Background: Midfacial fractures are common outcomes of facial trauma. While younger individuals typically sustain these injuries through high-energy events like assaults and traffic or sports accidents, elderly patients increasingly present with fractures from low-energy mechanisms, primarily falls. Purpose: The aim of this study was to analyze age- and gender-specific patterns in midfacial fractures over a 10-year period, with emphasis on elderly individuals and low-energy trauma. Methods: A retrospective review was performed of proven midfacial fractures between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery (University of Pécs, Hungary). The patients were stratified by age (<65 vs. ≥65 years) and gender. The variables included the injury mechanism, fracture localization, the dental status, hospitalization, and the presence of associated injuries. Bivariate analyses were performed, and the significance level was set to p < 0.05. Results: A total of 957 radiologically confirmed midfacial fracture cases were evaluated, of whom 344 (35.9%) were ≥65 years old. In the elderly group, females had a 19-fold higher risk for midfacial trauma than younger females (OR: 19.1, 95%CI: 9.30–39.21). In the older group, a fall was significantly the most frequent injury mechanism (OR: 14.5; 95%CI: 9.9–21.3), responsible for 89.5% of the cases, while hospitalization (OR: 0.36; 95%CI: 0.23–0.56) was less characteristic. Most of the fractures occurred in the zygomatic bone, in the zygomaticomaxillary complex, or in the anterior wall of the maxilla. Associated injuries in the elderly group included mostly lower limb injuries—particularly pertrochanteric femoral fractures in females—and upper limb injuries, with a slight male dominance. Conclusions: Low-energy falls are the primary cause of midfacial fractures in elderly patients, particularly in women. Tailored prevention and management strategies are essential for improving the outcomes in this growing demographic group.

Introduction:This study aimed to determine if the treatment algorithm used for nonsyndromic cleft patients required alteration to manage syndromic cleft lip and/or palate patients.Methods:The records of patients managed by the Pécs Cleft Team between January 1999 and December 2015 were analyzed retrospectively. The sources of the data included clinical and genetic records.Results:A total of 607 patients were managed by the cleft team during the study. Sixteen patients (2.6%) were noted to be afflicted with a particular identifiable syndrome. Seven different genetic syndromes and one sequence were present in the study. The Pierre Robin sequence occurred most often, comprising 50% of the cohort. The treatment algorithm used in managing nonsyndromic clefts required modification in 13 of the 16 syndromic patients.Discussion:The presence of a genetic syndrome may notably affect the treatment algorithm in children born with cleft lip and/or palate. The surgical treatment of certain associated anomalies has by necessity, priority over the timing of the reconstruction of the cleft lip and/or cleft palate in syndromic patients.

Background With the ageing population, more patients lose their teeth and need dental rehabilitation with implants. Minimally invasive surgical techniques being increasingly used throughout medicine, often replacing conventional surgery. Several techniques for transcrestal sinus floor elevation are described in the literature and used widely. Some reports doubt the efficiency and predictable success of some of the techniques. Aim/Hypothesis In this poster the authors present their experience with a simple but efficient technique the IBS "Bone Expansion by Bending" technique for sinus floor elevation with Nobel Biocare Replace implants. Material and Methods Twenty middle aged patients (eleven males and nine females) reported to our clinic for dental rehabilitation in the lateral maxilla. Patients were examined, CB-CT scans were assessed. The bone in the lateral region was adequately wide but only 5–7 mms high. Patients were informed about the need for sinus augmentation. The location of available bone made it possible to use a bone expansion technique. These twenty patients rejected any form of bone augmentation. The location of available bone made it possible to insert implants with bone expansion technique. Forty-four implants were inserted into the maxilla, using IBS "Bone Expansion by Bending" technique. Results The patients were satisfied with the functionality and aesthetics results of their new implant anchored porcelain fused crowns and bridges. The patients were followed up for 2 years. There is no bone loss or any problems with the inserted 40 implants and crowns. Conclusion and Clinical Implications Transcrestal sinus floor elevation is a widely discussed technique in the literature. IBS BEB technique is minimally invasive, easy to perform and safe technique needing simple instrumentation with a quick learning curve.

