Dental age estimation based on third molar eruption in First Nation people of Canada.

Forensic age estimation of living subjects has become an increasing focus of interest in modern society. One main criterion for dental age estimation in the relevant age group is the evaluation of third molar eruption. The importance of ethnic variation in dental development requires population specific data for dental age evaluation. In the present study, we determined the stages of third molar eruption in 347 female and 258 male First Nations people of Canada aged 11 to 29 years based on radiological evidence from 605 conventional orthopantomograms. The results presented here provide data on the age of alveolar, gingival, and complete eruption of the third molars in the occlusal plane that can be used for forensic estimation of the minimum and most probable ages of investigated individuals.

Benign cementoblastoma: a case report.

The case of a 23-year-old with a benign cementoblastoma is presented. The clinicopathologic features, treatment and prognosis are discussed and a brief review of the literature is presented. Although this neoplasm is rare, the dental practitioner should be aware of the clinical features that will lead to its early diagnosis and treatment.

Drug use for the pregnant or lactating patient.

The dental patient who is pregnant or lactating may require management involving the administration or prescription of drugs. The approach of completely avoiding all drugs may not permit appropriate treatment of the patient and most often is not warranted. This article reviews the current considerations in the use of drugs in the dental patient who is either pregnant or lactating. The safety of the local anesthetics, vasoconstrictors, analgesics, antimicrobials, and sedatives used in dentistry is discussed.

Presence of impacted teeth as a determining factor of unfavorable splits in 1256 sagittal-split osteotomies.

OBJECTIVES: The purpose of this study was to determine the incidence of unfavorable mandibular fracture in sagittal-split osteotomies in the presence or absence of impacted third molar teeth. STUDY DESIGN: This retrospective study evaluated 1256 mandibular sagittal-split osteotomies in two groups of patients: Group I had impacted third molar teeth removed during sagittal-split osteotomy; in Group II, the third molar teeth had been removed at least 6 months before the sagittal-split osteotomy. Statistical testing consisted of chi-square analysis of contingency table for p < 0.05. RESULTS: In 1256 mandibular sagittal-split osteotomies there were 24 (1.9%) with unfavorable fractures. Five of 24 occurred when third molar teeth were removed at the time of osteotomy and 19 of 24 mandibular fractures occurred when no impacted third molar tooth was present at the time of osteotomy. However, no significant difference was demonstrated between the groups. CONCLUSION: The result of this study suggests that mandibular fractures may occur with greater frequency when the impacted third molar teeth have been removed at least 6 months before sagittal-split osteotomy as compared with that when third molar teeth are removed concomitant with sagittal-split osteotomy.

Management considerations for the pregnant or nursing emergency patient.

It is important to realize the risk-benefit ratio in all therapeutic modalities in any patient and that these variables vary from patient to patient as do circumstances. The emergency patient who is pregnant or nursing should not be feared or be denied appropriate treatment. It is always best to err on the side of safety and remain conservative. The dental problem can usually be treated with the use of adequate local anaesthesia and supplemental nitrous oxide in the second or third trimester. Nevertheless, situations arise that may warrant consultation with the patient's physician or specialist. This brief overview should refamiliarize the dental practitioner with the medications available to treat the gravid patient. It is important to have an understanding of our common therapeutics as well as the inherent treatment risks and benefits as they relate to the changing maternal-fetal physiology.

Ring avulsion injuries and the basketball player.

As basketball increases in worldwide popularity, more epidemiological data on injury rate and type will be documented. A serious ring avulsion injury (Urbaniuk Class I) is here reported in an adolescent incurred while attempting a slam dunk. The management of this injury is discussed as well as safety concerns for coaches and supervisory staff.

Tori mandibularis: a case report and review of the literature.

Many dentists have patients in their practice with mandibular exostoses, termed torus mandibularis. The majority of these asymptomatic, benign bony outgrowths remain undisturbed over the patient's lifetime. However, the tori occasionally need to be removed. The differential diagnosis for the tori are discussed as well as the indications and techniques for their removal. Various hypotheses concerning the etiology and epidemiology of torus mandibularis are also reviewed.

Odontogenic infections: Part two. Microbiology, antibiotics and management.

This article deals with the microbiological aspects of infections, the principles and role of antibiotic use and the general management of the patient suffering from an odontogenic infection. Clinical aspects of the most common presentations will be addressed to understand the organized management of these challenging patients. (Part one appeared in Oral Health, May, 1995).

Odontogenic infections: Part one. Anatomy and radiology.

Odontogenic infections are frequently encountered by the dentist. The signs and symptoms of these common dental emergencies are outlined in this two-part article. A thorough knowledge of the fascial planes and anatomical routes of infection spread is a critical prerequisite to understanding the clinical manifestations, potential complications, and appropriate management of these infections.

Maxillary nerve block: a case report and review of the intraoral technique.

Maxillary nerve blockade is not commonly used by general practitioners due to a lack of experience with the techniques involved and the fear of iatrogenic damage. Nevertheless, it represents an excellent method of producing profound anesthesia in the maxilla, with definite indications in selected instances. The anatomy and techniques associated with the maxillary block, as well as the indications, contraindications and complications are reviewed, and the use of the greater palatine foramen approach to treat a patient with a facial abscess is described.

Calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint. A case report and review of the literature.

An asymptomatic preauricular swelling in a 58-year-old man appeared as a parotid mass and was diagnosed as calcium pyrophosphate dihydrate crystal deposition disease of the temporomandibular joint. This article describes the diagnostic criteria and management of this rare condition and reviews the 13 cases that have been reported to date.

Diagnosis and management of nasal fractures.

Nasal fractures are very common in facial trauma but should not be considered minor injuries until they have been thoroughly assessed. Trauma care providers need to have an understanding of common mechanisms of injury, normal anatomy, and assessment techniques to make the diagnosis. Management of the injury will depend on whether the fracture is nondisplaced, displaced, open, or associated with a complication that necessitates a more aggressive approach.