Cranial base dynamics in craniofacial dysostosis

Cephalometric analyses of twenty-one patients with Crouzon's disease were undertaken to correlate the cranial base abnormalities to altered facial morphology. Angular deformities of the cranial base, i.e., the vertical sloping of the anterior cranial fossa and the angulation of the cranial base flexure were found to correlate well to observed exorbitism and midface retrusion , respectively. Normal craniofacial growth and clinical implications of these data are discussed.

Spontaneous oral-facial dyskinesia: neuropathology of a case

The neuropathologic findings in a previously reported patient with spontaneous oral-facial dyskinesia are presented. The main microscopic abnormalities were limited to the dorsal halves of the caudate and putamen, which showed a unique pattern of neuronal cell loss and severe gliosis, giving a mosaic appearance. These findings differ from those of other known hereditary or acquired involuntary movement disorders.

Osteology of a slave burial population from Barbados, West Indies

A unique seventeenth-nineteenth century slave cemetery population from Newton plantation, Barbados, allows examination of craniodental characters in relation to ethnohistorical data. Age-at-death estimates suggest life expectancy at birth of 29 years and low infant mortality; historical demography, however, suggests life expectancy of 20 years and very high infant mortality. Tooth decay, bilateral tooth loss, periodontal disease, root hypercementosis, and severe enamel hypoplasia are high in frequency. The teeth yield evidence of such cultural practices as pipe-smoking and incisor mutilation. Several skeletal features reflect periodic near-starvation. Directional and fluctuating dental asymmetry, relative tooth size, and hypoplasia distribution suggest slaves experienced considerable weaning trauma; metabolic stress at this time exceeded that of prenatal and immediate postnatal periods. Odontometrics and dental and cranial nonmetric traits indicate that modern Blacks are intermediate between the ancestral slaves and modern Whites but more similar to the latter, suggesting effects of environmental covariance exceed those of genetic admixture. Nonmetric trait distributions show nonrandom patterns according to area of burial in the cemetery, a possible result of family segregation.

Jaw cysts with special regard to keratocyst recurrence. A long-term follow-up

From an original material of 50 patients with 55 jaw cysts, 39 patients were followed up 32--129 months after surgery (mean: 92 months). In 21 of 55 cysts the primary lesion was histologically classified as a keratocyst. All keratocysts had a follow-up period of at least 6 years (72 months). The keratocyst recurrence rate was 50%. Seven of eight recurrences in the total material were keratocysts. There was no difference between males and females concerning the incidence of keratocysts or age at diagnosis.

Dentition on Bahrain, 2000 B.C

Teeth and jaws excavated from 25 burial mounds on the island of Bahrain were examined. Dating: 2000 B.C. The number of individuals buried was estimated from the dentition. An approximate determination of the age for death was attempted. Non-metric and metric traits of the teeth were observed. The teeth showed Caucasoid but no Mongoloid traits. They were small, worn at an early age, with a great deal of carious lesions, no multiple fractures, only a little calculus and alveoloclasia but frequent enamel hypoplasia. The mandibles showed fine healing after the widespread antemortem loss of molars, possibly extracted due to the consequence of caries, caused by the consumption of many carbohydrates.

Destruction and regeneration of jawbone after cryogenic application. An experimental study

On 13 rabbits part of the lateral aspect of the jawbone was frozen with liquid nitrogen in two sessions. The animals were sacrificed 2, 4, 12 and 24 weeks after the cryosurgery. The specimens were analyzed with microangiography according to the Spalteholz technique and with light microscopy. The whole width of the lateral cortex, measuring around 3 mm, was subject to bone destruction two weeks after cryosurgery. New bone formation, on the other hand, was evident in the frozen area and on the undamaged periosteum some distance from the lesion. The same area, 12 weeks after the injury, was completely restored. Bone destruction and regeneration are discussed with special reference to the vascular response to the injury.

Radiographic changes of the jawbones in end stage renal disease

Thirty-eight patients with a history of end stage renal disease (ESRD) were evaluated with panoramic and periapical radiographs for changes in lamina dura, trabecular pattern, radiographic density, and pulp chamber size, as well as the presence of radiolucent lesions not associated with the roots of teeth. Partial or complete loss of lamina dura, delicate of absent trabecular patterns, and an overall granular or chalky white appearance associated with an increase in radiographic density were the most common alterations. These tended to occur together and were most easily observed in the lower molar area superior to the mandibular canal. Radiolucent lesions not associated with the roots of teeth, expansion of alveolar ridges, and radiographic loss of the cortical borders of the maxillary sinus, nasal floor, and mandibular canal were less common but were occasionally noted. Multiple correlation coefficients between radiographic changes and selected biomedical patient data were obtained by computer analysis, and their significance discussed. The pathogenesis of end stage renal disease was also reviewed.

Dental lesions causing abnormalities on skeletal scintigraphy

The dental lesions of periodontitis, periodontal cysts, and tooth extraction were studied by Tc-99m phosphate scintigraphy of the jaws. Inflamed apical periodontal lesions caused a localized area of increased concentration of radiotracer regardless of the presence or absence of symptoms. Scintigrams may be positive up to eight months after dental extractions but tend to return to normal thereafter unless complications arise.

