Pneumosinus dilatans multiplex, mental retardation, and facial deformity

Pneumosinus dilatans is a term used to describe enlargement of one or more paranasal sinuses without radiological evidence of localized bone destruction, hyperostosis, or mucous-membrane thickening. To date, many cases have been reported that involved frontal, ethmoid, sphenoid, and maxillary sinus. However, no case has been reported that involved all paranasal sinuses. Our case involved mastoid air cells as well as all paranasal sinuses. It is named pneumosinus dilatans multiplex by us. This is the first case to be reported in English literature that has this syndromic condition of pneumosinus dilatans multiplex, mental retardation, and facial deformity.     

Roberts syndrome,normal cell division,and normal intelligence

Roberts-SC phocomelia syndrome (RS) is an autosomal recessive disorder of symmetric limb defects, craniofacial abnormalities, pre- and postnatal growth retardation, and mental retardation. Patients with RS have been reported to have premature separation of heterochromatin of many chromosomes and abnormalities in the cell-division cycle. No case has been reported who had normal intelligence and normal cell division with typical clinical features of the RS. We report a case of a six-year-old male of clinical and radiologic findings of typical RS with normal cell division and normal intelligence.Although he showed growth retardation, his intelligence was normal. Van Den Berg and Francke later reported that 79 out of 100 cases of Roberts syndrome had premature cell separation (PCS). We think that this case may demonstrate severe expression of the Roberts syndrome even though PCS is not exhibited. The limb involvement of this case was symmetrical, and he showed phocomelia of upper limbs, equinus valgus deformity of ankle, aplasia of fibula, and shortness of fifth toes while his hands and feet were normal with 5 rays each. Craniofacial abnormalities of this case were typical; he showed scaphocephaly, mild hypertelorism, mandibular hypoplasia, dysplastic helix of ear, narrowing of external auditory canal, and cleft palate with wide gap.This report supports the theory that normal intelligence can make social-personal adjustment possible even if all of the stigmata of Roberts syndrome is present.     

Treatment of severe mandibular retrusion in class II, division 2 malocclusion.

The case of an adult patient with a severe mandibular retrusion of the Class II, Division 2 malocclusion type has been presented. The patient's marked anteroposterior discrepancy was complicated by the severe malocclusion. The solution to this case involved presurgical orthodontic treatment to allow for surgical mandibular advancement by a modified sagittal osteotomy and postsurgical orthodontic care for alignment of the dentition. A discussion of the importance of the patient's facial growth type for stable mandibular advancement has also been presented.     

Clinical,radiographic, histologic,and histomorphometric comparison of PepGen P-15 particulate and PepGen P-15 flow in extraction sockets: a same-mouth case study

PURPOSE: Although the efficacy of PepGen P-15 particulate has been conclusively demonstrated in two multicenter clinical studies, the effect of a new hydrogel formulation containing PepGen P-15 on bone repair has not been previously demonstrated. MATERIALS AND METHODS: PepGen P-15 Flow contains PepGen P-15 particulate in a biocompatible hydrogel, which provides spacing between the particles. In this case study, bone repair of both PepGen P-15 particles and PepGen P-15 Flow was compared to natural bone in same-mouth extraction sockets. RESULTS: The radiographic, histologic, and histomorphometric evaluations showed enhanced bone formation and faster particle resorption with PepGen P-15 Flow compared to the PepGen P-15 particulate. CONCLUSION: The accelerated bone formation by PepGen P-15 Flow may provide faster implant placement.     

Treatment of marked anteroposterior and transverse discrepancies in mandibular prognathism.

A case report of a patient with a severe skeletal Class III malocclusion has been presented. The patient's marked anteroposterior discrepancy was complicated by the fact that his buccolingual occlusion was normal. The solution to this case thus involved a correction of the transverse discrepancy in addition to the anteroposterior discrepancy, which required orthodontic and surgical solutions. A discussion of mandibular prognathism has also been presented.     

Hemophilic arthropathy of the temporomandibular joint: Review of the literature,a case report,and discussion

Hemarthrosis of extremity joints in patients with hemophilia has been well documented. However, hemarthrosis of the temporomandibular joint in patients with coagulopathies appears to be rare. Consequently, management of a temporomandibular joint hemarthrosis is difficult because of the lack of treatment guidelines. The purpose of this article is to review the pathophysiology of hemophilic arthropathy and its management. A case of temporomandibular joint hemophilic arthropathy in a patient with a factor XI deficiency will be presented. A brief review of factor XI deficiency and a hypothetical pathophysiological mechanism for internal derangement induced by myofascial pain dysfunction are included.     

