The effect of cryopreservation in liquid nitrogen at -196 degrees C for 1 week was studied by histometric analysis of 60 mature teeth replanted in 10 green Vervet monkeys. The effect of preincubation in enriched tissue culture medium was also investigated. 2 different freezing rates were compared, and the effect of stepwise equilibration of DMSO was studied as well as the effect of root canal treatment. The histometric analysis carried out 8 weeks after replantation revealed that if the cryoprotectant was equilibrated stepwise at room temperature, 10% DMSO had an even better cryoprotecting effect than previously shown by 5% DMSO equilibrated at 0 degree C. When this procedure was combined with a slow freezing rate of 0.3 degree C/min from -4 degrees C to -35 degrees C followed by plunging in liquid nitrogen, and supplemented by endodontic treatment before replantation, the amount of normal periodontal healing was almost similar to unfrozen and immediately replanted control teeth. Furthermore, this cryoprofile induced replacement resorption equal to the replanted control teeth. Preincubation in enriched medium for 24 h did not reduce resorption activity of the periodontal ligament. Endodontic treatment reduced the inflammatory resorption, demasking, however, hereby limited amount of ankylosis, that could be reduced by the above-mentioned cryoprofile. An optimal cryoprofile for mature teeth seemed to be slow equilibration at room temperature to a final concentration of 10% DMSO, slow freezing rates (0.3 degree C/min) and plunging in liquid nitrogen at -35 degrees C combined with fast thawing after storage at -196 degrees C, and followed by endodontic treatment after thawing.
The clinical presentation and histological features of peripheral ameloblastoma, occurring on the floor of the mouth in a 65-year-old male, are described. The lesion was surgically excised. All the classical features of peripheral ameloblastoma were seen in this patient.
The Hajdu-Cheney syndrome or acro-osteolysis syndrome is a rare disease. Only 18 well-documented cases are described in the literature. Presentation of cases in the oral surgical literature is rare. The syndrome is characterized by dissolution of terminal phalanges of the hands and feet, dolichocephaly, open cranial sutures, multiple wormian bones, absence of frontal sinuses, wide open sella turcica, progressive basilar invagination, early loss of teeth, short stature and characteristic facies. Inheritance is most likely autosomal dominant. 3 patients are presented, 2 of them are mother and son, the latter (case 2) being the youngest patient reported to date. The parents of the 3rd patient were consanguineous, raising the possibility of genetic heterogeneity. Dental, surgical and genetic aspects are discussed.
Psychological factors are involved in TMJ dysfunction but much previous research has tried to identify single personality factors. Multiple factors, however, are involved. These can be divided into 2 main groups: external social factors and the innate psychiatric state of the patient. The concepts involved and their measurement by life events and illness behaviour questionnaires are discussed. The clinical importance of this to the oral surgeon is emphasised, in relation to the patient who fails to respond to conservative therapy and for whom TMJ surgery is planned. Some of these difficult patients may be less well socially integrated than the majority of TMJ patients.
The ultrastructure of 10 lepromatous lesions in the face and the palatal mucosa after different duration and length of treatment was studied. Biopsies taken from patients who showed erythema nodosum leprosum (ENL) revealed different ultrastructural characteristics from those taken from 'burnt out' and non-medicated cases. Multiple secondary lysosomes were rarely seen in non-ENL cases. The presence of Mycobacterium leprae and an increased lysosomal activity in ENL reactive cases is interpreted as a reaction to the lysis of the cytoplasmic matrix of M. leprae; however, drug-specific (diaminodiphenylsulphone) reactions must also be considered.
The purpose of the present study was to identify factors which might influence the success of autotransplantation, such as root development, root resorption, pulp condition and tooth eruption. The material consisted of 100 human premolars transplanted in 87 patients. The observation period ranged from 3-18 years, with a mean value 6.3 years. Clinical and radiographic examinations were performed. The transplanted premolars were divided into 7 stages of root development. At the final control, 93 teeth remained and 7 teeth were extracted. Periodontal healing without root resorption was related to stage of root development. It decreased from 93% in teeth with 3/4 root development to 37% in teeth with fully developed roots. Inflammatory root resorption was seen in 7 cases and replacement root resorption in 12 cases. Pulp revascularization was observed in 100% in stages with initial root development to 1/2 root development and decreased to 0% for teeth with fully developed roots. Pulp obliteration was observed in all cases with revascularized pulp tissue. The gingival condition was similar to contralateral, not transplanted premolars or adjacent teeth. Root growth increased with the stage of root development at the time of transplantation. It is concluded that transplantation of premolars with 1/2-3/4 root development provides a good chance of pulp survival, limited risk of root resorption and ensures sufficient final root length, and is thus recommended.
Radionuclide imaging has been suggested as a means to assess healing and viability of bone grafts and implants. This study deals with the in vivo uptake of 99mTc-MDP in the initial postoperative period in rats. Isogeneic or xenogeneic bone was implanted in subcutaneous pouches. The isogeneic grafts and implants were treated with saline or freeze-treated or demineralized. The xenogeneic implants consisted of Kiel bone or collagen sponge. One day after surgery, the accumulation of 99mTc after an intraperitoneal injection of 99mTc-MDP was seen in all grafts and implants containing bone mineral independent of prior treatment of the graft and implant. In implants composed of only the organic part of bone, no accumulation was observed. One prerequisite for accumulation of 99mTc-MDP is the presence of the inorganic phase. Thus, the interpretation of the initial postoperative scan is based on whether or not the graft or implant initially contained mineral.
