Foreign-body (silica) granuloma of the lip.

A foreign-body granuloma may occur in the lip secondary to traumatic implantation of dirt and sand. Several recommendations for the clinician encountering such contaminated wounds follow. Debridement of the wound and copious flushing are of primary importance as a preventive measure. The patient should be informed of possible sequelae and advised to seek treatment if nodules occur in later years. The development of a granulomatous response necessitates initial surgical intervention to establish the histologic diagnosis; however, repeated surgical procedures are not indicated unless subsequent enlargements cannot be resolved by intralesional injection of steroids. Last, it must be emphasized that a histologic diagnosis of a granulomatous lesion obligates the oral and maxillofacial surgeon to request additional studies to rule out a systemic involvement.

Unusual management problems in the treatment of a long-standing destructive periapical cyst. Report of a case.

A case report is presented in which an orthognathically compromised patient presented with a destructive periapical lesion that caused resorption of first and second molar roots and buccal and palatal cortical plates. The initial diagnosis and treatment were influenced by the absence of pre-existing dental records and an unrecountable dental history. Unusual endodontic management problems were encountered when copious intracoronal fluid, determined to be saliva, continually flowed through the open canals via a periodontal defect. The pathology report described the rare finding of large portions of fibrous scar tissue, indicating that some healing had occurred prior to treatment.

Facial hemihypertrophy associated with nevus unius lateris syndrome.

A review of the clinical characteristics and etiologic theories of nevus unius lateris and associated facial hemihypertrophy is presented. A case report with significant medical and dental findings is discussed in light of the significant social and physical impairment resulting from oral hemihypertrophy and other physical deformities.

Cheilitis glandularis.

A case of cheilitis glandularis simplex occuring in a 65-year-old white man is presented. The condition is characterized by an everted lower lip, with enlarged labial salivary glands secreting a clear, thick mucus. A history of sun exposure, dry atrophic lip, and histologic findings of epithelial dysplasia, sclerosed glands, markedly dilated ducts, chronic inflammation, and basophilic degeneration of collagen indicate a solar etiology. Surgical excision by vermilionectomy gave excellent results. A high incidence of severe epithelial dysplasia and squamous cell carcinoma associated with cheilitis glandularis indicate surgery as the treatment of choice.

Clinical criteria in diagnosis of early squamous cell carcinoma of the lower lip.

Squamous cell carcinoma of the lower lip may be unsuspected and undiagnosed in its early clinical stages and may appear in occult and noncharacteristic forms. Specific risk factors and characteristics of lesions were sought after clinical and histologic data were correlated in a survey of patients with precancerous and cancerous lesions of the lower lip.

Malignant hyperthermia. Report of two cases.

A dentist using local or general anesthetics must be cognizant of the possibility of malignant hyperthermia presenting as a catastrophic emergency. The purpose of this article is to describe the syndrome of malignant hyperthermia, to emphasize its early clinical symptoms, and to outline definitive treatment. Two cases of malignant hyperthermia in pediatric dental patients illustrate the clinical and laboratory features and the appropriate therapy.

The effect of topical antihistamine on the initial pulpal inflammatory response of monkey teeth.

Cavity preparations were made in sixty sound teeth of healthy monkeys. Thermal trauma was delivered to the pulps of all teeth through application of a heated soldering iron to the floor of a cavity preparation. Fifteen teeth were randomly designated as controls and were restored immediately with zinc oxide and eugenol. Forty-five teeth were designated as test teeth. These were treated topically with a 4 per cent antihistamine solution and restored with zinc oxide and eugenol. Histologic sections were prepared to show the effect of the antihistamine on the thermally initiated inflammatory response during the postoperative period. No significant difference was observed in the inflammatory reactions of treated or untreated pulps. A 4 per cent aqueous solution of topically applied antihistamine did not appear to be of any significant value in obviating pulpal inflammation.