[Throat ache ans swelling of the neck: first symptoms of Lemierre's syndrome]. / Keelpijn en zwelling van de hals: eerste symptomen van het syndroom van Lemierre.

Lemierre's syndrome, a thrombophlebitis of the internal jugular vein, is a rare disorder, usually caused by the microorganism Fusobacterium necrophorum. Throat ache and swelling of the neck are often the first symptoms. Without adequate treatment, Lemierre's syndrome may result in thrombosis of the internal jugular vein and metastatic lung abscesses, with a mortality rate of 18%. On the basis of 2 cases, Lemierre's syndrome is described here. In cases where Lemierre's syndrome is suspected, hospitalization often follows, with the administration of intravenous antibiotics and drainage of the abscesses. One should be on the alert for Lemierre's syndrome when a patient is presented with swelling in the neck following an oropharyngeal infection.

Arthroscopic cauterization of retrodiscal tissue as a successful minimal invasive therapy in habitual temporomandibular joint luxation.

Habitual temporomandibular joint (TMJ) luxation is a serious condition for the patient, and is often managed by extensive open joint surgery. Arthroscopic eminoplasty is an alternative, but this technique could also cause concomitant damage to the articular surface. The aim of this study was to evaluate the therapeutic effects and side effects of arthroscopic electrocautery of retrodiscal tissues in habitual TMJ luxation. All patients with habitual TMJ luxations who needed surgical management from 1 January 2000 to 31 December 2009 in the authors' institution in The Netherlands, were included in this study. All patients were primarily treated with arthroscopic electrocautery. Pre- and postoperative evaluation parameters were: TMJ luxations, maximum mouth opening, translatory capacity, pain and joint noises. Sixteen patients with habitual luxation were treated with arthroscopic electrocautery. Patient reluxation occurred in one. None of the patients had joint pain or mobility restrictions. The overall success rate was 95%. After 86 months there was a high success rate for this therapy. No other morbidity was seen, in contrast with open joint surgery or using sclerosing agents. The authors conclude that arthroscopic eletrocautery of retrodiscal tissues is a highly successful minimal invasive therapy in habitual TMJ luxation without side effects.

[Two unusual ulcers in one patient]. / Twee keer een ongewoon ulcus bij dezelfde patiënt.

A 39-year-old Antillean woman was referred by her family doctor to an oral and maxillofacial surgeon because of an unusual and painful ulcer in the buccal region of the first left mandibular molar. Earlier that day, she was diagnosed as HIV-positive. The ulcer was diagnosed as an atypical necrotising ulcerating periodontitis. Antibiotics were subscribed and after removal of the first left mandibular molar, the ulcer healed. After several weeks, the patient was referred by her internist because of another ulcer at the lateral border of the tongue. This ulcer was diagnosed as an eosinophilic ulcer and was healing slowly. Both ulcer types are seen rarely and are strongly related to immunodeficiency diseases.

Evaluation of failure characteristics and bond strength after ceramic and polycarbonate bracket debonding: effect of bracket base silanization.

The objectives of this study were to evaluate the effect of silanization on the failure type and shear-peel bond strength (SBS) of ceramic and polycarbonate brackets, and to determine the type of failure when debonded with either a universal testing machine or orthodontic pliers. Silanized and non-silanized ceramic and polycarbonate brackets (N = 48, n = 24 per bracket type) were bonded to extracted caries-free human maxillary central incisors using an alignment apparatus under a weight of 750 g. All bonded specimens were thermocycled 1000 times (5-55 degrees C). Half of the specimens from each group were debonded with a universal testing machine (1 mm/minute) to determine the SBS and the other half by an operator using orthodontic debonding pliers. Failure types of the enamel surface and the bracket base were identified both from visual inspection and digital photographs using the adhesive remnant index (ARI) and base remnant index (BRI). As-received ceramic brackets showed significantly higher bond strength values (11.5 +/- 4.1 MPa) than polycarbonate brackets [6.3 +/- 2.7 MPa; (P = 0.0077; analysis of variance (ANOVA)]. Interaction between bracket types and silanization was not significant (P = 0.4408). Silanization did not significantly improve the mean SBS results either for the ceramic or polycarbonate brackets (12.9 +/- 3.7 and 6.3 +/- 2.7 MPa, respectively; P = 0.4044; two-way ANOVA, Tukey-Kramer adjustment). There was a significant difference between groups in ARI scores for ceramic (P = 0.0991) but not polycarbonate (P = 0.3916; Kruskall-Wallis) brackets. BRI values did not vary significantly for ceramic (P = 0.1476) or polycarbonate (P = 0.0227) brackets. Failure type was not significantly different when brackets were debonded with a universal testing machine or with orthodontic debonding pliers. No enamel damage was observed in any of the groups.