A comparison of template bleeding time with mucosal petechiometry as a measure of the platelet function defect induced by aspirin.

The object of this study was to assess the value of mucosal petechiometry as a useful method of measuring the haemostatic defect induced by aspirin. The template bleeding time was done for comparison. The results indicated that mucosal petechiometry did not measure the haemostatic defect induced by aspirin and that aspirin-induced alterations in platelet function were not important in the development of petechiae in healthy subjects.

Catastrophic otologic injury from oral jet irrigation of the external auditory canal.

Jet irrigation is an accepted method for removal of cerumen from the external auditory canal. Even at a submaximal power setting, oral jet irrigators can generate enough force to rupture the tympanic membrane. Parameters for safe use of these irrigators have never been established. Three cases are reported in which, in addition to tympanic membrane rupture, oral jet irrigators caused ossicular disruption, round and oval window fistulae, and subluxation of the stapedial footplate. A prospective study performed on 25 fresh cadavers demonstrated a 6% incidence of tympanic membrane perforation when the power setting was one-third full power or greater. Recommendations are made for safe use of oral jet irrigators for removal of external auditory canal cerumen.

A survey of general anaesthesia and sedation in dental practice in two cities.

Using a postal questionnaire, the use of general anaesthesia and sedation in general dental practice in two cities over a 4-week period was investigated. Questionnaires were sent to a random sample of one in five dental practitioners in Bristol and Sheffield, and an 82% response rate was attained. More practices in Sheffield administered general anaesthesia than those in Bristol. The differences between the facilities provided are discussed. Equipment and facilities have improved since a larger survey was described in 1976, but the use and availability of monitoring equipment has changed little since then. The results reflect the decline in the use of general anaesthesia in dental practice seen nationally. The survey provides an insight into the current anaesthetic services provided in general dental practice in two cities, both of which contain dental hospitals, and provides a basis for the design of a protocol for a further national survey.

One visit apicectomy technique using calcium hydroxide cement as the canal filling material combined with retrograde amalgam.

A prospective study was set up to evaluate a one-visit apicectomy technique. Calcium hydroxide cement was used as the root canal filling material. The calcium hydroxide cement set rapidly and clearly revealed the position, size and outline form of the root canals at the level of resection. This facilitated preparation of the apical cavities to a depth of 3 mm. Each cavity was varnished before placement of the amalgam. Sixty-eight patients (93 teeth) were included in the study. Five patients (8 teeth) were lost to follow-up. The success rate, based on clinical and radiographic examination after a minimum of 2 years, was 91.8 per cent.

Blue rubber-bleb naevus syndrome.

A case is reported of a patient who presented with facial pain and was found to have phleboliths associated with venous anomalies of the face and neck. Systemic investigation revealed a microcytic, hypochromic anaemia which was the result of haemorrhage from multiple haemangiomas of the gastro-intestinal tract. The finding of anaemia together with cutaneous and intestinal haemangiomas fits with a diagnosis of blue rubber-bleb naevus syndrome.

Candida glabrata (syn. Torulopsis glabrata) associated with a chronic hyperplastic lesion of the palate.

A case initially presenting as chronic hyperplastic candidosis is described. After treatment with nystatin on three separate occasions over a seven-year period, a lesion similar to that diagnosed originally occurred in the same site. Further examination of this later occurrence showed it to be associated with the imperfect fungus Candida glabrata which had a high minimum inhibitory concentration for nystatin (greater than 30 micrograms/ml). The lesion eventually resolved following treatment with miconazole gel and surgical excision of the hyperplastic tissue. The patient has remained symptomless for a two-year follow-up period.

Nystatin-resistance of candida albicans isolates from two cases of oral candidiasis.

Two cases of oral candidiasis are described which failed to respond to nystatin therapy when used in combination with triamcinolone acetonide. The isolates of C. albicans obtained from the patients after treatment showed high in vitro resistance to nystatin when tested in combination with triamcinolone acetonide. Triamcinolone acetonide was detected in the saliva of both patients after treatment. Addition of this saliva to the isolates of C. albicans obtained after treatment was found to confer nystatin resistance. Both patients were treated with miconazole nitrate and a mycological and clinical cure was obtained in one of the cases.

ACTH and resistance of small blood vessels to trauma: use of mucosal petechiometry.

The effect of an intramuscular injection of ACTH on the resistance to trauma of oral mucous membrane blood vessels was assessed by petechiometry. In a double-blind cross-over study involving 20 healthy volunteers, 18 showed a reduction in petechial count after the active injection but only nine did so after the injection of placebo. These findings may justify the use of ACTH in the management of patients with a history of haemorrhage after dental extraction.

Mucosal petechiometry: a reliable method for the measurement of capillary resistance.

The method of mucosal petechiometry, as described by Kozam (1968), was investigated and found to be a valid technique for investigating capillary resistance. Recommendations are made on the use of this technique as a research method.