Dental students on instruction in local anaesthesia

In order to find out how dental students feel about their education in the application of local anaesthesia, a questionnaire was distributed via e-mail among all dental students in the Netherlands. A total of 397 completed questionnaires were analyzed statistically. At all 3 dental schools in the second year instruction in theoretical aspects of local anaesthesia began. Practical teaching began in the second or third study year. A preclinical training model was used by 15% of the students in Amsterdam, 20% of the students in Nijmegen and 35% of the students in Groningen. When they administered their first injection in a human, a fellow dental student in 91-98% of all cases, 24-74% of the students felt that they were insufficiently prepared. 35-52% of the students said that they would also like to receive instruction in intraligamentary anaesthesia in the dental curriculum. Other changes in the curriculum were also frequently suggested, especially the introduction of preclinical training models (29%, 55% and 56% for Groningen, Nijmegen and Amsterdam respectively).     

Glycan-Based Near-infrared Fluorescent (NIRF) Imaging of Gastrointestinal Tumors: a Preclinical Proof-of-Concept In Vivo Study

Molecular Imaging and Biology - Aberrantly expressed glycans in cancer are of particular interest for tumor targeting. This proof-of-concept in vivo study aims to validate the use of aberrant Lewis...     

Bone transplantation in cleft palate patients. A retrospective study

Bone-grafts were evaluated in 45 patients with uni- or bilateral residual alveolar clefts. In this population there were 31 unilateral clefts and 14 bilateral clefts. This makes a total of 59 bone grafts. The mean follow-up period was 5.7 years. The patients were divided into two groups. Group A (grafting prior to the eruption of the homolateral canine) and group B (grafting after the eruption of the homolateral canine). Group A consisted of 38 grafts in 30 patients and group B consisted of 21 grafts in 15 patients. The grafts were harvested from the iliac crest. The alveolar bone-height was evaluated on occlusal radiographs. Results in patients treated prior to the eruption of the homolateral canine were significantly better then in patients treated after eruption of the canine. No difference was found between unilateral or bilateral clefts. Of the 38 canines which had not erupted at the time of the grafting procedure 26 (68.4%) erupted spontaneously.     

Donor Age and Mechanosensitivity of Human Bone Cells

With increasing age the human skeleton decreases in density, thereby compromising its load-bearing capacity. Mechanical loading activates bone formation, but an age-dependent decrease in skeletal mechanoresponsiveness has been described in rats. In this paper we examine whether age-related bone loss is reflected by a decrease in the mechanosensitivity of isolated bone cells from human donors. Bone cell cultures were obtained from 39 donors (males and females) between 7 and 85 years of age. Cultures were challenged with 1,25-dihydroxyvitamin D₃ (1,25(OH)₂D₃) or mechanically stressed by treatment with pulsating fluid flow (PFF; 0.7 ± 0.03 Pa at 5 Hz for 1 h). The growth capacity of the bone-derived cell population almost halved between 7 and 85 years of age. Basal alkaline phosphatase activity of the cells increased with donor age, while the response to 1,25(OH)₂D₃, measured as stimulated osteocalcin production, decreased with age. Together this suggests that the cell cultures from older donors represented a more mature, slower-growing cell population than the cultures from young donors. All cell cultures responded to mechanical stress with enhanced release of prostaglandin E₂ (PGE₂) and I₂ (PGI₂). The magnitude of the response was positively correlated with donor age, cell cultures from older donors showing a higher response than cultures from younger donors. There was also a positive correlation between time to reach confluency and mechanosensitivity, i.e., the PGE₂ response to PFF treatment was higher in bone cell cultures with a slower growth rate. We conclude that bone cell cultures from older donors have a lower proliferative capacity and a higher degree of osteoblastic maturation than younger donors. The higher degree of osteoblastic maturation explains the higher response of the cultures to mechanical stress, in line with earlier studies on chicken bone cells. This study found no evidence for loss of mechanosensitivity with donor age. The reduced growth capacity might, however, be a factor in age-related bone loss. Received: 18 May 2001 / Accepted: 20 August 2001     

Actinic reticuloid simulating sézary syndrome

Summary A report is given on two male patients who showed all the main characteristics of Sézary syndrome (SS). When phototested, however, they proved to be extremely photosensitive, which suggested a diagnosis of actinic reticuloid (AR). This was supported by the predominance in blood and skin specimens of lymphoid cells with a suppressor/cytotoxic phenotype, the absence of clonal cell proliferation and a benign clinical course. Differential diagnostic problems of SS and erythrodermic AR are discussed.     

Diseases of the maxillary sinus: an overview for the dentists

Because of the intimate relationship between the upper dentition and the maxillary sinus, it is no surprise that inflammatory, cystic and neoplastic odontogenic diseases may extend into the maxillary sinus and, occasionally, into the nasal cavity. On the other hand, diseases of the maxillary sinus may extend into the oral cavity or may cause symptoms that mimic those of diseases of odontogenic origin. An overview is presented of the various odontogenic and nonodontogenic diseases that may involve the maxillary sinus.     

Needle breakage during mandibular block anaesthesia: prevention and retrieval

Disposable needles for dental local anaesthesia do not break easily. Still, needle breakage does occur, and is mainly caused by unexpected movements of the patient or pre-use bending of the needle by the dentist. If a dental needle breaks while administering local anaesthesia, the dentist should prevent panic. If the patient opens his mouth wide the needle might still be visible. If so, the needle is removed. If the needle is no longer visible, the site where the needle has penetrated the mucosa should be marked with a permanent marker. The dentist will contact a maxillofacial surgeon for immediate consultation. The maxillofacial surgeon will try to retrieve the broken dental needle under general anaesthesia.     

Transient paresis after mandibular block anaesthesia

Mandibular block anaesthesia is frequently used in dentistry. The technique is more susceptible to failure than local anaesthesia by infiltration. Two cases of patients who were afflicted by transient paresis of (branches of) the facial and vagus nerves after mandibular block anaesthesia have been analysed. With reference to both these cases advice is given on how to react in case of a misdirected mandibular block anaesthesia.     

Syndromes 14. Rendu-Osler-Weber disease

The Rendu-Osler-Weber disease is due to an autosomal dominant disease with multiple telangiectasia in skin and mucosa. Recurrent bleeding of the nose is due to telangiectasia of the nasal mucosa. Haemorrhage of the oral mucosa also occurs. Extensive arteriovenous malformations can be present in lungs, liver and brain. Treatment of bleedings in the oral mucosa is easily possible by means of coagulation. Patients with pulmonary arteriovenous malformations should receive prophylactic antibiotic treatment before extractions, removal of third molars and subgingival curettage.