Jawbone cavities and trigeminal and atypical facial neuralgias

The possible role of dental and oral disease in the etiology of idiopathic trigeminal and atypical facial neuralgias has been examined. Among thirty-eight patients with idiopathic trigeminal neuralgia and twenty-three patients with atypical facial neuralgia, there was in nearly all instances a close relationship between pain experienced and the existence of cavities in alveolar bone and jawbone of the patients. The cavities were at the sites of previous tooth extractions and, although at times more than 1 cm. in a given diameter, were usually not detectable by x-rays. A new method for their detection and localization was developed empirically, based on the observation that peripheral infiltration of local anesthetic into or very close to the bone cavity rapidly abolished trigger and pain perception by patients during persistence of the anesthetic action. Histopathologic examination of bone removed from cavities by curettage revealed, in both idiopathic trigeminal and atypical facial neuralgias, a similar pattern characterized by a highly vascular abnormal healing response of bone. Some lesions presented a mild chronic inflammatory (lymphocytic) infiltration. Preliminary microbiologic studies of material from the walls of the cavities showed the existence within them of a complex, mixed polymicrobial aerobic and anaerobic flora. Treatment consisted of vigorous curettage of the bone cavities, repeated if necessary, plus administration of antibiotics to induce healing and filling-in of the cavities by new bone. Responses of patients to the above treatment consisted of marked to complete pain remissions, the longest of which has been for 9 years. Complete healing leads to complete and persistent pain remissions. It was concluded that in both idiopathic trigeminal and atypical facial neuralgias, dental and oral pathoses may be major etiologic factors.

Grafting in dentistry today (author's transl)

Enossal grafts are common practice in dentistry. The prognosis of such grafts fluctuates between primary failure and 10 years, and is largely determined by the indication: the more accurate the indication, the better the prognosis! In partial diastemata in the lower jaw, satisfactory results for a longer time are to be expected if the concurrently blocked remaining denture is periodontally sound.

Epignathus, double pituitary and agenesis of corpus callosum

Two infants from unrelated families died on the 1st day of life with epignathus, duplication of the entire pituitary, infundibulum and sella, and widening or separation of midline structures of the head including absent corpus callosum. We suggest that some infants surviving surgery for large epignathi may have relatively symptomless absent corpus callosum or double pituitary.

Application of the "Wits" appraisal

The "Wits" appraisal is intended as a diagnostic aid to be used in conjunction with other analyses. Whereas the popularly used ANB angular reading is a simple method of measuring degree of jaw disharmony, there are many instances in which this reading is suspect. The "Wits" appraisal permits easy identification of these shortcomings and substitutes a reasonably reliable means of measuring extent of anteroposterior jaw disharmony.

[Burkitt's disease in the Ivory Coast: anatomo-clinical and epidemiologic considerations]

The authors study the epidemiological conditions of the appearance of Burkitt's disease on the Ivory Coast. This condition represents 4.12% of cancers observed in this country. From a thorough study of the differences in temperature, relative humidity, vapour pressure, hours of sunlight, amount of rainfall, they were able to pick out that equatorial forest zones are more at risk than the savannah zones. The climatic conditions in the forest render intervention by a vector plausible, either directly or indirectly via malaria or other parasitic infestations.

Sarcoplasmic masses. Enzyme histochemistry and autoradiography

A comparative enzyme-histochemical study was made of the sarcoplasmic masses in a muscle biopsy specimen from a patient with myotonic dystrophy and those in the jaw-muscle of the Rana temporaria tadpole. The enzyme-histochemical patterns of the two methods proved to be identical. An autoradiographic study was made of the sarcoplasmic masses in the R temporaria tadpole with DL-thyroxine-2-14C and levomethionine 35S. The radioactivity labeled compounds were found to be stored or incorporated mainly in the myofibrillae, and virtually not at all in the sarcoplasmic masses.

[Cartilaginous tumors of the jaws. Apropos of 11 cases]

Over a period of 20 years and among a total amount of 585 tumors of the jaws including 61 sarcomas, 4 benign cartilaginous tumours and 11 chondrosarcomas have been observed. Chondromas and osteo-chondromas, exceptional in this site, occured one time in the median and anterior part of the upper jaw and three times in the coronoid process, the condyle and in the area of the symphysis of mandible. Chondrosarcomas of the jaws, observed in relatively young patients, have a tendency to involve the upper jaw and to recur repeatedly. Moreover they are characterized by an increased severity with regard to osteosarcomas and fibrosarcomas of same location.

Changes in the anterior nasal spine and the alveolar process of the macillae in leprosy a clinical examination

A brief review is presented of the Danish medieval skeletons with leprosy changes, particularly in the skulls, where the pathologic specific changes found are termed facies leprosa. The clinical aspect of facies leprosa is termed Bergen Syndrome I (nasal leprosy) and Bergen Syndrome II (the leprogenic changes of the alveolar process of the maxilla superior with loosening and/or loss of the frontal incisors). An account is given of the interim result of a clinical examination of 333 inpatients at the Prapradaeng Leprosarium in Bangkok, Thailand. In the group of 258 patients with lepromatous leprosy, 62.4% presented Bergen Syndrome I and 16.3% Bergen Syndrome II. These proportions differ clearly from the corresponding ratio found in the Danish medieval skulls.