Salivary IL-6 mRNA was previously identified as a promising biomarker of oral squamous cell carcinoma (OSCC). We performed a multi-center investigation covering all geographic areas of Hungary. Saliva from 95 patients with OSCC and 80 controls, all Caucasian, were collected together with demographic and clinicopathological data. Salivary IL-6 mRNA was quantified by real-time quantitative PCR. Salivary IL-6 protein concentration was measured by enzyme-linked immune-sorbent assay. IL-6 protein expression in tumor samples was investigated by immunohistochemistry. Normalized salivary IL-6 mRNA expression values were significantly higher (p < 0.001) in patients with OSCC (mean ± SE: 3.301 ± 0.885) vs. controls (mean ± SE: 0.037 ± 0.012). Differences remained significant regardless of tumor stage and grade. AUC of the ROC curve was 0.9379 (p < 0.001; 95% confidence interval: 0.8973–0.9795; sensitivity: 0.945; specificity: 0.819). Salivary IL-6 protein levels were significantly higher (p < 0.001) in patients (mean ± SE: 70.98 ± 14.06 pg/mL), than in controls (mean ± SE: 12.45 ± 3.29). Specificity and sensitivity of IL-6 protein were less favorable than that of IL-6 mRNA. Salivary IL-6 mRNA expression was significantly associated with age and dental status. IL-6 manifestation was detected in tumor cells and tumor-infiltrating leukocytes, suggesting the presence of a paracrine loop of stimulation. Salivary IL-6 mRNA is one of the best performing and clinically relevant biomarkers of OSCC.

The aim of this study was to determine the increase in heat production, preparation time, and cutting surface quality of conventional, high-speed rotating instruments and piezoelectric preparation for coronectomy procedures.

Background More patients lose their teeth and need dental rehabilitation with implants. The longer time is spent between the loss of teeth and implant surgery will result the loss of more alveolar bone, requiring bone augmentation. Some patients reject bone augmentation, some simply cannot afford it, but still have enough bone to insert implants and have successful rehabilitation with bone expansion. Aim/Hypothesis In this poster the authors present their experience with IBS “Bone Expansion by Bending” technique using Anthogyr Axiom PX BL implants. Material and Methods Report of three cases – Three middle aged patients (two males and one female) reported to our clinic for dental rehabilitation in the lateral mandibular region. Patients were examined, CB-CT scans were assessed. The bone in the lateral region was adequately high but only 3.5–4 mm wide. Patients were informed about the need for bone augmentation with GBR technique but rejected bone augmentation. The location of available bone made it possible to use a bone expansion technique. These three patients rejected any form of bone augmentation. The location of available bone made it possible to insert implants with bone expansion technique. 8 Anthogyr Axiom PX BL implants were inserted in 3 patients in the lateral molar region of the mandible, using IBS “Bone Expansion by Bending” technique. Results The patients were satisfied with the functionality and aesthetics results of their new implant anchored porcelain fused crowns and bridges. The patients were followed up for 2 years. There is no bone loss or any problems with the implants and crowns. Conclusions and Clinical Implications For implant insertion in areas of compromised bone the gold standard is bone augmentation with GBR technique. The GBR technique is well documented, safe and widely accepted, despite this, some patients reject the technique for material or other reasons. In cases when the location of available bone is optimal, it's height is enough and bone width is more than 3.5 mms bone expansion is may be a good alternative to bone augmentation. The IBS BEB technique is minimally invasive, easy to perform and s.

Background. High temperatures during drilling can cause thermal osteonecrosis and abnormal wound healing. According to our best knowledge, a widely accepted recommendation for optimal drilling parameters in routine oral surgery bone removals does not exist. Purpose. Our aim was to investigate the correlations of different drilling parameters, including axial load and revolution speed on drilling temperatures and preparation times. Materials and Methods. Standard, 5 mm deep cavities were drilled in 20 PCF (lb/ft3) dens polyurethane blocks with 3 mm (50PCF) cortical layer using new and worn, 3.1mm in diameter tungsten carbide round drills. Worn drills were used in 50 impacted third molar operations before. Axial loads of 3N, 10N, and 25N and speeds of 4.000-8.000-16.000-40.000 revolutions per minute (rpm) were tested. Temperature differences of drilling parameters were calculated by 1-way ANOVA, followed by Tukey’s HSD post hoc tests. Time differences and differences among “optimal” and “suboptimal” groups (with the cut-off value of 3°C and 3s) were estimated by Kruskal-Wallis test with pairwise comparisons. P<0.05 was considered significant. Results. The highest mean temperatures with new and worn drills were 4.64±0.53°C and 6.89±1.16°C, while drilling times varied between 0.16±0.02s and 22.77±5.45s. A 3°C and 3s cut-off value classified drillings significantly to (1) optimal [3N and 8000-16000-40000 rpm or 10N and 4000-8000-16000-40000 rpm] or suboptimal due to (2) high temperatures or (3) long preparation times. Using worn drills, the following parameters should be avoided: 3N with 4.000-8.000 rpm, 10N with 40000 rpm, and 25N at any revolutions. Discussion. The study extensively mapped the drilling temperatures and preparation times of tungsten carbide round drills. Temperatures did not exceed 10°C during drillings with maximal amount of cooling, as well as the drilling parameters, which kept temperatures and preparation times in the most optimal range which were clearly established.

