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1.
BMJ Case Rep ; 12(9)2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31540922

RESUMO

We report a case that illustrates how chronic migraine headaches and multiple dental pathologies caused severe and long-standing cranial pain that affected the quality of life of a man for more than 35 years. His case was investigated at several settings including the neurology outpatient clinic of the hospital without a definitive diagnosis or resolution. After investigations, multiple oral pathologies including two occult dental abscesses were diagnosed. Once both affected teeth and associated abscesses were surgically removed, with subsequent antibiotic therapy the headaches resolved.


Assuntos
Antibacterianos/uso terapêutico , Cefaleia/diagnóstico , Transtornos de Enxaqueca/diagnóstico , Abscesso Periapical/diagnóstico , Qualidade de Vida/psicologia , Odontalgia/diagnóstico , Cefaleia/etiologia , Cefaleia/fisiopatologia , Cefaleia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/fisiopatologia , Transtornos de Enxaqueca/psicologia , Saúde Bucal , Abscesso Periapical/complicações , Abscesso Periapical/fisiopatologia , Abscesso Periapical/psicologia , Radiografia Dentária , Fatores de Tempo , Extração Dentária , Odontalgia/complicações , Odontalgia/fisiopatologia , Odontalgia/psicologia , Resultado do Tratamento
2.
Endodoncia (Madr.) ; 37(1): 10-18, jun. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-186291

RESUMO

El doctor J. E. Groves, psiquiatra estadounidense, en un artículo publicado en el New England Journal of Medicine en 1978, fue el primero en atreverse a plantear de forma sincera y abierta la existencia de pacientes a los que definió como "odiosos" o "indeseables" (hateful patient). El paciente endodóncico que padece el "síndrome de Groves" se caracteriza por provocar en el dentista sentimientos de contratransferencia tales como el odio, la aversión, el aborrecimiento, o, incluso, el recelo, el temor y el miedo, todo ello sin que el paciente pueda ser encuadrado en un cuadro psiquiátrico específico. En este artículo se analiza, desde un punto de vista muy personal, la epidemiología, etiología, formas clínicas, el diagnóstico diferencial y el manejo terapéutico de este síndrome cuando se presenta en pacientes que necesitan tratamiento endodóncico


No disponible


Assuntos
Humanos , Síndrome , Medo , Endodontia/métodos , Relações Dentista-Paciente , Emoções , Pacientes/psicologia , Teoria Ética , Abscesso Periapical/diagnóstico , Abscesso Periapical/terapia , Atitude do Pessoal de Saúde , Comportamento Autodestrutivo , Recusa do Paciente ao Tratamento
3.
J Endod ; 45(3): 263-271.e1, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30803533

RESUMO

INTRODUCTION: Physicians are often patients' first point of contact for management of nontraumatic dental conditions (NTDCs). This study's aim was to evaluate the knowledge and practices of Ontario physicians in managing NTDCs, with a specific focus on antibiotic usage. METHODS: A Web-based survey featured 4 NTDC clinical scenarios: irreversible pulpitis, localized acute apical abscess with or without systemic involvement, and chronic apical abscess. The survey link was distributed to active Ontario family and emergency physicians. The sample group was asked questions about their management of and experience with NTDCs, and demographic and practice characteristics were collected. Descriptive and multivariate logistic regression analyses were undertaken (P ≤ .05). RESULTS: Sampled Ontario physicians tend to manage NTDCs in a manner that is not consistent with evidence-based care. For irreversible pulpitis and for localized acute apical abscess with or without systemic involvement, most physicians would prescribe an antibiotic (57.4%, 84.8%, and 96.3%, respectively), and 23.5% would prescribe an antibiotic for chronic apical abscess. Approximately half the sample (52.9%) felt discomfort in managing NTDCs, and 85.3% felt they were inadequately trained to manage NTDCs. CONCLUSION: Areas that present opportunities for improvement in the physician management of NTDCs were identified, including the incorporation of further NTDC training in medical curricula and continuing medical education courses, and development and dissemination of guidelines for physicians in managing NTDCs.


