated pedicled buccal fat pad: closure of anterior and middle skull base defects after tumor resection.

    Science.gov (United States)

    Cherekaev, Vasily A; Golbin, Denis A; Belov, Alexander I

    2012-01-01

    Problem of closure of skull base defects after removal of craniobasal lesions, especially, craniofacial, is one of the most challenging in neurosurgery. Persistent skull base defect produces extremely high risk of cerebrospinal fluid leaks and consecutive infectious complications. Local pedicled grafts are the preferred material for plasty. In this study, the authors present original technique of using a pedicled buccal fat pad (BFP) graft. Anatomy and functions of BFP are discussed in details as well as surgical technique illustrated by 2 case reports. From 2004 to 2010, 188 patients with anterior and middle skull base mass lesions were operated on in Burdenko Neurosurgical Institute (Moscow, Russia) using BFP as plastic material for closure of different defects (male-female ratio=61:127; mean age was 47 years [range, 10-74 years]). In 93.6% of cases, pedicled BFP flap was applied; in 6.4%, free flap was used. Follow-up period ranged between 1 and 7 years. Only 1 case of postoperative cerebrospinal fluid leak was observed; flap rejection was not registered in the series. High effectiveness and minimal invasiveness are principal advantages of the described technique, which is applied in neurosurgery for the first time. Other benefits include proximity of donor site and defect, simplicity of surgical technique, minimal postoperative discomfort, and very low risk of benign complications.

  1. Use of periosteal membrane as a barrier membrane for the treatment of buccal Grade II furcation defects in lower molars: A novel technique

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    Vikas Verma

    2011-01-01

    Full Text Available Objective : To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. Materials and Methods : This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL, and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. Results : Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. Conclusion: This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.

  2. MODIFIED SINGLE ROLL FLAP APPROACH FOR SIMULTANEOUS IMPLANT PLACEMENT AND GINGIVAL AUGMENTATION

    OpenAIRE

    Kamen Kotsilkov

    2017-01-01

    INTRODUCTION: The frequent result of tooth extraction is the resorption of the buccal alveolar wall and formation of I class (Siebert) alveolar ridge defect. Another frequent problem in the implant surgery after the elevation of the standard full thickness flap is the choice of the exact vertical implant position to provide adequate biological width with 3mm keratinized soft tissue above a bone level implant. Nowadays the aim is to develop minimally invasive surgical approaches for ot...

  3. Mucormycosis at pectoralis major myocutaneous flap donor site

    Directory of Open Access Journals (Sweden)

    Saraiya Hemant

    2006-01-01

    Full Text Available Background: Advanced carcinomas involving the head and neck present a major therapeutic challenge because of their poor prognosis particularly in old age irrespective of the treatment modality used. Materials and Methods: A 71-year-old patient presented with right-sided buccal mucosal carcinoma involving the mandible. Composite resection with removal of mandible and radical neck dissection was done. Pectoralis major myocutaneous flap (PMMC with deltopectoral flap was done to cover the defect. On the 14th day mucormycosis was noted on pectoralis major myocutaneous flap donor site. Radical debridement and appropriate antibiotic and antifungal treatment was started. The patient was put on life support system. Results: Despite aggressive treatment the patient died. Conclusion: This case reaffirms the views that radical surgical procedure should be carried out with caution in old patients with preexisting diseases as the chances of life-threatening complications are very high in these patients. Mucormycosis at pectoralis major myocutaneous flap (PMMC donor site is probably being reported for the first time.

  4. A new transmucosal drug delivery system for patients with breakthrough cancer pain: the fentanyl effervescent buccal tablet

    Science.gov (United States)

    Freye, Enno

    2009-01-01

    Breakthrough pain, a transitory severe pain with the background of otherwise controlled persistent pain has a prevalence between 52% and 67% in outpatients with cancer. Medications for such sudden-onset pain require non-invasive delivery of a potent and short-acting opioid for rapid pain relief. Although oral transmucosal delivery of fentanyl citrate (OTFC) has been shown to provide better pain relief than a typical oral opioid administration such as morphine sulfate immediate release (MSIR) in the management of breakthrough pain in patients with cancer-related pain, newer delivery systems offer a potential for further enhancement of pain relief. The fentanyl effervescent buccal tablet (FBT) formulation employs a novel drug delivery system that relies on an effervescence reaction to improve buccal fentanyl absorption. Using the effervescence reaction results in the production and dissipation of carbon dioxide with a dynamic shift in pH as the tablet dissolves. The induced low pH favors dissolution of fentanyl citrate in saliva (higher water solubility). The subsequent increase in pH thereafter favors the buccal absorption of non-ionized fentanyl across the buccal mucosa. Such a pH “pumping” mechanism increases the permeation of fentanyl into and through the buccal to the vascular system from where the agent is transported to the specific opioid receptor sites in the CNS. Compared with OTFC, data in healthy volunteers show that the effervescence reaction employed in FBT increases the total amount and the speed of absorption of fentanyl being absorbed. Compared with OTFC there is an increase in peak fentanyl blood concentrations, and an enhancement of the amount of buccal delivery of fentanyl. Such favorable data are underlined by the results of clinical studies where the FBT technology was studied in patients with breakthrough pain in chronic malignant pathologies. PMID:21197291

  5. Prediction of flap response.

    Science.gov (United States)

    Potgieter, Frederik J; Roberts, Cynthia; Cox, Ian G; Mahmoud, Ashraf M; Herderick, Edward E; Roetz, Marlize; Steenkamp, Wouter

    2005-01-01

    To find predictors of the induced biomechanical and optical effects of lamellar flap creation on the cornea. Optimed Eye and Laser Clinic, Pretoria, South Africa, and the Department of Ophthalmology and Biomedical Engineering Center, The Ohio State University, Columbus, Ohio, and Bausch & Lomb Vision Research Laboratory, Rochester, New York, USA. This prospective study monitored the refractive, wavefront aberration, and corneal topographic changes in 29 eyes of 15 patients for 3 months after the creation of a corneal lamellar flap. The main outcome measures for statistical analysis were refraction, total corneal thickness, residual corneal bed thickness, horizontal white-to-white corneal diameter, horizontal flap diameter, topography data, and wavefront data. Statistically significant changes were seen in the autorefraction mode. Wavefront data showed significant change in 4 Zernike modes-90/180-degree astigmatism, vertical coma, horizontal coma, and spherical aberration. The topography data indicated the corneal biomechanical response was significantly predicted by stromal bed thickness in the early follow-up period and by total corneal pachymetry and flap diameter in a 2-parameter statistical model in the late follow-up period. Uncomplicated lamellar flap creation is responsible for systematic changes in corneal topography and induction of higher-order optical aberrations. Predictors of this response include stromal bed thickness, flap diameter, and total corneal pachymetry.

  6. Analysis of the Genotoxic Effects of Mobile Phone Radiation using Buccal Micronucleus Assay: A Comparative Evaluation.

    Science.gov (United States)

    Banerjee, Sumita; Singh, Narendra Nath; Sreedhar, Gadiputi; Mukherjee, Saikat

    2016-03-01

    Micronucleus (MN) is considered to be a reliable marker for genotoxic damage and it determines the presence and the extent of the chromosomal damage. The MN is formed due to DNA damage or chromosomal disarrangements. The MN has a close association with cancer incidences. In the new era, mobile phones are constantly gaining popularity specifically in the young generation, but this device uses radiofrequency radiation that may have a possible carcinogenic effect. The available reports related to the carcinogenic effect of mobile radiation on oral mucosa are contradictory. To explore the effects of mobile phone radiation on the MN frequency in oral mucosal cells. The subjects were divided into two major groups: low mobile phone users and high mobile phone users. Subjects who used their mobile phone since less than five years and less than three hours a week comprised of the first group and those who used their mobile since more than five years and more than 10 hours a week comprised of the second group. Net surfing and text messaging was not considered in this study. Exfoliated buccal mucosal cells were collected from both the groups and the cells were stained with DNA-specific stain acridine orange. Thousand exfoliated buccal mucosal cells were screened and the cells which were positive for micronuclei were counted. The micronucleus frequency was represented as mean±SD, and unpaired Student t-test was used for intergroup comparisons. The number of micronucleated cells/ 1000 exfoliated buccal mucosal cells was found to be significantly increased in high mobile phone users group than the low mobile phone users group. The use of mobile phone with the associated complaint of warmth around the ear showed a maximum increase in the number of micronucleated cells /1000 exfoliated buccal mucosal cells. Mobile phone radiation even in the permissible range when used for longer duration causes significant genotoxicity. The genotoxicity can be avoided to some extent by the

  7. Drug delivery from the oral cavity: a focus on mucoadhesive buccal drug delivery systems.

    Science.gov (United States)

    Shinkar, Dattatraya Manohar; Dhake, Avinash Sridhar; Setty, Chitral Mallikarjuna

    2012-01-01

    Since the early 1980s the concept of mucoadhesion has gained considerable interest in pharmaceutical technology. The various advantages associated with these systems made buccal drug delivery as a novel route of drug administration. It prolongs the residence time of the dosage form at the site of application. These systems remain in close contact with the absorption tissue, the mucous membrane, and thus contribute to improved and/or better therapeutic performance of the drug and of both local and systemic effects. This review highlights the anatomy and structure of oral mucosa, mechanism and theories of mucoadhesion, factors affecting mucoadhesion, characteristics and properties of desired mucoadhesive polymers, various types of dosage forms, and general considerations in design of mucoadhesive buccal dosage forms, permeation enhancers, and evaluation methods. Over the past few decades the mucoadhesive buccal drug delivery system has received a great deal of attention to develop mucoadhesive dosage forms to enable the prolonged retention at the site of action, providing a controlled release of drug for improved therapeutic outcome. Mucoadhesive drug delivery gives facility to include a permeation enhancer/enzyme inhibitor or pHmodifier in the formulation and versatility in designing as multidirectional or unidirectional release systems for local and systemic action. Local delivery to tissues of the oral cavity has a number of applications, including treatment of local conditions such as periodontal disease, bacterial and fungal infections, and aphthous stomatitis and vesiculo bullous diseases. For the treatment of chronic diseases, the mucoadhesive buccal drug delivery system allows easily accessibility and is generally well-accepted for administeringdrugs by systemic action.

  8. COMPARISON OF MICRONUCLEATED CELL IN BUCCAL SMEARS AMONG SMOKERS AND NON-SMOKERS

    Directory of Open Access Journals (Sweden)

    Vani Dayanand

    2017-01-01

    Full Text Available BACKGROUND The health complexities caused due to tobacco smoking has not been restricted to any geographic region and has spread worldwide. As the oral mucosal cells, which line the oral cavity are the first barrier, they represent the preferred target site for the early genotoxic events. Tobacco use is one of the most important aetiological factors in initiation of oral cancer as it increases the risk of cancer by exposing the buccal mucosal to the carcinogenic chemicals either through inhalation or by ingestion. Micronuclei are round to oval cytoplasmic chromatin mass, which occurs as a result of segregation defects due to chromosomal instability causing chromatin to be excluded from the reformed nucleus. Micronuclei assay in exfoliated buccal cells is a useful and less invasive method for monitoring genetic damage. MATERIALS AND METHODS A total of 100 male subjects (50 smokers, 50 non-smokers were examined. Buccal smears were wet fixed and stained with pap stain. 100 cells per slide were counted and assessed for micronuclei count. T-test and Pearson correlation was used as a statistical tool for analysis. RESULTS Significantly, smokers had higher percentage of micronucleated cells (T-5.865; P (0.000, total number of micronuclei (T- 6.713; P (0.000 and mean micronuclei count (T-5.865; P (0.000 than non-smokers. Pack years correlated significantly and positively with mean micronuclei count. However, pack year did not have significant relation with percentage of micronucleated cells and total number of micronuclei. CONCLUSION The genotoxic effects of tobacco smoke cause chromosomal damage in the epithelial cells of buccal mucosa and are reflected in the increased micronuclei in smokers. Micronuclei assay can be used as a simple and reliable marker for genotoxic evaluation.

  9. Buccal bone plate remodeling after immediate implant placement with and without synthetic bone grafting and flapless surgery: radiographic study in dogs.

    Science.gov (United States)

    Novaes, Arthur B; Suaid, Flávia; Queiroz, Adriana C; Muglia, Valdir A; Souza, Sérgio L S; Palioto, Daniela B; Taba, Mário; Grisi, Márcio F M

    2012-12-01

    Recent studies in animals have shown pronounced resorption of the buccal bone plate after immediate implantation. The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone resorption and to favor osseointegration. The aim of this study was to evaluate the healing of the buccal bone plate following immediate implantation using the flapless approach, and to compare this process with sites in which a synthetic bone graft was or was not inserted into the gap between the implant and the buccal bone plate. Lower bicuspids from 8 dogs were bilaterally extracted without the use of flaps, and 4 implants were installed in the alveoli in each side of the mandible and were positioned 2.0 mm from the buccal bone plate (gap). Four groups were devised: 2.0-mm subcrestal implants (3.3 × 8 mm) using bone grafts (SCTG), 2.0-mm subcrestal implants without bone grafts (SCCG), equicrestal implants (3.3 × 10 mm) with bone grafts (ECTG), and equicrestal implants without bone grafts (ECCG). One week following the surgical procedures, metallic prostheses were installed, and within 12 weeks the dogs were sacrificed. The blocks containing the individual implants were turned sideways, and radiographic imaging was obtained to analyze the remodeling of the buccal bone plate. In the analysis of the resulting distance between the implant shoulder and the bone crest, statistically significant differences were found in the SCTG when compared to the ECTG (P = .02) and ECCG (P = .03). For mean value comparison of the resulting linear distance between the implant surface and the buccal plate, no statistically significant difference was found among all groups (P > .05). The same result was observed in the parameter for presence or absence of tissue formation between the implant surface and buccal plate. Equicrestally placed implants, in this methodology

  10. Raman spectroscopy of normal oral buccal mucosa tissues: study on intact and incised biopsies

    Science.gov (United States)

    Deshmukh, Atul; Singh, S. P.; Chaturvedi, Pankaj; Krishna, C. Murali

    2011-12-01

    Oral squamous cell carcinoma is one of among the top 10 malignancies. Optical spectroscopy, including Raman, is being actively pursued as alternative/adjunct for cancer diagnosis. Earlier studies have demonstrated the feasibility of classifying normal, premalignant, and malignant oral ex vivo tissues. Spectral features showed predominance of lipids and proteins in normal and cancer conditions, respectively, which were attributed to membrane lipids and surface proteins. In view of recent developments in deep tissue Raman spectroscopy, we have recorded Raman spectra from superior and inferior surfaces of 10 normal oral tissues on intact, as well as incised, biopsies after separation of epithelium from connective tissue. Spectral variations and similarities among different groups were explored by unsupervised (principal component analysis) and supervised (linear discriminant analysis, factorial discriminant analysis) methodologies. Clusters of spectra from superior and inferior surfaces of intact tissues show a high overlap; whereas spectra from separated epithelium and connective tissue sections yielded clear clusters, though they also overlap on clusters of intact tissues. Spectra of all four groups of normal tissues gave exclusive clusters when tested against malignant spectra. Thus, this study demonstrates that spectra recorded from the superior surface of an intact tissue may have contributions from deeper layers but has no bearing from the classification of a malignant tissues point of view.

  11. In vivo Raman spectroscopic identification of premalignant lesions in oral buccal mucosa

    Science.gov (United States)

    Singh, S. P.; Deshmukh, Atul; Chaturvedi, Pankaj; Murali Krishna, C.

    2012-10-01

    Cancers of oral cavities are one of the most common malignancies in India and other south-Asian countries. Tobacco habits are the main etiological factors for oral cancer. Identification of premalignant lesions is required for improving survival rates related to oral cancer. Optical spectroscopy methods are projected as alternative/adjunct for cancer diagnosis. Earlier studies have demonstrated the feasibility of classifying normal, premalignant, and malignant oral ex-vivo tissues. We intend to evaluate potentials of Raman spectroscopy in detecting premalignant conditions. Spectra were recorded from premalignant patches, contralateral normal (opposite to tumor site), and cancerous sites of subjects with oral cancers and also from age-matched healthy subjects with and without tobacco habits. A total of 861 spectra from 104 subjects were recorded using a fiber-optic probe-coupled HE-785 Raman spectrometer. Spectral differences in the 1200- to 1800-cm-1 region were subjected to unsupervised principal component analysis and supervised linear discriminant analysis followed by validation with leave-one-out and an independent test data set. Results suggest that premalignant conditions can be objectively discriminated with both normal and cancerous sites as well as from healthy controls with and without tobacco habits. Findings of the study further support efficacy of Raman spectroscopic approaches in oral-cancer applications.

  12. One-stage and two-stage penile buccal mucosa urethroplasty

    African Journals Online (AJOL)

    G. Barbagli

    2015-12-02

    Dec 2, 2015 ... a Centro Chirurgico Toscano, Arezzo, Italy b Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy c Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano, Italy. Received 28 September 2015; accepted 28 September 2015.

  13. Goat Model for Direct Visualizing the Effectiveness of Detaching Sinus Mucosa in Real Time During Crestal Maxillary Sinus Floor Elevation.

    Science.gov (United States)

    Fan, Jiadong; Hu, Pin; Li, Yanfeng; Wang, Fuli; Dong, Xinming; Liu, Bin; Liu, Le; Zhang, Yue; Gu, Xiangmin

    2017-08-01

    The procedure of crestal maxillary sinus floor elevation presents a great challenge to the field of implant dentistry. Due to the limited visualization in this procedure, the effectiveness of detaching sinus mucosa could not be assessed in real time. We recently developed an ex vivo goat sinus model by cutting the goat residual skulls along four lines determined from computerized tomography (CT) scans, extracting the maxillary premolar or molar teeth, and preparing implant socket in the maxilla. The generated ex vivo goat sinus models exposed the maxilla and the whole maxillary sinus mucosa, thus enabling real-time observation of detaching maxillary sinus mucosa via directly visualizing the working situation of sinus lift tool in the models and directly measuring the length of detached mucosa and space volume generated under the elevated sinus mucosa. One commercially available umbrella-shaped sinus lift curette was used to detach the maxillary sinus mucosa to evaluate the effectiveness of the ex vivo goat sinus models. The results showed that this curette could detach the sinus mucosa 3.75 mm in length in the mesiodistal direction and 2.81 mm in the buccal-palatal direction. Moreover, a space volume of 52.7 μl could be created under the elevated sinus mucosa in the goat ex vivo models. All the experimental results suggested that this ex vivo goat sinus model might be useful in the evaluation of improved or newly designed sinus lift tools for elevating the maxillary sinus mucosa via the crestal approach.

  14. Reduction of mandibular residual ridge after vestibuloplasty. A two-year follow-up study comparing the Edlan flap, mucosal and skin graft operations

    DEFF Research Database (Denmark)

    Hillerup, Søren; Eriksen, Erik; Solow, B

    1989-01-01

    Mandibular residual ridge reduction (RRR) after Edlan flap vestibuloplasty, buccal mucosal graft, and split skin graft vestibuloplasty was measured on lateral cephalometric radiographs obtained 1, 3, 6, 12 and 24 months postsurgery in 50 patients. The ridge reduction was most severe during the im...

  15. Linfangioma bucal del tipo capilar: Reporte de un caso en un paciente adulto Capillary buccal lymphangioma: Case report in adult patient

    Directory of Open Access Journals (Sweden)

    Fabiano Gonzaga Rodrigues

    2007-03-01

    Full Text Available Se describe un caso clínico de linfangioma localizado en la mucosa bucal de un paciente de 68 años de edad, tratado con eletrocauterización. La presentación del caso comprende una breve revisión de la literatura; se aborda el diagnóstico y las características clínico-patológicas en el tratamiento del linfagioma bucal.In this paper, the authors describe a case report of a buccal lymphangioma localizeted in jugal mucosa of a sixty eight years old patient, treated by the electrocauterization. Also, they present a literature revision approaching the diagnosis, the clinical and histopathological characteristics, and the different types of treatment of the buccal lymphangioma.

  16. Free Gingival Graft to Increase Keratinized Mucosa after Placing of Mandibular Fixed Implant-Supported Prosthesis

    Directory of Open Access Journals (Sweden)

    Danny Omar Mendoza Marin

    2017-01-01

    Full Text Available Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis. The treatment included the manufacturing of a maxillary complete denture and a mandibular fixed implant-supported prosthesis followed by a free gingival graft to increase the width of the mandibular keratinized mucosa. Free gingival graft was obtained from the palate and grafted on the buccal side of interforaminal area. The follow-up of 02 and 12 months after mucogingival surgery showed that the free gingival graft promoted peri-implant health, hygiene, and patient comfort. Clinical Significance. The free gingival graft is an effective treatment in increasing the width of mandibular keratinized mucosa on the buccal side of the interforaminal area and provided an improvement in maintaining the health of peri-implant tissues which allows for better oral hygiene.

  17. Antimicrobial compounds of porcine mucosa

    Science.gov (United States)

    Kotenkova, E. A.; Lukinova, E. A.; Fedulova, L. V.

    2017-09-01

    The aim of the study was to investigate porcine oral cavity mucosa (OCM), nasal cavity mucosa (NCM), rectal mucosa (RM) and tongue mucosa (TM) as sources of antimicrobial compounds. Ultrafiltrates with MW >30 kDa, MW 5-30 kDa and MW antimicrobial activity against Escherichia coli and Proteus vulgaris. NCM ultrafiltrates revealed the highest antibacterial activity in respect to negative control: for the fraction with MW >30 kDa, the zone of microbial growth inhibition was 7.5 mm, for the MWantimicrobial compounds, which could be an actual alternative for reduction of microbial spoilage of foods.

  18. Influence of periodontal biotype on buccal bone remodeling after tooth extraction using the flapless approach with a xenograft: a histomorphometric and fluorescence study in small dogs.

    Science.gov (United States)

    Maia, Luciana Prado; Reino, Danilo Maeda; Novaes Junior, Arthur Belém; Muglia, Valdir Antonio; Taba Junior, Mário; Grisi, Márcio Fernando de Morais; Souza, Sérgio Luís Scombatti de; Palioto, Daniela Bazan

    2015-01-01

    Several approaches have been used to counteract alveolar bone resorption after tooth extraction. The aim of the present study was to evaluate the influence of gingival thickness and bone grafting on buccal bone remodeling in extraction sockets with thin buccal bone, using a flapless approach. The gingiva of 8 dogs was thinned at one side of the mandible and mandibular premolars were extracted without flaps. The sockets were randomly assigned to the test group (thin gingiva) (TG), the test group with grafting material TG + GM, the control group (normal gingiva) (CG), or the control group with grafting material CG + GM. Ground sections were prepared from 12-week healing biopsies, and histomorphometry and fluorescence analysis were performed. In the groups with thin gingiva, numerically greater buccal bone loss was observed, while there were no differences between grafted and nongrafted sites. A numerically higher rate of mineralization was observed for the grafted sites, as compared with the nongrafted sites, at 12 weeks. A thin buccal bone plate leads to higher bone loss in extraction sockets, even with flapless surgery. The gingival thickness or the use of a graft material did not prevent buccal bone resorption in a naturally thin biotype, but modified the mineralization process. © 2013 Wiley Periodicals, Inc.

  19. Flap double twist technique for prevention of LASIK flap striae

    Directory of Open Access Journals (Sweden)

    Nabil KM

    2016-11-01

    Full Text Available Karim Mahmoud Nabil Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt Abstract: A novel flap double twist technique was applied to reduce the incidence of post-laser-assisted in situ keratomileusis (LASIK flap striae. The flap is floated and stroked in the same way as is done for management of first postoperative day striae, where the method is to float and irrigate the flap into position, followed by applying gentle pressure on the flap with a wet Merocel microsponge and moving the flap away from the hinge position. The sponge is then manually squeezed to become drier, and the flap is continuously stroked in a direction opposite to the hinge. Next, the flap is carefully twisted obliquely and sequentially in two opposite directions while applying gentle pressure on the flap in order to completely dehydrate the flap and stromal bed. Finally, the flap is repositioned while applying gentle horizontal pressure in two opposite directions. This novel flap double twist technique shows great success in post-LASIK striae prevention. Keywords: laser-assisted in situ keratomileusis, wrinkles, pressure, microsponge

  20. Feasibility of Shape-Memory Ni/Ti Alloy Wire Containing Tube Elevators for Transcrestal Detaching Maxillary Sinus Mucosa: Ex Vivo Study

    Directory of Open Access Journals (Sweden)

    Yanfeng Li

    2016-12-01

    Full Text Available Background: Osteotome sinus floor elevation is a less invasive approach to augment an insufficient alveolar bone at the posterior maxilla for dental implantation. However, this approach has some limitations due to the lack of sinus lift tools available for clinical use and the small transcrestal access to the maxillary sinus floor. We recently invented shape-memory Ni/Ti alloy wire containing tube elevators for transcrestal detaching maxillary sinus mucosa, and developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time during transcrestal maxillary sinus floor elevation. Methods: We evaluated our invented elevators, namely elevator 012 and elevator 014, for their effectiveness for transcrestal detaching maxillary sinus mucosa using the goat ex vivo models. We measured the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions using the invented elevators. Results: Elevator 012 had a shape-memory Ni/Ti alloy wire with a diameter of 0.012 inch, while elevator 014 had its shape-memory Ni/Ti alloy wire with a diameter of 0.014 inch. Elevator 012 could detach the goat maxillary sinus mucosa in the mesial or distal direction for 12.1±4.3 mm, while in the buccal or palatal direction for 12.5±6.7 mm. The elevator 014 could detach the goat maxillary sinus mucosa for 23.0±4.9 mm in the mesial or distal direction, and for 19.0±8.1 mm in the buccal or palatal direction. An average space volume of 1.7936±0.2079 ml was created after detaching the goat maxillay sinus mucosa in both mesial/distal direction and buccal/palatal direction using elevator 012; while the average space volume created using elevator 014 was 1.8764±0.2366 ml. Conclusion: Both two newly invented tube elevators could effectively detach the maxillary sinus mucosa on the goat ex

  1. Comparison of soft tissue healing around implants in beagle dogs: flap surgery versus flapless surgery.

    Science.gov (United States)

    Lei, Qun; Chen, Jiang; Jiang, Jianhui; Fu, Xiaoming; Lin, Hengzhang; Cai, Zhiyu

    2013-03-01

    The objective of this study was to compare soft tissue healing after implant placement in flap and flapless surgery in the dog model. Mandibular premolars were extracted from 10 beagle dogs. The extraction sockets were allowed to heal for 8 weeks. After healing, 3 implants on each side of the mandible were implanted using either flap or flapless techniques. One implant was installed on each side at the 0-, 4-, and 6-week time point. Eight weeks later, the peri-implant soft tissue healing was subjected to clinical and immunohistochemical analysis. It was revealed that vascular endothelial growth factor (VEGF) expression, peri-implant crevicular fluid (PICF) volume, and the aspartate aminotransferase and alkaline phosphatase activity in PICF increased significantly in the 2-week flap group compared with the 2-week flapless group. Microvascular density and VEGF expression in the 8-week flap group was statistically significantly lower than the 8-week flapless group and normal group. Buccal gingival recession was less pronounced in the flapless group than in the flap group after 4 and 8 weeks. Within the limits of this study, the results demonstrate that flapless surgery contributes to better esthetic outcomes in implants compared with the flap approach. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

  2. Genotoxic assessment of chlorhexidine mouthwash on exfoliated buccal epithelial cells in chronic gingivitis patients

    Directory of Open Access Journals (Sweden)

    Saif Khan

    2016-01-01

    Full Text Available Background: Chlorhexidine (CHX is the gold standard of all chemical plaque control agents and the most commonly prescribed mouthwash. However, several studies have shown cytotoxic and genotoxic effects of CHX on various eukaryotic cells. In this study, we have used micronuclei as a biomarker of DNA damage in buccal epithelial cells of chronic gingivitis patients who were given adjunct 0.2% CHX for plaque control. Materials and Methods: Chronic gingivitis patients who were exclusively on mechanical plaque control methods were taken as control (Group A (n = 101, and chronic gingivitis patients who along with mechanical plaque control measures were taking 0.2% chlorhexidine mouthwash as adjunct were taken as cases (Group B (n = 255. The Group B was further divided into 5 subgroups (B1, B2, B3, B4, B5 (n = 51 on increasing duration of usage of CHX from ≤1 week to 24 weeks. Buccal epithelial cells were gently scrapped from the buccal mucosa using soft toothbrush. The epithelial cells were collected in buffer solution and centrifuged at 8000 rpm for 5 min. The buccal epithelial cells were air dried, fixed, and stained with 5% Giemsa stain on preheated glass microscopic slides and observed under microscope to screen 2000 nucleated cells per individual for number of micronucleated cells and micronuclei as genotoxic measure. Results: The mean number of micronucleated cells was found to be 0.41 ± 0.71 for Group A as compared values ranging from 1.65 ± 2.09 (Group B1 to 11.7 ± 1.87 (Group B5 in different subgroups of Group B, and similarly, the mean number of micronuclei was found to be 0.48 ± 0.80 for Group A as compared to values ranging from 2.57 ± 1.64 (Group B1 to 14.5 ± 2.49 (Group B5 in different subgroups of Group B using analysis of variance (P < 0.001. Conclusion: We conclude that CHX mouthwash is genotoxic to buccal epithelial cells and there is incremental trend in genotoxicity as the duration of usage is increased.

  3. An analysis of free flap failure using the ACS NSQIP database. Does flap site and flap type matter?

    Science.gov (United States)

    Kwok, Alvin C; Agarwal, Jayant P

    2017-09-01

    We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure. There were 1,187 microvascular free tissue transfers identified. The overall flap failure rate was 5.1%. Head and neck flaps had the highest rate of free flap failure at 7.7%. Prolonged operative time is an independent predictor of flap failure for all free flaps (OR: 2.383, P = 0.0013). When examining predictors of failure by flap site, free flaps to the breast with prolonged operative time are independently associated with flap failure (OR: 2.288, P = 0.0152). When examining predictors of flap failure by flap type, muscle based free flaps with an ASA classification ≥3 are associated with flap failure (P = 0.0441). Risk factors for free flap failure differ based upon flap site and flap type. Prolonged operative time is an independent risk factor for the failure of free flaps used for breast reconstruction. An ASA classification ≥3 is associated with the failure of free muscle based flaps. Our findings identify actionable areas that may help to improve free flap success. © 2016 Wiley Periodicals, Inc.

  4. KYSTE DERMOÏDE DU PLANCHER BUCCAL

    African Journals Online (AJOL)

    18 juin 2007 ... INTRODUCTION. Le kyste dermoïde du plancher buccal représente 1,6% des kystes dermoïdes cervico-faciaux. Il s'agit le plus sou- vent d'un kyste congénital mais découvert généralement entre la 2ème et la 3ème décennie de la vie. Nous rappor- tons l'observation d'un nourrisson, chez qui nous avons.

  5. In vivo human buccal permeability of nicotine

    DEFF Research Database (Denmark)

    Adrian, Charlotte L; Olin, Helle B D; Dalhoff, Kim

    2006-01-01

    -smokers using a buccal perfusion cell. The disappearance of nicotine from perfusion solutions with pH 6.0, 7.4, and 8.1 was studied for 3h. The apparent permeability of nicotine (P(app)) was determined at each pH value. Parotid saliva was collected in an attempt to assess systemic levels of nicotine......(app) values and non-ionised nicotine, which indicates that the nicotine transfer occurred by means of passive diffusion. P(app) values of 0.60 x 10(-4) and 6.18 x 10(-4)cms(-1) were obtained for the mono-protonated and non-ionised species of nicotine, respectively. The analysis of the parotid saliva samples...... indicated that these samples might be useful in the assessment of systemic absorption of nicotine. Previous buccal in vitro models underestimated the in vivo human permeability of nicotine. However, the in vitro models were capable of predicting the effect of pH on the nicotine permeability....

  6. [Modified sternocleidomastoid myocutaneous flap for reconstruction of soft tissue defects following tumorectomy of maxillofacial region].

    Science.gov (United States)

    Lin, Yi; Zhu, Huiyong; Liu, Jianhua; Wang, Huiming

    2010-04-01

    To investigate clinical effect and prognosis of the modified sternocleidomastoid (MSCM) myocutaneous flap for reconstruction of tissue defects in patients with oral carcinomas undergoing tumorectomy. From April 2001 to January 2007, 43 patients with large or medium-sized tissue defects because of oral carcinomas radical operation were treated with MSCM myocutaneous flap. There were 31 males and 12 females with an average age of 58.5 years (25-76 years). The disease course was 25 days to 14 months (4.5 months on average). There were 27 cases of well-differentiated squamous cell carcinoma (SC), 14 cases of poorly-differentiated SC, 1 case of rhabdomyosarcoma, and 1 case of adenoid cystic carcinoma. Affected locations were tongue in 25 cases, mouth floor in 11 cases, lower gingiva in 4 cases, and buccal mucous membranes in 3 cases. According to 2002 International Union Control Cancer criterion for clinical stage, there were 3 cases of stage I, 13 cases of stage II, 7 cases of stage III, and 20 cases of stage IV. Both the ranges of soft tissue defects and the flap were from 4 cm x 3 cm to 8 cm x 6 cm. The vitality of the flaps and the healing of wounds were observed postoperatively. The function restoration of deglutition and dehisce were observed during the follow-up period. Necrosis of quarter MSCM myocutaneous flap occurred in 3 cases 1 week after operation, wounds healed by secondary intention after dressing; other flaps were survival. Infection with fluidity occurred at the donor site of 2 cases, wounds healed by incision and drainage; other incision at the donor sites healed primarily. No arterial or venous crisis occurred in all 43 flaps after 48 hours of operation. Thirty-nine patients were followed up for 6 months to 6 years. The 3 patients with buccal carcinoma could open their mouths normally. The function of deglutition and pronunciation were recovered in 24 patients with tongue carcinoma. Only 3 patients needed to have soft diet after operation. In 26

  7. Applications of a modified palatal roll flap in peri-implant soft-tissue augmentation – A case series

    Directory of Open Access Journals (Sweden)

    Mihir Raghavendra Kulkarni

    2017-01-01

    Full Text Available Abrams's palatal roll technique has been used extensively to augment peri-implant soft tissues in the maxillary esthetic zone and has seen numerous modifications. An adaptation of the palatal roll technique is described here and its simplicity of application in three different scenarios is demonstrated. At second-stage implant surgery, a partial thickness initial incision followed by a palatal subepithelial dissection at the site of implant was done and a connective tissue graft with a buccal pedicle was obtained. The graft was rolled under the buccal flap and allowed to heal with the support of a healing abutment. The graft healed uneventfully and provided excellent contours of tissues around the implant. The procedure demonstrated good results for augmentation of a buccal ridge deficiency, for covering exposed and unsightly implant fixtures and was also done with a papilla preservation incision. In addition, a second surgical site to obtain the connective tissue graft was avoided.

  8. Development of Buccal Patches for Delivery of Darifenacin from Beta-Cyclodextrin Complexes

    Directory of Open Access Journals (Sweden)

    Swati C. Jagdale

    2014-01-01

    Full Text Available Drug-cyclodextrin complexes improve aqueous solubility and dissolution rate of poorly water-soluble drugs. Solubilisation followed by buccal delivery of poorly water-soluble drugs can be advantageous for increasing drug absorption. Darifenacin is an antispasmodic used against urinary incontinence and specifically blocks M3 muscarinic acetylcholine receptors in smooth muscle. M3 receptors are mainly located in exocrine glands, smooth muscle and vascular endothelium. The oral absorption of darifenacin is poor owing to its low solubility. It also has poor bioavailability (15-19% due to a high rate of first-pass metabolism. Complexation with beta-cyclodextrin was carried out to enhance solubility. The best results were obtained by co-grinding in a 1:1 molar ratio of drug: β-cyclodextrin. The solid inclusion complexes were characterized by DSC, X-ray diffractometry and FTIR. Inclusion complexes showed higher dissolution rates than the pure drug. Controlledrelease mucoadhesive patches were prepared with two hydroxypropyl methylcellulose (HPMC polymers, K100M CR and K15. The patches were assessed for surface pH, folding endurance, swelling, mucoadhesive properties, in-vitro residence time, vapor transmission test and in-vitro (cellophane, egg membrane and exvivo (goat buccal mucosa release. Formulations Ha2 (2% HPMC K100M CR and Pa4 (4% HPMC K15 showed good mucoadhesive strength, in-vitro and exvivo residence times, with controlled release for 10 hours.

  9. Buccal Transmucosal Delivery System of Enalapril for Improved ...

    African Journals Online (AJOL)

    Transmucosal buccal delivery has been investigated for various drugs including protein and peptides [14-17]. Various TMDDS like tablets, films, patches, disks, strips, ointments and gels have been investigated [14-21]. Out of these transmucosal buccal films have been reported to be more flexible, comfortable with relatively ...

  10. Preparation of Mucoadhesive Patches for Buccal Administration of ...

    African Journals Online (AJOL)

    Purpose: To develop mucoadhesive patches for buccal administration of metoprolol succinate and to evaluate their in vitro and in vivo bioadhesion. Methods: The mucoadhesive buccal patches were prepared by solvent casting technique using two different mucoadhesive polymers. The formulations were tested for in vitro ...

  11. Buccal bone plate remodeling after immediate implants with or without synthetic bone grafting and flapless surgery: a histomorphometric and fluorescence study in dogs.

    Science.gov (United States)

    Suaid, Flávia A; Novaes, Arthur B; Queiroz, Adriana C; Muglia, Valdir A; Almeida, Adriana L G; Grisi, Márcio F M

    2014-02-01

    The aim of this study was to evaluate the buccal bone plate remodeling after immediate implantation using the flapless approach with or without bone graft into the gap between the implant and the buccal bone. Eight dogs had the mandibular bicuspids extracted without flaps, and four implants were installed on each side, totaling eight implants per animal. Randomly, in one side, the implants were positioned at the bone crest level (equicrestal), and on the opposite side, the implants were positioned 2 mm subcrestal. All the implants were positioned 2.0 mm from the buccal bone plate (gap) and associated or not with grafting material. Therefore, the following treatments were performed: implants subcrestal test (SCTG) with bone graft and control (SCCG) without bone graft, and equicrestal test (ECTG) with bone graft and control (ECCG) without bone graft. One week following the surgeries, metallic prostheses were installed. Bone markers were administered 1, 2, 4, and 12 weeks after implant placement for fluorescence analysis. Ground sections were prepared from 12-week healing biopsies, and histomorphometry was performed. The histomorphometric evaluation presents significant better results for the ECTG in the vertical crestal bone resorption, but the other parameters showed better results for the SCCG. The fluorescence evaluation in adjacent areas showed numerically different results between groups with a small decrease at 12 weeks, except for the SCCG, which was higher at this time. The distant area showed a continuous increase in the marked bone. The equicrestally placed implants presented little or no loss of the buccal bone wall. The subcrestally positioned implants presented loss of buccal bone, regardless of the use of bone graft. However, the buccal bone was always coronal to the implant shoulder. Both the equicrestal and subcrestal groups were benefited in the early stages of bone healing as evidenced by the fluorescence analysis. © 2012 John Wiley & Sons A/S.

  12. Sacrificing the buccal branch of the facial nerve during parotidectomy.

    Science.gov (United States)

    Dhiwakar, Muthuswamy; Khan, Zubair A

    2016-12-01

    The need for and consequence of sacrificing the buccal branch of the facial nerve during parotidectomy is unknown. We sought to determine the indication, frequency, and functional outcome of buccal branch sacrifice. We conducted a prospective study of all cases of parotidectomy at a tertiary referral center. Of 100 consecutive cases of parotidectomy, the buccal branch was sacrificed in 23 cases. This subgroup was more likely to have anterior or deep lesions (p < .001), retrograde facial nerve dissection (p = .037), and immediate postoperative upper and lower facial weakness (p = .051 and .002, respectively). However, if the temporozygomatic and cervicomandibular branches were anatomically preserved, full facial (including buccal) function was restored. Deep or anterior lesions may warrant sacrifice of the buccal branch for adequate access and excision. However, this does not result in long-term impairment of facial function. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1821-1825, 2016. © 2016 Wiley Periodicals, Inc.

  13. Functional physico-chemical, ex vivo permeation and cell viability characterization of omeprazole loaded buccal films for paediatric drug delivery.

    Science.gov (United States)

    Khan, Sajjad; Trivedi, Vivek; Boateng, Joshua

    2016-03-16

    Buccal films were prepared from aqueous and ethanolic Metolose gels using the solvent casting approach (40°C). The hydration (PBS and simulated saliva), mucoadhesion, physical stability (20°C, 40°C), in vitro drug (omeprazole) dissolution (PBS and simulated saliva), ex vivo permeation (pig buccal mucosa) in the presence of simulated saliva, ex vivo bioadhesion and cell viability using MTT of films were investigated. Hydration and mucoadhesion results showed that swelling capacity and adhesion was higher in the presence of PBS than simulated saliva (SS) due to differences in ionic strength. Omeprazole was more stable at 20°C than 40°C whilst omeprazole release reached a plateau within 1h and faster in PBS than in SS. Fitting release data to kinetic models showed that Korsmeyer-Peppas equation best fit the dissolution data. Drug release in PBS was best described by zero order via non-Fickian diffusion but followed super case II transport in SS attributed to drug diffusion and polymer erosion. The amount of omeprazole permeating over 2h was 275 ug/cm(2) whilst the formulations and starting materials showed cell viability values greater than 95%, confirming their safety for potential use in paediatric buccal delivery. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Inhibitory activity of the isoflavone biochanin A on intracellular bacteria of genus Chlamydia and initial development of a buccal formulation.

    Directory of Open Access Journals (Sweden)

    Leena Hanski

    Full Text Available Given the established role of Chlamydia spp. as causative agents of both acute and chronic diseases, search for new antimicrobial agents against these intracellular bacteria is required to promote human health. Isoflavones are naturally occurring phytoestrogens, antioxidants and efflux pump inhibitors, but their therapeutic use is limited by poor water-solubility and intense first-pass metabolism. Here, we report on effects of isoflavones against C. pneumoniae and C. trachomatis and describe buccal permeability and initial formulation development for biochanin A. Biochanin A was the most potent Chlamydia growth inhibitor among the studied isoflavones, with an IC50 = 12 µM on C. pneumoniae inclusion counts and 6.5 µM on infectious progeny production, both determined by immunofluorescent staining of infected epithelial cell cultures. Encouraged by the permeation of biochanin A across porcine buccal mucosa without detectable metabolism, oromucosal film formulations were designed and prepared by a solvent casting method. The film formulations showed improved dissolution rate of biochanin A compared to powder or a physical mixture, presumably due to the solubilizing effect of hydrophilic additives and presence of biochanin A in amorphous state. In summary, biochanin A is a potent inhibitor of Chlamydia spp., and the in vitro dissolution results support the use of a buccal formulation to potentially improve its bioavailability in antichlamydial or other pharmaceutical applications.

