Oral Surgery, Oral Medicine, Oral Pathology最新文献

A recent study reported that the mean density of periapical cysts was greater than that of periapical granulomas. This study, which used a larger sample size and a robust method for standardization of density and contrast between images, found no difference between the radiographic density of cysts and granulomas classified by microscopic evaluation. Cysts tend to be larger than granulomas, but there was wide variation in size of both types of lesions. There was no significant correlation between the density of a lesion and its size.

Diffuse sclerosing osteomyelitis of the mandible has been described as a localized disease of unknown origin. We offer evidence that mandibular involvement in the recently described synovitis acne pustulosis hyperostosis osteitis syndrome exactly fits the accepted description for diffuse sclerosing osteomyelitis of the mandible. The clinical, radiologic, and pathologic findings in seven such cases are presented and discussed.

Dermoid cyst, frequently used to describe three closely related histologic cysts, the dermoid, epidermoid, and teratoma, is commonly considered a rare finding in the floor of the mouth. This review, which identifies 195 case reports of dermoid cysts in the floor of the mouth, has unveiled some findings that do not support conclusions expressed in previous articles. Examination of the literature includes muscle influence on clinical presentation and surgical approaches, locations, age distribution, histologic distribution, infection rate, incidence of multiple cysts, fibrous attachments, airway problems, anesthesia administration, surgical difficulties, and diagnostic aids. Brief suggestions in treatment are made in light of the clinical, radiographic, and historic findings. Three clinical cases are also included.

To our knowledge there has been no previous study of factors specifically involved in the pathogenesis of patients who complain of burning sensation of the lips when the lips appear clinically normal. The complaint is akin to patients who complain of a burning sensation of the mouth when it appears clinically normal, a condition known as burning mouth syndrome. This study therefore studied precipitating factors in patients with burning mouth syndrome who reported lip involvement. Previous studies have shown that the lips are the third most common site reported as involved in patients who have burning mouth syndrome. Indeed patients with burning mouth syndrome often report multiple oral site involvement. To investigate the precipitating factors involved in the lip component of burning mouth syndrome, we studied 104 patients who reported the lips as a site affected by the condition from a total population of 312 patients with burning mouth syndrome. Hematologic, biochemical, and microbiologic parameters were studied in these patients. Sialometry, patch testing, psychological testing, and examination of denture status as well as questioning of parafunctional habits were also undertaken. No clear differences were noted in relationship to the frequency of abnormalities in burning mouth syndrome alone or burning mouth syndrome with lip involvement suggesting that similar precipitating factors apply. The precipitating factors in patients with lip involvement were found to be the same as burning mouth syndrome in general. Treatment of patients with lip involvement alone in burning mouth syndrome or lip involvement in burning mouth syndrome in conjunction with other intraoral sites gave an equally good response. The results suggest that similar precipitating factors are involved when the lips are involved in burning mouth syndrome.

The role of microorganisms in the cause of endodontic lesions has been intensively investigated. Bacterial components such as endotoxin and other cell wall components are implicated in the development of pulpal and periapical inflammation. Newer anaerobic microbiologic techniques have facilitated accurate and reproducible identification of endodontic pathogens, some of which have been reclassified. This article reviews and correlates newer microbiologic findings with clinical symptoms.

Rhabdomyosarcoma is a neoplasm composed of striated muscle. One of the most common types of soft tissue mesenchymal tumors in infants, children, and adolescents, rhabdomyosarcoma was considered an almost uniformly fatal cancer as recently as 30 years ago. Presently a multimodal approach consisting of surgery, radiation, and chemotherapy has significantly improved the outlook for the patient with rhabdomyosarcoma. This article presents a case of intraoral rhabdomyosarcoma that was initially poorly controlled because of a lack of patient compliance. After proper treatment, the cancer went into remission. The patient remained cancer-free for 7 years, albeit with significant morbidity. This case demonstrates the significantly improved prognosis achieved with multimodal therapy.

Facial and perioral molluscum contagiosum is a common and often disfiguring condition in patients with HIV infection. The purpose of this study was to report on the clinical aspects of eight HIV-positive patients with facial molluscum contagiosum. Also we describe the histopathologic and electron microscopic findings and discuss the treatment modalities for this unusual disease.

Objective. This study compares the effectiveness of tiaprofenic acid with diclophenac sodium over a 7-day period with respect to pain, facial swelling, and trismus.

Study design. Sixty patients who required general anesthesia for removal of bilateral impacted third molar teeth were included. Intraoperatively, they received intramuscular injections of either tiaprofenic acid or diclophenac sodium followed respectively by tiaprofenic acid tablets for 5 days and placebo for an additional 2 days or diclophenac sodium tablets for the full 7 days. Surgical and anesthetic techniques were standardized. Pain levels were compared hourly for 4 hours postoperatively and thereafter twice daily for 7 days. Changes in facial swelling and trismus were compared on days 2 and 7 postoperatively.

Results. No statistically significant difference was found between the two treatment groups with respect to pain or facial swelling. Only with respect to recovery in mouth-opening ability (trismus) from day 2 to day 7 did diclophenac sodium reveal a statistically significant advantage (p = 0.0452).

One hundred seventeen patients with reflux disease were examined with respect to the severity of their disease and oral, dental, and salivary findings. Twenty-eight patients had dental erosion, whereas the remaining 89 patients did not. No mucosal changes could be observed to be linked with the reflux disease. In the mean, the patients with erosion were older (54 versus 49 years), and the mean duration of their reflux disease was longer in comparison to those without erosion (17 versus 11 years, respectively). The severity of the reflux disease was more marked among patients with erosion than in those without as assessed by esophagogastroduodenoscopy, the Maratka classification, histologic examination of gastric and esophageal biopsy specimens, and 24-hour esophageal pH monitoring. No statistically significant differences were observed between the groups in any salivary parameters studied, although the number of patients with low salivary-buffering capacity was higher among those with erosion than among those without. Patients taking β-blocking agents or tranquilizers had more erosion than those who did not take these medications. The severity of the reflux disease was not associated with any subjective symptoms in the mouth or pharynx. The frequency of consumption of acidic drinks and foodstuffs as determined by a questionnaire did not differ between the patients with and without dental erosion. Thus severe reflux disease of long duration was found to be potentially detrimental to the teeth, whereas milder forms of the disease need not cause dental side effects.

Differences between sequential radiographs may be displayed in color if the individual radiographs are transformed into monochromatic images and then added. Information in regions where the radiographs are identical is retained whereas differences are emphasized by the color coding that comes about in a quantitative manner from the gray level values in the sequence of radiographs. By using the three additive primary colors, red, blue, and green, two or three radiographs from a sequence may be added. Every possible state of a bone disease, progression, regression, or any combination, will produce a different and specific color code. Different development cycles are described, and the color coding that appears when color image addition is performed is analyzed. The color addition technique should constitute a useful substitute or alternative to subtraction.