Complicated late mandibular fracture following third molar removal.

Mandibular fractures are a rare complication after third molar removal. Symptoms show a wide variance. Treatment options range from prescription of a soft diet to surgical treatment by open reduction and internal fixation. This article describes a patient who presented a late mandibular fracture following third molar removal. The fracture was not detectable in radiographs at the time of fracture. Six weeks after the reported cracking noise, the patient presented a mandibular fracture with associated osteomyelitis. Treatment by open reduction and internal fixation and autologous iliac crest graft was performed via a submandibular approach. The delayed diagnosis of this pathologic fracture demonstrates the necessity of repeated radiologic controls to prevent osteomyelitis when a fracture is suspected.

Aerosolized BC-819 inhibits primary but not secondary lung cancer growth.

Despite numerous efforts, drug based treatments for patients suffering from lung cancer remains poor. As a promising alternative, we investigated the therapeutic potential of BC-819 for the treatment of lung cancer in mouse tumor models. BC-819 is a novel plasmid DNA which encodes for the A-fragment of Diphtheria toxin and has previously been shown to successfully inhibit tumor growth in human clinical study of bladder carcinoma. In a first set of experiments, we examined in vitro efficacy of BC-819 in human lung cancer cell-lines NCI-H460, NCI-H358 and A549, which revealed >90% reduction of cell growth. In vivo efficacy was examined in an orthotopic mouse xenograft lung cancer model and in a lung metastasis model using luminescent A549-C8-luc adenocarcinoma cells. These cells resulted in peri- and intra-bronchiolar tumors upon intrabronchial application and parenchymal tumors upon intravenous injection, respectively. Mice suffering from these lung tumors were treated with BC-819, complexed to branched polyethylenimine (PEI) and aerosolized to the mice once per week for a period of 10 weeks. Using this regimen, growth of intrabronchially induced lung tumors was significantly inhibited (p = 0.01), whereas no effect could be observed in mice suffering from lung metastasis. In summary, we suggest that aerosolized PEI/BC-819 is capable of reducing growth only in tumors arising from the luminal part of the airways and are therefore directly accessible for inhaled BC-819.

Diplopia and acute rectus muscle palsy as symptoms of an infected follicular cyst of a maxillary right third molar: a case report.

Severely impacted third molars have a high risk of developing a dentigerous cyst. Dental cysts in the maxilla can cause acute infection of the maxillary sinus that can involve the orbital cavity. Possible complications of infections of the orbital cavity are eyesight reduction, including blindness, and disseminated infections, including brain abscesses. This article reports on a 53-year-old male patient with diplopia caused by acute rectus inferior muscle palsy as symptoms of an empyema of the maxillary right sinus. An infected follicular cyst due to the impacted and displaced maxillary right third molar caused the empyema. An emergency trepanation with drainage of the right maxillary sinus was performed. Additionally, intravenous antibiotic therapy with penicillin G and metronidazole resulted in improvement. In a secondary surgical process 2 weeks later, the cyst and the third molar were removed. Complete recovery was noted. It is important to be familiar with clinical diagnostics in cases of undefined pain of the teeth and jaws. Radiographic imaging is indicated in such cases. Disseminated odontogenic infections must be considered as the primary origin of pain and diplopia.

Case report: brain and liver abscesses caused by oral infection with Streptococcus intermedius.

Organ abscesses are a rare and life-threatening complication mostly of hematogenously disseminated infections. We report a case of brain and liver abscesses. Identification of the lesions was made by contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), respectively. An oral examination comprised an oral focus of infection. Streptococcus intermedius was isolated from oral smear, liver and ventricular drainage, and blood sample. After the commencement of antibiotic therapy, drainage of abscesses and oral rehabilitation, complete recovery was noted.