  15. Permeability barrier properties of oral keratinocyte cultures: a model of intact human oral mucosa.

    Science.gov (United States)

    Selvaratnam, L; Cruchley, A T; Navsaria, H; Wertz, P W; Hagi-Pavli, E P; Leigh, I M; Squier, C A; Williams, D M

    2001-07-01

    The aim of this study was to establish whether an in vitro model of human oral mucosa had similar permeability characteristics to normal oral mucosa. Such a model would have considerable value as an alternative to the use of mucosal biopsies in studies of transmucosal drug delivery. Keratinocytes obtained from buccal mucosa, hard palate and abdominal skin were seeded onto inert collagen membranes (Cellagen Discs) or dead de-epidermised dermis (DDED) and grown either as submerged or air-liquid interface cultures. Subsequently the ultrastructural characteristics, permeability to water and barrier lipid content of the epithelial cultures were assessed and compared with samples of intact mucosa and skin. All the cultures stratified into multilayered epithelia and displayed features of differentiation including tonofilaments, desmosomes and membrane coating granules. The permeability characteristics and barrier lipid content of the oral mucosal cultures resembled those of intact mucosa. By contrast, epidermal keratinocytes failed to produce a permeability barrier comparable with that of skin and had low levels of barrier associated lipids. Cultures of human oral mucosal keratinocytes obtained from healthy adults develop similar permeability properties and barrier lipid composition to their site of origin. This model system may be useful for the evaluation of local and systemic oral mucosal drug delivery.

  16. Cultivated Oral Mucosa Epithelium in Ocular Surface Reconstruction in Aniridia Patients.

    Science.gov (United States)

    Dobrowolski, Dariusz; Orzechowska-Wylegala, Boguslawa; Wowra, Bogumil; Wroblewska-Czajka, Ewa; Grolik, Maria; Szczubialka, Krzysztof; Nowakowska, Maria; Puzzolo, Domenico; Wylegala, Edward A; Micali, Antonio; Aragona, Pasquale

    2015-01-01

    Efficacy of cultivated oral mucosa epithelial transplantation (COMET) procedure in corneal epithelium restoration of aniridia patients. Study subjects were aniridia patients (13 patients; 17 eyes) with irregular, vascular conjunctival pannus involving visual axis who underwent autologous transplantation of cultivated epithelium. For the procedure oral mucosa epithelial cells were obtained from buccal mucosa with further enzymatic treatment. Suspension of single cells was seeded on previously prepared denuded amniotic membrane. Cultures were carried on culture dishes inserts in the presence of the inactivated with Mitomycin C monolayer of 3T3 fibroblasts. Cultures were carried for seven days. Stratified oral mucosa epithelium with its amniotic membrane carrier was transplanted on the surgically denuded corneal surface of aniridia patients with total or subtotal limbal stem cell deficiency. Outcome Measures. Corneal surface, epithelial regularity, and visual acuity improvement were evaluated. At the end of the observation period, 76.4% of the eyes had regular transparent epithelium and 23.5% had developed epithelial defects or central corneal haze; in 88.2% of cases visual acuity had increased. VA range was from HM 0.05 before the surgery to HM up to 0.1 after surgery. Application of cultivated oral mucosa epithelium restores regular epithelium on the corneal surface with moderate improvement in quality of vision.

  17. Cultivated Oral Mucosa Epithelium in Ocular Surface Reconstruction in Aniridia Patients

    Directory of Open Access Journals (Sweden)

    Dariusz Dobrowolski

    2015-01-01

    Full Text Available Purpose. Efficacy of cultivated oral mucosa epithelial transplantation (COMET procedure in corneal epithelium restoration of aniridia patients. Methods. Study subjects were aniridia patients (13 patients; 17 eyes with irregular, vascular conjunctival pannus involving visual axis who underwent autologous transplantation of cultivated epithelium. For the procedure oral mucosa epithelial cells were obtained from buccal mucosa with further enzymatic treatment. Suspension of single cells was seeded on previously prepared denuded amniotic membrane. Cultures were carried on culture dishes inserts in the presence of the inactivated with Mitomycin C monolayer of 3T3 fibroblasts. Cultures were carried for seven days. Stratified oral mucosa epithelium with its amniotic membrane carrier was transplanted on the surgically denuded corneal surface of aniridia patients with total or subtotal limbal stem cell deficiency. Outcome Measures. Corneal surface, epithelial regularity, and visual acuity improvement were evaluated. Results. At the end of the observation period, 76.4% of the eyes had regular transparent epithelium and 23.5% had developed epithelial defects or central corneal haze; in 88.2% of cases visual acuity had increased. VA range was from HM 0.05 before the surgery to HM up to 0.1 after surgery. Conclusion. Application of cultivated oral mucosa epithelium restores regular epithelium on the corneal surface with moderate improvement in quality of vision.

  18. Buccal microbiology analyzed by infrared spectroscopy

    Science.gov (United States)

    de Abreu, Geraldo Magno Alves; da Silva, Gislene Rodrigues; Khouri, Sônia; Favero, Priscila Pereira; Raniero, Leandro; Martin, Airton Abrahão

    2012-01-01

    Rapid microbiological identification and characterization are very important in dentistry and medicine. In addition to dental diseases, pathogens are directly linked to cases of endocarditis, premature delivery, low birth weight, and loss of organ transplants. Fourier Transform Infrared Spectroscopy (FTIR) was used to analyze oral pathogens Aggregatibacter actinomycetemcomitans ATCC 29523, Aggregatibacter actinomycetemcomitans-JP2, and Aggregatibacter actinomycetemcomitans which was clinically isolated from the human blood-CI. Significant spectra differences were found among each organism allowing the identification and characterization of each bacterial species. Vibrational modes in the regions of 3500-2800 cm-1, the 1484-1420 cm-1, and 1000-750 cm-1 were used in this differentiation. The identification and classification of each strain were performed by cluster analysis achieving 100% separation of strains. This study demonstrated that FTIR can be used to decrease the identification time, compared to the traditional methods, of fastidious buccal microorganisms associated with the etiology of the manifestation of periodontitis.

  19. Airbag-induced corneal flap.

    Science.gov (United States)

    Liyanage, Sidath E; Mearza, Ali A

    2009-02-01

    To describe a case of airbag-induced corneal flap in a previously normal cornea. Case report. A 27-year-old woman presented with complete loss of vision in her left eye following a road traffic accident which involved airbag deployment. There was no previous ocular history. Examination revealed a large corneal flap of 6mm in diameter, extending to the depth of anterior stroma. This was accompanied by a traumatic optic neuropathy. One month follow-up revealed complete reattachment of the corneal flap. This is the first reported case of a corneal flap induced by airbag deployment in a cornea with previously normal architecture.

  20. Vertical and horizontal ridge alterations after tooth extraction in the dog: flap vs. flapless surgery.

    Science.gov (United States)

    Blanco, Juan; Mareque, Santiago; Liñares, Antonio; Muñoz, Fernando

    2011-11-01

    To compare ridge alterations after flap and flapless tooth extraction in the vertical and horizontal dimension in the dog model. This study was carried out on five Beagle dogs. Four extractions were performed in the lower jaw of each dog (two per side. Pm3, Pm4). At the time of tooth extraction, flap surgery was performed on one side (control group). On the contra-lateral side, a flapless extraction was performed (test group). Mesial sockets were left untreated on both sides. After 3 months of healing, the dogs were sacrificed and prepared for histological analysis. Ten samples were evaluated on each group. The vertical difference in height between the buccal and lingual crest was 1.48 mm for the flap, and 1.22 mm for the flapless group. The horizontal dimension of the ridge was 4.41 mm (at 1 mm from the crest), 5.72 mm (at 3 mm from the crest) and 6.67 mm (at 5 mm form the crest) in the flap group. In the flapless group, the measurements were 4.5, 5.58 mm and 6.44 at 1, 3 and 5 mm from the crest, respectively. Evaluating ridge alterations in the vertical and horizontal dimension after 3 months of healing following tooth extraction, results for the flap and the flapless group were very similar. © 2011 John Wiley & Sons A/S.

  1. Pharmacokinetics and dose proportionality of fentanyl effervescent buccal tablets in healthy volunteers.

    Science.gov (United States)

    Darwish, Mona; Tempero, Kenneth; Kirby, Mary; Thompson, Jeffrey

    2005-01-01

    Fentanyl effervescent buccal tablets (FEBT) are designed to enhance the rate and efficiency of fentanyl absorption through the buccal mucosa. This study was undertaken to characterise the pharmacokinetics and assess the dose proportionality of FEBT in healthy volunteers within the potential therapeutic dose range. Twenty-five healthy adults (mean age 33 years) completed a single-dose, randomised, open-label, four-dose, four-period, crossover study of FEBT. They were administered FEBT 200, 500, 810 or 1080microg. The subjects in this study were not opioid tolerant; therefore, naltrexone was administered to block any opioid receptor-mediated effects of fentanyl. Venous blood samples for measurement of serum fentanyl concentrations were obtained over 36 hours following dosing. Adverse events were recorded throughout the study. The pharmacokinetics of FEBT were characterised by an absorption phase with a median time to reach maximum serum concentration (tmax) of 0.75-0.99 hours that was consistent irrespective of dose. Mean serum fentanyl concentrations exhibited a biexponential decline from peak after FEBT 200 and 500microg doses and a triexponential decline after FEBT 810 and 1080microg doses. The maximum serum concentration (Cmax) of fentanyl was proportional up to and including the 810microg dose. The increase in Cmax was 20% less than proportional at the 1080microg dose. Systemic exposure to fentanyl, as measured by the area under the serum concentration-time curve from time zero to infinity (AUCinfinity), increased proportionally with increasing doses of FEBT (200-1080microg). No serious adverse events were reported during the study. The pharmacokinetics of FEBT were characterised by a high early fentanyl concentration as a result of absorption across the buccal mucosa of the oral cavity, which results in bypassing first-pass metabolism. This high early tmax contributed to enhanced early systemic fentanyl exposure. Maximum concentration and AUCinfinity of FEBT

  2. Papilla Preservation Flap as Aesthetic Consideration in Periodontal Flap Surgery

    Directory of Open Access Journals (Sweden)

    Sandra Olivia

    2013-07-01

    Full Text Available Flap surgery is treatment for periodontal disease with alveolar bone destruction. Surgical periodontal flap with conventional incision will result in gingival recession and loss of interdental papillae after treatment. Dilemma arises in areas required high aesthetic value or regions with a fixed denture. It is challenging to perform periodontal flap with good aesthetic results and minimal gingival recession. This case report aimed to inform and to explain the work procedures, clinical and radiographic outcomes of surgical papilla preservation flap in the area that requires aesthetic. Case 1 was a surgical incision flap with preservation of papillae on the anterior region of teeth 11 and 12, with a full veneer crown on tooth 12. Case 2 was a surgical incision flap with preservation of papillae on the posterior region of tooth 46 with inlay restoration. Evaluation for both cases were obtained by incision papilla preservation of primary closure was perfect, good aesthetic results, minimal gingival recession and the interdental papillae can be maintained properly. In conclusion, periodontal flap surgery on the anterior region or regions that require high aesthetic value could be addressed with papilla preservation incision. Incision papilla preservation should be the primary consideration in periodontal flap surgery if possible.DOI: 10.14693/jdi.v19i3.144

  3. Exfoliative cytology of buccal squames: A quantitative cytomorphometric analysis of patients with diabetes.

    Science.gov (United States)

    Sankhla, Bharat; Sharma, Abhishek; Shetty, Raju Singam; Bolla, Sheetal Chowdary; Gantha, Naga Sribala; Reddy, Prasun

    2014-09-01

    Diabetes is a third leading cause of mortality and morbidity in the world. Diabetes is one of the most common endocrine metabolic disorders and its prevalence has been increasing worldwide. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability. The purpose of this study is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of diabetes. Smears were taken from the buccal mucosa of 30 diabetes patients (study group) and 30 healthy individuals (control group). All the smears were stained with rapid Papanicolaou stain (PAP). In the PAP smears, the nuclear area (NA), cytoplasmic area (CA), and cytoplasmic-to-nuclear ratio (CNR) were evaluated for 50 cells in each smear, using the Image Analysis Software (Magnus Pro™) and research microscope (Lawrence and Mayo™). The results showed that the mean NA was significantly higher (P 0.001). The mean CNR was significantly lower in the study group (P exfoliative cytology, which can be used in the diagnosis of the disease.

  4. Soft palate functional reconstruction with buccinator myomucosal island flaps.

    Science.gov (United States)

    Massarelli, O; Vaira, L A; Gobbi, R; Biglio, A; Dell'aversana Orabona, G; De Riu, G

    2018-03-01

    Oropharyngeal reconstruction after ablative surgery is a challenge. The results of a retrospective study of 17 patients who underwent total or sub-total soft palate reconstruction with a buccinator myomucosal island flap, between 2008 and 2016, are reported herein. An analysis of flap type and size, harvesting time, and postoperative complications was performed. Patients underwent standardized tests to assess the recovery of sensitivity, deglutition, quality of life (QoL), and donor site morbidity, at >6 months after surgery or the end of adjuvant therapy, if performed. All flaps were transposed successfully. Only minor donor and recipient site complications occurred. The sensitivity assessment showed that touch, two-point discrimination, and pain sensations were recovered in all patients. Significant differences between the flap and native mucosa were reported for tactile (P=0.004), pain (P=0.001), and two-point discrimination (P=0.001) thresholds. The average deglutition score reported was 6.1/7, with only minimal complaints regarding deglutition. The QoL assessment showed high physical (24.6/28), social (25/28), emotional (19.1/24), and functional (24.6/28) scores. No major donor site complications were noted in any patient; the average donor site morbidity score was 8.1/9. Buccinator myomucosal island flaps represent a valuable functional oropharyngeal option for reconstruction, requiring a short operating time and presenting a low donor site morbidity rate. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Loratadine bioavailability via buccal transferosomal gel: formulation, statistical optimization, in vitro/in vivo characterization, and pharmacokinetics in human volunteers.

    Science.gov (United States)

    Elkomy, Mohammed H; El Menshawe, Shahira F; Abou-Taleb, Heba A; Elkarmalawy, Marwa H

    2017-11-01

    Loratadine (LTD) is an antihistaminic drug that suffers limited solubility, poor oral bioavailability (owing to extensive first-pass metabolism), and highly variable oral absorption. This study was undertaken to develop and statistically optimize transfersomal gel for transbuccal delivery of LTD. Transfersomes bearing LTD were prepared by conventional thin film hydration method and optimized using sequential Quality-by-Design approach that involved Placket-Burman design for screening followed by constrained simplex-centroid design for optimization of a Tween-80/Span-60/Span-80 mixture. The transferosomes were characterized for entrapment efficiency, particle size, and shape. Optimized transferosomes were incorporated in a mucoadhesive gel. The gel was characterized for rheology, ex vivo permeation across chicken pouch buccal mucosa, in vitro release, and mucoadhesion. Pharmacokinetic behavior of LTD formulations was investigated in healthy volunteers following administration of a single 10-mg dose. Optimal transferosomes characterized by submicron size (380 nm), spherical shape and adequate loading capacity (60%) were obtained by using quasi-equal ratio surfactant mixture. In terms of amount permeated, percentage released, and mucoadhesion time, the transferosomal gel proved superior to control, transferosome-free gel. Bioavailability of the transferosomal gel was comparable to Claritin® oral tablets. However, inter-individual variability in Cmax and AUC was reduced by 76 and 90%, respectively, when the buccal gel was used. Linear Correlation of in vitro release with in vivo buccal absorption fractions was established with excellent correlation coefficient (R2>0.97). In summary, a novel buccal delivery system for LTD was developed. However, further clinical investigation is warranted to evaluate its therapeutic effectiveness and utility.

  6. Innervated digital artery perforator flap.

    Science.gov (United States)

    Ozcanli, Haluk; Coskunfirat, Osman Koray; Bektas, Gamze; Cavit, Ali

    2013-02-01

    To describe a technique for covering defects of the fingertips: the innervated digital artery perforator (IDAP) flap. A total of 17 patients were treated with an IDAP flap. The size of the flaps varied between 2 ×1 cm and 3.5 × 2 cm. Postoperative evaluation of the patients consisted of the Semmes-Weinstein Monofilament test, static 2-point discrimination, patient satisfaction, extension loss, and an investigation into complications. All IDAP flaps survived completely, and no patients required secondary interventions. The mean follow-up period was 7 months (range, 6-10 mo). The Semmes-Weinstein monofilament test results ranged from 3.22 to 3.84. The static 2-point discrimination in the flaps ranged from 2 mm to 4 mm (mean, 3.4 mm) compared with a range of 2 mm to 3 mm (mean, 2.7 mm) on the contralateral hand. There were no joint contractures in the reconstructed fingertips, although 2 patients developed mild hook nail deformity. One patient experienced mild cold intolerance, and 1 patient exhibited mild postoperative hypersensitivity. The advantages of the IDAP flap include minimally invasive surgery; a reliable, versatile flap; and the ease of the technique for different-sized fingertip defect reconstructions with few complications. The IDAP flap may be useful in fingertip amputations when the amputated part is not suitable for replantation. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Variation in buccal surface morphology of deciduous first molars

    Directory of Open Access Journals (Sweden)

    M Simratvir

    2012-01-01

    Full Text Available Background: The buccal bulge of the deciduous first molars has always been a restorative challenge to the pediatric dentist. Morphologically it may vary from a slight prominence to a well-developed cusp-like structure. Aim: This study was conducted to determine the variable buccal surface morphology of deciduous first molar and its clinical relevance. Materials and Methods: A prospective study was conducted whereby 2016 patients visiting the outpatient clinic of dental hospital over 1 year were evaluated. Any variation in buccal surface morphology of the deciduous first molars was recorded photographically or by replicating in dental stone. Results: Varied morphological patterns on buccal surface were observed for which a new classification scheme has been proposed. Conclusion: The surface morphology of deciduous teeth crowns must be studied carefully as it may be indicative of pulpal extensions and accessory roots, requiring consideration during restorative treatment planning.

  8. Preparation of Mucoadhesive Patches for Buccal Administration of ...

    African Journals Online (AJOL)

    Erah

    Methods: The mucoadhesive buccal patches were prepared by solvent casting technique using two different mucoadhesive polymers. The formulations ... and nucleic acids possessing superior pharmacological efficacy, site specificity and ... Metoprolol succinate was obtained as a gift from Aarti Pharmaceuticals, India while.

  9. Úlcera eosinófila de la mucosa oral Eosinophilic ulcer of oral mucosa

    Directory of Open Access Journals (Sweden)

    A.C. Bencini

    2009-08-01

    Full Text Available La Úlcera Eosinófila de la Mucosa Oral, es una entidad poco frecuente, pobremente descrita en la literatura mundial. Se define como una lesión benigna autolimitada que si bien puede presentarse en distintas áreas de la cavidad bucal, presenta una marcada predilección por la mucosa ventral de la lengua. Clínicamente, se presenta como una lesión ulcerada de bordes indurados y sobreelevados. Los hallazgos histopatológicos son característicos y consisten en un infiltrado mixto rico en eosinófilos, acompañado de una población de grandes células mononucleadas. Recientes artículos basados en estudios inmunohistoquimicos, permiten afirmar la presencia de grandes linfocitos atípicos CD30+ y por lo tanto, incluir esta lesión en el espectro de las entidades simuladoras de desordenes linfoproliferativos. A pesar de esto, el mecanismo etiopatogenico permanece oscuro y el trauma local juega un rol todavía no dilucidado; aunque se halla presente en la mayoría de las publicaciones, explicando el fenómeno como un mecanismo reactivo. La importancia de esta lesión, radica en su diagnostico diferencial por su semejanza clínica al carcinoma espinocelular, histoplasmosis, chancro sifilítico, Úlcera tuberculosa, carcinoma epidermoide y otras. En nuestro trabajo se revisa la literatura y se discuten la características clínicas, histopatológicas y alternativas terapéuticas, a partir del artículo de un caso clínico en una paciente joven, que luego de la biopsia escisión como método para el diagnostico de certeza, se produce una recidiva de la lesión; lo que orientó el tratamiento hacia la cirugía combinada con corticoterapia local intralesional, logrando su remisión.Eosinophilic Ulcer of the Oral Mucosa, an entity, poorly deciphers in world-wide literature. It is defined as a self-limited, benign injury that although it can appear in different areas of the buccal cavity it presents a noticeable predilection via the ventral mucosa of the

  10. Entrainment control in the Aplysia buccal ganglion

    Science.gov (United States)

    Hunter, John D.; Milton, John G.

    2000-03-01

    Many dynamical systems, such as neural networks, can be pushed into or out of an entrained state by varying a system parameter. However, implementing this control strategy in a real biological system remains a difficult problem since many biological effectors have multiple effects. An example is an inhibitory interneuron that generates a postsynaptic current with a constant component, which alters the firing rate of its target, and a time-varying component, which can have a variety of effects. Here we explore the effects of an inhibitory interneuron on the ability of a regularly spiking Aplysia buccal motoneuron to synchronize to an external periodic input. After measuring the Arnold tongue structure of the motoneuron's response to sinusoidal input, we drive the motoneuron to and from an entrained state (onto and off of a tongue) by using the interneuron as a rate controller. These observations indicate that rate control of synchronization is robust even in the case when effectors have multiple actions. Moreover, these results provide direct evidence that inhibitory interneurons can serve as a sensitive mechanism to control the synchronization of neural populations by producing only slight changes in neural firing rate.

  11. Do you mind if I vape? Immediate effects of electronic cigarettes on perfusion in buccal mucosal tissue--a pilot study.

    Science.gov (United States)

    Reuther, William J; Hale, Beverley; Matharu, Jas; Blythe, John N; Brennan, Peter A

    2016-04-01

    The association between smoking and postoperative complications is compounded in patients who have oral and maxillofacial operations by an additional local effect, and patients often continue to smoke after operation despite advice to stop. Recent studies have suggested that nicotine may reduce inflammation and improve angiogenesis, so topical application may be beneficial for smokers. The electronic cigarette is increasing in popularity and more patients ask whether they can vape after operation. We investigated the effect of electronic cigarettes (of which half contained nicotine and half did not) on blood flow in the buccal mucosa in 10 volunteers immediately after vaping. Smokers were excluded as this was considered an additional variable in a small pilot study and our Trust has a no-smoking policy. After vaping for 5 minutes, capillary blood flow was measured in the buccal mucosa at 5-minute intervals using a laser Doppler probe, and the results were expressed as arbitrary perfusion units. There was a wide variation in results and a small but significant rise (p=0.008) as a result of nicotine vaping, but these fell to the same levels as before within 30 minutes. Electronic cigarettes may have an effect on blood flow to the oral mucosa, although further studies are needed to show whether they improve healing time after operation. Additional work is also needed to compare them with cigarettes. Copyright © 2016. Published by Elsevier Ltd.

  12. Active Control of Long Bridges Using Flaps

    DEFF Research Database (Denmark)

    Hansen, H. I.; Thoft-Christensen, Palle

    The main problem in designing ultra-long span suspension bridges is flutter. A solution to this problem might be to introduce an active flap control system to increase the flutter wind velocity. The investigated flap control system consists of flaps integrated in the bridge girder so each flap...... is the streamlined part of the edge of the girder. Additional aerodynamic derivatives are shown for the flaps and it is shown how methods already developed can be used to estimate the flutter wind velocity for a bridge section with flaps. As an example, the flutter wind velocity is calculated for different flap...

  13. Cryopreserved lip mucosa tissue derived keratinocytes can fabricate tissue engineered palatal mucosa equivalent.

    Science.gov (United States)

    Xiong, Xuepeng; Jia, Jun; He, Sangang; Zhao, Yifang

    2010-07-01

    Clinical application of tissue engineered palatal mucosa is hampered by unavailability of suitable oral keratinocytes as seeding cells. The aim of this study is to fabricate a tissue engineered palatal mucosa equivalent from the oral keratinocytes which cultured from cryopreserved lip mucosa tissues. Abundant lip mucosa tissues during cheilorrhaphy were firstly cryopreserved in liquid nitrogen for four to six months, and then recovered to culture oral keratinocytes for the fabrication of oral mucosa equivalent. In the control groups, oral keratinocytes cultured from fresh lip mucosa, fresh palate mucosa, and cryopreserved palate mucosa were used to fabricate oral mucosa equivalents. Attachment rate of the oral keratinocytes derived from cryopreserved lip mucosa was lower than that of the keratinocytes from fresh lip mucosa samples, however, the cell cycle distribution of oral keratinocytes cultured from all four groups of mucosa samples were similar. Histologically, the fabricated mucosa equivalents from these four groups had four- to six epithelial layers, the basal cells were cubic and the outmost cells were flatten with narrow nuclei which paralleled to the surface of the dermal matrix. Additionally, Ki-67 positive stained cells were mainly located in the basal layer of the epithelium of these equivalents. These characteristics disclosed that the oral mucosa equivalent cultured from the cryopreserved lip mucosa tissue was not different with the equivalents from other groups and similar to the native palate mucosa tissue. It suggested that the cryopreserved lip mucosa tissues could be used for the construction of palatal mucosal equivalent for clinical application. (c) 2010 Wiley Periodicals, Inc.

  14. Versatility of the thin groin flap.

    Science.gov (United States)

    Murakami, R; Fujii, T; Itoh, T; Tsutsui, K; Tanaka, K; Lio, Y; Yano, H

    1996-01-01

    The groin flap is one of the most usable flaps. It provides a large amount of skin coverage with an easily concealed donor site. However, when the flap is used to reconstruct areas of the neck, hand, or foot, a secondary procedure for defatting is usually necessary. Thinner flaps are thought to be more useful in these areas. We present an anatomical study of the thin groin flap, including its dissection and defatting, and 12 clinical cases using the thin groin flap for neck (n = 7), foot (n = 4), and scalp (n = 1) reconstruction. The largest successful flap measured 13 x 30 cm. Eight flaps survived completely, two had partial necrosis, and two had total necrosis. Complications were thought to be caused by dissection around the pedicle. Meticulous dissection and thinning are required to create the thin groin flap. Excellent aesthetic results requiring no secondary defatting procedures are possible with this new thin groin flap.

  15. The Pedicled LICAP Flap Combined with a Free Abdominal Flap In Autologous Breast Reconstructions

    Directory of Open Access Journals (Sweden)

    Thomas Sjøberg, MD

    2018-01-01

    Conclusion:. In selected patients with insufficient abdominal flap tissue, a combination of a free abdominal flap and a pedicled LICAP flap is a valuable option to increase breast size and cosmetic outcome. Additional symmetrizing surgery might still be necessary.

  16. Dancing girl flap: a new flap suitable for web release.

    Science.gov (United States)

    Shinya, K

    1999-12-01

    To create a deep web, a flap must be designed to have a high elongation effect in one direction along the mid-lateral line of the finger and also to have a shortening effect in the other direction, crossing at a right angle to the mid-lateral line. The dancing girl flap is a modification of a four-flap Z-plasty with two additional Z-plasties. It has a high elongation effect in one direction (>550%) and a shortening effect in the other direction at a right angle (<33%), creating a deep, U-shaped surface. This new flap can be used to release severe scar contracture with a web, and is most suitable for incomplete syndactyly with webs as high as the proximal interphalangeal joint.

  17. Horizontal stability of connective tissue grafts at the buccal aspect of single implants: a 1-year prospective case series.

    Science.gov (United States)

    De Bruyckere, Thomas; Eghbali, Aryan; Younes, Faris; De Bruyn, Hugo; Cosyn, Jan

    2015-09-01

    To clinically evaluate the horizontal stability of a connective tissue graft (CTG) at the buccal aspect of single implants (1); to compare actual gingival thickness between thin and thick gingival biotype (2). Periodontally healthy non-smoking patients with a single implant in the anterior maxilla (15-25) were selected for a prospective case series. All demonstrated a horizontal alveolar defect and were in need of contour augmentation by means of CTG for aesthetic reasons. Patients were enrolled 3 months after implant surgery and had been provided with a provisional screw-retained crown. CTG was inserted in the buccal mucosa via the envelope technique using one intrasulcular incision. An ultrasonic device was used to evaluate mucosal thickness (MT) at the buccal aspect. MT was assessed at t0 (before CTG), t1 (immediately after CTG), t2 (2 weeks after CTG = suture removal), t3 (3 months after CTG = permanent crown installation) and t4 (1 year after implant placement). The gingival biotype was categorized as thin or thick based on the transparency of a periodontal probe through the soft tissues while probing the buccal sulcus of the contra-lateral tooth. Gingival thickness (GT) was measured at the contra-lateral tooth using the same ultrasonic device. Thirty-seven patients (19 men, 18 women; mean age 38) met the selection criteria and consented to the treatment. Mean soft tissue gain immediately after CTG was on average 1.07 mm (SD 0.49). What remained of this tissue gain after 1 year was on average 0.97 mm (SD 0.48; 90.5%). Hence, mean soft tissue loss amounted to 0.10 mm (SD 0.23; 9.5%; p = 0.015) with no significant difference between patients with a thin or thick biotype (p ≥ 0.290). Patients with a thin biotype had a mean GT of 1.02 mm (SD 0.21), whereas GT was on average 1.32 mm (SD 0.31) in subjects with a thick biotype (p = 0.004). Connective tissue graft substantially thickens the peri-implant mucosa with acceptable stability over a 1-year period. © 2015

  18. Mycobacterium leprae is identified in the oral mucosa from paucibacillary and multibacillary leprosy patients.

    Science.gov (United States)

    Morgado de Abreu, M A M; Roselino, A M; Enokihara, M; Nonogaki, S; Prestes-Carneiro, L E; Weckx, L L M; Alchorne, M M A

    2014-01-01

    In leprosy, the nasal mucosa is considered as the principal route of transmission for the bacillus Mycobacterium leprae. The objective of this study was to identify M. leprae in the oral mucosa of 50 untreated leprosy patients, including 21 paucibacillary (PB) and 29 multibacillary (MB) patients, using immunohistochemistry (IHC), with antibodies against bacillus Calmette-Guérin (BCG) and phenolic glycolipid antigen-1 (PGL-1), and polymerase chain reaction (PCR), with MntH-specific primers for M. leprae, and to compare the results. The material was represented by 163 paraffin blocks containing biopsy samples obtained from clinically normal sites (including the tongue, buccal mucosa and soft palate) and visible lesions anywhere in the oral mucosa. All patients and 158 available samples were included for IHC study. Among the 161 available samples for PCR, 110 had viable DNA. There was viable DNA in at least one area of the oral mucosa for 47 patients. M. leprae was detected in 70% and 78% of patients using IHC and PCR, respectively, and in 94% of the patients by at least one of the two diagnostic methods. There were no differences in detection of M. leprae between MB and PB patients. Similar results were obtained using anti-BCG and anti-PGL-1 antibodies, and immunoreactivity occurred predominantly on free-living bacteria on the epithelial surface, with a predilection for the tongue. Conversely, there was no area of predilection according to the PCR results. M. leprae is present in the oral mucosa at a high frequency, implicating this site as a potential means of leprosy transmission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  19. Buccal Epithelium in treating Ocular Surface Disorders

    Directory of Open Access Journals (Sweden)

    Srinivas KR

    2008-11-01

    Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.

  20. Cytogenetic biomonitoring of oral mucosa cells from adults exposed to dental X-rays.

    Science.gov (United States)

    Ribeiro, Daniel A; Angelieri, Fernanda

    2008-07-01

    Although it has been clearly demonstrated that X-rays play a key role in diagnosing medical and dental problems, this type of ionizing radiation is also able to induce noxious activities, such as genetic damage. The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death in exfoliated buccal mucosa cells from healthy individuals (smokers and nonsmokers) following dental X-ray exposure. A total of 39 healthy people who had submitted to panoramic dental radiography were included in the study: 9 smokers and 30 nonsmokers. The results indicated no significant statistically differences (P>0.05) in micronucleated oral mucosa cells before and after dental X-ray exposure. On the other hand, X-ray exposure did increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis, and karyolysis. It seems that cigarette smoke did not affect X-ray outcomes induced in buccal cells. These data indicate that dental panoramic radiography may not induce chromosomal damage, but it is able to promote cytotoxicity. Because cellular death is considered a prime mechanism in nongenotoxic mechanisms of carcinogenesis, dental X-ray should be used only when necessary.

  1. Intraoperative and early postoperative complications using the buccal fat pad during cleft palate surgery in East Indonesia

    Directory of Open Access Journals (Sweden)

    Eveline Vere Konijnendijk

    2016-06-01

    Full Text Available Six baby’s with cleft are born in Indonesia every hour. There is no standardized treatment of cleft in East Indonesia. Closure is an important aspect during cleft lip and palate surgery. Various techniques have been advocated to gain tissue for closure of cleft area. Mostly these techniques may only provide a small amount of additional length. For lager defects they may be use the local flaps or the buccal fat pad flap. The aim of this study is gain more information about intraoperative and early postoperative complications using the buccal fat pat during cleft palate surgery in East Indonesia. The mouth can be divided in six parts therefor the LAHSAL index will be used. This LAHSAL system is a diagrammatic classification of cleft lip and palate. The LAHSAL system is being used for this study as this system classifies the cleft primarily on location and also on the cleft being complete or incomplete, which can be significant for the research. After diagnosis and classification, the following patient data was obtained: patient age, weight, gender, type of surgery (primary or following, i.e. when the surgery is a correction of a previous treatment, if a bone graft is needed for closure, history of maxillofacial surgery or orthodontics, operation technique, operation duration, type of an aesthesia (local or general, radiographical records and light photos. These data were collected during the pre-operative consultation, about 24 hours before surgery. It was the policy of the team to admit and see all patients one day prior to surgery for counselling, postoperative instructions and evaluating the patient's facial defect.

  2. Comparison of equivalent doses of fentanyl buccal tablets and arteriovenous differences in fentanyl pharmacokinetics.

    Science.gov (United States)

    Darwish, Mona; Kirby, Mary; Robertson, Philmore; Hellriegel, Edward; Jiang, John G

    2006-01-01

    The fentanyl buccal tablet (FBT) is designed to enhance the rate and extent of fentanyl absorption through the buccal mucosa. To evaluate the bioequivalence of microg-equivalent doses of FBT administered as single and multiple tablets and assess differences in the arterial and venous pharmacokinetics of FBT in healthy volunteers. Twenty-seven healthy adults, aged 19-45 years, participated in the randomised, open-label, three-period, crossover study. In the first two periods, FBT was administered as four 100 microg tablets simultaneously or one FBT 400 microg to assess bioequivalence. Venous blood samples were obtained over a 72-hour period to measure plasma fentanyl concentrations. In the third period, arterial and venous blood samples were obtained simultaneously from before administration of one FBT 400 microg through 4 hours after administration to evaluate the impact of arterial versus venous sampling on the pharmacokinetic profile. As subjects were not opioid tolerant, naltrexone was administered to block opioid receptor-mediated effects of fentanyl. Adverse events were recorded throughout. Maximum plasma concentration (C(max)) and area under the plasma concentration-time curve from time zero to infinity (AUC(infinity)) on average were approximately 12% and 13% higher, respectively, for FBT administered as four 100 microg tablets simultaneously compared with one FBT 400 microg. Maximum plasma concentrations in the arterial circulation were approximately 60% higher and occurred 15 minutes earlier than those measured from the venous circulation. No serious adverse events were reported during the study. Despite small differences in C(max) and AUC(infinity) (on average 12% and 13%, respectively), FBT administered as four 100 microg tablets simultaneously compared with one 400 microg tablet did not meet the criteria for bioequivalence. An increased surface area exposure with four tablets compared with one tablet may account for the slightly higher maximum

  3. Autofluorescence characteristics of oral mucosa.

    Science.gov (United States)

    Ingrams, D R; Dhingra, J K; Roy, K; Perrault, D F; Bottrill, I D; Kabani, S; Rebeiz, E E; Pankratov, M M; Shapshay, S M; Manoharan, R; Itzkan, I; Feld, M S

    1997-01-01

    The fluorescence characteristics of tissues depend upon their biochemical composition and histomorphological architecture, both of which undergo a change during malignant transformation. These changes are detectable as an alteration in the fluorescence spectral profile of the tissues. Biopsy specimens from clinically suspicious lesions and normal-appearing oral mucosa were obtained from patients. Fluorescence spectroscopic measurements were obtained to study the differences between normal and dysplastic tissues and to determine the most appropriate excitation wavelength(s) for exploiting these differences. Fluorescence spectra from a total of 12 histologically normal (healthy mucosa or benign lesions) and ten abnormal (dysplastic or malignant) tissue samples were compared. Significant spectral differences were seen between the two groups. These differences were most marked at the excitation wavelength of 410 nm. Using this wavelength, fluorescence correctly diagnosed 20 of 22 samples studied. This technique accurately differentiates normal from abnormal tissues in vitro and has the potential applications for in vivo use as a noninvasive diagnostic tool.

  4. Drug Reactions in Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Emine Derviş

    2012-12-01

    Full Text Available Both immunologic and nonimmunologic drug reactions can be seen in oral mucosa. Since considerable number of these reactions heals spontaneously without being noticed by the patients, exact frequency of the lesions is unknown. Most common lesions are xerostomia, taste disorders, mucosal ulcerations and edema. In this article, oral lesions resulting from drug intake similar to those from oral lesions of local and systemic diseases, and diagnostic problems caused by these similarities, have been reviewed.

  5. Formulation and in vivo evaluation of omeprazole buccal adhesive tablet.

    Science.gov (United States)

    Choi, H; Jung, J; Yong, C S; Rhee, C; Lee, M; Han, J; Park, K; Kim, C

    2000-09-03

    For the development of omeprazole buccal adhesive tablets, we studied the release and bioavailability of omeprazole delivered by buccal adhesive tablets composed of sodium alginate, hydroxypropylmethylcellulose (HPMC), magnesium oxide and croscarmellose sodium. Croscarmellose sodium enhanced the release of omeprazole from the tablets. The analysis of the release mechanism showed that croscarmellose sodium changed the release profile of omeprazole from first- to zero-order release kinetics by forming porous channels in the tablet matrix. However, it decreased the bioadhesive forces and stability of omeprazole tablets in human saliva. The tablet is composed of omeprazole-sodium alginate-HPMC-magnesium oxide-croscarmellose sodium (20:24:6:50:10 mg). It may be attached to the human cheek without collapse and it enhanced the stability of omeprazole in human saliva for at least 4 h, giving a fast release of omeprazole. The plasma concentration of omeprazole in hamsters increased to reach a maximum of 370 ng/ml at 45 min after buccal administration and remained at the high level of 146-366 ng/ml for 6 h. The buccal bioavailability of omeprazole in hamsters was 13.7+/-3.2%. These results demonstrate that the omeprazole buccal adhesive tablet would be useful to deliver omeprazole which degrades very rapidly in acidic aqueous medium and undergoes hepatic first-pass metabolism after oral administration.

  6. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    Directory of Open Access Journals (Sweden)

    Andrea Cassoni

    2014-01-01

    Full Text Available Uterine leiomyosarcoma (LMS is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery.

  7. [Treatment of severe scrotal hypospadias with onlay-type urethroplasty using mouth mucosa].

    Science.gov (United States)

    Castañón, M; Grande, C; Muñoz, M E; García, A; Morales, L

    1999-07-01

    Failure in repairing severe hypospadias complicated with fistula and cutaneous retraction is often associated with lack of subcutaneous tissue and skin providing protection to the neourethra. We report the results of treatment in 6 patients with scrotal hypospadias with severe deviation and scarce dorsal prepuce. A neourethra was created by the onlay technique applying an oral mucosa graft and preserving in all cases the dorsal preputial skin for the island cutaneous flap. All patients had hypospadias without previous repairs excepting one of them, who had had one first time hypospadias repair in other hospital. Patients age ranged between 2 years and 3 months, and 4 years (mean: 2 years and 9 months). In all cases, hypospadias was scrotal type with severe deviation and scarce dorsal prepuce. All patients had prior hormone stimulation with dehydrotestosterone 3%. Surgical repair was performed in one-stage. Urethroplasty included preservation of the urethral plate, oral mucosa graft to provide ventral coverage, and island cutaneous flap with the dorsal preputial skin. In all cases, the chord was dissected behind the urethral plate. In 3 patients a dorsal Nesbit plication was necessary to obtain a complete straighten penis. Results in all 6 cases were satisfactory. Only one patient had a small leakage at the previous neomeatus. The other five patients are asymptomatic. Follow-up ranges from 6 months to 2 years. We conclude that urethroplasty in association with a well vascularized island flap of dorsal preputial skin decrease the incidence of fistulae. In patients with severe hypospadias with scarce dorsal prepuce urethroplasty should be completed with oral mucosa grafts preserving dorsal preputial skin for the ventral cutaneous plasty.

  8. Buccal Dosage Forms: General Considerations for Pediatric Patients.

    Science.gov (United States)

    Montero-Padilla, Soledad; Velaga, Sitaram; Morales, Javier O

    2017-02-01

    The development of an appropriate dosage form for pediatric patients needs to take into account several aspects, since adult drug biodistribution differs from that of pediatrics. In recent years, buccal administration has become an attractive route, having different dosage forms under development including tablets, lozenges, films, and solutions among others. Furthermore, the buccal epithelium can allow quick access to systemic circulation, which could be used for a rapid onset of action. For pediatric patients, dosage forms to be placed in the oral cavity have higher requirements for palatability to increase acceptance and therapy compliance. Therefore, an understanding of the excipients required and their functions and properties needs to be particularly addressed. This review is focused on the differences and requirements relevant to buccal administration for pediatric patients (compared to adults) and how novel dosage forms can be less invasive and more acceptable alternatives.

  9. The buccal minor salivary glands as starting point for a metastasizing adenocarcinoma – report of a case

    Directory of Open Access Journals (Sweden)

    Schwarz Stephan

    2008-07-01

    Full Text Available Abstract Background With the 2005 WHO classification of salivary gland tumours and its increasingly recognized diagnostic entities, the frequency of adenocarcinoma (NOS has decreased significantly. Case presentation This paper describes a fast growing adenocarcinoma (NOS, originating from the minor salivary glands of the left buccal mucosa with a rapid onset of multiple local and distant metastases, especially in the lung. A lung primary was unlikely as the tumour was characterized by positivity for cytokeratin 20 and negativity for the thyroid transcription factor-1 protein (TTF-1 in immunohistochemistry. Conclusion A rare case of an adenocarcinoma (NOS of the minor salivary glands with a rapid development and an unfavourable clinical course is reported. It shows that additional immunohistochemical analysis can decisively contribute to determine the site of the primary tumour in cases with unknown primary.

