Prevention of self-mutilation in patients with Lesch-Nyhan syndrome: review of literature.

There have been no standard methods established to prevent the self-mutilation seen in LNS. Preventive treatment must be developed, therefore, for each patient based on clinical findings. The first method to be utilized should be a nonsurgical splint or mouth guard. If it proves to be unsuccessful then the benefits of surgical procedures should be considered. In the future, the use of medication, such as carbamazepine, may prove to restructure the current approach advocated by the literature today.

Hemostatic technique. Using a splint in oral bleeding.

Controlling hemorrhage from dental treatment in bleeding disorder patients is one of the most serious procedures encountered by the dentist. Local hemostatic techniques combined with replacement therapy are the usual management. A polyurethane stent as an adjunct therapy is beneficial in controlling hemorrhage. The hemostatic stent provides pressure at the surgical site and adequate protection.

Cervicofacial subcutaneous emphysema after lower root canal therapy.

Subcutaneous emphysema can occur when high-speed, air-cooled, rotary cutting instruments are used near open wounds and introduce air into subcutaneous or facial spaces of the face and neck. The case reported here describes an episode of cervicofacial subcutaneous emphysema after lower tooth root canal therapy.

Focal dermal hypoplasia. Goltz syndrome. A case report.

Focal dermal hypoplasia (Goltz syndrome) is a rare syndrome comprising developmental anomalies of tissues and organs of mesoectodermal origin. As a result, there are abnormalities of the eyes, skin, oral structures, musculoskeletal system and central nervous system. This article describes the case of a four-year-old female with focal dermal hypoplasia (FDH) who displayed many of the oral features associated with this syndrome. Her condition was complicated by recurrent episodes of facial cellulitis in relation to skin lesions of the face. This is an unusually severe case of FDH with previously unreported association of cutaneous anomalies and facial cellulitis.

Conservative management of a large odontogenic keratocyst.

Odontogenic keratocysts, although well recognized to have a high recurrence rate, are not invasive tumors and should not be treated by radical surgery with its attendant morbidity. A case report of successful management by fenestration for a time followed by successful enucleation suggests that conservative methods can be used in the treatment of large odontogenic keratocysts.

Use of oral premedicants in pediatric dental population.

Oral surgeons are frequently called upon to extract children's nonrestorable teeth. The procedure is often accomplished with either mask-induced general anesthesia or physical restraint with local anesthesia techniques. This article reviews many of the salient issues surrounding pediatric dental extraction and the techniques used for this procedure. It also highlights their difficulties. Special attention is paid to the pharmacology of midazolam and ketamine, and a protocol for dental extractions is defined.

Lymphangiomatous macroglossia. Medical and surgical treatment.

The case of an 8-year-old male diagnosed both clinically and histologically as having lymphangiomatous macroglossia is presented. It is a case that did not require surgical intervention as there were no functional or respiratory deficits. Cases in which there are deficits will require intervention as described.

The use of mucosal inserts.

Mucosal inserts increase the retention of any well-made denture but should not be attempted as a substitute for good prosthetic technique. They are especially useful with the trauma or cancer patient where functional anatomy has been altered. Final results of the patient's removable prosthesis will depend on mechanical, anatomical and psychological factors. The mucosal insert denture can satisfy the expectations of many of these patients, if the patients are informed and managed properly.

Simplified approach to use of electrical pulp tester.

The routine use of gloves as a barrier technique is recommended by the American Dental Association and the Centers for Disease Control. The use of the electrical pulp tester necessitates that the dentist contact the patient's skin or mucosa to complete the circuit. A technique is presented that simplifies the operation of the electrical pulp tester by the dentist wearing gloves. Advantages of this method include a sound barrier technique, an enhanced psychological benefit to the dentist, and an abatement in discomfort for the patient.