Acceptance, caries reduction and reported adverse effects of fluoride prophylaxis in Norway

Water fluoridation has not been introduced in Norway, although 99% of the population receive water with suboptimal fluoride levels. Alternative methods of fluoride prophylaxis have gained wide acceptance in this country. While less than 1% of the children received fluoride tablet in 1971, sales data in 1976 indicated a daily supply of fluoride tablets to 50% of the 0-5-year-olds and to 20% of the 6-11-year-olds. Most schoolchildren have joined mass prophylactic programs with regular with regular applications of fluoride solutions. Furthermore, fluoride-containing dentifrices have become available and are increasingly used. The increased use of fluoride has been paralleled by a marked reduction in caries and restorative need. During the past 5 years, a reduction of about 45% in the number of fillings inserted in 6-17-year-old children has been noted. In some areas, a 70% reduction has been recorded. The ratio between expenses for prophylaxis and savings in cost of treatment is favorable. The Norwegian Adverse Drug Reaction Committe received 34 case reports of adverse effects ascribed to fluoride prophylaxis, from 1970 to 1977. None of the 25 follow-up studies performed, suggested fluoride to have been responsible for the reported symptoms. In Norway, the benefits of fluoride prophylaxis are becoming increasingly evident.     

A combined endodontic-peripdontic lesion Its management and resolution

Abstract A case report of a combined endodontic and periodontic lesion is described. Emphasis has been placed on the difficulty in diagnosing this type of case. Solutions to this problem including sequence of therapy have been discussed.     

A rare craniofacial cleft: numbers 7, 2, and 3 clefts accompanied by a single median lip pit.

OBJECTIVE: A unique case of a unilateral partial Tessier no. 7 cleft accompanied by no. 2 and 3 clefts along with a single median lip pit is presented. The history, genetics, epidemiology, classifications, embryology, pathogenesis, and correction techniques are briefly reviewed. After an extensive review of the literature, we conclude that this particular constellation of anomalies has not previously been described.     

Triad of bilateral duplicated permanent teeth, persistent open apex, and tooth malformation: a case report

AIM: The aim of this article is to report a case of bilateral multiple impacted supernumerary teeth. A discussion of possible mechanisms of development is also presented along with a concise review of the literature. BACKGROUND: Supernumerary teeth occur in the context of various scenarios in the primary and the permanent dentition. Multiple supernumerary teeth are a rare finding especially in the absence of associated syndrome or disease. REPORT: A case of bilateral multiple impacted supernumerary teeth localized to the mandibular premolar region is reported. Some of the supernumerary teeth as well as the erupted premolars had persistent open apices. Coronal malformation of the right maxillary first premolar was another interesting finding. There was an absence of any concomitant disease. SUMMARY: The aforementioned combination of findings has not been reported previously. The anatomical, geometrical, and spatial relationships of supernumerary teeth with their erupted equivalents may shed light on some controversial aspects of the etiology.     

Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case

Florid cemento-osseous dysplasia has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually manifests as multiple radiopaque cementum-like masses distributed throughout the jaws. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. The authors present a case of an uncomplicated florid cemento-osseous dysplasia in a 48-year-old black woman. Multiple sclerotic masses with radiolucent border in the mandible were identified radiographically. Histopathologic findings revealed formation of calcified dense sclerotic masses similar to cementum. All clinical, radiographic, biochemical and histological features were suggestive of the diagnosis of florid cemento-osseous dysplasia.     

Electrochemical behaviour of amino acids on Pt(h,k, l). A voltammetric and in situ FTIR study. Part II. Serine and alanine on Pt(111)

A spectroelectrochemical study of the adsorption and oxidation of serine and alanine on Pt(111) electrodes has been carried out in 0.1 M HClO₄ solutions. From the voltammetric and FTIR spectroscopic results, we concluded that adsorbed cyanide is formed at the Pt(111) surface as a product of serine and alanine oxidation. In the case of serine, adsorbed cyanide is detected at potentials above 0.4 V, whereas a higher potential is needed in the case of alanine. Linear and multibonded CO have also been detected as poisoning species during serine oxidation. These adsorbed species have been isolated by irreversible adsorption experiments of amino acids. Dissolved CO₂ has been found by FTIR spectroscopy as an oxidation product of both amino acids. The role played by the R group in the electrochemical behaviour of these molecules is significant. Reversibly adsorbed serinate and alaninate anions have been also detected. As in the case of the anions present in glycine solutions, the serinate and alaninate anions are two-fold coordinated to the Pt(111) surface through the car?ylate group.     

Labial piercing and localized periodontal destruction - partial periodontal regeneration following periodontal debridement and free gingival graft.

Localized periodontal destruction has been reported as a rare complication of intraoral piercings. The purpose of this case report was to illustrate the destructive nature of a lip stud and to describe the successful treatment of this case. The lip stud was removed and supra- and subgingival debridement was performed. Because of a shallow vestibule, the absence of keratinized gingiva, and the strong frenulum insertion at the gingival margins, a free gingival graft was placed. Subsequently the patient demonstrated a significant amount of osseous regeneration and partial coverage of the recession, which has been clinically and radiographically (computed tomography) documented.     

