Non-HIV-associated Kaposi's sarcoma of the tongue. Case report and review of the literature.

Kaposi's sarcoma is a frequently seen AIDS-related malignant neoplasm in the head and neck region, especially in the oral cavity, but is rarely described in the HIV-negative and non-immunosuppressed individual. The case of a 76-year-old HIV-negative, non-immunocompromised woman with a solitary Kaposi's sarcoma of the tongue is reported. The tumour was locally excised with subsequent local radiotherapy. Diagnosis and therapy are discussed and compared with a review of the contemporary literature.

Observations on pulpal response to carbon dioxide laser drilling of dentine in healthy human third molars.

Preservation of pulpal health is the primary prerequisite for successful application of laser systems in the hard tissue management of vital teeth. The purpose of this study was to investigate the short and long-term pulpal effects to cavity preparations in healthy human teeth using carbon dioxide (CO2) laser. A total of seven, healthy, third molars that were scheduled to be removed due to space problems were used. After the laser drilling, the occlusal cavities were closed temporarily, and the teeth were extracted 7 days (n=5) and 3 months (n=2) after the operation. The specimens were fixed, decalcified, subdivided and processed for light and transmission electron microscopy. Seven days postoperatively all the five teeth that had been irradiated with the CO2 laser did not reveal any pathological changes in the pulpo-dentine complex. Three months postoperatively the two teeth that were prepared with the laser showed subtle but distinct apposition of tertiary dentine that was lined with intact odontoblasts. One of the specimens at 3 months revealed the presence of a mild, but very circumscribed, pulpal infiltration of chronic inflammatory cells subjacent to the cavity preparation. The latter is unlikely to be due to a direct effect of the laser irradiation but a possible consequence of microleakage of oral antigens and/or other tissue-irritating molecules through the temporary restoration and the remaining dentine thickness (RDT). Although these preliminary histological results suggest that the CO2 laser under investigation induced only minimal response of the dentine-pulp complex when used as a hard-tissue drilling tool, with specific energy settings, pulse duration within thermal relaxation time and emitting radiations at 9.6 microm of wavelength, larger clinical trials involving various types of teeth are necessary to reach definite conclusions for large-scale clinical application of the laser device.

Primary chronic osteomyelitis in childhood and adolescence: a retrospective analysis of 11 cases and review of the literature.

PURPOSE: Primary chronic osteomyelitis (PCO) of the jaw is a rare, nonsuppurative, chronic inflammation of an unknown cause. The disease is not age specific. So far, only case reports of this disease with an onset in childhood or adolescence have been described. PATIENTS AND METHODS: Review of the patient data of our department from the past 30 years revealed 11 patients with an early onset of PCO in childhood and during puberty. RESULTS: Demographic data, clinical course, radiologic and histologic examinations, and treatment modalities are described and compared with the literature with special emphasis on the somewhat confusing terminology used for this pathology. CONCLUSION: We present a group of 11 patients with an early onset of PCO of the mandible, which, to our knowledge, is the largest described series to date. The series shows the complexity of this disease in a young patient population, demanding a careful evaluation of each case before initiation of therapy.

Laser-induced temperature changes in dentine.

OBJECTIVE: The purpose of this work is to study the temperature rise and potential thermal damage caused during ablation of human dentine using a super pulsed carbon dioxide laser of 9.6-microm wavelength, equipped with a water-cooling spray and scanner system. BACKGROUND DATA: There have been no reports on thermal effects of super pulsed CO2 laser of 9.6 microm wavelength on human dentine recently. MATERIALS AND METHODS: Two different types of samples were investigated to yield data most consistent with a typical clinical situation. Human dentine slices and crown segments were studied at a drilling depth of 1.0 +/- 0.1 mm and 2.5 +/- 0.5 mm, respectively. A control group treated with a conventional hand piece was compared to four laser groups with settings varying from 2 to 8 W. RESULTS: In the laser group demonstrating the highest elevation in temperature of the four studied, dentine slices lased at 2 W for 15 sec showed a mean temperature rise of less than 1.68 degrees C at an ablation rate of 0.86 +/- 0.08 mm. Conventional drilling with a comparable ablation rate of 0.76 +/- 0.59 mm resulted in a mean rise of 2.87 degrees C. The laser groups of crown segments revealed a constant decrease in temperature. SEM observations were lacking the typical morphological changes seen in earlier studies, specifically extensive melting, charring or cracking. CONCLUSION: A maximum rise of mean temperature to 1.68 degrees C in closest vicinity to the pulpal chamber and the morphological unaltered dentine surfaces demonstrate the safe and tissue preserving character of the superpulsed 9.6 microm CO2 laser. The laser caused an even lower temperature rise than conventional drilling. Moreover, the laser showed acceptable efficacy with ablation rates that did not significantly differ from the conventional dental drill.

The extensor digitorum brevis island flap: possible applications based on anatomy.

In the past few years, the proximally based extensor digitorum brevis island flap has been recognized as a useful method in the reconstruction of the lower extremity. The major goal of this study, which was performed in 16 cadavers, was to show the possible application of the extensor digitorum brevis island flap based on its anatomy. The vascularization and morphology of the muscle were also studied. We are able to show that, with sufficient mobilization of the vascular pedicle, the extensor digitorum brevis easily can reach both the lateral and the medial malleoli. In most cases, the island flap even reaches the Achilles tendon, the posterior aspect of the heel, and the lower to middle part of the anterior crural region. The vascular supply of the extensor digitorum brevis muscle shows a great consistency, with the lateral tarsal artery being the dominant supply of the muscle. The mean surface of 27 cm2 allows coverage of small to medium-sized defects.