An investigation of the effect on 27-gauge needle tips following a single local anaesthetic injection

One hundred and forty one, 27-gauge local anaesthetic needles were collected, each following a single injection of local anaesthetic using four commonly performed local anaesthetic injection techniques. The needles were examined for needle tip damage under the scanning electron microscope. Ten unused needles were used as controls. Bone was contacted in 75 (59%) instances and, of these, 73 (97.3%) showed needle tip deformity. Of the four techniques used, bone contact was commonest with the inferior alveolar nerve block, occurring in 88% of instances.

Rhinoliths presenting during routine radiography: two cases

Rhinoliths are calcified masses found within the nasal cavity. They are an uncommon finding and usually present to ENT surgeons. This article presents two cases where rhinoliths have been recognized in the dental setting, and discusses their management and treatment.

Surgical emphysema following dental treatment: two cases

Surgical emphysema is an uncommon complication of dental treatment despite the frequent use of air-driven handpieces and high-speed water-cooled equipment in dental practice. As a consequence it may either go unrecognized or be misdiagnosed. Although most cases resolve spontaneously, some patients require emergency intervention. This article outlines the condition and its management and describes two cases that arose during routine dental treatment.

An ossifying fibroma presenting as Stafne's idiopathic bone cavity

The purpose of this paper is to present a case of a fibro-osseous lesion which was diagnosed as an ossifying fibroma rather than a cemento-ossifying fibroma because of its location away from the tooth bearing parts of the jaw and the absence of cemental tissue in the excised specimen. Its location and features on a panoramic radiographic made Stafne's idiopathic bone cavity a possible diagnosis.

Orofacial radiological manifestations of systemic sclerosis

OBJECTIVE

To ascertain the orofacial radiological manifestations of systemic sclerosis.

METHODS

Twenty-one patients with known systemic sclerosis underwent panoramic, and where appropriate periapical, radiography parotid sialography and a labial gland biopsy.

RESULTS

The prevalence of periodontal ligament space widening was 33%, bone resorption 9.5% and abnormal parotid gland sialographic findings 43%. Root resorption affected 4 (33%) of the 12 dentate patients.

CONCLUSIONS

Orofacial radiological manifestations occur commonly in systemic sclerosis. Root resorption has not previously been reported.

A comparison of manual and automatic processing in general dental practice

Although automatic processing is becoming more widely available in general dental practice, there is little objective information regarding the quality of this type of processing. Thus a postal study was undertaken to compare manual and automatic processing using a questionnaire together with a standardised, pre-exposed test radiograph for routine processing. Analysis of variance showed significant differences between the manually processed, automatically processed and control test films, in respect of D Min (P < 0.001), test strip (P < 0.001), and step density values (P < 0.01) but not for D Max (P > 0.1). The manually processed test films generally had significantly less density than the automatically processed test films or control test films.

An adverse reaction following sialography

Reactions following the administration of iodine are well documented in general radiography, but are unusual following sialography. A patient who experienced an adverse reaction following sialography with an iodine-based, low osmolar, contrast medium, Hexabrix 320, is presented. The reaction consisted of severe shoulder and back pain 24 h after the procedure. A skin rash was identified involving the right axilla, groin and elbow, with swelling visible around the right elbow joint. It was not possible to distinguish, on the basis of the available evidence, between an anaphylactoid and idiosyncratic allergic reaction.

Gingival Kaposi's Sarcoma: the first indication of HIV infection

This article presents a case of gingival Kaposi's sarcoma that initially mimicked an acute periodontal infection, but was the first clinical sign of HIV infection in a 38-year-old male homosexual patient. The clinical features and treatment of oral Kaposi's sarcoma are discussed and the variable histopathology of the lesion is demonstrated.

Concentration of cefuroxime in mandibular alveolar bone following a single preoperative dose

A pilot study was undertaken on 12 patients undergoing the bilateral removal of impacted mandibular wisdom teeth to determine the level of cefuroxime sodium within the alveolar bone adjacent to the third molar teeth following a single preoperative intravenous administration. The results indicated that a single 1.5 g intravenous bolus injection provided satisfactory alveolar bone concentrations for routine antibiotic prophylaxis at the time of wisdom tooth removal.