Assuntos
Antibacterianos/administração & dosagem , Gestão de Antimicrobianos/estatística & dados numéricos , Serviços Médicos de Emergência , Medicina de Família e Comunidade , Conhecimentos, Atitudes e Prática em Saúde , Abscesso Periapical/diagnóstico , Abscesso Periapical/terapia , Médicos/psicologia , Pulpite/diagnóstico , Pulpite/terapia , Doença Aguda , Canadá/epidemiologia , Doença Crônica , Estudos Transversais , Prática Clínica Baseada em Evidências , Humanos , Prescrição Inadequada/psicologia , Prescrição Inadequada/estatística & dados numéricos , Padrões de Prática Médica , Prescrições/estatística & dados numéricos
4.
Ann Emerg Med ; 74(1): 45-49, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30392733

RESUMO

STUDY OBJECTIVE: The frequency of antibiotic prescribing and types of antibiotics prescribed for dental conditions presenting to the emergency department (ED) is not well known. The objective of this study is to quantify how often and which dental diagnoses made in the ED resulted in an antibiotic prescription. METHODS: From 2011 to 2015, there were an estimated 2.2 million (95% confidence interval [CI] 1.9 to 2.5 million) ED visits per year for dental-related conditions, which accounted for 1.6% (95% CI 1.5% to 1.7%) of ED visits. This is based on an unweighted 2,125 observations from the National Hospital Ambulatory Medical Care Survey in which a dental-related diagnosis was made. RESULTS: An antibiotic, most often a narrow-spectrum penicillin or clindamycin, was prescribed in 65% (95% CI 61% to 68%) of ED visits with any dental diagnosis. The most common dental diagnoses for all ages were unspecified disorder of the teeth and supporting structures (44%; 95% CI 41% to 48%; International Classification of Diseases, Ninth Revision, Clinical Modification[ICD-9-CM] code 525.9), periapical abscess without sinus (21%; 95% CI 18% to 25%; ICD-9-CM code 522.5), and dental caries (18%; 95% CI 15% to 22%; ICD-9-CM code 521.0). Recommended treatments for these conditions are usually dental procedures rather than antibiotics. CONCLUSION: The common use of antibiotics for dental conditions in the ED may indicate the need for greater access to both preventive and urgent care from dentists and other related specialists as well as the need for clearer clinical guidance and provider education related to oral infections.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Prescrições/estatística & dados numéricos , Doenças Estomatognáticas/diagnóstico , Adolescente , Assistência Ambulatorial/normas , Antibacterianos/uso terapêutico , Criança , Clindamicina/uso terapêutico , Assistência à Saúde/métodos , Cárie Dentária/diagnóstico , Cárie Dentária/tratamento farmacológico , Pesquisas sobre Serviços de Saúde , Humanos , Penicilinas/uso terapêutico , Abscesso Periapical/diagnóstico , Abscesso Periapical/tratamento farmacológico , Doenças Estomatognáticas/tratamento farmacológico , Doenças Estomatognáticas/epidemiologia , Estados Unidos/epidemiologia
5.
Endodoncia (Madr.) ; 36(2): 24-35, nov. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-175978

RESUMO

Actualmente un gran porcentaje de dientes tratados endodóncicamente necesitan un nuevo tratamiento por aparición o persistencia de la lesión periapical. Cuando un paciente presenta una periodontitis apical crónica tras un tratamiento de conductos, debemos decidir si realizamos un retratamiento convencional por vía ortógrada o procedemos a un retratamiento quirúrgico. Si analizamos la evidencia científica, actualmente no existe un consenso en cuanto a cuál es la vía de acceso idónea en un retratamiento. Sin embargo, aunque el tratamiento de elección suele ser en primer lugar por vía ortógrada, presentamos un caso de retratamiento quirúrgico retrógrado como primra opción


