Repair of the trigeminal nerve: a review

Nerve surgery in the maxillofacial region is confined to the trigeminal and facial nerves and their branches. The trigeminal nerve can be damaged as a result of trauma, local anaesthesia, tumour removal and implant placement but the most common cause relates to the removal of teeth, particularly the inferior alveolar and lingual nerves following third molar surgery. The timing of nerve repair is controversial but it is generally accepted that primary repair at the time of injury is the best time to repair the nerve but it is often a closed injury and the operator does not know the nerve is injured until after the operation. Early secondary repair at about three months after injury is the most accepted time frame for repair. However, it is also thought that a reasonable result can be obtained at a later time. It is also generally accepted that the best results will be obtained with a direct anastamosis of the two ends of the nerve to be repaired. However, if there is a gap between the two ends, a nerve graft will be required to bridge the gap as the two ends of the nerve will not be approximated without tension and a passive repair is important for the regenerating axons to grow down the appropriate perineural tubes. Various materials have been used for grafting and include autologous grafts, such as the sural and greater auricular nerves, vein grafts, which act as a conduit for the axons to grow down, and allografts such as Neurotube, which is made of polyglycolic acid (PGA) and will resorb over a period of time.     

An Innovative and Simple Approach to Functional Salivary Reservoir Fabrication

Saliva is a valuable oral fluid that is often taken for granted. Impaired salivary function is a major and a debilitating sequela of radiation treatment for patients with head and neck cancer. It can persist for years and thereby increases the risk of oral infection significantly. Moreover, it has a notably negative impact on the quality of life of such patients. To help overcome this problem, a number of techniques have been proposed for incorporating a reservoir containing salivary substitute into a removable prosthesis. A new design for a functional salivary reservoir is presented here. This design is simple to construct and easily maintained by the wearer. Details of its design, construction, and other potential advantages are presented.     

An Alternative Procedure for Fabricating a Hollow Interim Obturator for a Partial Maxillectomy Patient

A technique is described for fabricating an interim obturator for a partial maxillectomy patient. This technique enables the immediate and easy chairside fabrication of a lightweight hollow-type interim obturator when a preoperative cast is not available. After a master cast is formed, two duplicate casts are made from the master cast. One portion of the obturator is fabricated on a duplicate cast with a corrected defect, and the other portion of the prosthetic base is made on the second duplicate cast with a corrected alveolar ridge. These two portions are connected and adjusted in the patient's oral cavity. This technique is beneficial because it helps patients maintain good esthetics and their ability to speak, swallow, and chew just after surgery.     

Temporomandibular Disorder: a practical guide for dental practitioners in diagnosis and management

Temporomandibular disorder is a broad term encompassing pain and/or dysfunction of the masticatory musculature and the temporomandibular joints. Pain arising from a temporomandibular disorder is a common reason for seeking dental care. It is essential that dental practitioners are able to accurately diagnose and manage this condition. Identifying people at highest risk of developing a temporomandibular disorder and knowing which procedures are more likely to initiate or exacerbate a temporomandibular disorder, are important to reduce the likelihood of its acute and chronic presentation. The aim of this paper is to provide the dental practitioner with a clinical guideline for reference including practical tools to examine, diagnose and manage patients with temporomandibular disorder. In addition the risk profile of patients and procedures is explored to help minimize the occurrence of temporomandibular disorders and mitigate its symptoms. The scope of the dental practitioner in the management of acute and chronic temporomandibular disorders is presented, with guidance about when referral to a specialist is indicated.     

A minimum separating diffusion and adsorption waves in polarography using a static mercury drop electrode

A sampled dc polarogram of a reversible redox reaction complicated by the reactant adsorption on the surface of the static mercury drop electrode may consist of a main wave and a post-wave which are separated by a minimum. This phenomenon is analysed theoretically for Langmuir and Frumkin isotherms. The minimum is a part of the postwave. It appears in the potential range in which the maximum surface coverage is diminished below 0.8. The minimum is the consequence of the change of the current–time relationship during the life-time of a single drop. A minumum followed by a very steep postwave is an indication of strong lateral attractions in the adsorbed layer.     

