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β-Tricalcium phosphate was combined with silica aerogel in composites prepared using the sol–gel technique and supercritical drying. The materials were used in this study to check their biological activity and bone regeneration potential with MG63 cell experiments. The composites were sintered in 100 °C steps in the range of 500–1000 °C. Their mechanical properties, porosities, and solubility were determined as a function of sintering temperature. Dissolution studies revealed that the released Ca-/P molar ratios appeared to be in the optimal range to support bone tissue induction. Cell viability, ALP activity, and type I collagen gene expression results all suggested that the sintering of the compound at approximately 700–800 °C as a scaffold could be more powerful in vivo to facilitate bone formation within a bone defect, compared to that documented previously by our research team. We did not observe any detrimental effect on cell viability. Both the alkaline phosphatase enzyme activity and the type I collagen gene expression were significantly higher compared with the control and the other aerogels heat-treated at different temperatures. The mesoporous silica-based aerogel composites containing β-tricalcium phosphate particles treated at temperatures lower than 1000 °C produced a positive effect on the osteoblastic activity of MG63 cells. An in vivo 6 month-long follow-up study of the mechanically strongest 1000 °C sample in rat calvaria experiments provided proof of a complete remodeling of the bone.

Abstract: Writing a constat is a professional skill required of every general physician and dentist. Constats are issued by healthcare providers on the investigating authority’s, court’s or injured person’s request. This document is an official judicial evidence, a record of medical examination, and it is also a medical opinion which can determine the outcome of the subsequent legal process. Incomplete and incorrect injury descriptions make it difficult for forensic experts to form accurate and appropriate opinions. The authors examined 147 dental and oral surgical constats from the Universities of Pécs and Debrecen using multidisciplinary approach (according to terminological, dental, surgical, forensic and criminal legal aspects). Several medical reports contained mistakes in terms of inaccuracies and self-contradictions, terminology and professional medical practice. The documents included 352 injuries (11.1% of which were tooth injuries, 47.7% bone injuries and 41.2% soft-tissue injuries). The low number of attributes per injury (0.64 on average) indicates insufficient documentation. As a result of the comparative analysis, significant differences were found between the documentation of dental injuries and that of other bone injuries pertaining to their information content. We can state that physicians are most consistent when describing bone injuries, while they are less articulate about tooth injuries. The authors provide an overview of the legal consequences of injuries as well as the legal practice regarding tooth injuries in Germany and Austria, and recommend the creation of a nationwide, unified terminology for both dental and trauma departments on nasal and dental injuries. Orv Hetil. 2018; 159(51): 2154–2161.

In this study, a mesoporous silica-aerogel with β-tricalcium phosphate (β-TCP-AE) was manufactured. The effect of β-TCP-AE on gene expressions (BMP2, BMP7, Runx2 and OSX) of SAOS-2 cells was tested...