  10. The "Tokyo" consensus on propeller flaps.

    Science.gov (United States)

    Pignatti, Marco; Ogawa, Rei; Hallock, Geoffrey G; Mateev, Musa; Georgescu, Alexandru V; Balakrishnan, Govindasamy; Ono, Shimpei; Cubison, Tania C S; D'Arpa, Salvatore; Koshima, Isao; Hyakusoku, Hikko

    2011-02-01

    Over the past few years, the use of propeller flaps, which base their blood supply on subcutaneous tissue or isolated perforators, has become increasingly popular. Because no consensus has yet been reached on terminology and nomenclature of the propeller flap, different and confusing uses of the term can be found in the literature. In this article, the authors report the consensus on the definition and classification of propeller flaps reached by the authors that gathered at the First Tokyo Meeting on Perforator and Propeller Flaps in June of 2009. Some peculiar aspects of the surgical technique are discussed. A propeller flap can be defined as an "island flap that reaches the recipient site through an axial rotation." The classification is based on the nourishing pedicle (subcutaneous pedicled propeller flap, perforator pedicled propeller flap, supercharged propeller flap), the degrees of skin island rotation (90 to 180 degrees) and, when possible, the artery of origin of the perforator. The propeller flap is a useful reconstructive tool that can achieve good cosmetic and functional results. A flap should be called a propeller flap only if it fulfils the definition above. The type of nourishing pedicle, the source vessel (when known), and the degree of skin island rotation should be specified for each flap.

  11. Ultrasonographic evaluation of inflammatory swellings of buccal space

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    Srinivas K

    2009-01-01

    Full Text Available Objectives : The main objective of the study was a to differentiate cellulitis and abscess in buccal space region, b to study the ultrasonographic anatomy of cheek region and c to investigate the use of ultrasound in the diagnosis of inflammatory swellings of cheek region. Patients and Methods : The study consisted of 25 patients with unilateral buccal space inflammatory swellings of odontogenic origin. The contra lateral side was used as control. Toshiba ultrasonographic device with a linear array transducer (5-8 MHz was used. The areas of interest were scanned under both transverse and longitudinal sections and were interpreted by a single observer. The clinical diagnosis of cellulitis or abscess was confirmed by the absence or presence of pus respectively both sonographically and by aspiration. Also various anatomical structures present in buccal space were studied. Results : Clinically 23(92% were diagnosed as buccal space abscess and 2 (8% were cellulitis. Ultrasonographically and therapeutically 24 (96% were buccal space abscess and 1 (4% was cellulits. The sensitivity of clinical criteria over ultrasonographic diagnosis was 96% with a specificity of 100%. Also the cheek thickness in males and females varied from 8.2 to 17.1mm with a mean of 11.6mm±2.1 (SD and 8.2 mm to 14.2 mm with a mean of 11±1.8 (SD. The subcutaneous tissue appeared moderately echogenic, buccinator - highly echogenic, deep adipose tissue - less echogenic and parotid duct was appreciated as a thin hyperechogenic band crossing the buccinator muscle. Buccal space, masticator space and parotid space were appreciated. Conclusion : This study supports the ultrasonographic method of imaging of orofacial inflammatory swellings with high sensitivity and specificity. This imaging modality can also help in aspiration of pus in different spaces. We have described the ultrasonographic anatomy of the above mentioned spaces which can help a beginner in this field.

  12. The Hamster Buccal Pouch Model of Oral Carcinogenesis.

    Science.gov (United States)

    Nagini, Siddavaram; Kowshik, Jaganathan

    2016-01-01

    The hamster buccal pouch (HBP) carcinogenesis model is one of the most well-characterized animal tumor models used as a prelude to investigate multistage oral carcinogenesis and to assess the efficacy of chemointervention. Hamster buccal pouch carcinomas induced by 7,12-dimethylbenz[a]anthracene (DMBA) show extensive similarities to human oral squamous cell carcinomas. The HBP model offers a number of advantages including a simple and predictable tumor induction procedure, easy accessibility for examination and follow-up of lesions, and reproducibility. This model can be used to test both chemopreventive and chemotherapeutic agents.

  13. HGF is released from buccal fibroblasts after smokeless tobacco stimulation

    DEFF Research Database (Denmark)

    Dabelsteen, S; Christensen, S; Gron, B

    2005-01-01

    To investigate the effect of smokeless tobacco (ST) on (1) HGF, KGF and GM-CSF expression by buccal fibroblasts and (2) on keratinocyte and fibroblast proliferation. Buccal fibroblasts were stimulated with different concentrations of ST extracts in a double dilution from 0.50% w/v to 0.03% w/v. S....... Keratinocytes and fibroblasts showed no increase in proliferation after stimulation with increased concentrations of ST. The results suggest that HGF and KGF may play an important role as a paracrine growth factor in epithelial hyperplasia in ST lesions....

  14. A mechanistic based approach for enhancing buccal mucoadhesion of chitosan

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Muff-Westergaard, Christian; Sander, Camilla

    2014-01-01

    the mucoadhesiveness of buccal formulations. The interaction between chitosan of different chain lengths and porcine gastric mucin (PGM) was studied using a complex coacervation model (CCM), isothermal titration calorimetry (ITC) and a tensile detachment model (TDM). The effect of pH was assessed in all three models...... and the approach to add a buffer to chitosan based drug delivery systems is a means to optimize and enhance buccal drug absorption. The CCM demonstrated optimal interactions between chitosan and PGM at pH 5.2. The ITC experiments showed a significantly increase in affinity between chitosan and PGM at pH 5...

  15. Buccal-sided mandibular angle exostosis - A rare case report

    Directory of Open Access Journals (Sweden)

    Salman Basha

    2011-01-01

    Full Text Available Buccal exostoses are benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. They begin to develop in early adulthood and may very slowly enlarge over the years. They are painless and self-limiting, but occasionally may become several centimeters across and then contribute to periodontal disease of the adjacent teeth by forcing food during chewing in toward the teeth instead of away from them, as is normally the case. The following paper presents a very rare case of buccal-sided mandibular angle exoxtosis and its management with surgical exploration.

  16. [Efficacy of a fentanyl citrate buccal tablet for esophageal cancer pain management in a patient unable to take oral medication].

    Science.gov (United States)

    Fujimura, Yoshinori; Nakahara, Osamu; Ohshima, Shigeki; Baba, Hideo

    2015-04-01

    We report a case ofa 60-year old male esophageal cancer patient who was unable to take oral medication, but was successfully treated using a fentanyl citrate buccal tablet. The patient survived a suicide attempt as a youth in which he ingested poison, but was left with a stricture of the esophagus. It became difficult for him to take nutrition orally, and he underwent an esophageal bypass operation, although he still required frequent endoscopic esophageal dilation. He subsequently presented with an anastomotic stenosis due to anastomotic leakage, and oral intake became completely impossible. The onset of esophageal cancer presented as corrosive esophagitis. We used oxycodone hydrochloride to treat a sharp pain resulting from cataplectic cancer in the jejunal tube, but this provided only limited pain relief. We therefore used a fentanyl citrate oral mucosa absorption preparation with a rescue agent, which did provide effective pain relief. Thus a fentanyl citrate buccal tablet could effectively relief pain in cancer patients who are unable to receive oral medication.

  17. Buccal micronucleus cytome assay of populations under chronic heavy metal and other metal exposure along the Santiago River, Mexico.

    Science.gov (United States)

    Gómez-Meda, B C; Zúñiga-González, G M; Sánchez-Orozco, L V; Zamora-Perez, A L; Rojas-Ramírez, J P; Rocha-Muñoz, A D; Sobrevilla-Navarro, A A; Arellano-Avelar, M A; Guerrero-de León, A A; Armendáriz-Borunda, J S; Sánchez-Parada, M G

    2017-09-26

    The Santiago River is one of the most contaminated rivers in Mexico, with heavy metal levels above the allowed limits. Scientific evidence indicates that chronic heavy metal exposure leads to cytogenotoxic effects. The aims of this study were to evaluate the genotoxic and cytotoxic effects of such exposure in buccal mucosa cells by micronucleus (MN) assay and to identify other nuclear abnormalities (NAs), such as nuclear buds (NBUDs), binucleated cells (BNs), pyknotic nuclei (PNs), karyorrhexis (KX), karyolysis (KL), and abnormally condensed chromatin (CC). Assays were performed on samples from four populations located alongside the Santiago River that are under chronic exposure to heavy metals and other metals (HMMs), and the results were compared with those of a population without exposure to HMMs. The exposed group showed increased frequencies of NAs (KX, CC, and KL), which are associated with cytotoxic damage, and NBUDs, which are associated with genotoxic damage. Increased frequencies of NBUDs and CC were observed in subjects from El Salto/Juanacatlán, Ocotlán, and Paso de Guadalupe, and an increase in KX frequency was observed in subjects from El Salto/Juanacatlán. Significant differences in KL frequency were observed in subjects from La Barca, El Salto/Juanacatlán, Paso de Guadalupe, and Ocotlán. Predictors for increased development of MNs and NBUDs were high concentrations of Al, Zn, and Cu. In conclusion, chronic exposure to HMMs, especially Al, Cu, and Zn, in the studied population could be related to increased frequencies of NAs, such as NBUDs, KX, CC, and KL, in the buccal mucosa cells.

  18. Combined posterior flap and anterior suspended flap dacryocystorhinostomy: A modification of external dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Amarendra Deka

    2010-01-01

    Conclusion : We believe that combined posterior flap and anterior suspended flap DCR technique is simple to perform and has the advantage of both double flap DCR and anterior suspension of anterior flaps. The results of the study showed the efficacy of this simple modification.

  19. 14 CFR 23.701 - Flap interconnection.

    Science.gov (United States)

    2010-01-01

    ... Systems § 23.701 Flap interconnection. (a) The main wing flaps and related movable surfaces as a system... on one side of the plane of symmetry inoperative and the remaining engines at takeoff power. For...

  20. Anthropometric analysis of maxillary anterior buccal bone of Korean adults using cone-beam CT

    National Research Council Canada - National Science Library

    Lee, Seung-Lok; Kim, Hee-Jung; Son, Mee-Kyoung; Chung, Chae-Heon

    2010-01-01

    The aim of this study was to evaluate the thickness of buccal and palatal alveolar bone and buccal bony curvature below root apex in maxillary anterior teeth of Korean adults using Cone-beam CT images...

  1. Vascularized Fibula Flaps for Mandibular Reconstruction: An ...

    African Journals Online (AJOL)

    For decades, osseous vascularised flaps have been used for reconstruction of the mandible with the vascularised fibula flap (VFF) remaining the commonly used osseous free flap, reasons ranging from its adequate bone and pedicle length to its receptive dental implant placement quality. This report considers a modest use ...

  2. New model of flap-gliding flight.

    Science.gov (United States)

    Sachs, Gottfried

    2015-07-21

    A new modelling approach is presented for describing flap-gliding flight in birds and the associated mechanical energy cost of travelling. The new approach is based on the difference in the drag characteristics between flapping and non-flapping due to the drag increase caused by flapping. Thus, the possibility of a gliding flight phase, as it exists in flap-gliding flight, yields a performance advantage resulting from the decrease in the drag when compared with continuous flapping flight. Introducing an appropriate non-dimensionalization for the mathematical relations describing flap-gliding flight, results and findings of generally valid nature are derived. It is shown that there is an energy saving of flap-gliding flight in the entire speed range compared to continuous flapping flight. The energy saving reaches the highest level in the lower speed region. The travelling speed of flap-gliding flight is composed of the weighted average of the differing speeds in the flapping and gliding phases. Furthermore, the maximum range performance achievable with flap-gliding flight and the associated optimal travelling speed are determined. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Efficient flapping flight of pterosaurs

    Science.gov (United States)

    Strang, Karl Axel

    In the late eighteenth century, humans discovered the first pterosaur fossil remains and have been fascinated by their existence ever since. Pterosaurs exploited their membrane wings in a sophisticated manner for flight control and propulsion, and were likely the most efficient and effective flyers ever to inhabit our planet. The flapping gait is a complex combination of motions that sustains and propels an animal in the air. Because pterosaurs were so large with wingspans up to eleven meters, if they could have sustained flapping flight, they would have had to achieve high propulsive efficiencies. Identifying the wing motions that contribute the most to propulsive efficiency is key to understanding pterosaur flight, and therefore to shedding light on flapping flight in general and the design of efficient ornithopters. This study is based on published results for a very well-preserved specimen of Coloborhynchus robustus, for which the joints are well-known and thoroughly described in the literature. Simplifying assumptions are made to estimate the characteristics that can not be inferred directly from the fossil remains. For a given animal, maximizing efficiency is equivalent to minimizing power at a given thrust and speed. We therefore aim at finding the flapping gait, that is the joint motions, that minimize the required flapping power. The power is computed from the aerodynamic forces created during a given wing motion. We develop an unsteady three-dimensional code based on the vortex-lattice method, which correlates well with published results for unsteady motions of rectangular wings. In the aerodynamic model, the rigid pterosaur wing is defined by the position of the bones. In the aeroelastic model, we add the flexibility of the bones and of the wing membrane. The nonlinear structural behavior of the membrane is reduced to a linear modal decomposition, assuming small deflections about the reference wing geometry. The reference wing geometry is computed for

  4. Design and evaluation of chitosan/ethylcellulose mucoadhesive bilayered devices for buccal drug delivery.

    Science.gov (United States)

    Remuñán-López, C; Portero, A; Vila-Jato, J L; Alonso, M J

    1998-11-13

    This paper describes the preparation of new buccal bilayered devices comprising a drug-containing mucoadhesive layer and a drug-free backing layer, by two different methods. Bilaminated films were produced by a casting/solvent evaporation technique and bilayered tablets were obtained by direct compression. The mucoadhesive layer was composed of a mixture of drug and chitosan, with or without an anionic crosslinking polymer (polycarbophil, sodium alginate, gellan gum), and the backing layer was made of ethylcellulose. The double-layered structure design was expected to provide drug delivery in a unidirectional fashion to the mucosa and avoid loss of drug due to wash-out with saliva. Using nifedipine and propranolol hydrochloride as slightly and highly water-soluble model drugs, respectively, it was demonstrated that these new devices show promising potential for use in controlled delivery of drugs to the oral cavity. The uncrosslinked chitosan-containing devices absorbed a large quantity of water, gelled and then eroded, allowing drug release. The bilaminated films showed a sustained drug release in a phosphate buffer (pH 6.4). Furthermore, tablets that displayed controlled swelling and drug release and adequate adhesivity were produced by in situ crosslinking the chitosan with polycarbophil.

  5. Buccal absorption of diazepam is improved when administered in bioadhesive tablets-An in vivo study in conscious Göttingen mini-pigs.

    Science.gov (United States)

    Meng-Lund, Emil; Jacobsen, Jette; Müllertz, Anette; Jørgensen, Erling B; Holm, René

    2016-12-30

    Buccal delivery may be clinically beneficial for compounds with a high gastrointestinal and hepatic first pass metabolism or in situations where a fast systemic absorption is desired. The delivery of a crystalline low soluble compounds, e.g. diazepam, may be limited due to the low volume of saliva available to facilitate solvation in order to drive the permeation of drug through the buccal mucosa. Therefore, the present study investigated the potential benefits of administering diazepam either as an amorphous or as a crystalline form in mucoadhesive tablets to conscious Göttingen mini-pigs. Presentation of the compound in the amorphous form lead to a very fast absorption, however, the obtained bioavailability was at the same level observed following buccal administration of a commercially immediate release tablet. Addition of chitosan, as a mucoadhesive excipient, resulted in a higher absolute bioavailability compared to tablets without chitosan. The absorption rate for the chitosan-based tablets was significant slower, probably due to the slower diffusion of the compound out of the tablet. In vitro release data was able to predict the variations in t max , but otherwise no correlation could be found between in vitro and in vivo data. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Buccal Mucosal Graft for Crippled Hypospadias (Experience in 11 ...

    African Journals Online (AJOL)

    Background: Hypospadias is defined as the incomplete virilization of the genital tubercle causing an incomplete development of the tissues forming the ventral urethra. Objective: Free buccal mucosal graft is an excellent option if the genital tissue is fibrous or deficient. We would like to present our small experience with ...

  7. Buccal Transmucosal Delivery System of Enalapril for Improved ...

    African Journals Online (AJOL)

    Buccal Transmucosal Delivery System of Enalapril for Improved Cardiac Drug Delivery: Preparation and Characterization. Wen-Shuai He, Hao-Wei Xiong, Dan Xi, Tian-Tian Luo, Hao Lu, Meng-Hao Li, Ji-Cheng Liu, Zhi-Gang Guo ...

  8. Buccal versus intranasal midazolam sedation for pediatric dental patients.

    Science.gov (United States)

    Sunbul, Nada; Delvi, Mohamed Bilal; Zahrani, Tariq Al; Salama, Fouad

    2014-01-01

    The purpose of this randomized, controlled, crossover clinical trial was to evaluate and compare the behavioral differences resulting from the sedative effects of atomized buccal (transmucosal) and atomized intranasal (parenteral) midazolam (0.3 mg/kg) as a method for sedation of pediatric dental patients. Twenty-five 36- to 72-month-old patients were randomly selected and divided into two groups that were sedated with either atomized buccal in the first visit or intranasal midazolam in the second visit (0.3 mg/kg). Patient be- havior was rated, and drug acceptance by method of administration was determined. There were no statistically significant differences between both groups in maximum working time. There were significant differences between both groups in drug acceptance (P=.008) and onset time (P=.00). The statistical differences between the two groups were not significant in all behavior rating scales, except for the crying rating scale, since the buccal group showed more crying. Atomized buccal and intranasal midazolam are both effective for sedation of pediatric dental patients and have the same maximum working time. However, atomized intranasal is more acceptable by children, has faster onset time, and children demonstrate less crying.

  9. Biomonitoring with Micronuclei Test in Buccal Cells of Female Farmers and Children Exposed to Pesticides of Maneadero Agricultural Valley, Baja California, Mexico

    Directory of Open Access Journals (Sweden)

    Idalia Jazmin Castañeda-Yslas

    2016-01-01

    Full Text Available Feminization of the agricultural labor is common in Mexico; these women and their families are vulnerable to several health risks including genotoxicity. Previous papers have presented contradictory information with respect to indirect exposure to pesticides and DNA damage. We aimed to evaluate the genotoxic effect in buccal mucosa from female farmers and children, working in the agricultural valley of Maneadero, Baja California. Frequencies of micronucleated cells (MNc and nuclear abnormalities (NA in 2000 cells were obtained from the buccal mucosa of the study population (n=144, divided in four groups: (1 farmers (n=37, (2 unexposed (n=35, (3 farmers’ children (n=34, and (4 unexposed children (n=38. We compared frequencies of MNc and NA and fitted generalized linear models to investigate the interaction between these variables and exposition to pesticides. Differences were found between farmers and unexposed women in MNc (p<0.0001, CC (p=0.3376, and PN (p<0.0001. With respect to exposed children, we found higher significant frequencies in MNc (p<0.0001, LN (p<0.0001, CC (p<0.0001, and PN (p<0.004 when compared to unexposed children. Therefore working as a farmer is a risk for genotoxic damage; more importantly indirectly exposed children were found to have genotoxic damage, which is of concern, since it could aid in future disturbances of their health.

  10. Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review.

    Science.gov (United States)

    Chen, Melissa J; Creinin, Mitchell D

    2015-07-01

    To summarize clinical outcomes and adverse effects of medical abortion regimens consisting of mifepristone followed by buccal misoprostol in pregnancies through 70 days of gestation. We used PubMed, ClinicalTrials.gov, and reference lists from published reports to identify relevant studies published between November 2005 and January 2015 using the search terms "mifepristone and medical abortion" and "buccal and misoprostol." Studies were included if they presented clinical outcomes of medical abortion using mifepristone and buccal misoprostol through 70 days of gestation. Studies with duplicate data were excluded. We included 20 studies with a total of 33,846 women through 70 days of gestation. We abstracted efficacy and ongoing pregnancy rates as an overall rate and by gestational age in days in reference to completed weeks (eg, 49 days or less, 50-56 days, 57-63 days, 64-70 days) and adverse effects when reported. The overall efficacy of mifepristone followed by buccal misoprostol is 96.7% (95% confidence interval [CI] 96.5-96.8%) and the continuing pregnancy rate is 0.8% (95% CI 0.7-0.9%) in approximately 33,000 pregnancies through 63 days of gestation. Only 332 women with pregnancies between 64 and 70 days of gestation are reported in the literature with an overall efficacy of 93.1% (95% CI 89.6-95.5%) and a continuing pregnancy rate of 2.9% (95% CI 1.4-5.7%). Currently available data suggest that regimens with a 24-hour time interval between mifepristone and buccal misoprostol administration are slightly less effective than those with a 24- to 48-hour interval. Rates of surgical evacuation for reasons other than ongoing pregnancy range from 1.8% to 4.2%. Severe adverse events like blood transfusion (0.03-0.6%) and hospitalization (0.04-0.9%) are uncommon. Outpatient medical abortion regimens with mifepristone followed in 24-48 hours by buccal misoprostol are highly effective for pregnancy termination through 63 days of gestation. More data are needed to

  11. Genotoxic and Cytotoxic Potential of Smoke Crack Cocaine on the Epithelium of the Human Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Raphaela Cássia de Lima

    2016-09-01

    Full Text Available Crack cocaine is an illicit drug derived from cocaine. It can produce some damages to the lungs and oral cavity. Objective: The aim of this study was to analyze the frequency of micronuclei and some nuclear alterations in epithelial cells of crack cocaine users. Methods: Oral smears were collected from clinically normal-appearing buccal mucosa exfoliative cytology of 30 individuals (15 crack cocaine users and 15 controls. Results: Crack cocaine users consumed about 3.8 grams per day and the time consumption of the drug was of 6.4 (+3.3 years. The prevalence of micronuclei, binucleated cells, broken egg cells, budding cells, picnosis, karyolysis, and karyorrhexis was determined. The frequencies of micronuclei for case and control groups were, respectively, 2.87 + 3.46 and 0.57 + 1.6 (p=0.018. No statistical difference was observed for binucleated cells, broken egg cells, budding cells, picnosis, and karyolysis. The frequency of karyorrhexis was significantly increased on crack cocaine users than controls (54.07 + 38.58 and 24.87 + 23.97, p=0.001. Conclusion: Smoke crack might have a cytotoxic and genotoxic effects to the oral mucosa due to increased frequency of micronuclei and karyorrhexis. Thus, individuals who used crack cocaine in the long term need to be frequently examined in order to prevent neoplastic transformation.Keywords: Crack Cocaine; Micronucleus Tests; Mouth Mucosa; Cytological Techniques; Carcinogens.

  12. DNA damage in oral mucosa cells of patients with fixed orthodontic appliances.

    Directory of Open Access Journals (Sweden)

    Farzin Heravi

    2013-12-01

    Full Text Available The release of toxic metal ions from orthodontic alloys has induced concerns regarding the biocompatibility of fixed appliances. This study investigated the genotoxic effect of metal appliances in a sample of patients undergoing fixed orthodontic treatment.The study included twenty-five healthy individuals requiring orthodontic therapy in both jaws. The patients were treated by stainless steel orthodontic brackets and nickel-titanium or stainless steel arch wires. The oral mucosa cells were gathered just before the appliance placement and 9 months later. The cells were centrifuged, fixed and dropped onto slides. After staining, the micronucleus (MN assay was used to determine genome alteration. The data were analyzed by paired sample t-test.The mean micronuclei frequency in the buccal mucosa was 10.6 ± 5.7 per 1000 cells before the appliance placement and 9.2 ± 6.37 per 1000 cells 9 months later. No significant difference was found in the MN count before and 9 months after therapy (p=0.336.Under the conditions used in this study, application of fixed orthodontic appliances did not expose healthy individuals to increased risk of DNA damage in oral mucosa cells.

  13. Diagnostic Workup and Treatment of a Rare Apocrine Hidrocystoma Affecting the Oral Mucosa: A Clinical and Histological Case Report

    Directory of Open Access Journals (Sweden)

    Pier Paolo Poli

    2017-01-01

    Full Text Available Apocrine hidrocystomas are rare benign cystic tumors originating from the secretory portion of apocrine sweat glands. To the best of our knowledge, there is no evidence currently available reporting the presence of apocrine hidrocystomas in the oral cavity. Therefore, this case report aims to describe the clinical and histological features of an apocrine hidrocystoma affecting the oral mucosa. A 69-year-old male patient presented with a 1-year history of a solitary, well-circumscribed, submucosal mass in the left posterior buccal mucosa. The clinical examination revealed a yellowish soft, fluctuant, and painless lesion with no clinical signs of erythema or ulcerations of the overlying epithelium. The entire lesion was excised and histopathological analysis confirmed the diagnosis of apocrine hidrocystoma. No recurrence was observed after a 1-year follow-up.

  14. DNA damage and cellular death in oral mucosa cells of children who have undergone panoramic dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Angelieri, Fernanda; Oliveira, Gabriela R. de [Sao Paulo Metodista University (UMESP), Department of Orthodontics, Sao Bernardo do Campo, Sao Paulo (Brazil); Sannomiya, Eduardo K. [Sao Paulo Metodista University (UMESP), Department of Dento-Maxillofacial Radiology, Sao Bernardo do Campo, Sao Paulo (Brazil); Ribeiro, Daniel A. [Federal University of Sao Paulo (UNIFESP), Department of Health Sciences, Santos, Sao Paulo (Brazil); Universidade Federal de Sao Paulo (UNIFESP), Departamento de Ciencias da Saude, Santos, Sao Paulo (Brazil)

    2007-06-15

    Despite wide use as a diagnostic tool in medical and dental practice, radiography can induce cytotoxic effects and genetic damage. To evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells taken from healthy children following exposure to radiation during dental radiography. A total of 17 children who had undergone panoramic dental radiography were included. We found no statistically significant differences (P > 0.05) between micronucleated oral mucosa cells in children before and after exposure to radiation. On the other hand, radiation did cause other nuclear alterations closely related to cytotoxicity including karyorrhexis, pyknosis and karyolysis. Taken together, these results indicate that panoramic dental radiography might not induce chromosomal damage, but may be cytotoxic. Overall, the results reinforce the importance of evaluating the health side effects of radiography and contribute to the micronucleus database, which will improve our understanding and practice of this methodology in children. (orig.)

  15. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers.

    Science.gov (United States)

    Yang, Deng-Fu; Lee, Jeng-Woei; Chen, Hsin-Ming; Hsu, Yih-Chih

    2014-09-01

    Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of human oral precancerous lesions. This animal study aimed to assess whether topical methotrexate (MTX) pretreatment could enhance the therapeutic effect of topical ALA-PDT on hamster buccal pouch precancerous lesions. Twenty hamster buccal pouch precancerous lesions were treated with either topical ALA-PDT with topical MTX pretreatment (topical MTX-ALA-PDT group, n = 10) or topical ALA-PDT alone (topical ALA-PDT group, n = 10). The intracellular protoporphyrin IX (PpIX) level in another 12 precancerous lesions (n = 6 for either the topical MTX-ALA or topical ALA group) was monitored by fluorescence spectroscopy. The intracellular PpIX reached its peak level in precancerous lesions 6.5 hours and 2.5 hours after topical ALA application for the topical MTX-ALA group (5.63-fold higher in the lesion than in the normal mucosa) and topical ALA group (2.42-fold higher in the lesion than in the normal mucosa), respectively. The complete response rate of precancerous lesions was 80% for the topical MTX-ALA-PDT group and 70% for the topical ALA-PDT group. In addition, the topical MTX-ALA-PDT group required a significantly lower mean treatment number (2.1 ± 0.6) to achieve complete response than the topical ALA-PDT group (4.4 ± 1.3, p hamster buccal pouch precancerous lesions and significantly improves the outcomes of the precancerous lesions treated with topical ALA-PDT. Copyright © 2014. Published by Elsevier B.V.

  16. Sternocleidomastoid Muscle Flap after Parotidectomy

    Directory of Open Access Journals (Sweden)

    Nofal, Ahmad Abdel-Fattah

    2015-04-01

    Full Text Available Introduction Most patients after either superficial or total parotidectomy develop facial deformity and Frey syndrome, which leads to a significant degree of patient dissatisfaction. Objective Assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle (SCM flap after superficial or total parotidectomy. Methods A prospective cohort study for 11 patients subjected to parotidectomy using a partial-thickness superiorly based SCM flap. The functional outcome (Frey syndrome, facial nerve involvement, and ear lobule sensation and the esthetic results were evaluated subjectively and objectively. Results Facial nerve palsy occurred in 5 cases (45%, and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 3 patients (27%, although only 1 (9% subjectively complained of gustatory sweating. The designed visual analog score completed by the patients themselves ranged from 0 to 3 with a mean of 1.55 ± 0.93; the scores from the blinded evaluators ranged from 1 to 3 with a mean 1.64 ± 0.67. Conclusion The partial-thickness superiorly based SCM flap offers a reasonable cosmetic option for reconstruction following either superficial or total parotidectomy by improving the facial deformity. The flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve.

  17. The inner arm fasciocutaneous flap.

    Science.gov (United States)

    Budo, J; Finucan, T; Clarke, J

    1984-04-01

    A fasciocutaneous flap raised on the inner surface of the upper arm has been used to release 16 burn scar contractures of the anterior axillary fold. It is a relatively quick and simple procedure that adequately corrects the contracture and does not have to followed by prolonged splinting.

  18. Characteristics of benign lymphoadenosis of oral mucosa.

    Science.gov (United States)

    Li, Shu-Xia; Yu, Shi-Feng; Sun, Kai-Hua

    2005-08-07

    To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM). The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia, 15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed. The expression of Ki-67 in BLOM with dysplasia, oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa. Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

  19. The possibility for use of venous flaps in plastic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Baytinger, V. F., E-mail: baitinger@mail.tomsknet.ru; Kurochkina, O. S., E-mail: kurochkinaos@yandex.ru; Selianinov, K. V.; Baytinger, A. V. [Research Institute of Microsurgery, Tomsk (Russian Federation); Dzyuman, A. N. [Siberian State Medical University, Tomsk (Russian Federation)

    2015-11-17

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  20. The possibility for use of venous flaps in plastic surgery

    Science.gov (United States)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  1. Permeability of skin and oral mucosa to water and horseradish peroxidase as related to the thickness of the permeability barrier

    Energy Technology Data Exchange (ETDEWEB)

    Squier, C.A.; Hall, B.K.

    1985-03-01

    The permeability of porcine skin and keratinized and nonkeratinized oral mucosa to tritium-labeled water and horseradish peroxidase (HRPO) was determined using perfusion chambers. Small blocks from each tissue were also incubated with HRPO and the extent of penetration visualized microscopically; this enabled measurements to be made of the thickness of the permeability barrier to this water-soluble tracer. Results obtained after inverting the oral mucosa in the chambers or adding metabolic inhibitors indicated that both compounds diffuse across the tissue. The permeability constants derived directly in the study showed that skin was less permeable than oral mucosa and that the floor of the mouth was significantly more permeable than all other regions. When these constants were normalized in terms of a standard permeability barrier thickness and the different tissues compared, the values obtained for skin were again less than those of the oral regions but, of these, the buccal mucosa was significantly higher. The difference in permeability between epidermis and keratinized oral epithelium may be due to differences in the volume density of membrane-coating granules known to exist between the tissues; differences between the oral mucosal regions may reflect differences in the nature of the intercellular barrier material.

  2. [Adhesion of clinical Candida albicans isolate to buccal epithelial cells].

    Science.gov (United States)

    Wellmer, A

    1999-01-01

    Mucosal adherence and germ tube formation are considered to be important virulence factors of C. albicans. Adherence is a precondition for colonisation and invasion. We investigated 11 clinical isolates (among them 5 cases recovered from oesophageal thrush) for quantification of the two characteristics and correlated the results with clinical data. Adherence was measured on buccal epithelial cells and the continuous flow culture was used for quantification of germ tube formation. Adherence of strains recovered from clinically, culturally and serologically confirmed oesophageal thrush adhered stronger to buccal epithelial cells than isolates from patients with heavy colonisation without signs of candidosis. Strains with stronger adherence showed a significantly faster and an increased germ tube formation in the continuous flow culture. Strains from oesophageal thrush therefore show a more marked expression of the investigated virulence factors. Therefore a good adherence is a necessity for infection of the oesophagus by C. albicans. The preferential isolation of C. albicans from oesophageal thrush (> 90%) supports this assumption.

  3. Improvement of buccal delivery of morphine using the prodrug approach

    DEFF Research Database (Denmark)

    Christrup, Lona Louring; Jørgensen, A.; Christensen, C.B.

    1997-01-01

    The feasibility of achieving buccal delivery of morphine using the prodrug approach was assessed by studies of bioactivation, in vitro permeation and in vivo absorption. The bioactivation of various morphine-3-esters was studied in human plasma and saliva. The in vitro permeation of morphine...... of 0.2. This discrepancy could however be explained by the enzymatic stability of the two esters in saliva, since it was found that morphine-3-propionate was more rapidly hydrolysed in saliva than was morphine-3-acetate. The study demonstrates that the buccal delivery of morphine can be markedly...... Improved by using ester prodrugs with higher lipophilicity than morphine itself. However, the enzymatic stability of the prodrugs in saliva also play an important role for the overall improvement in absorption properties....

  4. [Buccal bony exostoses induced by free gingival grafts].

    Science.gov (United States)

    Tal, H; Slutzkey, S

    2011-01-01

    Buccal Bony Exostoses (BBE) is a local benign osseous overgrowth continuous with the facial aspect of the jaw. Post operative BBE may be the result of dermal grafts used to restore the buccal vestibulum, of connective tissue graft placement, and of Free Gingival Grafts (FGG) procedures. In 46 patients in whom 72 FGG procedures were performed by the senior author (HT) over the past 12 years, BBE was clinically and radiographically diagnosed. In one case the tumor was surgically removed. The etiology, pathogenesis and frequency of BBE following FGG procedures was reviewed and discussed. We suggest that the BBE may develop owing to periosteal surgical trauma during FGG procedures, and suggest that this phenomenon receives further attention.

  5. Cytological Changes in Normal Oral Mucosa of Individuals with Tobacco Habits: A Cytomorphometric Study.

    Science.gov (United States)

    Palakurthy, Pavan; Kulkarni, Pavan G; Nandan, Rateesh K; Rao, T Madhusudan; Reddy, D Shyam P; Muddana, Keerthi

    2017-08-01

    Oral cancer is one of the six most common cancers in the world, and globally more than 50% of head and neck cancers occur in Asia, remarkably in India. Overall, 200,000 cases of head and neck cancers occur each year in India, among which 80,000 are oral cancers. Epidemiological and clinical studies suggest a causative role of tobacco use in the evolution of oral potentially malignant and malignant disorders. The aim of the study is to evaluate independently and compare the cytological effects of smoking, tobacco chewing, and smoking in conjunction with tobacco chewing on oral mucosa by cytomorphometric analysis. The study included a total of 120 individuals subdivided into four groups, each group with 30 individuals. Group I was tobacco smokers, group II tobacco chewers, and group III both tobacco smokers and chewers. Group IV comprised 30 individuals without tobacco habit. Smears were prepared from buccal mucosa of both the study and control groups using a cytobrush and stained using Papanicolaou staining. The cells were quantified using image analysis software. The results of the study showed alterations in the nuclear and cellular parameters in the study groups when compared with control groups and were statistically significant (p exfoliative cytology and cytomorphometry aid as a valuable tool to evaluate the effect of tobacco on oral mucosa. Simple noninvasive techniques like exfoliative cytology can be employed as a chairside technique and in mass screening programs for identification of cellular changes in oral mucosa of individuals with tobacco habits. Thereby, it can be used as an early diagnostic tool for identification of potentially cancerous and cancerous lesions.

  6. Usefulness of myofascial flap without skin in contemporary oral and maxillofacial reconstruction.

    Science.gov (United States)

    Wada, Takeshi; Nakatani, Ken; Hiraishi, Yukihiro; Negoro, Kenji; Iwagami, Yoshinobu; Fujita, Shigeyuki

    2011-06-01

    Pedicle myofascial graft should be considered in contemporary oral and maxillofacial reconstruction for the following reasons: 1) the pedicle myofascial unit is reliable and easily handled; 2) on the grafted myofascia in the oral cavity, the mucosa regenerates naturally with regard to suppleness and surface characteristics; and 3) vascularized myofascial coverage of tissues or materials is useful in some clinical situations. The purpose of this retrospective study was to evaluate the usefulness of this graft material. Using myofascial flaps from the pectoralis major muscle in 15 patients and from the platysma muscle in 11 patients, several types of reconstructive procedures were conducted in the Department of Oral and Maxillofacial Surgery, Wakayama Medical University. Myofascial tissue was used to cover the surgical defect and for regeneration of oral mucosa (24 patients), to prevent exposure of the mandibular reconstruction plate (4 patients), for prevention of wound breakdown and secondary infection in the oral cavity (2 patients), for vascularized coverage of free grafted autologous bone (2 patients), and for protection of large vessels after radical neck dissection (9 patients). Although partial flap necrosis or wound dehiscence was noticed in 3 patients with a platysma-myofascial graft, the healing process of all patients was favorable and required no additional operations. This procedure is most suitable for the reconstruction of small to medium-sized soft tissue defects in the oral cavity, because it induces the formation of nearly normal mucosa through epithelial regeneration without clear scar formation. Myofascial flap is a useful option in certain oral and maxillofacial reconstruction cases in which mucosal regeneration and/or vascularized soft tissue coverage are required. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Formulation and Evaluation of Mucoadhesive Buccal Bilayered Tablets of Salbutamol

    OpenAIRE

    Dr. N.G Raghavendra Rao; Gururaj S. Kulkarni

    2012-01-01

    Salbutamol is a short-acting 2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. The salbutamol buccal mucoadhesive tablets were fabricated with objective of avoiding first pass metabolism and prolonging duration of action. Salbutamol mucoadhesive bilayered tablets were prepared by direct compression method using the bioadhesive polymers such as xanthan gum, sodium alginate and carbopol 937P along with ethyl...

  8. Evaluation of genotoxic effect of X-rays on oral mucosa during panoramic radiography

    Directory of Open Access Journals (Sweden)

    Mahima Sandhu

    2015-01-01

    Full Text Available Introduction: X-rays are potent mutagenic agents capable of inducing both gene mutations and chromosomal aberrations. They act directly on the DNA molecule or indirectly through the formation of reactive compounds that interact with this molecule. In spite of their mutagenic potential, this kind of radiation is an important tool for diagnosis. Aim: The aim of this study is to analyze the genotoxic effects on oral mucosa during conventional and digital panoramic radiography. Objectives: 1. To assess the nuclear abnormalities, mainly micronuclei in exfoliated buccal mucosal cells, before X-ray exposure and 10 days after exposure using conventional and digital panoramic radiography. 2. Comparison of micronuclei count obtained during conventional and digital panoramic radiography. Materials and Methods: One hundred healthy individuals were chosen who were free of all deleterious habits. Epithelial buccal cells were obtained with an exfoliative cytobrush immediately before exposure and 10 days after exposure. The smears were stained using Giemsa stain and analyzed under low-power and high-power microscope. Results: There was a significant difference in the mean values obtained pre- and post-exposure to conventional panoramic radiography, as the mean value of micronuclei before exposure was 0.025 ± 0.01 which increased to 0.064 ± 0.02 post-exposure. Similarly, there was a significant difference in the mean values obtained pre- and post-exposure to digital panoramic radiography, as the mean value of micronuclei before exposure was 0.022 ± 0.01 which increased to 0.041 ± 0.01 post-exposure. In the present study, there was a highly significant increase in the number of micronuclei post-exposure in conventional panoramic radiography when compared to digital panoramic radiography. Conclusion: This results show that panoramic radiography does induce genotoxic effects in buccal epithelial cells and should be used only when indicated, and that digital

  9. Effect of Platform Shift/Switch and Concave Abutments on Crestal Bone Levels and Mucosal Profile following Flap and Flapless Implant Surgery.

    Science.gov (United States)

    Gamborena, Inãki; Lee, Jaebum; Fiorini, Tiago; Wenzel, Brent A; Schüpbach, Peter; Wikesjö, Ulf M E; Susin, Cristiano

    2015-10-01

    Crestal remodeling/bone loss appears to be a common sequel to dental implant placement. Several hypotheses/clinical strategies have been proposed to explain/avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of these clinical approaches uncertain. The objective of the present study was to provide a histological account of crestal bone levels and mucosal profile at platform shift/switch and concave abutments following flapless and conventional flap surgery and subcrestal implant placement using a dog model. Four dental implants each were placed in the left/right mandibular posterior jaw quadrants in five adult male Hound/Labrador mongrel dogs using flap surgery with a 1 × 5 mm gap defect or using a flapless approach, both involving placement 2 mm subcrestally and platform shift/switch versus concave abutments. Block biopsies for histological/histometric analysis were collected at 8 weeks. No significant differences were observed regarding crestal bone levels, with all groups showing mean bone levels above the implant platform. Similarly, crestal bone-implant contact was not significantly different among groups. Moreover, peri-implant mucosal profiles were not statistically different among groups for buccal sites; average mucosal height reached 4.1 to 4.9 mm above the implant platform. Comparison between buccal and lingual sites showed a nonsignificant tendency toward greater crestal resorption at buccal sites, adjusting for other factors. Mean crestal bone-implant contact level approximated the implant platform for lingual sites while consistently remaining below the platform at the buccal sites. Peri-implant mucosal height was significantly higher at buccal than at lingual sites, with the epithelial attachment located a significant distance away from the implant platform at buccal sites. The surgical approaches (subcrestal implant placement by flap surgery or a flapless approach) and abutment designs (platform shift/switch or

  10. Preparation and evaluation of buccal bioadhesive tablets containing clotrimazole.

    Science.gov (United States)

    Singh, S; Jain, S; Muthu, M S; Tilak, R

    2008-04-01

    Buccal bioadhesive tablets of clotrimazole (CTZ) and clotrimazole: hydroxypropyl-beta-cyclodextrin (CTZ-HPbetaCD) complex were prepared by using polymer xanthan gum in combination with carbopol 974P. The prepared buccal bioadhesive tablet formulations were evaluated for physicochemical characteristics (weight, hardness, friability, diameter, and drug content), swelling index, microenvironment pH, in-vitro drug release, bioadhesion strength, residence time and duration of antifungal activity (in-vitro). The dissolution of CTZ from the prepared tablets into phosphate buffer (pH 6.8) was controlled up to 8 h. All the prepared tablets gave reasonable in-vitro residence time (7.13 - 9.34 h). X-ray diffraction (XRD) studies of the CTZ-HPbetaCD complex, made by kneading and freeze-dried method, showed no CTZ crystal signals, demonstrating the inclusion of CTZ in the hydrophobic cavity of hydroxypropyl-beta-cyclodextrin (HPbetaCD) and formation of amorphous inclusion complex. Duration of the antifungal activity was measured by the inhibition zone of Candida albicans by agar diffusion assay. It is evident from the results obtained, the prepared buccal bioadhesive tablets of CTZ would markedly prolong the duration of the antifungal activity and may prove to be a viable alternative to the conventional local oral medication.