A new oral surgery teaching model

An anatomical model for teaching the practical aspects of routine oral surgery in a clinical or laboratory environment, is described. Replaceable sections allow the model to be rapidly re-used so that successive students may practise procedures such as incisions, flap reflection, bone removal, tooth removal, apicectomy and suturing. Keeping the cost per procedure to a minimum was considered to be of fundamental importance and this has been achieved through the use of 'factory produced' replacement parts.

Human tissue response to porous hydroxyapatite implants. A case report

Histological examination of 2 porous hydroxyapatite implants removed from a patient showed a pattern of ossification similar to that reported in a previous animal study. New bone was laid down on the surface of the hydroxyapatite but did not progress to occupy all the pores. Although porous hydroxyapatite blocks are biocompatible and well tolerated by the tissues, they are not recommended for augmentation of the resorbed alveolar ridge where the overlying mucosa is thin and atrophic, because of the risk of mucosal dehiscence and implant exposure. They are suitable in situations where they are deeply buried in the tissues and not subjected to direct trauma.

A comparison of ibuprofen and dihydrocodeine in relieving pain following wisdom teeth removal

Although dihydrocodeine (DF118) is widely prescribed by general dental practitioners, there is little evidence that it is successful in controlling post-operative dental pain. Ibuprofen is known to be effective in this situation. A single dose, double-blind study was carried out in 148 patients to compare 400 mg ibuprofen with 30 mg dihydrocodeine and placebo for treating moderate to severe pain following the removal of unilateral, impacted mandibular third molar teeth under local anaesthesia. An additional dose of either ibuprofen or dihydrocodeine was available after 2 hours. The post-operative ibuprofen reduced pain and produced more pain relief than dihydrocodeine or placebo. Furthermore, fewer patients receiving ibuprofen took additional analgesic at 2 hours. Patients who received ibuprofen as supplementary medication also experienced less pain and had greater pain relief than those receiving dihydrocodeine as supplementary medication, even when their post-operative treatment had been placebo. More patients reported the medication as having been effective if they took ibuprofen either post-operatively or as supplementary analgesia. Ibuprofen is an appropriate analgesic for treating post-operative dental pain.

The post-operative maxillary cyst. Experience with 23 cases

23 cases, diagnosed as post-operative maxillary cyst, from outside Japan are described. Clinical, radiographic and histopathological features are not dissimilar to those cases reported from Japan, and various parameters have been found to be helpful in diagnosis. This lesion is more common outside Japan than previously suggested, and this is probably largely due to faulty diagnosis.

Ridge augmentation using solid and porous hydroxylapatite particles with and without autogenous bone or plaster

Edentulous areas of dog jaws were augmented with solid or porous particles of hydroxylapatite (HA) alone, or combined with either finely crushed autogenous bone or plaster of paris. At the end of the experiment (24 weeks), the augmented ridges were firm and stable and covered with healthy mucosa. The ridges augmented with only porous particles of HA demonstrated a greater amount of bone ingrowth compared with the solid, dense particles. The new bone formation occurred in those parts of the implants adjacent to the underlying alveolar bone. The addition of autogenous bone to the HA particles did not enhance bony deposition, and none of the autogenous bone chips survived for 24 weeks. The amount of new bone in the ridges augmented with plaster of paris and HA was similar to the other groups, and the plaster did not interfere with healing. There was evidence of resorption of the underlying cortical bone in many of the specimens.

Recurrent swelling of the upper lip. A case report

Recurrent swelling of the lips may be due to a number of causes. A case is presented of recurrent swelling of the upper lip caused by trauma from a displaced and apically dilacerated 1. There was abnormal development of 32 which were also displaced although 123 appeared unaffected. The surgical, endodontic and orthodontic management of this problem is discussed.