Transient loss of power of accommodation in 1 eye following inferior alveolar nerve block: report of 2 cases

Unintended intravascular injection from inferior alveolar nerve blocks can result in frustrating distant complications affecting such structures as the middle ear and eyes. Possible complications affecting the eyes include blurring of vision, diplopia, mydriasis, palpebral ptosis and amaurosis (temporary or permanent). In this article, we present a complication that has been reported only rarely. Two patients developed transient loss of power of accommodation of the eye resulting in blurred vision after routine inferior alveolar nerve blocks on the ipsilateral side. Clear vision returned within 10-15 minutes after completion of the blocks. The possible explanation for this phenomenon is accidental injection into the neurovascular bundle of local anesthetic agents, which were carried via the blood to the orbital region. This resulted in paralysis of a branch of cranial nerve III, the short ciliary nerves that innervate the ciliary muscle, which controls accommodation.     

Extended bleaching of tetracycline-stained teeth: a 5-year study

Bleaching tetracycline-stained teeth is the most challenging form of tooth lightening. This article reports on 44 subjects who bleached their tetracycline-stained teeth for 6 months using trays with reservoirs overnight in a half-mouth designed study and 2 of 3 different concentrations of carbamide peroxide (10%, 15% or 20%). The subjects were followed for 5 years. The area evaluated was the middle third of the teeth. More than 55% of tooth lightening occurred within 1 month; after 5 years, more than 65% of the maximum tooth whitening remained for all 3 gel concentrations. Tooth whitening can be accomplished with any of the 3 concentrations used.     

Immunohistochemical demonstration of epithelial glutathione S-transferase isoenzymes in normal, benign, premalignant and malignant human oral mucosa

The expression and localization of glutathione S-transferase (GST) isoenzymes in the epithelium of normal oral mucosa ( n = 9), overlying reactive fibrous hyperplasia ( n =9), and of potentially malignant [leukoplakia ( n =25), submucous fibrosis ( n =12), verrucous hyperplasia ( n =16)] and malignant [squamous cell carcinoma ( n =36), verrucous carcinoma ( n =13)] oral lesions were examined immunohistochemically using polyclonal antibodies raised against GST isoenzymes (alpha, mu and pi) with the standard avidin-biotin-peroxidase complex (ABC) method. GST alpha, mu and pi were almost completely absent in the epithelium of normal oral mucosa and overlying benign fibrous tissues. GST alpha staining was cytoplasmic and focally positive, while GST mu staining was similar to but weaker than that seen for GST alpha. GST pi showed both cytoplasmic and nuclear staining and was expressed in 60% of leukoplakias with mild dysplasia ( n =15), 80% of leukoplakias with moderate to severe dysplasia ( n =10). 75% of submucous fibrosis samples ( n =12), 75% of verrucous hyperplasias ( n =16), 77% of verrucous carcinomas ( n =13), 81% of well-differentiated squamous cell carcinomas ( n = 26) and 70% of moderate- to poorly-differentiated squamous cell carcinomas ( n =10). In addition, GST pi expression was independent of the state of differentiation of oral cancers. Since GST pi was significantly over-expressed in the oral premalignant and malignant lesions, the kinetics of GST pi-positive cells and the value of GST pi as a tumor marker in oral carcinogenesis need further investigation.     

后牙复合树脂磨耗的临床评价

为探索评价复合树脂磨耗的最佳方法，本研究采用直接临床评价法和间接模型比较法，对以４种复合树脂修复的９３例磨牙面洞修复体进行了３年的评估。结果表明，直接法对修复体早期磨耗的评估不敏感，但对修复体其它方面的评价目前仍为首选；间接法评估修复体的磨耗更准确、敏感，量化的磨耗值便于统计学分析；直接法与间接法相结合可更客观，更全面地评价复合树脂修复体的临床效果。     

带控制阀种植牙手术骨粉收集器的研制及临床应用

目的 介绍自行研制的带控制阀种植牙手术骨粉收集器,并观察其临床应用效果.方法 选取2008年5月至2009年10月38例牙种植患者,应用自制的骨粉收集器收集种植窝制备时产生的骨碎屑,并将其用于修复种植体周围骨缺损,其中开窗式骨缺损29处,唇颊(舌)侧种植体颈部角形缺损23处.结果 所有病例术后均无创口感染及裂开,原缺损处局部形态饱满,牙龈无明显退缩,X线片示种植体与周围牙槽骨形成良好的骨结合.结论 应用自制骨粉收集器收集的骨粉修复种植体周围小型骨缺损效果良好,使用方便,具有良好的应用前景.