Currently, a large percentage of teeth treated endodontically require a new treatment due to the appearance or persistence of the periapical lesion. When a patient presents a chronic apical periodontitis after a root canal treatment, we must decide if we perform a conventional retreatment by orthograde or we proceed to a surgical retreatment. If we analyze the scientific evidence, there is no clear procedure in this regard, although there is a tendency to try to always carry out a conventional retreatment that is more conservative first and if it does not work to perform the surgical procedure. We present a case in which we acted a little differently but with a correct evolution


Assuntos
Humanos , Masculino , Adolescente , Abscesso Periapical/cirurgia , Abscesso Periapical/diagnóstico , Falha de Tratamento , Reoperação
7.
Full dent. sci ; 9(36): 130-135, 2018. tab, graf
Artigo em Português | BBO - Odontologia | ID: biblio-994810

RESUMO

O sucesso da terapia endodôntica depende do conhecimento teórico e prático dos princípios e passos clínicos dessa especialidade. O presente estudo teve como objetivo calcular o índice de sucesso endodôntico obtido pelos acadêmicos do último ano de graduação da UniCesumar. Para isso, foram realizadas avaliações clínica e radiográfica em pacientes atendidos no projeto de extensão PROENDO, no qual alunos de graduação realizaram procedimentos endodônticos na rede pública de saúde de Marialva-Paraná, nos anos de 2013 e 2014. Foram avaliados 33 dentes tratados endodonticamente. O tempo de proservação mínima foi de pelo menos um ano, em que foram submetidos à avaliação clínica e radiográfica por um profissional de Odontologia devidamente treinado e calibrado. O índice de sucesso endodôntico demonstrado pela pesquisa foi de 97%, o que indica que os acadêmicos estão recebendo um ensino de qualidade e os pacientes, tratamentos satisfatórios (AU).


The success of endodontic therapy depends on the theoretical and practical knowledge of principles and clinical steps in this specialty. The present study aimed to calculate the endodontic success rate obtained by undergraduated students of the final year of UniCesumar University. For this, clinical and radiographic evaluations were performed in patients who received treatment in the PROENDO extension project, in which the final year undergraduate students performed endodontic procedures in the public health network of Marialva-Paraná in the years of 2013 and 2014. Thirty-three endodontically treated teeth were evaluated. The minimum proservation time was at least one year, and they were submitted to clinical and radiographic evaluation by a trained professional. The rate of endodontic success demonstrated by the survey was 97%, which indicates that academics are receiving quality education and patients are receiving satisfactory treatments (AU).


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Abscesso Periapical/diagnóstico , Reabsorção da Raiz , Estudantes de Odontologia , Radiografia Dentária/instrumentação , Endodontia/métodos , Brasil , Distribuição de Qui-Quadrado
8.
Dent Update ; 44(3): 241-2, 244-5, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29172335

RESUMO

Facial nerve palsy has specific symptomology, but varied aetiology. Prompt and thorough assessment is required to ascertain if upper or lower motor neurone damage has occurred. This report discusses a 6-year-old female, presenting in the Emergency Department with unilateral facial weakness. Initially thought to be facial swelling relating to her carious dentition, clinical assessment from the maxillofacial team identified that the patient had a unilateral facial palsy, later diagnosed as Bell's palsy. Her delayed presentation was due to initial misdiagnoses in primary care. This case report aims to highlight its aetiology, clinical features and appropriate management. Clinical relevance: To make the general dental practitioner aware of different causes of facial paralysis, and to provide GDPs with an algorithm to follow in the presentation of a facial palsy in the primary care setting.


Assuntos
Paralisia de Bell/diagnóstico , Abscesso Periapical/diagnóstico , Doença Aguda , Algoritmos , Paralisia de Bell/terapia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Abscesso Periapical/terapia
9.
J Am Vet Med Assoc ; 251(9): 1070-1077, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29035648