  11. Advances in Tissue-engineered Oral Mucosa.

    Science.gov (United States)

    Meng, Fan Hao; Shao, Xiao Lin; Song, Yu; Zhang, Tao

    2017-12-20

    The large defect of oral and maxillofacial region doesn't only affect the function and aesthetics but also has an adverse impact on patients' psychology. The traditional way to restore the defects are limited by donor site and secondary trauma. In recent years,the oral mucosal tissue engineering has developed rapidly and provides a new solution for craniofacial reconstruction. Tissue-engineered oral mucosa is an ideal substitute of oral mucosa. It can be used in clinical settings and in vitro experiments. This articles review the recent advances in tissue-engineered oral mucosa and its applications.

  12. [Significance of abdominal wall CT-angiography in planning DIEA perforator flaps, TRAM flaps and SIEA flaps].

    Science.gov (United States)

    Fansa, H; Schirmer, S; Frerichs, O; Gehl, H B

    2011-04-01

    Muscle sparing TRAM flaps and DIEA perforator flaps are standard procedures for breast reconstruction. Recently CT-angiography has been established to evaluate perforator vessels pre-operatively. CT-angiography was introduced to our department in July 2009. In a retrospective analysis data of the last 20 patients (altogether 22 flaps) before CT-angiography introduction and the following 20 (also 22 flaps) patients after introduction of CT-angiography were analysed with regard to the ratio of TRAM to DIEP flaps, and the time required to raise the flaps. The same surgeon raised all flaps. As different surgeons performed dissection of the recipient site, anastomoses, and insertion of flaps, and patients received primary (with sentinel or complete lymphadenctomy) or secondary reconstructions, only the time required harvesting the flap was compared. Thus other influences on raising the flap were eliminated. DIEP flaps were harvested with one single perforator. If perfusion or was considered not to be safe via one single perforator a muscle sparing TRAM flap (ms2) was raised. Angiography was performed using a 64-slice multi-detector CT scanner. CT-angiography did not lead to an increased rate of DIEP flaps in relation to ms2-TRAM flaps. Harvesting time of all flap types with CT-angiography on average was 121 min, without CT-angiography 135 min. This was not significantly different. However, separate analysis of DIEP flaps and ms2-TRAM flaps revealed a significant advantage of CT-angiography based harvesting of DIEP flaps of 26 min: with CT-angiography 101 min vs. 127 min without CT-angiography (p<0.028). There were no significant differences for ms2-TRAM flaps. All scans showed course and branching, diameter and size of the inferior epigastric artery. If evident the superficial inferior epigastric artery (SIEA) was marked. Dosage was 292 mGy-606 mGy×cm dependent on body weight. CTDI was 6.8-14.7 mGy. CT-angiography is a reproducible and observer independent procedure

  13. Exotic wakes of flapping fins

    DEFF Research Database (Denmark)

    Schnipper, Teis

    We present, in 8 chapters, experiments on and numerical simulations of bodies flapping in a fluid. Focus is predominantly on a rigid foil, a model fish, that performs prescribed pitching oscillations where the foil rotates around its leading edge. In a flowing soap film is measured, with unpreced......We present, in 8 chapters, experiments on and numerical simulations of bodies flapping in a fluid. Focus is predominantly on a rigid foil, a model fish, that performs prescribed pitching oscillations where the foil rotates around its leading edge. In a flowing soap film is measured......-speed and the strength ratio of the vortices formed at the foil’s leading and trailing edge. The simulated vortex particles and measured thickness variations in the soap film show similar behaviour which indicates that the soap film provides a good approximation the flow of a two-dimensional incompressible and Newtonian...

  14. The Gradual Expansion Muscle Flap

    Science.gov (United States)

    2014-01-01

    struck an improvised explosive device, sustaining a III-B open tibia fracture with large anteromedial soft tissue defect and bone loss involving the...GEM flap technique. The average age was 26.0 years (range, 21–39 years), and all patients were male. Four patients had sustained their injuries as a...Biochem Cytol. 1961;9:493 495. 42. Sola OM, Christensen DL, Martin AW. Hypertrophy and hyperplasia of adult chicken anterior latissimus dorsi muscles

  15. The place of nasolabial flap in orofacial reconstruction: A review

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2016-12-01

    Conclusion: Nasolabial flap is an old flap for reconstructive purposes. Over time different modifications have been introduced to expand its usage. Clear definition of the terms used with this flap is given.

  16. Congenital breast deformity reconstruction using perforator flaps.

    Science.gov (United States)

    Gautam, Abhinav K; Allen, Robert J; LoTempio, Maria M; Mountcastle, Timothy S; Levine, Joshua L; Allen, Robert J; Chiu, Ernest S

    2007-04-01

    Congenital breast deformities such as Poland syndrome, unilateral congenital hypoplasia, tuberous breast anomaly, and amastia pose a challenging plastic surgical dilemma. The majority of patients are young, healthy individuals who seek esthetic restoration of their breast deformities. Currently, both implant and autologous reconstructive techniques are used. This study focuses on our experience with congenital breast deformity patients who underwent reconstruction using a perforator flap. From 1994 to 2005, a retrospective chart review was performed on women who underwent breast reconstruction using perforator flaps to correct congenital breast deformities and asymmetry. Patient age, breast deformity type, perforator flap type, flap volume, recipient vessels, postoperative complications, revisions, and esthetic results were determined. Over an 11-year period, 12 perforator flaps were performed. All cases were for unilateral breast deformities. The patients ranged from 16 to 43 years of age. Six patients had undergone previous correctional surgeries. Eight (n = 8) flaps were used for correction of Poland syndrome and its associated chest wall deformities. Four (n = 4) flaps were used for correction of unilateral breast hypoplasia. In all cases, the internal mammary vessels were the recipient vessels of choice. No flaps were lost. No vein grafts were used. All patients were discharged on the fourth postoperative day. Complications encountered included seroma, hematoma, and nipple malposition. Revisional surgery was performed in 30% of the cases. Esthetic results varied from poor to excellent. Perforator flaps are an acceptable choice for patients with congenital breast deformities seeking autologous breast reconstruction. Deep inferior epigastric artery (DIEP) or superficial inferior epigastric artery (SIEA) flaps are performed when adequate abdominal tissue is available; however, many young patients have inadequate abdominal tissue, thus a GAP flap can be used

  17. Regional quantitative histological variations in human oral mucosa.

    Science.gov (United States)

    Ciano, Joseph; Beatty, Brian Lee

    2015-03-01

    Oral mucosa demonstrates regional variations that reflect contact with food during mastication. Though known qualitatively, our aim was to quantitatively assess regions to establish a measurable baseline from which one could compare in pathological and comparative studies, in which the abrasiveness of diets may differ. We assessed variations in the epithelial-connective tissue junction (rete ridges counts), collagen organization within the lamina propria, and elastin composition of the lamina propria of 15 regions of the labial (buccal) gingiva, lingual gingiva, vestibule, and palate. All characteristics varied more between regions within the same individual than between individuals. Lingual gingiva had high rete ridges counts, high level of collagen organization, and moderate elastin composition compared to other regions. The labial gingiva had few rete ridges, high collagen organization, and low elastin. The vestibule had the fewest average of rete ridges, least organized collagen, and high elastin. The hard palate had the highest average of rete ridges, high collagen organization, and the lowest elastin content. The soft palate conversely had the smallest average of rete ridges, moderate collagen organization, and the highest elastin composition. Our results indicate that comparison of these quantitative histological differences is warranted only for collagen organization and elastin composition. Differences in rete ridges counts were not statistically significant. Most histological characteristics observed were not significantly different between dentulous and edentulous cadavers, and the group containing all individuals. An exception was the level of collagen fiber organization within the lamina propria, which was higher in most regions when teeth were present. © 2014 Wiley Periodicals, Inc.

  18. Endoscopic appearance of irradiated gastric mucosa

    Energy Technology Data Exchange (ETDEWEB)

    De Sagher, L.I.; Van den Heule, B.; Van Houtte, P.; Engelholm, L.; Balikdjan, D.; Bleiberg, H.

    1979-09-01

    Irradiation of the epigastric area for gastric cancer may induce actinic lesions of the stomach characterized on endoscopic examination by ulcerations, haemorrhagic gastritis, fragility of the mucosa, thickening and congestion of the gastric folds.

  19. Pseudopathologies and Examination of the Oral Mucosa

    OpenAIRE

    Can Ceylan

    2012-01-01

    Oral mucosa for shedding light on diagnosis of many cutaneous and systemic diseases, is an area not to be overlooked during the physical examination. Unlike cutaneous lesions, oral mucosa includes the non-keratinized sections and since it has anatomically and histologically special structures such as salivary glands and papillaries, the physician must recognize some detail, and features during the examination. To distinguish of usual and unusual changes in this area is important for both diag...

  20. Influence of additives on a thermosensitive hydrogel for buccal delivery of salbutamol: relation between micellization, gelation, mechanic and release properties.

    Science.gov (United States)

    Zeng, Ni; Dumortier, Gilles; Maury, Marc; Mignet, Nathalie; Boudy, Vincent

    2014-06-05

    Thermosensitive hydrogels developed for buccal delivery of salbutamol were prepared using poloxamer analogs (Kolliphor(®) P407/P188), xanthan gum (Satiaxane(®) UCX930) and NaCl. P188 increased gelation temperature (Tsol-gel) by 2.5-5°C, micellization temperature (3s. To obtain a suitable Tsol-gel at 28-34°C, P407 and P188 concentrations were set to 18-19% and 1%. NaCl reduced Tsol-gel (>2°C) out of the optimal range. Six formulations containing 0.05-0.1% Satiaxane(®) fulfilled the temperature criteria. Concerning the gel strength, 1% P188 had no significant effect, NaCl increased it at 20°C, and Satiaxane(®) enhanced it at 20°C and 37°C. The release study using membrane-less (to mimic oral cavity) and membrane (to mimic buccal mucosa side) methods allowed a complete investigation showing that erosion and diffusion both contributed to the drug release but differed according to the formulation. In the membraneless method, simple P407 formulations had weak ability to retain salbutamol (T80=35 min). P188 accelerated drug release. NaCl accelerated release in the membraneless method by 5-11 min but slightly reduced it in the membrane method. The hydrogels containing Satiaxane(®) exhibited the slowest release. In the membrane method, combination of P407/P188/Satiaxane(®) provided a sustained diffusion with a burst effect (T25=9.6 min, T80=97.8 min), which provides potential clinical interests. Copyright © 2014. Published by Elsevier B.V.

  1. Characterization of hyperbranched core-multishell nanocarriers as an innovative drug delivery system for the application at the oral mucosa.

    Science.gov (United States)

    Jager, J; Obst, K; Lohan, S B; Viktorov, J; Staufenbiel, S; Renz, H; Unbehauen, M; Haag, R; Hedtrich, S; Teutloff, C; Meinke, M C; Danker, K; Dommisch, H

    2018-02-01

    In the oral cavity, the mucosal tissues may develop a number of different pathological conditions, such as inflammatory diseases (gingivitis, periodontitis) and autoimmune disorders (eg, oral lichen planus) that require therapy. The application of topical drugs is one common therapeutic approach. However, their efficacy is limited. Dilution effects due to saliva hinder the adherence and the penetration of drug formulations. Therefore, the bioavailability of oral topical drugs is insufficient, and patients may suffer from disease over years, if not life-long. In the present study, we characterized core-multishell (CMS) nanocarriers for their potential use as drug delivery systems at oral mucosal tissues. For this purpose, we prepared porcine masticatory as well as buccal mucosa and performed Franz cell diffusion experiments. Penetration of fluorescently labeled CMS nanocarriers into the mucosal tissue was analyzed using confocal laser scanning microscopy. Upon exposure to CMS nanocarriers, the metabolic and proliferative activity of gingival epithelial cells was determined by MTT and sulforhodamine B assays, respectively. Here, we could show that the carriers penetrate into both mucosal tissues, while particles penetrate deeper into the masticatory mucosa. Electron paramagnetic resonance spectroscopy revealed that the 3-carboxy-2,2,5,5-tetramethyl-1-pyrrolidinyloxy-labeled glucocorticoid dexamethasone loaded on to the CMS nanocarriers was released from the carriers in both mucosal tissues but with a higher efficiency in the buccal mucosa. The release from the nanocarriers is in both cases superior compared to the release from a conventional cream, which is normally used for the treatment of inflammatory conditions in the oral cavity. The CMS nanocarriers exhibited neither cytotoxic nor proliferative effects in vitro. These findings suggested that CMS nanocarriers might be an innovative approach for topical drug delivery in the treatment of oral inflammatory diseases

  2. Innovation in the planning of V-Y rotation advancement flaps: A template for flap design

    Directory of Open Access Journals (Sweden)

    Utku Can Dölen

    2018-01-01

    Full Text Available Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5, anterior tibia (n=1, posterior axilla (n=1, ischium (n=1, and trochanter (n=2. The template for a bilateral flap was used on the sacrum (n=8, arm (n=1, and anterior tibia (n=1. The causes of the defects were meningocele (n=3, a decubitus ulcer (n=5, pilonidal sinus (n=3, and skin tumor excision (n=10. The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19–80 years. All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

  3. Innovation in the planning of V-Y rotation advancement flaps: A template for flap design.

    Science.gov (United States)

    Dölen, Utku Can; Koçer, Uğur

    2018-01-01

    Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1). The causes of the defects were meningocele (n=3), a decubitus ulcer (n=5), pilonidal sinus (n=3), and skin tumor excision (n=10). The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19-80 years). All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

  4. Does buccal cancer have worse prognosis than other oral cavity cancers?

    Science.gov (United States)

    Camilon, P Ryan; Stokes, William A; Fuller, Colin W; Nguyen, Shaun A; Lentsch, Eric J

    2014-06-01

    To determine whether buccal squamous cell carcinoma has worse overall survival (OS) and disease-specific survival (DSS) than cancers in the rest of the oral cavity. Retrospective analysis of a large population database. We began with a Kaplan-Meier analysis of OS and DSS for buccal versus nonbuccal tumors with unmatched data, followed by an analysis of cases matched for race, age at diagnosis, stage at diagnosis, and treatment modality. This was supported by a univariate Cox regression comparing buccal cancer to nonbuccal cancer, followed by a multivariate Cox regression that included all significant variables studied. With unmatched data, buccal cancer had significantly lesser OS and DSS values than cancers in the rest of the oral cavity (P cancer versus nonbuccal oral cancer were no longer significant. Univariate Cox regression models with respect to OS and DSS showed a significant difference between buccal cancer and nonbuccal cancer. However, with multivariate analysis, buccal hazard ratios for OS and DSS were not significant. With the largest series of buccal carcinoma to date, our study concludes that the OS and DSS of buccal cancer are similar to those of cancers in other oral cavity sites once age at diagnosis, tumor stage, treatment, and race are taken into consideration. The previously perceived poor prognosis of buccal carcinoma may be due to variations in tumor presentation, such as later stage and older patient age. 2b. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Identification of Streptococcus parasanguinis DNA contamination in human buccal DNA samples.

    Science.gov (United States)

    Mahfuz, Istiak; Cheng, Wei; White, Stefan J

    2013-11-22

    The use of buccal swabs in clinical and scientific studies is a very popular method of collecting DNA, due to its non-invasive nature of collection. However, contamination of the DNA sample may interfere with analysis. Here we report the finding of Streptococcus parasanguinis bacterial DNA contamination in human buccal DNA samples, which led to preferential amplification of bacterial sequence with PCR primers designed against human sequence. Contamination of buccal-derived DNA with bacterial DNA can be significant, and may influence downstream genetic analysis. One needs to be aware of possible bacterial contamination when interpreting abnormal findings following PCR amplification of buccal swab DNA samples.

  6. A mechanistic based approach for enhancing buccal mucoadhesion of chitosan.

    Science.gov (United States)

    Meng-Lund, Emil; Muff-Westergaard, Christian; Sander, Camilla; Madelung, Peter; Jacobsen, Jette

    2014-01-30

    Mucoadhesive buccal drug delivery systems can enhance rapid drug absorption by providing an increased retention time at the site of absorption and a steep concentration gradient. An understanding of the mechanisms behind mucoadhesion of polymers, e.g. chitosan, is necessary for improving the mucoadhesiveness of buccal formulations. The interaction between chitosan of different chain lengths and porcine gastric mucin (PGM) was studied using a complex coacervation model (CCM), isothermal titration calorimetry (ITC) and a tensile detachment model (TDM). The effect of pH was assessed in all three models and the approach to add a buffer to chitosan based drug delivery systems is a means to optimize and enhance buccal drug absorption. The CCM demonstrated optimal interactions between chitosan and PGM at pH 5.2. The ITC experiments showed a significantly increase in affinity between chitosan and PGM at pH 5.2 compared to pH 6.3 and that the interactions were entropy driven. The TDM showed a significantly increase in strength of adhesion between chitosan discs and an artificial mucosal surface at pH 5.2 compared to pH 6.8, addition of PGM increased the total work of adhesion by a factor of 10 as compared to the wetted surface without PGM. These findings suggest that chitosan and PGM are able to interact by electrostatic interactions and by improving the conditions for electrostatic interactions, the adhesion between chitosan and PGM becomes stronger. Also, the three complementary methods were utilized to conclude the pH dependency on mucoadhesiveness. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Morsicatio mucosae oris--a chronic oral frictional keratosis, not a leukoplakia.

    Science.gov (United States)

    Woo, Sook-Bin; Lin, Dorothy

    2009-01-01

    Morsicatio mucosae oris (MMO) presents as white papules and plaques that may resemble leukoplakia, and are often biopsied. The objective of this study is to document the clinical features and histopathology of MMO and to reevaluate the prevalence of dysplasia and/or cancer when this frictional keratosis is removed from the category of leukoplakia. Cases that were submitted to a single laboratory with a provisional diagnosis of "leukoplakia," "hyperkeratosis," or "white lesion" were evaluated. Fifty-six lesions of MMO from 56 patients were identified out of 584 white lesions. Most cases occurred in the third to sixth decades of life. Thirty (53.6%) and 18 (32.1%) out of 56 lesions were located on the lateral tongue and buccal mucosa, respectively. The lesions showed hyperparakeratosis with a characteristic frayed, shaggy, peeling surface, and acanthosis with insignificant inflammation. When MMO is removed from the category of leukoplakia, the percentage of true leukoplakia that are dysplastic or malignant increased by 12.9%. MMO is a form of chronic oral frictional keratosis that has no malignant potential, and should be signed out as such and not merely "hyperparakeratosis and acanthosis" so that it can be removed from the category of leukoplakia where it does not belong.

  8. The role of autofluorescence diagnostics in the diseases of oral mucosa

    Science.gov (United States)

    Kosciarz-Grzesiok, A.; Waskowska, J.; Kawczyk-Krupka, A.; Ledwon, A.; Misiak, A.; Latos, W.; Koszowski, R.; Sieron-Stoltny, K.; Sieron, A.

    2008-02-01

    Introduction. Life induced fluorescence (LIFE) diagnostics can be used as an imaging system of precancerous and neoplastic lesions of the oral mucosa. Neoplastic lesions are visible in pseudo colours, healthy tissue in green colour and abnormal tissue in red colour. All the observed colours present different intensity. Colour intensity is relevant to the grade of dysplasia, carcinoma progress and is called Numerological Value of Color Index (NCV). The aim of our study was to find correlation between autofluorescence diagnostics combined with NCV assessment and histopathological findings of taken specimen biopsies. Patients and methods. 10 patients participated in our study. Lesions affected a variety of intraoral sites. The most common location was: buccal, gingival and mandibular mucosa. Patients were examined using Life Induced Fluorescence diagnosis (400 - 750 nm wavelength) with Numerological Value of Color index (NCV) using Onco LIFE system. Afterwards the specimen biopsies from the lesions were taken and histopathological examination was performed. Results. Different NCV and dependence of NCV on the histopathological findings were observed. Conclusion. Diagnostic procedures with the application of white-light imaging with LIFE imaging is not only a significantly faster method and a better diagnostic tool of preneoplastic and neoplastic lesions, but there exist also correlations between measured NCV and histopathological diagnosis. The farther investigations are necessary in order to prove these preliminary findings.

  9. Radioautographic analysis of changes in different phases of cell kinetics in murine oral mucosa

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Suck; You, Dong Soo [Department of Radiology, Osaka Dental University, Department of Radiology, College of Dentistry, Seoul Nation Uni versity, Seoul (Korea, Republic of)

    1983-11-15

    The age related changes in the life cycle of the progenitor cell population of murine oral epithelia was studied. Using radioautographic methods which have been adopted in previous cell cycle studies, the age-related changes of different phases in renewing cells of the palatal, buccal and lingual mucosae were determined. The results confirm published findings on cell cycle changes of epithelia with aging and illustrated further that mitotic phases which has hither to been considered stationary, also changes with aging. The major parts revealed by this study are as follows: 1. The basal progenitor cells in different regions of oral mucosa have different generation times. 2. The basal cell cycle time increases as a function of aging and the region most affected by aging appears to be the epithelium of the cheek. 3. The phases of the cell cycle affected by the process of aging are in increasing order of magnitude: M-, S- and G1-phase. 4. The age related change in the number of DNA synthesizing basal progenitor cells occurs at two age periods. Between 1 and 12 months of life it decreases, while from 12 to 20 months it increases.

  10. ORAL MUCOSA DAMAGE BECAUSE OF HYPOCHLORITE ACCIDENT – A CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Elitsa Deliverska

    2016-08-01

    Full Text Available Background Hypochlorite solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue especially due to its cytotoxic features. Objective The aim of our paper is to present a case of damage of oral mucosa because of leakage of 3% hypochlorite through rubber dam during endodontic treatment. Material and methods We present a 31 years old female with necrosis of buccal mucosa during the endodontic treatment of 46. Results Three days after the procedure the patient was referred to our department for consultation and treatment. Antiseptic lavage was performed and oral antibiotic was administrated. After 5 days intraoral examination showed signs of almost full recovery. Conclusion The need for proper tooth isolation during restorative procedures is obvious. Anything that obscures the operative field negatively impacts operator efficiency and effectiveness. Visibility, patient/operator safety, infection control and the physical properties of dental materials are all compromised when proper isolation is lacking.

  11. IMMUNOHISTOCHEMICAL ANALYSIS OF ORAL MUCOSA LEUKOPLAKIA

    Directory of Open Access Journals (Sweden)

    Yu. G. KOLENKO

    2016-06-01

    Full Text Available In recent years, substantial changes have occurred in the structure of oral mucosa diseases, in particular an increased ratio of precancerous diseases, so that an effective non-invasive detection of any sign of malignancy appears as an urgent and most actual task of dentistry. Aim: To study the proliferative activity of epithelial cells in Ki-67 antigenin patients with leukoplakia of the oral mucosa. Materials and method: A complex clinical and laboratory examination was performed on 155 patients with oral leukoplakia, who addressed the Operative Dentistry Department of the “A.A.Bogomolets” National Medical University of Kiev between 2010 and 2014. All patients have been subjected to a careful clinical examination, which included: dental anamnesis, visual inspection, oral examination and digital palpation of oral mucosa and tongue mucosa, biopsy of leukoplakia lesions for cytological and histological examination. Results: Histological evaluation of the material has been performed according to the WHO (2005 classification of leukoplakia. 10 (14% sites of unaltered mucosa, 10 (14% samples of hyperkeratosis without atypia, 14 (19% biopsy specimens of hyperkeratosis SIN1, 15 (21% – hyperkeratosis SIN2, 10 (14% - SIN3 and 13 (18% cases of squamous cell carcinoma were evidenced. Immunohistochemical investigation evidenced the presence of protein Ki-67 in the nuclei of epithelial cells. In the unmodified epithelium of the oral mucosa, all epithelial cells with stained nuclei are virtually located in the basal layer. Conclusion: Against the general increase of the proliferative activity of epithelial cells with increasing SIN, a characteristic distribution of proliferating cells in the thickness of the epithelium was revealed for each studied group, as follows: in the control group and in leukoplakia without atypia, immunopositive cells are located in the basal layer, in leukoplakia (SIN1, SIN2 and SIN3 – in parabasal position while, in squamous

  12. FORMULATION DEVELOPMENT AND EVALUATION OF TERBUTALINE SULPHATE MUCOADHESIVE BUCCAL TABLETS

    OpenAIRE

    Gururaj S.Kulkarni; N.G RaghavendraRao; D.Narasimhareddy

    2013-01-01

    The main objective of developing any new dosage form is reduce the side effects and increase the therapeutic effect of drug in existing dose of dosage form. Mucoadhesive drug delivery system is oral dosage form, where the tablet, gel or patch is attached to the buccal region for direct absorption of drug into blood circulation. This route can prevent the metabolism of drug in G.I tract or liver and side effects of metabolites avoided. In this study, the attempt was made to prepare mucoadhesiv...

  13. The Lateral Thigh Perforator Flap for Autologous Breast Reconstruction: A Prospective Analysis of 138 Flaps.

    Science.gov (United States)

    Tuinder, Stefania M H; Beugels, Jop; Lataster, Arno; de Haan, Michiel W; Piatkowski, Andrzej; Saint-Cyr, Michel; van der Hulst, René R W J; Allen, Robert J

    2018-02-01

    The septocutaneous tensor fasciae latae or lateral thigh perforator flap was previously introduced by the authors' group as an alternative flap for autologous breast reconstruction when the abdomen is not suitable as a donor site. The authors analyzed their experience with the lateral thigh perforator flap and present the surgical refinements that were introduced. A prospective study was conducted of all lateral thigh perforator flap breast reconstructions performed since September of 2012. Patient demographics, operative details, complications, and flap reexplorations were recorded. Preoperative imaging with magnetic resonance angiography was performed in all patients. Surgical refinements introduced during this study included limitation of the flap width and the use of quilting sutures at the donor site. A total of 138 lateral thigh perforator flap breast reconstructions were performed in 86 consecutive patients. Median operative times were 277 minutes (range, 196 to 561 minutes) for unilateral procedures and 451 minutes (range, 335 to 710 minutes) for bilateral. Median flap weight was 348 g (range, 175 to 814 g). Two total flap losses (1.4 percent) were recorded, and 11 flaps (8.0 percent) required reexploration, which resulted in viable flaps. The incidence of donor-site complications was reduced significantly after the surgical refinements were introduced. Wound problems decreased from 40.0 percent to 6.3 percent, seroma decreased from 25.0 percent to 9.5 percent, and infection decreased from 27.5 percent to 9.5 percent. The lateral thigh perforator flap is an excellent option for autologous breast reconstruction, with minimal recipient-site complications. The surgical refinements resulted in a significant reduction of donor-site complications. Therefore, the lateral thigh perforator flap is currently the authors' second choice after the deep inferior epigastric artery perforator flap. Therapeutic, IV.

  14. Reconstruction of Complex Facial Defects Using Cervical Expanded Flap Prefabricated by Temporoparietal Fascia Flap.

    Science.gov (United States)

    Zhang, Ling; Yang, Qinghua; Jiang, Haiyue; Liu, Ge; Huang, Wanlu; Dong, Weiwei

    2015-09-01

    Reconstruction of complex facial defects using cervical expanded flap prefabricated by temporoparietal fascia flap. Complex facial defects are required to restore not only function but also aesthetic appearance, so it is vital challenge for plastic surgeons. Skin grafts and traditional flap transfer cannot meet the reconstructive requirements of color and texture with recipient. The purpose of this sturdy is to create an expanded prefabricated temporoparietal fascia flap to repair complex facial defects. Two patients suffered severe burns on the face underwent complex facial resurfacing with prefabricated cervical flap. The vasculature of prefabricated flap, including the superficial temporal vessel and surrounding fascia, was used as the vascular carrier. The temporoparietal fascia flap was sutured underneath the cervical subcutaneous tissue, and expansion was begun in postoperative 1 week. After 4 to 6 months of expansion, the expander was removed, facial scars were excised, and cervical prefabricated flap was elevated and transferred to repair the complex facial defects. Two complex facial defects were repaired successfully by prefabricated temporoparietal fascia flap, and prefabricated flaps survived completely. On account of donor site's skin was thinner and expanded too fast, 1 expanded skin flap was rupture during expansion, but necrosis was not occurred after the 2nd operation. Venous congestion was observed in 1 patient, but after dressing, flap necrosis was not happened. Donor site was closed primarily. Postoperative follow-up 6 months, the color, texture of prefabricated flap was well-matched with facial skin. This method of expanded prefabricated flap may provide a reliable solution to the complex facial resurfacing.

  15. Median forehead flap - beyond classic indication

    Directory of Open Access Journals (Sweden)

    Cristian R. Jecan

    2016-11-01

    Full Text Available Introduction. The paramedian forehead flap is one of the best options for reconstruction of the median upper two-thirds of the face due to its vascularity, color, texture match and ability to resurface all or part of the reconstructed area. The forehead flap is the gold standard for nasal soft tissue reconstruction and the flap of choice for larger cutaneous nasal defects having a robust pedicle and large amount of tissue. Materials and Methods. We are reporting a clinical series of cutaneous tumors involving the nose, medial canthus, upper and lower eyelid through a retrospective review of 6 patients who underwent surgical excision of the lesion and primary reconstruction using a paramedian forehead flap. Results. The forehead flap was used for total nose reconstruction, eyelids and medial canthal reconstruction. All flaps survived completely and no tumor recurrence was seen in any of the patients. Cosmetic and functional results were favorable. Conclusions. The forehead flap continues to be one of the best options for nose reconstruction and for closure of surgical defects of the nose larger than 2 cm. Even though is not a gold standard, median forehead flap can be an advantageous technique in periorbital defects reconstruction.

  16. Analysis of tail effects in flapping flight

    NARCIS (Netherlands)

    Tay, W.B.; Bijl, H.; Van Oudheusden, B.W.

    2011-01-01

    Numerical simulations have been performed to examine the interference effects between an upstream flapping airfoil and a downstream stationary airfoil in a tandem configuration at a Reynolds number of 1000, which is around the regime of small flapping micro aerial vehicles. The objective is to

  17. POSTERIOR INTEROSSEOUS FLAP IN PEDIATRIC HAND RECONSTRUCTIONS

    Directory of Open Access Journals (Sweden)

    I. O. Golubev

    2014-01-01

    Full Text Available Purpose: to assess early and long-term results of the pediatric hand reconstructions with posterior interosseous flap, including those in children younger than 3 years old. Materials and methods: results of the hand reconstructions with posterior interosseous artery reverse flap were studied in 10 children (4 males and 6 females aged from 1 year and 1 month to 13 years old. In 4 cases flap coverage were performed due to acquired posttraumatic hand deformity, in 6 cases reconstruction was assumed for congenital hand deformities. Combined procedures consisted of posterior interosseous artery flap coverage and other types of microsurgical reconstructions were suggested in 4 patients. Preoperative color doppler visualization of the posterior interosseous vessels were mandatory. All flaps were risen under 3.5x-4.5x magnification. Results: all flaps survived completely in 3 weeks postoperatively. There were no postoperative complications such as flap’s arterial or venous insufficiency, deep infection, or posterior interosseous nerve palsy. Nearly whole group (9 of 10 of patients and/or their parents were satisfied with the esthetic view of the reconstructed hand and donor site of the forearm 1 year postoperatively. Conclusion: posterior interosseous flap is a reliable and versatile option in pediatric hand reconstructions, providing excellent skin coverage with good color match and texture. Preservation of major vascular bundles of the forearm (radial and ulnar arteries during flap harvest gives a possibility to perform a simultaneous microsurgical reconstructions of the hand (e.g. free toe transfer.

  18. Optical detection of (pre-)malignant lesions of the oral mucosa : autofluorescence characteristics of healthy mucosa

    NARCIS (Netherlands)

    de Veld, DCG; Witjes, MJH; Roodenburg, JLN; Sterenborg, HJCM; Papazoglou, TG; Wagnieres, GA

    2001-01-01

    Previous clinical results demonstrate the potential of in vivo autofluorescence spectroscopy for early detection of (pre-)malignant lesions of the oral mucosa. For reliable diagnosis, it is necessary to study auto fluorescence spectra of healthy mucosa first. We measured excitation-emission maps in

  19. Blood flow autoregulation in pedicled flaps

    DEFF Research Database (Denmark)

    Bonde, Christian T; Holstein-Rathlou, Niels-Henrik; Elberg, Jens J

    2009-01-01

    INTRODUCTION: Clinical work on the blood perfusion in skin and muscle flaps has suggested that some degree of blood flow autoregulation exists in such flaps. An autoregulatory mechanism would enable the flap to protect itself from changes in the perfusion pressure. The purpose of the present study...... was to evaluate if, and to what extent, a tissue flap could compensate a reduction in blood flow due to an acute constriction of the feed artery. Further, we wanted to examine the possible role of smooth muscle L-type calcium channels in the autoregulatory mechanism by pharmacological intervention with the L......-type calcium channel blocker nimodipine and the vasodilator papaverine. MATERIAL AND METHODS: Pedicled flaps were raised in pigs. Flow in the pedicle was reduced by constriction of the feed artery (n=34). A transit time flow probe measured the effect on blood flow continuously. Following this, three different...

  20. A flight control through unstable flapping flight

    Science.gov (United States)

    Iima, Makoto; Yokoyama, Naoto; Hirai, Norio; Senda, Kei

    2012-11-01

    We have studied a flight control in a two-dimensional flapping flight model for insects. In this model, the model of center-of-mass can move in both horizontal and vertical directions according to the hydrodynamic force generated by flapping. Under steady flapping, the model converges to steady flight states depending on initial conditions. We demonstrate that simple changes in flapping motion, a finite-time stop of flapping, results in changes in the vortex structures, and the separation of two steady flight state by a quasi-steady flight. The model's flight finally converges to one of the final states by way of the quasi-steady state, which is not observed as a (stable) steady flight. The flight dynamic has been also analyzed. KAKENHI (23540433, 22360105, 21340019) and CREST No. PJ74100011.

  1. Fasciocutaneous flap for vaginal and perineal reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Wang, T.N.; Whetzel, T.; Mathes, S.J.; Vasconez, L.O.

    1987-07-01

    A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial vessels were consistently found to enter the proximal plexus from within 5 cm of the perineum. Preservation of these vessels permitted reliable elevation of a 9 X 20 cm fasciocutaneous flap without using the gracilis muscle as a vascular carrier. Fifteen flaps in 13 patients were used for vaginal replacement and coverage of vulvectomy, groin, and ischial defects. Depending on the magnitude of the defect, simultaneous and independent elevation of the gracilis muscle provided additional vascularized coverage as needed. Our experience indicates that the medial thigh fasciocutaneous flap is a durable, less bulky, and potentially sensate alternative to the gracilis musculocutaneous flap for vaginal and perineal reconstruction.

  2. Localization of antileukoprotease in middle ear mucosa.

    Science.gov (United States)

    Carlsson, B; Ohlsson, K

    1983-01-01

    The localization of antileukoprotease was studied immunohistologically in normal middle ear mucosa specimens obtained at autopsy and in chronically inflamed middle ear mucosa specimens obtained at middle ear surgery for chronic otitis media. In the sections of normal as well as in the sections of chronically inflamed middle ear mucosa, antileukoprotease localization was confined to PAS-positive goblet cells of surface epithelium and to PAS-positive goblet-like cells of submucosal glands and crypts, whereas ciliated mucosal cells and stratified squamous epithelial cells were devoid of anti-leukoprotease. In comparison with normal middle ear mucosa, an increased number of goblet cells--and thus an increased number of cells containing antileukoprotease--was present in the chronically inflamed middle ear mucosa. Since antileukoprotease is a potent inhibitor of granulocyte elastase and Cathepsin G, it was concluded that this proliferation of the respiratory epithelium during inflammatory processes in the middle ear indicates an increased activity of the biologic defence system against the action of granulocyte proteases.

  3. [One stage combined endoscopic and per-oral buccal fat pad approach for large oro-antral-fistula closure with secondary chronic maxillary sinusitis].

    Science.gov (United States)

    Horowitz, G; Koren, I; Carmel, N N; Balaban, S; Abu-Ghanem, S; Fliss, D M; Kleinman, S; Reiser, V

    2015-07-01

    There are numerous surgical approaches for oro-antral-fistula (OAF) closure. Secondary sinus disease is still considered by many experts a relative contra indication for primary closure. To describe a single-stage combined endoscopic sinus surgery and per-oral buccal fat pad (BFP) flap approach for large OAF causing chronic maxillary sinusitis. The records of all the patients with OAF and chronic manifestations of secondary rhinosinusitis that were treated between 2010 and 2013 in our tertiary care medical center were reviewed. The exclusion criteria were: OAF 5 mm, resolved sino-nasal disease, OAF secondary to malignancy, recurrent fistula, medical history that included radiotherapy to the maxillary bone and age One patient required revision surgery due, to an unresolved OAF. The OAF of all the other 44 patients (97.8%) was closed after the first procedure and the paranasal sinuses on the treated side were completely recovered. The mean follow-up time for the group was 7.6 ± 4.3 months (7-21 months), and no untoward sequelae or recurrence were reported. Combined, one step, endoscopic Maxillary sinus drainage together with per-oral BFP flap approach is an efficacious surgical approach for safe closure of OAFs that are complicated with secondary chronic maxillary sinusitis.

  4. Formulation and Evaluation of Rifampicin Liposomes for Buccal Drug Delivery.

    Science.gov (United States)

    Lankalapalli, Srinivas; Tenneti, V S Vinai Kumar

    2016-01-01

    Drug delivery through liposomes offers several advantages, but still challenging to the researchers for the use of liposomes as carriers in drug delivery due to their poor physical stability, unpredictable drug encapsulation and systemic availability of the loaded drug. The present investigation was planned with an objective to prepare Rifampicin loaded liposomes by using response surface methodology of statistical 32 factorial design and further to formulate them into pastilles for deliver through buccal route thereby to enhance systemic absorption. Rifampicin liposomes were prepared by using different ratios of soya lecithin and cholesterol by solvent Injection method. These liposomes were characterized by using optical microscopy, Scanning Electron Microscopy (SEM) and evaluated for particle size, entrapment efficiency (EE), in vitro and ex vivo drug release. Main effects and interaction terms of the formulation variables were evaluated quantitatively using a mathematical statistical model approach showing that both independent variables have significant (P value membrane (P value: 0.0047) and percentage drug release through porcine buccal membrane (P value: 0.0019). The statistical factorial design of liposomal formulations fulfilled all the requirements of the target set and exhibited suitable values for the selected test parameters. Pastilles were prepared for liposomes using glycerol gelatin base and were found to be soft, smooth with uniform drug content and drug release.

  5. Tobacco smoking-response genes in blood and buccal cells.

    Science.gov (United States)

    Na, Hyun-Kyung; Kim, Minju; Chang, Seong-Sil; Kim, Soo-Young; Park, Jong Y; Chung, Myeon Woo; Yang, Mihi

    2015-01-22

    Tobacco smoking is a well-known cause of various diseases, however, its toxic mechanisms for diseases are not completely understood, yet. Therefore, we performed biological monitoring to find tobacco smoking-responsive mechanisms including oxidative stress in Korean men (N=36). Whole genome microarray analyses were performed with peripheral blood from smokers and age-matched nonsmokers. We also performed qRT-PCR to confirm the microarray results and compared the gene expression of blood to those of buccal cells. To assess the effects of tobacco smoking on oxidative stress, we analyzed urinary levels of malondialdehyde (MDA), a lipid peroxidation marker, and performed PCR-based arrays on reactive oxygen species (ROS)-related genes. As results, 34 genes were differently expressed in blood between smokers and nonsmokers (ps1.5-fold change). Particularly, the genes involved in immune responsive pathways, e.g., the Fcγ-receptor mediated phagocytosis and the leukocyte transendothelial migration pathways, were differentially expressed between smokers and nonsmokers. Among the above genes, the ACTG1, involved in the maintenance of actin cytoskeleton, cell migration and cancer metastasis, was highly expressed by smoking in both blood and buccal cells. Concerning oxidative stress, smokers showed high levels of urinary MDA and down-regulation of expressions of antioxidant related genes including TPO, MPO, GPX2, PTGR1, and NUDT1 as compared to nonsmokers (pssmoking-responsive biomarker. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Nuclear anomalies in the buccal cells of calcite factory workers.

    Science.gov (United States)

    Diler, Songül Budak; Ergene, Serap

    2010-04-01

    The micronucleus (MN) assay on exfoliated buccal cells is a useful and minimally invasive method for monitoring genetic damage in humans. To determine the genotoxic effects of calcite dust that forms during processing, MN assay was carried out in exfoliated buccal cells of 50 (25 smokers and 25 non-smokers) calcite factory workers and 50 (25 smokers and 25 non-smokers) age- and sex-matched control subjects. Frequencies of nuclear abnormalities (NA) other than micronuclei, such as binucleates, karyorrhexis, karyolysis and 'broken eggs', were also evaluated. Micronuclei and the other aforementioned anomalies were analysed by two way analysis of covariance. The linear correlations between the types of micronucleus and nuclear abnormalities were determined by Spearman's Rho. There was a positive correlation between micronuclei and other types of nuclear abnormalities in accordance with the Spearman's Rho test. Results showed statistically significant difference between calcite fabric workers and control groups. MN and NA frequencies in calcite fabric workers were significantly higher than those in control groups (p < 0.05). The results of this study indicate that calcite fabric workers are under risk of significant cytogenetic damage.

  7. Nuclear anomalies in the buccal cells of calcite factory workers

    Directory of Open Access Journals (Sweden)

    Songül Budak Diler

    2010-01-01

    Full Text Available The micronucleus (MN assay on exfoliated buccal cells is a useful and minimally invasive method for monitoring genetic damage in humans. To determine the genotoxic effects of calcite dust that forms during processing, MN assay was carried out in exfoliated buccal cells of 50 (25 smokers and 25 non-smokers calcite factory workers and 50 (25 smokers and 25 non-smokers age- and sex-matched control subjects. Frequencies of nuclear abnormalities (NA other than micronuclei, such as binucleates, karyorrhexis, karyolysis and 'broken eggs', were also evaluated. Micronuclei and the other aforementioned anomalies were analysed by two way analysis of covariance. The linear correlations between the types of micronucleus and nuclear abnormalities were determined by Spearman's Rho. There was a positive correlation between micronuclei and other types of nuclear abnormalities in accordance with the Spearman's Rho test. Results showed statistically significant difference between calcite fabric workers and control groups. MN and NA frequencies in calcite fabric workers were significantly higher than those in control groups (p < 0.05. The results of this study indicate that calcite fabric workers are under risk of significant cytogenetic damage.

