The influence of preoperative antibiotics on success of endosseous implants up to and including stage II surgery: a study of 2,641 implants.

According to the American College of Surgeons, complex oral surgical procedures, including the transoral placement of endosseous implants, are of the type that may require prophylactic antibiotics. However, the routine use of prophylactic antibiotics in the field of dental implantology continues to be controversial, and their utilization varies widely. No data from a randomized prospective clinical study of the prophylactic use of antibiotics in implant surgery have been previously published. As part of the comprehensive Dental Implant Clinical Research Group clinical implant study, the preoperative or postoperative use of antibiotics, the type used, and the duration of coverage was left to the discretion of the surgeon. These data were recorded and correlated with failure of osseointegration during healing (stage I) and at stage II surgery (uncovering). The results showed that significantly fewer failures occurred when preoperative antibiotics were used.

The influence of maxillary sinus augmentation on the success of dental implants through second-stage surgery.

An interim evaluation of the status of 102 implants placed in 42 augmented sinuses in 27 patients involved in an alternate category of the Dental Implant Clinical Research Group's long-term, randomized, prospective clinical investigation is presented. Autogeneic, allogeneic, and alloplastic sinus grafts were used, individually or mixed. Through second-stage surgery, 101 implants were found to be integrated. The mean Periotest value at uncovering was -3.36, with a standard deviation of 4.19. The results suggest that root form implants placed in augmented sinuses are successful through second-stage surgery, regardless of the augmentation material or implant design used.

Adult day services--the next frontier.

Even within the home care industry, the benefits of adult day care services may not be recognized. Yet the market in the changing health care system is ripe for their expansion. For home care, adult day care represents a logical addition to services as well as a good business opportunity.

Multiple oral petechiae and ecchymoses in a patient with osteoarthritis.

Ibuprofen is a frequently used medication, and possible drug reactions should be familiar to the clinician. Because oral manifestations of thrombocytopenia are often the initial finding and possibly represent the only clinical evidence of this disease, the dentist should be able to recognize the significance of these lesions and refer the patient for appropriate evaluation and therapy.

Multiple linear ulcers on the dorsum of the tongue in a patient with Waldenstrom's macroglobulinemia.

An unusual clinical presentation of an eosinophilic ulcer of the tongue has been described. This lesion is seen most often in the fourth to sixth decades of life and has been shown to have a strong predilection for males. The etiology is unknown although trauma has been implicated by several investigators. Because of the clinical resemblance of eosinophilic ulcer to carcinoma, biopsy examination is recommended. After the diagnosis is made, conservative management is most appropriate.

Case report. Disseminated sporotrichosis presenting as sarcoidosis: electron microscopic and immunologic studies.

A 50-year-old black man with constitutional symptoms, cutaneous nodules, and bilateral hilar adenopathy was found to have non-caseating granulomata on bronchial biopsy. He was treated with corticosteroids for sarcoidosis. Within five months he was found to have disseminated sporotrichosis. Electron microscopy revealed mycelial forms of S. schenckii in superficial lesions and yeast forms from deep tissue sites: no novel forms were seen. Blood mononuclear cell studies revealed hyperactive suppressor cells with respect to non-specific T cell targets and the antigen specific target. Examination of the initial biopsy material after digestion with diastase before PAS staining revealed budding yeast consistent with S. schenckii. This case emphasizes the need for careful histopathologic examination of clinical material before a diagnosis of sarcoidosis is made, and reveals an immunologic abnormality which may account for the patient's anergic state and susceptibility to S. schenckii infection.

Henoch-Schönlein purpura: report of case.

A case of Henoch-Schönlein purpura in a man has been presented. The patient was a typical candidate for the disease, with a history of major allergies and antecedent events of an upper respiratory infection and ingestion of at least two drugs previously implicated as etiologic agents. However, no specific allergen was identified and tests to verify it as an example of a circulating immune complex disease were not successful. The patient had many of the commonly found symptoms of HSP and additionally had the rare complications of both genital involvement and intraoral lesions. The disease ran its course in approximately eight weeks; there is little reason to believe that the patient will have a recurrence.