1/185. Management of mandibular fascial space infection of odontogenic origin. cellulitis is an acute, painful infection whose swelling is larger with diffuse borders. When palpated, early cellulitis can be very soft or doughfy; a severe cellulitis is almost always described as indurated or even as being "board-like". It can be innocuous in its early stages and extremely dangerous in its more advance, indurated, rapidly spreading stages. Randy, a 16 years old boy who thought that a regularly occurring toothache can advance into a life-threatening complication has a lot to be thankful for. The patient was referred to the pediatric dentistry Division by the E.R. doctors for further evaluation and management due to a swelling on the lower quadrant of his face. This was on the 8th day after he experienced the first pain on tooth no. 47. ( info) |
2/185. Chronic factitial ulcer of chin cured by endodontic (root-canal) surgery for underlying periapical abscess. In a determined search for the cause of a "factitial" ulcer of the jaw, consultation with 3 dentists was required before an underlying periapical abscess was discovered. Within 3 months of endodontic surgery, this ulcer of 12 years duration had completely healed and remains healed. Too often dental infection is neither suspected nor detected as a cause of skin disease. ( info) |
3/185. Surgical treatment of a periradicular lesion on an invaginated maxillary lateral incisor (dens in dente). The complex anatomy of invaginated teeth make their root canal treatment difficult. Moreover, this treatment may compromise the future of the tooth if it is destined to support a post-retained coronal restoration. This case reports the successful surgical root canal treatment of an invaginated tooth using a retrograde filling with gutta-percha. After surgical exposure of the root-end and cleaning of the root canal, the gutta-percha was compacted in the root canal which had been coated previously with a zinc oxide-eugenol cement. The gutta-percha was then cold-burnished. Periapical radiographic examination after 1, 2, 3, 6 and 12 months showed periapical healing with osseous formation. This procedure, resulting in minimal loss of hard tissues, permitted subsequent restoration of the tooth. ( info) |
4/185. Dentinal dysplasia type I: report of a case. A case of dentinal dysplasia type I is presented. This rare hereditary disturbance of dentine is characterized by short-rooted teeth with sharp conical apical constrictions, aberrant growth of dentine in the pulp chamber leading to reduced pulp space in permanent teeth and total pulpal obliteration in the primary dentition. Clinical, radiographic and histopathological material from a 7-year-old boy, showing the typical features of this disorder in which teeth are prematurely lost through periapical abscesses, cysts or spontaneous exfoliation, is described. A review of the theories of pathogenesis of this condition is included. Management of patients with dentinal dysplasia is difficult and a discussion of the shortcomings of various treatment strategies, including conventional endodontic therapy, periapical curettage and retrograde root filling, and a preventive regimen, are discussed. In this case, despite diagnosis being made at an early age and the provision of regular dental care, the patient is now losing teeth because of spontaneous abscess formation. ( info) |
5/185. diagnosis and treatment of cutaneous facial sinus tracts of dental origin. BACKGROUND: Cutaneous draining sinus tracts of dental origin often are a diagnostic challenge. A delay in correctly diagnosing these types of lesions can result in ineffective and inappropriate treatment. CASE DESCRIPTION: The authors present five cases of facial lesions that were initially misdiagnosed as lesions of nonodontogenic origin. The correct diagnosis in each case was cutaneous sinus tract secondary to pulpal necrosis and suppurative apical periodontitis. All facial sinus tracts resolved after the patients received nonsurgical root canal therapy. CLINICAL IMPLICATIONS: As patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, possible dental etiology may be overlooked. Early correct diagnosis and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment. ( info) |
6/185. Recalcitrant acne vulgaris secondary to a dental abscess. This case report describes a middle-aged man with acne that was recalcitrant to numerous medications, including three courses of isotretinoin. His condition cleared after an infected tooth was removed and recurred when another tooth became carious. acne vulgaris is associated with several immunologic responses including the production of antibodies against propionibacterium acnes, the gram-positive bacteria found in acne lesions. We believe that the presence of our patient's dental infections provoked a follicular inflammatory response resulting in his recalcitrant acne. ( info) |
7/185. A dentoalveolar abscess in a pediatric patient with ketoacidosis caused by occult diabetes mellitus: a case report. oral health professionals are frequently asked to evaluate patients with routine odontogenic infections. These patients can sometimes present with systemic signs and symptoms, including fever, malaise, tachycardia, and dehydration. It is important for the astute clinician to understand the possible associated systemic diseases that may be contributing to odontogenic infections. We present here an interesting case of a pediatric patient with a routine canine space infection who exhibited classic clinical signs and symptoms of diabetic ketoacidosis. ( info) |
| A severe case of ludwig's angina which was treated along the historical lines of surgical decompression is presented. The problem resulting from this approach are discussed together with alternative methods of management. The conclusion is made that surgical decompression as a means of avoiding respiratory obstruction should be abandoned and that tracheotomy should be used. ( info) |
9/185. Metastatic melanoma of the maxilla presenting as a gingival swelling. Malignant melanoma metastatic to the gingiva has been reported only once. We present a case in which the occurrence of melanoma in the gingiva followed extraction of a periapically "abscessed" tooth. Since the initial periapical mass may well have been a metastatic tumor, particularly in a patient undergoing therapy for disseminated malignant disease, the need for biopsy of such lesions is emphasized. ( info) |
10/185. Gingival metastasis from a medullary thyroid carcinoma: case report. BACKGROUND: Metastatic tumors to the oral cavity are rare, representing about 1% of oral tumors, and they affect jaws more often than the oral soft tissues. methods: Fifteen cases of metastases to the jaw bones from thyroid carcinoma were found in a recent review, with no cases located in the oral mucosa. RESULTS: The authors describe the first cases of gingival metastasis from a thyroid medullary carcinoma. CONCLUSIONS: Periodontists must recognize oral soft tissue metastases because they can be the first sign of an undiscovered malignancy, and they can be easily mistaken with several different benign lesions. ( info) |