Ampicillin concentrations in human serum, gingiva, mandibular bone, dental follicle, and dental pulp following a single oral dose of talampicillin

Eighty-one patients who underwent the extraction of impacted mandibular third molars in the nonfasting state were given a single oral dose of talampicillin (500 mg) preoperatively. Specimens of venous blood (n = 132), gingiva (n = 70), mandibular bone (n = 78), dental follicle (n = 63), and dental pulp (n = 59) were obtained during the operation and assayed for ampicillin content. The mean peak concentrations in serum (9.64 micrograms/ml), gingiva (4.72 micrograms/mg), mandibular bone (1.77 micrograms/ml), dental follicle (3.46 micrograms/ml), and dental pulp (5.53 micrograms/mg) all occurred at approximately 150 minutes after administration of talampicillin. The ratios of the corresponding serum concentration to the peak concentrations in the various oral tissues when both were plotted as drug concentration curves were: gingiva, 0.50; mandibular bone, 0.16; dental follicle, 0.34; and dental pulp, 0.52. Talampicillin was absorbed well by the intestine, and sufficient concentrations of the resulting metabolite, ampicillin, were found in oral tissues.     

Pulse granuloma in the wall of a dentigerous cyst

An unusual case of pulse granuloma in the wall of a dentigerous cyst is presented. The microscopic pattern showed the typical features of a foreign body granuloma containing identifiable particles of leguminous foods in the deeper subepithelial tissue. An interesting feature was metaplastic bone formation in the area of droplet calcification. From the clinicopathologic findings, it was hypothesized that the fragments of pulse were probably introduced through an alveolar sinus tract.     

Nasolabial cyst: presentation of a case with a review of the literature

This report presents the clinical and histologic features and treatment of a classic nasolabial (nasoalveolar) cyst. Review of the literature confirms the fact that this lesion is a benign developmental cyst that may arise from epithelium of the nasolacrimal duct. The lesion is usually unilateral, but may be bilateral, is located beneath the ala of the nose, and occurs more frequently in females. Histologically, it is most frequently lined by a pseudostratified columnar epithelium, although both stratified squamous and cuboidal epithelium and goblet cells may be found. The cyst responds well to conservative enucleation.     

Gigantic parotid retention cyst

Cysts of the parotid gland are rare. Recently, in a series of 183 surgical parotid gland specimens, 16 parotid cysts, of which seven were true parotid cysts and nine were cystic neoplasms, were reported.¹ Of the seven true cysts, only one was a retention cyst and the rest were epidermoid and lymphoepithelial cysts. In another series of 23 reported cases, five cysts were of the retention type.² Apart from these two reported series, there are only sporadic case reports of parotid retention cysts.^3–5 Excellent discussions of the differential diagnosis of cystic lesions of the parotid gland has been presented in the literature.^1,2,6Analysis of the sizes of all reported cases of parotid cysts revealed that none were larger than 3.5 cm in diameter. We report a case of a parotid retention cyst of a gigantic proportion, 10 cm in diameter. To the best of our knowledge, this is the largest retention cyst of the parotid gland reported.     

Chondrosarcoma of the jaw: review of fourteen cases

From 1960 to 1983 a total of 14 cases of chondrosarcoma of the jaws were treated at the University College Hospital in Ibadan, Nigeria. The age of the patients ranged from 19 to 55 years (average age, 35 years), and nine of the patients were male. Six of the lesions were located in the maxilla and eight in the mandible. Most of the patients presented too late in the course of the disease to benefit from treatment; only one is known to be still alive.     

An atypical solitary bone cyst

The solitary bone cyst (traumatic, hemorrhagic, extravasation, simple bone, unicameral) is not considered to be a true cyst because it lacks an epithelial lining. Most cases are located in the body or symphysis of the mandible in young patients.^1.2Several cases also have been reported in the ramus,^2,3 one of which intruded into the condyle.² The following is an account of an unusual case that occurred in the mandibular condyle and was diagnosed because the patient required a surgical correction of a mandibular laterognathism.     

