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End Stage Palliative Care of Head and Neck Cancer: a Case Study

  • Shishodia, Nitin Pratap;Divakar, Darshan Devang;Al Kheraif, Abdulaziz Abdullah;Ramakrishnaiah, Ravikumar;Pathan, Akbar Ali Khan;Parine, Narasimha Reddy;Chandroth, Santhosh Vediyera;Purushothaman, Binu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1255-1258
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    • 2015
  • Background: Locally advanced head and neck cancer is generally incurable and has a short survival rate. This study aimed to evaluate symptom relief, disease response, and acute toxicity after palliative hypo-fractionated radiotherapy and long-term survival in affected patients. Materials and Methods: Between January 2011 to December 2011, 80 patients who were histopathologically diagnosed as having stage III or stage IV head and neck squamous cell carcinoma based on Eastern Cooperative Oncology Group (ECOG) performance status 1-3, were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Later these patients were evaluated on 30th day after completion of treatment for disease response based on World Health Organisation (WHO) criteria and palliation of symptoms using symptomatic response grading and acute toxicities by the Radiation Therapy Oncology Group (RTOG). Many patients were given post radiation therapy (RT) palliative chemotherapy for appropriate palliative care and a few patients were selected for further curative RT. The overall survival was also evaluated among this group of patients with last follow up date of 1st May, 2014. Results: The most common presenting complaint was pain followed by dysphagia. Most patients (60-70%) had appreciable relief in their presenting symptoms. A good response was observed in the majority following palliative RT; a few patients had progressive disease and some had stable and regressed disease. None of the patients experienced radiation toxicity that required hospital admission. Almost all showed grade one and two acute skin and mucosal toxicity one month after completion of treatment. The mean survival days for patients given only hypofractionated palliative RT was 307 days, those with post palliative RT and palliative chemotherapy was 390 days and patients who went on to receive further palliative RT and curative RT dose had significantly overall survival of 582 days. Conclusions: Advanced head and neck cancer should be identified for suitable palliative hypofractionated radiotherapy to achieve acceptable symptom relief in a great proportion of patients and should be followed by palliative chemotherapy or curative RT in suitable cases for long-term symptom-free survival.

Comparison of Serum Fucose Levels in Leukoplakia and Oral Cancer Patients

  • Rai, Narendra Prakash;Anekar, Jayaprasad;Shivaraja, Shankara YM;Divakar, Darshan Devang;Al Kheraif, Abdulaziz Abdullah;Ramakrishnaiah, Ravikumar;Sebastian, Roopa;Raj, AC;Al-Hazmi, Ali;Mustafa, habil Mohamed
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7497-7500
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    • 2015
  • Background: Tumor markers, designated as a broad group of substances produced by malignancies, could be in the form of biochemical substances, immunological substances, cell surface changes and genetic alterations. Cancer, a disorder of cellular behavior is characterized by alteration of serum glycoproteins. L-fucose, a hexose, which is the terminal sugar in most of the plasma glycoproteins, may be useful as a tumor marker for the detection, monitoring and prognostic assessment of malignancies. The aim of the study was to ascertain the role of serum fucose as a biomarker for early detection of oral cancer and to compare serum fucose levels in healthy controls, leukoplakia and oral cancer patients. Materials and Methods: The study included 60 (100.0%) subjects, who were grouped as 20 (33.3%) control subjects, 20 (33.3%) squamous cell carcinoma patients and 20 (33.3%) leukoplakia patients. Fucose estimation was done using UV-visible spectrophotometry based on the method as adopted by Winzler using cysteine reagent. The results were analyzed statistically using ANOVA with Bonferroni post hoc tests. Results: Results showed a high significance in serum fucose in oral squamous cell carcinoma (OSCC) and leukoplakia subjects compared to normal controls. There was a gradual increase in the values noted from control to leukoplakia and to squamous cell carcinoma. Conclusions: Estimation of serum fucose may be a reliable marker and can be used as an effective diagnostic biomarker in oral squamous cell carcinoma patients.

