Faculty Bibliography

The submandibular glands are subject to several pathologies that require excision. The most common problem that affects these salivary glands is sialadenitis combined with sialolithiasis. This problem occurs in the submandibular gland 10 times more frequently than it does in the parotid gland. Other illnesses frequently involving the submandibular glands are represented by sialadenosis and benign, malign, and intermediate neoplasms. Diagnosis of any disturbance in the submandibular gland involves both a clinical and instrumental (echography, traditional radiography [ortopantomography] and eventually computed tomography (CT) or magnetic resonance imaging) assessment. Surgery is the usual method of treatment of both chronic sialadenitis and neoplasms in the submandibular gland. A submandibular gland surgical approach can be cervical, intraoral, or endoscopic. The authors present their clinical experience with a total of 40 patients with illnesses involving the submandibular gland treated with submandibular gland excision by a transcervical approach. Their experience suggests that this approach entails a relatively simple procedure, involves low risks for the nerve structure around the gland, permits wide resection margins for neoplasms, and incurs little aesthetic damage.

This study was initiated to establish a treatment algorithm for preoperative evaluation of donor sites prior to the harvest of free osteocutaneous flaps, in the setting of complex mandibulofacial reconstruction. A total of 29 consecutive patients were treated between 1999 and 2003 in a university-based setting. Reconstructions were completed using either a free fibula osteocutaneous flap or a radial forearm free flap. Functional and aesthetic results were determined by completing a thorough patient physical examination postoperatively. We hypothesized that a routine preoperative angiogram at the donor site was unnecessary. The Allen's test was the only preoperative evaluation completed in the 13 patients undergoing the free radial forearm reconstruction. In the remaining 16 patients undergoing free fibula reconstruction, a thorough physical examination was completed, along with noninvasive Doppler examinations. No angiograms were obtained. Using this systematic approach, no ischemic complications were observed at the donor site. Only two complete flap losses were seen, one in each group, due to microvascular thrombosis. We conclude that preoperative assessment of the donor site(s) with only an Allen's test in the free radial forearm group and a thorough pulse exam and a noninvasive Doppler in the free fibula group appear adequate. Routine preoperative angiogram of the donor extremity may be unnecessary and place the patient at additional risk for associated complications.

Squamous cell carcinoma is the most common form of oral cancer in adults. Because orthodontists often treat many adult patients, practitioners need to be aware of the clinical signs of this malignancy. In this article, we discuss the epidemiology, clinical appearance, and pathology of squamous cell carcinoma, and present the orthodontic management of a patient.

INTRODUCTION: Angle's system for classifying molar relationships has been the standard in orthodontics for over a century. The purpose of this study was to determine what orthodontic students are being taught about the terminology of molar relationships and the use of Angle's molar classification system. METHODS: An e-mail survey was sent to the department chair or the program director of every orthodontic program in the United States, Canada, and Puerto Rico (n = 80). The survey included photos of models placed into 1/4 cusp, 1/2 cusp, and 3/4 cusp distal occlusions, and the participants were asked to classify them by selecting from a list of terms or writing 1 of their own. They were also asked whether they thought that the Angle molar classification was adequate for communication and diagnosis. RESULTS: Forty surveys were completed and returned. The results showed that a variety of terminology is being taught, and most educators do not use Angle's system as he defined it. About half of the respondents were dissatisfied with the Angle molar classification system. CONCLUSIONS: A modification of Angle's system that is more descriptive is needed.