RESUMO

CASE DESCRIPTION 2 female red-necked wallabies (Macropus rufogriseus) were evaluated because of sudden-onset mandibular swelling, ptyalism, and hyporexia. CLINICAL FINDINGS Physical examination revealed a mandibular swelling with a fluctuant center in both wallabies. Hematologic analysis revealed leukocytosis with a mature neutrophilia and monocytosis in one wallaby (case 1) and a slight neutrophilia, hyperglobulinemia, and high serum alanine aminotransferase activity in the other (case 2). Cytologic examination of the swelling revealed a uniform population of gram-negative rods in case 1 and neutrophilic inflammation in case 2. Radiography revealed a soft tissue mandibular swelling with osteolucency around mandibular incisor roots in both wallabies. Computed tomography revealed changes consistent with chronic active mandibular osteomyelitis and reactive bone formation, but also sequestra formation not appreciable via radiography. TREATMENT AND OUTCOME Long-term antimicrobial treatment was initiated with clindamycin (17 to 21 mg/kg [7.7 to 9.5 mg/lb], IV, q 12 h for 40 to 55 days) and high-dose benzathine penicillin G (80,000 U/kg [36,364 U/lb], SC, q 12 h for 150 days). Serial CT was performed to evaluate response to treatment and resolution of disease. A CT scan 18 months after the initial evaluation revealed complete resolution of osteomyelitis and sequestra. CLINICAL RELEVANCE Advanced imaging and long-term treatment and management were integral to the successful outcome for these wallabies, given that the osseous changes visible on CT images were not visible on standard radiographs, guiding therapeutic decision-making. This report provides new therapeutic and diagnostic monitoring information to assist clinicians with similar cases.


Assuntos
Antibacterianos/uso terapêutico , Doenças Mandibulares/veterinária , Marsupiais , Tomografia Computadorizada por Raios X/veterinária , Animais , Antibacterianos/administração & dosagem , Doenças Mandibulares/tratamento farmacológico , Doenças Mandibulares/cirurgia , Osteomielite , Abscesso Periapical/diagnóstico , Abscesso Periapical/terapia , Abscesso Periapical/veterinária
10.
Odontol. pediatr. (Lima) ; 15(2): 162-168, jul.-dic. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-835091

RESUMO

Actualmente, se han publicado diversos casos cl¡nicos que describen la esterilizaci¢n de la lesi¢n pulpar en dientes deciduos como un tratamiento alternativo a la pulpectom¡a, evitando la exodoncia en dientes con necrosis pulpar y absceso. El procedimiento incluye: anestesia local, aislamiento absoluto, apertura cameral, remoci¢n de la pulpa cameral, ampliaci¢n de la entrada a los conductos, colocaci¢n de una pasta triantibi¢tica y la restauraci¢n. Se presenta el reporte de caso de una ni¤a de 4 a¤os de edad, la cual acude a la Cl¡nica Estomatol¢gica Central de la Facultad de Estomatolog¡a Roberto Beltr n de la Universidad Peruana Cayetano Heredia; con dolor, aumento de volumen en la regi¢n inferior izquierda y movilidad de la pieza 75. Radiogr ficamente se observa reabsorci¢n de la ra¡z distal de 1/3 y una lesi¢n osteol¡tica a nivel de la furcaci¢n. Por lo cual se decide realizar el tratamiento endod¢ntico no instrumentado de conductos, acompa¤ado de controles hasta los 12 meses, donde cl¡nicamente permanece asintom tico acompa¤ado con una regeneraci¢n de tejidos blandos, y radiogr ficamente una aposici¢n ¢sea en furca. Se concluye que el tratamiento endod¢ntico no instrumentado, muestra resultados prometedores y podr¡a ser una alternativa a la pulpectom¡a y/o exodoncia en dientes deciduos en algunos casos.


Now a days, clinical cases has been published in which describes the esterilization of pulpar lesi¢n on primary teeths as an alternative treatment to the pulpectomies avoiding the toot extractions on primary and necrotics or abscessed teeth. The procedure includes: local anesthesia, isolation with a rubber dam, remove the necrotic tissue from the coronal portionof the pulp chamber, enlarged of the canal orificie and a three mix paste placed over the pulpar floor. A case of 4 years old girl is presented in this work , that went to “Cl¡nica Estomatol¢gica Central de la Facultad de Estomatolog¡a Roberto Beltr n de la Universidad Cayetano Heredia”, with pain, mandibular left posterior swelling and mobility of her mandibular left second primary molar. X-ray shows 1/3 distal root resorption and furcation radiolucency. The clinical procedure ofnon- instrumented endodontic treatment was performed successfully and 12 months posterior controls was maded, in which soft tissue healing was showed, increased trabeculation in the furcation area, normal mobility and the patient was symptom-free. It concludes that this treatment shows promising results for the future pediatric dentistry and is an alterantive to pulpectomy and tooth extraction.