Writing a constat is a professional skill required of every general physician and dentist. Constats are issued by healthcare providers on the investigating authority's, court's or injured person's request. This document is an official judicial evidence, a record of medical examination, and it is also a medical opinion which can determine the outcome of the subsequent legal process. Incomplete and incorrect injury descriptions make it difficult for forensic experts to form accurate and appropriate opinions. The authors examined 147 dental and oral surgical constats from the Universities of Pécs and Debrecen using multidisciplinary approach (according to terminological, dental, surgical, forensic and criminal legal aspects). Several medical reports contained mistakes in terms of inaccuracies and self-contradictions, terminology and professional medical practice. The documents included 352 injuries (11.1% of which were tooth injuries, 47.7% bone injuries and 41.2% soft-tissue injuries). The low number of attributes per injury (0.64 on average) indicates insufficient documentation. As a result of the comparative analysis, significant differences were found between the documentation of dental injuries and that of other bone injuries pertaining to their information content. We can state that physicians are most consistent when describing bone injuries, while they are less articulate about tooth injuries. The authors provide an overview of the legal consequences of injuries as well as the legal practice regarding tooth injuries in Germany and Austria, and recommend the creation of a nationwide, unified terminology for both dental and trauma departments on nasal and dental injuries. Orv Hetil. 2018; 159(51): 2154-2161.Absztrakt: Látlelet írása minden orvosi ellátásnak – így a fogorvosi ellátásnak is – a részét képezheti. A látleletet az ellátást végző orvos az ellátási lap alapján a nyomozó hatóság és a bíróság részére hivatalból, a sérült kérésére magánúton köteles kiállítani. A látlelet az orvosi vizsgálat során észleltek mellett a sérülés gyógytartamára vonatkozó orvosi véleményt is tartalmazza. A sérülés leírásának hiányosságai az igazságügyi orvosszakértő munkáját kedvezőtlenül befolyásolhatják, mivel megnehezíthetik a szakértői vélemény elkészítését. A szerzők 147, a Pécsi Tudományegyetemről és a Debreceni Egyetemről származó, fogászati és szájsebészeti ellátások után kiállított látlelet retrospektív vizsgálatát végezték el a nyelvészet, a fogászat, a traumatológia, a büntetőjog és az igazságügyi orvostan szakmai szempontjai szerint. A leletekben dokumentált sérülések 11,1%-a fogakat érintő sérülés, 47,7%-a a fej-nyak régiót érintő egyéb csontsérülés és 41,2%-a szintén ebben a régióban található lágyrészsérülés volt. A dokumentációs hiányosságokat az egy sérülésre jutó sebjellemzők arányszámával jellemeztük, mely a vizsgált leletekben alacsony (0,64) volt. A különböző csontsérülések és a fogsérülések dokumentációja között szignifikáns különbséget találtunk: fogsérülések esetén a sérülés pontos megnevezése szignifikánsan több esetben hiányzott. A fogsérülések részletes és egységes leírása azonban elengedhetetlen a sérülés gyógytartamának büntetőjogi megítéléséhez. A szerzők ismertetik orr- és fogsérülések dokumentációja esetén a szakmaspecifikus terminológiák közötti különbségek okozta nehézségeket, a hiányos sérülésleírások alapján keletkező igazságügyi orvosszakértői vélemények jogi következményeit, valamint a fogsérülések esetén alkalmazott németországi és ausztriai joggyakorlatot. A problémák jelentős részének megoldását ez alapján az egységes – az igazságügyi orvostani szempontoknak is megfelelő, valamint fogászatokon és akut ellátás során is kiválóan alkalmazható – terminológia kidolgozásában látják. Orv Hetil. 2018; 159(51): 2154–2161.

In a previous pilot study, a significantly poorer outcome of laryngeal cancer was found in patients co-infected with human papillomavirus (HPV) and genogroup 1 torque tenovirus (TTV). The present study aimed to collect data on the overall prevalence of TTVs on the prevalence of genogroup 1 TTV in two other malignancies associated with HPV, oral squamous cell cancer and cervical cancer, and in oral and cervical premalignant lesions (oral lichen planus, oral leukoplakia, cervical atypia). Oral samples from all patients were accompanied with a sample from the healthy mucosa. The overall prevalence of TTV was significantly higher both in oral squamous cell cancer and cervical cancer compared with other patient groups or with the respective controls. The prevalence of genogroup 1 TTV was significantly higher in lesions of oral squamous cell cancer and oral lichen planus, but not in lesions of oral leukoplakia (24.6%, 10.1%, and 4.5%, respectively), compared with the prevalence in the oral cavity of controls (1.4%). Co-infection rates with genogroup 1 TTV and HPV were significantly higher in oral squamous cell cancer than in controls, oral lichen planus or oral leukoplakia patients (12.3%, 0.0%, 6.7%, and 4.5%, respectively). The prevalence of genogroup 1 TTV in all cervical samples were comparable. These data suggest that genogroup 1 TTV may be associated specifically with some head and neck mucosal disorders, but disproves a (co)carcinogenic role in oral cancer or cervical cancer as well as an association with HPV or with malignancies associated with HPV.

