Ellis-van Creveld syndrome: a case report

Ellis-van Creveld syndrome (EvC) is a disease complex, where all the three embryonic layers appear to be involved. This disorder is also called as Chondroectodermal dysplasia. EvC is an autosomal recessive disorder resulting from mutations in these patients. Mutations in the two genes EVC and EVC2, have been identified to cause the condition. It has been considered as a skeletal dysplasia with an incidence of approximately 1 out of 1,50,000 live births. A high prevalence has been reported among certain populations like Amish and Arabs of Gaza strip. There are more than 300 cases of EvC reported into the literature. About 50-60% of cases have been reported with congenital cardiac malformations.     

Is peripheral alcohol injection of value in the treatment of trigeminal neuralgia? An analysis of 100 cases

This retrospective study assessed the effectiveness and complications of peripheral alcohol injections in the management of trigeminal neuralgia (TN). 100 patients were analyzed who received 250 peripheral alcohol injections from June 2004 to January 2010. The duration of effect of alcohol blocks, the effect of repeated administration, and complications associated with alcohol injections were examined. The distal injection technique was applied. The branch of the nerve was identified and confirmed. After carefully anesthetizing the nerve with local anesthesia, 1-1.5 ml of absolute alcohol was injected depending on the nerve involved. Pain relief lasted for a mean of 14.13 ± 8.66 months. There was a fall in the duration of effect with subsequent injections. No serious complications were reported. Only 3% patients presented with non-neuralgic pain, swelling, burning sensation, trismus, dysesthesia, soreness, infection and the expected loss of sensation along the branch involved in TN. The combination of efficacy and reduced morbidity makes this procedure preferable for the treatment of TN. Alcohol injections are useful in those who are refractory to drug therapy, the elderly, medically compromised patients, unwilling to undergo neurosurgical procedures and in whom surgery is delayed for any reason.     

Plasmacytoma of anterior maxilla mimicking periapical cyst.

An unusual case of plasmacytoma mimicking a large periapical cyst in the anterior maxilla is described. Of the involved teeth, 22 was discoloured and had an open, immature apex, a feature strongly suggestive of the lesion being of pulpal origin. The case was treated by a conservative endodontic approach, but failed to show any improvement. Apical surgery comprising complete enucleation of the cystic lesion and extraction of the involved tooth was carried out. The unexpected histopathological finding was a plasmacytoma.     

Generalized odontodysplasia--a case report

Odontodysplasia is a relatively uncommon condition that can affect both primary and permanent dentition. It is characterized by defective formation of both enamel and dentin, with enlarged pulp chambers and root canals with open apices. It is usually a localised condition where one or few teeth may be involved. Sometimes, an entire quadrant or more than one quadrant may be involved but generalized involvement is extremely rare. An interesting case of a generalized odontodysplasia affecting both primary and permanent dentition in an eight year old girl is presented here.     

Pediatric patients' orthodontic treatment need, quality of life, and smiling patterns -- an analysis of patient, parent, and provider responses

Objectives: The objectives of this study is to explore the relationship between pediatric patients' orthodontic treatment need, the patients' assessments of their smile‐related quality of life (QoL), their parents' proxy assessment of their child's QoL and own assessments of their child's smile, and the patients' objectively assessed smiling patterns. Methods: Survey data were collected from 102 patients (53 boys/49 girls; age range: 9–13 years) and their parents. Orthodontic treatment need was assessed with the Index of Complexity, Outcome, and Need (ICON). Smiling patterns were determined by videotaping patients' smiles while they watched a cartoon. Thirty predetermined sections of these tapes were then assessed by two independent raters to measure the patients' smiling patterns. Results: The aesthetic component and total ICON scores correlated with the patients' smile‐related QoL (r = 0.25; P = 0.014/r = 0.23; P = 0.024), parental proxy assessments of the child's smile‐related QoL (r = 0.29; P = 0.004/r = 0.26; P = 0.009), the parents' own assessments of their child's smile (r = 0.32; P = 0.002/r = 0.29; P = 0.005), and the number of negative adjectives chosen by the parents to describe their child's smile (r = 0.32; P = 0.002/r = 0.30; P = 0.004). Although the smiling patterns were correlated with the patients' smile‐related QoL responses (height of smile: r = 0.29; P = 0.005/number of teeth shown: r = 0.30; P = 0.004), the ICON scores were not correlated with the patients' smiling patterns. Conclusions: Objectively assessed orthodontic treatment need correlates with the patients' and parents' assessments of the child's smile‐related QoL scores. However, while objective smiling patterns are related with the patients' smile‐related QoL, they are not correlated with the patients' orthodontic treatment need.     