Assuntos
Humanos , Feminino , Pré-Escolar , Abscesso Periapical/diagnóstico , Dente Decíduo/lesões , Necrose da Polpa Dentária/diagnóstico
11.
Endodoncia (Madr.) ; 34(4): 204-219, oct.-dic. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-160979

RESUMO

La caries dental es la principal etiología de la pulpitis y la periodontitis apical. Ante un diente afectado por caries, el diagnóstico correcto de la extensión de la lesión cariosa y del grado de afectación pulpar es esencial para decidir entre el tratamiento endodóncico invasivo o un procedimiento operatorio preventivo y conservador. En la actualidad, el tratamiento de la lesión de caries debe basarse en los principios y las técnicas de la odontología mínimamente invasiva. Sin embargo, un problema importante que se aprecia cuando se lee literatura científica sobre la caries es que la terminología utilizada para referirse a la dentina cariada y a los procedimientos que se emplean para eliminar el tejido cariado no es uniforme. En este trabajo se abordan y se revisan los cambios propuestos por el grupo International Caries Consensus Collaboration (ICCC) en su reunión de Leuven (Bélgica) en 2015, en lo relativo a terminología, manejo de la caries y a las técnicas operatorias indicadas para el tratamiento de los diferentes tipos de lesiones de caries dentinaria


Dental caries is the main etiologic factor of pulpitis and apical periodontitis. When a tooth affected by caries must be treated, the correct diagnosis of the extent of carious lesion and the degree of pulp involvement is essential to decide between invasive endodontic treatment or preventive and conservative operative procedure. At present, the treatment of carious lesion should be based on the principles and techniques of minimally invasive dentistry. However, an important problem when reading scientific literature about dental caries is that the terminology used to refer to carious lesions and to the procedures used to remove the carious tissue is not uniform. The aim of this paper is to address and review the changes proposed by the International Caries Consensus Collaboration Group (ICCC), in its convention in Leuven (Belgium) in 2015, with regard to the terminology, management of caries, and operative techniques indicated for the treatment of the different types of dentine carious lesions


Assuntos
Humanos , Masculino , Feminino , Cárie Dentária/diagnóstico , Endodontia/métodos , Dentina/lesões , Pulpite/diagnóstico , Abscesso Periapical/diagnóstico , Selantes de Fossas e Fissuras/uso terapêutico , Consenso , Traumatismos Dentários/terapia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
12.
Endodoncia (Madr.) ; 34(4): 229-242, oct.-dic. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-160981

RESUMO

Objetivo: Evaluar la calidad de tratamiento de conductos radiculares (TCR) en una muestra de pacientes con diabetes mellitus tipo 2 y diferente grado de control de la glucemia. Material y Método: Se examinaron las radiografías panorámicas de 106 pacientes con diabetes mellitus tipo 2. El control glucémico se realizó midiendo los valores de hemoglobina glicosilada (HbA1c). La periodontitis apical (PA) fue diagnosticada como lesión radiolúcida periapical (LRP), mediante la utilización del índice periapical (PAI). Entre los análisis estadísticos realizados se encuentra el cálculo de la t-student y regresiones logísticas uni/ multivariantes. Resultados: Entre los pacientes con diabetes mellitus el 39% fueron pacientes con buen control glucémico (HbA1c < 6,5%) y el 61% fueron pacientes con peor control glucémico (HbA1c ≥ 6,5%). El 32% de los pacientes tuvieron al menos un diente con TCR y el 24% un TCR con LRP. En la muestra total el 3.2% de los dientes presentaban un TCR, de los cuales el 12% estaba asociado a una LRP (p > 0,5). Las LRP estuvieron presentes en el 25% de los TCR con inadecuada obturación tridimensional de los conductos radiculares (p > 0,05), en el 16% de los TCR con inadecuada obturación de la longitud radicular (p > 0,05), en el 27% de los TCR con inadecuada restauración coronal (p = 0,056), y en el 14% de los pacientes con peor control glucémico (p > 0,05). Conclusiones: Considerando la calidad del TCR y la restauración coronal como covariables, no se encontró una asociación significativa entre el estado periapical de los dientes con TCR y el control glucémico


