Versatility of Dieffenbach’s Modification of Weber Fergusson’s Approach for Treatment of Maxillary Pathologies

Objective

The aim of the study is to evaluate the usage of Dieffenbach’s modification of Weber–Fergusons approach in the treatment of lesions involving maxilla.

Study

In this study five different maxillary pathologies were approached through Dieffenbach’s modification of Weber–Fergusons approach. Partial and subtotal procedures were performed depending on the type of pathology and the extent of the lesion which was assessed both clinically and radiologically. The study evaluates the easy exposure of the site, post operative complications like scar formation and infra orbital nerve parasthesia.

Results

There were two subtotal maxillectomy procedures and three partial maxillectomy procedures approached through Dieffenbach’s modification of Weber–Fergusson’s approach. All the cases recovered well in the post operative healing period without noticeable scarring. There was parasthesia in three cases which subsided in 3 months.

Conclusion

The approach through Dieffenbach’s modification of Weber–Fergusons incision gave better visibility and accessibility to the lesions of maxilla. Because there is direct access to the pathology, the inadvertent resection of the un-involved structures is prevented thus minimizing the morbidity.     

Malignant tumors of Stensen’s duct

A rare case of squamous cell carcinoma arising in Stensen’s duct is reported. The literature concerning malignant neoplasia originating in this site is reviewed, with attention given to the histopathologic diversity of neoplasms occurring in the duct, criteria for determination of origin in the duct, and outcomes of therapy. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:73-7)     

Association between a child’s caries experience and the mother’s perception of her child’s oral health status

BackgroundMothers play a primary role in the health of their children. This role may be of particular importance for children in Appalachia who have increased caries relative to children in other regions of the United States. The authors examined the degree to which a child’s caries experience was in concordance with the mother’s perception of the health of her child’s teeth, and how concordance varied by sociodemographic factors.MethodsThe authors obtained cross-sectional data on mother-child dyads with children younger than 6 years through the Center for Oral Health Research in Appalachia study. They interviewed and clinically examined a community-based sample of 815 mother-child dyads from Pennsylvania and West Virginia. They used an unadjusted zero-inflated negative binomial model to estimate the association between a mother’s perception of her child’s oral health status and her child’s caries. The authors compared sociodemographic factors between concordant and nonconcordant mother-child dyads using χ² tests.ResultsThe mother’s perception of her child’s oral health status was associated with the child’s caries experience (P < .001). Two-thirds of mother-child dyads showed concordance between the mother’s perception of her child’s oral health status and the child’s caries experience (n = 522, 64%). Concordance was associated with younger child age and the child having dental insurance (P < .01).Conclusions and Practical ImplicationsOn average, mothers accurately perceived their child’s caries experience. This accuracy was higher for younger children and children with dental insurance. The mother’s awareness of her child’s oral health status could be used to develop effective prevention and treatment strategies, particularly for young children vulnerable to caries.     

Hogan’s modification of the Sanvenero-Rosselli velopharyngoplasty

Purpose

A competent velopharyngeal mechanism is essential for the production of intelligible speech and the secondary procedure of the posterior pharyngeal flap may be necessary in some patients to achieve this goal. The purpose of this study was to examine short and long-term results between the Sanvenero-Rosselli and Hogan’s modification of the cranially based velopharyngoplasty.

Methods

During a 20-year period, 17 patients underwent secondarily a posterior pharyngeal flap to treat velopharyngeal incompetence. All the patients were treated in the same institution and under the supervision of the same stuff surgeon. Nine patients were operated on according to the Sanvenero-Rosselli method and eight according to Hogan’s modification, which consists of the preparation of two mucosal flaps on the dorsal side of the soft palate. Both mucosal flaps are sutured at the base of the pharyngeal flap and cover its raw surface.

Results

Comparing the post-operative condition of the patients in two groups to their pre-operative state, it was observed that speech and comprehensibility were significantly improved, but Hogan’s technique produced better speech results.

Conclusions

According to our limited experience, additional surgical effort to create mucosal flaps on the nasal surface of the soft palate in Hogan’s technique is compensated for by the reliable and substantial advantages that this technique holds, compared to Sanvenero-Rosselli’s original proposition.     

