A trigeminal neuralgia-like paroxysmal pain condition presumably due to buccal nerve compression in the temporalis muscle

We encountered three patients with trigeminal neuralgia-like paroxysmal pain in the buccal nerve region. In all cases, paroxysmal pain was felt spreading to the receptive field of the ipsilateral buccal nerve, and clear tenderness was observed during intraoral palpation at the inner side of the mandibular ramus where the temporalis muscle runs and attaches. It was assumed that the paroxysmal pain might be caused by nerve compression related to temporalis muscle hyperactivity. To lend support to this hypothesis, we also studied the anatomical relationship between the buccal nerve and the masticatory muscles. In this autopsy study, the buccal nerve pierced the temporalis muscle in six (12%) of 52 specimens from 26 cadavers. These findings support the hypothesis that peripheral buccal nerve compression could be an etiology of paroxysmal neuropathic pain in the unilateral orofacial region.     

Solubility study of phytochemical cross-linking agents on dentin stiffness

Objectives

The effects of interactions between cross-linking proanthocyanidins (PA) in polar solvents and type-I collagen of demineralized dentin were investigated.

Methods

Three PA-rich extracts, two from grape seed (GSEP and GSES) and one from cocoa (COE), were dissolved (water, ethanol:water and acetone:water) and analyzed for their ability to increase the modulus of elasticity of demineralized dentin. Sound dentin beams (0.5 mm × 1.7 mm × 7 mm) were fully demineralized and divided into 12 groups according to the type of cross-linking agent and solvents used. Specimens were immersed in the respective solutions and tested at baseline, 10, 30, 60, 120 and 240 min.

Results

The elastic modulus (EM) of dentin was significantly increased by the PA treatment regardless of time (p < 0.05 for all times). The extracts showed different solubility in different solvents. GSEP showed the highest increase in EM when diluted in distilled water and acetone at all exposure times. Both GSEs showed superior results when diluted in distilled water and after 4 h of treatment, while COE produced strongest enhancement when dissolved in ethanol:water.

Conclusions

The results indicates that herbal extraction process and other pharmacognostic parameters have an important influence on extract solubility as well as constitution and, consequently, on the PA–dentin matrix interaction.     

EDTA or H3PO4/NaOCl dentine treatments may increase hybrid layers’ resistance to degradation: A microtensile bond strength and confocal-micropermeability study

Objectives

The aim of this study was to reduce hybrid layer degradation created with simplified dentine adhesives by using two different methods to condition the dentine surface.

Methods

A smear-layer was created on flat dentine surfaces from extracted human third molars with a 180-grit/SiC-paper. Dentine specimens were conditioned before bonding with the following procedures: 37% H₃PO₄; H₃PO₄/0.5% NaOCl; 0.1 M EDTA; 0.1 M EDTA/0.5% NaOCl. Two etch-and-rinse adhesives: (Scotchbond 1XT or Optibond Solo Plus) were applied and light-cured. Composite build-ups were constructed. The bonded teeth were sectioned into beams, stored in distilled water (24 h) or 12% NaOCl solution (90 min) and finally tested for microtensile bond strengths (μTBS). Additional dentine surfaces were conditioned and bonded as previously described. They were prepared for a pulpal-micropermeability confocal microscopy study and finally observed using confocal microscopy.

Results

μTBS results revealed that both adhesives gave high bond strengths to acid-etched dentine before, but not after a 12% NaOCl challenge. Bonds made to acid-etched or EDTA-treated dentine plus dilute NaOCl, gave high μTBS that resisted 12% NaOCl treatment, as did EDTA-treated dentine alone. A confocal micropermeability investigation showed very high micropermeability within interfaces of the H₃PO₄, etched specimens. The lowest micropermeability was observed in H₃PO₄ + 0.5% NaOCl and 0.1 M EDTA groups.

Conclusions

The use of dilute NaOCl (0.5%) after acid-etching, or the conditioning of dentine smear layers with 0.1 M EDTA (pH 7.4) produced less porous resin–dentine interfaces. These dentine-conditioning procedures improve the resistance of the resin–dentine bond sites to chemical degradation (12% NaOCl) and may result in more durable resin–dentine bonds.     

Butyric acid induces apoptosis in inflamed fibroblasts

Butyric acid, an extracellular metabolite from periodontopathic bacteria, induces apoptosis in murine and human T- and B-cells, whereas intact gingival fibroblasts isolated from healthy humans are resistant to butyric-acid-induced apoptosis. We examined the susceptibility of inflamed gingival fibroblasts isolated from adult persons with periodontitis to butyric-acid-induced apoptosis. Butyric acid significantly suppressed the viability of inflamed gingival fibroblasts and induced apoptosis in a dose-dependent manner. The incubation of inflamed gingival fibroblasts with butyric acid induced DNA fragmentation and apoptotic changes such as chromatin condensation, hypodiploid nuclei, and mitochondrial injury. Furthermore, butyric-acid-induced apoptosis in inflamed gingival fibroblasts was reduced by caspase-3/7, -6, -8, and -9 inhibitors. Thus, inflamed gingival fibroblasts from adult persons with periodontitis appear to be highly susceptible to mitochondria- and caspase-dependent apoptosis induced by butyric acid, compared with healthy gingival fibroblasts.     

