George S. Sharp

THE INTRA-ORAL USE OF THE FREE SPLIT-THICKNESS SKIN GRAFT IN COMMANDO-TYPE PROCEDURES.

Abstract The rationale, technic, and results obtained in using a free split-thickness skin graft to develop a new lateral border of the tongue, a new floor of the mouth, and a new buccal mucosa has been presented. These new areas are created to decrease the serious functional and cosmetic problems which are unavoidable when the tongue is sutured to the cheek, as in the usual full-fledged “commando” operation. The advantages of immediate skin grafting in the “commando” patient are numerous, since the maximum amount of rehabilitative surgery is accomplished in a single, one stage, composite operation. The inevitable postoperative scarring and contracture are, to a great degree, eliminated by the immediate application of a graft. The results indicate that there need be no increase in morbidity or mortality if strict observance of the contraindications is followed. The technic, we believe, has proved to be extremely worthwhile, to warrant wider use, and to merit further investigation and endorsement.

Carcinoma of the tongue

Abstract A study of carcinoma of the tongue, based on 156 patients treated in private practice in The Pasadena Tumor Institute over a twenty-seven year period, is presented by classification of our total experience with the disease and tabulation of a determinate group of 134 patients. Similarity of the five year survival rates of the two groups is evident when comparing the total groups rate of 44.2 per cent with the determinate groups figure of 51.5 per cent. (Table V.) Our policy of treating a patient as an individual problem, rather than as part of a systematized program, has proved to be the best course of action over the years. Our selection of the type of therapy to be used (either surgery or radiation) is based on the age of the patient, his general condition, and the exact involvement of disease on admission. For this reason, we find it impossible to support one method of treatment over another. The gradual increase in prognosis is definitely encouraging, and the optimistic conclusion can be drawn that if a patient presents himself in stage I or II, even with operable cervical nodes, he has a 50 per cent prognosis for remaining free of disease for five years. This is nearly twice the survival rate of the first three decades of this century.

THE MOUTHWASH TECHNIC. A METHOD OF SCREENING FOR INTRA-ORAL CARCINOMA.

Abstract The method presented is suggested as a valuable screening test in intra-oral carcinoma, and we believe it is simple, reproducible, accurate, and results in a cell population representative of the entire oral cavity.

Radiolucent spaces in the jaws: A new guide in diagnosis☆

Abstract Attention to the diagnostic guide presented herein will provide distinction not only among types of cysts but will separate them from benign and malignant tumors.

Oral manifestations of systemic disease. Regimen of treatment.

Abstract The sore mouth is the most common oral complaint, and it has a myriad of specific and idiopathic etiologic factors. In the majority of these conditions a preliminary diagnosis may be made on the basis of general history, oral examination findings, and the results of simple laboratory procedures, such as blood counts, urine tests, and the azure-A test. With the exception of those conditions with specific etiology, all are within the province of the dental profession for diagnosis and treatment. The diseases with specific etiology are readily detected, and the patients should be referred to an internist for a coordinated curative effort. The large group of patients with less specific symptoms and signs may be partially or completely relieved of their complaints when placed on an optimal high-protein diet with liver or acid supplementation.

Treatment for low tolerance to dentures: Supplemental report

Abstract A program for the symptomatic and objective relief of sore mouth and low tolerance to dentures has been described. This program was successful in over 90 per cent of the patients observed. The following steps are followed: 1.Obtain a complete history, physical examination, and laboratory studies. 2.Initiate therapy with the combined liver fraction tablet. 3.After two to four weeks, give the patients who have achlorhydria the slow-release acid supplementation tablet with each meal, in addition to the liver fraction tablet. 4.Place emphasis on increased food intake as denture tolerance permits, with special emphasis upon protein needs. 5.Proceed with replacement of dentures as indicated. These patients are willing experimentors and the periodic omission of either or both of the supplements or the reduction of dietary foods may be expected. A return of symptoms will usually lead to continuation of the beneficial regimen.