Three-dimensional analysis of dentist’s eye movements

We measured the eye movements of a dentist while a pediatric patient walked toward a dental chair. Bilateral eye movements were measured and analyzed three-dimensionally based on the angle of convergence. The frequency of fixation points registered in each test ranged from 2 to 11, with an average of 6.6. No significant differences were observed when the experiments were grouped according to the age of the observed child. In 13 out of 74 experiments, the calculated distances between the observer and the fixation points corresponded to the actual distances. According to the patterns of where the fixation points occurred, 13 experiments had an inside-outside pattern and 61 had an outside-only pattern. None of the experiments had an inside-only pattern. The outside-only group was further subclassified into 50 behind-only patterns, 5 in front-only patterns, and 6 in-front-and-behind patterns. As far as depth perception is concerned, the angle of convergence determined by the eye movements would rarely correspond to the actual distance between the observer and the fixation point.     

(iii) Ewing’s sarcoma of bone

Ewing’s sarcoma is a primitive malignant bone tumour consisting of small, blue, round malignant cells that may show varying degrees of neural differentiation. It accounts for approximately 5% of all malignant bone tumours and arises most frequently in children or adolescents. Despite significant progress with the use of intensive multiagent chemotherapy and local control measures (survival rates have increased from 10–15% to 65–70% in the last 40 years), a significant proportion of patients still die of disease progression. Clinical and biological prognostic factors should be used to guide the therapeutic choices for each patient. The treatment of Ewing’s sarcoma of bone is currently based on combined therapy with neoadjuvant chemotherapy, radiation therapy and surgical resection of the primary tumour. Survival in primary metastatic Ewing’s sarcoma is poor (less than 30%) and new therapies are needed for these patients.     

Publisher’s note

Due to their physicochemical properties, Tm₂O₃ nanoparticles have been employed in bioanalytical applications. In this report, body-centered shaped Tm₂O₃ nanoparticles with size of about 10 nm were successfully synthesized by the hydrothermal homogeneous method and used as a novel electrochemical biosensing platform for glucose based on a Tm₂O₃–Nafion modified electrode. Transmission electron microscopy (TEM) and energy-dispersive spectroscopy (EDS) were used to characterize the Tm₂O₃ nanoparticles, and cyclic voltammetry (CV) was used to investigate the electrochemical behavior of the modified electrode. The experimental results showed that glucose oxidase (GOD) immobilized on the Nafion–Tm₂O₃ film achieved direct electron transfer with an apparent heterogeneous electron transfer rate constant (k_s) of 3.27 ± 0.43 s⁻¹ and kept its bioactivity. Confirmation of the retained bioactivity can be demonstrated by its bioelectrocatalytic activity to the reduction of dissolved oxygen. The GOD/Tm₂O₃/Nafion/GC electrode displayed potential application for the fabrication of glucose biosensors with a linear glucose response up to 7 mM. Additionally, the biosensor based on the Tm₂O₃ nanoparticle-modified electrode exhibited good stability and selectivity. The successful practice of using the Tm₂O₃ modified electrode for the direct electrochemical analysis of proteins and the bioelectrocatalytic activity of enzymes offers an efficient strategy and a new promising platform for the application of rare earth oxide materials in the field of electrochemical sensors.     

The role of the orthodontist in the diagnosis of Gorlin’s syndrome

Gorlin’s syndrome is a relatively rare generalized disorder. Its diagnosis in childhood is usually through oral abnormalities. Some of the most frequent clinical features of this syndrome are discovered through radiographs commonly used in orthodontia. Thus, the orthodontist may be able to contribute to its diagnosis. The article shows three clinical cases that illustrate the role that the orthodontist may play in diagnosis of this syndrome. (Am J Orthod Dentofacial Orthop 1999;115:89-98)     

The influence of biofilm maturation on fluoride’s anticaries efficacy

Clinical Oral Investigations - (1) To explore the influence of biofilm maturation and timing of exposure on fluoride anticaries efficacy and (2) to explore biofilm recovery post-treatment. Bovine...