利多卡因过敏性休克伴呼吸循环骤停急救1例报告

报告1例6岁女孩在局麻注射利多卡因时,即刻发生过敏性休克伴呼吸循环骤停的抢救经过和体会。利多卡因过敏反应虽十分罕见,但可能发生速发型过敏性休克甚至呼吸循环骤停而致死。普鲁卡因过敏或过敏性体质者可改用利多卡因,但应先做皮试,并备好氧气和急救药品,以防不测。抢救成功的关键是及时正确的诊断和急救,首选药物是肾上腺素。     

Parathyroid hormone-related protein is a developmental regulatory molecule

Parathyroid hormone-related peptide (PTHrP) was discovered as the tumor product that is responsible for most instances of the syndrome of humoral hypercalcemia of malignancy. It is now known that the PTHrP and PTH genes arose on the basis of an ancient duplication event. One result of this heritage is a short stretch of highly homologous sequence at the N-terminus of each of the peptides, and another is the fact that these N-terminal products seem to be serviced by a single G protein-coupled receptor referred to as the type I receptor. Overexpression and null strategies in mice have recently provided convincing evidence that one such PTHrP function is as a developmental regulatory molecule. For example, overexpression of PTHrP in keratinocytes, mammary epithelial cells and chondrocytes results in a developmental phenotype in each case, while knockout of the gene is associated with a chondrodystrophy that is lethal at birth. Rescue of the PTHrP-null mouse via a genetic strategy involving a cross between the knockout mouse and a transgenic mouse with targeted PTHrP overexpression in chondrocytes provides a window on previously unappreciated PTHrP developmental regulatory effects in multiple tissues that share a common epithelial-mesenchymal morphogenetic background.     

Xeroradiography and its application to dentistry

Abstract Xeroradiography is a highly accurate electrostatic imaging technique. In this technique a conventional single-phase dental x-ray unit is used as an x-ray source, but instead of a silver-halide film image, a uniformly charged selenium alloy plate housed in a light-proof cassette is used. In this article the equipment, procedure, properties and artifacts related to the xeroradiographic technique are described. An evaluation of the xeroradiographic images is also presented. Xeroradiography, which requires only about one-third of the dose required for conventional radiographs, is a valuable alternative to conventional radiography for detecting carious lesions, calculus deposits and periodontal disease. It is also of value in interpreting periapical structures.     

Ameloblastoma and Intracranial Involvement: The Current Challenge of the Radical Surgical Treatment. Comprehensive Review of the Literature and Institution experience

BackgroundAmeloblastoma (AMBL) is an odontogenic tumor, considered to be benign, but aggressive, whose principal risk is a recurrence. The growth can be enormous, and it can extend into the intracranial compartment with serious consequences. PurposeThe intracranial involvement of AMBL is rare, and it may require an extensive surgery. Although it is a rare condition for the neurosurgeon to treat, knowing this condition can lead to a significant increase in survival for these patients. MethodsA case of a 56-year-old woman presented with a history of recurrent left maxilla AMBL with intracranial extension and dural involvement of the anterior and medial cranial fossa is reported, followed by a systematic review of the literature with the aim to identify the best surgical treatment. ResultsA total of 32 cases were included in the qualitative analysis. Management is varied and often not described, resulting in an almost complete lack of information and indications for treatment. Radical surgery tends to yield the best outcomes, and it is recommended to have adequate surgical margins when possible.ConclusionsIntracranial involvement from AMBL compartment is an uncommon manifestation of this rare pathology, but which deserves to be treated in a multidisciplinary way in order to ensure maximum surgical radicality. Recurrence reflects failure of the primary surgical resection. If recurrence is the major consideration, surgeons are encouraged to select radical surgery. Whenever a follicular-type maxillary AMBL is diagnosed, it is advisable to check for intracranial spreading and distant metastases during follow-up.     

正畸治疗与颞下颌关节紊乱病关系的研究进展

颞下颌关节紊乱病是口腔临床常见病之一.一般认为颢下颌关节紊乱病是由多因素导致的咀嚼肌功能紊乱、颞下颌关节异常和退行性改变.近几十年来,正畸治疗与颢下颌关节紊乱病之间可能存在的关系一直是正畸医生研究和关注的焦点.本文就两者之间关系的研究作一.     

Composite resin inlays: a single appointment technique

This article presents a time efficient technique for the fabrication and subsequent placement of a composite resin inlay. An inlay preparation is cut into a tooth and a polyvinylsiloxane impression is made. A polyether impression of the polyvinylsiloxane impression forms a die, then a composite resin inlay is fabricated on the die. The inlay is contoured and polished on the die and occlusion is evaluated clinically. The inlay has a final polymerization under intense light and vacuum pressure, then is cemented with a mixture of unfilled resin and hybrid composite. The technique allows an esthetic restoration to be placed in one appointment. The die provides easy access and rapid inlay fabrication. There is no need to place a separator on the prepared tooth, no chance of premature tooth bonding, and interproximal contact is easily achieved.     

Cervical necrotizing fasciitis and diabetic ketoacidosis: Literature review and case report

Necrotizing fasciitis (NF) is a rare polymicrobial infection that can be life-threatening. It is a rapidly progressive inflammatory process affecting the deep fascia, with secondary necrosis of the subcutaneous tissue. It is characterized by its fulminant course and its high mortality rate. Most cases of NF affect the abdomen, groin, and extremities. NF in the neck is reported to be rare and most cases are odontogenic in origin. Misdiagnosis and delayed treatment can result in death from sepsis, mediastinitis, carotid artery erosion, jugular vein thrombophlebitis, or aspiration pneumonia. The diagnosis is based on a combination of clinical history and predisposing factors, Gram staining and culture, imaging, and surgical exploration. Early and aggressive surgical treatment and intensive medical care are essential. The aim of this article is to report a case of severe and extensive cervical NF worsened by a diabetic ketoacidosis as a first appearance of diabetes mellitus.     

