ABSTRACT
This article discusses the radiographic manifestation of jaw lesions whose etiology may be traced to underlying systemic disease. Some changes may be related to hematologic or metabolic disorders. A group of bone changes may be associated with disorders of the endocrine system. It is imperative for the clinician to compare the constantly changing and dynamic maxillofacial skeleton to the observed radiographic pathology as revealed on intraoral and extraoral imagery.
Subject(s)
Mandibular Diseases/diagnostic imaging , Maxillary Diseases/diagnostic imaging , Radiography, Dental/methods , Bone Diseases, Metabolic/complications , Bone Diseases, Metabolic/diagnosis , Humans , Mandibular Diseases/diagnosis , Mandibular Diseases/etiology , Maxillary Diseases/diagnosis , Maxillary Diseases/etiologyABSTRACT
Examination of the oral cavity can provide significant diagnostic information regarding the general health of the patient. The oral cavity is affected by a multitude of pathologic conditions of variable cause and significance; however, there are numerous normal variations of oral soft tissue structures that may resemble a pathologic state. Understanding these variations assists practitioners to discriminate between normal versus abnormal findings and determine the appropriate course of management, if necessary.
Subject(s)
Mouth Diseases/diagnosis , Mouth Diseases/therapy , Primary Health Care , Soft Tissue Injuries/diagnosis , Soft Tissue Injuries/therapy , Ankyloglossia , Diagnosis, Oral , Humans , Leukoedema, Oral/diagnosis , Leukoedema, Oral/therapy , Lingual Thyroid/diagnosis , Lingual Thyroid/therapy , Mouth Abnormalities/diagnosis , Mouth Abnormalities/therapyABSTRACT
Oral herpes virus infections (OHVIs) are among the most common mucosal disorders encountered by oral health care providers. These infections can affect individuals at any age, from infants to the elderly, and may cause significant pain and dysfunction. Immunosuppressed patients may be at increased risk for serious and potential life-threatening complications caused by OHVIs. Clinicians may have difficulty in diagnosing these infections because they can mimic other conditions of the oral mucosa. This article provides oral health care providers with clinically relevant information regarding etiopathogenesis, diagnosis, and management of OHVIs.
Subject(s)
Herpesviridae Infections/diagnosis , Mouth Diseases/virology , Stomatitis, Herpetic/diagnosis , Antiviral Agents/therapeutic use , Diagnosis, Differential , Herpesviridae/classification , Herpesviridae/physiology , Herpesviridae Infections/therapy , Humans , Immunocompromised Host , Recurrence , Stomatitis, Herpetic/therapy , Virus Activation/physiologyABSTRACT
Pseudoxanthoma elasticum (PXE) is a disorder characterized by progressive degeneration of elastic fibers and ectopic mineralization. Cutaneous manifestations are a hallmark of this disease and organs that may be affected by the disease process include cardiovascular, central nervous system, ocular and gastrointestinal systems. Oral manifestations of PXE have been previously reported as intramucosal nodules observed on various intraoral surfaces. We present a case of a 46-year-old female with PXE diagnosed with temporomandibular disorder (TMD). To our knowledge, this is the first report of a patient with TMD coexisting with PXE in the scientific literature.
