Cheek

Abstract: A healthy 50-year-old man notices that his face is drooping on the right side. On examination, facial asymmetry is evident, and some saliva has accumulated on the right side of the patient's mouth. When the patient attempts to close his eyes, his right eye does not close, although it rolls upward, and he is unable to show his teeth or inflate his cheek on the right. How should the patient be evaluated? Does he need immediate treatment?

Abstract: SINCE the discovery by Yamagiwa in 1915 that skin cancer could be produced at will by tarring the ear of the rabbit, and since the isolation from tar of the carcinogenic hydrocarbon, benzpyrene, by Cook and Kennaway in 1932, some 1,300 different compounds have been studied for their cancerogenic properties. The literature on experimental carcinogenesis has reached voluminous proportions. However, most of these reports deal with the chemical induction of cancer in regions of the body other than the oral cavity. When it is considered that 8 to 10 per cent of all human cancer occurs in the mouth, and that 4 per cent of cancer deaths in the United States result from intra-oral tumors,9 it is surprising that so little work of an experimental nature has been done in this seemingly important field. Of the few reports that do appear, results for the most part have been negative or inconclusive. Levy11 painted methyleholanthrene on the labial mucosa of mice and hamsters up to sixteen weeks, noting no gross or histologic change in the treated tissues. He also implanted pellets of the same compound at the apex of the lower incisors with a resultant disorderly growth of enamel, dentin, and cementum. In 1950 Levy and Ring13 succeeded in producing malignant tumors of connective tissue, sarcomas, by implanting crystalline 9,10-dimethyl1,2-benzanthracene subgingivally in hamsters. Eighty per cent of their animals exhibited tumors after four to five months. Levy, Gorlin, and Gottsegen'2 studied the effect of a single topical application of 9,10-dimethyl-1,2-benzanthracene on the skin and mucous membrane of the lips of mice. The study was terminated after thirty-five days with some premalignant changes noted histologically in the mucous membrane. Wantland17 sprayed and painted 20-methylcholanthrene, 1,2,5,6-dibenzanthracene, and 2-acetylaminofluorine into the hamster pouch for six weeks with no changes noted other than hyperplasia. Since 90 to 95 per cent of oral cancer is epithelial in origin,9' 15 efforts in this study were directed toward attempting to produce this type of tumor. The Syrian hamster (Cricetus auratus) was chosen as the most suitable experimental animal for several reasons. It possesses two cheek pouches which communicate with the mouth on either side and which are lined by stratified squamous epithelium similar to that lining the oral cavity proper. The pouch can be readily inverted or pulled out for easy access and gross observation. When in

Abstract: Traditionally, DNA used for PCR-based diagnostic analysis has originated from white cells fractionated from whole blood. Although this method yields substantial quantities of DNA, there are some drawbacks to the procedure, including the inconvenience of drawing blood, risk of exposure to blood-borne pathogens, liquid sample handling, and the somewhat involved extraction procedure. Alternatively, DNA for genetic diagnosis has been derived from finger stick blood samples, hair roots, cheek scrapings, and urine samples. Oral saline rinses have also been used extensively as a means of collecting buccal epithelial cells as a DNA source. However, this method still requires liquid sample handling. Herein, we present our results involving the rapid extraction of DNA from buccal cells collected on cytology brushes and swabs for use in PCR reactions, specifically the multiplex amplification of 5 exons within the CFTR gene. The quality of DNA isolated from buccal cells, collected in this manner, has been sufficient to reproducibly support multiplex amplification. Cheek cell samples and the DNA prepared from them as described here are highly stable. The success rate of PCR amplification on DNA prepared from buccal cells is 99%. In a blind study comparing the analysis of 12 mutations responsible for cystic fibrosis in multiplex products amplified with DNA from both blood and buccal cell samples from 464 individuals, there was 100% correlation of results for blood and cheek cell DNA, validating the use of DNA extracted from cheek cells collected on cytology brushes for use in genetic testing.

Abstract: The buccal fat pad is an anatomically complex structure that has great importance in facial contour. In properly selected individuals, judicious harvesting of buccal fat can produce dramatic changes in facial appearance by reducing the fullness of the cheek and highlighting the malar eminences. Using fresh cadaver dissection, the anatomy of the buccal fat pad is delineated and its relationship to the masticatory space, facial nerve, and parotid duct is defined. An intraoral approach for buccal fat harvesting is described based on these anatomic findings. Clinical experience manipulating the buccal fat pad for aesthetic modification of facial contour is illustrated.