1/50. Presentation and management of chronic osteomyelitis in an African patient with pycnodysostosis.A case is reported of pycnodysostosis (PCD) with chronic osteomyelitis in the mandible. The clinical and radiological features and the problems of management and follow-up are discussed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/50. Maxillofacial osteonecrosis in a patient with multiple "idiopathic" facial pains.Previous investigations have identified focal areas of alveolar bone tenderness, increased mucosal temperature, abnormal anesthetic response, radiographic abnormality, increased radioisotope uptake on bone scans, and abnormal marrow within the quadrant of pain in patients with chronic, idiopathic facial pain. The present case reports a 53-year-old man with multiple debilitating, "idiopathic" chronic facial pains, including trigeminal neuralgia and atypical facial neuralgia. At necropsy he was found to have numerous separate and distinct areas of ischemic osteonecrosis on the side affected by the pains, one immediately beneath the major trigger point for the lancinating pain of the trigeminal neuralgia. This disease, called NICO (neuralgia-inducing cavitational osteonecrosis) when the jaws are involved, is a variation of the osteonecrosis that occurs in other bones, especially the femur. The underlying problem is vascular insufficiency, with intramedullary hypertension and multiple intraosseous infarctions occurring over time. The present case report illustrates the extreme difficulties involved in the diagnosis and treatment of this disease.- - - - - - - - - - ranking = 0.90549451271503keywords = jaw (Clic here for more details about this article) |
3/50. Sliding plates on complete dentures as a treatment of temporomandibular disorder: a case report.This work presents a case report of a woman, aged 62, who presented with signs and symptoms of temporomandibular disorder (TMD). The patient reported pain in the masticatory system and examination showed a reduction in the occlusal vertical dimension (OVD). She was treated with complete dentures incorporating a modification to the posterior regions developed by the authors and which were termed "sliding plates." Through analysis of photographs taken of the patient prior to the extraction of the patient's natural dentition, sliding plates were utilized to reestablish the OVD. The sliding plates also allowed for unrestricted eccentric mandibular movements, thereby accelerating the neuromuscular deprogramming and making it possible for the mandible to adopt a more physiologic position. The dentures reduced the pain and were well-accepted by the patient. Therefore, sliding plates may be of great benefit to completely edentulous patients with painful symptoms that result from alterations in the OVD and inappropriate condylar positioning.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
4/50. Diaphragmatic cramp as a possible cause of noncardiac chest pain and referred mandibular pain.The initial assumption that sudden acute chest pain may be of cardiac origin is justifiable, but when this proves not to be the case the patient is left with little explanation of the cause. It is suggested here that diaphragmatic cramp may be a cause of some undiagnosed noncardiac chest pains associated with mandibular referred pain. The phrenic nerve provides both motor and sensory innervation to the diaphragm, while the trigeminal nerve carries sensation from the mandibular teeth. Both nerves originate in separate nuclei close together in the lower medulla. Interconnections between these nuclei and others higher up in the brain may provide one explanation for this problem.- - - - - - - - - - ranking = 0.00089634381790203keywords = lower (Clic here for more details about this article) |
5/50. cluster headache and cocaine use.We present 3 patients who had episodes of orofacial pain compatible with cluster headache, the differential diagnosis being established with pulp pain of dental origin. cocaine inhalation triggered pain in the premolar zone of the upper jaw, followed by spread of pain to the periorbital region on the same side. The pain episodes were very intense and lasted between 30 and 120 minutes. The patients presented conjunctival injection and lacrimation of the affected eye during these episodes. The crises were always unilateral. In one patient, pain shifted sides from one crisis to another within the same symptomatic or cluster period, affecting the side through which the drug was inhaled. Pain usually appeared 1 to 2 hours after cocaine consumption, though it disappeared 5 to 10 minutes after again inhaling the drug. None of our patients acknowledged cocaine consumption at the first visit; drug inhalation was only admitted at subsequent visits, once a degree of confidence had been established with the physician.- - - - - - - - - - ranking = 0.90549451271503keywords = jaw (Clic here for more details about this article) |
6/50. Painful chewing and blindness: signs and symptoms of temporal arteritis.BACKGROUND: This case report illustrates the need to consider temporal arteritis in the differential diagnosis of jaw or tooth pain. This disease affects the cranial arteries, more frequently in women and usually in those older than age 60 years, causing jaw pain, visual symptoms, headache, scalp pain and sometimes blindness. CASE DESCRIPTION: A 71-year-old man had jaw pain that increased with chewing and speaking, scalp tenderness and dimming vision. A temporal artery biopsy confirmed the diagnosis of temporal arteritis. Treatment with decreasing amounts of oral steroids over 23 months was successful in relieving his signs and symptoms and in saving his vision. CLINICAL IMPLICATIONS: patients with this disease may seek care from their dentist first. jaw or tooth pain is the most reliable clinical symptom in the diagnosis of temporal arteritis. diagnosis and timely referral for treatment with oral steroids can prevent blindness.- - - - - - - - - - ranking = 2.7164835381451keywords = jaw (Clic here for more details about this article) |
7/50. Unhealed extraction sites mimicking TMJ pain.A case of unhealed extraction sites in the mandible is described, including clinical, radiographic, and biopsy findings. The subject was treated for TMJ disease in the past but still had related signs and symptoms and facial pain.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
8/50. Treatment of fibrous dysplasia of the mandible with radical excision and immediate reconstruction: case report.Monostotic fibrous dysplasia of the mandible is an unusual manifestation of the disease that is usually benign, occurs in young individuals, and is managed by conservative curettage or debridement. We present a case of persistent fibrous dysplasia complicated by pain and intraoral bony exposure that was successfully managed by radical resection and reconstruction with a free fibular flap. Although mandibular fibrous dysplasia is preferentially managed conservatively, treatment of this disease has evolved to a point where total excision and immediate reconstruction may be the treatment of choice and offer the best outcome.- - - - - - - - - - ranking = 5keywords = mandible (Clic here for more details about this article) |
9/50. Sympathetic activity-mediated neuropathic facial pain following simple tooth extraction: a case report.This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.- - - - - - - - - - ranking = 0.0017926876358041keywords = lower (Clic here for more details about this article) |
10/50. Enigmatic pain referred to the teeth and jaws.A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.- - - - - - - - - - ranking = 4.5274725635752keywords = jaw (Clic here for more details about this article) |
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