Absztrakt 1941.VI. és 1942.I. között szovjet ejtőernyős csoportokat dobtak le Kárpátaljára és Észak -Erdélyre.Ezeket a rendvédelem és az újonnan megszervezett ejtőernyős elhárító szolgálat gyorsan felszámolta.Az akciók sikertelensége és a

PurposeThe aim of this in vitro study was to investigate temperature increases in the inferior alveolar canal (IAC), when different bone preparation methods approximate and penetrate the IAC.Materials and methodsIn pig mandible, buccal bone removals were performed until the neurovascular bundle became visible. Temperatures were registered with thermocouple probes and with infrared thermometer. Preparations were performed with diamond drills (DD), tungsten carbide drills (TCD), piezoelectric diamond sphere (PT_D) and saw (PT_S) tips, and a combined preparation method was also performed whereby the superficial three-fourths of the bone was removed with TCD and the deepest one-fourth of the bone with PT_D (TCD + PT_D_7 °C) or PT_S (TCD + PT_S_7 °C), using cooled irrigation (7 °C).ResultsPreparations using room temperature irrigation caused significantly less heat on the bone surface than in the IAC. Piezosurgery in the IAC produced significantly higher temperatures (>13 °C) than the drills (<4 °C). Heat productions of the piezoelectric tips were reduced significantly by applying the combined bone removal methods. The speed of PT_S and TCD + PT_S_7 °C were comparable to the speed of TCD, whereas TCD + PT_D_7 °C was found to be significantly slower.ConclusionThe speed of piezosurgery is comparable to that of the drills; however, it produces the highest, potentially nerve-harming temperatures. To eliminate the heat consequences during piezosurgery in the IAC, the use of cooled irrigation at 7 °C and predrilling is recommended.

The Hungarian guideline can be applied safely, without increasing the risk of postoperative bleeding, however, rural dental practices are frequently unprepared for these treatments. Orv. hetil., 2016, 157(43), 1722-1728.

Introduction: In 2015 a new Hungarian guideline was published regarding dental treatment and management of anticoagulated patients in agreement of the Hungarian Association of Oral and Maxillofacial Surgeons and the Dental Implantology Association of Hungarian Dentists. Aim: The aim of the authors was to evaluate the efficiency and safety of local hemostatic measures recommended by the guideline in anticoagulated patients. Method: In these patients, postoperative bleeding episodes were examined after dental and oral surgical treatments, retrospectively. Results: Overall 263 bleeding risk cases were treated; 138 patients with vitamin K antagonists, 97 patients with antiplatelet therapy and 6 patients with novel oral anticoagulants. Six patients (2.3%) had minor postoperative bleeding after the "one hour control", while one patient needed a night duty support (0.5%). In contrast, 86 patients who were treated in rural practices neglecting the guideline attended the night duty with postoperative bleeding (3 patients treated with vitamin K antagonists, 24 patients taking low molecular weight heparin, 30 patients receiving antiplatelet therapy and one patient on novel oral anticoagulant therapy. Conclusions: The Hungarian guideline can be applied safely, without increasing the risk of postoperative bleeding, however, rural dental practices are frequently unprepared for these treatments.

