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1.
Int J Oral Maxillofac Surg ; 47(11): 1433-1438, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29960838

ABSTRACT

Costochondral grafting (CCG) can be used for the reconstruction of ankylotic, hypoplastic, and resected temporomandibular joint (TMJ) defects. CCGs have previously been considered the gold standard in children due to their growth potential and autogenous origin, but the disadvantages are unpredictable growth and joint ankylosis. This was a retrospective study of all children who received CCGs for TMJ reconstruction from 1985 to 2004, to allow a 10-year follow-up. Fifty-five patients were included in this study, with 74 grafts being placed; their mean age was 7.9±4.2years. Infection-related ankylosis (18.2%) and craniofacial microsomia (16.4%) were the most common diagnoses. Overall, 58.2% of patients suffered one or more complications over the follow-up period, with ankylosis (32.7%) and overgrowth (16.4%) being most common. There was a significant correlation between those with infection-related ankylosis and subsequent complications (χ2=8.8, df=1, P<0.005), while ankylotic patients in general exhibited greater overall complication rates (χ2=9.0, df=1, P<0.005). Patients with congenital TMJ defects were more likely to be complication-free than those with acquired defects (χ2=4.0, df=1, P<0.05). Caution is advised when placing CCGs in paediatric patients with ankylosed TMJs, especially those with infection-related ankylosis.


Subject(s)
Cartilage/transplantation , Mandibular Reconstruction/methods , Postoperative Complications/epidemiology , Temporomandibular Joint Disorders/surgery , Adolescent , Child , Child, Preschool , Female , Humans , Infant , London/epidemiology , Male , Retrospective Studies , Treatment Outcome
3.
Br Dent J ; 217(12): 679-84, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25525012

ABSTRACT

Sodium hypochlorite (NaOCl) is the most common irrigant used in modern endodontics. It is highly effective at dissolving organic debris and disinfecting the root canal system due to the high pH. Extravasation of NaOCl into intra-oral and extra-oral tissues can lead to devastating outcomes leading to long-term functional and aesthetic deficits. Currently no clear guidelines are available which has caused confusion among the dental and oral and maxillofacial (OMFS) surgical community how best to manage these patients. Following a literature review and considering our own experience we have formulated clear and precise guidelines to manage patients with NaOCl injury.


Subject(s)
Root Canal Irrigants/adverse effects , Sodium Hypochlorite/adverse effects , Dental Pulp Cavity/drug effects , Dental Pulp Cavity/injuries , Humans , Practice Guidelines as Topic , Root Canal Irrigants/therapeutic use , Root Canal Preparation/adverse effects , Root Canal Preparation/methods , Sodium Hypochlorite/therapeutic use
4.
Br Dent J ; 213(4): E6, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22918373

ABSTRACT

OBJECTIVE: The National Institute for Health and Clinical Excellence (NICE) introduced the antibiotic prophylaxis guideline in 2008 for cardiac patients in the UK, which has led to a decrease in national prescription levels for antibiotic prophylaxis. Despite the introduction of the guideline there is still a discrepancy in levels of compliance among the dental community. The aims of this study were to determine the understanding of the NICE clinical guideline on antimicrobial prophylaxis against infective endocarditis (IE) and the difference in antibiotic prescription for high risk cardiac patients (HRCP) between dental trainers and trainees. METHODS: A proforma was designed and distributed among dental trainers and trainees attending a conference at the London deanery. The trainers were GDPs responsible for training dental trainees allocated to them over a 12 month period based in a general dental practice. Dental trainees were recent graduates about to commence their vocational dental training. Eighty-five vocational dental trainees and 70 trainers completed the proforma on a voluntary basis. RESULTS: The results of the study confirm that most trainers (95.7%) and trainees (94.1%) are aware of this guideline but only 62% of trainers and 69.7% of trainees have read the guideline. Compliancy with the guideline was low among trainers (55.7%) and trainees (77.6%). Compliance was high among those who had read the guideline. Trainers were more likely to prescribe prophylaxis antibiotics for HRCP. The majority (74-76%) would prescribe antibiotics on a specialist's request. Some trainers (54.9%) and trainees (48.2%) would want antibiotics themselves if they were HRCP. CONCLUSION: This study concludes that much needs to be done to improve the understanding and practice of NICE guideline among the dental trainers and trainees.


Subject(s)
Antibiotic Prophylaxis , Dental Care for Chronically Ill , Education, Dental , General Practice, Dental/education , Guideline Adherence , Heart Diseases , Internship and Residency , Practice Guidelines as Topic , Adult , Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Attitude of Health Personnel , Dentists/psychology , Education, Dental, Graduate , Endocarditis, Bacterial/prevention & control , Female , Humans , Male , Middle Aged , Prescription Drugs , United Kingdom
5.
ScientificWorldJournal ; 7: 1004-6, 2007 Jun 12.
Article in English | MEDLINE | ID: mdl-17619782

ABSTRACT

A 20-month-old boy, who underwent left nephrectomy, had a suprapubic catheter inserted that knotted within the bladder. This case report identifies possible causes for such occurrences and how best to manage them.


Subject(s)
Catheters, Indwelling/adverse effects , Urinary Bladder Diseases/etiology , Urinary Bladder Diseases/prevention & control , Urinary Catheterization/adverse effects , Equipment Design , Equipment Failure Analysis , Humans , Infant , Male , Practice Guidelines as Topic
6.
Cytogenet Cell Genet ; 33(1-2): 35-41, 1982.
Article in English | MEDLINE | ID: mdl-6180864

ABSTRACT

In view of the success of hyperthermia as a modality in cancer treatment, we have studied its effect on chromosomes in combination with anticancer antibiotics. Three classes of chemicals, one with a non-delayed type of effect (adriamycin), one with a delayed type of effect (mitomycin C), and one with a truely radio-mimetic effect (bleomycin) were selected for study on human lymphocytes and Chinese hamster K-1 cells. Propane sultone was also included because its effect on plants is suppressed by hyperthermia. The data show increased because its effect on plants is suppressed by hyperthermia. The data show increased potential of these chemicals to induce chromosome aberrations when applied at temperatures higher than 37 degrees C, irrespective of the phase of cell cycle. The potentiation may be due to true synergism (bleomycin) of facilitation of entry of larger quantities of the drug (adriamycin). No potentiating effect was observed on the induction of sister chromatid exchanges (SCEs).


Subject(s)
Antibiotics, Antineoplastic/pharmacology , Chromosome Aberrations , Hot Temperature , Animals , Bleomycin/pharmacology , Cell Cycle/drug effects , Cells, Cultured , Cricetinae , Cricetulus , Doxorubicin/pharmacology , Humans , Lymphocytes/drug effects , Mitomycin , Mitomycins/pharmacology , Sister Chromatid Exchange/drug effects , Thiophenes/pharmacology
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