Surface properties and ultrastructure of Porphyromonas gingivalis W50 and pleiotropic mutants

Cell surface ultrastructure and other surface properties of Porphyromonas gingivalis strain W50 and pleiotropic mutants W50/BP1 (brown), and W50/BE1 (beige) were studied. The percentage hydrophobicity of strains W50, W50/BP1, W50/BR1, and W50/BE1 gradually decreased from 24 to 9. Ruthenium red stained cells studied by transmission electron microscopy revealed a layer of extracellular polymeric material of varying thickness depending on the strain. The layer was thickest in W50/BP1 (15-20 nm), strains W50 and W50/BR1 both had a layer of 12-15 nm, while strain W50/BE1 completely lacked this layer. The results clearly showed that the hydrophobicity of P. gingivalis was related not only to the thickness of the layer but also to other factors like the composition of the capsular material, such that only strain W50/BE1, for example, showed no haemagglutinating activity. The surface properties of the pleiotropic mutants appeared to be stable characteristics as cells grown on either solid or in liquid media gave comparable results. The loss of virulence of the beige strain (W50/BE1) is probably partly due to the alteration of these surface properties. Both virulent and avirulent strains, however, possessed extracellular vesicles.     

Unnecessary extractions in patients with hemicrania continua: case reports and implication for dentistry

Headache and facial pain are both very high in the general population. Headache has been identified as one of the associated conditions in patients with chronic orofacial pain. The interrelation between the two has not been explored in the literature. Patients with facial pain often initially seek the care of a dentist. Misdiagnosis and multiple failed treatments (including invasive procedures) are very common in this population. This case report describes four patients whose condition fulfilled the International Headache Society's criteria for hemicrania continua but whose teeth were extracted because their pain was suspected to be of odontogenic origin. Each patient's records and the literature were reviewed for possible reasons for the unnecessary extractions. The findings suggest that initial treatment with drugs specific for primary headache disorders should be instituted before subjecting patients to invasive procedures.     

Marginal gap formation of composites in dentine: effect of water storage

This study investigated the effects of water storage on the marginal adaptation of two composite resins (Spectrum TPH and Ariston AT), two polyacid-modified composite resins (Dyract AP and F2000) and a new PRG composite (Reactmer) to dentine over time. Two cylindrical dentine cavities (1.5 mm diameter and 1.5 mm deep) were prepared on the horizontally sectioned surfaces of freshly extracted teeth. In each tooth, one cavity was restored using composites with their respective bonding system and the other without the bonding system. The sample size for each material with/without bonding system was 6. The composites were placed in one increment, bulk-polymerized, immediately finished/polished with the Sof-lex discs system and fine polished on 30 microm silicon carbide/9 microm aluminium oxide lapping film discs in a microgrinding system. The specimens were then stored in distilled water at 37 degrees C and the maximum marginal gap width between the material and the dentine wall was determined at 24 h, 1 week, 2 weeks, 3 weeks and 4 weeks using a measurescope at x500 magnification. Results were subjected to statistical analysis using monva, anova/Scheffe's post hoc test and independent samples of t-test at significance level 0.05. At all time intervals, no significant difference in marginal gap formation was observed between materials. Where bonding systems were not used, a decrease in gap widths over time was observed with most materials but only Dyract AP exhibited a significant decrease. The latter was observed after 2 weeks storage in water. The use of bonding systems reduced dentine marginal gaps significantly and is therefore mandatory for all composites evaluated. Marginal gaps arising from polymerization contraction of conventional, polyacid-modified and PRG composites cannot be fully compensated by hydroscopic expansion. Clinical relevance Bonding systems are mandatory for all composites when bonding to dentin. In the event of a bond failure at placement, hygroscopic expansion of composites can reduce marginal gaps but not completely.     

The effect of thermocycling on the bonding of different restorative materials to access opening through porcelain fused to metal restorations

PURPOSE

Porcelain fused to metal (PFM) crowns provide the best treatment option for teeth that have a large or defective restoration. More than 20% of teeth with PFM crowns or bridges require non-surgical root canal treatment (NSRCT). This may be due to the effect of restorative procedures and the possible leakage of bacteria and or their by-products, which leads to the demise of the tooth pulp. Thus, this study was planned to compare the ability of the restorative materials to seal perforated PFM specimens.

MATERIALS AND METHODS

The study evaluates the ability of amalgam, composite or compomer restorative materials to close perforated PFM specimen''s in-vitro. Ninety PFM specimens were constructed using Ni-Cr alloys and feldspathic porcelain, and then they were divided into 3 groups: amalgam (A), composite + Exite adhesive bond (B) and compomer + Syntac adhesive bond (C). All the PFM samples were embedded in an acrylic block to provide complete sealing of the hole from the bottom side. After the aging period, each group was further divided into 3 equal subgroups according to the thermocycling period (one week for 70 cycles, one month for 300 cycles and three months for 900 cycles). Each subgroup was put into containers containing dye (Pelikan INK), one maintained at 5℃ and the other at 55℃, each cycle for 30 sec time. The data obtained was analyzed by SPSS, 2006 using one way ANOVA test and student t-test and significant difference level at (P<.01).

RESULTS

The depth of dye penetration was measured at the interfaces of PFM and filling materials using Co-ordinate Vernier Microscope. The lowest levels of the dye penetration for the three groups, as well as subgroups were during the first week. The values of dye leakage had significantly increased by time intervals in subgroups A and C.

CONCLUSION

It was seen that amalgam showed higher leakage than composite while compomer showed the lowest level of leakage.