Localized juvenile spongiotic gingival hyperplasia (LJSGH) represents a distinct subtype of inflammatory hyperplasia with a unique predilection for the anterior gingiva in children and adolescents. Lesions are typically refractory to improvements in oral hygiene and conventional periodontal therapies. The pathogenesis of LJSGH remains poorly understood, although derivation from exteriorized junctional epithelium is favored based on morphologic and immunophenotypic similarities between the two. The most common treatment is surgical excision and recurrences have been documented in 6% to 16.7% of cases. We describe a 9-year-old Caucasian female who presented for evaluation of several erythematous, finely granular lesions involving her anterior maxillary and mandibular gingiva. Her mother reported that she had noted the lesions two years prior, immediately before completion of phase one orthodontic therapy. The patient denied potential inciting events at the time of onset although moderate plaque accumulation was observed. An incisional biopsy revealed epithelial spongiosis with mild neutrophilic exocytosis overlying a richly vascularized and inflamed lamina propria, characteristic of LJSGH. Given the multifocality of the patients lesions and her thin tissue biotype, concerns were raised regarding the need for future connective tissue grafts should excisions be undertaken. Consequently, she elected to undergo laser ablation followed by a course of topical corticosteroids. She is without evidence of recurrence at one year. Management of multifocal LJSGH can be challenging, especially if lesions involve the marginal gingiva in the esthetic zone. A hybrid approach utilizing laser and topical corticosteroid therapy may be a therapeutic alternative in these cases.

Intimate partner violence (IPV) may affect one to four million individuals per year in the United States, with women accounting for the majority of both reported and unreported cases. Dental professionals are in a unique position to identify many types of IPV because injuries to the head and neck may be indicators or predictors of IPV abuse. Fewer than half of dental programs surveyed have reported having IPV-specific curricula, and most dental students surveyed have reported having little experience or training to recognize IPV. Based on this information, this pilot study sought to assess the awareness and beliefs regarding IPV among first-year dental students at the University of Nevada, Las Vegas. Using a voluntary survey, followed by a one-hour educational seminar facilitated by an experienced IPV/domestic violence advocate, a post-seminar survey was administered to assess changes in student perceptions and beliefs and to determine the magnitude and direction of any changes. The survey had an 81.25 percent response rate (65/80). The results demonstrated that more than two-thirds of the students had no previous IPV-specific education. In addition, approximately half of these students began the educational session reporting they did not believe IPV was a health care issue, although the overwhelming majority had decided it was when surveyed after the seminar. Moreover, their perceptions and beliefs about the responsibilities of the dental professional, as well as knowledge about resources and available support services, were significantly changed. These results suggest that targeted, information-specific seminars may be sufficient to provide dental students with an understanding of the key issues regarding IPV. With this knowledge, they can better provide specific information about resources and referrals for services to their patients who have experienced IPV. Recommendations based on these findings are being used to develop and refine IPV-specific curricula at this institution, which may be of significant value to other dental schools with plans to develop and integrate this material into their programs.

