Unusual Presentation of Caustic Ingestion and its Surgical Treatment: A Case Report

Treatment and reconstruction of oral scar contracture, is always a challenging procedure to restore structure and functions of the oral cavity. We present a case of a patient with limited mouth opening who sustained extensive oral scar contracture with complete adhesion of tongue to floor of mouth following ingestion of caustic soda without his knowledge 4 years back. We performed a surgical release of the scar contractures from buccal mucosa on both sides, along with a release of the tongue from the floor of the mouth, followed by reconstruction of all sites using split skin grafts. Adequate mouth opening and tongue movement was achieved. There was a follow up period of 1 month with excellent mouth opening and tongue function.     

Orthodontic treatment and temporomandibular joint disorders.

The overall objective of this project was to study the relationship between orthodontic treatment and temporomandibular joint (TMJ) disorders. This relationship has been and remains an important and complex issue in orthodontics. The objectives of the study were to determine the incidence of TMJ pain and dysfunction in a group of orthodontic patients who were symptom-free on entering treatment, and to assess and characterize the level of pain and dysfunction in patients with symptoms, and track changes in these parameters during the course of orthodontic treatment. Standardized functional indices and physical measurements were used to describe and assess TMJ pain and dysfunction. The results of this study showed that of 451 patients without symptoms undergoing treatment at our university clinic during the 18-month project, no patient developed signs and symptoms of TMJ disorders during that time. In addition, for the 11 patients who presented with signs and symptoms of TMJ disorders at the time of their entry into the treatment program, no clear or consistent changes in levels of pain and dysfunction occurred longitudinally during the treatment period followed in this study. On the basis of these findings, a relationship between either the onset of TMJ pain and dysfunction and the course of orthodontic treatment or the change in TMJ pain and dysfunction and the course of orthodontic treatment could not be established in this particular patient population.     

A clinical and morphological study of cervical hypersensitivity.

One-hundred five teeth with clinically diagnosed cervical hypersensitive dentin were studied using scanning electron microscopy on replica models and electrical impedance. Thirty-two percent of the teeth were in male patients in their 40s. Maxillary premolars comprised 31%; maxillary incisors, 27%; mandibular premolars, 17%; and mandibular incisors, 15%. Scanning electron microscopy of the models of hypersensitive spots showed enlarged dentinal tubules, agglutinated dentinal tubules, belt-like groups of agglutinated dentinal tubules, and tubule morphology not clearly visible. The electrical impedance of the cervical hypersensitive dentin ranged from 15 to 150 ohms, with an average of 54 ohms. There was a significantly high correlation between the dentinal tubule morphology and dentin hypersensitivity.     

Changes in vertical dimension of occlusion in conventional and microwave processing of complete dentures

An investigation was made to compare the increase in vertical dimension of occlusion in complete dentures after processing with conventional and microwave procedures. Lucitone-characterized denture base material was used for 15 sets of complete dentures cured conventionally. Justi-characterized acrylic resin and microliquid were used for 15 sets of complete dentures cured by the microwave procedure. The results of the study showed increases in vertical dimension of occlusion in both methods under 1 mm, which is considered technically acceptable. However, a statistically significant larger increase was present in the microwave technique.     

Clinical effects of electromagnetic stimulation as an adjunct to periodontal therapy

The clinical effects of electromagnetic stimulation (EMS) on periodontal soft tissues and alveolar bone level were studied among 23 patients. The sides of the arch to receive EMS were randomly selected and exposed for a period of eight weeks following periodontal surgery. The contralateral control sides received surgery only. The electromagnetic signal was a multiple pulse signal with 21 asymmetrical quasirectangular pulses per burst and a burst frequency of 16.9 Hz. The peak magnetic field strength reached 0.46 Gauss. Changes from baseline in clinical attachment level, probing depth, and radiographic alveolar bone level were assessed at six, 12, and 18 months postsurgically. A greater gain of clinical attachment level following EMS was observed only for pockets with initial depth of 1 to 3 mm. There were no consistent differences between test (EMS) and control sides in the change of clinical attachment level or probing depth for pockets deeper than 4 mm. Radiographically, the test sides demonstrated statistically significant gain of alveolar bone level compared with the control sides at six months following surgery. Hereafter, the rates of change were similar in the stimulated and unstimulated sides, and the total gain of alveolar bone level remained greater in the test side throughout the observation period. Within the limitations of this study, it was concluded that electromagnetic stimulation does not promote gains in clinical attachment or alveolar bone level to the extent that it can be recommended as an adjunct to conventional periodontal therapy.     

Radiobiologic risk estimation from dental radiology. Part I. Absorbed doses to critical organs

The aim of the present study was to generate one consistent set of data for evaluating and comparing radiobiologic risks from different dental radiographic techniques. To accomplish this goal, absorbed doses were measured in fourteen anatomic sites from (1) five different panoramic machines with the use of rare-earth screens, (2) a twenty-film complete-mouth survey with E-speed film, long round cone, (3) a twenty-film complete-mouth survey with E-speed film, long rectangular cone, (4) a four-film interproximal survey with E-speed film, long round cone, and (5) a four-film interproximal survey with E-speed film, long rectangular cone. The dose to the thyroid gland, the active bone marrow, the brain, and the salivary glands was evaluated by means of exposure of a tissue-equivalent phantom, fitted with lithium fluoride thermoluminescent dosimeters (TLDs) at the relevant locations.     

No evidence of hypersensitivity to dental restorative metals in oral lichen planus

Twelve patients with oral lichen planus (OLP) suspected of dental restorative metal allergy were examined. All patients were patch tested with several metals including six different mercury compounds. One (8%) patient showed a positive patch test to two mercury compounds whereas no mercury allergy was found in a reference group of 17 patients suspected of dental restorative material allergy but without OLP lesions. The mercury allergic OLP patient was further tested on palatal mucosa but no reactions developed. Moreover, the energy dispersive X-ray microanalysis failed to show any contaminating metals in his OLP lesion. Mucosal biopsies were taken in close contact with amalgam fillings from nine OLP patients but these disclosed no evidence of lichenoid or dysplastic alterations. In OLP lesions, the immunofluorescence findings showed fibrinogen deposition, altered basement membrane and elastic fiber staining and intense Ulex europeaus I lectin fluorescence through all epithelial cell layers. Therefore, the present patch tests did not reveal increased frequency of mercury or other metal allergy in OLP patients and the mucosal biopsies failed to show any histologic or immunofluorescence alterations deviating from idiopathic OLP lesions.     

Replicability of electromyographic recordings of the masseter muscle during mastication

This study evaluates the reliability of a method to duplicate the location of surface electrodes for recording the electromyographic activity of masseter muscles during mastication and quantifying the activity by a microcomputer system. A plastic framework consisting of a bite fork and electrode positioners was used to place the electrodes by relating the positioners to an occlusal index and keeping this relationship constant at subsequent sittings. EMG recordings were repeated on two different days for each of 10 subjects while they performed standardized masticatory performance tests with peanuts and carrots. The muscle activity recorded with hardware integrators was an average of 26.7% of the computerized software integrations but measures derived from the two methods of integration were highly correlated (r = 0.965) and yielded similar results. Significant correlations were found between test sessions for each measure of masticatory performance and integrated EMG activity for ipsilateral and contralateral muscles. For each subject, no significant differences were found between sessions for any masticatory performance or EMG variable. The results indicate that reliable inter session EMG recordings during mastication can be made by using the template for positioning of the electrodes. In addition, the microcomputer data acquisition system provides results comparable to those obtained with conventional hardware integrators, with the added benefit of providing information on each individual stroke and its various components.