Purpose: The aim of this in vitro study was to examine the effects of surgical drill wear after coronectomy on bone temperature changes and preparation times for bone cavity drilling.Materials and Methods: Tungsten carbide round drills were used to perform 10 (D_10), 20 (D_20), or 30 (D_30) coronectomies on extracted lower third molars to elicit drill wear, and then 5-mm-deep cavities were drilled in pig ribs with a testing apparatus-controlled surgical unit. Temperature changes and preparation times were measured. Differences in mean values were examined with analyses of variance and the Tukey honest significant difference post hoc test.Results: The unused drills prepared the holes significantly faster (2.52 +/- 1.6 seconds) than the D_20 (13.29 +/- 5.76 seconds) and D_30 (31.48 +/- 12.93 seconds) drills (P =.01 and P < .001, respectively). The D_10 (change, 2.33 +/- 0.77 degrees C), D_20 (change, 2.57 +/- 0.57 degrees C), and D_30 (change, 3.94 +/- 0.62 degrees C) drills produced significantly more heat than the D_0 drills (change, 1.18 +/- 0.28 degrees C; P < .001). At higher axial pressures of 25 N (to provoke <= 3-second preparation times in line with new drills), the D_30 drills produced a temperature change of 6.31 +/- 1.23 degrees C with 60 mL/minute and significantly more heat (change, 20.48 +/- 8.84 degrees C; P < .001) with 20 mL/minute of irrigation.Conclusions: Intraosseous heat produced by surgical tungsten carbide round drills remains under the threshold temperature of bone necrosis for up to 30 coronectomies; however, the use of increased axial pressure (similar to 25 N), especially with the combination of decreased irrigation (similar to 33%), can cause unacceptable temperatures during bone removal. Professionals should select drills and drilling parameters that generate an acceptable amount of heat during surgical tooth removal. (C) 2016 American Association of Oral and Maxillofacial Surgeons

e22229 Background: Head and neck squamous cell carcinoma (HNSCC) is characterized by elevated constitutive activity or aberrant regulation of NFκB signal transduction. NFκB acts as a survival facto...

Background: Oral squamous cell carcinoma (OSCC) development involves complex machinery of genomic and epigenetic regulations including microRNA (miRNA) expression changes. We aimed to analyze the expression patterns of a set of miRNAs in human TNM stage I and II OSCC samples in an autologous normal mucosa-controlled experimental design. Materials and Methods: Forty samples of OSCC and 40 matched normal tissues were evaluated for miR-21, miR-155, miR-191, miR-146a, miR-221 and miR-222 expression in a LightCycler 480(PCR) system. Results: Our results showed significant overexpression of miR-21, miR-155, miR-191 and miR-221 in paired-sample t-test and the sensitivity/specificity of tests were over 90% in the case of miR-21 and miR-155 on the receiver operating characteristic curve (ROC) analysis. Conclusion: Our results underline the role of miR-21 in OSCC and support the possible causal role of miR-155 and miR-221 in oral carcino genesis. The overexpression of miR-191 is a novel finding in squamous cell carcinoma.

Several theories have been proposed regarding the genesis of sialoliths, including the organic core theory, which suggests epithelial or bacterial etiology originating in the central core. Our aim was to use novel methodologies to analyze central areas (the core) of calculi from sialolithiasis patients.

A szájüregi laphámrák morbiditási és mortalitási rátája folyamatosan növekvő tendenciát mutat világszerte, ezért a betegség korai felismerése kiemelkedő szerepet játszik. A diabétesz és a laphámrák kapcsolatát ez idáig epidemiológiai és állatkísérletes modelleken bizonyították. Szerzők célja ennek az összefüggésnek az igazolása volt, humán nyálból izolált, nem invazív detektáló módszerrel nyerhető biomarkerek segítségével.

Since oral squamous cell carcinoma (OSCC) is one of the most important causes of death worldwide, the prevention and early detection plays a crucial role. Recent epidemiological studies have incriminated diabetes as a risk factor for the development of OSCC, as well as oral premalignant lesions. As for the last 20 years diabetes and oral squamous cell carcinoma rates have been increasing rapidly, therefore a reliable detection method of major saliva proteins as possible biomarkers for OSCC is of key priority. In this study we collected whole saliva samples from patients with diabetes and from healthy subjects. To reduce the risk of failure and to keep the investigation good reproducible, we proposed an examination and saliva collecting technique. The proteins were analyzed using SDS-PAGE and MALDI TOF/TOF mass spectrometry. Our findings show that the expression of Annexin A8, Peroxiredoxin-2 and Tyrosine kinase is elevated by patients having diabetes. All these proteins have been previously described in cancer saliva samples also in OSCC. Our current findings showed that testing saliva may be an effective and reliable method for detecting oral cancer in early stages.