Coroners are public ocials, usually elected at the county level of government, whose principal duty is to inquire into the cause of any death, but especially those deaths that may not be due to natural causes. Most coroners are not required to have medical training. Medical examiners have replaced coroners in some jurisdictions. Medical examiners usually are physicians and oen have training in medicolegal death investigation, pathology, and forensic pathology. Medical examiner requirements vary from state to state (U.S. Department of Labor, 2012). Medical examiners generally have greater expertise in unnatural death1.4 Bitemarks and Bitemark Cases 27 1.4.1 William I of England, 1027-1087 27 1.4.2 George Burroughs and the Salem Witch Trials, 1692 27 1.4.3 Ansil L. Robinson Murder Trial, 1870 27 1.4.4 Doyle v. Texas, 1954 28 1.4.5 Public Prosecutor (Norway) v. Torgersen, 1958 28 1.4.6 Crown (Scotland) v. Hay, 1967 28 1.4.7 Illinois v. Johnson, 1972 29 1.4.8 California v. Marx, 1975 29 1.4.9 Illinois v. Milone, 1976 29 1.4.10 Florida v. Bundy, 1979 29 1.4.11 Florida v. Stewart, 1979 30 1.4.12 State of Wisconsin v. Robert Lee Stinson, 1984 30 1.4.13 Louisiana v. Willie Jackson, 1986 30 1.4.14 Oklahoma v. Wilhoit, 1987 30 1.4.15 Commonwealth of Pennsylvania v. Kunco, 1991 31 1.4.16 New York v. Roy Brown, 1992 31 1.4.17 Arizona v. Krone, 1992 and 1996 31 1.4.18 Michigan v. Moldowan and Cristini, 1991 32 1.4.19 Illinois v. Young and Hill, 1992 32 1.4.20 Mississippi v. Brewer, 1995, and Mississippi v. Brooks, 1992 32 1.4.21 West Memphis ree, 1994, Alford Plea 2011 33 1.4.22 New Jersey v. Jesse K. Timmendequas, 1997: Megan's Law 33 1.4.23 Massachusetts v. Edmund Burke, 1998 33 1.4.24 State of New York v. James O'Donnell, 1998 331.5 Age Estimation 34 1.5.1 Louis XVII "e Lost Dauphin," 1894 34 1.5.2 Massler and Shour, 1941 and 1944 34 1.5.3 Moorrees, Fanning and Hunt, 1963 34 1.5.4 Mincer, Harris and Berryman, 1993 34 1.5.5 King Tutankhamen, 2005 351.6 Abuse and Neglect 35 1.6.1 Mary Ellen Wilson, 1874 351.7 Forensic Odontology; Books and Chapters in Books 36 Acknowledgments 37 References 37investigations than do coroners (Hanzlick and Combs, 1998). e American Board of Pathology certies physicians who meet the criteria in anatomic and clinical pathology and in the subspecialty of forensic pathology. For some local and state jurisdictions, certication in forensic pathology is required. Some states have mixed medical examiner/coroner systems. At present, there are insucient numbers of board certied forensic pathologists to serve as medical examiners or coroners at every local level (Hanzlick, 2007).

AbstractClinical experience indicates that newly available portable hand-held x-ray units provide advantages compared to traditional fixed properly installed and operated x-ray units in dental radiography. However, concern that hand-held x-ray units produce higher operator doses than fixed x-ray units has caused regulatory agencies to mandate requirements for use of hand-held units that go beyond those recommended by the manufacturer and can discourage the use of this technology. To assess the need for additional requirements, a hand-held x-ray unit and a pair of manikins were used to measure the dose to a simulated operator under two conditions: exposures made according to the manufacturer’s recommendations and exposures made according to manufacturer’s recommendation except for the removal of the x-ray unit’s protective backscatter shield. Dose to the simulated operator was determined using an array of personal dosimeters and a pair of pressurized ion chambers. The results indicate that the dose to an operator of this equipment will be less than 0.6 mSv y−1 if the device is used according to the manufacturer’s recommendations. This suggests that doses to properly trained operators of well-designed, hand-held dental x-ray units will be below 1.0 mSv y−1 (2% of the annual occupational dose limit) even if additional no additional operational requirements are established by regulatory agencies. This level of annual dose is similar to those reported as typical dental personnel using fixed x-ray units and appears to satisfy the ALARA principal for this class of occupational exposures.

Operator exposure to backscatter radiation while using an Aribex (TM) NOMAD (TM) radiation emitting device (a portable, self-contained, cordless, hand-held dental X-ray unit) was determined while the operator employed various typical and atypical use scenarios during the exposure of 715 digital and/or film-based dental radiographs and 200 study control exposures. Study data was compared to the radiation safety occupational exposure annual Maximum Permissive Dose (MPD) of 50 mSv (5000 mrem) to determine the possible exposure risk to an unprotected operator using this device. The results showed the reproductive organs received the highest dose and the thyroid the least. The average operator whole body dose for the study was determined to be 0.047 mSv (4.47 mrem) or 0.09% of the annual MPD. Extrapolating the data as an expression of averaged annual operator exposure resulted in a whole body dose of 0.4536 mSv (45.36 mrem) or 0.9% of the annual MPD, These results are well below established occupation exposure limits and are compatible with those published by the manufacturer.