Aneurysmal bone cyst of the mandible

Aneurysmal bone cyst is a multilocular cystlike lesion in the bone which is filled with blood. In 1942, Jaffe and Lichtenstein¹ separated a cystic lesion containing numerous pools of blood from other cysts, and in 1950 Lichtenstein² proposed the name “aneurysmal bone cyst” for this entity. He stated that the aneurysmal bone cyst usually occurred in vertebrae, clavicle, rib, and limb bones and produced eccentric bone expansion with numerous pools of blood. The histologic findings showed that spongy bone and marrow were replaced by a fibrous tissue in which hemorrhage, giant cell reaction, and reparative new bone formation were observed.Lichtenstein³ reported statistically that vertebrae and limb bones were commonly affected, constituting about 60% of the total number of cases. Studies by Biesecker et al⁴ and Ruiter et al⁵ showed almost the same result. The aneurysmal bone cyst rarely affects the craniofacial bones. Biesecker reported only two cases in the mandible in 66 cases, and Ruiter reported one case in the maxilla in 105 cases. Daugherty⁶ mentioned that only 2% of these lesions were in the facial bones.     

Recurrent aneurysmal bone cyst of the mandible

A case of aneurysmal bone cyst is presented, which demonstrates the surgical findings and recurrence potential of this lesion.     

The use of fibrin sealant in oral and maxillofacial surgery

A fibrin sealing system is described and its application in various oral and maxillofacial surgical procedures is discussed. The system produces hemostasis, promotes wound healing, and serves as a tissue adhesive.     

Effective treatment of the postoperative maxillary cyst by marsupialization

The postoperative maxillary cyst occurs as a delayed complication after radical surgical intervention in the maxillary sinus. The recommended procedures for treating this entity have been enucleation followed by formation of an antronasal window, primary closure, or open packing. To prevent recurrence and unnecessary tissue destruction from surgery, marsupialization was performed in eight unilocular postoperative maxillary cysts. With the exception of a case in which the long-term results could not be obtained, the cysts disappeared in four months to two and a half years. Possible indications for marsupialization of the postoperative maxillary cyst are discussed.     

Blood pressure fluctuations in hypertensive patients during oral surgery

The lability of blood pressure during oral surgical procedures and the effects of antihypertensive drugs on this lability have not been investigated sufficiently to evaluate potential medical risks. The purpose of this study was to accurately evaluate blood pressure fluctuations during oral surgical procedures in three groups of patients: normotensive patients; stratum I hypertensive patients not taking medication; and stratum I hypertensive patients taking antihypertensive medication. Blood pressure measurements were recorded by an American Heart Association certified technician at baseline, immediately prior to surgery, during administration of the local anesthetic, during the surgical procedure, and 15 minutes after surgery. Analysis of variance indicated that the blood pressure fluctuations (systolic and diastolic) among these five intervals were not statistically significant for any of the groups. The clinical significance of the above findings is that stratum I hypertensive patients experience minimal fluctuations in blood pressure that are no greater than those in normotensive patients and, therefore, may present no greater clinical risk during the dental stress associated with certain oral surgical procedures.     

Parapharyngeal pack for oral surgery

A parapharyngeal pack that is kind to oral tissue, highly absorbent, and autoclavable is presented for use in minor oral surgery procedures under sedation and amnesic techniques.     

Hemangiopericytoma of the oral cavity

A rare case of hemangiopericytoma of the oral cavity is reported, and a review of the literature is presented because histopathologic findings of hemangiopericytoma are not always in agreement with the clinical prognosis, careful follow-up is necessary after surgery.     

Acid trench effect of a surgical splint used following orthognathic surgery

A case is reported in which decalcification of the maxillary teeth apparently occurred from the excessive use of acidic diet cola beverages while the patient was wearing a splint following orthognathic surgery.     

Malignant melanoma of the oral mucosa

Among neoplasms of skin, melanoma ranks as the most malignant. In Australia, primary malignant melanoma of the skin is relatively common, especially in Queensland.¹ Mucosal melanoma, however, is uncommon. It is found primarily on the vulva but may occur in the anorectal region, vagina, noso-oropharyngeal regions and esophagus, and on the penis.²There have been few reports of oral mucosal melanomas in Caucasians. In Australia, primary malignant melanoma of the oral mucosa is rare. Since 1946, three cases have been recorded in the Victorian Cancer Registry (personal communication). It the porpose of the present communication to report a case of oral malignant melanoma, and to briefly review the pertinent literature.     

Histologic investigation of pulpal changes following maxillary and mandibular alveolar osteotomies in the dog

An animal study was done to investigate pulpal responses after creation of dentoalveolar segments in the maxilla and mandible. The animals were sacrificed after one, four, and eight weeks. Histologic examination of the pulps showed micromorphologic changes, but they were generally not sufficiently severe to lead to devitalization.