The impacted maxillary canine. Further observations on aetiology, radiographic localization, prevention/interception of impaction, and when to suspect impaction

A bstract — Adjacent anomalous or missing maxillary lateral incisors have been implicated in the aetiology of palatally displaced canines by not providing proper guidance to the canine during its eruption. However, a recent review of the literature suggests that the aetiology of palatally displaced canines is genetic in origin. The aetiology of labially impacted canines differs, being due to inadequate arch space. Vertex occlusal radiographs have been recommended for localization but have limitations, and a case is illustrated where this radiograph is deceptive. The prevention/interception of a palatally displaced canine by the extraction of the deciduous canine is best carried out as early as the displacement is detected, mostly soon after 10 years of age. Usually, prevention/interception will avoid the surgical and orthodontic treatment needed to align a palatally impacted canine and may help prevent resorption of the adjacent incisor root. Suspicions that an impaction could occur or has occurred arise a) before the age of 10 years if there is a familial history and/or the maxillary lateral incisors are anomalous or missing; b) after the age of 10 years if there is asymmetry in palpation or a pronounced difference in eruption of canines between the left and right side; or, the canines cannot be palpated and occlusal development is advanced; or, the lateral incisor is proclined and tipped distally; and, on a panoramic radiograph of the late mixed dentition if the incisal tip of the canine overlaps the root of the lateral incisor.     

低频超声对牙菌斑生物膜促渗作用的研究进展

牙菌斑生物膜是一种细菌性生物膜,为基质包裹的互相粘附,或粘附于牙面、牙间或修复体表面的软而未矿化的细菌性群体,不能被水冲去或漱掉。它是一个具有结构、形态和代谢活动的独立微生态环境,其耐药性是浮游生物的许多倍。研究人员发现,低频率超声可以提高药物在生物膜中的渗透效应,从而更好地发挥杀菌作用。具有很好的临床应用前景。本文对低频超声对牙菌斑生物膜促渗作用的研究进展作一综述。     

A technique to reinforce weakened roots with post canals

Abstract A method to strengthen the weakened coronal portion of roots with post canals is described. The apical portion of the root canal is prepared using a Dormer twist drill to fit a matching Wiptam wire post. After removal of the Wiptam wire, the root canal of the weakened coronal portion of the root is prepared and acid-etched. The Wiptam wire, lubricated with petroleum jelly, is repositioned into the root canal, and after painting the coronal root den tin with bonding agent, radiopaque composite resin is syringed around the wire into the coronal defect. Following polymerization of the composite material, the wire is removed, leaving a reinforced root with a patent post canal. Preparation of the root face is completed for restoration with a post crown.     

Proposed requirements for a European Doctorate in Dentistry: a discussion document prepared by a special interest group under the auspices of the Association for Dental Education in Europe

In the Bologna process a third cycle is distinguished at the doctoral level. In documents on the Bologna process it is advocated to harmonise the structure and requirements of the doctorate, which in Europe are characterised by a wide variety. Differences exist in all possible requirements between countries, and even between schools within one country differences can be seen. In this paper an inventory is made of these differences in the dental doctorate between European countries. Moreover, the need for necessary harmonisation of requirements for a European dental doctorate is strongly advocated and a proposal is presented.     

正中关系获取方式及评价体系的研究现状

正中关系(Centric Relation,CR)是上下颌关系的唯一稳定参考位,是咬合重建时重要的参考颌位。它涉及到口腔修复学、牙合学及正畸学等多个学科。目前,正中关系是近一个世纪以来牙科学领域最受争议的话题,对于正中关系的定义、获取方式及其评价标准等问题,学术界尚不能达成共识。因此,了解CR的确切概念、正确地获取方法及如何评价其精确程度对于口腔临床工作有着重要的意义。本文就正中关系的概念、获取方式及其评价体系等方面作一综述。     

破骨细胞蛋白酪氨酸磷酸酶与正畸移动牙牙根吸收的关系

牙根吸收是正畸治疗过程中一种常见的并发症,影响正畸牙牙根吸收的因素十分复杂。牙根吸收的过程与骨吸收过程相似,由与破骨细胞形态相似功能相仿的破牙骨质细胞发挥主要作用。破骨细胞蛋白酪氨酸磷酸酶（PTP-oc）主要在破骨细胞中表达,且对破骨细胞具有正调节作用。本文探讨PTP-oc的作用机制,旨在为防治牙根吸收提供一定的参考依据。