Panoramic radiograph as a method for detecting calcified atheroma plaques. Review of literature

Cerebrovascular accident (CVA) is the third cause of death in industrialized countries, following cardiovascular disease and cancer. It is therefore a significant public health issue, not only due to its high incidence, but also to the high costs involved in the physical and psychological rehabilitation of these patients. Dental Practitioners, as health care providers, ought to play their part in this issue and contribute, within their means, to the early detection of patients at risk of having a CVA. Since the eighties, different authors have described the possibility of detecting calcified atheroma plaques located at carotid artery bifurcation through panoramic radiograph. In this way, the Dental Practitioner s possibilities in this field have been extended. However, this new use of panoramic radiograph must overcome certain obstacles before it is implemented as a new screening method for patients at risk of having a CVA. Amongst these, we would have, on the one hand, the assessment of the real clinical significance, as regards prognosis, of atheroma plaque calcification as well as its usefulness as a factor for predicting the appearance of CVA symptoms and, on the other hand, the possibility of making a correct differential diagnosis regarding other calcified structures that may appear on panoramic radiograph.     

Oral myiasis: a case report

Oral Myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis and others conditions. The treatment is a mechanical removal of the maggots one by one but a systemic treatment with Ivermectin, a semi-synthetic macrolide antibiotic, have been used for treatment for oral myiasis. We present a case report of a 32-year-old man indigent, alcohol-dependent with an extensive necrotic area and acute swelling in upper lip and fetid odor. The patient's management included topic use of gentian violet, oral therapy with ivermectin (6 mg orally), surgical exploration to remove the larvae and necrotic tissue. After the complete larvae removal the swelling and the wounds were healing normally, the patients was referred to plastic surgery to repair tissue damage. The prevention of human myiasis is by education, but unfortunately in the developing countries some people live in low social condition, predisposing the occurrence of the infestation.     

The use of doxycycline in periodontology. Histologic in vivo study on mice affected by diabetes mellitus

Delay in wound healing process and periodontal disease are 2 possible complications of diabetes mellitus; in case of periodontitis, surgical therapy is necessary if, due to the anatomical and topographical characteristics of periodontal lesions, it is not technically possible to eliminate all the etiological factors by scaling and root-planing therapy only. This work aimed at analysing the effectiveness of doxycycline hyclate as an accelerator of the healing process in laboratory animals (mice with diabetes mellitus). The results obtained after surgical incision of the oral epithelium in diabetic mice show that the topical application of doxycycline hyclate improves, in terms of reparative response time, the regenerative capacity of tissues analysed. Further studies are suggested to test the topical use of doxycycline hyclate in diabetic patients undergoing a periodontal operation in order to accelerate the wound healing process of the tissues concerned.     

Mandibular posture following tooth extrac- tion.

Mandibular posture was analysed on cephalometric radiographs of 24 adult patients who had all of their remaining teeth removed under general anaesthesia. The radiographs were taken before operation, the day following operation and three months later before insertion of dentures.

After extraction, patients adopted a posture of the mandible which was further forward and closer to the maxilla than before. These changes were accompanied by elevation of the dorsum of the tongue and forward movement of the soft palate, hyoid bone and pharyngeal tongue.

Mandibular posture is greatly influenced by oral anatomy. The resting length of the masticatory muscles is only of secondary importance in the determination of mandibular resting posture.     

An ectopic maxillary second molar

A bstract — A rarely encountered ectopic and dilacerate maxillary second molar is described. The tooth was found to be attached to the medial wall of the maxillary sinus. Its location is thought to be due to ankylosis consequent to injury sustained during infancy.     

THE HSA: A FOCUS FOR ADVANCING PRIMARY PREVENTIVE DENTAL PROGRAMS

In conclusion, as community agencies under P.L. 93-641 embark upon the definition of health status goals, health system goals, and program implementation, dentists have the opportunity to clarify and assist in developing a vigorous approach to meeting dental health needs through primary prevention. Insofar as public health dentistry is able to provide technical assistance and leadership at the local HSA and SHPDA levels, the powerful tools for change embodied in this law can be a force for promoting the oral health of our population.     

The flow-rate-dependent excretion of ionized calcium in human parotid saliva.

The total calcium content of parotid saliva is increased in various diseases. Because of methodological difficulties, little is known about the ionized calcium fraction although it might be of importance for the secretion of fluid and proteins. Using a new method with calcium-selective disc electrodes, which gives an easy and exact estimation of ionized calcium, the Ca²⁺ activity in pilocarpine-stimulated parotid saliva of 10 healthy males was measured. With increasing flow-rate (0.1–0.6 ml/min), the concentration of ionized calcium rose exponentially from 1.13 ± 0.36 mequiv./litre (0.57 ± 0.18 mmol/litre) to 1.76 ± 0.21 mequiv./litre. At higher flow-rates (up to 2.5 ml/min), a plateau was observed. The total calcium concentration and the ionic calcium concentration were closely correlated (r = 0.93) and the ratio ionic/total remained nearly constant at 0.54 at all flow-rates.