Vertical distraction of a free vascularized osteocutaneous scapular flap in the reconstructed mandible for implant therapy

This paper describes a case of vertical distraction osteogenesis of a free vascularized osteocutaneous scapular flap in the reconstructed mandible before implant therapy. The patient was a 67-year-old woman with squamous cell carcinoma of the right lower gingiva. She underwent segmental mandibulectomy for tumor ablation and reconstruction with an osteocutaneous scapular flap. The distraction protocol, clinical course and implant therapy are presented. Through this procedure, the bone height of the scapular graft increased by 10mm. Implants with adequate length could be placed in the distracted area. Two years after masticatory loading, the condition of these implants was stable. Vertical distraction osteogenesis of the scapular flap was considered effective when performed before implant therapy, to facilitate postoperative functional and esthetic restoration after tumor resection.     

A comparison of two methods for the evaluation of the daily urinary fluoride excretion in Romanian pre-school children

OBJECTIVE: To compare two different methods of estimating daily fluoride urinary excretion in pre-school children under stable fluoride intake conditions. DESIGN: Thirty-five healthy kindergarten children, permanent residents of Targu-Mures, Romania, where the average drinking water fluoride concentration is 0.12 mg F/L, participated on two separate occasions, when they were aged 4-6 and 5-7 years, respectively in the collection of a) a mid-morning spot urine sample and b) a 16-h time-controlled urine sampling. In case a), the ratio of concentrations of fluoride and creatinine were measured, while in case b) the rates of fluoride excretion in two separate 8-hour periods were used to estimate the 24-hour fluoride urinary excretion. RESULTS: The estimated average daily fluoride urinary excretion values (S.D.) were 0.318 (0.182) mg F/day for method a) and 0.341 (0.193) mg F/day for method b). These values were not significantly different (Mann-Whitney U test; p = 0.49). The estimated daily fluoride doses were 0.040 (0.021) and 0.043 (0.022) mg F/kg body weight/day, respectively. The latter values were not significantly different (Mann Whitney U test; p = 0.38). CONCLUSIONS: Results obtained suggest that under stable F-intake conditions the estimation of the daily fluoride urinary excretion by means of a mid-morning spot urine sample yields comparable results to those obtained with the more involved method of separate, two 8 h (16 h) time-controlled urine sampling recommended by the WHO. Use of spot urine sampling appears to be particularly useful for epidemiological studies.     

The susceptibility of bleached enamel to staining as measured by Quantitative Light-induced Fluorescence (QLF)

OBJECTIVES: To report the use of Quantitative Light-induced Fluorescence (QLF) to determine if there was a tendency for bleached enamel to take up extrinsic stains more than unbleached enamel. METHODS: Bovine teeth devoid of stains were selected, the roots removed and enamel gently pumiced. Each tooth was sectioned into two and each half randomly assigned to two groups (bleached or unbleached). Windows were created on each half using clear acid resistant varnish. 38% Hydrogen peroxide gel was applied to the exposed windows of the bleached group for 1 hour. The teeth were rinsed and dried. Bleached and unbleached halves of the same teeth were then mounted on glass rods attached to pot lids using green stick. QLF images were taken. The teeth were subjected to a cycle of artificial saliva, chlorhexidine and tea (2 minutes in each solution). This was repeated 5 times. QLF images were taken at the end of each cycle. RESULTS: The uptake and progression of stain was detected in all the sections by QLF. Using paired t- test (SPSS) there was no significant difference between the two groups for the change from baseline to the final stain cycle (p > 0.05), however there was variability in stain uptake within the groups as the cycles progressed. CONCLUSION: Bleaching of enamel in vitro does not appear to increase the susceptibility of enamel to extrinsic staining.     

Crouzon syndrome with acanthosis nigricans: case report and mutational analysis.

OBJECTIVE: To describe the 22nd case of Crouzan syndrome with acanthosis nigricans, a hyperkeratotic skin disorder with hyperpigmentation. METHODS: DNA analysis and sequencing of the FGFR3 gene were performed. RESULTS: The 13-year-old Japanese boy described here also had dyspnea, facial palsy, sensorineural hearing loss, and skeletal and mental retardation. Examination of a skin biopsy specimen revealed the typical findings of acanthosis nigricans. Genetic analysis revealed the Ala391Glu mutation in one FGFR3 gene. CONCLUSIONS: Crouzon syndrome with acanthosis nigricans is a distinct clinical entity different from classic Crouzon syndrome.     

Diffuse but unilateral gingival enlargement associated with von Recklinghausen neurofibromatosis: a case report

BACKGROUND: An 8-year old girl was referred for diagnosis and treatment to the Department of Periodontology Oral Surgery of the University Hospital of Liège with an unusual clinical situation: a major, non-inflammatory, diffuse but unilateral enlargement of the interproximal, marginal and attached gingiva around all teeth of the right side of both the upper maxilla and mandible, whereas the alveolar process of the left side of upper and lower arches appeared strictly normal. METHOD: The clinical examination showed delayed eruption of some permanent teeth in the 1st and 4th quadrants. Except for its asymmetric occurrence, this gingival enlargement strongly resembled phenytoin-induced enlargement or gingival fibromatosis. This unilateral expression was evocative of a vascular or neurologic pathology. Several large "café-au-lait" spots were found disseminated on the body. Several selective surgical removals of thick gingival caps impairing the eruption of some permanent teeth were performed, and the removed tissues were histologically analyzed. RESULTS: Because of the presence of the large "café-au-lait" spots, a clinical diagnosis of Von Recklinghausen's disease was given and later confirmed several times by the histological analysis of the gingival biopsies. Now, 6 years later, this gingival enlargement due to the development of intra-gingival neurofibromas is stable and all permanent teeth have had a normal eruption, but alveolar bone growth has been partly impaired by the presence of the tumor. CONCLUSIONS: The present case of unilateral diffuse hyperplasia is a unique clinical expression of neurofibromatosis type I, a slowly evolving neurodermic dysplasia.