Aspiration of a primary tooth in a patient with a tracheostomy

Aspiration of a foreign object is uncommon in a patient with a tracheostomy. The following case history describes the consequences of failure to diagnose an aspirated object and how the aspiration of an exfoliated tooth can occur despite the presence of a tracheostomy tube. Dentists play an important role in preventing foreign body aspiration in debilitated patients.     

When to refer a patient with a nerve injury to a specialist

BackgroundNerve injury is a known and accepted risk of many oral surgical and dental procedures. Such injuries may occur despite the practitioner's providing the best of care. Taking proactive measures during evaluation and surgery may reduce the incidence of nerve injury.ResultsInjuries to the peripheral branches of the trigeminal nerve can cause unfavorable effects on orofacial sensation and related functions such as eating, drinking, washing, speaking, shaving and kissing.ConclusionsWhen nerve injuries secondary to dental or oral surgery procedures fail to resolve promptly and the resulting dysesthesia is unacceptable to the patient, timely treatment gives the patient the best chance of a favorable outcome. Treatment may involve surgical exploration and repair of the injured nerve.Practical ImplicationsRecognition of and prompt referral for nerve injuries give the patient the best chance of achieving improvement or recovery of sensory function in the distribution of the injured nerve.     

Treatment of a cracked tooth with a resin-ionomer restoration and a connective tissue graft: a case report

Treatment of a cracked tooth can be difficult and unpredictable. Quite often, the most predictable treatment possible is simply extraction. This is a case report of the treatment of a cracked tooth with a resin-ionomer restoration and a connective tissue with partial-thickness double pedicle graft. The crack was detected during a routine root coverage procedure using this type of graft. A resin-ionomer was used to repair the crack. Then, the root coverage procedure was completed. Complete root coverage was obtained, including the portion of the root that was repaired. The results remained stable and the tooth treated remained asymptomatic. Clinically, the treatment was a success.     

Bone wax as a cause of a foreign body granuloma in a cranial defect: a case report

Bone wax was used to stop bleeding of the diploic vessels after harvesting cranial bone for reconstruction of an orbital floor defect. After five months a fistula in the overlying skin of the donor site appeared and was eventually surgically explored. Remnants of bone wax and surrounding inflammatory tissue were removed and the fistula was excised. Histological examination revealed a foreign body granuloma. The use of bone wax and possible alternative local haemostatic agents and their complications are discussed.     

Temporomandibular joint arthrography: a comparison between a fluoroscopic and a nonfluoroscopic technique

A nonfluoroscopic temporomandibular joint arthrographic technique is contrasted with a more widely employed fluoroscopically guided technique. The nonfluoroscopic technique uses a posterior approach to joint injection, as contrasted with the lateral injection approach of the fluoroscopically guided technique. The advantages of the nonfluoroscopic technique are less radiation dose to the patient, less expensive and less sophisticated imaging equipment, and less potential for neurovascular trauma. The fluoroscopic technique offers greater control of the procedure, less patient and operator time, and the capability for a dynamic videofluoroscopic study. Both techniques appear to be safe and efficacious. Differences in anatomy, imaging modalities, patient radiation exposure, and potential complications are also discussed as part of this comparison.     

Management of a mutilated orthodontic case through a multidisciplinary approach- a case report

A female patient aged 35 years reported with mutilated occlusion with mid line shift, aggravation of skeletal Cl II with posterior cross bite on patient's right side. This was a case of Skeletal Class II Div 1 malocclusion which had been treated previously by other operator with extraction of all 1st premolars except in upper right quadrant. Multidisciplinary approach was taken to resolve all the problems as follows: mid line shift & cross bite were corrected by the orthodontist with application of “FORSUS: Fatigue Resistant Device”, the odontome was eliminated by the oral surgeon, reconstruction of a premolar crown was done by the specialist in esthetic conservative dentistry & gingival grafting on a canine was done by the Periodontist. The objective of this presentation is to demonstrate the satisfactory outcome of the multidisciplinary approach in a mutiliated occlusion.1, 2     

Treatment of a traumatic ulcer on a handicapped individual: a case report

Ulcerations of oral mucosa caused by trauma or irritation are not uncommon. Irritation of tissues by fractured teeth or rough restorations often results in ulcerations. Additionally, oral habits have been reported to produce untoward tissue response.¹ Fortunately, most traumatic oral ulcerations respond rapidly and favorably to removal of the source of irritation. In the case of handicapped individuals, removal of the causative factor may be difficult because of the inability to communicate and cooperate. This is particularly true when the oral lesion is caused by habitual behavior. Some habits may have serious sequela. Phelan and others² reported on a deaf-mute child who had the habit of thumbsucking. Blood loss from an ulceration precipitated by this habit resulted in hospitali-zation and fluid replacement.
The case reported in this paper identifies an unusual problem found in a 9-year-old child with excessive lip sucking that perpetuated a large lip ulceration.     

Transformation of a lateral incisor to a central incisor with a ceramometal crown

To change a maxillary lateral incisor into a central incisor by using a ceramo-metallic crown, it is required to schedule a rational plan of treatment. All the different pre-prosthetic (orthodontic, periodontic, and endodontic) and prosthetic steps are described and justified. In order to achieve a compromise between esthetic and a stable periodontium the mesial profile of emergence of the ceramic should be conceived to prevent any overcontour.