1/35. A five-year-old with a dental abscess: a case study.dental caries remain one of the most common disorders of childhood in the United States. Often nurse practitioners (NPs) will see children who are suffering from the complications of a dental carie, such as a dental abscess and/or cellulitis. This article describes the case of a 5-year-old girl who presented at an evening clinic with tooth pain, fever, and facial swelling. Three treatment choices are discussed: (1) 400 mg of amoxicillin (Augmentin), by mouth, with comfort measures, and return to the clinic in the morning; (2) 2 g of ceftriaxone by injection, with comfort measures, and return to the clinic in the morning; (3) or hospitalize via emergency department for intravenous fluids and antibiotics. The treatment that was chosen not only takes into account the disease process, but also the impact of this choice on the family. A model for the progression of dental caries in low-income groups with recommendations for prevention is also presented.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/35. 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 = 2keywords = mouth (Clic here for more details about this article) |
3/35. Greening of the tooth-amalgam interface during extended 10% carbamide peroxide bleaching of tetracycline-stained teeth: a case report.At-home bleaching with 10% carbamide peroxide in a custom-fitted tray has been shown to have some minor effects on certain brands of amalgam, pertaining to mercury release, but generally, effects on amalgam are not considered clinically significant. However, in this case report, a greening of the tooth structure in certain areas immediately adjacent to amalgam restorations in the maxillary and mandibular first molars occurred during tooth whitening. Other amalgam restorations in mandibular and maxillary second molars in the same mouth did not demonstrate any green discoloration of the teeth. Upon removal of the affected amalgam restorations, recurrent decay was present in the areas of tooth greening but not in other areas adjacent to the restoration. The teeth were restored with posterior composite restorations. Whether the green discoloration was a result of some loss of material from a particular brand of amalgam, indicating leakage, or indicative of original or recurrent tooth decay is unclear in this single-patient situation. Other patients in the same study did not demonstrate this occurrence. dentists should be ready to replace amalgam restorations should this green discoloration in adjacent tooth structure occur during bleaching, in case decay is present. CLINICAL SIGNIFICANCE: The unusual discoloration cited suggests that amalgam restorations in potentially esthetic areas, including the lingual of anterior teeth, should be replaced prior to bleaching, to avoid the problem of difficult stain removal or translucency allowing restoration visibility following bleaching.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
4/35. Juvenile dermatomyositis: literature review and report of a case.dermatomyositis is a rare disease of unknown origin, which affects both children and adults. In the juvenile form, dermatomyositis is a multisystem disease, characterized by myositis; an erythematous rash over the bridge of the nose, around the eyes, and on the trunk and limbs; vasculitis; and dilatation of the capillaries in the nail beds and gum margin. Late development of calcinosis is seen in approximately two-thirds of the patients. This case describes a 5-year-old dental patient diagnosed with dermatomyositis. This article includes the clinical manifestations of dermatomyositis in the body and in the oral cavity as well as the considerations that should be taken when treating these patients.- - - - - - - - - - ranking = 2.121789855957keywords = oral cavity, cavity (Clic here for more details about this article) |
5/35. alopecia areata of dental origin.The association of alopecia areata and infectious foci of dental origin is relatively common, and may be explained by the autoimmune nature of the disorder. We describe a case of alopecia areata with no apparent cause and that was effectively resolved by eliminating a focalized dental infection via endodontic treatment. The presence of common immune mediators in the pathogenesis of both alopecia areata and dental infection could account for the dental origin of the hair loss. In this sense, patients with localized alopecia should be subjected to careful exploration of the oral cavity in search of possible dental infections.- - - - - - - - - - ranking = 2.121789855957keywords = oral cavity, cavity (Clic here for more details about this article) |
6/35. Etiopathogenic analysis of the caries on three patients with noonan syndrome.INTRODUCTION: noonan syndrome is a genetic disease frequently characterized by short height, winged neck and a thoracic defect, among other alterations. However, there are no reports that mention oral health complications. In this article three children are presented with this syndrome in which multiple caries are observed, determining in each case which factors increase their susceptibility to caries. CLINICAL CASES: 1. A 4 year old girl who suffered neonatal sepsis, pyelocalyceal ecstasia, congenital hypertrophic pyloric stenosis, cardiopathy, hypoacusia and psychomotor delay. Presented multiple cavitated caries, requiring the extraction of the 4 incisors. 2. A 4-year-old boy afflicted with myocardiopathy pyelocalyceal ecstasia and psychomotor delay. Exhibited multiple cavitated caries of atypical locations. 