Clinical experiences with patients with facial bone deformities associated with hemifacial microsomia.

Eighteen adult patients with hemifacial microsomia were treated with a combination of skeletal and augmentation surgery. Three typical cases are presented. In principle, skeletal and augmentation surgery have recently been performed in combination in a single stage. Groin flaps and scapular or scapular ostocutaneous flaps have mainly been employed for augmentation surgery.     

Vasovagal syncope with asystole associated with intravenous access

Two cases of vasovagal syncope (VVS) during venous access are reported. Both patients had a history of fainting episodes and experienced bradycardia with asystole, hypotension, and fainting. Pain and phobic stress during venous access triggered an increase in parasympathetic tone, resulting in bradycardia with asystole and hypotension in both cases. Hypotension and bradycardia likely caused cerebral hypoperfusion, leading to fainting. The intense parasympathetic tone triggered by somatic or emotional stress was likely responsible for directly depressing the sinus node, leading to asystole and bradycardia. Bradycardia with asystole progressing to syncope is a potentially fatal dysrhythmia in patients with cardiovascular disease or older patients with decreased cardiac function. Appropriate treatment for VVS includes the administration of intravenous fluids, vagolytics, ephedrine, and the rapid use of the Trendelenburg position. Intravenous fluids and atropine were used to treat the present patients.     

Inflammation associated with implants with different surface types

OBJECTIVES: The aim of this study was to determine the nature of the inflammatory infiltrate associated with different transmucosal implant surfaces in dogs. METHODS: Three experimental and one control single-stage implants were randomly placed on each side of the jaw in eight dogs. The transmucosal portion of the test implants consisted of an acid-etched surface (type A), a machined surface with a circumferential groove (type C) and a surface prepared by mild anodic oxidation (type D). The control was a standard machined surface (type B). In order to determine the response to the different surfaces, plaque control was carried out twice weekly following placement of the implants for the entire period of the experiment. At 6 months, gingival biopsies and plaque samples were obtained. The area of inflammatory infiltrate and the nature of the infiltrating cell types were determined using immunohistology. Real-time polymerase chain reaction was used to identify putative periodontal pathogens. RESULTS: Inflammatory infiltrates were associated with all implant surfaces and were commonly found subepithelially and perivascularly. T cells were the predominant infiltrating cell type in all lesions, associated with the different surfaces. In all lesions the CD4 : CD8 ratio was approximately 2 : 1. Statistical analysis showed that the type C surface (machined surface with a groove) had significantly larger inflammatory infiltrates than the type B surface (machined surface without a groove; P<0.05). No statistically significant differences were found with respect to the size of the inflammatory infiltrates or in terms of the nature of infiltrating cells. However, despite the intensive plaque control regime, plaque was present on all implant surfaces at the time of biopsy 6 months after placement. All implants had similar numbers of Tannerella forsythia, Fusobacterium nucleatum and Porphyromonas gingivalis. Actinobacillus actinomycetemcomitans, was not detected in any sample. CONCLUSIONS: These results suggest that the development of inflammation associated with implants is independent of surface type, but is nevertheless associated with the presence of plaque. The different surfaces had no influence on the nature of the infiltrate, with T cells being the predominant cell type in all lesions. Finally, the different implant surface types seemed not to influence the peri-implant microbiota. However, the presence of the circumferential groove tended to be associated with larger infiltrates. Whether this is due to increased plaque accumulation remains to be determined.     

Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids

The development of recurrent pyogenic granulomas as multiple satellite lesions has not been reported in the oral cavity. This report describes an unusual case of intraoral pyogenic granuloma recurring multiple times after surgical excisions with the formation of satellite lesions. Due to failure of surgical management, an alternative approach was taken. We illustrate how the lesions were successfully treated with a series of intralesional corticosteroid injections.     

Professional Musicians with Craniomandibular Dysfunctions Treated with Oral Splints

Abstract

Craniomandibular dysfunction (CMD) symptoms occur frequently in violin/viola and wind players and can be associated with pain in the neck, shoulders and arm. In the current study, the effect of oral splint treatment of CMD on reducing pain and symptoms especially in these areas was investigated. Thirty (30) musicians undergoing CMD treatment with oral splints participated in this study. They completed a questionnaire that addressed CMD symptoms, localization of pain, and subjective changes in symptoms. Pain in the shoulder and/or upper extremity was the most frequent symptom reported by 83% of subjects, followed by neck pain (80%) and pain in the teeth/TMJ regions (63%). Treatment with oral splints contributed to a significant decrease in neck pain in 91%, teeth/TMJ pain in 83%, and shoulder and upper extremity pain in 76% of the musicians. Eighty percent (80%) of the patients reported improvement of their predominant symptoms. CMD can be a potential cause for pain in the neck, shoulders, and upper extremities of musicians. It is paramount that musicians with musculoskeletal problems be examined for CMD symptoms. Treatment with oral splints seems to be valuable. Further prospective, randomized controlled studies are necessary to confirm efficacy of oral splint treatment in CMD-associated pain and problems in the neck, shoulder, and the upper extremities in musicians.     

Genetic counseling of parents with children with clefts]

The elucidation of the aetiology of the individual case has proved to be of fundamental importance to the counselling interview as well as to the assessment of the risk for further affected children. Up to now, a genetic cause in the form of chromosomal or gene mutations can be assumed only if the cleft is related to a distinct syndrome. An isolated cleft obviously owes its origin to a combination of genetic and extrinsic factors. Consequently, the assessment of the risk of repetition is to a great extent based on empirical values.     

