John Beumer

Hard and soft tissue necroses following radiation therapy for oral cancer

Abstract Three hundred and fifty-four patients, who underwent radiation therapy for oral cancer (excluding lip) at the University of California Medical Center at San Francisco between 1961 and 1969, were reviewed as to site of tumor, mode of therapy, tumor dose, and occurrence of tissue necrosis. The study group was limited to those 278 patients who were available for follow-up for at least 6 months. Osteonecrosis occurred in 3.6 per cent: 8 of 141 dentulous patients (5.7 per cent) and 2 of 137 edentulous patients (1.5 per cent). All cases of bone necrosis occurred in the mandible and were within the treatment field. There were 18 cases (6.5 per cent) of soft tissue necrosis. Eleven of these patients were treated by needle implantation or intraoral cone technique. Fifteen were self limited (5.2 per cent).

Childhood hypophosphatasia and the premature loss of teeth: A clinical and laboratory study of seven cases

Abstract Hypophosphatasia, an inheritable metabolic disease, causes a premature loss of deciduous teeth. Because of the early dental exfoliation, the dentist is often consulted first. The diagnosis can be established by certain clinical features, x-ray findings, and chemical abnormalities. The childhood form of the disease is self-limiting and does not require treatment.

Maxillary speech prostheses for mandibular surgical defects

Abstract Speech distortion is one of the debilitating consequences of radical surgery of the tongue, floor of the mouth, and mandible. The major cause of this speech impairment is restricted motion of the tongue and lack of lingual-palatal contact. Since contact between the tongue and the posterior part of the palate is anatomically impossible, a prosthesis is functionally formed to lower the palatal vault. The sounds “k” and “g” require this palatal contact. A series of test words beginning with these consonants was, therefore, used to evaluate possible speech improvement. The results indicated significant improvement in speech intelligibility for those patients with severely restricted tongues with the use of the prosthesis.

Restoration of irradiated patients using osseointegrated implants: Current perspectives

STATEMENT OF PROBLEM The success rates of osseointegrated implants used to restore patients who were irradiated for head and neck tumors are influenced by radiation-induced changes in the hard and soft tissues. PURPOSE This article examined, by review of the literature, current perspectives on the restoration of irradiated patients using osseointegrated implants. RESULTS In published reports that investigated both intraoral and extraoral applications, irradiation decreased implant success rates and the amount of reduction was dependent on the location within the craniofacial skeleton. The limited number of implants and patients in these studies precludes definitive conclusions regarding the efficacy of placing implants into irradiated tissues. The implants placed into the irradiated anterior mandible have demonstrated an acceptable implant success rate of 94% to 100% with a minimal risk of osteoradionecrosis. The efficacy of implants in the posterior mandible has not been examined. Implant success rates ranged from 69% to 95% in the irradiated maxilla for intraoral applications. Extraoral applications demonstrated excellent implant success rates in the temporal bone (91% to 100%). The rates in the anterior nasal floor have varied from 50% to 100%. The implant success rates in the frontal bone decreased as the length of the studies increased (96% to 33%). The long-term efficacy of implants in the irradiated frontal bone is poor.

Primary malignant melanoma of the oral cavity: Report of two cases☆

Abstract Two cases of primary oral malignant melanoma have been presented, and some of the problems incurred in the diagnosis, pathogenesis, and management of this disease have been discussed.