A rare case of a papillary cystadenoma, mucous-cell type, in the lower lip of a 73-year-old male is presented. The tumor consisted of many small cysts with multiple papillary projections into their cystic spaces. The projections and cyst walls were lined with pseudostratified mucous-cell epithelium. Clinically and histologically, the present papillary cystadenoma was considered as a true tumor originated from the ducts of minor salivary glands. There exists only one case report of a papillary cystadenoma with adequate description and photomicrographs in the Japanese dental literature.
Cherubism is a benign, hereditary giant cell lesion of the jaws, that appears in children as a bilateral painless swelling, between the ages of 2 and 5 years and progresses until puberty, when it spontaneously regresses. It normally requires no treatment. We had the chance to operate on a 5-year-old boy with cherubism 8 years ago, and used homogenous bone grafts to replace the diseased tissue to avoid pathological fracture of the mandible. Since then we have been following the patient, witnessing the gradual involvement of other sites in the jaws and the displacement of teeth and tooth germs.
Congenital epulis is not a common lesion. 2 rare neonatal multiple cases are reported. The treatment of choice of these lesions is radical excision during early infancy.
Experience with 31 mandibular fractures treated by intraoral open reduction techniques is reviewed and the techniques described. A 12.9% complication rate was experienced, no complication causing significant morbidity. Indications for intraoral open reduction are reviewed and the literature is discussed. The intraoral open reduction technique is a satisfactory treatment method for selected cases of fractures of the mandible.
A stereophotographic method for volumetric determination of the extraoral swelling after mandibular third molar removal is developed. The method error was 1.0 cm3. Compared to the size of the maximal swelling after removal of impacted wisdom teeth, this error is considerable. The technique can, however, be improved and furthermore applied to measurements of volume changes in other cranio-facial areas, as well as in other parts of the body.
The purpose of the present study was to identify factors which might influence the success of autotransplantion, such as root development, root resorption, pulp condition and tooth eruption. The material consisted of 100 human premolars transplanted in 87 patients. The observation period ranged from 3–18 years, with a mean value 6.3 years. Clinical and radiographic examinations were performed. The transplanted premolars were divided into 7 stages of root development. At the final control, 93 teeth remained and 7 teeth were extracted. Periodontal healing without root resorption was related to stage of root development. It decreased from 93% in teeth with ¾ root development to 37% in teeth with fully developed roots. Inflammatory root resorption was seen in 7 cases and replacement root resorption in 12 cases. Pulp revascularization was observed in 100% in stages with initial root development to ½ root development and decreased to 0% for teeth with fully developed roots. Pulp obliteration was observed in all cases with revascularized pulp tissue. The gingival condition was similar to contralateral, not transplanted premolars or adjacent teeth. Root growth increased with the stage of root development at the time of transplantation.
A case of injury to the facial nerve as a complication to sagittal split osteotomy is reported.
The aim of the study was to investigate the prevalence of previous clinical hepatitis B virus (HBV) infection and the prevalence of HBV markers in Danish oral surgeons, to estimate the annual HBV infection rate, and to assess whether the use of hepatitis B vaccine is to be recommended for this group. The total study population comprised 40 individuals occupied with oral surgery. A questionnaire and a request for a blood sample were sent to all dentists employed at the Danish hospitals and the departments of oral surgery at the 2 dental colleges. 36 (90%) answered a questionnaire, whereas only 27 (67.5%) had a blood sample taken for analysis of hepatitis surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis core antigen (anti-HBcAg), antibody to hepatitis A virus (anti-HAV), and serumtransaminases. One had been clinically ill from HBV infection and was positive for anti-HBs. The prevalence rate was thus 3.7% (95% confidence limits: 0.1%-19.0%) and the annual attack rate was 0.3%. The prevalence was not higher than among Danish dentists in general, and they are not considered a high-risk group in Denmark. Even with due statistical consideration to the present small sample, Danish oral surgeons do not seem to belong to a high-risk group like other surgeons in different medical specialities. It is concluded that the use of a hepatitis B vaccine is not recommended at present for this group of dentists.
A review of the literature suggests that traumatic bone cysts have been detected more frequently since the advent of panoramic radiography. Some authorities believe that these lesions may regress spontaneously without intervention within a period of time. Surgical exploration will enhance the bony repair of these cysts and is the usual recommended treatment. A case is reported in which complete regression of a traumatic bone cyst has occurred within 30 months of aspiration of its contents.
A long-term follow-up (7-2 years) of 152 patients who underwent a vestibuloplasty is presented. Special emphasis has been put on the condition of the graft, nerve disturbances and chin contour changes. As a result of this study, a mandibular vestibuloplasty procedure is recommended that has minimal side effects, and yet provides an adequate base on which to build a denture on.
Oral submucous fibrosis is defined as a collagen disease. The major immunoglobulin profile of 10 patients of oral submucous fibrosis (OSF) is estimated by radial immunodiffusion technique. The possible existence of autoimmune phenomena is expressed. It was observed in the present study that the severity of oral submucous fibrosis was directly proportional to the estimated elevated levels of major immunoglobulins. This may be taken as an indicator to know the gravity of this oral condition and also to evaluate the various related gammopathies and their possible management. It is anticipated that the knowledge of the immunoprofile would open new avenues for exploration of the condition from a new dimension.