Abstract：

Objective To introduce a self-developed bone collector designed by the authors and evaluate its effect in clinical application. Methods A self-developed bone collector was used in 38 patients who underwent the dental implant operation from May 2008 to October 2009. During the operation the bone particles were harvested, which was used for the reconstruction of the bone defects around the implant simultaneously. The defects were fenestrate in 29 regions and triangle in 23 regions on buccal or lingual side of the dental implants. Results All cases had no surgical wound infection and dehiscence 7-10 days after operation. Three to six months after implantation, the X-ray showed that all the dental implants had perfect osseointergration and the alveolar bone were successfully augmented. Conclusions Bone debris harvested by self-developed bone collector could repair small peri-implant bone defects, which is simple to use in clinic.     

Surface alteration of human tooth enamel subjected to acidic and neutral 30% hydrogen peroxide

Objectives

To investigate the effects of acidic and neutral 30% hydrogen peroxide (HP) on human tooth enamel in terms of chemical structure, mechanical property, surface morphology and tooth colour.

Methods

Twenty-seven human dental blocks were obtained from premolars and randomly divided into three groups (n = 9): Group acidic HP (30% HP, pH ≈ 3.6), Group neutral HP (30% HP, pH ≈ 7.0) and Group DW (distilled water, pH ≈ 6.8). Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR), Raman spectroscopy, atomic force microscopy (AFM) investigation, microhardness test and colour measurements were carried out before and after treatments. ATR-FTIR and Raman spectroscopy were analysed and then the carbonate:mineral ratio (C:M), Raman absolute intensity (RAI), Raman relative intensity (RRI), and laser-induced fluorescence intensity (FI) were obtained for evaluation.

Results

The C:M, percentage microhardness and percentage RRI of group acidic HP decreased more significantly than those of group neutral HP (P = 0.02, P = 0.001, P < 0.001, respectively) and group DW (P = 0.01, P = 0.008, P < 0.001, respectively). Whilst group neutral HP and group DW had no statistical difference in above terms (P = 0.818, P = 0.528, P = 0.158, respectively). Significant morphological alterations were observed in group acidic HP. Group acidic HP and neutral HP had no significant difference in percentage FI (P = 0.652) and ΔE (P = 0.906).

Conclusions

This study suggested that neutral 30% HP had the same efficiency in tooth bleaching and it caused less deleterious effects on enamel than acidic 30% HP.     

填料含量对牙科光固化粘结剂残余单体量的影响

目的：探讨填料的加入对牙科光固化粘结剂聚合转化度的影响。方法：采用高效液相色谱仪测试了不同填料含量的光固化粘结剂固化后的残余单体量。结果：无填料粘接剂残余单体量最大，随填料含量增加而减少；照射６０ｓ，９．１％组显示最小。结论：填料含量５％（ｗｔ），照射６０ｓ较适宜     

Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases

Over a 10-year period (1982–1991), a total of 150 patients divided into two groups with varying degrees of oral submucous fibrosis (OSF) were treated by either medical or surgical therapies. Medical treatment involved (a) conservative oral administration of vitamin B-complex, buflomedial hydrochloride and topical triamcinolone acetonide 0.1%, or (b) conventional submucosal injections of a combination of dexamethasone and hyaluronidase, or (c) a combination of both (a) and (b). The surgical group was treated by the excision of fibrotic tissues and covering the defect with split-thickness skin, fresh human amnion, or buccal fat pad (BFP) grafts. Treatment was chosen according to the stage of clinical progression to gain maximal interincisal distance (ID). The cases were followed up by monthly examinations for at least two years, or when possible even longer. A combination of (a) and (b) medical treatment was satisfactory in cases of mild impairment (ID > 20 mm) but in the long term it led to symptomatic relief only. Surgical therapy, on the other hand, when accepted by the patients, led to a significant improvement of trismus in cases of severe limitation (ID < 20 mm). Following this strategy, an additional ID increase was observed in all patients. BFP grafting was particularly successful in diminishing scarring after two years as compared with the other two grafts. Together with a cessation of the betel quid chewing habit before and after therapy, these treatment regimens combined with daily mouth opening exercises were found to be necessary to manage OSF cases in early and advanced stages of progression.