UNIT-CHAIR 사용시 응급처치법

  • The Korean Dental Association
    • The Journal of the Korean dental association
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    • v.29 no.2 s.261
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    • pp.149-151
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    • 1991
  • 치과의사의 생명은 유니트체어라고 해도 과언이 아니지만 의외로 유니트체어에 대한 상식을 갖고 있는 의원은 드물고 사소한 고장에도 쩔쩔매는 경우가 허다하다. 유니트 체어중 신흥의 Mermaid와 SIGNO모델을 예로하여 고장시 응급처치요령을 앞으로 몇회에 걸쳐 알아본다

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Computer-guided implant surgery and immediate provisionalization by chair-side CAD-CAM: A case report (진료실 CAD-CAM에 의한 컴퓨터 가이드 임플란트 수술과 즉시 임시보철치료: 증례보고)

  • Hyun, Sang Woo;Lee, sungbok Richard;Lee, Suk Won;Cho, Young Eun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.478-486
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    • 2021
  • This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.

A Study on Hybrid material of Making Dental restorations by CAD/CAM System (치과 CAD/CAM용 복합소재를 이용한 치과보철물의 제작에 대한 연구)

  • Choi, Beom-Jin
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.2
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    • pp.86-94
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    • 2014
  • In recent years, perhaps the biggest driver in new material development is the desire to improve crown and bridge esthetics compared to the traditional PFM or all-metal restorations. As such, zirconia, leucite-containing glass ceramic and lithium disilicate glass ceramic have become prominent in the dental practice. Each material type performs differently regarding strength, toughness, ease of machining and the final preparation of the material prior to placement. For example, glass ceramic are typically weaker materials which limits its use to single-unit restorations. On the other hand, zirconia has a high fracture toughness which enables multi-unit restorations. This material requires a long sintering procedure which excludes its use for fast chair side production. Developed hybrid material of CAD/CAM is contained nano ceramic elements. This new material, called a Resin Nano Ceramic is unique in durability and function. The material is not a resin or composite. It is also not a pure ceramic. The material is a mixture of both and consists of ceramic. Like a composite, the material is not brittle and is fracture resistant. Like a glass ceramic, the material has excellent polish retention for lasting esthetics. The material is easily machined chair side or in a dental lab, polishes quickly to an esthetic finish and if necessary, can be useful restoratives.

Association of Poly (ADP-Ribose) Polymerase 1 Variants with Oral Squamous Cell Carcinoma Susceptibility in a South Indian Population

  • Anil, Sukumaran;Gopikrishnan, PB;Basheer, Ashik Bin;Vidyullatha, BG;Alogaibi, Yahya A;Chalisserry, Elna P;Javed, Fawad;Dalati, MHN;Vellappally, Sajith;Hashem, Mohamed Ibrahim;Divakar, Darshan Devang
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4107-4111
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    • 2016
  • Background: Oral cancers account for approximately 2% of all cancers diagnosed each year; however, the vast majority (80%) of the affected individuals are smokers whose risk of developing a lesion is five to nine times greater than that of non-smokers. Tobacco smoke contains numerous carcinogens that cause DNA damage, including oxidative lesions that are removed effectively by the base-excision repair (BER) pathway, in which poly (ADP-ribose) polymerase 1 (PARP-1), plays key roles. Genetic variations in the genes encoding DNA repair enzymes may alter their functions. Several studies reported mixed effects on the association between PARP-1 variants and the risk of cancer development. Till now no reported studies have investigated the association between PARP-1 variants and oral squamous cell carcinoma (OSCC) risk in an Indian population. Materials and Methods: In the present case control study 100 OSCC patients and 100 matched controls were genotyped using PARP1 single nucleotide peptides (SNP's) rs1136410 and rs3219090 using TaqMan assays. Results: The results indicated significantly higher risk with PARP1 rs1136410 minor allele "C" (OR=1.909; p=0.02942; CI, 1.060-3.439). SNP rs1136410 also showed significantly increased risk in patients with smoking habit at C/C genotype and at minor allele C. Conclusions: The PAPR-1 Ala762Val polymorphism may play a role in progression of OSCC. Larger studies with a greater number of samples are needed to verify these findings.

Chair-side CAD/CAM fabrication of a single-retainer resin bonded fixed dental prosthesis: a case report

  • Jurado, Carlos Alberto;Tsujimoto, Akimasa;Watanabe, Hidehiko;Villalobos-Tinoco, Jose;Garaicoa, Jorge Luis;Markham, Mark David;Barkmeier, Wayne Walter;Latta, Mark Andrew
    • Restorative Dentistry and Endodontics
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    • v.45 no.2
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    • pp.15.1-15.7
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    • 2020
  • This clinical report describes designing and fabricating a single-retainer resin-bonded fixed dental prosthesis with a chair-side computer-aided design/computer-aided manufacturing system. The whole procedure, from tooth extraction to final placement of the prosthesis, was completed in one day, and a single clinic visit. No clinical complications were found at the 2-year follow-up after placement of the restoration, and satisfactory functional and esthetic results were achieved.

