An unusual lateral incisor

Abstract

Objectives: To assess whether structured abstracts improved the sensitivity, precision and yield of retrieving clinical trials, using electronic searches, for example, MEDLINE, from dental journals.

Design: Retrospective, observational study.

Sample: Clinical trials, published in six dental journals. Three that adopted structured abstracts (BDJ, CPJ, JO) and three that remained unchanged (JDR, EJO, AJODO) between January 1995 and December 1998 (extended to December 2002 for the JO).

Intervention: Adoption of a structured abstract format.

Control: Continued use of a non-structured abstract format.

Method: A combination of handsearching and the Cochrane Collaboration Oral H1ealth Group’s Trials Register and/or CENTRAL were used to identify randomised controlled trials (RCTs) and controlled clinical trials (CCTs) over the selected time period. MEDLINE was used to identify clinical trials in the selected journals over the same time period.

Results: There was no significant difference in the sensitivity or yield of clinical trial retrieval in journals with either abstract format over time. However, there was a significant increase in precision in journals that did not change their format (OR=4.96 (95% CI 1.18, 20.86) but not those that did. There was no significant difference in the sensitivity or yield of clinical trial retrieval either before or after the change in format or precision of retrieval before the change. However, in the later period, the precision of retrieval was significantly better in journals with unstructured abstracts compared to those with structured abstracts (OR=0.17 (95% CI 0.04, 0.7).

Conclusion: The use of a structured abstract format does not improve the sensitivity, precision or yield of retrieval of clinical trials from MEDLINE.     

Facial talon cusp in primary maxillary lateral incisor: a report of two unusual cases

Talon cusp is an uncommon dental anomaly in which an accessory cusp-like structure projects from the cingulum area or cemento-enamel junction of the maxillary or mandibular anterior teeth. This anomalous cusp resembles an eagle's talon. It occurs in both the primary and the permanent dentition. A comprehensive literature review shows that only 37?cases of talon cusps have been reported in the primary dentition, of which only 4?cases report this anomaly on the primary maxillary lateral incisor. Though labial/facial talon cusps have been reported in the permanent dentition, no case of a labial talon has been reported in the primary dentition. We report two females with cleft lip and palate with facial talon cusps on the primary lateral incisor and believe that these are the first cases to be reported. Clinical considerations and debate on the etiology of this anomaly are discussed.     

An unusual presentation of erythema migrans

A case of erythema migrans is presented. The histology and appearance are demonstrated, and the intermittent nature of the condition mentioned.     

An unusual presentation of oral syphilis

A case of late, non-infectious, gummatous syphilis presenting with intra-oral arterial haemorrhage in an 81 year-old lady is described.     

An unusual healing of a replanted permanent lateral incisor

Background:  Continued development and healing of an immature permanent tooth root was reported to have occurred. The continued viability of Hertwig's root sheath was thought to be necessary and responsible. Continued development of a tooth root separate from the body of the tooth was reported, but the initiation and development associated with a replanted tooth was not observed.
Methods:  A 9-year-old boy sustained an avulsion injury to his upper right lateral incisor. The tooth was replanted within 5–10 minutes of the incident and was splinted approximately 30 minutes after the injury, and then monitored for 2.25 years.
Results:  The periodontal tissues healed well. Root development was arrested with calcific deposit evident in the pulp canal. A radio-opaque structure, apical to the tooth root, was seen to develop on the radiograph 11 weeks after the initial trauma. The opaque mass continued to develop over the next two years of observation.
Conclusions:  Immature permanent tooth roots show remarkable reparative powers. Clinicians need to be vigilant and close continued monitoring of traumatized immature teeth is recommended.     

An unusual presentation of talon cusp: a case report

The talon cusp is a relatively rare dental developmental anomaly characterised by cusp-like projections, usually observed on the lingual surface of the affected tooth. Normal enamel covers the cusp and fuses with the lingual aspect of the tooth. The cusp may or may not contain an extension of the pulp. This occurs in either maxillary or mandibular anterior teeth in both the primary and permanent dentition. This study reports the unusual case of a 47-year-old female with a taloned tooth on the right maxillary central incisor possessing both lingual and labial talons, with an x-shaped appearance when viewed occlusally.     

An unusual primary presentation of myasthenia gravis

This patient presented with progressive eating difficulties, having been originally investigated for mechanical gastroenterological problems. Fruitless examinations led to referral to a tertiary oral medicine unit and a detailed review of his history, where the significance of progressive fatiguability during and after mastication became apparent in his dysphagia.The insidious onset contrasted with his more rapid decline in function between the initial examination and specialist electromyographic investigations, neurological admission and management. The dangers of fatigue and pharyngeal incompetence are of particular relevance to oral and maxillofacial clinicians.     

An unusual oral presentation of a metastatic basal cell carcinoma

A case report of a metastasising basal cell carcinoma is presented. The primary lesion was situated on the right upper lip with metastasis to soft tissue on the buccal aspect of the right molar region of the mandible. The literature regarding this unusual occurrence is reviewed.     

An unusual presentation of all the mandibular anterior teeth with two root canals--a case report

A rare case of two root canals in all mandibular anterior teeth is presented. The patient initially reported for the treatment of mandibular right central and lateral incisors. However, radiographic evaluation revealed variant root canal and apical foramen patterns.     

An unusual dental presentation of cat scratch disease

A bstract — A case of cat scratch disease which confronted a general dental practitioner as a submandibular swelling is described. Other interesting aspects of the case include a fluctuating response to antibiotic therapy and a presumed appearance of the disease within the immediate family of the affected child.