Oral tuberculosis associated with a treatment with anti-rheumatic drugs

BACKGROUND: The use of immunosuppressive medication is a dominant risk factor for infection in patients with rheumatoid arthritis (RA). Methotrexate (MTX) is one of the traditional disease-modifying antirheumatic drugs. Adalimumab [a human anti-tumor necrosis factor-alpha (anti-TNF-alpha) monoclonal antibody] represent an important advance in the treatment of RA and has been recently come in use. TNF-alpha plays a role in the host defense against Mycobacterium tuberculosis and notably in granuloma formation. Infections occur at a high rate among those who use one or the combination of the two medications. METHOD: We examined a female patient that was referred to our department for evaluation and treatment of a granular lesion on the soft palate and uvula, complaining of mild dysphagia. The patient was treated for 4 months with MTX and adalimumab for RA before the oral lesion appeared. RESULTS: The histopathological examination of a specimen of the oral lesion, taken by biopsy, showed a chronic inflammation characterized by tuberculous granulomas. Polymerase chain reaction test and culture of a new specimen was positive for M. tuberculosis. CONCLUSIONS: The therapeutic use of MTX or/and adalimumab for the treatment of RA or few others diseases, can cause oral tuberculosis.     

Evaluation of relapse with thermoplastic retainers equipped with microsensors

ObjectivesTo examine relapse with thermoplastic retainers equipped with microsensors 1 year after treatment.Materials and MethodsA total of 42 patients (29 females, 13 males) treated with four premolar extractions were included in this study. Thermoplastic appliances equipped with TheraMon microsensors (Handelsagentur Gschladt, Hargelsberg, Austria) were used to assess daily wear time (DWT), and the patients were monitored at 2-month intervals for a period of 12 months. At the end of the follow-up, the following two groups were formed based on the mean DWT: short wear time (SWT; <9 h/d) and long wear time (LWT; ≥9 h/d). Digital models were constructed before treatment (T0), at debonding (T1), and 6 months (T2) and 12 months (T3) after debonding. Little''s Irregularity Index (LII) and the intercanine and intermolar widths, arch lengths, overjet, and overbite were calculated based on the digital models. Data were analyzed statistically.ResultsIrregularity and overjet increased, whereas transverse measurements and arch lengths decreased with time in both groups. During the retention period, overbite decreased in the SWT group but increased in the LWT group. There were significant differences between groups only in mandibular irregularity. The LII values of the SWT group were significantly higher than those of the LWT group for the T1–T2 and T1–T3 time intervals (P < .05).ConclusionsA mean DWT less than 9 hours/day was inadequate for controlling irregularity within clinically acceptable limits. A wear time of at least 9 h/d is recommended for the maintenance of mandibular anterior alignment.     

Mandibular augmentation in dogs with hydroxylapatite combined with demineralized bone

This study investigates the tissue response in dogs to mandibular augmentation with hydroxylapatite (HA) combined with demineralized bone. Thirty mongrel dogs underwent ridge augmentation with 3 ml of HA alone (HAO), HA combined with autogenous bone (HAB), or HA combined with demineralized bone (HAD). Bone was not found in the HAO augmented ridges through 52 weeks; bone was found in the HAB augmented ridges by 12 weeks, and the HAD augmented ridges had bone formation after 26 weeks. This study demonstrates that demineralized bone can induce osteogenesis within the HA augmented dog ridge, but it is delayed when compared to HAB augmentations.     

中草药治疗三叉神经痛疗效观察

三叉神经痛是口腔科的常见疾病之一 ,其发病原因至今尚未完全明了。我们自 1995年开始用中草药方剂治疗原发性三叉神经痛患者 50例 ,经临床随访观察取得比较满意的效果 ,现报告如下。1　材料与方法1.1　病例资料本组病例共 50例 ,男性 15例 ,女性 35例。年龄最大者 82岁 ,平均年龄 57岁。疼痛分布区 ,发生在三叉神经第Ⅰ支者 4例 ,第Ⅱ支者 10例 ,第Ⅲ支者 18例 ,三支同时受累者 18例。病变部位在右侧者 2 8例 ,左侧者 2 2例。疼痛性质均为短暂的刀割样及撕裂样疼痛。疼痛持续时间在 3ｍｉｎ以内者 3例 ,超过 3ｍｉｎ者 12例 ,最长时间达 10…     

Marginal adaptation with glass-ceramic inlays adhesively luted with glycerine gel

The purpose of this study was to examine the effectiveness of glycerine gels in preventing the formation of an oxygen-inhibition layer during the polymerization of composite resin materials. Sixteen glass-ceramic inlays were adhesively luted with and without the application of glycerine gels on the inlay margins before the polymerization of the luting composite resin material. To remove the oxygen-inhibition layer, the inlays were brushed with acetone. Replicas were obtained before and after acetone brushing, and a computerized quantitative marginal analysis was carried out under the scanning electron microscope. Statistical analysis revealed significant differences between the polymerization with and the polymerization without the use of a glycerine gel. The inlay margins polymerized after the application of a glycerine gel showed better marginal adaptation than did the inlay margins polymerized without it, suggesting that oxygen inhibition during polymerization can be prevented by the application of glycerine gels to the surface of composite resin materials.     

Indirect bonding with thermal glue and brackets with positioning jigs

In orthodontics the precise location of bracket placement on the teeth is a goal in order to individualize and optimize treatment outcome. The authors will describe the indirect bonding procedure with thermal glue transfer tray and brackets with positioning jigs for precise bracket placement.