Subject(s)
Pseudoxanthoma Elasticum/complications , Temporomandibular Joint Disorders/etiology , Diagnosis, Differential , Diagnostic Imaging , Female , Humans , Middle Aged , Pseudoxanthoma Elasticum/diagnosis , Temporomandibular Joint Disorders/diagnosisABSTRACT
BACKGROUND: The authors evaluated the efficacy and tolerability of 10 percent and 20 percent benzocaine gels compared with those of a vehicle (placebo) gel for the temporary relief of toothache pain. They also assessed the compliance with the label dose administration directions on the part of participants with toothache pain. METHODS: Under double-masked conditions, 576 participants self-applied study gel to an open tooth cavity and surrounding oral tissues. Participants evaluated their pain intensity and pain relief for 120 minutes. The authors determined the amount of gel the participants applied. RESULTS: The responders' rates (the primary efficacy parameter), defined as the percentage of participants who had an improvement in pain intensity as exhibited by a pain score reduction of at least one unit on the dental pain scale from baseline for two consecutive assessments any time between the five- and 20-minute points, were 87.3 percent, 80.7 percent and 70.4 percent, respectively, for 20 percent benzocaine gel, 10 percent benzocaine gel and vehicle gel. Both benzocaine gels were significantly (P ≤ .05) better than vehicle gel; the 20 percent benzocaine gel also was significantly (P ≤ .05) better than the 10 percent benzocaine gel. The mean amount of gel applied was 235.6 milligrams, with 88.2 percent of participants applying 400 mg or less. CONCLUSIONS: Both 10 percent and 20 percent benzocaine gels were more efficacious than the vehicle gel, and the 20 percent benzocaine gel was more efficacious than the 10 percent benzocaine gel. All treatments were well tolerated by participants. Practical Implications. Patients can use 10 percent and 20 percent benzocaine gels to temporarily treat toothache pain safely.
Subject(s)
Anesthetics, Local/administration & dosage , Benzocaine/administration & dosage , Toothache/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Double-Blind Method , Female , Gels , Humans , Male , Medication Adherence , Middle Aged , Pain Measurement , Patient Satisfaction , Pharmaceutical Vehicles , Placebos , Self Administration , Time Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head and neck neoplasms. PPS tumors are difficult to diagnose due to limited presenting signs and symptoms and because of their location deep within the neck. METHODS AND RESULTS: A 60-year-old woman presented with complaints of otalgia, which appeared to be consistent with a temporomandibular disorder (TMD). Due to disproportionate symptoms, an MRI of the temporomandibular joints was ordered. The MRI revealed a mass within the PPS, which was later diagnosed as a mucoepidermoid carcinoma. A literature search failed to reveal otalgia, and facial pain, thought to be related to a TMD, as the primary presenting symptoms of a PPS neoplasm. CONCLUSION: Patients presenting with disproportionate signs and symptoms of a TMD should be evaluated with advanced imaging to rule out occult pathology.
Subject(s)
Carcinoma, Mucoepidermoid/complications , Earache/etiology , Pharyngeal Neoplasms/complications , Temporomandibular Joint Disorders/etiology , Carcinoma, Mucoepidermoid/diagnosis , Carcinoma, Mucoepidermoid/pathology , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Neck Dissection , Pharyngeal Neoplasms/diagnosis , Pharyngeal Neoplasms/pathologyABSTRACT
SUBJECTS: Fifty-two disinfected photostimulable phosphor (PSP) plates in plastic barrier envelopes were evaluated for contamination following placement in 30 study participants. Forty-four plates were acceptable for use in the study. KEY RISK/STUDY FACTOR: The risk factor was the abundant oropharyngeal microbial flora and its ability to breach infection-control barrier sheaths. MAIN OUTCOME MEASURE: The presence of bacterial colonies on an agar plate was used to determine bacterial contamination and the presence of any growth indicated failure of the barrier envelope. MAIN RESULTS: Before clinical placement of the plates, quality review of the PSP plates revealed defects in the integrity of 4 barrier envelopes most likely caused by forceps-related damage or failure to achieve a uniform seal during manufacturing. These defects allowed substantial contamination. Contamination also occurred as a result of failure to extract the PSP plate from the barrier envelope cleanly. Of the 44 barriers with no obvious signs of a defect, 3 produced bacterial growth following culture. CONCLUSIONS: The authors concluded that digital sensor sheathed in barrier envelopes remain a potential source of contamination. PSP plates must be disinfected between removal from a contaminated barrier envelope (used in a patient) and placement in a new barrier envelope. In addition, placement into the barrier envelope should ideally be carried out under aseptic conditions. Finally, the integrity of each sealed barrier envelope must be verified visually.