4 incisors were extracted and replaced with preformed crowns. 3. A 9-year-old boy affected with plagiocephaly, laryngomalasia, hiatal hernia, urinary infections and psycho-motor delay. Presented multiple profound and extensive caries, which needed pulp treatment and preformed crown placement. DISCUSSION: The caries in all three patients were similar and of rapid progression. The most relevant factors were: reflux and vomiting of 2 of the patients and continuous and prolonged ingestion of fruit juices of the other. In all three of them there was abnormal exposure to both intrinsic and extrinsic acids in the oral cavity, so as muscular hypotony and psychomotor deficiency that hindered the autoclisis and oral hygiene. It is inferred that in all 3 cases the initial pathology was a description of demineralization of chemical origin concordant to dental erosion, upon which an immediate colonization of microorganisms arose, accelerating tissue destruction. It is concluded that the systemic and familial conditions of children with noonan syndrome favor erosion and the establishment of caries that are potentially harmful foci, of which adequate and preventive measures should be implemented.- - - - - - - - - - ranking = 2.121789855957keywords = oral cavity, cavity (Clic here for more details about this article) |
7/35. Cariostatic and ultraconservative sealed restorations: six-year results.The objective of this clinical study was to determine the ability of an ultraconservative, sealed composite resin restoration, without a traditional cavity preparation and without the removal of the carious lesion, to arrest Class I caries. tooth preparation was limited to placing a bevel in the enamel. These restorations were compared, over 6 years, with (1) ultraconservative, localized, sealed amalgam restorations with no extension for prevention and (2) traditional, unsealed amalgam restorations with the usual extension for prevention outline form. Caries was arrested by the ultraconservative, sealed composite resin restorations for 6 years. Complete sealant retention on the sealed amalgam restorations was somewhat lower than that on the sealed composite resin restorations; conversely, partial sealant retention was higher for the sealed amalgam group. The marginal integrity of the sealed amalgam restorations was significantly superior to that of the unsealed amalgam restorations. The sealant also protected Class I posterior composite resin restorations against wear.- - - - - - - - - - ranking = 0.12332168579102keywords = cavity (Clic here for more details about this article) |
8/35. Primary sjogren's syndrome.Columbia University's Salivary Gland Center (SGC) has examined more than 6,000 patients with a variety of concerns stemming from salivary gland disease and/or salivary secretory dysfunction. Not unexpectedly, the most common patient complaint centers around symptoms associated with dry mouth. Such patients are usually first seen by the dental practitioner. Because sjogren's syndrome (SS) causes dry mouth, and because it is a relatively common entity--encountered in about three million Americans--and because the dental profession has become aware of its classic manifestation of xerostomia, patients experiencing SS are referred in increasing numbers to the SGC for evaluation. Therefore, the authors wish to call attention to the methodology used in accurately diagnosing SS and to illustrate its signs and symptoms with a case report.- - - - - - - - - - ranking = 2keywords = mouth (Clic here for more details about this article) |
9/35. The dentofacial features of Sanjad-Sakati syndrome: a case report.Sanjad-Sakati syndrome is an autosomal recessive disorder that was first reported by Sanjad et al. in 1988. It is characterized by congenital hypoparathyroidism, severe growth failure and dysmorphic features. The clinical features include deep set eyes, microcephaly, thin lips, depressed nasal bridge with beaked nose, external ear anomalies and learning difficulties. This report presents the case of a 4-year-old patient who was referred to our dental clinic because of pain in her mouth and poor dental health. Oral findings included micrognathic mandible and maxilla, microdontia, enamel hypoplasia as well as severely decayed teeth. Treatment was carried out under general anaesthesia to extract the most severely affected teeth and restore those which could be conserved. It was concluded that these patients have special dental needs; early diagnosis of the affected children is therefore important in order to commence preventive dental therapy and carry out appropriate dental treatment at the optimum time.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
10/35. Treatment options for the occlusal surface of first permanent molars.Restorative dentistry has been increasingly concerned with preservation of the dental structure. For that reason, ultraconservative cavity preparations have been performed with air abrasion systems. The aim of this study was to present treatment options for the occlusal surface of first permanent molars with employment of the conventional method and the air abrasion system for accomplishment of the cavity preparation and a composite occlusal matrix for an accurate reproduction of the tooth surface.- - - - - - - - - - ranking = 0.24664337158203keywords = cavity (Clic here for more details about this article) |
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