Nederlands tijdschrift voor tandheelkunde最新文献

Subcutaneous emphysema is a relatively harmless finding which is pathognomonic for a mid-facial fracture in most cases. Increasing pressure will cause air to expand beyond the tissues. It is often caused by blowing one's nose, but can also result from intubation in cases of more severe trauma. Crepitus can be heard or felt subcutaneously upon palpitation. Two cases of patients presenting at an oral and maxillofacial unit with extensive emphysema in the head and neck region illustrate both a common and an unusual cause.

In 30 patients (average age 38 ± 8 years, 77% male, 23% female) with intra-oral scans made at intake and after 3 years, tooth wear progression was measured. With the aid of GeoMagic to superimpose the scans, the maximum difference in height of 64 surfaces was measured per surface. A large variation was found in progression rates between patients, between various teeth in a single mouth, and between surfaces on a single tooth. Tooth wear progression rates are therefore highly individual and can even be very localized. Treatment must therefore be individualized, with an essential role for measuring tooth wear when deciding on the need for restorative treatment.

Crohn's disease and ulcerative colitis are chronic inflammatory diseases of the gastrointestinal tract. In addition to bowel symptoms, patients may also have oral manifestations. This thesis investigated potential associations between disease activity in the gut, oral health, salivary gland function, and saliva composition. Patients with Crohn's disease had a significantly higher DMFT index, but showed no difference in periodontal diseases compared to a healthy control group. The saliva composition in patients with active bowel disease differed from that in patients with inactive bowel disease, suggesting that saliva analysis could potentially be used in the future to determine the degree and severity of bowel disease. The knowledge of gastroenterologists and dentists regarding oral manifestations of bowel diseases was found to be limited. Gastroenterologists and dentists valued interdisciplinary patient consultation as very useful, but the frequency of consultation was considered insufficient.

With the Paris climate goals in prospect and the latest IPCC reports in mind, it is urgent and necessary that the healthcare sector also looks at how to limit global warming. Healthcare is a major producer of greenhouse gasses, air pollution and waste. In addition, it uses a lot of raw materials and energy. Both the World Health Organization, the World Dental Federation and national parties are trying to draw up an agenda based on goals to make the healthcare sector more sustainable. English research shows that the largest emissions in oral care are caused by travel, purchasing and use of materials and energy use in practice. Based on these topics, steps can be taken to become more sustainable. The e-book 'Sustainable oral healthcare practice' provides a good starting point for this.

A 61-year-old edentulous patient presented with dental problems. Examination revealed a very narrow alveolar process in the symphysis area of the chin, with moderate vertical resorption. The decision was made for bone augmentation by means of harvesting an autologous bone graft from the alveolar process. This method can be carried out in an outpatient or day surgery unit and is much more cost effective and less invasive than harvesting an autologous bone graft from the hip area.

More than 1.1 million people in the Netherlands have a mild intellectual disability (MID). They are relatively more likely to have poor oral health. The aim of this study was to investigate the oral health of MID young adults with multiple problems (such as addiction). A questionnaire was administered orally to 76 inpatient clients of the Salvation Army in Amsterdam and intraoral examinations were also performed. The research group consisted of young adults with MID and additional multi-problems. The collected data was compared with a reference group (Dutch young adults with a low socio-economic status). The results suggest that oral hygiene is poor in this population, and that a more internal locus of control is associated with a higher caries index. The findings of this study emphasize the importance of professional oral care in young adults with MID given poor oral hygiene and treatment delays. A tailor-made approach with more flexibility in treatment is essential to provide young adults with MID the right oral care.

Removal of third molars in healthy patients is considered a procedure with a low risk of bleeding. However, exactly how low the incidence of postoperative bleeding is remains unclear due to the heterogeneity of available studies. To determine the exact postoperative risk of bleeding after the removal of third molars in healthy patients, a prospective observational multicentre study was conducted. A total of 1,035 patients with complete follow-up was included. Of these, 329 patients reported subsequent bleeding, but did not consult their attending physician. A total of 15 patients visited the hospital, 8 of whom required minimally invasive (re)treatment. No hospitalizations were necessary. There was a large difference between the incidence of postoperative bleeding reported by patients and postoperative bleeding requiring clinical examination and/or treatment. To reduce this difference in future, patients should be given detailed information about what degree of postoperative bleeding is considered normal after removal of a third molar.

A recent publication in the Nederlands Tijdschrift Voor Tandheelkunde (Dutch Journal of Dentistry) suggests botulinum toxin as a primary treatment for bruxism, especially for severe complaints of teeth grinding or jaw clenching. However, in the opinion of Lobbezoo et al., some outdated views on bruxism are used, and botulinum toxin is incorrectly classified as safe, according to them. In this Vision article, the authors describe the current insights into bruxism; they indicate how the presence of bruxism can be assessed in the clinic; when and how bruxism is treated; and finally, what the role of botulinum toxin is: an ultimum refugium. Therefore, regarding the use of botulinum toxin within the discipline of orofacial pain and dysfunction Lobbezoo et al. recommend: think twice!

A 60-year-old man was referred to an oral and maxillofacial surgeon with discomfort caused by pressure on the left-hand side of the maxilla. Examination revealed a very elevated third molar in contact with the orbital floor and infundibulum, and, possibly, a follicular cyst. On account of the threat to the orbital floor, it was first decided to decompress the cyst and place an in situ drain. After 4 months, the tooth and cyst could be removed and the diagnosis of a follicular cyst was confirmed.Auteursinformatie.

Salivary stones are hardened, stony calcifications that primarily develop in the drainage duct of a salivary gland. They can lead to obstruction of the saliva flow, resulting in swelling and pain. Since the aetiology of salivary stones remains largely unclear, this was further investigated in this PhD study. A case-control review of patient records showed that systemic diseases and lifestyle factors most likely do not play a role in their occurrence. The biochemical composition of salivary stones removed by oral-maxillofacial surgeons was examined, revealing that large salivary stones have a different inorganic composition than small salivary stones. Several salivary proteins were detected in submandibular salivary stones, including lysozyme, s-IgA, and -amylase. Clumping together of these proteins may play a role in the initial formation of salivary stones.