In Hungary oral and pharyngeal cancers have been reported the fourth most common malignancy in males and the sixth for both sexes. The aim of the present study was to characterize oral squamous cell carcinoma (OSCC) patients in Northeastern Hungary. 119 randomly selected patients with OSCC were included in the study. Epidemiological data, clinicopathological parameters and the risk factors were registered. The most common sites of OSCC were the floor of the mouth (27.7%), the lip (26.9%) and the tongue (22.7%). The majority of the patients was diagnosed with early stage (I-II) lesions and moderately differentiated tumors. The 5-year overall survival rate was 38.7%. There was a significant correlation between survival and tumor size, lymph node involvement and clinical stage. At the time of diagnosis 65.5% of the patients were smokers. Smoking significantly correlated with younger age, male gender, advanced clinical stages and alcohol consumption. 75.5% of the patients consumed alcohol, 41.1% of them exceeding the conventional amount regularly. Drinking habit significantly correlated with younger age, male gender and tumor site i.e. gingiva, retromolar region, tongue. The dental status was acceptable only in 12.6% of the cases. There was a significant correlation between dental status and age, smoking and drinking habits. Clinical stage has the most significant impact on survival and the most important high-risk habits in Northeastern Hungary are smoking and alcohol consumption. Therefore, early detection and treatment, cessation of tobacco and alcohol abuse, and a regular dental care may improve patients' survival in the region.

Oral human papillomavirus (HPV) carriage rates were investigated in relation to genital HPV carriage in women with HPV-associated cervical lesions and male partner of such women, including several couples, in comparison with healthy individuals. Buccal and lingual mucosa of 60 males and 149 females with healthy oral mucosa and without known genital lesion, genital and oral mucosa of further 40 females with cervical high-grade squamous intraepithelial lesion (HSIL) and 34 male sexual partners of women with HSIL (including 20 couples) were sampled. HPV DNA was detected using MY/GP PCR. Genotype was determined by sequencing or restriction fragment length polymorphism. Virus copy numbers were determined by real-time PCR. Overall, oral HPV carriage rate was 5.7% (12/209) in healthy individuals; average copy number was 5.8 × 10(2) copies/1 μg DNA; male and female rates were comparable. Oral carriage in women with HSIL was significantly higher, 20.0% (8/40, P = 0.003); males with partners with HSIL showed a carriage rate of 17.6% (6/34), copy numbers were similar to the healthy controls. In contrast, genital carriage rate (52.9%, 18/34 vs. 82.5%, 33/40; P = 0.006) and average copy number were lower in males (5.0 × 10(5) vs. 7.8 × 10(5) copies/1 μg DNA; P = 0.01). Oral copy numbers in these groups and in healthy individuals were comparable. High-risk genotypes were dominant; couples usually had the same genotype in the genital sample. In conclusion, genital HPV carriage is a risk factor of oral carriage for the individual or for the sexual partner, but alone is not sufficient to produce an oral HPV infection in most cases.

Occurrence of genetic and epigenetic alterations affecting p14ARF and p16INK4A were investigated in tumour samples of 37 oral (OSCC) and 28 laryngeal squamous cell cancer (LSCC) patients, and compared to exfoliated buccal epithelial cells of 68 healthy controls. Presence of deletions and mutations/polymorphisms affecting exons were examined using sequencing. Methylation status of promoters was assessed by methylation-specific PCR. Chi-square and Fisher’s exact tests were used to compare frequency of events. Exon deletions were found in four controls, one OSCC and 22 LSCC patients; the latter significantly differed from controls (p < 0.001). Only two mutations (T24610A and C24702A) were in p16 exon 1 of two OSCC patients. Polymorphisms G28575A (Ala140Thr), G31292C (C540G) and G28608A were found in both patient groups. The p14 promoter was unmethylated in 86.7 % of OSCC and in 85.7 % of LSCC patients; for the p16 promoter these rates were 69.0 % and 76.2 % for OSCC and LSCC patients, respectively. Combining the two patient groups, unmethylated promoter was significantly less frequent in case of both p14 and p16 (p = 0.043 and p = 0.001, respectively) compared to the control group. In summary, exon deletion may be important in LSCC, while promoter methylation was relatively frequent in both patient groups.

