Tongue myokymia presenting twelve years after radiation therapy.

OBJECTIVE: This case is a patient with tongue myokymia following radiation therapy 12 years earlier, documented using video and EMG. CASE REPORT: A 68-year-old woman with a history of nasopharyngeal carcinoma presented with subacute onset of difficulty in speaking and involuntary movements of her tongue approximately 12 years after radiation therapy to head and neck. Electromyography displayed myokymic discharges. There was no evidence of recurrent malignancy. SIGNIFICANCE: Delayed effects of radiation therapy might be seen decades later. Myokymic discharges may reveal radiation-induced neuropathy.

The predominant bacteria isolated from radicular cysts.

PURPOSE: To detect predominant bacteria associated with radicular cysts and discuss in light of the literature. MATERIAL AND METHODS: Clinical materials were obtained from 35 radicular cysts by aspiration. Cultures were made from clinical materials by modern laboratory techniques, they underwent microbiologic analysis. RESULTS: The following are microorganisms isolated from cultures: Streptococcus milleri Group (SMG) (23.8%) [Streptococcus constellatus (19.1%) and Streptococcus anginosus (4.7%)], Streptococcus sanguis (14.3%), Streptococcus mitis (4.7%), Streptococcus cremoris (4.7%), Peptostreptococcus pevotii (4.7%), Prevotella buccae (4.7%), Prevotella intermedia (4.7%), Actinomyces meyeri (4.7%), Actinomyces viscosus (4.7%), Propionibacterium propionicum (4.7%), Bacteroides capillosus (4.7%), Staphylococcus hominis (4.7%), Rothia denticariosa (4.7%), Gemella haemolysans (4.7%), and Fusobacterium nucleatum (4.7%). CONCLUSIONS: Results of this study demonstrated that radicular cysts show a great variety of anaerobic and facultative anaerobic bacterial flora. It was observed that all isolated microorganisms were the types commonly found in oral flora. Although no specific microorganism was found, Streptococcus spp. bacteria (47.5%) - especially SMG (23.8%) - were predominantly found in the microorganisms isolated. Furthermore, radicular cysts might be polymicrobial originated. Although radicular cyst is an inflammatory cyst, some radicular cyst fluids might be sterile.

Biomechanical comparison of plating techniques for fractures of the mandibular condyle.

We compared the biomechanical behaviour of various rigid internal fixation techniques for treatment of fractures of the mandibular condylar process. Fifteen sheep hemimandibles were used to evaluate three bicortical plating techniques. A custom-made 3-point biomechanical test model was used for the samples. Each group was tested with compression forces by an Instron Lloyd LRX machine. The resistance to forces (N) that caused displacements of 1.75 and 3.50mm were compared using the Instron software programme and displacement graphics. There were no significant differences among the three groups for displacements of 1.75 and 3.50mm. Our study showed that the titanium miniadaptation plates, minicompression plates, and the absorbable miniplates did not differ significantly in their biomechanical behaviour.

Impacted teeth and mandibular fracture.

OBJECTIVES: In this retrospective study, we measured the relationship between the presences of impacted or unerupted teeth in the mandible and mandibular fractures. METHODS: The records and radiographs of 41 patients with mandibular fracture associated with impacted or unerupted teeth were examined. The presence of impacted or unerupted teeth were assessed for each patient and related to the occurrence of fractures of mandible. RESULTS: Patients with fracture in the impacted or unerupted teeth area present had a 1,73 times greater chance of an mandibular fracture than patients with no fracture in the impacted or unerupted teeth area. There was a statistically significant variation in the risk for a mandibular fracture depending on impacted or unerupted teeth presence (x2=5.29, P< .05). CONCLUSION: The presence of an impacted or unerupted teeth significantly increases the likelihood of an mandibular fracture.

Comparison of two chlorhexidine rinse protocols on the incidence of alveolar osteitis following the surgical removal of impacted third molars.

PRINCIPLES: Alveolar osteitis (dry socket) is the most common complication following the extraction of permanent teeth. This study was undertaken to compare the effect of two chlorhexidine rinse protocols on the incidence of alveolar osteitis in patients undergoing surgical removal of impacted mandibular third molar teeth. METHODS: A prospective randomized clinical trial was conducted among 99 subjects. Patients were randomly assigned into two groups. Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine rinse 30 seconds for one week before and one week after surgery (group I) or one week after surgery (group II). Postoperatively, all patients were instructed to return in one week or sooner if bothersome pain increased or persisted. Data were collected regarding abnormal healing, presence of necrotic tissue, exposed bone, and absence of clot. RESULTS: The results indicated group I and group II were not statistically significant different in the reduction of alveolar osteitis. CONCLUSIONS: To reduce alveolar osteitis after impacted third molar surgery, it was observed use of postoperative chlorhexidine rinse was adequate. The postoperative use of chlorhexidine is more feasible than both preoperative and postoperative use.

Use of pedicled buccal fat pad in the closure of oroantral communication: analysis of 75 cases.

OBJECTIVE: This report evaluates the use of pedicled buccal fat pad for closure of oroantral communications. METHOD AND MATERIALS: Seventy-five patients were treated with pedicled buccal fat pad. Fifty-two were treated immediately after tooth extractions. The remaining 23 had chronic oroantral communication and were treated similarly after irrigation of the maxillary sinus with saline for 7 days. RESULTS: The 6-month follow-up revealed uneventful healing in all of the patients. Though partial necrosis of the flap was observed in three patients, this did not effect the final healing. Total necrosis of the flap was not noted. CONCLUSION: The use of pedicled buccal fat pad is an acceptable and reliable alternative in acute or chronic oroantral communications management and may even be used as a first treatment choice by experienced surgeons.