Bruxism-induced parotitis: A retrospective case series analysis

ABSTRACT

Objective: A group of patients with recurrent parotitis had clinical symptoms suggesting an obstruction of the glandular duct system, though without any signs of sialoliths or other ductal pathologies.

Methods: Clinical and radiological data of five patients with recurrent obstructive parotitis and long-standing definite bruxism were reviewed retrospectively. Ultrasonography, MRI, and sialendoscopy were performed for evaluation of ductal pathologies as the cause of glandular obstruction. Electromyography was used to evaluate the activity of masticatory muscles in all patients. The parotitis was treated with injection of botulinum toxin into the buccinator muscle.

Results: Dilatation of the Stensen’s duct proximal to the area of the buccinator muscle was shown in radiological examination with no evidence of ductal strictures. Electromyography revealed an abnormal activity of the ipsilateral buccinator muscle. All patients were free of disease after treatment of the buccinator muscle.

Discussion: Bruxism should be considered as a possible cause of recurrent parotitis.     

Does occlusal splint affect posture? A randomized controlled trial

ABSTRACT

Objective

The aim of this study was to evaluate the effect of an occlusal splint on body posture of intra-articular temporomandibular joint (TMJ) disorders patients.     

Implant-Supported Rehabilitation of the Severely Atrophic Maxilla: A Clinical Report

Implant-supported rehabilitation in the posterior maxillary region presents a series of challenges because of the possibility of increased pneumatization of the maxillary sinus after dental loss. In cases where significant maxillary bone resorption has occurred, efforts center on maximizing the use of the remaining bone to afford primary stability to the implants. This clinical report describes a patient with extreme maxillary atrophy for whom fixed rehabilitation supported on 8 implants was accomplished. A zygomatic implant, a pterygomaxillary implant, and 2 implants mesial and distal to both canine eminences were placed. This rehabilitation was accomplished with a less invasive technique and in a much shorter time period compared to a sinus lift procedure. One year after prosthetic loading, the clinical and radiological results remain satisfactory.     

Timing the early treatment of Class II,division 1 malocclusion — Clinical and research considerations

The aim of this study was to evaluate the correlation between timing of emergence of the permanent teeth and sagittal occlusal changes in children enrolled in a prospective clinical trial of Class II, division 1 treatment. The children, ages 7.2–13.3 years, met strict inclusion criteria and were assigned at random to treatment with either a headgear or a Fränkel functional appliance. Relationships between maxillary and mandibular first molars and canines, as well as overjet, were measured with digital calipers on casts made every 2 months and mounted on a SAM II articulator. The emergence of a permanent tooth was scored on a scale from 1 to 3, depending on the eruptive level of the tooth from cutting through the gingiva (1) to reaching the occlusal table (3). Specifically, emergence of the second premolars (PM2) and permanent second molars (M2), the most adjacent teeth to the first molars, was evaluated as it interacted with the development of the sagittal occlusion. Treatment of the distocclusion was as effective in late childhood as in mid-childhood. Within each appliance group, the emergence of PM2 and M2 did not affect the amount of progress toward Class I significantly (p> 0.05), indicating that improvement from distocclusion to neutrocclusion with each appliance is not influenced by the timing of emergence of these teeth. Although these findings support a one-phase treatment starting in the late mixed dentition, earlier intervention in mid-childhood may be required in the presence of several developmental conditions, or when the dental and skeletal development deviate significantly in the individual patient.     

Dentofacial features of a family with Crouzon syndrome. Case reports

Crouzon syndrome is an autosomal dominant condition characterized by craniosynostosis with associated dentofacial anomalies. This paper describes the variable clinical features in affected individuals over two generations of a family with particular reference to the dentofacial deformities and discussion of management strategies.     

A custom mandibular distraction device for the rat

In the last several years, the rat model has been used as a reliable means of studying distraction osteogenesis (DO). This model has several benefits, including lower cost, the availability of molecular reagents for the rat, and the ability to perform a large number of operations in a short time. We have recently developed an external device that is custom-made for the rat mandible and secured at the mandibular ramus. The device consists of a Leone (Florence, Italy) jackscrew distraction assembly (0.2 mm per one-quarter turn), 2 Luhr L-shaped 0.8-mm five-hole microplates, and four 0.8-mm x 3-mm microscrews (Stryker-Leibinger Corp., Kalamazoo, MI) for fixation. Additionally, there is a methylmethacrylate block that is placed on the lingual surface of the angle of the mandible to support the posterior screws. Sterile surgical technique was used, and the same two surgeons performed all operations. To date, we have operated on 153 Sprague-Dawley rats. The procedure has been well tolerated by the animals. We had 17 postoperative deaths (11% mortality), largely as a result of anesthetic complications. There were no wound infections or dehiscence. A mandible fracture was noted in 6 rats (4%), which occurred at the time of device placement. There were no device dislodgments. Postmortem examination showed the device to be well positioned in all rats, with good callous formation at the distraction site. The rats surpassed their preoperative weight after an average of 9.2 days. These results compare favorably with those of other models currently in use. We have developed a device that is currently being used in the study of DO in the rat mandible. Our device is small in size, does not require wide undermining for its placement, and has had a low incidence of device dislodgment or infection. This model has shown great reproducibility and thus should be effective in its application for the histologic and biochemical investigation of DO in the rat.     

Primarily Research

Abstract: Composite materials have become an integral part of the wide range of filling materials currently available. Conditioning is necessary to achieve adequate bonding of the composite material to enamel and dentin. Normally, this is done by applying acid preparations to the dental surfaces. These acids have an etching effect that causes surface roughening. The increasing application of lasers in dentistry has introduced another possibility. Laser irradiation can cause roughening of enamel and dentin surfaces. Another interesting alternative is the so-called kinetic cavity preparation technique. This method also results in distinct surface roughening. The purpose of the present study, was to compare the described methods. Tensile bond strength tests and shear bond tests were carried out to examine the adhesion of a composite material to surfaces treated with these methods. Laser irradiation with certain devices and the air-abrasive technique yielded results similar to those with acid etching.     

Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis

The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances.     

Squamous cell carcinoma of the gingiva presenting as localized periodontal disease.

Gingival squamous cell carcinoma represents less than 10% of diagnosed intraoral carcinoma. Many unique features of gingival squamous cell carcinoma clearly delineate it from oral squamous cell carcinoma arising in other sites. This article presents the clinicopathologic findings of a case. An 81-year-old woman presented for evaluation of multiple oral lesions primarily limited to the maxillary gingiva; the lesions had been present for about 2 years. Differential diagnosis included epithelial dysplasia, benign mucous membrane pemphigoid, inflammatory lesion of endodontic/periodontic origin, lichen planus, and squamous cell carcinoma. Clinical examination revealed extensive erythematous and ulcerative lesions of maxillary buccal and palatal gingiva extending into the maxillary buccal vestibule; the lesions did not respond to antibiotic therapy. Radiographic evaluation demonstrated advanced alveolar bone loss as well as displacement of the maxillary right first molar. Subsequent histology confirmed diagnosis of moderately differentiated squamous cell carcinoma. Gingival squamous cell carcinoma can mimic a multitude of oral lesions, especially those of inflammatory origin. In addition, predisposing and presenting factors are different from those of other oral squamous cell carcinomas. Careful examinations as well as routine biopsy are crucial for accurate diagnosis.