A coding solution for supernumerary teeth.

In South Africa payments for treatment rendered are routinely delayed because of the medical fund industry's apparent inability to capture codes denoting supernumerary teeth. The suggested protocol allows for up to 13 supernumerary teeth to be identified by two digits. Meetings planned between SADA and key funding stakeholders to "ensure that protocols related to tooth numbering are acceptable", provide the ideal opportunity to introduce the suggested two-digit protocol for numbering supernumerary teeth. If this proposal is implemented, it could alleviate the frustration associated with the rejection of accounts where supernumerary teeth are appropriately identified.

A randomized observer blind comparison of bilateral facial ice pack therapy with no ice therapy following third molar surgery.

This study compares the efficacy of Tecnol bilateral facial ice packs with no cold therapy in reducing pain, swelling and trismus during the first 24 h following third molar surgery. Sixty patients requiring general anaesthesia for removal of bilateral, impacted third molar teeth were included and randomly assigned to one of two treatment groups. One group received Tecnol bilateral facial ice packs following surgery, while a control group received no form of cold therapy. Facial ice packs were applied in the recovery room within 15 min of the end surgery and patients were asked to use the ice packs continuously for the next 24 h. Surgical and anaesthetic techniques as well as pharmacological regimens were standardized. Postoperative pain levels were compared hourly, for 4 h, then on the evening of surgery and the following morning. Facial swelling and trismus were compared preoperatively and 24 h postoperatively. No statistically significant difference was found between the two treatment groups with respect to pain, facial swelling or trismus.

Eagle's syndrome: lesser cornu amputation: an alternative surgical solution?

A case is reported of a 42-year-old female patient, who presented with clinical symptoms of Eagle's syndrome, radiographic evidence of marginally elongated styloid processes as well as markedly elongated lesser cornua of the hyoid. The symptoms were successfully treated by amputating the lesser cornua of the hyoid. The patient has now been asymptomatic for more than 6 years.

Central calcifying odontogenic cyst. A review of the literature and the role of advanced imaging techniques.

The central calcifying odontogenic cyst (CCOC) is a rare lesion. This paper reports a new case, reviews the clinical, histomorphological and radiographic features reported in the literature and describes the CT and MRI features of this new case. We postulate that, as part of an evolutionary process, cystic COCs originate as unilocular lesions but may later become multilocular. The role of advanced imaging and histology in the diagnostic process are discussed.

Anesthetic management of a patient with Bartter's syndrome undergoing orthognathic surgery.

Bartter's syndrome is a rare disorder characterized by severe hypokalemic alkalosis, marked elevation in plasma renin activity, pressor insensitivity to angiotensin II, and normal or low values of plasma sodium, plasma chloride, and blood pressure. Many of the clinical features and biochemical abnormalities appear to be secondary to chronic hypokalemia. We managed a 22-yr-old man requiring orthognathic surgery for correction of facial asymmetry under general anesthesia.

Randomized double-blind comparison of tiaprofenic acid and diclophenac sodium after third molar surgery.

OBJECTIVE: This study compares the effectiveness of tiaprofenic acid with diclophenac sodium over a 7-day period with respect to pain, facial swelling, and trismus. STUDY DESIGN: Sixty patients who required general anesthesia for removal of bilateral impacted third molar teeth were included. Intraoperatively, they received intramuscular injections of either tiaprofenic acid or diclophenac sodium followed respectively by tiaprofenic acid tablets for 5 days and placebo for an additional 2 days or diclophenac sodium tablets for the full 7 days. Surgical and anesthetic techniques were standardized. Pain levels were compared hourly for 4 hours postoperatively and thereafter twice daily for 7 days. Changes in facial swelling and trismus were compared on days 2 and 7 postoperatively. RESULTS: No statistically significant difference was found between the two treatment groups with respect to pain or facial swelling. Only with respect to recovery in mouth-opening ability (trismus) from day 2 to day 7 did diclophenac sodium reveal a statistically significant advantage (p = 0.0452).

A rapidly fatal palatal ulcer: rhinocerebral mucormycosis.

A case of a patient with a palatal ulcer who was in a diabetic ketoacidotic coma is described. This ulcer proved to be the presenting sign of rhinocerebral mucormycosis. The patient had hemifacial swelling, ocular signs, and gross tissue destruction and died less than 4 weeks after she was first seen.