1/8. Congenital neutropenia. Report of a case and a biorationale for dental management.Congenital neutropenia is characterized by a marked decrease in or lack of circulating PMN's in children with no prior history of drug intake. The neutropenia is persistent and the clinical course is one of early onset of severe, recurrent, and eventually fatal infections. bone marrow studies show a maturation arrest of neutrophilic precursors. Because of their greatly increased susceptibility to infection, patients with congenital neutropenia present a difficult dental management problem. A case of congenital neutropenia has been presented, as well as a biorationale for dental treatment. On the basis of reports in the literature, the following recommendations for the management of patients with congenital neutropenia are made: 1. The prevention and control of infection and the interception of dental disease before surgical intervention becomes necessary should be the overriding considerations in the management of patients with congenital neutropenia. 2. The carious breakdown of teeth should be prevented by the daily application of a 0.4 per cent stannous fluoride gel in addition to oral hygiene and limitation of sucrose intake. 3. Periodontal therapy should be palliative only, since alveolar bone loss is progressive despite frequent oral hygiene instruction and prophylaxis. The goal of periodontal therapy for patients with congenital neutropenia should therefore be a decrease in gingival inflammation to make the patient's mouth more comfortable and to slow down alveolar bone loss. Periodontal surgery is contraindicated. 4. bacteremia and subsequent septicemia should be prevented since a minor infection can become life threatening in patients with congenital neutropenia. The patient should rinse for 30 seconds and the gingival sulci should be irrigated with a phenolated antiseptic mouthwash prior to all dental manipulations of the soft tissue. This will significantly reduce the incidence of bacteremia. 5. Surgery should be avoided if at all possible because of the high risk of post-operative infection. All surgery sholld be performed in the hospital, and the patient should be given antibiotics as determined by his physician. Primary closure should be done with fine polyglycolic acid sutures to reduce the chance of infection. If postoperative infection can be prevented, wound healing will progress normally despite the complete absence of PMN's.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. parietal lobe abscess after routine periodontal recall therapy. Report of a case.This paper reports on a case of a 70-year-old physician diagnosed with a parietal lobe abscess following such treatment. After stereotactic biopsy and drainage and a 6-week course of intravenous antibiotic treatment, the patient recovered with minimal neurologic deficits. Although brain abscesses are not commonly encountered in practice, clinicians must be aware of the potential virulence of the anaerobic components of the periodontal pocket and the possibility of resulting systemic infection, which can produce a life-threatening situation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Oral diseases in older adults.In the case presented, a 65-year-old man with multiple dental, medical, and social problems benefited from interdisciplinary assessment and treatment. Despite his poor oral-health status and oral-health behaviors upon admission, patient education and dental therapy resulted in improved daily oral hygiene, elimination of oral diseases, and improved oral function. The overall quality of life of any individual, particularly an older one, can be enhanced through oral-disease prevention, health promotion, and, when indicated, dental therapy. This patient was treated in a hospital environment with a well-established team approach to geriatric care. However, regardless of the care setting, the physician can play a key role in improving the oral health status and quality of life of older adults by including an oral screening examination as part of the periodic comprehensive geriatric assessment, recognizing oral pathology, requesting dental consultations and encouraging appropriate dental service utilization.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. Hematologic and surgical management of the dental patient with plasminogen activator deficiency.Anticoagulation therapy is used to treat patients with a variety of hemostatic disorders in an attempt to prevent thrombus formation. A thorough understanding of the patient's medical history is essential before dental treatment that may require alteration of this anticoagulation therapy. Alteration of anticoagulation therapy should be undertaken only after consultation with the patient's physician because some patients are at greater risk than others for thrombus formation or hemorrhage. This case of a 29-year-old man with plasminogen activator deficiency illustrates how consultation can result in a coordinated treatment plan for medical and dental management formulated to help ensure safe surgical treatment for these medically compromised patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. pseudotumor cerebri, a rare adverse reaction to tetracycline therapy. A case report.WITH THE MORE FREQUENT USE of antibiotics as adjuncts to periodontal therapy today, it is imperative that dental clinicians be aware of adverse reactions to these drugs, regardless of their reported incidence. It is the purpose of this case report to present and describe a rare adverse reaction to tetracycline hydrochloride called pseudotumor cerebri or benign intracranial hypertension. It is manifested by an abnormal increase in intracranial pressure and papilledema in a patient with an otherwise normal neuroradiologic condition. Although severe headache appears to be the most bothersome acute symptom, the more important long-term side effect is visual loss caused by the papilledema. Treatment should be directed towards discontinuation of the drug therapy, and immediate referral to a physician for a neuro-ophthalmic evaluation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Chronic urticaria associated with bacterial infection. A case of dental infection.In most cases of chronic urticaria, a specific etiology cannot be determined. This should not discourage the physician from continuing to search for its underlying cause. infection has long been considered a cause of urticaria, although the incidence is probably low when all other common causes are considered. A case of chronic urticaria of five years duration, which was associated with chronic extensive dental infection and periodontal disease, is presented to show the importance of infection as a trigger mechanism of urticaria.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. Periodontal and prosthetic treatment of a cleft lip and palate patient: a case report.Although cleft lip and palate patients are usually treated by a multidisciplinary team involving physicians and dentists, their periodontal condition may be over-looked. Crowded or malpositioned teeth, hypertrophic gingiva, orthodontic appliances, and prosthetic replacements can impede proper plaque removal and thus perpetuate periodontal disease. It is important to incorporate periodontal treatment into the comprehensive treatment as early as possible. This case report discusses the periodontal surgical procedures involved in eliminating a residual ridge defect and the fitting of the final prosthetic reconstruction. Also, the importance of the identification and management of periodontal conditions characteristic of cleft lip and palate patients before and after surgical, orthodontic, and prosthetic rehabilitation will be emphasized.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. Unusual presentation of cervicothoracic actinomycosis complicated by pericardial effusion: a case report.actinomycosis is a chronic-suppurative disease characterized by abscesses and draining sinus tracts, with fibrosis and granulation involving the face and neck and thoracic or pelvic-abdominal regions. Dermatological findings in patients at high risk are the key to the correct diagnosis. actinomycosis is frequently undiagnosed or misdiagnosed until the correct diagnosis is made after surgical resection. Alcoholic, homeless, and disadvantaged individuals and patients with other factors predisposing to infection including poor dentition, alcoholism, seizures, and trauma are common in the emergency department; thus, emergency physicians should be aware of the different presentations and complications of this disease. The treatment of choice is a high dose of penicillin in conjunction with surgical debridement. The prognosis is excellent with correct diagnosis and therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |