Association between epilepsy and oral maxillofacial trauma: A systematic review and meta‐analysis

A systematic literature search was conducted (through April 2017), using Web of Science, PubMed and Virtual Health Library, manual reference list, and grey literature searches. The quality of the studies was evaluated using the Newcastle‐Ottawa Quality Assessment Scale. The meta‐analysis was performed using R software. A total of 30 studies was included in this review. From a total of 25 studies included in the meta‐analysis, the prevalence of oral and maxillofacial injuries among epileptic subjects was 19%. Among the epileptic patients who suffered some type of injury due to epileptic seizures, 52% had facial soft tissue injuries (95%CI: 28‐75%), 18% suffered dental trauma (95%CI: 11‐29%), and 12% (95%CI: 4‐28%) suffered maxillofacial fractures. Epileptic patients were more likely to have oral and maxillofacial injuries than healthy individuals (OR: 5.22, 95%CI: 2.84‐9.36) and subjects with psychogenic nonepileptic seizures (OR: 2.77, 95%CI: 1.28‐5.99), but not than patients with special needs (OR: 2.45,95%CI: 0.95‐6.31).     

Treatment of oral manifestations of toxic epidermal necrolysis with low‐level laser therapy in a pediatric patient

Drug‐induced reactions are complications associated with high mortality and significant morbidity. Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are examples of these conditions, which are characterized by skin and mucous lesions. Here, we report a case of a 9‐year‐old girl who presented with blisters associated with an extensive vesicular rash and multiple ulcerations on the lips and oral cavity. A drug‐induced hypersensitivity reaction to antibiotics was suspected, and a diagnosis of TEN was made. The patient was managed with withdrawal of the suspected causative agent, and the oral lesions were treated with low‐level laser therapy (LLLT) and oral hygiene. This case highlights that TEN requires interdisciplinary intervention with dental assistance and follow‐up to improve symptoms, nutrition, systemic condition, and quality of life.     

Defects in Mitochondrial Efficiency and H2O2 Emissions in Obese Women Are Restored to a Lean Phenotype With Aerobic Exercise Training

The notion that mitochondria contribute to obesity-induced insulin resistance is highly debated. Therefore, we determined whether obese (BMI 33 kg/m²), insulin-resistant women with polycystic ovary syndrome had aberrant skeletal muscle mitochondrial physiology compared with lean, insulin-sensitive women (BMI 23 kg/m²). Maximal whole-body and mitochondrial oxygen consumption were not different between obese and lean women. However, obese women exhibited lower mitochondrial coupling and phosphorylation efficiency and elevated mitochondrial H₂O₂ (mtH₂O₂) emissions compared with lean women. We further evaluated the impact of 12 weeks of aerobic exercise on obesity-related impairments in insulin sensitivity and mitochondrial energetics in the fasted state and after a high-fat mixed meal. Exercise training reversed obesity-related mitochondrial derangements as evidenced by enhanced mitochondrial bioenergetics efficiency and decreased mtH₂O₂ production. A concomitant increase in catalase antioxidant activity and decreased DNA oxidative damage indicate improved cellular redox status and a potential mechanism contributing to improved insulin sensitivity. mtH₂O₂ emissions were refractory to a high-fat meal at baseline, but after exercise, mtH₂O₂ emissions increased after the meal, which resembles previous findings in lean individuals. We demonstrate that obese women exhibit impaired mitochondrial bioenergetics in the form of decreased efficiency and impaired mtH₂O₂ emissions, while exercise effectively restores mitochondrial physiology toward that of lean, insulin-sensitive individuals.     

Light shielding effect of overlaying resin composite on the photopolymerization cure kinetics of a resin composite and a dentin adhesive.

OBJECTIVES: The purpose of this study was to simultaneously determine the impact of exposure times and incremental resin composite overlaying thickness on the cure kinetics of a light activated composite and a dentin adhesive at selected depths of a simulated restoration. METHODS: Levels and kinetics of polymerization of a light activated resin composite (Z250, 3M-ESPE) and dentin adhesive (Excite, Ivoclar) cured with a halogen light unit (Demetron, Kerr, USA) operating at low/medium intensity (500 mW/cm2) for different exposure durations (20 and 60 s) were measured at selected depths (0.3, 0.6 and 1mm) using a modified calorimetric analyzer (DSC 25, METLLER-TOLEDO). RESULTS: Final polymerization levels of materials up to 1mm through the composite are not significantly different while the light shielding effect of incremental resin composite overlaying progressively reduces their reaction rates. SIGNIFICANCE: Prolonged irradiation time at low/medium energies is effective for proper conversion of a resin composite and dentin adhesive; 60 s irradiation time provides the maximum obtainable conversion through the dental resin composite for thicknesses up to 1mm.     

Trans-antral temporalis transfer for the repair of adult cleft palates

Temporalis muscle transfer is a versatile technique frequetly used for reconstructive procedures in the maxillofacial region. However the thickness of the pedicle may interfere with masticatory function when used anteriorly in the oral cavity. To repair full-length mid-palatal defects in fully dentate patients the flap can be passed through the maxillary sinus and combined with local repair of the soft palate, thus avoiding any occlusal trauma from the posterior teeth.
The operation is a single stage procedure with low morbidity and few complications, and is a useful technique for repairing the large untreated clefts frequently encountered in developing countries. The procedure is used by members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons Bangladesh Project who have operated in Dhaka teaching hospitals on a regular basis since 1991.     

The number of implants required to support a maxillary overdenture: a systematic review and meta-analysis

Purpose

The number of implants needed to support a maxillary overdenture is still a controversial issue. The aim of this systematic review was to investigate the number of implants required to support a maxillary overdenture in order to obtain optimal treatment outcomes in terms of implant survival, overdenture longevity and patient satisfaction.

Glomus tumor of the lower lip. A case report

A glomus tumor is a benign neoplasm originating from the modified smooth muscle cells of the vascular glomus. This neoplasm was firstly considered by Masson in 1924, and generally it has a solitary lesions but in some cases multiple lesions were described. Differential diagnosis is usually made with Kaposi sarcoma and hemangiopericytoma. The histopathologic examination is essential together with the immunohistochemical study. The clinical case of a 65-year-old man with a glomus tumor of the lower lip is described.     

Traumatic neuroma of the great auricular nerve. A clinical case

A clinical case of neuroma resulting from an amputation which occurred following parotid surgery is reported. The present paper discusses the importance of differential diagnosis relating to this pathology and the surgical techniques that may contribute to setting a limit on its onset. Traumatic neuroma is a possible complication of parotid surgery together with motor deficiencies and Frey's syndrome and the less frequent salivary fistulas. It may also occur following oncological or plastic-reconstructive surgery. During parotidectomy operations, section of the great auricular nerve may be required to facilitate access to the parotid region. This manoeuvre may, however, also be associated with the onset of a neuroma during a time period varying from 2 to 10 years, according to the various authors who have examined the subject. The laterocervical tumefaction associated with neuroma poses a number of diagnostic problems as it has to be differentiated from a likely relapse or possibly from more complex inflammatory or metastatic lymphnodal pathology. A correct clinical and diagnostic multidisciplinary approach is fundamental if the pathology is to be classified in the right way and contributes to alleviating a state of mental unease in the patient that is associated with the sudden appearance of the tumefaction. Sectioning the nervous trunk by means of thermocautery and its subsequent sinking below the main trunk of the sternocleidomastoid muscle, are simple surgical manoeuvres that are useful for preventing the onset of traumatic neuroma.