Singapore Dental Journal最新文献

This study analyses the US Army Joint Theatre Trauma Registry database for craniomaxillofacial (CMF) battle injuries (BI) experienced by US Service Members in Iraq/Afghanistan conflict to describe type, distribution and mechanism of injury.

Methods and materials

Joint Theatre Trauma Registry was queried from 19 October 2001 to 12 December 2007 for CMF BI entered in the database using ICD-9 codes; the data was compiled for BI soldiers.

Results

We have identified 7770 BI. About 26% had CMF BI. There were 4783 CMF BI among the 2014 BI (2.4 injuries per soldier). Majority of CMF BI were male (98%). Average age was 26 years. CMF BI by branch of service was Army 72%, Marines 24%, Navy 2% and Air Force 1%. Penetrating soft tissue injuries and fractures were 58% and 27%, respectively; 76% of fractures were open and 24% of soft tissue injuries were noted as complicated. Frequency of facial fractures was mandible 36%, maxilla/zygoma 19%, nose 14%, and orbit 11%. Remaining 20% not otherwise specified. Primary mechanism of injury was explosive devices (84%).

Conclusions

Twenty-six per cent of all BI were to CMF area. CMF BI account for a disproportionate number of injuries observed in Iraq and Afghanistan compared with the previous American Wars. Mechanism of CMF BI involves explosive devices 84%.

Ectodermal dysplasia (ED) comprises a large heterogeneous group of inherited disorders that are characterized by primary defects in the skin, hair, nails, eccrine glands and teeth. The most characteristic findings are the reduced number of teeth. All rehabilitative programmes involve proper evaluation of skeletal relationships. Prosthetic-implantological treatment at the end of bony growth can be used. In this article a case of ED treated with Le Fort I for maxillary advancement, femur homografts, implants' insertion and immediate loading is described. In December 2007, a 38-year-old female was referred to the Maxillofacial Department of Galeazzi Hospital (Milan, Italy) who had a diagnosis of ED. Twelve implants were inserted in one-step surgical procedure. No implant was lost and all are stable. The occlusion is stable after 15 months of follow-up. The results indicate that the one-step oral rehabilitation can be performed in adults who are affected by ED. Also, this significantly reduces the time of oral and facial rehabilitation.

Fixed functional appliance is an effective way of treating skeletal Class II malocclusion in children and adolescents. The following case report documented a 13-year-old boy with 15 mm overjet treated by a phase I 12-month growth modification therapy using Herbst appliance with Hyrax palatal expander and high pull headgear in a stepwise mandibular advancement protocol followed by a phase II pre-adjusted edgewise appliance therapy. It is one of the cases submitted for the Membership of Orthodontics Examination of the Royal College of Surgeons of Edinburgh.

Mental foramen is an opening of the mental canal onto the lateral surface of the mandible. In this pilot radiographical study, in Malay population the effects of ageing towards the location and visibility of the mental foramen were determined. Most of the mental foramina were found to be located inferior to the apex of the second premolar. Non-visibility of the foramen was greatly increased in patients aged 50 years and above (Pearson Chi-square; p = 0.00). This finding may provide a guide to dental surgeries in Malay patients of different age groups.

Any foreign body in the paranasal sinuses can cause chronic complications. It is therefore important to remove these foreign bodies meticulously. Various approaches are available to accomplish this. This article is a case report of a patient who had gutta-percha as a foreign body in left maxillary sinus, after a gutta-percha point had been used to trace a sinus to confirm that it was an oroantral fistula. Traditional surgical approaches to the maxillary sinus require invasive techniques, such as radical antrostomy and the Caldwell–Luc approach. These may result in further complications and morbidity. The gutta-percha point in this case report was removed endoscopically in an otolaryngology clinic with local anaesthesia using a sublabial antroscopy. There is only one case reported in the dental literature regarding the endoscopically-assisted technique for removal of displaced gutta-percha using the sublabial antroscopy approach (Yura S, Ohga N, Ooi K, Izumiyama Y. Procedure of endoscopic removal of a gutta-percha point in maxillary sinus mucosa by ultrathin arthroscope. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;104:e58–60).

The presurgical nasoalveolar molding plate appliance with stent (PNAM) extended from the palatal molding plate; to correct the nostril shape of infants with cleft lip and palate is well known. The PNAM appliance is based on the finding that a high degree of plasticity is maintained in the cartilage of infants during the first 6 weeks after birth. However, on the current PNAM protocol described by Grayson et al. the nasal stent is supposed to be an adjunct to the palatal molding plate after reducing the severity of the alveolar cleft width. We have used the modified Hotz's plate from the setup model and built up the nasal stent even before reducing the severity of the alveolar deformity. In this study we assess the effects of the modified Hotz's plate and the modified PNAM appliance for the alveolar and palatal form. The lateral deviation of the incisal point, the width of the palatal cleft, and the degree of curvature of the palatal vault were first evaluated on plaster models. The PNAM group is smaller on the lateral deviation of the incisal point than the modified Hotz's group. The decreased average width of the palatal cleft and curvature of the palate, was almost the same in both the modified Hotz's and PNAM groups. In comparison with the modified Hotz's plate, the modified PNAM appliance also improves the molding of the alveolar segments and reduces cleft width.

Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-cally by duct-like structures derived from the epithelial component of the lesion and can be distinctly classified into follicular, extrafollicular and extraosseous variants (Neville BW, Damm DD, Allen CM, et al. Adenomatoid Odontogenic Tumor. A Text Book for Oral and Maxillofacial Pathology, 2^nd edition, 621-3). Most of these tumours develop in the second or third decade of life and have a distinct predilection for women. The follicular variant accounts for 75% of reported cases (Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical cyst that originated in a woman in her first trimester of pregnancy and enlarged rapidly thereafter. The lesion was enucleated and sent for histopathology and immunohistochemistry, which revealed AOT with a cystic component with no dependence on oestrogen or progestrone for its growth. This case of AOT introduces us to the unique variation in its presentation and the difficulty in differentiation from periapical disease of inflammatory origin.