Generalized idiopathic root resorption: a case report

BACKGROUND: Cases of generalized idiopathic root resorption have been reported in the literature. However the majority of previously reported cases have affected adults, and it has been rare that a possible link to a medical condition has been found. CASE REPORT: The subject of this case report was 11 years old when generalized root resorption was first diagnosed. This case report is unusual in that the resorption may be connected to a bone dysplasia. The possible medical diagnoses and links to tooth resorption have been discussed for this very rare case. CONCLUSION: The investigation into the exact diagnosis of the patient and the treatment of tooth resorption is still ongoing and has required input from many disciplines of Medicine and Dentistry.     

Labial piercing and localized periodontal destruction – partial periodontal regeneration following periodontal debridement and free gingival graft

Abstract –  Localized periodontal destruction has been reported as a rare complication of intraoral piercings. The purpose of this case report was to illustrate the destructive nature of a lip stud and to describe the successful treatment of this case. The lip stud was removed and supra- and subgingival debridement was performed. Because of a shallow vestibule, the absence of keratinized gingiva, and the strong frenulum insertion at the gingival margins, a free gingival graft was placed. Subsequently the patient demonstrated a significant amount of osseous regeneration and partial coverage of the recession, which has been clinically and radiographically (computed tomography) documented.     

Day-case total hip arthroplasty: a safe and sustainable approach to improve satisfaction and productivity,and meet the needs of the orthopaedic population

The demand for lower limb arthroplasty is projected to increase significantly over the next three decades, which poses a major challenge to healthcare services. Novel solutions in arthroplasty services are required to meet the growing volume of patients that require essential orthopaedic surgery. These solutions must be safe, efficient, and reproducible at scale. They must also be robust to the disruption felt with increasing frequency from the need to accommodate the growth of unscheduled inpatient care services. Day case total hip arthroplasty (THA) has become established in North America and is being used with increasing frequency in the UK and Europe. This approach been shown to be safe and effective in a wide variety of settings and is associated with good outcomes and high levels of patient satisfaction. Day case arthroplasty may improve the efficiency and productivity of planned essential surgery by reducing the burden on inpatient services, and consequently the demand for day case THA is likely to increase. It is therefore essential that the principles of day case THA are included in the continued professional development of clinicians in orthopaedic surgery, anaesthetics and perioperative care, and allied health professionals involved in the delivery of arthroplasty services. The first part of this article offers a narrative review of day case THA and considers the relative merits of this approach to lower limb arthroplasty services. The second part describes the experiences of successful units and provides a summary of the principles that are essential to deliver safe and effective care.     

Management of a patient with Factor VII deficiency

Several approaches to the dental treatment of patients with Factor VII deficiencies have been explained. The case of a patient with Factor VII deficiency who required dental extractions has been presented and the rationale for the treatment used in this case has been discussed.     

An unusual oronasal fistula induced by prolonged cocaine snort. Case report and literature review

In the last 50 years cocaine usage has had a growing incidence worldwide. Chronic nasal abuse of this drug can cause extensive oromaxillofacial destructive process as oronasal perforation. To author's knowledge the only type of oronasal fistula in cocaine abusers that has been reported to date has been perforation of the hard palate; a case of oronasal fistulas involving another region of oral cavity, the anterior gingival sulcus, has been reported only once. In this article authors present the first case of oronasal fistula involving hard palate and the right supero-lateral vestible induced by prolonged cocaine snort described in literature, review about the better surgical management for this lesion and the relationship between chronic cocaine abuse and elevated serum levels of c-ANCA.     

Bisphosphonate‐associated osteonecrosis of the jaw,with healing after teriparatide:a review of the literature and a case report

This paper reports the case history of a patient who had bisphosphonate‐associated osteonecrosis of the jaw (ONJ) in which adjunctive treatment with teriparatide was used. The patient was treated for 5 years with alendronate for osteoporosis and developed ONJ after extraction of maxillary teeth. An implant was placed at the site of the extracted teeth. The pathology report confirmed the clinical diagnosis of ONJ; treatment was changed from alendronate to teriparatide and the ONJ resolved. To our knowledge, this is the third case history reported in the literature in which teriparatide was successfully used as adjunct therapy in ONJ because it has an anabolic effect and presumed role in accelerating bone healing. ONJ is a serious but infrequent condition that has been recently associated with nitrogen‐containing bisphosphonate therapy. Teriparatide may be a useful adjunctive therapy when ONJ develops.     

Severe congenital hypoglossia and micrognathia with other multiple birth defects

Severe congenital hypoglossia with the anterior two-thirds of the tongue missing is a rare finding. This case report describes an infant 14 months of age who manifests this tongue anomaly along with other congenital malformations including an underdeveloped mandible, partial anodontia, enamel hypoplasia, situs inversus, dextrocardia, and asplenia. Only one other case similar to this case has been reported in the literature. There is no report of any case of severe congenital hypoglossia with asplenia. The etiology of this birth defect is only speculative at this time, but the mother of our patient was exposed to radiation from routine chest films during her first trimester of pregnancy.