No abstract

The NBCCS keratocysts have a different immunophenotype from sporadic keratocysts and both types are distinguishable from dentigerous, radicular and non-specified odontogenic cysts. These findings confirm the separate biological potential of these lesions and the results of the immunohistochemical analysis have diagnostic and prognostic implications.

Background. Odontogenic keratocysts (OKCs) now reclassified as Keratocystic odontogenic tumours (KCOTs) are a clinical entity with a characteristic microscopic picture, kinetic growth and biological behaviour. They arise from the proliferation of the epithelial dental lamina in both maxilla and mandible and occur in patients of all ages. 70-80% of keratocysts are found in the mandible commonly in the angle between the jaw and mandibular branch and maxillary region of the third molar. The cysts are long latent, often symptomless and may attain remarkable dimensions without significant deformation of the jaw bones. They are often found during routine dental X-ray examination. Compared to other types of jaw cyst, odontogenic cysts have a striking tendency to rapid growth and re-occurrence. Aims. This review focuses on the biological characteristics, clinical behaviour and treatment of KCOTs. Methods. The databases searched were the PubMed interface of MEDLINE and LILACS. Results and Conclusions. Ondontogenic keratinocysts are not currently a diagnostic problem. Orthopantomograms which are today ordinary tools of dental investigation enable diagnosis of clinically asymptomatic cystic lesions. The problem remains the optimal therapeutic approach to reduce the still high likelihood of postoperative recurrence. There is no complete consensus on the ideal operating procedure but cystectomy with delayed extirpation is favoured. An open question also remains the timeliness of screening for postoperative recurrences. Given that the first clinical manifestation of Nevoid Basal Cell Carcioma Syndome (NBCCS) may be lesions of this type, routine histopathological classification supplemented by analysis of immunophenotype should be done. Patients with proven sporadic and especially syndromic OKC should be long term screened. In patients with NBCC preventive X ray examination is recommended only once a year.

This paper confines itself to the description of the profile of a general dentist while outlining where the boundary between specialist and generalist may lie. The profile must reflect the need to recognize that oral health is part of general health. The epidemiological trends and disease variation of a country should inform the profile of the dentist. A particular tension between the provision of oral healthcare in publicly funded and private services may result in dentists practicing dentistry in different ways. However, the curriculum should equip the practitioner for either scenario. A dentist should work to standards appropriate to the needs of the individual and the population within the country’s legal and ethical framework. He/she should have communication skills appropriate to ascertain the patient’s beliefs and values. A dentist should work within the principles of equity and diversity and have the knowledge and clinical competence for independent general practice, including knowledge of health promotion and prevention. He/she should participate in life‐long learning, which should result in a reflective practitioner whose clinical skills reflect the current evidence base, scientific breakthroughs and needs of their patients. Within the 4–5 years of a dental degree it is not possible for a student to achieve proficiency in all areas of dentistry. He/she needs to have the ability to know their own limitations and to access appropriate specialist advice for their patients while taking responsibility for the oral healthcare they provide. The dentist has the role of leader of the oral health team and, in this capacity; he/she is responsible for diagnosis, treatment planning and the quality control of the oral treatment. The dental student on graduation must therefore understand the principles and techniques which enable the dentist to act in this role. He/she should have the abilities to communicate, delegate and collaborate both within the dental team and with other health professionals, to the benefit of the patient. The profile of a dentist should encompass the points raised but will also be based upon competency lists which are published by a variety of countries and organizations. It is important that these lists are dynamic so that they are able to change in light of new evidence and technologies.

Background. For more than 20 years, infection with the human papillomavirus (HPV) has been of a matter of interest not only to gynecologists but also to maxillofacial surgeons and othorhinolaryngologists. HPV is generally known to be involved in cervical cancer. Recently, there are many clinical studies pointed out the potentially dangerous connection between HPV infection and head and neck carcinomas (HNC). HPV infection was identified as a possible etiological factor in 15-30% of HNC.Methods. Aim of this article is to summarize the recent knowledge about the HPV infection with regards to etiology of head and neck cancer.Results. It has been proven that HPV infection is related to development of head and neck cancer and that the sexual behavior has played an important role in the viral transmission. HNC of viral etiology have been observed mostly in younger people; their curability is difficult and prognosis serious.Conclusion. Beside the well known correlation between developing of new head and neck cancer and bad habits (smoking, alcohol abuse, poor oral hygiene etc.) we should take into consideration the sexual promiscuity and alternative sexual practices. Vaccination against cervical cancer, recommended to young women, should be extended to their male partners to prevent the virus transmission and decrease the HNC incidence.