Case report of multiple implant failure in a patient with ankylosing spondylitis.

This report details a case of multiple implant failure (so-called 'cluster phenomenon') in a patient with ankylosing spondylitis and considers some factors for implant failure including reduced bone density. It highlights the relationship between ankylosing spondylitis and osteoporosis although no direct link is made between these conditions and the implant failures in this case.

Facial scoliosis--a diagnostic dilemma.

Facial scoliosis may be caused by frontal plagiocephaly or muscular torticollis. Determining the correct cause has implications for patient management. Past confusion in the literature has led to difficulty in determining appropriate treatment plans. The correct diagnosis may be readily obtained by using a series of clinical and radiological features peculiar to each condition. Four cases are shown demonstrating these diagnostic features.

Lymphangiomas of the tongue.

Lymphangiomas of the tongue are relatively uncommon developmental anomalies, which may present as either localised or diffuse lesions. Two cases are reported, and the literature reviewed.

Columella reconstruction in midline facial cleft: a case report.

Columella reconstruction in a case of midline cleft of lip alveolus and palate with nasomaxillary hypoplasia is described. The use of an Abbe flap to provide locally available tissue for reconstruction is discussed.

Acquired angioedema.

An unusual case of angioedema is presented. The initial presentation occurred at 84 years-of-age without a family history of this condition. Further investigation revealed an underlying lymphoproliferative disorder which was associated with an acquired deficiency of the complement component C1 esterase inhibitor. It is important to distinguish this condition from the hereditary form.

Basal cell carcinoma with hepatic metastases.

A case of metastatic basal cell carcinoma is presented which illustrates precisely the type of lesion most likely to metastasise to distant sites. The primary growth had been present for over 20 years at presentation, was in the middle third of the face, was widely invasive locally extending to involve bone, and was subject to repeated partially successful attempts at eradication. Histologically it was of the metatypical subtype. All are risk factors for metastasis of basal cell carcinoma which, in this case, eventually developed to the liver.

The effects of small plate osteosynthesis on postoperative radiotherapy.

Small plate osteosynthesis is becoming increasingly popular in reconstruction following ablative surgery for oral malignancies. In those cases where postoperative radiotherapy is to be included in the treatment it has been suggested that these plates may cause problems such as dose enhancement and tumour shielding and should therefore be removed prior to the radiotherapy. A physical method is described to assess the anticipated radiation dose changes at the tissue/plate interface both behind and in front of the plate. As a result of this assessment certain recommendations are made.

Atypical cervico-facial mycobacterial infections in childhood.

We describe three patients who presented with atypical mycobacterial infection. Although antituberculous drugs are ineffective, combination treatment with clarithromycin or amikacin and ciprofloxacin (with or without cotrimoxazole) leads to eventual resolution of the lesions. The treatment of choice, however, remains complete excision of the affected area which obviates the need for prolonged chemotherapy and minimizes the scarring which may otherwise develop after conservative treatment.

Multiple idiopathic external root resorption.

An unusual case of multiple idiopathic root resorption involving all of the maxillary and mandibular incisor, canine, and premolar teeth is presented. A review of the literature reveals that this case is unusual in that, although other cases of multiple idiopathic root resorption have been described, the site of the resorption has been at the cervical margin in most reports, not at the apices as in this case. In other reports in which the resorption did affect the apices, the resorption usually affected only one, two, or three teeth. The pattern of resorption in this case, affecting only teeth with deciduous precursors, appears to be unique.

Small plate osteosynthesis for mandibular reconstruction following osteotomy for tumor resection.

Cases have been presented that demonstrate the advantages of small plate ostesynthesis in the reconstruction of the mandible following resection of neoplastic disease. Mandibulotomies provide improved access to tumors and thus allow the tumor to be better excised. Prelocalization of the plates allows the precise reconstruction of the mandible following mandibulotomy with minimal morbidity and disturbance of function.

Implant-supported prosthesis in a child with hereditary mandibular anodontia: the use of ball attachments.

This report describes the provision of an implant-supported hybrid overdenture in an 8-year-old child with mandibular anodontia. An interdisciplinary approach to treatment planning was employed. Two implant fixtures were placed in the canine regions and ball attachments connected to provide support and retention for the prosthesis. There was only one implant-related complication during the first follow-up year. Close follow-up during the child's growing years is essential for the maintenance of the peri-implant tissues and to replace the prosthesis as mandibular growth occurs.