Malignant tumor involving paranasal sinuses

Carcinoma of the paranasal sinuses is a very serious disease, but its incidence is lower than that of any other oral malignancy. Failure to diagnose it early because of misleading symptoms resembling sinusitis usually leads to its detection at a stage when it has already destroyed the bony walls of the sinus and has spread to surrounding structures (infratemporal fossa, posterior ethmoid cells, orbit, cribriform plate, nasopharynx, sphenoid sinus or base of the skull). It is uncommon for this cancer to spread to the regional lymph nodes as long as it remains confined within the maxillary sinus. CT scanning provides an accurate assessment of the extent of resection required and is usually used as an indicator of operability. A 56-year-old man with a chief complaint of palatal swelling, pain and pus discharge was referred to Seoul National University Dental Hospital. Orthopantomogram and Waters' view revealed an aggressive bone destruction in the right maxillary molar area, ipsilateral sinus opacification and destruction of the lateral wall of the maxillary sinus. The CT fidding showed that the right maxillary sinus was occupied by a soft tissue mass which represented a central low density, with an irregular shape at some levels. The tumor mass also involved the pterygopalatine fossa, right esthmoid sinus, nasal cavity and hard palate. Incisional biopsy was done and the biopsy report was squamous cell carcinoma. He was transferred to Internal Medicine for chemotheraphy because of inoperability.     

Eosinophilic granuloma of the ramus similar to malignant neoplasm or osteomyelitis: Report of a case

An eosinophilic granuloma was discovered in the region of the ramus of the mandible. This case occured in a very rare location limited only to the ramus, and showed similar features resembling osteomyelitis or malignant neoplasm at different stages of the disease. The radiographic findings indicated a diagnosis of malignant neoplasm and the scintigraphic manifestations showed that of osteomyelitis. The histopathological examinations showed different manifestations in accordance with the respective stages of the disease. This case was finally diagnosed as eosinophilic granuloma showing rapid regression.     

An in vitro evaluation of a prototype CFRC prefabricated post developed for the restoration of pulpless teeth

Carbon fibre reinforced carbon (CFRC) in the form of a prefabricated post has recently been developed and is theoretically acceptable for consideration in an endodontic post-retained crown system. This study compared four different types of postcore system cemented into 40 extracted anterior human teeth. The test groups consisted of CFRC posts cemented with a composite resin luting agent, and used with either a cast gold alloy core (Group B) or a composite resin core (Group C). Two existing post-core techniques were used as controls for comparison with the CFRC groups. One control was a prefabricated wrought precious alloy post having a cast gold alloy core, and cemented with zinc phosphate cement (Group A). The other was a prefabricated stainless steel post with a composite resin core, and cemented with a composite resin luting agent (Group D). All specimens were restored with a gold alloy crown and tested to failure with an obliquely applied compressive load at 130 degrees in an Instron using a cross-head speed of 5 cm min-1. The results showed that post-retained crowns using a prefabricated CFRC post exhibited properties comparable with, and in some cases better than, those of existing prefabricated posts. The mode of failure of specimens restored with a CFRC post was more favourable to the remaining tooth tissue than was that of specimens restored with a metallic post.     

Acute phase protein levels as an index of severity of physical injury

Inflammation resulting from any form of tissue injury causes an increase in plasma concentration of a number of liver-derived proteins (the acute phase reactant proteins), the measurement of which provides an indication of the magnitude of the inflammatory response. C reactive protein (CRP) is an example of an acute phase protein. Although concentrations increase particularly dramatically in response to inflammation and reflect the degree of ongoing tissue damage, this method has yet to be used to assess severity of injury in traumatology and forensic medicine. The rate at which the acute phase protein response occurred after injury was therefore explored in a series of 16 patients with maxillofacial skeletal injuries and in a series of 22 age- and sex-matched control patients. Increases in the plasma concentration of CRP were not detected until 6-12 h after injury and peaked at 48-72 h. Concentration of CRP was less than 10 mgm/l in all control patients. There was significant relation between peak levels and Abbreviated Injury Scale and Injury Severity scores. Results suggest that this method of assessing the severity of traumatic injury deserves further investigation and may be of use clinically, medico-legally and in relation to compensation awards.     