  8. A cytomorphometric analysis of the oral mucosa in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    RS Lamichhane

    2015-09-01

    Full Text Available Background:  Although many of the pathological conditions of oral mucosa are clinically distinguishable, most lesions require a definitive diagnosis. This article tried the use of exfoliative cytology as an alternative tool in the screening, diagnosis and follow-up of diabetes mellitus.Materials and Methods: After rinsing the mouth with normal saline, slides were prepared from buccal mucosa and dorsum of tongue and fixed in 95% ethyl alcohol. The slides were stained with Papanicolaou stain and Acridine orange. Fifty clearly defined cells in each slide were visualized under light microscope for cytomorphometric analysis of cells using Image J software and under fluorescence microscope for assessment of nuclear alterations like micronuclei, nuclear budding, binucleation, multinucleation and karyorrhexis.Results: Statistically significant increase in Nuclear area BM (p = 0.000057, Nuclear Area Tongue (p= 0.0000113, total Nuclear Area (p= 000079, Cellular Area BM (p= 0.0475, Cellular Area Tongue (p= 0.0105, Total Cellular Area (p= 0.00496, Cytoplasmic Area Tongue (p= 0.00358, Total Cytoplasmic Area (p= 0.00268 were obtained from epithelial cells in the diabetic group when compared with the control group. Also the epithelial cells from the diabetic group showed features such as nuclear budding, micronuclei, binucleation, karyorrhexis and perinuclear halo. Conclusion:  The objective demonstration of cytomorphometric and nuclear alterations by the oral exfoliated cells indicate the presence of cytological changes in the oral mucosa of diabetic patients despite the apparently normal clinical appearance. Hence, cytomorphometric analysis would aid the health professional as an additional non-invasive tool for the screening and monitoring of Diabetes Mellitus.

  9. Innate tissue fluorescence of the oral mucosa of controls and head-and-neck cancer patients

    Science.gov (United States)

    Savage, Howard E.; Kolli, Venkateswara; Ansley, John; Chandawarkar, Rajiv Y.; Alfano, Robert R.; Schantz, Stimson P.

    1995-04-01

    Base line spectral excitation and emission scans were defined for the oral mucosa in a population of 61 controls, 16 oral tongue cancer patients and 2 patients with tongue leukoplakia. A xenon-based fluorescence spectrophotometer (Mediscience Corp.) with a fiberoptic probe (Mediscience Corp.) was used to collect excitation and emission spectra. Two excitation scans ((lambda) Ex 200-360 nm, (lambda) Em 380 nm; (lambda) Ex 240-430 nm, (lambda) Em 450 nm) and two emission scans ((lambda) Ex 300 nm, (lambda) Em 320-580 nm; (lambda) Ex 340 nm, (lambda) Em 360-660 nm) were used to analyze the buccal mucosa (BM), hard palate (HP), floor of mouth (FOM) and dorsal tongue (DT) of 61 control individuals. In 41 controls the lateral tongue site (LT) was added. The same set of scans was performed on tumor lesions and contralateral normal tissues of 16 patients with lateral tongue tumors and on two individuals with leukoplakia of the tongue. Ratios of points on the individual scans were used to quantitate data. The excitation scan ((lambda) Ex 200-360 nm, (lambda) Em 380 nm) and the emission scan ((lambda) Ex 300 nm, (lambda) Em 320-580 nm) were able to statistically discriminate the HP and DT from the BM and FOM. The ratios of intensities of neoplastic mucosa and contralateral sites were significantly different with the excitation scans ((lambda) Ex 200-360 nm, (lambda) Em 380 nm, p < 0.001) and ((lambda) Ex 240-430 nm, (lambda) Em 450 nm, p < 0.01) and with the emission scan ((lambda) Ex 300 nm, (lambda) Em 320-580 nm, p < 0.001). Discrimination was significant with the emission scan ((lambda) Ex 340 nm, (lambda) Em 360- 660 nm, p < 0.07). Innate tissue fluorescence has potential as a monitor of cancer patients and populations at risk for head and neck cancer.

  10. Characterization of Multi-layered Tissue Engineered Human Alveolar Bone and Gingival Mucosa.

    Science.gov (United States)

    Almela, Thafar; Al-Sahaf, Sarmad; Bolt, Robert; Brook, Ian; Moharamzadeh, K

    2017-11-01

    Advances in tissue engineering have permitted assembly of multi-layered composite tissue constructs for potential applications in the treatment of combined hard and soft tissue defects and as an alternative in vitro test model to animal experimental systems. The aim of this study was to develop and characterize a novel three-dimensional combined human alveolar bone and gingival mucosal model based on primary cells isolated from the oral tissues. Bone component of the model was engineered by seeding primary human alveolar osteoblasts (HAOBs) into a hydroxyapatite/tricalcium phosphate (HA/TCP) scaffold and culturing in a spinner bioreactor. The engineered bone was then laminated, using an adhesive tissue sealant, with tissue engineered gingival mucosa consisting of air/liquid interface-cultured normal human gingival keratinocytes on oral fibroblast-populated collagen gel scaffold. Histological characterization revealed a structure consisting of established epithelial, connective tissue, and bone layers closely comparable to normal oral tissue architecture. The mucosal component demonstrated a mature epithelium undergoing terminal differentiation similar to that characteristic of native buccal mucosa, as confirmed using cytokeratin 13 (CK13) and cytokeratin 14 (CK14) immunohistochemistry. Ultrastructural analysis confirmed the presence of desmosomes and hemi-desmosomes in the epithelial layer, a continuous basement membrane and newly synthesized collagen in the connective tissue layer. Quantitative PCR (qPCR) assessment of osteogenesis-related gene expression showed a higher expression of genes encoded Collagen I (COL1) and Osteonectin (ON) compared with Osteocalcin (OC), Osteopontin (OPN), and Alkaline phosphatase (ALP). ELISA quantification of COL1, ON, and OC confirmed a pattern of secretion which paralleled the model's gene expression profile. We demonstrate here that replicating the anatomical setting between oral mucosa and the underlying alveolar bone is

  11. [Clinical applications of the anterolateral skin flap and the fascial flap in the lower leg].

    Science.gov (United States)

    Feng, D; Chen, P; Feng, D

    1999-07-01

    To introduce the applied anatomy, operative method and clinical application of the anterolateral skin flap and fascial flap of the lower leg. Anatomic dissection was performed on 14 adult cadavers' legs and one amputated lower limb. The origin, course and distribution of cutaneous branches of the superficial peroneal vessels were traced. Four types of anterolateral flaps were designed in the lower leg including the island skin flap, the island fascial flap, the rectangular flap, and the cross-leg flap. Since 1988, twenty-six cases of leg defects(21 patients), chronic osteomyelitis of the tibia(3 cases) and defects on the back of the opposite heel and ankle(2 cases) were treated with the operative methods. All the flaps survived. Primary healing occurred in 23 and secondary in 3 cases. Twenty cases were followed-up for 4 months to 5 years. The flaps were growing well, the tibia fracture healed 3 months after the treatment and the chronic osteomyelitis of tibia had no recurrence. This flap is a useful method for repairing various defects in the leg and adjacent regions. It is simple, safe and reliable in manipulation and has minimal influence to the donor site.

  12. Influence of buccal corridor dimension on smile esthetics

    Directory of Open Access Journals (Sweden)

    Diana Cunha Nascimento

    2012-10-01

    Full Text Available OBJECTIVE: To assess the influence of buccal corridor width on smile esthetics of male and female, Caucasian and Afro-descendant subjects by means of digitally manipulated photographs, as well as compare assessments of full-face view (FFV and close-up view of the mouth (CUVM images. METHODS: Facial photographs were taken of four adults' smile, two Caucasians and two Afro-descendants of both genders. The resulting images were digitally manipulated with the aim of rendering - from each original smile - three other smiles simulating three different buccal corridor widths, namely, narrow, medium width and wide. The rendered images, 12 of which portraying FFVs and 12 providing CUVMs, were assessed by 60 examiners who rated the attractiveness of each smile by means of a visual analog scale (VAS. The data were treated with ANOVA and Tukey's post test to compare the different buccal corridors, and Student's t test to compare the two image views (FFV and CUVM. RESULTS: Medium width buccal corridors were considered the most attractive in the four individuals investigated, both in the assessment of FFVs and CUVMs (p 0.05. Furthermore, no statistically significant difference was found between the analyses of FFVs and CUVMs (p > 0.05. CONCLUSION: The buccal corridor exercised a remarkable influence on smile esthetics, with the medium width group being rated as the most attractive. No influence was exerted by the individuals' face, ethnicity or gender.OBJETIVO: avaliar a influência do corredor bucal na estética de sorrisos femininos e masculinos, de leucodermas e melanodermas, por meio de fotografias manipuladas, bem como comparar essa avaliação numa vista facial completa e numa vista aproximada da boca. MÉTODOS: foram realizadas fotografias faciais do sorriso de quatro indivíduos adultos, sendo dois leucodermas e dois melanodermas, de ambos os sexos. As imagens geradas foram manipuladas a fim de produzir, a partir de cada sorriso original, três outros

  13. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

    Directory of Open Access Journals (Sweden)

    Erdmann, Alfons

    2014-04-01

    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  14. 14 CFR 23.699 - Wing flap position indicator.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Wing flap position indicator. 23.699... Construction Control Systems § 23.699 Wing flap position indicator. There must be a wing flap position indicator for— (a) Flap installations with only the retracted and fully extended position, unless— (1) A...

  15. Hydrodynamic schooling of flapping swimmers

    Science.gov (United States)

    Becker, Alexander D.; Masoud, Hassan; Newbolt, Joel W.; Shelley, Michael; Ristroph, Leif

    2015-10-01

    Fish schools and bird flocks are fascinating examples of collective behaviours in which many individuals generate and interact with complex flows. Motivated by animal groups on the move, here we explore how the locomotion of many bodies emerges from their flow-mediated interactions. Through experiments and simulations of arrays of flapping wings that propel within a collective wake, we discover distinct modes characterized by the group swimming speed and the spatial phase shift between trajectories of neighbouring wings. For identical flapping motions, slow and fast modes coexist and correspond to constructive and destructive wing-wake interactions. Simulations show that swimming in a group can enhance speed and save power, and we capture the key phenomena in a mathematical model based on memory or the storage and recollection of information in the flow field. These results also show that fluid dynamic interactions alone are sufficient to generate coherent collective locomotion, and thus might suggest new ways to characterize the role of flows in animal groups.

  16. In vitro systems toxicology approach to investigate the effects of repeated cigarette smoke exposure on human buccal and gingival organotypic epithelial tissue cultures

    Science.gov (United States)

    Schlage, Walter K.; Kostadinova, Radina; Xiang, Yang; Sewer, Alain; Majeed, Shoaib; Kuehn, Diana; Frentzel, Stefan; Talikka, Marja; Geertz, Marcel; Mathis, Carole; Ivanov, Nikolai; Hoeng, Julia; Peitsch, Manuel C.

    2014-01-01

    Smoking has been associated with diseases of the lung, pulmonary airways and oral cavity. Cytologic, genomic and transcriptomic changes in oral mucosa correlate with oral pre-neoplasia, cancer and inflammation (e.g. periodontitis). Alteration of smoking-related gene expression changes in oral epithelial cells is similar to that in bronchial and nasal epithelial cells. Using a systems toxicology approach, we have previously assessed the impact of cigarette smoke (CS) seen as perturbations of biological processes in human nasal and bronchial organotypic epithelial culture models. Here, we report our further assessment using in vitro human oral organotypic epithelium models. We exposed the buccal and gingival organotypic epithelial tissue cultures to CS at the air–liquid interface. CS exposure was associated with increased secretion of inflammatory mediators, induction of cytochrome P450s activity and overall weak toxicity in both tissues. Using microarray technology, gene-set analysis and a novel computational modeling approach leveraging causal biological network models, we identified CS impact on xenobiotic metabolism-related pathways accompanied by a more subtle alteration in inflammatory processes. Gene-set analysis further indicated that the CS-induced pathways in the in vitro buccal tissue models resembled those in the in vivo buccal biopsies of smokers from a published dataset. These findings support the translatability of systems responses from in vitro to in vivo and demonstrate the applicability of oral organotypical tissue models for an impact assessment of CS on various tissues exposed during smoking, as well as for impact assessment of reduced-risk products. PMID:25046638

  17. In vitro systems toxicology approach to investigate the effects of repeated cigarette smoke exposure on human buccal and gingival organotypic epithelial tissue cultures.

    Science.gov (United States)

    Schlage, Walter K; Iskandar, Anita R; Kostadinova, Radina; Xiang, Yang; Sewer, Alain; Majeed, Shoaib; Kuehn, Diana; Frentzel, Stefan; Talikka, Marja; Geertz, Marcel; Mathis, Carole; Ivanov, Nikolai; Hoeng, Julia; Peitsch, Manuel C

    2014-10-01

    Smoking has been associated with diseases of the lung, pulmonary airways and oral cavity. Cytologic, genomic and transcriptomic changes in oral mucosa correlate with oral pre-neoplasia, cancer and inflammation (e.g. periodontitis). Alteration of smoking-related gene expression changes in oral epithelial cells is similar to that in bronchial and nasal epithelial cells. Using a systems toxicology approach, we have previously assessed the impact of cigarette smoke (CS) seen as perturbations of biological processes in human nasal and bronchial organotypic epithelial culture models. Here, we report our further assessment using in vitro human oral organotypic epithelium models. We exposed the buccal and gingival organotypic epithelial tissue cultures to CS at the air-liquid interface. CS exposure was associated with increased secretion of inflammatory mediators, induction of cytochrome P450s activity and overall weak toxicity in both tissues. Using microarray technology, gene-set analysis and a novel computational modeling approach leveraging causal biological network models, we identified CS impact on xenobiotic metabolism-related pathways accompanied by a more subtle alteration in inflammatory processes. Gene-set analysis further indicated that the CS-induced pathways in the in vitro buccal tissue models resembled those in the in vivo buccal biopsies of smokers from a published dataset. These findings support the translatability of systems responses from in vitro to in vivo and demonstrate the applicability of oral organotypical tissue models for an impact assessment of CS on various tissues exposed during smoking, as well as for impact assessment of reduced-risk products.

  18. Preparation of nucleoprotein from intestinal mucosa

    Energy Technology Data Exchange (ETDEWEB)

    Feinstein, R.N.; Butler, C.L.

    1950-12-31

    In an attempt to extract that substance from intestinal mucosa of rats, rabbits and sheep, expected to be mucoprotein, which imparted to the tissue its mucous, viscous nature, a highly viscous fraction was obtained which appears upon analysis to be nucleoprotein in nature. A somewhat detailed description of this technique and of the resulting product will be given here, because of the simplicity of the method and because of the biochemical demonstration of an effect of whole body irradiation upon this fraction of intestinal mucosa. 14 refs., 6 tabs.

  19. Anterolateral thigh myocutaneous flaps as the preferred flaps for reconstruction of oral and maxillofacial defects.

    Science.gov (United States)

    Ren, Zhen-Hu; Wu, Han-Jiang; Wang, Kai; Zhang, Sheng; Tan, Hong Yu; Gong, Zhao Jian

    2014-12-01

    The anterolateral thigh myocutaneous flap is one of the most commonly used flaps in reconstructive procedures, but its application in oral and maxillofacial defects has not been fully determined. Herein, we summarize the application of 1212 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects and examine their benefits in maxillofacial reconstruction of these defects. Patients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Patient ages ranged from 6 to 82 years with a mean age of 51.2 years. There are 1015 flaps showing single lobe and 197 flaps showing a multi-island pedicle and one of which carries the iliac bone. The largest area among the single flaps was 28 × 12 cm(2), and the smallest was 3 × 2 cm(2). Among the 1212 transferred flaps, 1176 survived and 36 showed necrosis, a survival rate of about 97.0%. The common complications at flap donor site were poor wound healing (10.1%), localized paraesthesia (50.1%), and altered quadriceps force (11.0%). No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time (23-121 min; average 51 min) for anastomosis of one vein and one artery was significantly less than that for two veins and one artery (45-153 min, average 83 min; p = 0.0003), which indicates one vein anastomosis can significantly reduce the operating time. The anterolateral thigh myocutaneous flaps can be easily obtained and can provide a good amount of muscle for filling dead space and fascia lata. These flaps can be prepared into a separate fat flap, multi-island fascia with iliac bone, and other composite pedicle flaps to meet the

  20. Perceptions of laypersons and orthodontists regarding the buccal corridor in long- and short-face individuals.

    Science.gov (United States)

    Zange, Sabrina Elisa; Ramos, Adilson Luiz; Cuoghi, Osmar Aparecido; de Mendonça, Marcos Rogério; Suguino, Rosely

    2011-01-01

    To determine the perception of orthodontists and laypersons regarding the size of the dark spaces in the buccal corridors and how that affects smile esthetics in individuals with long and short faces. Images of eight smiling individuals were modified to create five sizes of dark spaces in the buccal corridors (2%, 10%, 15%, 22%, and 28%) and were submitted to a group of laypersons and a group of orthodontists. Laypersons were more critical in their evaluation than orthodontists. Laypersons could not distinguish the gradation of dark spaces in the buccal corridor unless it was very plain. Orthodontists perceived this gradation beginning at 15%. Female evaluators were more critical than male evaluators in both groups. The presence or absence of dark spaces in the buccal corridors has little influence over smile esthetics. While this aspect must be considered in the orthodontic diagnosis, there is no justification for expanding the buccal corridor to eliminate dark spaces unless they are very evident.

  1. Anatomic basis for an algorithmic approach for free fibula flap donor side selection in composite oro-mandibular defects

    Directory of Open Access Journals (Sweden)

    Mohit Sharma

    2015-01-01

    Full Text Available Introduction: Head and neck oncological resections may result in composite oro-mandibular defects involving the oral mucosa (lining, mandibular bone and the skin (cover. Reconstructive options for such defects have evolved over a period. Free fibula flap reconstruction is currently accepted the world over as the gold standard for oro-mandibular defect reconstruction. Existing literature provides conflicting views about the use of a particular side and orientation of the fibula flap for achieving the optimal outcome. The purpose of this study is to confirm anatomically the effect of bone, soft tissue and vessel orientation on the ease of doing reconstruction. Materials and Methods: This is a cadaveric study. A mandibular model with a defect was used. This was pre plated to maintain continuity. Composite fibula flaps of the same dimension were harvested from both legs of a fresh cadaver. The harvested flaps were used to reconstruct the mandibular defect in different orientations and the best configuration for each reconstructive requirement was assessed. Results: Keeping the peroneal surface for plating, that is, facing outwards, four different configurations of the fibula flap are possible for a given mandibular defect. With a posterior vascular pedicle ipsilateral fibula is suitable for skin cover and contralateral for mucosal lining and the reverse for an anteriorly placed pedicle. Conclusion: The algorithm based selection of appropriate sided fibula flap facilitates complex mandibular reconstruction by placing the right kind of tissue at the right place and helps in reducing the donor site morbidity by allowing the surgeon to harvest only the required amount of skin.

  2. The plane problem of the flapping wing

    Science.gov (United States)

    Birnbaum, Walter

    1954-01-01

    In connection with an earlier report on the lifting vortex sheet which forms the basis of the following investigations this will show how the methods developed there are also suitable for dealing with the air forces for a wing with a circulation variable with time. The theory of a propulsive wing flapping up and down periodically in the manner of a bird's wing is developed. This study shows how the lift and its moment result as a function of the flapping motion, what thrust is attainable, and how high is the degree of efficiency of this flapping propulsion unit if the air friction is disregarded.

  3. New drag laws for flapping flight

    Science.gov (United States)

    Agre, Natalie; Zhang, Jun; Ristroph, Leif

    2014-11-01

    Classical aerodynamic theory predicts that a steadily-moving wing experiences fluid forces proportional to the square of its speed. For bird and insect flight, however, there is currently no model for how drag is affected by flapping motions of the wings. By considering simple wings driven to oscillate while progressing through the air, we discover that flapping significantly changes the magnitude of drag and fundamentally alters its scaling with speed. These measurements motivate a new aerodynamic force law that could help to understand the free-flight dynamics, control, and stability of insects and flapping-wing robots.

  4. Dendritic cells of the oral mucosa

    National Research Council Canada - National Science Library

    Hovav, A-H

    2014-01-01

    .... In this review, an overview of the phenotype and distribution of DCs in the oral mucosa is provided. In addition, the role of the various oral DC subsets in inducing immunity vs. tolerance, as well as their involvement in several oral pathologies is discussed.

  5. Proteome Analysis of Rheumatoid Arthritis Gut Mucosa

    DEFF Research Database (Denmark)

    Bennike, Tue Bjerg; Ellingsen, Torkell; Glerup, Henning

    2017-01-01

    Rheumatoid arthritis (RA) is an inflammatory joint disease leading to cartilage damage and ultimately impaired joint function. To gain new insight into the systemic immune manifestations of RA, we characterized the colon mucosa proteome from 11 RA-patients and 10 healthy controls. The biopsies were...

  6. Mucocele of the lower lip mucosa

    Directory of Open Access Journals (Sweden)

    Tais Frenzel da Rosa

    2008-01-01

    Full Text Available Mucocele, also known as mucous extravasation phenomenon, is a pseudocyst of traumatic etiology, in which a minor salivary gland ductruptures. Clinically it can be observed as a tumefaction or bubble; it is flaccid on palpation, asymptomatic, with a smooth surface andvariable size, and with coloring equal to that of the adjacent mucosa, or bluish, depending on its depth in the tissue. The patient generally reports a bubble that has burst and fills up again, releasing a salty tasting liquid. There is greater incidence in women (25.4%, between the ages of 8 and 14 years, the commonest site being the mucosa of the lower lip. In the present study, the authors will present a clinical case of mucocele seen at the School of Dentistry at the Federal University of Pelotas, in the State of Rio Grande do Sul, Brazil, in a patient, a 23-year-old leukoderma man, who presented a lesion situated in the mucosa of the lower lip on the right side, close to the bottom of the fold, measuring approximately 0.6 cm, with coloring similar to the adjacent normal mucosa. The treatment performed was surgical excision of the mucocele and the accessory glands involved in the region of the lesion. The histopathologic report confirmed the clinical diagnosis of mucocele.

  7. Comparison of buccal infiltration of 4% articaine with 1 : 100,000 and 1 : 200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study.

    Science.gov (United States)

    Lima, José Lacet; Dias-Ribeiro, Eduardo; Ferreira-Rocha, Julierme; Soares, Ramon; Costa, Fábio Wildson Gurgel; Fan, Song; Sant'ana, Eduardo

    2013-01-01

    We compared the buccal infiltration of 4% articaine with 1 : 100,000 or 1 : 200,000 epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with pericoronitis. Group 1 (15 patients) received 4% articaine with 1 : 100,000 epinephrine and group 2 (15 patients) received 4% articaine with 1 : 200,000 epinephrine by buccal infiltration. None of the patients in group 1 reported pain, but 3 patients in group 2 reported pain, which indicated a need for a supplementary palatal injection. The palatal injections were all successful in eliminating the pain. Two additional patients in group 2 experienced pain when the suture needle penetrated their palatal mucosa. Based on these results, 4% articaine with 1 : 100,000 epinephrine was found to be more effective for the removal of upper third molars in the presence of pericoronitis than 4% articaine hydrochloride with 1 : 200,000 epinephrine when only a buccal infiltration was used.

  8. A novel dosage form for buccal administration of bupropion

    Directory of Open Access Journals (Sweden)

    Nilsa Maria Galvão Almeida

    2015-03-01

    Full Text Available Bupropion is an antidepressant used in the treatment of smoking. The purpose of this study was to prepare controlled-release hydrogel films for buccal administration of bupropion and investigate its physicochemical and cytotoxic properties. The films were prepared from ultrapure sodium carboxymethylcellulose, hydroxypropylmethylcellulose K4M, and medium-viscosity chitosan. Evaluation of film physicochemical characteristics was based on scanning electron microscopy, bupropion content, mechanical strength (burst strength, relaxation, resilience, and traction, and cytotoxicity. Bupropion content in bilayer films was 121 mg per 9 cm2. The presence of bupropion modified film mechanical strength, but did not compromise the use of this pharmaceutical form. As shown by the cytotoxicity results, films containing bupropion did not cause cellular damage. Bupropion administration in the form of hydrogel films is a potentially useful alternative in the treatment of smoking.

  9. Use of Pedicled Buccal Fat Pad for Cranial Base Reconstruction.

    Science.gov (United States)

    Gadre, Pushkar; Ghadge, Murarji Tanaji; Singh, Divya; Gadre, Kiran

    2017-03-01

    Craniofacial reconstruction for closure of skull base defects after removal of anterior cranial base lesions is challenging. Persistent skull base defect produces extremely high risk of cerebrospinal fluid leaks and consecutive infectious complications. The authors' article focuses on the use of pedicled buccal fat pad for the reconstruction of anterior cranial base defects using combined endoscope-assisted approach and Lefort I access osteotomy. High effectiveness and minimal invasiveness are principal advantages of the technique. Other benefits include proximity of donor site to defect, simplicity of surgical technique, minimal postoperative discomfort, and very low risk of benign complications. Local pedicled grafts are the preferred material for plasty, adding aesthetic results in an ablative surgery using intraoral incision and access osteotomy. Thus, the technique solves the problem of relying on complex alloplastic reconstruction of anterior craniobasal defects.

  10. Autofluorescence characteristics of healthy oral mucosa at different anatomical sites

    NARCIS (Netherlands)

    de Veld, DCG; Skurichina, M; Witjes, MJH; Duin, RPW; Sterenborg, DJCM; Roodenburg, JLN

    2003-01-01

    Background and Objectives: Autofluorescence spectroscopy is a promising tool for oral cancer detection. Its reliability might be improved by using a reference database of spectra from healthy mucosa. We investigated the influence of anatomical location on healthy mucosa autofluorescence. Study

  11. Optical detection of (pre-)malignant lesions of the oral mucosa: autofluorescence characteristics of healthy mucosa

    Science.gov (United States)

    de Veld, Diana C. G.; Witjes, Max; Roodenburg, Jan L.; Star, Willem M.; Sterenborg, Hericus J. C. M.

    2001-10-01

    Previous clinical results demonstrate the potential of in vivo autofluorescence spectroscopy for early detection of (pre-)malignant lesions of the oral mucosa. For reliable diagnosis, it is necessary to study autofluorescence spectra of healthy mucosa first. We measured excitation-emission maps in healthy subjects and subjects with a history of cancer in the head -neck region. Our results show that different anatomical locations produce distinct autofluorescence spectra. Influences of, among others, smoking and drinking habits require further investigation.

  12. Postirradiation flap infection about the oral cavity

    Energy Technology Data Exchange (ETDEWEB)

    Cabbabe, E.B.; Herbold, D.R.; Sunwoo, Y.C.; Baroudi, I.F.

    1983-06-01

    Postirradiation alteration of oral flora is well documented in the literature. Infection as a complication leading to partial or complete loss of a flap used to reconstruct a defect in the oral cavity is a worrisome outcome. We describe how a flap that was judged clinically to be viable became overwhelmingly infected with the Klebsiella oxytoca, an oral cavity pathogen encountered in this patient following irradiation. Local and systemic changes led to detachment of the flap. This complication may be explained, in view of the absence of venous congestion or arterial ischemia both clinically and pathologically, by the proven contamination of the flap by the Klebsiella pathogen. Local factors resulted in lower resistance and subsequent overwhelming infection. Discussion of the case, review of pertinent literature, and proposed solutions are presented.

  13. Periodic and Chaotic Flapping of Insectile Wings

    CERN Document Server

    Huang, Yangyang

    2015-01-01

    Insects use flight muscles attached at the base of the wings to produce impressive wing flapping frequencies. The maximum power output of these flight muscles is insufficient to maintain such wing oscillations unless there is good elastic storage of energy in the insect flight system. Here, we explore the intrinsic self-oscillatory behavior of an insectile wing model, consisting of two rigid wings connected at their base by an elastic torsional spring. We study the wings behavior as a function of the total energy and spring stiffness. Three types of behavior are identified: end-over-end rotation, chaotic motion, and periodic flapping. Interestingly, the region of periodic flapping decreases as energy increases but is favored as stiffness increases. These findings are consistent with the fact that insect wings and flight muscles are stiff. They further imply that, by adjusting their muscle stiffness to the desired energy level, insects can maintain periodic flapping mechanically for a range of operating condit...

  14. Flapping flight aerodynamics for flying animals

    OpenAIRE

    Norizham, Abdul Razak; Dimitriadis, Grigorios

    2011-01-01

    Most research into the aerodynamics of flying animals is based on aircraft aerodynamics. Aircraft have rigid wings, therefore such research is mostly suited to the study of the gliding flight of animals. However, many species spend more time flapping than gliding. Some species don’t glide at all. This seminar presents recent work on flapping flight carried out at the University of Liège.

  15. Aerodynamic effects of flexibility in flapping wings.

    Science.gov (United States)

    Zhao, Liang; Huang, Qingfeng; Deng, Xinyan; Sane, Sanjay P

    2010-03-06

    Recent work on the aerodynamics of flapping flight reveals fundamental differences in the mechanisms of aerodynamic force generation between fixed and flapping wings. When fixed wings translate at high angles of attack, they periodically generate and shed leading and trailing edge vortices as reflected in their fluctuating aerodynamic force traces and associated flow visualization. In contrast, wings flapping at high angles of attack generate stable leading edge vorticity, which persists throughout the duration of the stroke and enhances mean aerodynamic forces. Here, we show that aerodynamic forces can be controlled by altering the trailing edge flexibility of a flapping wing. We used a dynamically scaled mechanical model of flapping flight (Re approximately 2000) to measure the aerodynamic forces on flapping wings of variable flexural stiffness (EI). For low to medium angles of attack, as flexibility of the wing increases, its ability to generate aerodynamic forces decreases monotonically but its lift-to-drag ratios remain approximately constant. The instantaneous force traces reveal no major differences in the underlying modes of force generation for flexible and rigid wings, but the magnitude of force, the angle of net force vector and centre of pressure all vary systematically with wing flexibility. Even a rudimentary framework of wing veins is sufficient to restore the ability of flexible wings to generate forces at near-rigid values. Thus, the magnitude of force generation can be controlled by modulating the trailing edge flexibility and thereby controlling the magnitude of the leading edge vorticity. To characterize this, we have generated a detailed database of aerodynamic forces as a function of several variables including material properties, kinematics, aerodynamic forces and centre of pressure, which can also be used to help validate computational models of aeroelastic flapping wings. These experiments will also be useful for wing design for small

  16. Aerodynamic effects of flexibility in flapping wings

    Science.gov (United States)

    Zhao, Liang; Huang, Qingfeng; Deng, Xinyan; Sane, Sanjay P.

    2010-01-01

    Recent work on the aerodynamics of flapping flight reveals fundamental differences in the mechanisms of aerodynamic force generation between fixed and flapping wings. When fixed wings translate at high angles of attack, they periodically generate and shed leading and trailing edge vortices as reflected in their fluctuating aerodynamic force traces and associated flow visualization. In contrast, wings flapping at high angles of attack generate stable leading edge vorticity, which persists throughout the duration of the stroke and enhances mean aerodynamic forces. Here, we show that aerodynamic forces can be controlled by altering the trailing edge flexibility of a flapping wing. We used a dynamically scaled mechanical model of flapping flight (Re ≈ 2000) to measure the aerodynamic forces on flapping wings of variable flexural stiffness (EI). For low to medium angles of attack, as flexibility of the wing increases, its ability to generate aerodynamic forces decreases monotonically but its lift-to-drag ratios remain approximately constant. The instantaneous force traces reveal no major differences in the underlying modes of force generation for flexible and rigid wings, but the magnitude of force, the angle of net force vector and centre of pressure all vary systematically with wing flexibility. Even a rudimentary framework of wing veins is sufficient to restore the ability of flexible wings to generate forces at near-rigid values. Thus, the magnitude of force generation can be controlled by modulating the trailing edge flexibility and thereby controlling the magnitude of the leading edge vorticity. To characterize this, we have generated a detailed database of aerodynamic forces as a function of several variables including material properties, kinematics, aerodynamic forces and centre of pressure, which can also be used to help validate computational models of aeroelastic flapping wings. These experiments will also be useful for wing design for small robotic

  17. Usefulness of the Paramedian Forehead Flap in Nasal Reconstructive Surgery: A Retrospective Series of 41 Patients.

    Science.gov (United States)

    Blázquez-Sánchez, N; Fernández-Canedo, I; Repiso-Jiménez, J B; Rivas-Ruiz, F; De Troya Martín, M

    2016-03-01

    Surgical reconstruction of the external nose, a common site for nonmelanoma skin cancer, is difficult. Oncologic surgery often leaves large skin defects, occasionally involving the underlying cartilage and nasal mucosa. We describe our experience with the paramedian forehead flap for reconstruction of nasal defects. We performed a retrospective study of consecutive patients in whom a paramedian forehead flap was used to repair surgical defects of the nose between July 2004 and March 2011. We describe the clinical and epidemiologic characteristics, the surgical technique, complications, secondary procedures, and cosmetic results. The series comprised 41 patients with a mean (SD) age of 67 (10.36) years. The majority were men (male to female ratio, 2.4:1). Associated risk factors included diabetes in 27% of patients, cardiovascular risk factors in 49%, and smoking or drinking in 19.5%. The tissue defects were distal in 80% of cases and nonpenetrating in 78%. The mean (SD) diameter was 21.6 (6.78) mm. Early postoperative complications occurred in 14.6% of patients and late complications in 31.7% (trap door effect in 22% and hair transposition in 19%), with a need for Readjustment in a second operation was needed in 19.5% of patients. The cosmetic results were considered acceptable or excellent in 90.2% of cases. The paramedian forehead flap is versatile and provides skin of a similar color and texture to that of the external nose. It has a reliable vascular pedicle that guarantees the viability not only of the flap but also of other tissues that may be used in combination, such as chondromucosal or chondrocutaneous grafts. Revision of the technique in a second operation may sometimes be required to achieve an optimal result. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  18. Mastoid fascia kite flap for cryptotia correction.

    Science.gov (United States)

    Simon, François; Celerier, Charlotte; Garabedian, Erea-Noël; Denoyelle, Françoise

    2016-11-01

    Cryptotia is one of the most common malformations of the upper auricle with aesthetic and functional consequences, however there is no standard treatment. We present the surgical technique and results of a kite flap procedure which can be used in the different cryptotia subtypes. We reviewed all patients treated in our department from 2010 to 2015, using a mastoid fascia kite flap technique. The incision of this local flap follows the retro-auricular sulcus along the rim of the helix superiorly and drawing a skin paddle inferiorly. The mastoid fascia is exposed and a superiorly and posteriorly based flap is drawn and detached from the skull. Finally, the skin paddle is rotated and sutured between the superior helix and temporal skin creating the superior sulcus. The retro-auricular incision is closed directly inferiorly. Six patients (mean age 12) and seven ears were studied. One patient had bilateral cryptotia and only two had a normal contralateral ear. Mean follow-up was of 45 months. There was no skin necrosis, no complications reported and no revision surgery. We describe a reliable flap with a simple design and improved aesthetic result, as the thickness of the flap projects the helix well, the scar is entirely hidden in the retro-auricular sulcus and the direct suture induces a harmonious medialization of the inferior part of the ear and earlobe. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Single-dose and steady-state pharmacokinetics of fentanyl buccal tablet in healthy volunteers.

    Science.gov (United States)

    Darwish, Mona; Kirby, Mary; Robertson, Philmore; Hellriegel, Edward; Jiang, John G

    2007-01-01

    This study evaluated the single-dose and steady-state pharmacokinetics of fentanyl buccal tablet 400 microg in healthy adult volunteers. After receiving naltrexone 50 mg to block opioid receptor-mediated effects of fentanyl, subjects received fentanyl buccal tablet 400 microg on day 1, then every 6 hours from day 4 to day 9 (21 doses). Naltrexone 50 mg was administered every 12 hours throughout the study. Plasma fentanyl concentrations were determined for 72 hours after administration of fentanyl buccal tablet 400 microg on day 1 and the last dose of fentanyl buccal tablet 400 microg on day 9. Following single- and multiple-dose administration of fentanyl buccal tablet, the median time to maximum concentration (tmax) was 52.2 and 49.8 minutes, respectively. Peak plasma concentration of fentanyl (Cmax) was 0.88 ng/mL for the single-dose regimen and 1.77 ng/mL for the multiple-dose regimen. Steady state was reached within 5 days, consistent with the observed median half-life of approximately 22 hours following multiple doses. Observed accumulation of fentanyl after multiple doses of fentanyl buccal tablet was slightly greater than would be expected based on the single-dose data. This was attributed to the redistribution of fentanyl from a deep tissue compartment into the plasma. This study indicates that fentanyl buccal tablet has predictable pharmacokinetics following multiple-dose administration.

  20. Multi-layered nanofibrous mucoadhesive films for buccal and sublingual administration of drug-delivery and vaccination nanoparticles - important step towards effective mucosal vaccines.

    Science.gov (United States)

    Mašek, Josef; Lubasová, Daniela; Lukáč, Róbert; Turánek-Knotigová, Pavlína; Kulich, Pavel; Plocková, Jana; Mašková, Eliška; Procházka, Lubomír; Koudelka, Štěpán; Sasithorn, Nongnut; Gombos, Jozsef; Bartheldyová, Eliška; Hubatka, František; Raška, Milan; Miller, Andrew D; Turánek, Jaroslav

    2017-03-10

    Nanofibre-based mucoadhesive films were invented for oromucosal administration of nanocarriers used for delivery of drugs and vaccines. The mucoadhesive film consists of an electrospun nanofibrous reservoir layer, a mucoadhesive film layer and a protective backing layer. The mucoadhesive layer is responsible for tight adhesion of the whole system to the oral mucosa after application. The electrospun nanofibrous reservoir layer is intended to act as a reservoir for polymeric and lipid-based nanoparticles, liposomes, virosomes, virus-like particles, dendrimers and the like, plus macromolecular drugs, antigens and/or allergens. The extremely large surface area of nanofibrous reservoir layers allows high levels of nanoparticle loading. Nanoparticles can either be reversibly adsorbed to the surface of nanofibres or they can be deposited in the pores between the nanofibres. After mucosal application, nanofibrous reservoir layers are intended to promote prolonged release of nanoparticles into the submucosal tissue. Reversible adsorption of model nanoparticles as well as sufficient mucoadhesive properties were demonstrated. This novel system appears appropriate for the use in oral mucosa, especially for sublingual and buccal tissues. To prove this concept, trans-/intramucosal and lymph-node delivery of PLGA-PEG nanoparticles was demonstrated in a porcine model. This system can mainly be used for sublingual immunization and the development of "printed vaccine technology". Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Characterization of Cancer Stem Cells in Moderately Differentiated Buccal Mucosal Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Helen H Yu

    2016-08-01

    Full Text Available Aim To identify and characterize cancer stem cells (CSC in moderately differentiated buccal mucosa squamous cell carcinoma (MDBMSCC. Methods 4μm-thick formalin-fixed paraffin-embedded MDBMSCC samples from six patients underwent 3,3-diaminobenzidine (DAB immunohistochemical (IHC staining for the embryonic stem cell (ESC markers NANOG, OCT4, SALL4, SOX2 and pSTAT3; cancer stem cell marker CD44; squamous cell carcinoma (SCC marker EMA; and endothelial marker CD34. The transcriptional activities of the genes encoding NANOG, OCT4, SOX2, SALL4, STAT3 and CD44 were studied using NanoString gene expression analysis and colorimetric in situ hybridization (CISH for NANOG, OCT4, SOX2, SALL4 and STAT3. Results DAB and immunofluorescent (IF IHC staining demonstrated the presence of (1 an EMA+/CD44+/SOX2+/SALL4+/OCT4+/pSTAT3+/NANOG+ CSC subpopulation within the tumor nests; (2 an EMA-/CD44-/CD34-/SOX2+/OCT4+/pSTAT3+/NANOG+ subpopulation within the stroma between the tumor nests; and (3 an EMA-/CD44-/CD34+/SOX2+/ SALL4+/OCT4+/pSTAT3+/NANOG+ subpopulation on the endothelium of the microvessels within the stroma. The expression of CD44, SOX2, SALL4, OCT4, pSTAT3 and NANOG was confirmed by the presence of mRNA transcripts, using NanoString analysis and NANOG, OCT4, SOX2, SALL4 and STAT3 by CISH staining. Conclusion This study demonstrated a novel finding of three separate CSC subpopulations within MDBMSCC: (1 within the tumor nests expressing EMA, CD44, SOX2, SALL4, OCT4, pSTAT3 and NANOG; (2 within the stroma expressing SOX2, SALL4, OCT4, pSTAT3 and NANOG; and (3 on the endothelium of the microvessels within the stroma expressing CD34, SOX2, SALL4, OCT4, pSTAT3 and NANOG.

  2. Backup perforator flap derived from a previously transferred musculocutaneous free flap.

    Science.gov (United States)

    Topalan, Murat; Guven, Erdem; Demirtas, Yener

    2010-09-01

    Reconstruction of the lower leg commonly requires a free tissue transfer after Gustillo grade IIIB-IIIC injuries and severe postoncological resections, where, free musculocutaneous flaps (MCF) are preferred for their size and robust blood supply. The anastomoses are performed at more proximal levels to keep them away from the trauma zone. This reasonable maneuver causes the distal of the flap to cover the most critical part of the defect. Any marginal necrosis, then, ends in exposure of the bone or implant. Reported here is the use of a perforator flap derived from a previously transferred free MCF as a backup tissue. Distal marginal necrosis exposing vital structures were encountered after six free MCF transfers during the last 6 years. These were highly complicated cases in which no regional flap options were available and a second free flap was unfeasible due to recipient vessel problems. A perforator flap was elevated on the perforator vessel(s) penetrating the underlying muscle of the previous MCF and either advanced or transposed to cover the defect. Donor sites on MCF were closed primarily. Wound dehiscence that healed secondarily was observed in two cases. The knee prosthesis was removed in one case due to uncontrolled osteomyelitis. No complications were detected in other three cases. The described flap can be a leg saver whenever a previously transferred free MCF fails to cover the distal site of the defect. The flap can be advanced for 3-5 cm and allows more than 90 degrees of rotation.

