Extraoral cutaneous sinus tracts of dental origin in the paediatric patient. A report of three cases and a review of the literature.

BACKGROUND: An extraoral sinus of odontogenic origin within the face and neck region is normally the consequence of long-standing chronic infection due to caries, trauma or periodontal infection. There is little reported literature on the prevalence of extraoral cutaneous sinus lesions in the paediatric dental patient as presentation is often delayed resulting in misdiagnosis and consequential mismanagement. CASE REPORT: The cases discussed concentrate on the aetiology, history, presentation and diagnosis of extraoral sinus lesions that presented in children referred to the Child Dental Health Department at the University Dental Hospital of Manchester over a six-month period. CONCLUSIONS: The importance of correct diagnosis and treatment management of an extra oral cutaneous sinus in the paediatric patient only occurred when the child attended a specialist led paediatric dental clinic for consultation.

The use of a 'bleach-etch-seal' deproteinization technique on MIH affected enamel.

AIMS: To ascertain whether deproteinization pretreatment of molar-incisor hypomineralization (MIH) enamel affects resin sealant infiltration. DESIGN: Thirty one extracted MIH teeth were divided into three sections and randomly allocated into the Control (etch and FS), Treatment 1 (5% NaOCl, etched and fissure sealed), and Treatment 2 (5% NaOCl and fissure sealed with no etch) groups. Two hundred seventy nine sealant tag/enamel grade observations were recorded by scanning electron microscopy. RESULTS: Control and Treatment 1 were similar in their outcomes, and Treatment 2 was markedly different. There was no statistical evidence to suggest that there was any difference between Treatment 1 and the Control Treatment (95% CI, 0.52, 1.51; P = 0.6). There was a marked difference between Treatment 2 and the Control Treatment (95% CI, 0.07, 0.25; P < 0.001). All treatments also demonstrated a high-predicted probability of obtaining 'poor' sealant tags (Control = 47%, Treatment 1 = 49%, and Treatment 2 = 40%). CONCLUSIONS: The findings suggest that there was no significant difference in the tag quality between the conventional technique (Control) and the 'bleach-etch-seal' technique (Treatment 1). There was no benefit in pre-treating with NaOCl alone (without etch) before sealing. This research also showed that there was a high-predicted probability of obtaining 'poor' sealant tags in MIH enamel, regardless of which of the three treatments was used.

Cacogeusia following pine nut ingestion: a six patient case series.

This is a retrospective case series of 6 patients complaining of a bad taste (cacogeusia) specifically metallogeusia, following the ingestion of pine nuts.(1) The taste arose always within 48h of ingestion, and in all but one patient spontaneously resolved within 14 days. Pine nuts also have a potential for triggering anaphylaxis.(2).