We tested 65, 44, and 116 patients with oral squamous cell cancer (OSCC), oral leukoplakia (OL), and oral lichen planus (OLP) against 68 age-matched controls for the presence of Epstein-Barr virus (EBV). Apparently healthy mucosa was simultaneously sampled and examined in all patients. Paraffin-embedded tissue sections of all EBV-positive patients with OSCC were examined for latent membrane protein-1 (LMP-1) expression (demonstrable in most EBV-associated malignancies) using immunohistochemistry. The prevalence of EBV in the controls and in OSCC, OL, and OLP lesions was 19.1%, 73.8%, 29.5%, and 46.6%, respectively, and 66.2%, 22.7%, and 31.9% in the healthy mucosa of patients, respectively. The prevalence of EBV in OSCC patients was significantly higher than in controls or in respective samples of the other two patient groups both in the lesion and in the healthy mucosa. Comparisons including only patients with EBV-negative lesions yielded similar results. Lesions of patients with OLP, but not of patients with OL, differed significantly from controls in EBV prevalence. In OSCC, LMP-1 expression was not detected, and EBV carriage was not significantly associated with any risk factors and did not influence the outcome. Although a high prevalence of EBV was found in OSCC, comparable carriage rates on healthy mucosa of patients indicated that an aetiological role of EBV is unlikely.

Introduction: We investigated the potential role of human papillomaviruses (HPVs) in potentially malignant oral disorders, oral leukoplakia (OL) and oral lichen planus (OLP), and in oral squamous cell cancer (OSCC) in an Eastern Hungarian population with a high incidence of OSCC. Methods: Excised tumor samples (65 OSCC patients) and exfoliated cells from potentially malignant lesions (from 44 and 119 patients with OL and OLP, respectively) as well as from healthy controls (72 individuals) were analysed. OLPs were classified based on clinical appearance, 61 patients had erosive–atrophic lesions (associated with higher malignancy risk, EA-OLP) and 58 had non-erosive non-atrophic lesions (with lower risk of becoming malignant, non-EA-OLP), respectively. Exfoliated cells collected from apparently healthy mucosa accompanied each lesion sample. HPV was detected by MY/GP polymerase chain reaction (PCR) and genotyped by restriction analysis of amplimers. Copy numbers in lesions were determined using real-time PCR. Prevalence rates, copy number distributions, and association with risk factors and diseases were analysed using chi-square test, t-test, and logistic regression, respectively. Results: We detected HPVs significantly more frequently in lesions than in controls (P ≤ 0.001 in all comparisons). HPV prevalence increased gradually with increasing severity of lesions (32.8, 40.9, and 47.7% in OLP, OL, and OSCC, respectively). Copy number distribution patterns roughly corresponded to prevalence rates, but OLP and OL were comparable. HPV prevalence differed significantly between EA-OLP and non-EA-OLP groups (42.6 vs. 22.4%); EA-OLP group showed a prevalence similar to that found in OL. Conclusion: HPVs may be involved in the development or progression of not only OSCC but also of potentially malignant oral lesions.

The purpose of this study is to determine the possible etiological factors of oral squamous cell carcinoma (OSCC) in North-Eastern Hungary. The medical records of 119 randomly selected patients with OSCC admitted to the Department of Maxillofacial Surgery of the Faculty of Dentistry, University of Debrecen were reviewed. The following risk factors were investigated: tobacco and alcohol consumption, dental status, rural vs. urban residence, and high risk HPV infection. The presence of HPV DNA has been evaluated by polymerase chain reaction from the tissue samples. Results were correlated with clinical data. At the time of diagnosis 65.5 percent of the patients were smokers. Under the age of 45 the rate was 86.4%. Smoking significantly correlated with younger age, male gender, advanced clinical stages and alcohol consumption. The majority of the patients (75.5%) consumed alcohol, 41.1% regularly over the acceptable range. Drinking habit significantly correlated with younger age, male gender and tumor site (gingiva, retromolar region, tongue). HR-HPV types were detected in 42.8% of samples tested. HPV DNA presence was not related to gender, clinical stage, histological grade or other risk factors. Authors found weak correlation between HR-HPV positivity, younger patient age and better 5-year survival rate. The dental status was acceptable only in 12.6 percent of the cases. There was a correlation between dental status and age, smoking and drinking habits. No significant urban-rural differences were found. In the study population the most important risk factor for developing oral cancer is tobacco smoking followed by alcohol consumption. Avoidance of tobacco smoking and a reduced amount of alcohol, together with healthy nutrition and regular dental care should be emphasized.