  3. The prepuce free flap in 10 patients : modifications in flap design and surgical technique

    NARCIS (Netherlands)

    Werker, Paul M N

    The prepuce free flap was used in 10 oral and oropharyngeal reconstructions. During the course of this study, various modifications took place. Residual penile skin necrosis and skin island necrosis early in the series led to modification of flap design. This solved the donor-site problem by placing

  4. Rescue of Primary Incomplete Microkeratome Flap with Secondary Femtosecond Laser Flap in LASIK

    Directory of Open Access Journals (Sweden)

    E. A. Razgulyaeva

    2014-01-01

    Full Text Available For laser-assisted in situ keratomileusis (LASIK retreatments with a previous unsuccessful mechanical microkeratome-assisted surgery, some surgical protocols have been described as feasible, such as relifting of the flap or the creation of a new flap and even the change to a surface ablation procedure (photorefractive keratectomy (PRK. This case shows the use of femtosecond technology for the creation of a secondary flap to perform LASIK in a cornea with a primary incomplete flap obtained with a mechanical microkeratome. As we were unable to characterize the interface of the first partial lamellar cut, a thick flap was planned and created using a femtosecond laser platform. As the primary cut was very thick in the nasal quadrant, a piece of loose corneal tissue appeared during flap lifting which was fitted in its position and not removed. Despite this condition and considering the regularity of the new femtosecond laser cut, the treatment was uneventful. This case report shows the relevance of a detailed corneal analysis with an advanced imaging technique before performing a secondary flap in a cornea with a primary incomplete flap. The femtosecond laser technology seems to be an excellent tool to manage such cases successfully.

  5. Aerodynamics power consumption for mechanical flapping wings undergoing flapping and pitching motion

    Science.gov (United States)

    Razak, N. A.; Dimitriadis, G.; Razaami, A. F.

    2017-07-01

    Lately, due to the growing interest in Micro Aerial Vehicles (MAV), interest in flapping flight has been rekindled. The reason lies in the improved performance of flapping wing flight at low Reynolds number regime. Many studies involving flapping wing flight focused on the generation of unsteady aerodynamic forces such as lift and thrust. There is one aspect of flapping wing flight that received less attention. The aspect is aerodynamic power consumption. Since most mechanical flapping wing aircraft ever designed are battery powered, power consumption is fundamental in improving flight endurance. This paper reports the results of experiments carried out on mechanical wings under going active root flapping and pitching in the wind tunnel. The objective of the work is to investigate the effect of the pitch angle oscillations and wing profile on the power consumption of flapping wings via generation of unsteady aerodynamic forces. The experiments were repeated for different airspeeds, flapping and pitching kinematics, geometric angle of attack and wing sections with symmetric and cambered airfoils. A specially designed mechanical flapper modelled on large migrating birds was used. It will be shown that, under pitch leading conditions, less power is required to overcome the unsteady aerodnamics forces. The study finds less power requirement for downstroke compared to upstroke motion. Overall results demonstrate power consumption depends directly on the unsteady lift force.

  6. Umbilicoplasty with 3 triangular skin flaps and excised diamond-shaped skin flap.

    Science.gov (United States)

    Takasu, Hidemi; Watanabe, Yoshio

    2010-10-01

    In cases of large umbilical hernias, standard surgical techniques have proven inadequate for diminishing the diameter of the umbilicus. We have modified the 3- and 4-triangular-skin-flap techniques to diminish the diameter of the umbilicus and achieve a cosmetically acceptable umbilicus. Umbilicoplasty was performed in 149 children (median age, 2.5 years; range, 3 months-10 years) between 2003 and 2008. We created 4 skin flaps 1.5 cm in length on the umbilicus and excised the cranial diamond-shaped skin flap. After closure of the fascial defect, the diameter of the umbilicus was diminished by suturing the opened cranial part of the diamond-shaped skin flap vertically. The tips of the 3 remaining flaps were then anchored to the closed fascia. Postoperatively, granulation tissue occurred in 18 cases (12%), transient erythema of a flap in 15 cases (10%), and bulging of a skin flap in 15 cases (10%). These complications were reduced by suturing adjoining skin flaps. No recurrent hernias were encountered. The postoperative umbilical appearance was satisfactory in all cases. This surgical technique is effective for diminishing the diameter of the umbilicus and creating a cosmetically acceptable shaped umbilicus, even for large umbilical hernias. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Enamel Matrix Derivative Promotes Healing of a Surgical Wound in the Rat Oral Mucosa.

    Science.gov (United States)

    Maymon-Gil, Tal; Weinberg, Evgeny; Nemcovsky, Carlos; Weinreb, Miron

    2016-05-01

    Enamel matrix proteins (EMPs) play a role in enamel formation and the development of the periodontium. Sporadic clinical observations of periodontal regeneration treatments with enamel matrix derivative (EMD), a commercial formulation of EMPs, suggest that it also promotes post-surgical healing of soft tissues. In vitro studies showed that EMD stimulates various cellular effects, which could potentially enhance wound healing. This study examines the in vivo effects of EMD on healing of an oral mucosa surgical wound in rats. A bilateral oral mucosa wound was created via a crestal incision in the anterior edentulous maxilla of Sprague-Dawley rats. Full-thickness flaps were raised, and, after suturing, EMD was injected underneath the soft tissues on one side, whereas the EMD vehicle was injected in the contralateral side. Animals were sacrificed after 5 or 9 days, and the wound area was subjected to histologic and immunohistochemical analysis of the epithelial gap, number of macrophages, blood vessels, proliferating cells, and collagen content in the connective tissue (CT). Gene expression analysis was also conducted 2 days post-surgery. EMD had no effect on the epithelial gap of the wound. On both days 5 and 9, EMD treatment increased significantly the number of blood vessels and the collagen content. EMD also enhanced (by 20% to 40%) the expression of transforming growth factors β1 and β2, vascular endothelial growth factor, interleukin-1β, matrix metalloproteinase-1, versican, and fibronectin. EMD improves oral mucosa incisional wound healing by promoting formation of blood vessels and collagen fibers in CT.

  8. Oral mucosa biology and salivary biomarkers.

    Science.gov (United States)

    Qin, Rosie; Steel, Andrea; Fazel, Nasim

    Although the surfaces of both the skin and oral mucosa are protected by squamous epithelial cells and fall within the scope of dermatologic practice, the oral cavity contains highly specialized structures and functions distinct from other skin biology and pathologic conditions and are also the purview of clinicians who care for patients with skin and mucosal diseases. We describe the distinct features of the tongue, mucosa, and salivary glands. In particular, we examine the composition and function of the saliva, with special focus on salivary biomarkers. Within the oral cavity, saliva shows great promise as a noninvasive and sensitive marker for many systemic diseases. Biomarkers are being used as diagnostic or monitoring tools for a wide variety of diseases, including systemic lupus erythematosus, Sjögren disease, Behçet disease, and autoimmune blistering disorders, as well as premalignant and malignant lesions of the mouth. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. [Application of the tension skin flap with different shapes in the pedicle of the reverse neurocutaneous island flap].

    Science.gov (United States)

    Li, Meng; Lan, Xu; Zheng, Ping; Liu, Xing-Yan; Gao, Qiu-Ming; Song, Ming-Jia

    2013-08-01

    To investigate the effects of the tension skin flap with different shapes on the transplantation of the reverse neurocutaneous island flap. From January 2006 to January 2012,there were 21 patients in the study (including 15 males and 6 females), and aged from 14 to 58 years old (35 years old on average). Tension skin flaps with different shapes (triangle ,round and ellipse) were used to improve the blood supply of the reverse neurocutaneous island flap. The tension skin flaps in the pedicle were designed triangularly (10 patients), spherically (8 patients) or elliptically (3 patients). There were 5 patients with defects in the hand (the size from 5.0 cm x 2.0 cm to 8.0 cm x 5.0 cm), and 16 patients with defects in the foot and inferior segment of leg, or around the ankle (the size from 6.0 cm x 4.0 cm to 13.0 cm x 7.0 cm). And all the patients were with the tendon and bone exposed. All the flaps were reversal transplanted, including 5 dorsal neurocutaneous flaps of foot, 4 superficial peroneal neurocutaneous flaps, 4 saphenous neurocutaneous flaps, 3 sural neurocutaneous flaps, 2 superficial radial neurocutaneous flaps, 3 lateral neurocutaneous flaps of forearm. And the survival rate, appearance and sensory recovery of the flaps were analyzed. The distant part of the reversed sural neurocutaneous island flap in 1 case necrosized and healed after dressing change. The other flaps survived entirely, and the donor site all healed primarily. The follow-up time was from 3 months to 2 years (averaged 7 months), and all the flaps had recovered pain and warm sensation with perfect appearance. The tension skin flap in the pedicle can enhance the blood supply and promote survival rate of the reverse neurocutaneous island flap, and can also improve its appearance.

  10. Intraoperative local flap transforming (iLoFT method; from hachet to reading-man flap

    Directory of Open Access Journals (Sweden)

    Motoi Kato

    2017-06-01

    Full Text Available Local flaps are widely used in soft tissue reconstruction because they result in good colour and texture match. They can be quickly placed without donor site morbidity. However, it is not always easy to preoperatively design a feasible procedure, predict the final scar line or image the tension that may occur on and around the flap, especially for inexperienced surgeons. Because the elasticity of the skin varies with anatomical location and among individuals, unpredictable intraoperative design changes are sometimes required. Therefore, a preoperative back-up plan would be helpful. We evaluated the possibilities and advantages of an intraoperative switch from a hatchet flap (HF to a reading man flap (RMF procedure. Using a previously reported computer simulation with the finite element method (FEM analysis, we developed an intraoperative local flap transformation (iLoFT model.

  11. Leishmaniasis mucosa y otras lesiones destructivas centrofaciales

    Directory of Open Access Journals (Sweden)

    G. Rodríguez

    1994-12-01

    Full Text Available Varias enfermedades producen lesiones del área centrofacial. Una de las más frecuentes en nuestro medio es la leishmaniasis destructivas mucosa. Como el INS es un centro de estudio de leishmaniasis, se atendieron pacientes o sus biopsias con afecciones del macizo centrofacial, primariamente remitidas con el diagnóstico clínico de leihsmaniasis mucosa. En un período de 7 años (1987-1993, se estudiaron 134 biopsias de estos pacientes. El diagnóstico de leishmaniasis mucosa fue definitivo en 26 casos, por demostración del amastigote con la coloración de hematoxilina eosina y el mismo diagnóstico se estableció por patrón histopatológico solamente, en 27 casos. Una técnica inmunoenzimática para demostrar los amastigotes no fue satisfactoria. La perforación banal del tabique nasal (52 biopsias es la entidad que el clínico y el patólogo confunden con mayor frecuencia con la leishmaniasis mucosa. Otras entidades demostradas fueron la paracoccidioidomicosis (3, histoplasmosis (2, rinosporidiosis (2. esporotricosis (l, tuberculosis bucal (3, lepra leprornatosa (l, escleroma nasal (2, granulomatosis de Wegener (2, linfomas angiocéntricos (4, aspiración crónica de cocaína (l, y carcinoma escamocelular palatino (1. La biopsia, luego de la historia clínica, es el pilar esencial para identificar y manejar adecuadamente estas lesiones, que pueden originar destrucción facial grave, a veces letal, si no se dispone del diagnóstico preciso y del tratamiento oportuno.

  12. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Gürel

    2012-12-01

    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  13. The potential of chitosan in enhancing peptide and protein absorption across the TR146 cell culture model-an in vitro model of the buccal epithelium

    DEFF Research Database (Denmark)

    Portero, Ana; Remuñán-López, Carmen; Nielsen, Hanne Mørck

    2002-01-01

    To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used.......To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used....

  14. Discoloration of the mucosa caused by different restorative materials - a spectrophotometric in vitro study.

    Science.gov (United States)

    Ioannidis, Alexis; Cathomen, Elena; Jung, Ronald E; Fehmer, Vincent; Hüsler, Jürg; Thoma, Daniel S

    2017-09-01

    To evaluate the discoloration of the mucosa caused by different ceramic and metal-based materials. On six pig maxillae, trap-door flaps were prepared bilaterally. Different ceramic and metal-based specimens were placed underneath the flap. To simulate increasing mucosal thicknesses (MC), connective tissue grafts (CTGs) were harvested. Spectrophotometric measurements were performed prior to flap elevation (TBL ) and for each material under the flap alone (1 mm MC) (TMC1 ), with a 1-mm CTG (2-mm MC) (TMC2 ) and with a 2-mm CTG (3-mm MC) (TMC3 ). Tested materials were as follows: Zr1 (zirconia), Zr2 (zirconia + pink ceramic), Zr3 (zirconia), Zr4 (fluorescent zirconia), Zr5 (zirconia), Zr6 (high translucent zirconia), Zr7 (low translucent zirconia) and Zr8 (low translucent zirconia), Gol (gold alloy), Ti1 (titanium alloy), Ti2 (anodized gold-shaded titanium alloy) and Ti3 (anodized pink-shaded titanium alloy). Color differences (ΔE) were calculated comparing the measurement of the native tissue (TBL ) and the measurements with varying mucosal thicknesses (TMC1-3 ). For ceramic materials, the median ΔE values for the different time-point comparison ranged as follows: 3.80 (Zr4) - 7.47 (Zr2) (pooled); 3.15 (Zr4) - 8.13 (Zr2) (TBL -TMC1 ); 3.39 (Zr4) - 7.24 (Zr2) (TBL -TMC2 ); 4.31 (Zr8) - 6.99 (Zr2) (TBL -TMC3 ). For metal-based materials, the median ΔE values were as follows: 4.20 (Gol) - 5.82 (Ti3) (pooled); 3.21 (Gol) - 13.56 (Ti1) (TBL -TCM1 ); 4.0 (Ti1) - 5.27 (Gol) (TBL -TCM2 ); 3.11 (Ti1) - 5.11 (Gol) (TBL -TCM2 ). The comparison of the materials and the time points showed in the nonparametric linear mixed model a significant interaction effect between material and time point (P ceramic materials) or gold alloy (metal-based materials) lead to the least discoloration. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Buccal vs. nasogastric tube administration of tacrolimus after pediatric liver transplantation

    NARCIS (Netherlands)

    Goorhuis, JF; Scheenstra, R; Peeters, PMJG; Albers, MJIJ

    Tacrolimus is an important drug for immunosuppression after liver transplantation. Bioavailability of enterally administered tacrolimus is poor, and further reduced by gastric residuals or by enteral nutrition. Buccal administration might be an alternative route especially in children. Tacrolimus

  16. Evaluation of resorbable membrane in treatment of human gingival isolated buccal recession

    Directory of Open Access Journals (Sweden)

    Sumit Narang

    2011-01-01

    Conclusion: Resorbable membrane is a versatile treatment modality for coverage of isolated buccal gingival recession. Although membrane exposure occurred in four patients, it did not interfere with post operative healing.

  17. Buccal absorption of ketobemidone and various ester prodrugs in the rat

    DEFF Research Database (Denmark)

    Hansen, L.B.; Jorgensen, A.; Rasmussen, S.N.

    1992-01-01

    The buccal absorption of ketobemidone, a strong narcotic analgesic, and various carboxylate and carbonate ester prodrugs was studied in rats. The compounds were administered in the form of aqueous solutions of pH 7.4. The absolute bioavailability of ketobemidone following buccal dosing was 26......% whereas the bioavailability of ketobemidone following buccal administration of the prodrugs ranged from 37 to 98%. The highest bioavailability was obtained with the ethyl carbonate ester. An apparent parabolic correlation between bioavailability and lipophilicity of the compounds was seen. All esters were...... rapidly hydrolyzed to ketobemidone after both buccal and intravenous administration. The acute toxicity of the esters after i.v. administration to mice and rats was similar to that of the parent drug. It is concluded that esterification of the phenolic hydroxyl group in ketobemidone to give a more...

  18. Long buccal nerve block injection pain in patients with irreversible pulpitis.

    Science.gov (United States)

    Drum, Melissa; Reader, Al; Beck, Mike

    2011-07-01

    The purpose of this study was to determine the pain associated with needle insertion (with or without topical anesthetic) and solution deposition for the long buccal nerve block injection in patients with irreversible pulpitis. Initial pain and any differences by age and gender were also studied. One hundred twelve emergency patients with irreversible pulpitis received long buccal nerve block injections using 2% lidocaine with 1:100,000 epinephrine. The patients recorded pain of needle insertion and solution deposition on a Heft-Parker visual analog scale (VAS). Moderate-to-severe pain occurred from 41% to 46% of the time with the long buccal nerve block. The use of topical anesthetic did not statistically decrease the pain of needle insertion. In conclusion, 41% to 46% of patients presenting with irreversible pulpitis have the potential for moderate-to-severe pain with the long buccal nerve block. Copyright © 2011 Mosby, Inc. All rights reserved.

  19. Comparison of the zygoma anchorage system with cervical headgear in buccal segment distalization

    National Research Council Canada - National Science Library

    Kaya, Burçak; Arman, Ayça; Uçkan, Sina; Yaz c, Ay e Canan

    2009-01-01

    ...) in buccal segment distalization in comparison with cervical headgear (CH). Thirty patients with Class II dental malocclusions were included in the study and were divided into two equal groups: the first group...

  20. Human buccal epithelium acquires microbial hyporesponsiveness at birth, a role for secretory leukocyte protease inhibitor

    NARCIS (Netherlands)

    Menckeberg, Celia L; Hol, Jeroen; Simons-Oosterhuis, Ytje; Raatgeep, H Rolien C; de Ruiter, Lilian F; Lindenbergh-Kortleve, Dicky J; Korteland-van Male, Anita M; El Aidy, Sahar; van Lierop, Pieter P E; Kleerebezem, Michiel; Groeneweg, Michael; Kraal, Georg; Elink-Schuurman, Beatrix E; de Jongste, Johan C; Nieuwenhuis, Edward E S; Samsom, Janneke N

    OBJECTIVE: Repetitive interaction with microbial stimuli renders epithelial cells (ECs) hyporesponsive to microbial stimulation. Previously, we have reported that buccal ECs from a subset of paediatric patients with Crohn's disease are not hyporesponsive and spontaneously released chemokines. We now

  1. Human buccal epithelium acquires microbial hyporesponsiveness at birth, a role for secretory leukocyte protease inhibitor

    NARCIS (Netherlands)

    Menckeberg, C.L.; Hol, J.; Simons-Oosterhuis, Y.; Raatgeep, H.R.; Ruiter, de L.F.; Lindenbergh-Kortleve, D.J.; Korteland-van Male, A.M.; Aidy, El S.F.; Lierop, van P.P.E.; Kleerebezem, M.; Groeneweg, M.; Kraal, G.; Elink-Schuurman, B.E.; Jongste, de J.C.; Nieuwenhuis, E.E.S.; Samsom, J.N.

    2015-01-01

    Objective Repetitive interaction with microbial stimuli renders epithelial cells (ECs) hyporesponsive to microbial stimulation. Previously, we have reported that buccal ECs from a subset of paediatric patients with Crohn's disease are not hyporesponsive and spontaneously released chemokines. We now

  2. Comparison of free anterolateral thigh flaps and free muscle-musculocutaneous flaps in soft tissue reconstruction of lower extremity.

    Science.gov (United States)

    Demirtas, Yener; Kelahmetoglu, Osman; Cifci, Mehmet; Tayfur, Volkan; Demir, Ahmet; Guneren, Ethem

    2010-01-01

    The objective of this study was to compare the free muscle-musculocutaneous flaps and free perforator skin flaps used for soft tissue reconstruction of the lower extremities. Fifty-three patients whose skin and soft tissue of the lower extremities had been reconstructed were divided into two groups: a perforator flap group, reconstructed using anterolateral thigh (ALT) free flap (23 cases), and a muscle-musculocutaneous flap group, in whom latissimus dorsi and rectus abdominus muscle-musculocutaneous free flaps were used (30 cases). Postoperative complications, long-term results, and donor site morbidities were studied in the two groups. Complete flap survival was 78.3% with four total and one partial flap loss in the ALT group and 90.0% with one total and two partial failure in the muscle-musculocutaneous flap group. Muscle-musculocutaneous flaps were the flaps of choice in Gustillo grade IIIB-C injuries and for reconstruction of more proximal localizations. ALT was preferred in relatively younger patients and was typically used for coverage of the distally localized defects. Flap complication rate was significantly higher in the ALT group, but the overall complication rate was similar between the groups. ALT perforator flap is a precious option for lower extremity soft tissue reconstruction with minimal donor site morbidity. Nevertheless, the beginners should be attentive to an increased rate of flap complications with the ALT flap and free axial muscle-musculocutaneous flaps would still be the tissue of choice for coverage of leg defects for a surgeon before gaining enough experience with perforator flap dissection.

  3. Flow field of flexible flapping wings

    Science.gov (United States)

    Sallstrom, Erik

    The agility and maneuverability of natural fliers would be desirable to incorporate into engineered micro air vehicles (MAVs). However, there is still much for engineers to learn about flapping flight in order to understand how such vehicles can be built for efficient flying. The goal of this study is to develop a methodology for capturing high quality flow field data around flexible flapping wings in a hover environment and to interpret it to gain a better understanding of how aerodynamic forces are generated. The flow field data was captured using particle image velocimetry (PIV) and required that measurements be taken around a repeatable flapping motion to obtain phase-averaged data that could be studied throughout the flapping cycle. Therefore, the study includes the development of flapping devices with a simple repeatable single degree of freedom flapping motion. The acquired flow field data has been examined qualitatively and quantitatively to investigate the mechanisms behind force production in hovering flight and to relate it to observations in previous research. Specifically, the flow fields have been investigated around a rigid wing and several carbon fiber reinforced flexible membrane wings. Throughout the whole study the wings were actuated with either a sinusoidal or a semi-linear flapping motion. The semi-linear flapping motion holds the commanded angular velocity nearly constant through half of each half-stroke while the sinusoidal motion is always either accelerating or decelerating. The flow fields were investigated by examining vorticity and vortex structures, using the Q criterion as the definition for the latter, in two and three dimensions. The measurements were combined with wing deflection measurements to demonstrate some of the key links in how the fluid-structure interactions generated aerodynamic forces. The flow fields were also used to calculate the forces generated by the flapping wings using momentum balance methods which yielded

  4. Changes in Morphology of Alveolar Buccal Walls Following Atraumatic Internal Root Fragmentation

    OpenAIRE

    Engelke, Wilfried; Beltrán, Víctor; Decco, Oscar; Valdivia-Gandur, Iván; Navarro, Pablo; Fuentes, Ramón

    2015-01-01

    The buccal alveolar wall represents the most important structure to provide shape and volume of the alveolous following tooth extraction. The aim of the study was the evaluation of buccal alveolar bone structures following minimally invasive surgery. In 15 patients (3 male, 12 female), aged 20–67 years, 3 central incisors, 5 lateral incisors, and 7 bicuspids were removed using flapless enucleation. The enucleation comprised endoscopically assisted mesiodistal root sectioning with inw...

  5. Perceptions of laypersons and orthodontists regarding the buccal corridor in long- and short-face individuals

    OpenAIRE

    Zange, Sabrina Elisa; Ramos, Adilson Luiz; Cuoghi, Osmar Aparecido [UNESP; Mendonça, Marcos Rogério de; Suguino, Rosely

    2011-01-01

    Objective: To determine the perception of orthodontists and laypersons regarding the size of the dark spaces in the buccal corridors and how that affects smile esthetics in individuals with long and short faces.Materials and Methods: Images of eight smiling individuals were modified to create five sizes of dark spaces in the buccal corridors (2%, 10%, 15%, 22%, and 28%) and were submitted to a group of laypersons and a group of orthodontists.Results: Laypersons were more critical in their eva...

  6. Genotoxicity assessment data for exfoliated buccal cells exposed to mobile phone radiation

    Directory of Open Access Journals (Sweden)

    F.M. de Oliveira

    2017-12-01

    Full Text Available Healthy mobile phone users aged 18–30 y.o. provided exfoliated buccal cells samples from the right and left inner cheeks. A total of 2000 cells per subject were screened for the presence of micronuclei as a sign of genotoxic damage, according to the mobile phone use profile of each user. Keywords: Electromagnetic fields, Mobile phones, Genotoxicity, Micronuclei, Exfoliated buccal cells, Feulgen stain

  7. Identification of Streptococcus parasanguinis DNA contamination in human buccal DNA samples

    OpenAIRE

    Mahfuz, Istiak; Cheng, Wei; White, Stefan J

    2013-01-01

    Background The use of buccal swabs in clinical and scientific studies is a very popular method of collecting DNA, due to its non-invasive nature of collection. However, contamination of the DNA sample may interfere with analysis. Findings Here we report the finding of Streptococcus parasanguinis bacterial DNA contamination in human buccal DNA samples, which led to preferential amplification of bacterial sequence with PCR primers designed against human sequence. Conclusion Contamination of buc...

  8. Intraoperative flap complications in lasik surgery performed by ophthalmology residents

    Directory of Open Access Journals (Sweden)

    Lorena Romero-Diaz-de-Leon

    2016-01-01

    Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye.

  9. The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction

    DEFF Research Database (Denmark)

    Jacobs, Jordan; Børsen-Koch, Mikkel; Gunnarsson, Gudjon Leifur

    2015-01-01

    BACKGROUND: The thoracodorsal artery perforator (TAP) flap is a versatile tool that can be used to reconstruct the breast. The authors use preoperative perforator mapping using color Doppler ultrasonography and present a safe, efficient harvesting technique to demonstrate reliable use of the TAP...... flap in reconstructive surgery. METHODS: A multicenter, retrospective review was performed on all patients undergoing TAP flap reconstruction from August 2011 to November 2014. Data were collected from patient records as well as outpatient interviews. RESULTS: A total of 106 TAP flaps were performed...... complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps. CONCLUSIONS: The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast...

  10. Breast shaping by an isolated tissue flap.

    Science.gov (United States)

    Voigt, Matthias; Andree, C

    2006-01-01

    Breast reshaping surgery for tuberous breast, breast reduction, and mastopexy procedures aim to keep the gained shape for a long time. In breast reduction, the surgeon must avoid loss of fullness in the upper pole, descent of the breast mass known as secondary dropout, and relapsed shape of the repaired tuberous breasts. As described in their clinical report, the authors use a caudally based thoracic wall flap to avoid these problems. The blood supply to the breast comes from two main sources: the mammary internal and lateral arteries. Because of vessels constantly perforating the pectoralis major muscle, it is possible to isolate a caudally based thoracic wall flap. These vessels originate from intercostal arteries as anteromedial intercostal perforators, and from the thoracoacromial artery as in the skin paddle of the pectoralis major muscle flap. This flap is long enough to reach every part of the breast where it is needed. Between January 2002 and June 2005, 64 patients underwent procedures in which the caudally based thoracic wall flap was used.

  11. The forked flap repair for hypospadias

    Directory of Open Access Journals (Sweden)

    Anil Chadha

    2012-01-01

    Full Text Available Context: Despite the abundance of techniques for the repair of Hypospadias, its problems still persist and a satisfactory design to correct the penile curvature with the formation of neourethra from the native urethral tissue or genital or extragenital tissues, with minimal postoperative complications has yet to evolve. Aim: Persisting with such an endeavor, a new technique for the repair of distal and midpenile hypospadias is described. Materials and Methods: The study has been done in 70 cases over the past 11 years. The "Forked-Flap" repair is a single stage method for the repair of such Hypospadias with chordee. It takes advantage of the rich vascular communication at the corona and capitalizes on the established reliability of the meatal based flip-flap. The repair achieves straightening of the curvature of the penis by complete excision of chordee tissue from the ventral surface of the penis beneath the urethral plate. The urethra is reconstructed using the native plate with forked flap extensions and genital tissue relying on the concept of meatal based flaps. Water proofing by dartos tissue and reinforcement by Nesbit′s prepucial tissue transfer completes the one stage procedure. Statistical Analysis: An analysis of 70 cases of this single stage technique of repair of penile hypospadias with chordee, operated at 3 to 5 years of age over the past 11 years is presented. Results and Conclusion: The Forked Flap gives comparable and replicable results; except for a urethrocutaneous fistula rate of 4% no other complications were observed.

  12. Hardware removal after osseous free flap reconstruction.

    Science.gov (United States)

    Day, Kristine E; Desmond, Renee; Magnuson, J Scott; Carroll, William R; Rosenthal, Eben L

    2014-01-01

    Identifying risk factors for hardware removal in patients undergoing mandibular reconstruction with vascularized osseous free flaps remains a challenge. The purpose of this study is to identify potential risk factors, including osteocutaneous radial forearm versus fibular flap, for need for removal and to describe the fate of implanted hardware. Case series with chart review Setting Academic tertiary care medical center. Two hundred thirteen patients undergoing 227 vascularized osseous mandibular reconstructions between the years 2004 and 2012. Data were compiled through a manual chart review, and patients incurring hardware removals were identified. Thirty-four of 213 evaluable vascularized osseous free flaps (16%) underwent surgical removal of hardware. The average length of time to removal was 16.2 months (median 10 months), with the majority of removals occurring within the first year. Osteocutaneous radial forearm free flaps (OCRFFF) incurred a slightly higher percentage of hardware removals (9.9%) compared to fibula flaps (6.1%). Partial removal was performed in 8 of 34 cases, and approximately 38% of these required additional surgery for removal. Hardware removal was associated with continued tobacco use after mandibular reconstruction (P = .03). Removal of the supporting hardware most commonly occurs from infection or exposure in the first year. In the majority of cases the bone is well healed and the problem resolves with removal.

  13. Onset of buccal pumping in catshark embryos: how breathing develops in the egg capsule.

    Directory of Open Access Journals (Sweden)

    Taketeru Tomita

    Full Text Available Respiration in fishes involves buccal pumping, which is characterized by the generation of nearly continuous water flow over the gills because of the rhythmic expansion/compression of the pharyngeal cavity. This mechanism is achieved by the functions of the vascular, skeletal, and muscular systems. However, the process by which the embryo establishes the mechanism remains a mystery. Morphological and kinematical observations on captive cloudy catsharks, Scyliorhinus torazame, have suggested that the embryo starts buccal pumping just before the respiratory slits open on the egg capsule. During the pre-opening period, the embryo acquires oxygen mainly via the external gill filaments. After slit opening, respiration of the embryo involves buccal pumping to pass water over the "internal gills." The onset of buccal pumping accompanies four morphological changes: (1 regression of the external gill filaments, (2 development of blood vessels within the "internal gills," (3 completion of the development of hyoid skeletal and muscular elements, and (4 development of the oral valve. A previous study showed that buccal pumping allows the embryo to actively regulate oxygen intake by changing the pumping frequency. Thus, establishment of buccal pumping in the egg capsule is probably important for embryo survival in the unstable oxygen environment of the egg capsule after slit opening.

  14. Factors affecting buccal corridor space in Angle′s Class II Division 1 malocclusion

    Directory of Open Access Journals (Sweden)

    Rashmi Bhat

    2014-01-01

    Full Text Available Background and Objectives: Buccal corridor space has been thought of primarily in terms of maxillary width, but there is also evidence that they are heavily influenced by the antero-posterior position of maxilla. The present study was undertaken with an aim of evaluating and comparing the dental and skeletal factors related to buccal corridor space in individuals having Class I and Class II Division 1 malocclusions. Materials and Methods: A total of 80 subjects of which 40 were males and 40 were females in the age group of 20-30 years were selected as per inclusion criteria and were grouped as Group I having Class I malocclusion and as Group II having Class II malocclusions based on angle ANB. 12 linear and 2 angular cephalometric measurements and 4 study cast measurements were used to correlate with the buccal corridor linear ratio (BCLR, calculated on smile photograph using the Adobe Photoshop 7.0 software (Adobe Systems Inc., San Jose, California, USA. The data obtained was statistically evaluated using independent t-test and multiple linear regression analysis. Result: Buccal corridor space is larger in individuals with Class II Division 1 malocclusion when compared with individuals with Class I malocclusions. There exists a significant difference in buccal corridor space between males and females. Conclusion: The present study helps in establishing the correlation between certain factors and the amount of buccal corridor space in individuals having skeletal Class II pattern.

  15. Inhibition of Streptococcus mutans adhesion to buccal epithelial cells by an aqueous extract of Thymus vulgaris.

    Science.gov (United States)

    Hammad, M; Sallal, A-K; Darmani, H

    2007-11-01

    The aim of this study was to investigate the effect of an extract of Thymus vulgaris (thyme) on the growth of Streptococcus mutans (S. mutans) and the adhesion of this bacterium to human buccal epithelial cells. Different concentrations of an aqueous extract of thyme were prepared and the effects investigated on growth of S. mutans. Furthermore, the effect of these extracts on adhesion of S. mutans to buccal epithelial cells was also investigated and compared with the effects of chlorhexidine digluconate. The data revealed that exposure of S. mutans to thyme extract showed a time and concentration-dependent decrease in bacterial viability. The greatest effect was observed when S. mutans had been exposed to 20% thyme extract for a period of 48 h which resulted in 96% inhibition of bacterial growth. Furthermore, the adhesion of S. mutans to buccal epithelial cells was also reduced when either buccal epithelial cells or S. mutans had been pre-incubated with different concentrations of aqueous thyme extracts (83-98% and 75-89% inhibition respectively). There was also greater reduction in the adherence of bacterial cells to buccal epithelial cells after mouth rinsing with 20% aqueous thyme extract compared to rinsing with chlorhexidine digluconate (45% and 89% inhibition of bacterial adhesion respectively). The diminished adherence of S. mutans to buccal epithelial cells after exposure to various concentrations of aqueous thyme extract as well as the antimicrobial properties of this plant may have clinical relevance.

  16. Immediate implant placement: the fate of the buccal crest. A retrospective cone beam computed tomography study.

    Science.gov (United States)

    Groenendijk, E; Staas, T A; Graauwmans, F E J; Bronkhorst, E; Verhamme, L; Maal, T; Meijer, G J

    2017-12-01

    This retrospective study aimed to analyse the fate of the buccal crest after immediate implant placement (IIP) through the use of cone beam computed tomography (CBCT). In 16 consecutive patients, an implant was placed in a more palatal position after extraction, thereby creating a gap of at least 2mm between the implant and the buccal crest. Subsequently, this gap was filled with a bone substitute. Preoperatively, immediate postoperatively, and late postoperatively, a CBCT was made to measure the thickness of the buccal crest. After application of the bone substitute, the buccal crest increased in thickness from 0.9mm to 2.4mm (mean). At a mean of 103 weeks after IIP, late postoperative CBCT scans showed that the thickness of the buccal crest was compacted to 1.8mm. In the same period, the height of the buccal crest increased by 1.6mm (mean) to, on average, 1.2mm above the implant shoulder. The aesthetic outcome was analysed using the White and Pink Esthetic Score (WES and PES). Both scored high: 8.4 and 11.8, respectively. Within the limitations of this study, the results of this IIP protocol are promising. Long-term prospective research on this topic on a large number of patients is necessary. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Facial reanimation utilizing combined orthodromic temporalis muscle flap and end-to-side cross-face nerve grafts.

    Science.gov (United States)

    Viterbo, Fausto; Romão, Adriana; Brock, Ryane Schmidt; Joethy, Janna

    2014-08-01

    Individuals with facial paralysis of 6 months or more without evidence of clinical or electromyographic improvement have been successfully reanimated utilizing an orthodromic temporalis transfer in conjunction with end-to-side cross-face nerve grafts. The temporalis muscle insertion is released from the coronoid process of the mandible and sutured to a fascia lata graft that is secured distally to the commissure and paralyzed hemilip. The orthodromic transfer of the temporalis muscle overcomes the concave temporal deformity and zygomatic fullness produced by the turning down of the central third of the muscle (Gillies procedure) while yielding stronger muscle contraction and a more symmetric smile. The muscle flap is combined with cross-face sural nerve grafts utilizing end-to-side neurorrhaphies to import myelinated motor fibers to the paralyzed muscles of facial expression in the midface and perioral region. Cross-face nerve grafting provides the potential for true spontaneous facial motion. We feel that the synergy created by the combination of techniques can perhaps produce a more symmetrical and synchronized smile than either procedure in isolation. Nineteen patients underwent an orthodromic temporalis muscle flap in conjunction with cross-face (buccal-buccal with end-to-side neurorrhaphy) nerve grafts. To evaluate the symmetry of the smile, we measured the length of the two hemilips (normal and affected) using the CorelDRAW X3 software. Measurements were obtained in the pre- and postoperative period and compared for symmetry. There was significant improvement in smile symmetry in 89.5 % of patients. Orthodromic temporalis muscle transfer in conjunction with cross face nerve grafts creates a synergistic effect frequently producing an aesthetic, symmetric smile. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online

  18. Perforator plus flaps: Optimizing results while preserving function and esthesis

    Directory of Open Access Journals (Sweden)

    Mehrotra Sandeep

    2010-01-01

    Full Text Available Background: The tenuous blood supply of traditional flaps for wound cover combined with collateral damage by sacrifice of functional muscle, truncal vessels, or nerves has been the bane of reconstructive procedures. The concept of perforator plus flaps employs dual vascular supply to flaps. By safeguarding perforators along with supply from its base, robust flaps can be raised in diverse situations. This is achieved while limiting collateral damage and preserving nerves, vessels, and functioning muscle with better function and aesthesis. Materials and Methods: The perforator plus concept was applied in seven different clinical situations. Functional muscle and fasciocutaneous flaps were employed in five and adipofascial flaps in two cases, primarily involving lower extremity defects and back. Adipofascial perforator plus flaps were employed to provide cover for tibial fracture in one patients and chronic venous ulcer in another. Results: All flaps survived without any loss and provided long-term stable cover, both over soft tissue and bone. Functional preservation was achieved in all cases where muscle flaps were employed with no clinical evidence of loss of power. There was no sensory loss or significant oedema in or distal to the flap in both cases where neurovascular continuity was preserved during flap elevation. Fracture union and consolidation were satisfactory. One patient had minimal graft loss over fascia which required application of stored grafts with subsequent take. No patient required re-operation. Conclusions: Perforator plus concept is holistic and applicable to most flap types in varied situations. It permits the exercise of many locoregional flap options while limiting collateral functional damage. Aesthetic considerations are also addressed while raising adipofascial flaps because of no appreciable donor defects. With quick operating times and low failure risk, these flaps can be a better substitute to traditional flaps and at

  19. The pudendal thigh flap as YV advanced flap for the release of perineum burns contractures.

    Science.gov (United States)

    Benito, P; De Juan, A; Cano, M

    2012-05-01

    Contractures secondary to burns affecting the perineum often cause severe functional, aesthetic and psychological harm. Many different surgical techniques are used to treat such conditions ranging from grafts, to triangular plasty transposition or advancement flaps of local tissue. It is usually advisable to use a flap or local perineoplasty because the quality of reconstruction tends to be better and the risk of reoccurrence of the contracture is lower. The pudendal thigh fasciocutaneous (PTF) flap is an axial patterned and sensate flap based on the groin crease. It has frequently been used for perineal and vaginal reconstructions. Technically, it is not difficult to perform, with a well tolerated scar located in the inguinal crease, and it is characterized by its thinness and its ready adaptation to the defects, and because it maintains sensitivity. To the best of our knowledge, no previous case of perineal contracture treatment has been reported with the use of a PTF flap harvested as an YV advanced flap. Here we report the case of a patient with a severe contracture who was treated using the flap described above, a satisfactory result being achieved. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Girth augmentation of the penis using flaps "Shaeer's augmentation phalloplasty": the superficial circumflex iliac flap.

    Science.gov (United States)

    Shaeer, Osama

    2014-07-01

    Penile girth augmentation can be achieved by various techniques, among which are liposuction injection, synthetic grafts, and autologous grafts, with variable outcome, mostly related to viability and receptivity of the tissue used for augmentation. Flaps are considered superior to grafts considering their uninterrupted blood supply. The current work describes long-term experience with penile girth augmentation using the superficial circumflex iliac artery and vein (SCIAV) flap. SCIAV flap was used for penile girth augmentation in 40 candidates who followed up for a minimum of 18 months. The flap was mobilized from the groin region. The penis was pulled out of a peno-pubic incision. The flap was tunneled under the pubic region to emerge at the base of the penis and was sutured to the subcoronal area and on either sides of the spongiosum. Another session was required for either de-bulking of the oversized flap (four overweight candidates), flap pedicle (n = 6), or for donor site scar revision (n = 11). Gain in girth in centimeters was evaluated. Excluding dropouts (n = 8) and participants who had encountered de-bulking of the flap body (n = 4), 40 participants had a preoperative average flaccid girth (AFG) of 9.3 ± 1.1 cm. Immediately postoperative AFG was 14.9 ± 1.1 cm (P < 0.001). Postoperative AFG at the final follow-up visit (a minimum of 18 months) was 14.5 ± 1.1 cm (55.6% gain compared with baseline, P < 0.001). SCIAV flap is a reliable option for long-lasting and sizable penile girth augmentation. One-stage augmentation is more suited for non-obese candidates. A second session may be indicated in overweight candidates or for scar revision. © 2014 International Society for Sexual Medicine.

  1. Presence of Epstein-Barr virus, cytomegalovirus and human papillomavirus in normal oral mucosa of HIV-infected and renal transplant patients.

    Science.gov (United States)

    Ammatuna, P; Campisi, G; Giovannelli, L; Giambelluca, D; Alaimo, C; Mancuso, S; Margiotta, V

    2001-01-01

    To determine the prevalence of EBV-DNA, CMV-DNA and HPV-DNA in oral healthy mucosa of HIV-infected and renal transplant patients. To associate the detection of viral genomes with laboratory parameters of immunodeficiency, gender, antiretroviral and immunosuppressive therapy. A cross-sectional analysis of lingual and buccal cytobrushings from HIV-infected and renal transplant patients. Lingual and buccal cytobrushings were obtained from clinically normal oral mucosa of 57 HIV+, 40 renal transplant patients and 30 healthy uninfected controls, all matched for age at baseline of examination. Presence of EBV-, CMV- and HPV-DNA was assessed by polymerase chain reaction (PCR). We evaluated their association, in HIV+ subjects, with gender, CD4+ cell count, HIV-RNA load, and antiretroviral therapy; and in renal transplant patients, with gender, CD4/CD8 ratio, and immunosuppressive therapy. Data were managed and analysed by Epi-Info 6.0. EBV-DNA was detected in 42.1% of HIV+ (24/57), in 65.0% of transplant patients (26/40), and in 16.6% of controls (5/30) (P = 0.03 and P = 0.0001, respectively). Furthermore, male gender in HIV+ group was found to be significantly associated with the presence of EBV-DNA (P = 0.02) vs females, after adjusting for CD4+ cell count and HIV-RNA load. CMV- and HPV-DNA were detected in 3.5% and 7.0% of HIV+, and in none and 20.0% of transplant patients, respectively. No relationship was found between the epithelial detection of these two viruses and any parameter evaluated. EBV genome was significantly detected in clinically normal oral mucosa of renal transplant and HIV+ patients. A significant gender association was found among HIV+, suggesting that oral hairy leukoplakia (OHL) is more likely to occur in HIV+ men than women.