Objectives: To evaluate the quality of root canal treatments (RCT) in a sample of type 2 diabetic patients with different grades of glycaemic control. Methods: The radiographic records of 106 type 2 diabetic patients were examined. Glycaemic control was assessed by mean of glycated haemoglobin (HbA1c) levels. AP was diagnosed as radiolucent periapical lesions (RPL) using the periapical index score (PAI). Statistical analysis were carried out using the Student t test, χ square test, and logistic regression analysis. Results: Amongst diabetic patients, 39% were well-controlled (HbA1c <6.5%) and 61% were poor-controlled. Thirty-two percent of patients had at least one root filled tooth (RFT), and 24% had at least one RFT with RPL. In the total sample, 3.2% of teeth were RFT, being 12% associated to RPLs (p > 0.5). RPLs were present in 25% of RFT with inadequate adaptation of root filling (p > 0.05), in 16% of RFT with inadequate length of root filling (p > 0.05), in 27% of RFT with inadequate coronal restoration (p = 0.056), and in 14% of poor-controlled diabetics (p > 0.05). Conclusions: Considering the quality of RCT and coronal restoration as covariates, no significant association between periapical status of RFT and glycaemic control has been found


Assuntos
Diabetes Mellitus Tipo 2/complicações , Endodontia/métodos , Cavidade Pulpar/cirurgia , Cavidade Pulpar , Materiais Restauradores do Canal Radicular/uso terapêutico , Abscesso Periapical/diagnóstico , Hemoglobina A Glicada/uso terapêutico , Modelos Logísticos , Estudos Transversais , Inquéritos e Questionários , Índice Glicêmico/fisiologia
13.
Quintessence Int ; 47(9): 785-90, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27284583

RESUMO

Intraosseous metastatic tumors (IOM) in maxilla are less frequent than the soft tissue metastatic tumors. Lung and bronchogenic metastatic tumors are uncommon in the maxilla. We present a maxillary bronchogenic metastasis with a rare clinical appearance. IOM was misdiagnosed as a dentoalveolar abscess and treated with antibiotics for 3 weeks. After not responding to antibiotics, the patient's general dental practitioner forwarded the patient to the Department of Oral and Maxillofacial Surgery. The associated tooth was extracted and the patient was recalled 1 week later. No signs of improvement were observed, and cytology, biopsy, and radiology diagnostics were performed. Cytologic results and biopsy could not differentiate a metastatic tumor from a salivary duct carcinoma. Ultimately, negative androgen receptors immunohistochemistry supported the diagnosis of bronchogenic metastatic adenocarcinoma. This case report stresses the importance of taking a thorough medical history. To our knowledge, this is the third bronchogenic IOM to the maxilla reported, mimicking a dentoalveolar abscess. General dental practitioners are among the first in contact with oral metastatic tumors and it is therefore important to report unusual clinical cases, as they present a diagnostic challenge for both the clinician and the pathologist.


