Delayed iliac abscess as an unusual complication of an iliac bone graft in an orthognathic case

The reconstruction of large maxillofacial defects generally requires harvesting bone from extra-oral sites. The main source of autogenous bone is the iliac crest. This donor site is used to obtain bone for augmentation in orthopaedic surgery, neurosurgery, and oral and maxillofacial surgery, where the main indications are secondary and tertiary osteoplasty in patients with cleft-lip and palate, reconstruction of bony defects after operations for tumours, and augmentation of severe atrophy of the alveolar crest in preprosthetic surgery. A review of the literature on complications following bone harvesting from the anterior iliac crest reveals persistent pain, nerve injury, haemorrhage, limping, persistent gait abnormalities, conspicuous scarring, bone contour alteration, infection, fracture, meralgia paraesthetica, peritonitis, and herniation. The authors report an unusual complication: a huge iliac abscess that appeared 4 years after bimaxillary surgery involving iliac bone grafts.     

Problems of an aging population in an era of technology

With the substantially growing number of elderly persons in Canada and the rest of the developed world, the need for adequate health and social care will increase. Health and social service providers must develop policies and programs allowing the elderly to lead rich and independent lives for as long as possible. As advances in age-related diseases are made, the elderly will potentially live longer and lead more active and fulfilling lives. Society, governments and those involved in the care of the elderly must meet the new challenges of this aging population in a humane and respectful way.     

Facial lipodystrophy in an HIV-positive patient using an orthodontic appliance

The aim of this article was to relate the clinical case of an HIV-positive orthodontic patient who reported that her cheeks had been hurting since treatment began. We started with the data collected in anamnesis and by contact with the patient's physician, and a diagnosis of facial lipodystrophy as a result of the use of retroviral drugs was reached. The patient was referred to a dermatologist for treatment of the facial lipodystrophy.     

Recurrence of an ameloblastoma in an autogenous iliac bone graft

A rare case of recurrent ameloblastoma in an iliac bone graft is presented.     

Recurrence of an ameloblastoma in an autogenous iliac bone graft

A rare case of recurrence of an ameloblastoma in an iliac bone graft many years after the initial operation for a mandibular amelolastoma with evidence of soft tissue invasion is presented. A review of the literature disclosed only 11 cases of recurrence of ameloblastoma in bone grafts. In the case presented the initial operation was a hemimandibulectomy followed by autogenous iliac bone graft. Sixteen years after the surgery there was clinical and radiographic signs of recurrence. It was concluded that extensive resection including bone as well as adjacent soft tissues is critical because the recurrences seem to stem from the soft tissues, especially from the adjacent periosteum.     

Efficacy of an alcohol-free chlorhexidine mouthrinse as an antimicrobial agent

Statement of problem. Antimicrobial mouthrinses have become an important part of comprehensive dental care. However, mouthrinses that contain alcohol have been shown to be detrimental to patients undergoing radiation therapy for head and neck cancer, to some immunocompromised patients, to families with small children, and to persons sensitive to alcohol. Purpose. This study evaluated the effectiveness of alcohol-free, 0.12% chlorhexidine mouthrinse in reducing microbial levels when compared with commercially available 0.12% chlorhexidine (CHX) and essential oils mouthrinses. Material and methods. This study consisted of both in vitro and in vivo investigations. The double-blind study included 32 subjects randomly assigned to 3 groups, equalized according to the indices tested. One group (n = 11) received essential oils rinse; the second group (n = 11) received CHX; and the last group (n = 10) received the alcohol-free CHX. Subjects were asked not to use any mechanical means of oral hygiene for 21 days. The in vitro part of the study consisted of Streptococcus mutans strip tests. Results. Mean plaque scores for both CHX products decreased after 21 days, whereas the mean for the essential oils increased. Bleeding and gingival index scores for all 3 groups increased, which may be due to the initially healthy tissues of the participants. Relative microbial growth for S mutans for both the CHX products decreased to 0 after 21 days, whereas the counts for the essential oils group remained varied.(J Prosthet Dent 1998;80:685-90.)     

Creating an adaptable anterior margin for an implant-retained auricular prosthesis

Achieving complete adaptation of the anterior margin of an auricular prosthesis often presents a challenge. Conventional solutions to this problem address soft tissue movements at static positions and do not necessarily reflect how the margin will adapt throughout a complete range of motion of the mandible and head. A technique is presented for creating an adaptable margin for an auricular prosthesis throughout a complete range of motion. This technique can be applied once adaptation of the diagnostic wax margin to the master cast is successful.     

Repair of an intrabony defect from an adenomatoid odontogenic tumor

This case report describes the occurrence and treatment of an adenomatoid odontogenic tumor (AOT) presenting as a periodontal intrabony defect on a upper lateral incisor. Following incision and flap reflection, a solid, rubbery specimen was enucleated in one piece leaving a wide moat-like intrabony defect. A bioabsorbable membrane of glycolide and lactide copolymer was sutured over the defect to maximize regeneration and the flaps then sutured over the membrane. Microscopic analysis of the biopsied specimen revealed dental hard tissue interspersed in a field of odontogenic epithelium in a glandular configuration, consistent with a diagnosis of AOT. AOT is a rare odontogenic tumor usually associated with unerupted teeth or dentigerous cysts, not periodontal defects. Clinical evaluation 6 months postoperatively revealed restoration of clinical attachment and periodontal health.     

Sleep bruxism: an updated review of an old problem

Objective To provide an update on what is known about bruxism and some of the major clinical highlights derived from new insights into this old problem in dentistry. Materials and methods A selective, non-systematic but critical review of the available scientific literature was performed. Results There are two main different types of bruxism, which are related to different circadian periods (sleep and awake bruxism) that may differ in terms of pathophysiology, but they share some common signs and symptoms. Approximately one out of 10 adult individuals may suffer from bruxism, but not all bruxers may need treatment. Bruxism is complicated to diagnose in the clinic and self-report of bruxism may not necessarily reflect the true presence of jaw muscle activity. Better understanding has been acquired of bruxism relationships with sleep stages, arousal responses and autonomic function with the help of polysomnography and controlled sleep studies. Meanwhile, there is still much more to learn about awake bruxism. With the available scientific knowledge it is possible to systematically assess the effects of bruxism and its potential risk factors for oral and general health. Moreover, we can be aware of the realistic possibilities to manage/treat the patient suffering from bruxism. Conclusion Bruxism is a parafunctional activity involving the masticatory muscles and probably it is as old as human mankind. Different ways have been proposed to define, diagnose, assess the impact and consequences, understand the pathophysiology and treat or manage bruxism. Despite the vast research efforts made in this field, there are still significant gaps in our knowledge.     

Herniation of an antral polyp through an oroantral fistula.

This paper reports a case of herniation of an antral polyp through an oroantral fistula, appearing as a polypoid lesion of the alveolar ridge. The patient was a 24-year-old female, and her upper molar had been extracted two months previously. The lesion was asymptomatic, and was a soft tissue mass, red in color and nontender to palpation, involving the alveolar ridge in the maxillary molar area. Review of the literature yielded only a few other such cases.     

Replacing an abutment crown for an existing removable partial denture

A method to replace an abutment crown for an existing removable partial denture has been presented.