  2. scrotal reconstruction with a pedicled gracilis muscle flap after ...

    African Journals Online (AJOL)

    better functional and cosmetic outcomes. Muscle and myocutaneous flaps like gracilis, rectus abdominis, split gluteus maximus flaps are needed for large skin defects with deep pockets or cavities to eliminate the dead space (2,3). The pedicled or free greater omental flap as well as scrotal tissue expansion have also been ...

  3. Study of design parameters of flapping-wings

    NARCIS (Netherlands)

    Wang, Q.; Goosen, J.F.L.; Van Keulen, F.

    2014-01-01

    As one of the most important components of a flapping-wing micro air vehicle (FWMAV), the design of an energy-efficient flapping-wing has been a research interest recently. Research on insect flight from different perspectives has been carried out, mainly with regard to wing morphology, flapping

  4. Prospective evaluation of outcome measures in free-flap surgery.

    LENUS (Irish Health Repository)

    Kelly, John L

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +\\/- 29 min) and in those that survived (92 +\\/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.

  5. Peroperative evaluation of vascularity of various flaps by fluorescein technique

    Directory of Open Access Journals (Sweden)

    Bhattacharya V

    2006-01-01

    Full Text Available Background: The viability of any pedicled flap depends upon its vascularity. When a flap is dissected it becomes relatively ischaemic. Ultimately, the viability of the flap depends on the vessels incorporated in the pedicle and their perfusion capacity. There are different techniques to evaluate the blood supply of a flap. Aims: This study deals with experimental and clinical efficiency of fluorescein dye technique to evaluate the vascularity of flaps of various compositions. Materials and Methods: The experimental study was conducted on rats to standardize the technique. Thereafter clinical evaluation was conducted for different flaps namely fasciocutaneous, skeletonized perforator based fasciocutaneous, adipofascial, fasciocutaneous flap with adipofascial extension, fasciocutaneous flap with fascial extension and fasciocutaneous flap with split fascial extension. Conclusions: The paper deals in detail with the technique and method of documentation of a fluorescein study on flaps both experimentally and clinically. The appearance of fluorescein on both the surfaces and distal margin of the flap confirmed the adequacy of vascularity soon after dissection of the flaps. It was found to be an easy, safe and reliable objective method.

  6. Propeller Flap for Complex Distal Leg Reconstruction: A Versatile ...

    African Journals Online (AJOL)

    Reverse sural artery fasciocutaneous flap has become a workhorse for the reconstruction of distal leg soft ... A Versatile Alternative when Reverse Sural Artery Flap is. Not Feasible. Samuel A. Ademola, Afieharo I. .... flaps that were raised in the patient and the logistics of limb positioning after application of external fixators ...

  7. The management of pelvic pressure ulcers by myocutaneous flaps ...

    African Journals Online (AJOL)

    The sex ratio was 5 men for 4 women 10 sacral ulcers were treated by gluteus maximus myocutaneous flaps, 10 trochanteric and 4 ischiatic ulcers were covered by tensor fascia lata myocutaneous flaps. The cure rate was 100%. The main complications were: infection (63.5%), serous fluid discharge (21.05%), and flap ...

  8. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap

    Science.gov (United States)

    Denadai, Rafael; Raposo-Amaral, Cassio Eduardo; Marques, Frederico Figueiredo; Raposo-Amaral, Cesar Augusto

    2015-01-01

    The temporoparietal fascia flap has been extensively used in craniofacial reconstructions. However, its use for eyebrow reconstruction has been sporadically reported. We describe a successfully repaired hair-bearing temporoparietal fascia flap after traumatic avulsion of eyebrow. Temporoparietal fascia flap is a versatile tool and should be considered as a therapeutic option by all plastic surgeons. PMID:25993077

  9. Double papilla flap technique for dual purpose

    Directory of Open Access Journals (Sweden)

    P Mohan Kumar

    2012-01-01

    Full Text Available Marginal tissue recession exposes the anatomic root on the teeth, which gives rise to -common patient complaints. It is associated with sensitivity, tissue irritation, cervical abrasions, and esthetic concerns. Various types of soft tissue grafts may be performed when recession is deep and marginal tissue health cannot be maintained. Double papilla flap is an alternative technique to cover isolated recessions and correct gingival defects in areas of insufficient attached gingiva, not suitable for a lateral sliding flap. This technique offers the advantages of dual blood supply and denudation of interdental bone only, which is less susceptible to permanent damage after surgical exposure. It also offers the advantage of quicker healing in the donor site and reduces the risk of facial bone height loss. This case report presents the advantages of double papilla flap in enhancing esthetic and functional outcome of the patient.

  10. Clinical and cytological study of the oral mucosa of smoking and non-smoking qat chewers in Yemen.

    Science.gov (United States)

    Hijazi, M; Jentsch, H; Al-Sanabani, J; Tawfik, M; Remmerbach, T W

    2016-05-01

    The study was conducted to investigate the role of qat and smoking habits on the prevalence of visible and cytological abnormalities in the oral mucosa among Yemenites. We recruited 30 non-smoking and 30 smoking Yemenites chewing qat unilaterally for at least 5 years. We inspected oral cavities for the presence of lesions and took brush biopsies from the buccal mucosa/gingiva of the chewing/non-chewing region. All visible oral lesions were flat and homogeneous, and cytological changes were detected frequently. Among both non-smokers and smokers, white lesions and cytological changes were detected in 77% of all cases. On the chewing area, the proportion with white lesions ranged--depending on anatomical area and smoking status--between 47 and 93% and was significantly more frequent than on the non-chewing side (range 3-47%). The proportion of regions with changes was similar in non-smokers and smokers. Kappa statistics for "interobserver" agreement between visual inspection and cytological specimens of brush biopsies was at best fair (≤0.25). The high prevalence of visible lesions and cytological abnormalities among qat chewers was independent of smoking status. The moderate level of agreement between visual inspection and exfoliative cytology demonstrates the still challenging clinical management of chronic qat chewers, though brush biopsies including adjuvant techniques like DNA cytometry may support the clinical decision-making process in future.

  11. Histopathological comparative analysis of periimplant bone inflammatory response after dental implant insertion using flap and flapless surgical technique. An experimental study in pigs.

    Science.gov (United States)

    Vlahović, Zoran; Marković, Aleksa; Lazić, Zoran; Šćepanović, Miodrag; Đinić, Ana; Kalanović, Milena

    2017-09-01

    To evaluate by histopathological analysis the peri-implant bone inflammation degree, in certain time intervals (7, 14, 21 and 28 days), following mini-incision flapless and flap implant placement. The experiment was conducted on four domestic pigs. Nine weeks prior to implant insertion, second and third mandibular premolars were extracted. Each animal received six implants in lower jaw. On one randomly chosen side of jaw flapless technique using mini-incision was performed, while on the other side implants were inserted after flap raising. After 7, 14, 21, and 28 days, the experimental animals were sacrificed. Following mandibular resection and decalcification, the samples for histopathological analysis of the peri-implant bone were obtained in the empty implant bed area, from the buccal side of the mandible, adjacent to implant neck region and parallel to crestal edge of implant bed. The degree of inflammatory response of the peri-implant bone was estimated through ordinal scores from 0 to 2. Seven days after the surgery all samples in the flap group had score 2 indicating high inflammation degree, in contrast to lower inflammatory reaction in flapless group. On the 14th and 21st postoperative day decreasing of inflammation degree was noted in all samples of the flapless group (score 1), while in flap group samples presented scores 1 and 2. Twenty-eight days after the implant placement, further reduction of inflammation in the flapless group (33% of samples had score 0) was observed. Flapless technique in comparison to conventional flap procedure minimizes postoperative bone inflammatory reactions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Flapless versus open flap implant surgery in partially edentulous patients subjected to immediate loading: 1-year results from a split-mouth randomised controlled trial.

    Science.gov (United States)

    Cannizzaro, Gioacchino; Felice, Pietro; Leone, Michele; Checchi, Vittorio; Esposito, Marco

    2011-01-01

    To evaluate the efficacy of flapless versus open flap implant placement in partially edentulous patients. Forty patients with two separate edentulous areas characterised by residual bone at least 5 mm thick and 10 mm in height had these sites randomised following a split-mouth design to receive at least one implant to each side after flap elevation or not. Implants were first placed in one site, and after 2 weeks in the other site freehand. Implants inserted with a torque >48 Ncm were immediately loaded with full occluding acrylic temporary restorations. Definitive single cemented crowns or screw-retained metal ceramic fixed dental prostheses were delivered after 2 months. Outcome measures were prosthesis and implant failures, complications, postoperative swelling and pain, consumption of analgesics, patient preference, surgical time, marginal bone level changes, and implant stability quotient (ISQ) values. Seventy-six implants were placed flapless and 67 after flap elevation. In the flapless group, four flaps had to be raised to control the direction of the bur, whereas one haemorrhage and one fracture of the buccal bone occurred in two patients of the flap elevation group. Four implants did not reach the planned stability (three belonging to the flapless group) and they were all immediately replaced by larger diameter ones. After 1 year, no drop-outs occurred. Two definitive bridges could not be placed when planned (one in each group) and two crowns had to be remade (one in each group). Two implants failed in each group, all in different patients. There were no statistically significant differences for prosthetic and implant failures, complications, ISQ values and marginal bone levels between groups. However, flapless implant placement required significantly less operation time (17 minutes less, saving almost two-thirds of the time for implant placement), induced less postoperative pain, swelling, analgesic consumption and was preferred by patients. Mean ISQ

  13. Treating Scars on the Oral Mucosa.

    Science.gov (United States)

    Evans, Erik William

    2017-02-01

    Mucosal wounds tend to heal more rapidly than skin wounds and with minimal to no scar formation and hence have a minimal impact on function or aesthetics. This is likely due to differences in the magnitude and timing of the various factors that contribute to wound healing. Some examples of these differences are fibroblast proliferation, transforming growth factor-β, macrophages, neutrophils, and T cells. Other factors, such as the moist environment, contribute to the favorable wound-healing characteristics of mucosa. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The transversely split gracilis twin free flaps

    Directory of Open Access Journals (Sweden)

    Upadhyaya Divya

    2010-01-01

    Full Text Available The gracilis muscle is a Class II muscle that is often used in free tissue transfer. The muscle has multiple secondary pedicles, of which the first one is the most consistent in terms of position and calibre. Each pedicle can support a segment of the muscle thus yielding multiple small flaps from a single, long muscle. Although it has often been split longitudinally along the fascicles of its nerve for functional transfer, it has rarely been split transversely to yield multiple muscle flaps that can be used to cover multiple wounds in one patient without subjecting him/her to the morbidity of multiple donor areas .

  15. Effects of aqueous cinnamon extract on chemically-induced carcinoma of hamster cheek pouch mucosa

    Directory of Open Access Journals (Sweden)

    Samah K. Ezzat

    2017-12-01

    Full Text Available This study aimed to investigate the effects of aqueous cinnamon extract (ACE on 7, 12-Dimethylbenz[a]anthracene (DMBA-induced oral carcinogenesis in hamster cheek pouch (HCP mucosa. Sixty male Syrian hamsters were randomly divided into six equal groups. The hamsters of groups I, II and III received no treatment, DMBA and ACE respectively, for 16 weeks. Groups IV and V were handled as group II and concomitantly treated with ACE for the same period and additionally group V received ACE for other 16 weeks after the stoppage of DMBA application. Group VI hamsters were handled as group III and additionally received DMBA for other 16 weeks after the stoppage of ACE supplementation. Hamsters of each group were euthanized according to the experimental schedule. The buccal pouches were and prepared for H&E stain, PAS reagent, CD3 and PDGF immunohistochemical reactivity. All groups showed dysplastic changes with varying degrees except groups I and III. Deep invasive carcinomas were recorded in 90% of the samples of group II, 60% of group IV, 50% of group V and 40% of group VI. From the previous results, it can be concluded that ACE has the potentiality preventing oral cancer initiation better than inhibiting oral cancer progression.

  16. Cytologic alterations in the oral mucosa after chronic exposure to ethanol Alterações citológicas na mucosa bucal após exposição crônica ao etanol

    Directory of Open Access Journals (Sweden)

    Sílvia Regina de Almeida Reis

    2006-04-01

    Full Text Available The effects of ethanol alone on the oral mucosa are still poorly understood, especially because there are few non-smoking chronic consumers of alcoholic beverages. The aim of this study was to evaluate the frequency of micronucleus, abnormal nucleus/cytoplasm ratio, pyknosis, karyorrhexis and karyolysis in exfoliated cells from the buccal mucosa and from the lateral border of the tongue in 36 non-smoker alcoholics (ethanol group and 18 non-smokers and non-drinkers (control group. The Papanicolaou method was used. Since alcoholics generally have hepatobiliary involvement, the association between serum gamma-glutamyl transpeptidase (GGT and some of the analyzed oral mucosa alterations was also investigated. The ethanol group showed a significant increase in the frequency of all alterations analyzed in the tongue cells when compared with the control group (p 0.05; Mann-Whitney. In the ethanol group, the correlation between serum GGT and the frequency of micronucleus and abnormal nucleus/cytoplasm ratio in oral mucosa cells was not significant (p > 0.05; Spearman. In conclusion, chronic exposure to ethanol may be associated with carcinogenic cytologic changes in the oral mucosa, even in the absence of tobacco smoking. These alterations were not correlated with hepatobiliary injury.Os efeitos do etanol isoladamente sobre a mucosa bucal permanecem pouco esclarecidos, sobretudo devido ao baixo número de não-fumantes consumidores crônicos de bebidas alcoólicas. O objetivo deste estudo foi avaliar as freqüências de micronúcleo, relação núcleo/citoplasma anormal, picnose, cariorrexe e cariólise em células esfoliadas da mucosa jugal e do bordo lateral da língua de 36 alcoólatras não-fumantes (grupo etanol e 18 abstêmios de álcool e fumo (grupo controle. O método de Papanicolaou foi utilizado. Uma vez que indivíduos alcoólatras geralmente apresentam comprometimento hepatobiliar, a associação entre gama-glutamil transpeptidase (GGT s

  17. Clinical and Radiographic comparative evaluation of buccal and palatal corticotomy with buccal corticotomy in periodontally accelerated osteogenic orthodontics with surgical bur

    Directory of Open Access Journals (Sweden)

    Pavankumar Addanki

    2017-01-01

    Full Text Available Background: Periodontally accelerated osteogenic orthodontics is a clinical procedure that combines selective corticotomy, particulate grafting, and application of orthodontics. It reduces treatment time, increases stability of teeth, and prevents relapse of orthodontic tooth moment. The present study was aimed to explore the clinical and radiographic comparison of bone density changes, retraction time differences in buccal and palatal corticotomy with buccal corticotomy which was done by surgical bur. Materials and Methods: A split-mouth was designed in 16 patients and divided into right (buccal and palatal corticotomy (Group I, left (buccal corticotomy (Group II sides. In both groups, decortication was done with surgical bur. Clinical parameters such as gingival bleeding index and probing pocket depth were recorded at baseline, 1 month, 3 months, and 6 months. Bone density changes were measured by computed tomography at baseline and after 6 months after surgery and also used for evaluating differences in bone density changes between two groups. Retraction time differences were also measured in both groups. Results: In both groups, there was significant difference between bone density changes at baseline and 6 months after surgery. However, the difference between two groups was not significant. The difference in clinical parameters between two groups was not significant. The difference in retraction time differences was not significant. Conclusion: Within limits of the study, it may be concluded that there was difference between bone density changes before and 6 months after surgery. Difference in total treatment time found to be no significant between two groups.

  18. An experimental cyst model established from human unkeratinized vaginal mucosa.

    Science.gov (United States)

    Thompson, I O; van Wyk, C W

    1996-12-01

    Because of the scarcity of sizeable specimens of normal oral mucosa and the availability of human vaginal mucosa, which resembles the lining mucosa of the mouth, we used the latter to establish a human cyst model. Fragments of vaginal mucosa, removed during corrective procedures, were sutured around 2 mm glass balls and implanted into the flanks of nude mice. Thirty-seven specimens were implanted and 31 harvested after 3, 6, 9 and 12 weeks. At 6 weeks the wall of the implanted cyst consisted of recognizable unkeratinized vaginal mucosa but had not healed completely at the sutured edges. From 9 weeks the cyst cavities were healed and the lumens lined by unkeratinized stratified squamous vaginal epithelium. The enclosing connective tissue had retained the characteristics of the lamina propria of the vaginal mucosa and could be distinguished from mouse tissue.

  19. Shear bond strength of orthodontic buccal tubes to porcelain

    Science.gov (United States)

    Purmal, Kathiravan; Alam, Mohammad K.; Sukumaran, Prema

    2013-01-01

    Background: Bonding of molar tubes is becoming more popular in orthodontics. Occasionally, these bonding are done on posterior porcelain crowns or bridges. The purpose of this study was to evaluate the shear bond strength of buccal tubes on feldspathic porcelain crowns with two different methods. Materials and Methods: Forty porcelain right molar crowns were fabricated for this study. The crowns were randomly divided into two groups. In group 1, the crowns were etched with 9.6% hydrofluoric acid, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT (3M Unitek, Monrovia, Calif). In group 2, the crowns were etched with phosphoric acid 37%, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT. All the crowns were stored for 24 hours at 37°C and thermo-cycled before the shear bond test. The analysis of variance (ANOVA) was used to determine whether significant difference were present between the groups. Results: The results of the analysis of variance (F = 0.23) indicated the shear bond strength of group 1 (3.57 ± 0.87 MPa) was not significantly different (P > 0.05) from group 2 (3.46 ± 0.65 Mpa). Fisher's exact test for the adhesive remnant index (ARI) revealed significant difference between both groups (P porcelain/resin interface. Conclusion: Etching with phosphoric acid with the use of silane coupling agent would be safer and should make it easier for clinicians to clean the adhesive on the porcelain surface after debonding. PMID:23878568

  20. Suspension Bridge Flutter for Girder with Separate Control Flaps

    DEFF Research Database (Denmark)

    Huynh, T.; Thoft-Christensen, Palle

    Active vibration control of long span suspension bridge flutter using separated control flaps (SFSC) has shown to increase effectively the critical wind speed of bridges. In this paper, an SFSC calculation based on modal equations of the vertical and torsional motions of the bridge girder including...... the flaps is presented. The length of the flaps attached to the girder, the flap configuration and the flap rotational angles are parameters used to increase the critical wind speed of the bridge. To illustrate the theory a numerical example is shown for a suspension bridge of 1000m+2500m+1000m span based...... on the Great Belt Bridge streamlined girder....

  1. Fascia-only anterolateral thigh flap for extremity reconstruction.

    Science.gov (United States)

    Fox, Paige; Endress, Ryan; Sen, Subhro; Chang, James

    2014-05-01

    The ability to use the anterolateral thigh (ALT) flap as a vascularized fascial flap, without skin or muscle, was first documented by Koshima et al in 1989. The authors mention the possibility of using the fascia alone for dural reconstruction. Despite its description more than 20 years ago, little literature exists on the application of the ALT flap as a vascularized fascial flap. In our experience, the ALT flap can be used as a fascia-only flap for thin, pliable coverage in extremity reconstruction. After approval from the institutional review board, the medical records and photographs of patients who had undergone fascia-only ALT free flaps for extremity reconstruction were reviewed. Photographic images of patients were then matched to patients who had undergone either a muscle-only or a fasciocutaneous free flap reconstruction of an extremity. Photographs of the final reconstruction were then given to medical and nonmedical personnel for analysis, focusing on aesthetics including color and contour. Review of cases performed over a 2-year period demonstrated similar ease of harvest for fascia-only ALT flaps compared to standard fasciocutaneous ALT flaps. Fascia-only flaps were used for thin, pliable coverage in the upper and lower extremities. There was no need for secondary procedures for debulking or aesthetic flap revision. In contrast to muscle flaps, which require muscle atrophy over time to achieve their final appearance, there was a similar flap contour from approximately 1 month postoperatively throughout the duration of follow-up. When a large flap is required, the fascia-only ALT has the advantage of a single-line donor-site scar. Photograph comparison to muscle flaps with skin grafts and fasciocutaneous flaps demonstrated improved color, contour, and overall aesthetic appearance of the fascia-only ALT over muscle and fasciocutaneous flaps. The fascia-only ALT flap provides reliable, thin, and pliable coverage with improved contour and color over

  2. A study of complexity of oral mucosa using fractal geometry

    OpenAIRE

    S R Shenoi; Payal Peshwani; Anup Garg; Rohit Moharil

    2017-01-01

    Background: The oral mucosa lining the oral cavity is composed of epithelium supported by connective tissue. The shape of the epithelial-connective tissue interface has traditionally been used to describe physiological and pathological changes in the oral mucosa. Aim: The aim is to evaluate the morphometric complexity in normal, dysplastic, well-differentiated, and moderately differentiated squamous cell carcinoma (SCC) of the oral mucosa using fractal geometry. Materials and Methods: A total...

  3. Correlation analysis of alveolar bone loss in buccal/palatal and proximal surfaces in rats

    Directory of Open Access Journals (Sweden)

    Carolina Barrera de Azambuja

    2012-12-01

    Full Text Available The aim was to correlate alveolar bone loss in the buccal/palatal and the mesial/distal surfaces of upper molars in rats. Thirty-three, 60-day-old, male Wistar rats were divided in two groups, one treated with alcohol and the other not treated with alcohol. All rats received silk ligatures on the right upper second molars for 4 weeks. The rats were then euthanized and their maxillae were split and defleshed with sodium hypochlorite (9%. The cemento-enamel junction (CEJ was stained with 1% methylene blue and the alveolar bone loss in the buccal/palatal surfaces was measured linearly in 5 points on standardized digital photographs. Measurement of the proximal sites was performed by sectioning the hemimaxillae, restaining the CEJ and measuring the alveolar bone loss linearly in 3 points. A calibrated and blinded examiner performed all the measurements. Intraclass Correlation Coefficient revealed values of 0.96 and 0.89 for buccal/lingual and proximal surfaces, respectively. The Pearson Correlation Coefficient (r between measurements in buccal/palatal and proximal surfaces was 0.35 and 0.05 for the group treated with alcohol, with and without ligatures, respectively. The best correlations between buccal/palatal and proximal surfaces were observed in animals not treated with alcohol, in sites both with and without ligatures (r = 0.59 and 0.65, respectively. A positive correlation was found between alveolar bone loss in buccal/palatal and proximal surfaces. The correlation is stronger in animals that were not treated with alcohol, in sites without ligatures. Areas with and without ligature-induced periodontal destruction allow detection of alveolar bone loss in buccal/palatal and proximal surfaces.

  4. Sphingosine-1-phosphate stimulated connective tissue growth factor expression in human buccal fibroblasts: Inhibition by epigallocatechin-3-gallate.

    Science.gov (United States)

    Sar, Jenny I-Chun; Yang, Chih-Jen; Tsai, Yi-Shin; Deng, Yi-Ting; Chen, Hsin-Ming; Chang, Hao-Hueng; Liu, Cheing-Meei

    2015-09-01

    Connective tissue growth factor (CCN2) has been associated with the pathogenesis of various fibrotic diseases, including oral submucous fibrosis (OSF). The chemical constituents of areca nut along with the mechanical trauma cause OSF. The coarse fibers of areca nut injure the mucosa and hence sphingosine-1-phosphate (S1P) is released at the wounded sites. Recent studies have shown that S1P is involved in wound healing and the development of fibrosis. The aims of this study were to investigate the effects of S1P on CCN2 expression in human buccal fibroblasts (HBFs) and identify the potential targets for drug intervention or chemoprevention of OSF. Western blot analyses were used to study the effects of S1P on CCN2 expression and its signaling pathways in HBFs and whether epigallocatechin-3-gallate (EGCG), the main and most significant polyphenol in green tea, could inhibit this pathway. S1P significantly enhanced CCN2 synthesis in HBFs. This effect can be inhibited by c-Jun NH2-terminal kinase (JNK) inhibitor and extracellular signal-regulated kinase inhibitor but not by P38 mitogen-activated protein kinase inhibitor. Interestingly, EGCG completely blocked S1P-induced CCN2 expression via suppressing S1P-induced JNK phosphorylation. S1P released by repetitive mechanical trauma during AN chewing may contribute to the pathogenesis of OSF through upregulating CCN2 expression in HBFs. EGCG could be an adjuvant to the current offered therapy options or the prevention of OSF through suppression of JNK activation. Copyright © 2013. Published by Elsevier B.V.

  5. Infecciones virales en piel y mucosas

    Directory of Open Access Journals (Sweden)

    María José Martínez G., Dra.

    2011-11-01

    Full Text Available Diversos virus pueden infectar la piel y las mucosas de los seres humanos, manifestándose en diferentes patologías, de acuerdo a la edad, género y estado inmunológico. Un grupo importante de éstos tiene capacidad de replicar en células epiteliales, originando cuadros clínicos en los cuales se evidencia la destrucción celular o bien la hiperplasia del tejido infectado. Gran parte de estos virus persisten en células infectadas por años y tienen la capacidad de reactivarse y de manifestar nuevamente enfermedades cutáneas o mucosas. En algunos casos, ésta sólo se expresa de manera subclínica en una excreción del virus por secreciones que son fuente de infección. En los últimos años, los avances en técnicas moleculares han permitido contar con metodologías diagnósticas cada vez más sensibles, específicas y rápidas. Así como también el progreso en el área de vacunas y antivirales nos entrega mayores herramientas profilácticas y terapéuticas.

  6. Middle ear mucosa in rats and humans.

    Science.gov (United States)

    Albiin, N; Hellström, S; Stenfors, L E; Cerne, A

    1986-01-01

    The purposes of the study were to review thoroughly the literature and summarize it in a standardized fashion; to study the mucosa, including the distribution of mast cells, in all parts of the middle ear cavity in rats; and to compare the experimental findings with those known in humans. Adult, healthy rats were studied by light, scanning electron, and transmission electron microscopic techniques. The ciliated and secretory cells of the rat tympanic cavity are confined to two tracts, one anterior and one inferoposterior to the promontory. The tracts connect the epitympanum with the eustachian tube. The pars flaccida exhibits the highest density of mast cells, but mast cells are also distributed in the subepithelial layer of the tracts and in the floor of the tympanic bulla. The structure of the rat mucosa shows striking similarities to that of humans. Thus, from a morphological point of view, the rat seems to be a suitable model for middle ear studies. However, to be able to compare results obtained in different species and/or different laboratories, the areas of the middle ear from which the specimens have been taken must be carefully defined and presented in a standardized manner.

  7. Honey and Apoptosis in Human Gastric Mucosa

    Directory of Open Access Journals (Sweden)

    Alireza Ostadrahimi

    2012-07-01

    Full Text Available Background: Gastric cancer is the fourth most common malignancy in the world. Honey is acomplex mixture of special biological active constituents. Honey possesses antioxidant and antitumorproperties. Nutritional studies have indicated that consumption of honey modulates therisk of developing gastric cancer. On the other hand, apoptosis has been reported to play a decisiverole in precancerous changes. Our chief study was conducted to assess the relationship betweenconsumption of honey and apoptosis in human gastric mucosa.Method: This cross-sectional study was conducted on 98 subjects over 18 years old, referred totwo hospitals in Tabriz, Iran. Subjects were undergone an upper gastrointestinal endoscopy, 62subjects were finally enrolled. Honey consumption was assessed by a Food Frequency Questionnaire(FFQ and apoptosis was detected by TUNEL technique. We tested polynomial curve tofind the best fit between honey consumption and apoptosis.Results: A positive relation between honey consumption and apoptosis was found (P=0.024.Our results indicated that the final and the best fit curve was: apoptosis = 1.714+1.648(honeyamount - 0.533(honey amount2 +1.833×10-5(honey amount7.Conclusion: Honey consumption had positive effects on gastric cancer by inducing apoptosis ingastric mucosa.

  8. Patterns of flap loss related to arterial and venous insufficiency in the rat pedicled TRAM flap.

    Science.gov (United States)

    Qiao, Q; Moon, W; Zhang, F; Chen, S G; Kunda, L; Lineaweaver, W C; Buncke, H J

    1999-08-01

    Vascular supply to the contralateral portion of the conventional transverse rectus abdominis musculocutaneous (TRAM) flap (zone IV) may become compromised, resulting in partial flap loss and requiring segmental excision. The etiology of this necrosis is not clear. This study determines skin necrosis patterns on a superiorly pedicled caudal TRAM flap during conditions of venous and arterial insufficiency, and determines whether cutaneous venous outflow can sustain a flap with venous insufficiency. Twenty-eight adult male Sprague-Dawley rats underwent superior pedicled TRAM flap elevation, and the zones were marked on the skin paddle. The animals were divided into four groups: control (group A, N = 6), arterial ligation (group B, N = 6), venous ligation (group C, N = 8), and venous ligation with cutaneous venous outflow (group D, N = 8). After 10 days, the skin paddle was photographed and the areas of necrotic skin were measured. Results showed that group B (selective arterial ligation) had 51.7 +/- 2.8% and 40.0 +/- 2.0% skin necrosis in zones I and II respectively. Zone I necrosis was significantly greater in group B compared with the control (p < 0.05). Group C (selective venous ligation) resulted in 73.8 +/- 16.4% and 93.8 +/- 33.4% skin necrosis in zones III and IV respectively. This necrosis was significantly greater compared with the control (p < 0.001). Group D rats' lateral skin necrosis compared significantly less with group C (p < 0.001). These results demonstrate that the patterns of flap necrosis in rat TRAM flaps with poor arterial inflow differ from those with venous stasis. Necrosis of the contralateral portion (zone IV) of human TRAM flaps may be related to problems with venous stasis; thus, a cutaneous venous outflow may prevent this problem.

  9. "Comparison of AgNORs count in exfoliative cytology of normal oral mucosa in smokers and non- smokers"

    Directory of Open Access Journals (Sweden)

    Shahrabi Sh.

    2005-07-01

    Full Text Available Background and Aim: A strong causal relationship exists between cigarette smoking and development of oral squamous cell carcinoma, so oral screening using exfoliative cytology has been recommended to facilitate the early diagnosis of cellular alterations in oral mucosa and silver staining (AgNOR technique has been proven to be of value in the detection of incipient cellular alterations. The purpose of this study was to compare the argyrophilic nucleolar regions (AgNORs count of cells collected from normal mucosa of cigarette smokers with that obtained from non- smokers. Materials and Methods: In this cross-sectional study, cytologic smears of normal tongue, buccal mucosa and floor of the mouth from 19 smokers and 19 non- smokers were stained for AgNORs. The AgNORs count was established on 100 cells. The count value of groups were compared and analyzed using the Levens, Paired T, Student and Factorial tests. Using P<0.05 as the limit of significance. Results: The AgNORs were round and had a clustered distribution in both groups. The mean AgNORs count was statistically higher in cells of smokers than non- smokers (P<0.05. There was a significant difference between smears from the floor of the mouth and other anatomical sites in both groups. In this study, no correlation was found between AgNORs count and gender. Conclusion: Analysis of AgNORs suggests that there might be a correlation between the smoking habit and an increased rate of cellular proliferation in the oral mucosal cells.

  10. Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2004-01-01

    Full Text Available Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.

  11. Prevention of hair growth in myocutaneous flap reconstruction.

    Science.gov (United States)

    Eliachar, I; Kraus, D H; Bergfeld, W F; Tucker, H M

    1990-08-01

    Myocutaneous flaps play a prominent role in the immediate reconstruction of surgical defects following ablative oncologic procedures in the head and neck. Transfer of hair-bearing skin into the reconstructed upper digestive tract can be a major disadvantage associated with the pectoralis major flap. De-epithelialization of skin to the dermal level, removing the majority of skin appendages, can convert a myocutaneous flap to a "myodermal" flap. Platysma myocutaneous and myodermal flaps were grafted into the oral cavity of 13 dogs. Gross and histologic evaluation confirmed decreased hair growth in the experimental myodermal flap. Wound complications and graft survival were similar for both techniques. Diminished hair growth further supports the utility of myodermal flaps in hairy male patients undergoing upper digestive tract reconstruction.

  12. Upregulated Expression of Transient Receptor Potential Cation Channel Subfamily V Receptors in Mucosae of Patients with Oral Squamous Cell Carcinoma and Patients with a History of Alcohol Consumption or Smoking.

    Science.gov (United States)

    Sakakibara, Akiko; Sakakibara, Shunsuke; Kusumoto, Junya; Takeda, Daisuke; Hasegawa, Takumi; Akashi, Masaya; Minamikawa, Tsutomu; Hashikawa, Kazunobu; Terashi, Hiroto; Komori, Takahide

    2017-01-01

    Transient receptor potential cation channel (subfamily V, members 1-4) (TRPV1-4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1-4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1-4 expression. Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1-4 by immunohistochemical staining and quantification of TRPV1-4 mRNA in human oral mucosa. In addition, we compared the TRPV1-4 levels in mucosa from patients with SCC to those in normal oral mucosa. The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1-4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels. Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention.

  13. To flap or not to flap: a discussion between a fish and a jellyfish

    Science.gov (United States)

    Martin, Nathan; Roh, Chris; Idrees, Suhail; Gharib, Morteza

    2016-11-01

    Fish and jellyfish are known to swim by flapping and by periodically contracting respectively, but which is the more effective propulsion mechanism? In an attempt to answer this question, an experimental comparison is made between simplified versions of these motions to determine which generates the greatest thrust for the least power. The flapping motion is approximated by pitching plates while periodic contractions are approximated by clapping plates. A machine is constructed to operate in either a flapping or a clapping mode between Reynolds numbers 1,880 and 11,260 based on the average plate tip velocity and span. The effect of the total sweep angle, total sweep time, plate flexibility, and duty cycle are investigated. The average thrust generated and power required per cycle are compared between the two modes when their total sweep angle and total sweep time are identical. In general, operating in the clapping mode required significantly more power to generate a similar thrust compared to the flapping mode. However, modifying the duty cycle for clapping caused the effectiveness to approach that of flapping with an unmodified duty cycle. These results suggest that flapping is the more effective propulsion mechanism within the range of Reynolds numbers tested. This work was supported by the Charyk Bio-inspired Laboratory at the California Institute of Technology, the National Science Foundation Graduate Research Fellowship under Grant No. DGE-1144469, and the Summer Undergraduate Research Fellowships program.

  14. The vastus intermedius periosteal (VIP) flap: a novel flap for osteoinduction.

    Science.gov (United States)

    Maercks, Rian Adam; Runyan, Christopher Michael; Jones, Donna Carlson; Taylor, Jesse Adam

    2010-07-01

    Periosteum's role in fracture healing is widely recognized, and its function in bone tissue engineering shows great potential. Here we introduce a novel periosteal free flap to be used as an abundant source of periosteum in the engineering and repair of bone. The descending branch of the lateral femoral circumflex vessels were isolated on 11 fresh human cadavers, preserving perforators to the vastus intermedius muscle. A cuff of vastus intermedius and approximately 75% of the circumference of the femoral periosteum were harvested from 6 cm proximal to the knee to 8 cm distal to the greater trochanter. Flap pedicle length and periosteal dimensions were measured. The pedicle arteries were injected with radiopaque dye, and radiographs were taken. A musculoperiosteal flap was elevated with visible descending perforators in each case. Mean flap surface area was 128 cm(2) (+/-99-143 cm(2)). Average pedicle length was 8 cm (+/-6-11 cm). Dye injection confirmed that the flaps blood supply was the descending branch of the lateral femoral circumflex artery. This anatomical study confirms the vascular supply of this large musculoperiosteal flap. Future work will test its efficacy as an osteoinductive agent in bone repair and tissue engineering in humans. Thieme Medical Publishers.

  15. Flapping micro plane watches where it goes

    NARCIS (Netherlands)

    de Wagter, C.; Lentink, D.; Mols, B.

    2005-01-01

    In a time span of only ten weeks, a team of eleven highly dedicated students have managed to design a unique flapping miniature aircraft, named DelFly. The aircraft can hover almost motionless in one spot and fly at considerable speed as well while being more stable and less vulnerable than a

  16. Computational Aerodynamics of Insects' Flapping Flight

    Science.gov (United States)

    Yang, Kyung Dong; Kyung, Richard

    2011-11-01

    The kinematics of the Insects' flapping flight is modeled through mathematical and computational observations with commercial software. Recently, study on the insects' flapping flight became one of the challenging research subjects in the field of aeronautics because of its potential applicability to intelligent micro-robots capable of autonomous flight and the next generation aerial-vehicles. In order to uncover its curious unsteady characteristics, many researchers have conducted experimental and computational studies on the unsteady aerodynamics of insects' flapping flight. In the present paper, the unsteady flow physics around insect wings is carried out by utilizing computer software e-AIRS. The e-AIRS (e-Science Aerospace Integrated Research System) analyzes and models the results of computational and experimental aerodynamics, along with integrated research process of these two research activities. Stroke angles and phase angles, the important two factors in producing lift of the airfoils are set as main parameters to determine aerodynamic characteristics of the insects' flapping flight. As a result, the optimal phase angle to minimize the drag and to maximize the lift are found. Various simulations indicate that using proper value of variables produce greater thrust due to an optimal angle of attack at the initial position during down stroke motion.

  17. Regional skin flaps in partial laryngectomy.

    Science.gov (United States)

    Conley, J

    1975-06-01

    The use of regional neck flaps for rehabilitation has permitted an extension of operations on the glottis. The resection may include both vocal cords, both ventricular bands, one arytenoid and slight subglottic extension in a one- or two-stage technique. The resultant voice is low pitched, soft and has limited range. The cure rate was 85 percent.

  18. Clinical application of free omental flap transfer

    Energy Technology Data Exchange (ETDEWEB)

    Harii, K.

    1978-04-01

    In the field of reconstruction surgery, the greater omentum has been used as a transposed flap for the treatment of chronic lymphedema, radionecrosis, and so forth. Its transferable range was limited by the length of its pedicle. Microvascular anastomosis allows for free transplantation of this organ and has vastly expanded its usefulness.

  19. Oral cavity reconstruction with the masseter flap

    NARCIS (Netherlands)

    Mahieu, R.; Russo, S.; Gualtieri, T.; Colletti, G.; Deganello, A.

    The purpose of this report is to highlight how an unusual, outdated, unpopular and overlooked reconstructive method such as the masseter flap can be a reliable, straightforward and effective solution for oral reconstruction in selected cases. We report the transposition of the masseter crossover

  20. Flapping wing aerodynamics: from insects to vertebrates.

    Science.gov (United States)

    Chin, Diana D; Lentink, David

    2016-04-01

    More than a million insects and approximately 11,000 vertebrates utilize flapping wings to fly. However, flapping flight has only been studied in a few of these species, so many challenges remain in understanding this form of locomotion. Five key aerodynamic mechanisms have been identified for insect flight. Among these is the leading edge vortex, which is a convergent solution to avoid stall for insects, bats and birds. The roles of the other mechanisms - added mass, clap and fling, rotational circulation and wing-wake interactions - have not yet been thoroughly studied in the context of vertebrate flight. Further challenges to understanding bat and bird flight are posed by the complex, dynamic wing morphologies of these species and the more turbulent airflow generated by their wings compared with that observed during insect flight. Nevertheless, three dimensionless numbers that combine key flow, morphological and kinematic parameters - the Reynolds number, Rossby number and advance ratio - govern flapping wing aerodynamics for both insects and vertebrates. These numbers can thus be used to organize an integrative framework for studying and comparing animal flapping flight. Here, we provide a roadmap for developing such a framework, highlighting the aerodynamic mechanisms that remain to be quantified and compared across species. Ultimately, incorporating complex flight maneuvers, environmental effects and developmental stages into this framework will also be essential to advancing our understanding of the biomechanics, movement ecology and evolution of animal flight. © 2016. Published by The Company of Biologists Ltd.

  1. Treatment of localized gingival recessions using enamel matrix derivative as an adjunct to laterally sliding flap: 2 case reports.

    Science.gov (United States)

    Kuru, Bahar Eren

    2009-06-01

    Predictable and optimal coverage of exposed root surfaces is an important goal in periodontal plastic surgery. In this report, recession coverage was performed as laterally sliding flap technique with the adjunctive use of enamel matrix derivative (EMD). The cases of 2 female patients with gingival recession on the maxillary canines are presented with 1-year follow-up observation. Initial vertical gingival recessions were 4.0 mm each, with a probing depth of 1.0 mm. The surgical procedure immediately produced a marked reduction in gingival recessions. In the course of healing, the soft tissue margin on the operated teeth showed some shrinkage in the first months. After 1 year, complete root coverage (100%) was observed, with a probing depth of 0.5 mm and 5.0-mm gain of clinical attachment in both cases, and there was 0.5-mm creeping tissue above the cemento-enamel junction. Within the limits of these cases, the results demonstrated the possibility of treating human buccal recessions with EMD plus laterally sliding flap, with predictable root coverage and clinical attachment gain.

  2. Morphology of the Lingual and Buccal Papillae in Alpaca (Vicugna pacos) - Light and Scanning Electron Microscopy.

    Science.gov (United States)

    Goździewska-Harłajczuk, K; Klećkowska-Nawrot, J; Janeczek, M; Zawadzki, M

    2015-10-01

    The aim of this study was the description of the lingual and buccal papillae in adult alpaca (Vicugna pacos) by light and scanning electron microscopy (SEM). The tongue consisted of apex, body and root. Four types of lingual papillae (filiform, fungiform, conical and circumvallate) in addition to two types of buccal papillae were observed. The filiform papillae, some with secondary papillae, were distributed on both the corpus and apex of the tongue, with stratified epithelium, and layer of keratin coat were recognized. The short (small) cone papillae had pointed top, while bunoform papillae were wide with smooth apex. The much less numerous circumvallate papillae with pseudopapillae on the each rim of the caudal lingual body were present with weak layer of keratin and intra-epithelial taste buds. The small fungiform papillae were found on the dorsal lingual surface, while the large fungiform papillae were situated on the ventral surface of the tongue, especially, in rostral part and were round in shape with numerous gustatory pores and very thin keratin coat. Pseudopapillae were present on the buccal conical 'bunoform' papillae surface, while 'elongate' buccal papillae surface was rather softly folded with thin coat of keratin. Microridges were observed in the less keratinized parts of each type of papillae. The orientation of either lingual or buccal papillae into the throat side facilitates the emptying of oral cavity from nutrient and swallowing of food. In conclusion, the anatomical features of the alpaca tongue are an adaptation to the feeding habits. © 2014 Blackwell Verlag GmbH.

