Pedunculated Natal Tooth: A Case Report.

Natal teeth are teeth present at birth and are a rare finding. They most commonly occur in the mandibular incisor region and are thought to occur as an accelerated premature growth of normal primary teeth. They may present in the varying stages of tooth eruption and rarely on a pedunculated stalk of alveolar mucosa as described in this case. Natal teeth may be surgically extracted if difficulty feeding or ventral tongue ulceration develops. This report presents the case of an unusual pedunculated natal tooth in a newborn at a community hospital and describes its surgical management.

Miniplate Fixation to an Edentulous Mandibular Fracture in Panfacial Trauma.

A 70-year-old edentulous male presented with bilateral mandible and left midface fractures following an assault. Imaging confirmed fractures and showed mandible thickness greater than 20 millimeters. The patient was treated by open reduction internal fixation with miniplates via an intra-oral approach and recovered without deficit. While miniplate fixation and an intra-oral approach is typically reserved for the dentulous patient, this case illustrates that in select edentulous patients with sufficient bone thickness and amenable midface fractures this technique may be successfully utilized.

Chromatographic performance of microfluidic liquid chromatography devices: Experimental evaluation of straight versus serpentine packed channels.

We prepared a series of planar titanium microfluidic (µLC) columns, each 100 mm long, with 0.15, 0.3 and 0.5 mm i.d.'s. The microfluidic columns were packed with 1.8 µm C18 sorbent and tested under isocratic and gradient conditions. The efficiency and peak capacity of these devices were monitored using a micro LC instrument with minimal extra column dispersion. Columns with serpentine channels were shown to perform worse than those with straight channels. The loss of efficiency and peak capacity was more prominent for wider i.d. columns, presumably due to on-column band broadening imparted by the so-called "race-track" effect. The loss of chromatographic performance was partially mitigated by tapering the turns (reduction in i.d. through the curved region). While good performance was obtained for 0.15 mm i.d. devices even without turn tapering, the performance of 0.3 mm i.d. columns could be brought on par with capillary LC devices by tapering down to 2/3 of the nominal channel width in the turn regions. The loss of performance was not fully compensated for in 0.5 mm devices even when tapering was employed; 30% loss in efficiency and 10% loss in peak capacity was observed. The experimental data for various devices were compared using the expected theoretical relationship between peak capacity Pc and efficiency N; (Pc-1) = N0.5 × const. While straight µLC columns showed the expected behavior, the devices with serpentine channels did not adhere to the plot. The results suggest that the loss of efficiency due to the turns is more pronounced than the corresponding loss of peak capacity.

Characterization of low-temperature cofired ceramic tiles as platforms for gas chromatographic separations.

A gas chromatography (GC) column is fabricated within a low-temperature cofired ceramic (LTCC) tile, and its analytical properties are characterized. By using a dual-spiral design, a 100 µm wide square channel up to 15 m in length is produced within an 11 cm × 5.5 cm LTCC tile. The channel is dynamically coated with an OV-101 stationary phase that is cross-linked with dicumyl peroxide. While the uncoated LTCC tiles were able to separate a mixture of n-alkanes, the peak shapes were broad (base width of ~2 min) and tailing. In contrast to this, the coated LTCC tiles produced sharp (base width of ~8-10 s), symmetrical, well-resolved peaks for the same analytes. By using a 7.5 m long channel, about 15,000 plates were obtained for a dodecane test analyte. Further, the coated LTCC tiles were found to produce plate heights that were about 3-fold smaller than those obtained from a conventional capillary GC column of similar length, dimension, and coating operated under the same conditions. As a result, test analyte separations were slightly improved in the LTCC tiles, and their overall performance fared well. In terms of temperature programming, it was found that a series of n-alkanes separated on the LTCC tile provided a cumulative peak capacity of around 54 peaks when using C8 to C13 as analyte markers. Results indicate that LTCC tiles provide a viable and useful alternative platform for performing good quality GC separations.

Severe deformational plagiocephaly: long-term results of surgical treatment.

INTRODUCTION: Deformational plagiocephaly (DP), a benign infantile condition, is often thought to improve spontaneously but can in fact lead to permanent skull asymmetry if left untreated. Deformational plagiocephaly can be completely corrected by nonsurgical treatments if recognized in the first year of life. Nevertheless, efficacy of these treatments drastically diminishes after 9 months as the calvaria thickens. Beyond 15 months, if the asymmetry is severe, surgical remodeling becomes an option. In this study, we analyzed the surgical morbidities and the morphologic outcome of surgical remodeling in DP. METHODS: This study was designed as a retrospective analysis of a craniofacial database combined with an outcome study. Between January 1992 and August 2006, 2363 occipital DP cases were treated by repositioning. Thirty patients were operated on, always after the age of 15 months (1.23%). Mean (SD) age at the time of the first clinic was 19.2 (± 5.8) months (range, 11-34 mo). A switch cranioplasty (A) was first used, progressively replaced since 1995 by a large occipital monobloc graft rotated 180 degrees and fixed with tongue-in-groove pillars (B). Morbidities were extracted from the database. Long-term morphologic outcomes were evaluated during a free clinic visit with a 4-point Likert-type outcome scale. RESULTS: Mean (SD) age at the time of surgery was 20.2 (± 5.6) months. Incidents (dural tears or venous sinus breaches) occurred in 28% (A) and 36% (B) or patients. One complication required repeat operation (extradural hematoma). No cerebrospinal fluid leaks and/or meningitis were recorded. Mean (SD) hospital stay was 5.3 (± 0.95) days. There was no statistical difference in the long-term morphologic outcome between the 2 groups (median of group A being "good but still visible"; median of group B being "excellent, unnoticeable"). CONCLUSIONS: Surgical correction of DP is a potentially life-threatening procedure, which should be indicated only in very severe cases, after exhaustion of all other nonsurgical methods, in a reference craniofacial center combining pediatric neurosurgery and plastic surgery.

Scaphocephaly part II: Secondary coronal synostosis after scaphocephalic surgical correction.

AIM: Occurrence of secondary coronal synostosis (SCS) and its functional consequences were retrospectively analyzed in sagittal synostosis. PATIENTS AND METHODS: Occurrence of SCS and/or fingerprinting and clinical signs of raised intracranial pressure were investigated in children with scaphocephaly with a minimum follow-up of 3 years. Children were divided in 4 groups according to surgery (group 1: "H" craniectomy [193 patients]; group 2: craniectomies with removal of the coronal sutures [24 children]; group 3:"H" craniectomies and flap transpositions without total removal of the coronal suture [36 patients]; and group 4: 253 nonsurgical patients with scaphocephaly). RESULTS: Among group 1, 20 (10.4%) developed SCS (3 mo to 6 y postoperatively). Fingerprinting was generalized in 13 patients, localized in 5, and absent in 2. Headaches were present in 8 patients. Papilledema appeared during follow-up in 2 of them. Intracranial pressure that was first recorded as normal became elevated, and they both required a surgical decompression. In group 2, none developed an SCS. In group 3, 11% developed SCS. In group 4, 1.2% nonsurgical patients with scaphocephaly presented with an SCS. However, group 4 corresponds to less severe morphologic deformation and/or parents refusing surgery. CONCLUSIONS: Secondary coronal synostosis appears to occur with an approximate 10% incidence after craniectomies not involving the coronal sutures, with 1% requiring surgical decompression. Patients with milder forms of scaphocephaly who were not operated on (1.2%) rarely developed an SCS. Long-term follow-up should be undertaken even in the milder forms for possible recurrence of secondary synostosis.