Assuntos
Carcinoma Broncogênico/diagnóstico , Neoplasias Maxilares/diagnóstico , Neoplasias das Glândulas Suprarrenais/secundário , Biópsia , Carcinoma Broncogênico/patologia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Abscesso Periapical/diagnóstico , Tomografia Computadorizada por Raios X
15.
J Am Dent Assoc ; 147(8): 646-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27046538

RESUMO

BACKGROUND: A preponderance of periapical radiolucencies are of inflammatory etiology (radicular cysts or periapical granulomas) secondary to pulpal disease. In some instances, however, a suspected periapical inflammatory lesion is not a consequence of pulpal disease but instead represents a lesion of noninflammatory origin. The differential diagnosis for such lesions is broad, ranging from odontogenic cysts and tumors to metastatic disease. As the biological behavior of such lesions is varied, the distinction between inflammatory odontogenic periapical lesions and lesions of noninflammatory origin in a periapical location is critical. METHODS: A retrospective study of 5,993 archival periapical biopsies over a span of 15 years from the database of the Oral Pathology Biopsy Service in the Henry M. Goldman School of Dental Medicine at Boston University recorded the incidence of various lesions in a periapical location. RESULTS: Of the cases studied, 97.2% represented lesions of inflammatory origin with histopathologic diagnoses as follows: periapical granuloma (60.0%), radicular cyst (36.7%), periapical fibrous scar (0.27 %), and periapical abscess (0.23 %). The remaining 2.8% cases were lesions of noninflammatory origin with histopathologic diagnoses of odontogenic keratocyst (also known as keratocystic odontogenic tumor), benign fibro-osseous lesions, and ameloblastoma. One patient had Langerhans cell disease, and 1 had central giant cell granuloma. CONCLUSIONS: Although most periapical specimens biopsied represented expected inflammatory periapical lesions, the biological behavior of underdiagnosed lesions may have considerable consequences for both the patient and the clinician. PRACTICAL IMPLICATIONS: This article serves to inform clinicians regarding the diversity of lesions arising in the periapical region of the jaws, to assist in the formulation of differential diagnoses, and to highlight the importance of submission of lesional tissue for histopathologic evaluation and definitive diagnosis when biopsy is clinically indicated.


Assuntos
Doenças Periapicais/diagnóstico , Ameloblastoma/diagnóstico , Ameloblastoma/patologia , Biópsia , Diagnóstico Diferencial , Humanos , Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/patologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Abscesso Periapical/diagnóstico , Abscesso Periapical/patologia , Doenças Periapicais/patologia , Granuloma Periapical/diagnóstico , Granuloma Periapical/patologia , Cisto Radicular/diagnóstico , Cisto Radicular/patologia , Estudos Retrospectivos
16.
Infez Med ; 24(1): 67-70, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27031901

RESUMO

Dental infections may lead to severe local or systemic infections such as endocarditis, brain abscesses and mediastinitis. Fever may be the only symptom. We aim to highlight dental/odontogenic abscesses as the occult source of unexplained fever by reporting on three cases and reviewing the relevant literature. Early dental evaluation and referral of patients with persistent fever (even without any oral symptoms) to a dentist plays a critical role in preventing unnecessary, time-consuming and high-cost further diagnostic tests and invasive procedures. A simple panoramic dental radiography may suffice to establish the diagnosis.


Assuntos
Febre de Causa Desconhecida/etiologia , Abscesso Periapical/complicações , Abscesso Periapical/diagnóstico , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Abscesso Periapical/diagnóstico por imagem , Abscesso Periapical/cirurgia , Radiografia Panorâmica/métodos , Tratamento do Canal Radicular/métodos , Extração Dentária , Resultado do Tratamento
17.
J Dent Child (Chic) ; 83(1): 46-50, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27098722

RESUMO

The purpose of this report is to describe the diagnosis and dental treatment of a medically complex 14-year-old boy with X-linked hypophosphatemic rickets who presented with a pre-eruptive abscess on a mandibular molar and facial swelling.