  3. Influence of anatomic reference on the buccal contour of prosthetic crowns

    Directory of Open Access Journals (Sweden)

    Flávia Sabrina Queirós Vasconcelos

    2009-09-01

    Full Text Available During clinical practice, when performing prosthetic rehabilitation with single crowns, improper reproduction of the dental contour by the dental laboratory is a common occurrence. Therefore, the present study evaluated the fidelity of the reproduction of the buccal contour in an upper left canine performed by three Dental Prosthesis Technicians (DPT using the indirect laminate veneer technique. First, the DPTs confected the veneers based on a model obtained from the upper arch of a dental dummy, containing a replica of an upper left canine with a prosthetic preparation for a laminate veneer. Then, the same DPTs received other identical models, now with the replica of the upper left canine with no preparation, to be used as an anatomical reference for confecting the laminate veneers. The laminate veneers were then bonded to the plaster models and had their buccal contour individually measured. Measurements were also made of the buccal contour of the reference canine. The data were analyzed by ANOVA and the t-test (p = 0.05. Results showed 100% of buccal overcontour when the laminate veneers were compared to the reference canine, regardless of which DPT confected the veneer and regardless of using or not the anatomical reference. The DPTs who participated in the present study were unable to acomplish a faithful anatomical reproduction of the buccal contour, creating an overcontour in all samples. This situation may be responsible for increasing the probability of periodontal and esthetic harm in clinical practice.

  4. Buccal space lesions: a new classification based on CT and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo Cheol; Han, Moon Hee; Moon, Min Hoan [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

    2004-02-01

    To present a new classification based on the CT and MR imaging findings of buccal space lesions, and to propose guidelines for their radiologic differentiation. Sixty-two histopathologically confirmed or clinically diagnosed buccal space lesions were classified on the basis of their morphologic appearance and extension to adjacent space as either (1) a mass with a distinct margin, confined to the buccal space; (2) a mass with surrounding infiltration, confined to the buccal space; or (3) a multi-space occupying mass. Type 1 included pleomorphic adenoma, ex-pleomorphic adenoma, carcinoma, B-cell lymphoma, acinic cell carcinoma, rhabdomyosarcoma, glomus tumor and ameloblastoma, and differentiation between malignant and benign neoplasms was not possible. Type 2 included adenoid cystic carcinoma, abscess, complicated dermoid cyst, and Kimura disease. T-cell lymphoma, neurofibroma, vascular malformation, inflammation, and foreign body granuloma pertained to type 3, and each type-3 entity showed different imaging characteristics. This new classification based on CT and MR imaging characteristics may provide useful guide-lines for predicting the differential diagnosis of buccal space lesions.

  5. DNA from buccal swabs suitable for high-throughput SNP multiplex analysis.

    Science.gov (United States)

    McMichael, Gai L; Gibson, Catherine S; O'Callaghan, Michael E; Goldwater, Paul N; Dekker, Gustaaf A; Haan, Eric A; MacLennan, Alastair H

    2009-12-01

    We sought a convenient and reliable method for collection of genetic material that is inexpensive and noninvasive and suitable for self-collection and mailing and a compatible, commercial DNA extraction protocol to meet quantitative and qualitative requirements for high-throughput single nucleotide polymorphism (SNP) multiplex analysis on an automated platform. Buccal swabs were collected from 34 individuals as part of a pilot study to test commercially available buccal swabs and DNA extraction kits. DNA was quantified on a spectrofluorometer with Picogreen dsDNA prior to testing the DNA integrity with predesigned SNP multiplex assays. Based on the pilot study results, the Catch-All swabs and Isohelix buccal DNA isolation kit were selected for our high-throughput application and extended to a further 1140 samples as part of a large cohort study. The average DNA yield in the pilot study (n=34) was 1.94 microg +/- 0.54 with a 94% genotyping pass rate. For the high-throughput application (n=1140), the average DNA yield was 2.44 microg +/- 1.74 with a >or=93% genotyping pass rate. The Catch-All buccal swabs are a convenient and cost-effective alternative to blood sampling. Combined with the Isohelix buccal DNA isolation kit, they provided DNA of sufficient quantity and quality for high-throughput SNP multiplex analysis.

  6. Corneal flap thickness and topography changes induced by flap creation during laser in situ keratomileusis.

    Science.gov (United States)

    Güell, José L; Velasco, Fortino; Roberts, Cynthia; Sisquella, Maria Teresa; Mahmoud, Ashraf

    2005-01-01

    To determine the corneal flap thickness profile produced by 3 microkeratomes and the topographic changes induced by flap creation in laser in situ keratomileusis (LASIK). Cornea and Refractive Surgery Unit, Instituto de Microcirugia Ocular de Barcelona, Autonoma University, Barcelona, Spain. In this prospective consecutive nonrandomized comparative study, patients were divided into 2 groups. In Group 1 (75 eyes), 3 microkeratomes were used: Moria LSX One, Moria M2, and Amadeus (AMO); 25 eyes per microkeratome. Pachymetry was measured with a DGH pachymeter in the center of the cornea and 3.0 mm from the center at 4 cardinal points (superior, inferior, nasal, and temporal; 3 measurements at each point) before and after the cut. The flap thickness in each sector was calculated by subtracting the mean post-flap corneal thickness from the mean pre-flap corneal thickness. In Group 2 (33 eyes), the M2 microkeratome with a 130 microm plate was used to create a superotemporal hinged flap (9 eyes) or a superonasal hinged flap (24 eyes). The topographic change induced by the microkeratome cut was evaluated using 4 sequential data acquisitions by the Keratron Scout topographic unit (Optikon) before and immediately after the cut (before laser ablation). Cardinal and oblique astigmatism and change in the axis were calculated by vectorial analysis of the simulated keratometry. Topographic Zernike analysis was performed in a subgroup. With the LSX One microkeratome, the mean flap thickness was 151.7 microm centrally, 161.9 microm superiorly, 151.4 microm inferiorly, 156.1 microm temporally, and 167.5 microm nasally. There was no statistically significant difference between the areas studied (P.05). With the Amadeus microkeratome, the mean flap thickness was 140.0 microm centrally, 152.5 superiorly, 128.5 microm inferiorly, 145.0 microm temporally, and 147.0 microm nasally. Statistically significant differences (P>.05) were found in the 4 sectors of the flap. With vectorial

  7. Penetration effect of prostaglandin E2 gel on oral mucosa of rats

    Directory of Open Access Journals (Sweden)

    Rafinus Arifin

    2012-09-01

    Full Text Available Background: Several researches reported that Prostaglandin E2 (PGE2 injection on buccal mucosa combined with orthodontic pressure can faster tooth movement but has disadvantages such as high alveolar bone and root resorption furthermore pain from injection needle. PGE2 gel was made to better replace the lacks of injectable PGE2. Purpose: This research was aimed to prove that PGE 2 gel can penetrate rat’s oral mucosa effecting the appearance of PMN cells. Methods: This research was an in vivo laboratory experiment using 36 Sprague Dawley rats which were divided into 3 groups: normal group, topical PGE2 gel group after 1, 2, 4, 8 hours (4 subgroups, and topical gel without PGE2 group after 1, 2, 4, 8 hours (4 subgroups. Each group consists of 4 rats, therefore the total sample for all research groups were 36 rats. Gel with 25 µg/mL of PGE2 and gel without PGE2 were applied on oral mucosa for 2 minutes. Then, the rats were sacrificed after 1 hour, 2 hours, 4 hours, and 8 hours application. After that, the samples were prepared for histological examination with Hematoxyllin and Eosin. The picture were taken with OptiLab View and PMN cells amount were counted with light microscope, set 400 times of magnification. Results: Penetration effect of PGE2 gel on rat’s oral mucosa result in PMN inflammation cells distribution. One-way ANOVA showed no significant difference on PMN cells count in rats’ lower jaws between groups of normal and gel without PGE2. There was significant difference between groups of PGE2 gel and gel without PGE2 (p=0,001. PGE2 gel application showed PGE2 as inflammatory media, even though administered topically. Conclusion: PGE2 gel can penetrate rat’s oral mucosa, effecting PMN cells 1, 2, 4 and 8 hours after application of PGE2 gel.Latar belakang: Beberapa penelitian melaporkan bahwa injeksi (Prostaglandin E2 PGE2pada mukosa bukal yang dikombinasikan dengan tekanan ortodonti dapat mempercepat pergerakan gigi, tapi

  8. Reverse-Flow Lateral Tarsal Island Flap for Covering the Great Toe Donor Site of Wraparound Flap.

    Science.gov (United States)

    Jia, Yachao; Xu, Jia; Kang, Qinglin; Zhang, Changqing; Chai, Yimin

    2016-10-01

    Coverage of the great toe donor site of wraparound flap remains a challenge. This report presents the results of using an innervated pedicled reverse-flow lateral tarsal island flap for covering the great toe donor site of wraparound flap. Between 2005 and 2010, 11 reverse-flow lateral tarsal island flaps were used to cover the great toe donor site of wraparound flap in 11 patients. This pedicled flap designed on the lateral tarsal area of foot was based distally on the dorsalis pedis artery; the lateral dorsal pedal cutaneous nerve was incorporated into the reverse-flow lateral tarsal island flap and coapted with the first plantar digital nerve. The donor sites of reverse-flow lateral tarsal island flap were covered with inguinal full-thickness skin grafts. All flaps achieved primary healing except for two that suffered from mild venous insufficiency which was managed by conservative intervention. All skin grafts covering the donor site of reverse-flow lateral tarsal island flap healed uneventfully. The mean follow-up was 24 months (range, 18-48 months). The mean hallux metatarsophalangeal-interphalangeal scale score was 92 points (range, 85-97 points) at 6 months postoperatively. The static 2-point discrimination of the reverse-flow lateral tarsal island flap ranged from 6 to 14 mm (mean 10 mm). None of the patients were restricted in standing or walking during follow-up. The reverse-flow lateral tarsal island flap based distally on the dorsalis pedis artery has a constant pedicle that is sufficiently long. This innervated pedicle flap is a reliable option to cover the great toe donor site of wraparound flap with satisfactory functional and cosmetic results and acceptable donor site morbidity.

  9. The value of the 'buccal pad of fat' in the reconstruction of oral defects following removal of intraoral tumours--a clinical assessment.

    Science.gov (United States)

    Stassen, L; Khosa, A D; Israr, M

    2013-01-01

    The buccal pad of fat (BPF) is an important structure found in the orofacial region of humans. It is larger in infants and gradually becomes smaller in adults. We present twenty seven (27) cases with an average age of 60 years, with a variety of pathological lesions in which we have used the BPF to reconstruct the defects following resection of tumours. Twenty (74%) patients were diagnosed with Squamous Cell Carcinma. The commonest surgical sites were the soft palate and maxilla (46%). A clinical analysis of the value of BPF in reconstruction was made by using assessment criteria, mouth opening, cosmesis, fistula formation, approved by the ethical committee of the Hospital. Our findings show that the BPF is an excellent pedicled graft for the reconstruction of defects up to 10x5.5x1.1 cm in size. The donor site had no morbidity in terms of fuctions including, mouth opening (normal), masticatory movement, deglution, motor / sensory loss and patients were unaffected cosmetically (no temporal hollwing). There was no abnormal finding e.g. fistula, Frey's syndrome, speech and movement of the soft palate was unaffected. Salivary function was not affected (parotid duct). Speech outcomes were normal. We used a pre-surgery constructed blow--down soft or a preformed acrylic plate to support the fat pad in 13 (50%) patients, secured with mini screws. The use of a splint to support and protect the flap allowed early feeding.

  10. Wing loading on a 60 degree delta wing with vortex flaps

    Science.gov (United States)

    Marchman, J. F., III; Donatelli, D. A.; Terry, J. E.

    1983-01-01

    Wind tunnel tests were conducted on a 60 deg delta wing with three vortex flap designs to determine pressure distributions over the wing and flap. The results showed that an optimum vortex flap design depends on proper definition of the vortex flap deflection angle. They also revealed that flap thickness plays an important role in the behavior of the vortex flow over the flap and wing and can have a substantial effect on wing and flap pressure loading. Design codes which fail to account for thickness may result in a much less than optimum flap and deprive the designer of an important tool in designing an effective flap with optimum loading.

  11. Urethral Mucosa Prolapse in an 18-Year-Old Adolescent

    OpenAIRE

    Akadiri Olumide; Ajenifuja Kayode Olusegun; Bakare Babatola

    2013-01-01

    Urethra mucosa prolapse is a benign condition in which there is a circular protrusion of the distal urethra through the external urethra meatus. It is more commonly seen in prepubertal black girls and postmenopausal white women. It is rare in the reproductive age group. This case describes the presentation and management of an 18-year-old adolescent with urethra mucosa prolapse.

  12. Oral medicine 6. Ulceraties van de oral mucosa

    NARCIS (Netherlands)

    Baart, J.A.; van der Waal, I.

    2013-01-01

    Een ulcus wordt gedefinieerd als een door weefselverval ontstaan oppervlaktedefect van de huid of de mucosa met geringe neiging tot genezing. Ulceraties van de orale mucosa kunnen variëren van een onschuldige afte tot een kwaadaardig plaveiselcelcarcinoom. Op grond van een zorgvuldig afgenomen

  13. Morphological characteristics of the canine and feline stomach mucosa.

    Science.gov (United States)

    Zahariev, P; Sapundzhiev, E; Pupaki, D; Rashev, P; Palov, A; Todorov, T

    2010-12-01

    The stomach mucosa structure in animals belonging to Order Carnivora indicates some specific characteristics in comparison with the other mammals. Between the bases of the mucosal glands and the lamina muscularis mucosae there is an additional plate which most of the morphologists have defined as lamina subglandularis. In currently used Nomina histologica this layer is indicated as stratum compactum in carnivorous stomach mucosa. The investigation aims were to study and compare canine and feline stomach tunica mucosa characteristics as well as to measure the thickness of stratum compactum and to specify some of the certain collagen types and fibronectin compounds. Conventional and differential histological and ultrastructural methods and immuno-histochemical approaches for investigation of the canine and feline stomach samples were used. The specific organization of the carnivorous stomach wall arrangement was established. In the structure of the canine stomach mucosa, no evidence of stratum compactum was observed. The presence of stratum compactum in feline stomach mucosa was ascertained and measured. Using an immunohistochemical method very high expression of collagen type IV and fibronectin, moderate positive reaction of collagen type III, and a comparatively weakest expression of collagen types I and V in the structure of stratum compactum from cat stomach mucosa was shown. The obtained results clarify the characteristics of the stomach mucosa morphology and could be used as a basis for distinguishing the stomach wall structure of the animal species belonging to Canidae and Felidae families although they are both carnivores. © 2010 Blackwell Verlag GmbH.

  14. Lateral thoracic artery axial pattern flap in cats.

    Science.gov (United States)

    Benzioni, Hadas; Shahar, Ron; Yudelevich, Sigal; Shipov, Anna; Milgram, Joshua

    2009-01-01

    To describe the location of the lateral thoracic artery (LTA), determine dimensions of an axial pattern flap based on this artery, and report use of this flap in 2 cats. Ex vivo study and case reports. Cat cadavers (n=8); cats (n=2) with thoracic limb skin defects. Dissection of the LTA was carried out on 1 side of each cadaver and the contralateral side was used for injection studies. In 4 specimens, the LTA was cannulated and injected with positive contrast material and the flap was raised and radiographed. In 4 specimens, the flap was injected with methylene blue. Adequacy of flap injection was subjectively evaluated and leakage of methylene blue from the cut edge was noted. The cutaneous location of the LTA caudal to the triceps muscle was confirmed. Mean flap size was 8.7 cm x 15.5 cm for a mature, average-sized cat. Perfusion of the entire flap was demonstrated and viability of the flap was confirmed in 2 clinical cases. The LTA flap is useful for repair of skin defects of the brachium and antebrachium in cats. The LTA flap is an alternative technique for repair of skin defects involving the thoracic limb of cats.

  15. Behaviour of the buccal crestal bone levels after immediate placement of implants subjected to immediate loading.

    Science.gov (United States)

    Lemes, H deP; Sartori, I A deM; Cardoso, L C; Ponzoni, D

    2015-03-01

    The aim of this study was to measure changes in buccal alveolar crestal bone levels after immediate placement and loading of dental implants with Morse taper prosthetic abutments after tooth extraction. This study followed the STROBE guidelines regarding prospective cohort studies. The sample comprised 12 patients with a mean age of 45 years, in whom a central or upper lateral incisor was indicated for extraction. Prior to extraction, computed tomography (CT) analysis was carried out to assess the presence of the buccal bone crest. CT scans were performed at 24 h and at 6 months after immediate implant placement and immediate loading. The distance from the most apical point of the implant platform to the buccal bone crest was assessed at the two time points. The buccal bone crest height was evaluated at three points in the mesio-distal direction: (1) the centre point of the alveolus, (2) 1mm mesial to the centre point, and (3) 1 mm distal to the centre point. The values obtained were subjected to statistical analysis, comparing the distances from the bone crest to the implant platform for the two time points. After 6 months there was a statistically significant, non-uniform reduction in height at the level of the crest of the buccal bone in the cervical direction. It is concluded that the buccal bone crest of the immediate implants that replaced the maxillary incisors underwent apical resorption when subjected to immediate loading. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion

    Energy Technology Data Exchange (ETDEWEB)

    Akyalcin, Sercan; Englih, Jeryl D.; Stephens, Claude R.; Winkelmann, Sam [Dept. of Orthodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Schaefer, Jeffrey S. [Todd Hughes Orthodontics, Houston (United States)

    2013-06-15

    This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.

  17. Study of the microcirculation of oral mucosa in healthy subjects.

    Science.gov (United States)

    Scardina, Giuseppe Alessandro; Messina, Pietro

    2003-01-01

    The research has the following aims: 1: to verify the applicability of capillaroscopic investigation to oral mucosa; 2: to propose oral mucosa as an alternative to the fingernail fold for capillaroscopic investigation; 3: to describe the characteristics of the microcirculation of oral mucosa in healthy subjects. 100 healthy patients were examined. The characteristics of the micro-circulation in the areas of gum mucosa and the mucosa covering of the lower lip were examined using computerised videomicroscopic techniques. For each patient we evaluated the visibility, the course, the density, the tortuosity and any images characteristic of capillary loops, besides the possible presence of microhaemorrhages, the average calibre of capillary loops and the number of capillary loops visible per square millimetre. The investigation was simple, non invasive and repeatable for each patient. An investigation of gum mucosa has revealed a course of capillary loops both parallel and perpendicular to the surface: often the tops of the capillary loops appear as regularly distributed dots or commas. Microcirculatory architecture in the area of the mucosa covering is characterised by capillary loops with a variable diameter, course and length; next to typical capillary loops with the appearance of horse stirrups, there are other loops similar to hairpins, commas and cork screws; there are also rare microhaemorrhages with the aspect of reddish stains, that could be caused by microtraumas. Visibility was very good in the area of the mucosa covering of the lower lip: mediocre in the area of gum mucosa. Our research has highlighted, that today it is possible to carry out a capillaroscopic investigation of oral mucosa in a simple and reliable way. Future research could evaluate how "normal microcirculation", that we describe in this paper, is modified during pathology

  18. High-throughput sequencing of forensic genetic samples using punches of FTA cards with buccal swabs

    DEFF Research Database (Denmark)

    Kampmann, Marie-Louise; Buchard, Anders; Børsting, Claus

    2016-01-01

    Here, we demonstrate that punches from buccal swab samples preserved on FTA cards can be used for high-throughput DNA sequencing, also known as massively parallel sequencing (MPS). We typed 44 reference samples with the HID-Ion AmpliSeq Identity Panel using washed 1.2 mm punches from FTA cards...... with buccal swabs and compared the results with those obtained with DNA extracted using the EZ1 DNA Investigator Kit. Concordant profiles were obtained for all samples. Our protocol includes simple punch, wash, and PCR steps, reducing cost and hands-on time in the laboratory. Furthermore, it facilitates...... automation of DNA sequencing....

  19. Effects Aerosol of Industrial Bleach and Detergent Mixture on Mucosa Layer and Lamina Mucosa Conjunctiva in Mice

    Directory of Open Access Journals (Sweden)

    Gh. Vaezi

    2013-06-01

    Full Text Available Today bleach and detergents are being frequently used and some people use their mixture for more cleaning. Because of chemical interaction of bleach and detergent, chlorine gas was released and thereby it could be dangerous for human health. This study examined the effects of exposed toxic mixture of bleach and detergent on the Mucosa layer and Lamina mucosa conjunctiva in the mice. In this study, 42 adult male mice NMRI race weighing 35-40 gr and from age 8 to 10 weeks were divided into 6 experimental groups and one control group. Experimental groups 1-2-3 with the use of chamber, the exposed 20 minutes were exposed to spray the amount 1 cc of mixture of bleach and detergent by nebulizer. Experimental groups 4-5-6 were for 35 minutes to inhale the same amount of material. Mice killed at 24-48-72 hours after exposed and the Mucosa Layer and Lamina mucosa conjunctiva tissue was studied pathology. In the study of microscopic sections prepared of mouse mucosa layer and Lamina mucosa conjunctiva tissue experimental group comparison with the control group, significant decrease was observed in mucosa layer the have (p ≤ 0.001  and significant decrease was observed in the Lamina mucosa have(p ≤ 0. 01,  p ≤ 0.001. As a result, increasing the exposed time of mixing bleach and detergent, as time passed, increasing the tissue damage and changes.

  20. Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

    Directory of Open Access Journals (Sweden)

    Edwin Jonathan Aslim

    2014-09-01

    Full Text Available BackgroundGroin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds.MethodsGroin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded.ResultsTwenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10 and the vertical rectus abdominis (n=13 pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series.ConclusionsThe anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.

  1. Modified one-stage dorsal-inlay buccal mucosa graft technique for ventral penile urethral and penile skin erosion: A step-by-step guide

    OpenAIRE

    Van Putte, Lennert; De Win, Gunter

    2016-01-01

    Objective To demonstrate the use of a modified single-stage technique for the repair of a ventral penile urethral erosion with involvement of the penile skin, as penile urethral erosion is a rare but potential complication of chronic indwelling catheterisation with a lack of available recommendations for reconstructive options. Patient and methods A 44-year-old male with paraplegia, neurogenic bladder dysfunction and chronic sacral decubitus, presented with a large mid-penile erosion of the v...

  2. Comparative Analyses Between the Smoking Habit Frequency and the Nucleolar Organizer Region Associated Proteins in Exfoliative Cytology of Smokers' Normal Buccal Mucosa

    Directory of Open Access Journals (Sweden)

    Cançado Renata

    2004-03-01

    Full Text Available Abstract An evaluation of the cellular alterations in the smoker's oral mucosal cells was performed. Exfoliative Citology technique were applied and the cytologic smears stained with silver for quantitative analyses of Argyrophilic nucleolar organizer regions. (AgNORs. Cytologic smears were collected from two anatomic sites, mouth floor and tongue border with the purpose of relating the frequency of smoking with the quantitative analyses of the AgNORs. This study showed that the average number of AgNORs/nucleus is related with the number of cigarettes per day in the mouth floor of smoker's. These results suggest a possible relation between the number of cigarettes per day and an increase rate of cellular proliferation in the oral mucosal cells.

  3. Diagnóstico del carcinoma escamoso de la mucosa bucal: reporte de 5 casos Diagnosis of the squamous carcinoma of the buccal mucous: report of 5 cases

    OpenAIRE

    JE Baudo

    2005-01-01

    Es indudable que el cáncer bucal causa un importante número de muertes a nivel mundial. El cáncer invasivo puede permanecer largo tiempo bajo cambios macroscópicos inespecíficos, sólo la biopsia permite su diagnóstico. La técnica más utilizada es la rutina con hematoxilina - eosina, actualmente se agrega a la misma otras que contribuyen a clarificar el diagnóstico, por ejemplo la inmunohistoquímica, que en muchos casos determinará la estirpe de una neoplasia.It is certain that the cancer bucc...

  4. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation.

    Science.gov (United States)

    Yang, Jae-Won; Kim, Jin-Soo; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young; Abdullah, Shalimar; Tien, Huey-Yuan

    2010-10-01

    The free thenar flap is useful for coverage of volar finger defects but has an inconstant innervation based on the presence of either the lateral antebrachial cutaneous nerve (LABC) or the superficial sensory branch of the radial nerve (SSRN). A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The palmar cutaneous branch of the median nerve (PCMN) was present within the flap in all cases. However, the LABC and the SSRN were available in only 43.33% and 46.66%, respectively, with neither of them in 33.33% of the cases. The constantly present PCMN allowed the design of a new flap named the radial artery superficial palmar branch (RASP) flap. The RASP flap is large enough to cover volar finger defects and contain direct skin perforators. Because it is constantly innervated, it is an excellent option for coverage of volar finger defects extending to the fingertips. © Thieme Medical Publishers.

  5. Proximally Based Anterolateral-Thigh (ALT) Flap for Knee Reconstruction: An Advancement Propeller Perforator Flap.

    Science.gov (United States)

    Cadenelli, Pierfrancesco; Bordoni, Daniele; Radaelli, Stefano; Marchesi, Andrea

    2015-10-01

    Adequate coverage of the knee region is often challenging for plastic and orthopedic surgeons. In the last decade, among several reconstructive techniques, local perforator flaps have become useful reconstructive units. After a wide resection for soft-tissue sarcoma, the knee vascular web may be reasonably damaged and, consequently, perforator flaps based on a local pedicle [such as the distally based anterolateral thigh (ALT) flap] are not reliable. Thus, we harvested a proximally based ALT for knee coverage. A 52-year-old man underwent local radiation therapy and a wide resection of a soft-tissue sarcoma on the anterior-lateral aspect of the left knee, which resulted in a 15 × 10 cm defect. The defect was covered with a proximally based ALT, through an advancement and propeller relocation of its skin paddle. All margins were tumor free. After 5 days, the donor site was closed primarily because of edema. Neither necrosis of the flap nor dehiscence of the wound was detected. No local relapses were detected at 6-month follow-up. In case of soft-tissue defects of the knee region, with likely involvement of the local vascular web, a local perforator solution is the advancement and propeller proximally based ALT flap. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  6. Poloxamer bioadhesive hydrogel for buccal drug delivery: Cytotoxicity and trans-epithelial permeability evaluations using TR146 human buccal epithelial cell line.

    Science.gov (United States)

    Zeng, Ni; Mignet, Nathalie; Dumortier, Gilles; Olivier, Elodie; Seguin, Johanne; Maury, Marc; Scherman, Daniel; Rat, Patrice; Boudy, Vincent

    2015-11-30

    A salbutamol sulfate (SS)-Poloxamer bioadhesive hydrogel specially developed for buccal administration was investigated by studying interactions with TR146 human buccal epithelium cells (i.e. cellular toxicity (i) and trans-epithelial SS diffusion (ii)). The assessment of cell viability (MTT, Alamar Blue), membrane integrity (Neutral Red), and apoptosis assay (Hoechst 33342), were performed and associated to Digital Holographic Microscopy analysis. After the treatment of 2h, SS solution induced drastic cellular alterations that were prevented by hydrogels in relation with the concentrations of poloxamer and xanthan gum. The formulation containing P407 19%/P188 1%/Satiaxane 0.1% showed the best tolerance after single and multiple administrations and significantly reduced the trans-epithelial permeability from 5.00±0.29 (×10(3)) (SS solution) to 1.83±0.22 cm/h. Digital Holographic Microscopy images in good agreement with the viability data confirmed the great interest of this direct technique. In conclusion, the proposed hydrogels represent a safe and efficient buccal drug delivery platform. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. The Effectiveness of Articaine and Lidocaine Single Buccal Infiltration versus Conventional Buccal and Palatal Injection Using Lidocaine during Primary Maxillary Molar Extraction: A Randomized Control Trial.

    Science.gov (United States)

    Kolli, Naveen Kumar Reddy; Nirmala, S V S G; Nuvvula, Sivakumar

    2017-01-01

    Despite the advent of modern injection techniques, palatal injection continues to be a painful experience for children. To compare the pain experienced during extraction of maxillary primary molars with conventional lignocaine anesthesia versus lignocaine and articaine buccal infiltration in children aged 6-14 years. A prospective randomized triple blinded study was conducted with ninety children (n = 90), randomly allocated to receive lignocaine conventional anesthesia (Group I [control group]), and buccal infiltration using articaine (Group II [articaine group]) or lignocaine (Group III [lignocaine group]). A composite score of self-report (faces pain scale-revised), behavioral measure (face legs activity cry consolability scale), and a physiological response (pulse rate) was measured following maxillary primary molar extraction. To test the mean difference between two groups, Students' t-test was used and among the three groups, one-way ANOVA with post hoc test was used. Articaine group had significantly lower pain scores for self-report (P 0.05) between articaine and control groups during primary maxillary molar extraction. Maxillary primary molar extraction procedure can be successfully accomplished by bypassing the palatal injection. Articaine buccal infiltration can be considered as an alternative to conventional local anesthesia for the extraction of maxillary primary molars.

  8. Effect of Flapless Immediate Implantation and Filling the Buccal Gap with Xenograft Material on the Buccal Bone Level: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mojgan Paknejad

    2017-12-01

    Full Text Available Objectives: Following tooth extraction, soft and hard tissue alterations occur; Different factors can affect this process. The objective of this study was to determine the effect of gap filling on buccal alveolar crestal bone level after immediate implant placement after 4- to 6-month observation period.Materials and Methods: This   randomized clinical trial was performed on 20 patients (mean age of 38.8 years requiring tooth extraction in a total of 27 areas in the anterior maxilla. The treatment strategy was as follows: atraumatic flapless tooth extraction, implant placement, insertion of a graft (test group or no material (control group between the implant and the socket wall, connection healing abutment placement and suturing the area. Clinical and cone beam computed tomographic examinations were performed before implant placement (baseline, 24 hours after surgery and 4-6 months (T2 after implant placement, to assess the buccal plate height (BH and implant complications.Results: After 4 months of healing, a reduction in different bone measurements was noticed in the two groups. No statistically significant differences were assessed in bone height measurements between the test and control groups at different time points. The study demonstrated that immediate implantation resulted in 1.30 and 1.66 mm reduction in buccal bone plate in the test and control groups, respectively.Conclusions: The study demonstrated that immediate implantation in the extraction socket together with xenograft failed to prevent bone resorption.

  9. Stability investigation of an airfoil section with active flap control

    DEFF Research Database (Denmark)

    Bergami, Leonardo; Gaunaa, Mac

    2010-01-01

    This work presents a method to determine flutter and divergence instability limits for a two-dimensional (2-D) airfoil section fitted with an actively controlled trailing edge flap. This flap consists of a deformable trailing edge, which deformation is governed by control algorithms based...... for fatigue load alleviation. The structural model of the 2-D airfoil section contains three degrees of freedom: heave translation, pitch rotation and flap deflection. A potential flow model provides the aerodynamic forces and their distribution. The unsteady aerodynamics are described using an indicial....... The implemented stability tool is then applied to an airfoil section representative of a wind turbine blade with active flap control. It is thereby observed that the airfoil stability limits are significantly modified by the presence of the flap, and they depend on several parameters: flap structural...

  10. Immediately observation on post-LASIK corneal flap

    Directory of Open Access Journals (Sweden)

    Kun Wu

    2014-08-01

    Full Text Available AIM:To immediately observe the complication of corneal flap after LASIK surgery.METHODS:A retrospective case series were studies.Totally 2 040 cases(4 080 eyesfrom January 2010 to October 2012 in our hospital were collected, the corneal flap was observed using lamp microscope after LASIK within 30min. Corneal flap dislocation, corneal flap strial and intraface debris were examined after operation, the effective treatment and controlled measure should be taken for these complications.RESULTS: Postoperative complications were corneal flap dislocation 102 eyes(2.5%, corneal flapstriae 95 eyes(2.33%, interface debris 105 eyes(2.57%. No failure case was seen. There had no corneal flap-related complications, which seriously impact the visual quality after the surgery.CONCLUSION: Carefully postoperative examination at the first-time is an effective way to manage some complications of post-LASIK. Thus promoting the diagnosis and treatment of post-LASIK complications.

  11. Temporal-based pericranial flaps for orbitofrontal Dural repair: A technical note and Review of the literature

    Directory of Open Access Journals (Sweden)

    Esther Dupépé

    2016-03-01

    Conclusions: A temporal-based pericranial flap represents an alternative vascularized pedicle flap to the classic frontal-based pericranial flap used in orbitofrontal dural repair. In certain clinical settings, the temporal-based flap may be preferable.

  12. Shape and Structural Optimization of Flapping Wings

    OpenAIRE

    Stewart, Eric C

    2014-01-01

    This dissertation presents shape and structural optimization studies on flapping wings for micro air vehicles. The design space of the optimization includes the wing planform and the structural properties that are relevant to the wing model being analyzed. The planform design is parameterized using a novel technique called modified Zimmerman, which extends the concept of Zimmerman planforms to include four ellipses rather than two. Three wing types are considered: rigid, plate-like deformable...

  13. Current indications for the osteoplastic flap.

    Science.gov (United States)

    Rivera, Teresa; Rodríguez, Manuel; Pulido, Natalia; García-Alcántara, Fernando; Sanz, Lorena

    2016-01-01

    Endoscopic sinus surgery is the technique of choice in most of the frontal sinus diseases, both inflammatory and tumour-related. This is why the external approach using osteoplastic flap (OF) would be limited to cases with a difficult endoscopic approach. Our aim was to review the current indications of the osteoplastic flap in the treatment of frontal sinus pathology, through a retrospective study of patients undergoing this technique. We performed a retrospective study of 14 patients who were treated with the osteoplastic flap procedure. All the surgical indication criteria, type of sinus disease, presence or absence of prior endoscopic surgery, surgical findings, complications and recurrence were reviewed. The pathologies found were 1 osteoma (7.1%), 3 inverted papilloma (21.4%) and 10 mucoceles (71.4%). Nine patients had a prior endoscopic surgery and 10 patients had an orbital dehiscence (9 mucocele, 1 papilloma). Frontal osteoma was Grade IV and the papilloma cases were Krouse Stage III. Surgical revision was required for 21.4%. The main indications for an OF in patients with inflammatory disease are lateral extension and frontal recess neo-osteogenesis. In osteoma cases, it depends on the size of the tumour. In inverted papilloma cases, the indication is multifocal implantation with origin in the anterior and lateral wall. In all cases, performing the osteoplastic flap must be individualised. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  14. Shape and Structural Optimization of Flapping Wings

    Science.gov (United States)

    Stewart, Eric Colby

    This dissertation presents shape and structural optimization studies on flapping wings for micro air vehicles. The design space of the optimization includes the wing planform and the structural properties that are relevant to the wing model being analyzed. The planform design is parameterized using a novel technique called modified Zimmerman, which extends the concept of Zimmerman planforms to include four ellipses rather than two. Three wing types are considered: rigid, plate-like deformable, and membrane. The rigid wing requires no structural design variables. The structural design variables for the plate-like wing are the thickness distribution polynomial coefficients. The structural variables for the membrane wing control the in-plane distributed forces which modulate the structural deformation of the wing. The rigid wing optimization is performed using the modified Zimmerman method to describe the wing. A quasi-steady aerodynamics model is used to calculate the thrust and input power required during the flapping cycle. An assumed inflow model is derived based on lifting-line theory and is used to better approximate the effects of the induced drag on the wing. A multi-objective optimization approach is used since more than one aspect is considered in flapping wing design. The the epsilon-constraint approach is used to calculate the Pareto optimal solutions that maximize the cycle-average thrust while minimizing the peak input power and the wing mass. An aeroelastic model is derived to calculate the aerodynamic performance and the structural response of the deformable wings. A linearized unsteady vortex lattice method is tightly coupled to a linear finite element model. The model is cost effective and the steady-state solution is solved by inverting a matrix. The aeroelastic model is used to maximize the thrust produced over one flapping cycle while minimizing the input power.

  15. Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen.

    Science.gov (United States)

    Parekh, Sanjay Manhar; Fields, Henry W; Beck, Michael; Rosenstiel, Stephen

    2006-07-01

    To evaluate changes in attractiveness on the basis of computerized variations of smile arcs and buccal corridors for male and female smiles judged by orthodontists and laypersons. Using a visual analog scale in a Web-based survey, orthodontists and laypersons rated the attractiveness of nine digitally altered smile arc and buccal corridor variations of male and female smiles. The variations were accomplished in a clinically relevant manner and based on standards set by experienced orthodontists in a pilot web-based survey. The results indicate that both laypersons and orthodontists prefer smiles in which the smile arc parallels the lower lip and buccal corridors are minimal. Significantly lower attractiveness ratings were found for smiles with flat smile arcs and excessive buccal corridors. Flattening of the smile arc overwhelms the deleterious effects of excessive buccal corridors on attractiveness ratings. On the basis of the results of this study, care should be taken not to produce an excessively flat smile arc during orthodontic treatment.

  16. Proline-Rich Peptide Mimics Effects of Enamel Matrix Derivative on Rat Oral Mucosa Incisional Wound Healing.

    Science.gov (United States)

    Villa, Oscar; Wohlfahrt, Johan C; Mdla, Ibrahimu; Petzold, Christiane; Reseland, Janne E; Snead, Malcolm L; Lyngstadaas, Staale P

    2015-12-01

    Proline-rich peptides have been shown to promote periodontal regeneration. However, their effect on soft tissue wound healing has not yet been investigated. The aim of this study is to evaluate the effect of enamel matrix derivative (EMD), tyrosine-rich amelogenin peptide (TRAP), and a synthetic proline-rich peptide (P2) on acute wound healing after a full-thickness flap procedure in an incisional rat model. This experimental study has a split-mouth, randomized, placebo-controlled design. Test and control wounds were created on the palatal mucosa of 54 Sprague-Dawley rats. Wounds were histologically processed, and reepithelialization, leukocyte infiltration, and angiogenesis were assessed at days 1, 3, and 7 post-surgery. EMD and P2 significantly promoted early wound closure at day 1 (P healing (P = 0.03 and 0.001, respectively). Leukocyte infiltration was decreased in EMD-treated wounds at day 1 (P = 0.03), and P2 and TRAP induced a similar effect at days 3 (P = 0.002 and P <0.0001, respectively) and 7 (P = 0.005 and P <0.001). EMD and P2 promoted reepithelialization and neovascularization in full-thickness surgical wounds on rat oral mucosa.

  17. Design, manufacturing and testing of Controllable Rubber Trailing Edge Flaps

    DEFF Research Database (Denmark)

    Løgstrup Andersen, Tom; Aagaard Madsen, Helge; Barlas, Thanasis K

    The overall goal for the INDUFLAP project was realization of a test facility for development and test of Controllable Rubber Trailing Edge Flaps (CRTEF) for wind turbines. This report covers experimental work at DTU Wind Energy including design, manufacture and test of different configurations...... of flaps with voids in chord- or spanwise direction. Development of rubber flaps has involved further design improvements. Non-metallic spring elements and solutions for sealing of continuous extruded rubber profiles have been investigated....

  18. A New Method for Creating the Bladder Flap

    Directory of Open Access Journals (Sweden)

    Alexandria J. Hill

    2013-01-01

    Full Text Available Background Bladder flaps are commonly created during routine cesarean deliveries and often require multiple steps that increase operating time and expose the surgeon to inadvertent injury. Objective We report a simple method of creating a bladder flap that eliminates the need for multiple instrument handoffs and repositioning. Conclusion The simplicity of this method allows the surgeon decreased operative entry time while decreasing exposure to injuries from multiple instrument handoffs during bladder flap development.

  19. Mastectomy skin flap necrosis: challenges and solutions

    Science.gov (United States)

    Robertson, Stuart A; Jeevaratnam, Johann A; Agrawal, Avi; Cutress, Ramsey I

    2017-01-01

    Introduction Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%–30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. Methods A MEDLINE search was performed using the search term “mastectomy skin flap necrosis”. Titles and abstracts from peer-reviewed publications were screened for relevance. Results MSFN is a common complication and may present as partial- or full-thickness necrosis. Predictive patient risk factors include smoking, diabetes, obesity, radiotherapy, previous scars and severe medical comorbidity. MSFN leads to a number of challenges, including wound management problems, delays to adjuvant therapy, esthetic compromise, implant extrusion, patient distress and financial loss. Careful preoperative planning and meticulous surgical technique may reduce the incidence of MSFN. A number of intraoperative techniques are available to try and predict skin flaps at risk of MSFN. MSFN may be managed operatively or nonoperatively. Early intervention may reduce the morbidity of MSFN in selected cases. Topical nitroglycerin ointment may be beneficial in reducing MSFN following immediate reconstruction, but the evidence base is still limited. Conclusion MSFN can result in considerable challenges for the patient and the health care service. This review discusses the management options for this problem. PMID:28331365

  20. The extended abdominal wall flap for transplantation.

    Science.gov (United States)

    Hollenbeck, S T; Senghaas, A; Turley, R; Ravindra, K V; Zenn, M R; Levin, L S; Erdmann, D

    2011-06-01

    Patients with extensive loss of the abdominal wall tissue have few options for restoring the abdominal cavity. Composite tissue allotransplantation has been used for limited abdominal wall reconstruction in the setting of visceral transplantation, yet replacement of the entire abdominal wall has not been described. The purpose of this study was to determine the maximal abdominal skin surface available through an external iliac/femoral cuff-based pedicle. Five human cadaveric abdominal walls were injected with methylene blue to analyze skin perfusion based on either the deep inferior epigastric artery (DIEA; n = 5) or a cuff of external iliac/femoral artery (n = 5) containing the deep circumflex iliac, deep inferior epigastric, and superficial inferior epigastric, and superficial circumflex iliac arteries. Abdominal wall flaps were taken full thickness from the costal margin to the midaxillary line and down to the pubic tubercle and proximal thigh. In all specimens, the deep inferior epigastric, deep circumflex iliac, superficial inferior epigastric, and superficial circumflex iliac arteries were found to originate within a 4-cm cuff of the external iliac/femoral artery. Abdominal wall flaps injected through a unilateral external iliac/femoral segment had a significantly greater degree of total flap perfusion than those injected through the DIEA alone (76.5% ± 4% vs 57.2% ± 5%; Student t test, P DIEA vessel alone. Copyright © 2011 Elsevier Inc. All rights reserved.