ABSTRACT
Acute porphyrias are classified into 3 distinct groups of rare genetic disorders of metabolic enzyme biosynthesis. Acute porphyrias can significantly impact multiple organ systems, which often provides a challenge to the dentist presented with such a patient. A case of hereditary coproporphyria is reported in a patient with many of the classical signs and symptoms. The patient also had complex dental needs that required special medical and pharmacotherapeutic modifications. The acute porphyrias are reviewed by the authors with presentation of this challenging case. Recommendations for other dental health care professionals encountering these patients are then presented.
Subject(s)
Dental Care for Chronically Ill , Mouth Diseases/etiology , Porphyrias, Hepatic/complications , Porphyrias , Acute Disease , Adult , Dental Caries/etiology , Female , Humans , Periodontitis/etiology , Porphyrias/classification , Porphyrias/complications , Porphyrias/metabolism , Porphyrias/therapy , Temporomandibular Joint Disorders/etiologyABSTRACT
Intraoral Kaposi's sarcoma (KS) is a lesion seen commonly in patients with AIDS. These lesions can interfere with both speech and mastication. The dental team should be aware of the various treatment modalities for KS and the complications associated with these treatments. One of the treatment modalities reviewed here can be safely administered in a dental office.
Subject(s)
Dental Care for Disabled , Palatal Neoplasms/drug therapy , Sarcoma, Kaposi/drug therapy , Vinblastine/administration & dosage , Acquired Immunodeficiency Syndrome/complications , Adult , Humans , Injections, Intralesional , Male , Palatal Neoplasms/etiology , Sarcoma, Kaposi/etiologyABSTRACT
Successful management of hospital dental programs and general practice residencies is challenging in this era of cost containment. The efforts of two hospitals to strengthen their dental departments through greater efficiency of operation, cost controls, and improvements in a general practice residency program are described.
Subject(s)
Dental Service, Hospital , General Practice, Dental/education , Hospital Shared Services , Internship and Residency , Cost Control , Dental Service, Hospital/organization & administration , HumansABSTRACT
This study was a comparison of the sedative and amnestic properties of midazolam and diazepam when administered for relief of patient discomfort during dental surgery. It was a double-blind placebo-controlled group study, which entailed the analysis of 60 patients randomly assigned to the three groups: midazolam, diazepam, and placebo. There were 20 patients in each group. Midazolam patients showed superior performance in the parameters of sedation and amnesia when compared to patients who were administered diazepam. Both groups showed better results than the placebo group, which had the best results with the Digit Symbol Substitution Test and the Trieger Test.
Subject(s)
Anesthesia, Dental , Diazepam/administration & dosage , Midazolam/administration & dosage , Preanesthetic Medication , Adolescent , Adult , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Injections, Intravenous , Male , Memory/drug effects , Middle Aged , Pain, Postoperative , Patient Compliance , Time FactorsABSTRACT
A rare occurrence of bilateral dental fusion is reported. An alternative to conventional treatment is described in which the supernumerary teeth are separated and maintained as part of the anterior complement of teeth.
Subject(s)
Fused Teeth/therapy , Incisor/abnormalities , Tooth Abnormalities/therapy , Tooth, Supernumerary/therapy , Child , Fused Teeth/surgery , Humans , Incisor/surgery , Male , Maxilla , Tooth Movement Techniques , Tooth, Supernumerary/surgeryABSTRACT
A puzzling case is presented, in which no known etiology existed for a progressively worsening idiopathic external root resorption throughout the entire dentition. Parents of the patient did not pursue the option of pulp extirpation and calcium hydroxide treatment as a possible means of arresting the condition.
Subject(s)
Root Resorption/diagnosis , Adolescent , Diagnosis, Differential , Humans , Male , Radiography , Root Resorption/diagnostic imaging , Root Resorption/pathology , Root Resorption/therapySubject(s)
Pharmacology , Absorption , Aged , Aging , Drug Interactions , Humans , Pharmaceutical Preparations/metabolismABSTRACT
A sedative technique with meperidine hydrochloride and promethazine hydrochloride via an intramuscular injection is presented. We believe this is an excellent technique because of the safety to the patient and the ease of administration. Like any technique using potentially dangerous medications, practitioners and their staff must be familiar with and prepared for possible complications. When the technique is mastered, it will be a valuable addition for treatment of certain mentally and physically handicapped patients.
Subject(s)
Anesthesia, Dental/methods , Anesthesia, General/methods , Buttocks , Humans , Hypnotics and Sedatives/administration & dosage , Injections, Intramuscular/methods , Meperidine/administration & dosage , Meperidine/pharmacology , Promethazine/administration & dosage , Respiration/drug effectsABSTRACT
The first reported case of endodontic therapy in dentinal dysplasia, Type I, is described. The first histologic diagnosis of periapical granuloma instead of periapical cyst in dentinal dysplasia, Type I, is also reported.
Subject(s)
Dentin Dysplasia/therapy , Mandibular Diseases/pathology , Periapical Granuloma/pathology , Retrograde Obturation , Adult , Dental Pulp Calcification/pathology , Dental Pulp Test , Dentin Dysplasia/classification , Female , HumansABSTRACT
A total of 600 handicapped patients had dental rehabilitation under general anesthesia during an eight-year period. Handicaps included mental retardation, cerebral palsy, Down syndrome, seizure disorders, autism, cystic fibrosis, osteogenesis imperfecta, and muscular dystrophy. No significant complications developed in the majority of patients. This is attributed to thorough preoperative evaluation, appropriate anesthetic management, and vigilant postoperative observation.