Assuntos
Raquitismo Hipofosfatêmico Familiar/complicações , Abscesso Periapical/diagnóstico , Abscesso Periapical/cirurgia , Dente não Erupcionado/cirurgia , Anormalidades Múltiplas , Adolescente , Dente Pré-Molar/anormalidades , Dente Pré-Molar/cirurgia , Humanos , Incisivo/anormalidades , Incisivo/cirurgia , Masculino , Mandíbula/cirurgia , Dente Molar/anormalidades , Dente Molar/cirurgia
18.
Anaerobe ; 38: 36-38, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26612007

RESUMO

Dialister pneumosintes and Slackia exigua are both obligatory anaerobe and known to be associated with periodontal diseases and other oral infection. We report a case of blood stream infection caused by D. pneumosintes and S. exigua. This occurred in a 78-year-old female patient that presented with general weakness and fever. We revealed that she had a periapical abscess. The blood culture was positive for D. pneumosintes and S. exigua; however, identifying them was challenging. Ultimately, 16S rRNA sequencing was used to identify the organisms. The patient recovered after being treated with ceftriaxone and clindamycin. To the best of our knowledge, this is the first report of bacteremia caused by mixed infection of D. pneumosintes and S. exigua.


Assuntos
Actinobacteria/genética , Bacteriemia/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Abscesso Periapical/microbiologia , Veillonellaceae/genética , Actinobacteria/efeitos dos fármacos , Actinobacteria/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/terapia , Coinfecção , Feminino , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Testes de Sensibilidade Microbiana , Abscesso Periapical/diagnóstico , Abscesso Periapical/terapia , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Resultado do Tratamento , Veillonellaceae/efeitos dos fármacos , Veillonellaceae/isolamento & purificação
19.
Rev. medica electron ; 37(2)mar.-abr. 2015.
Artigo em Espanhol | CUMED | ID: cum-59577

RESUMO

Introducción: las urgencias dentales, además de causar signos y síntomas, producen complicaciones que afectan la salud general de los pacientes, por lo que se requiere de atención priorizada, apoyo psicológico y maniobras no traumáticas. Objetivo: determinar el comportamiento de las urgencias estomatológicas. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal en la consulta de Estomatología del Hospital “Faustino Pérez” de Matanzas en el periodo marzo-diciembre del 2009. El universo estuvo constituido por 533 pacientes que asistieron a la consulta de Estomatología y que presentaron diferentes tipos de urgencias estomatológicas, los cuales se caracterizaron, según variables sociodemográficas y clínicas. Se realizó un interrogatorio minucioso y un examen bucal a cada paciente en el sillón dental y se confeccionó la historia clínica individual de Estomatología. Los datos se recopilaron de forma manual. Para su análisis se emplearon medidas de frecuencias absolutas y relativas. Se tuvo en cuenta el consentimiento informado. Resultados: el 59,5 por ciento de los pacientes con urgencias estomatológicas correspondió al sexo masculino y fue el más representado, los pacientes de 35 a 59 años constituyeron el 32,5 por ciento y predominaron los trabajadores. Conclusiones: el absceso dentoalveolar agudo fue la forma clínica más frecuente dentro de los trastornos pulpares y periapicales en el grupo de edad de 35 a 59 años y en el sexo femenino(AU)


Background: stomatologic emergencies, in addition to causing signs and symptoms, produce complications affecting the patients general health status, so they require prioritized care, psychological support and no-traumatic actions. Aim: to determine the stomatologic emergencies behavior. Material and methods: we carried out a cross-sectional, descriptive, observational study in the Stomatologic consultation of the Hospital “Faustino Perez” of Matanzas in the period March-December 2009. The universe was formed by 533 patients who attended the Stomatologic consultation having different kinds of stomatologic emergencies that were characterized according to clinical and social variables. Each patient was carefully questioned; a buccal examination was carried out to each of them and the Stomatologic individual historical record was filled out. Data were compiled manually. For their analysis we used absolute and relative frequency measures. The informed consent was taken into account.Results: 59,5 percent of the patients with stomatologic emergencies were male, the most represented gender. The patients aged 35-59 years were 32,5 percent, and workers predominated. Conclusions: the acute dental alveolar abscess was the most frequent clinical form among the pulp and periapical disorders in the 35-59 years age group and in the female gender(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Abscesso Periapical/diagnóstico , Abscesso Periapical/epidemiologia , Doenças da Boca/diagnóstico , Emergências , Doenças Periapicais/epidemiologia , Doenças Periapicais/prevenção & controle , Estudos Observacionais como Assunto , Epidemiologia Descritiva , Estudos Transversais
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