Clients Satisfaction with Oral Hygiene Care Services System Provided by the Dental Hygiene Clinics in the Department of Dental Hygiene, Yonsei University (연세대학교 치위생학과 구강위생교육실을 방문한 대상자의 구강위생관리 서비스체계에 대한 만족도 조사)

  • Kim, Nam-Hee;Kwon, Hye-Ri;Kim, Da-Hye;Kim, Da-Hee;Kim, Min-Hee;Yoo, Seung-Hee;Choi, Jin-Ah;Chung, Won-Gyun
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.419-431
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    • 2007
  • The setting of dental hygiene clinics is very important to dental hygiene education, which is the place not only to educate students but also to care clients. The purpose of this study is to provide basic research material for improvement of dental hygiene care system in dental hygiene clinics by analyzing the client satisfaction. A questionnaire survey by means of self-entry method was conducted to find out satisfaction of the client, who was visited to the dental hygiene clinics in the department of dental hygiene, Yonsei University. An analysis of frequency, one way ANOVA and T-Test were performed through SPSS 12.0K program. 1. Most clients were mainly composed of students in Wonju College of Medicine. 2. The clients visited for scaling(85.8%) and oral examination(9.73%) were much than treatment(4.42%). 3. Clients aged 21 to 25 were relatively lower in satisfaction with the facilities, system, attitude than any other ages. 4. The dental hygiene students are the lowest group in satisfaction with the facility, system, attitude than medical and nursing students. 5. The clients satisfaction with dental hygiene clinics was decreased in reverse proportion to visiting frequency. 6. Most of the clients pointed out the problems of appointment system(54.0%) and fee(23.0%), which should be improved than any other operation conditions. 7. Most of the clients were not satisfied with chair time and pain during care. 8. Most clients recognized to receive the better care service than other dental offices(81.3%). Especially, they paid attention to oral health education using phase-contrast microscope. 9. Many clients were dissatisfied with facilities of the dental hygiene clinics(71.7%). The problems of appointment system(54.0%) and chair time of dental hygiene care services(63.6%) had also inconvenienced to clients. The dental hygiene clinics in school play a crucial role in dental hygiene education to foster the student to be competent as a professional dental hygienist in the future. Therefore, well-organized dental hygiene care program based on dental hygiene process is essential. It is also required to improve the environment of dental hygiene clinics including facilities, appointment system and fee etc.

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Basic Life Support for Cardiac Arrest during Dental Treatment (치과진료 시 발생한 심정지에서 기본생명구조술)

  • Seo, Kwang-Suk
    • The Journal of the Korean dental association
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    • v.53 no.8
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    • pp.522-529
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    • 2015
  • Cardiac arrest can occur in dental clinics. All dental professionals should be trained to deal with emergency situations that is threatening life. Dental professionals should be familiar with the protocol which include basic life support, advanced life support and specific drugs to be administered in emergencies. Emergency can occur in any dental office without any warnings. Further, it has been noted in recent times there is an increase in a number of medico-legal cases due to rise in a number of death in the dental chair. This review article aims at briefing the basic life support required to manage the medical emergency having life-threatening potential.

The effect of Silver Diamine Fluoride in preventing dental caries (Silver Diamine Fluoride의 치아우식 예방 효과)

  • Song, Ji-Soo
    • The Journal of the Korean dental association
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    • v.56 no.8
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    • pp.424-431
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    • 2018
  • Silver diamine fluoride (SDF) is an alkaline topical solution and it derives from the conjunction of silver nitrate and fluoride. It reduces the growth of cariogenic bacteria, inhibits degradation of dentinal collagen, impedes demineralization and enhances remineralization. It is inexpensive due to the low cost of materials and its application to dental surface is very simple and requires relatively short chair time. Previous studies have shown that the dental caries prevention effect of SDF is superior or similar to topical fluoride application. The main disadvantage of SDF is its esthetic result, and it permanently blacken carious enamel and dentin. The use of SDF has not yet been approved in Korea, but it may be helpful to prevent and treat dental caries in patients with special health care needs and uncooperative young patients.

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