Syndrompatienten im Rahmen der kieferorthopädischen Frühbehandlung von Säuglingen mit Lippen-Kiefer-Gaumen-Spalten

Zusammenfassung Die kieferorthopädische Säuglingsbehandlung widmet sich schwerpunktmäßig Neugeborenen mit orofazialen Spaltbildungen und Kindern mit Syndromen, vornehmlichDown-Syndrom. Über 100 Dysmorphiesyndrome können mit Spaltbildungen einhergehen.An klinischen Beispielen (Robin-Syndrom,Stickler-Syndrom) wird die Problematik der Syndromdiagnostik umrissen und an einem Fall (orofaziodigitales Syndrom) der Beitrag des in der Spaltfrührehabilitation tätigen Kieferorthopäden zur Syndromidentifikation aufgezeigt.

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Summary The orthodontist's early orthopaedic treatment of the newborn focuses on cleft palate infants and children withDowns syndrome. In more than 100 malformation syndromes, orofacial clefting occurs. The problem of syndrome diagnosis is discussed by way of clinical examples (Robin-syndrome,Stickler-syndrome).A case of oro-facial digital syndrome serves to demonstrate the orthodontists contribution to syndromic diagnosis in early cleft rehabilitation.

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Résumé Le traitement orthodontique précoce de nourrissons se voue dans le plus grand nombre des cas aux nouveaunés atteints de malformations orofaciales et aux enfants souffrant de syndromes, surtout du syndrome deDown (mongolisme). La formation de fentes peut être accompagnée de plus de 100 syndromes de malformations.La problématique du diagnostic de syndromes (séquence deRobin et syndrome deStickler) est esquissée à titre d'exemples cliniques et l'apport que l'orthodontiste s'occupant de la rééducation précoce de fentes labiomaxillaires peut faire à l'indentification de syndromes est mis en évidence à propos d'un cas spécifique (syndrome oro-facio-digital).

     

Cephalometric appraisal of patients treated with fixed lingual orthodontic appliances: Historic review and analysis of cases

In the first part of this article, a retrospective look was taken of evolvement and progression in design of the lingual fixed orthodontic appliance. The second part is a retrospective study of treated lingual cases. By the use of standardized cephalometric radiographs, selected treatment parameters were analyzed:--namely, bite opening, changes in mandibular position, inclination, torque and intrusion of incisors, and soft-tissue effects. For the clinician who uses this treatment modality, the most significant effects are the bite opening, intrusion of the mandibular incisors (particularly in extraction cases), and limited reduction of lower lip protrusion. The mandibular plane angle and torque and inclination of incisors did not follow a consistent and predictable pattern. On the basis of the study's findings, it is suggested that lingual fixed appliance therapy is a useful supplement to our treatment modalities; good results are both realistic and possible.     

The effect of public or private management on patients with temporomandibular joint pain dysfunction

Australians may receive free dental treatment via the public sector if they have a health care card but otherwise must seek treatment via the private sector. These two modes of dental delivery have different objectives, facilities, and patient populations. Two groups of patients, one public and one private, who presented to the same clinicians with temporomandibular joint dysfunction were studied. There were differences in age, numbers of natural teeth and some psychological features. However, the outcome to simple non-surgical management resulted in similar levels of successful treatment.     

The evolution of the complete denture base. Theories of complete denture retention — A review. Part 1

The history of denture base materials and the accompanying development of impression techniques are traced from the earliest times to the present day (Part 1) as a prelude to a study (Part 2–4) of the various theories that have been advanced to explain retention of the base without mechanical support. These theories are critically reviewed and tabulated in chronological order. Some areas for further investigation are identified.