An unusual complication of osteotome sinus floor elevation: benign paroxysmal positional vertigo.

Maxillary sinus floor elevation in cases of reduced vertical bone height in the posterior maxilla allows predictable implant placement. The osteotome sinus floor elevation (OSFE) technique has shorter healing and waiting times because the fixture can be placed in the implant recipient site simultaneously with the ridge augmentation. Implant site preparation is more comfortable for the patient when performed with spiral drills than with continuous malleting of the osteotomes. Membrane perforation is the most frequent complication with the OSFE technique; postoperative infection is rare. Benign paroxysmal positional vertigo (BPPV) may be a complication of OSFE and may cause stress if not identified correctly and managed properly. The available treatment options, diagnostic strategies and the pathophysiology of this unusual complication are discussed. The authors present a case in which intense BPPV developed during OSFE, focusing on dental and maxillofacial surgery as risk factors for this pathology.

The use of etanercept as a non-surgical treatment for temporomandibular joint psoriatric arthritis: a case report.

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the skin and joints characterized by extensive intra-articular bone resorption and silver-red scaly plaques most commonly found on extensor surfaces of the skin. When this arthritis affects the temporomandibular joint (TMJ) and does not successfully halt in its early degenerative process, patients may undergo invasive joint reconstruction that irreversibly changes the TMJ physiologic joint dynamics. This study presents a case of TMJ PsA: anterior open bite, limited range of motion, and erythematous desquamative plaques of the upper limb extensors surfaces. The patient previously received non-steroidal anti-inflammatory drugs, immunosuppressors, and corticosteroids over a four-year period while suffering the idiosyncratic drug side effects from long-term therapy without improvement in joint function or rash resolution. The treatment team then chose etanercept, a synthetic fusion protein therapy that binds with tumor necrosis factor (TNF)-alpha, to interrupt reactive inflammatory arthritis. The patient received the TNF-alpha inhibitor monthly for two years. This last treatment led to full remission of both joint symptomatology and skin lesions. Our results should encourage general dental practitioners' involvement in curing patients with psoriatic arthritis when it affects the TMJ.

The impacts of postwar migration to Western Europe.

"This essay identifies and analyzes the four most important impacts of postwar migration to Western Europe. First, early postwar immigration facilitated the rapid and sustained expansion of the domestic economy. Second, it eventually precipitated major changes in domestic immigration and citizenship regimes. Third, the influx of millions of immigrants, refugees, asylees, and migrant workers profoundly and permanently altered the social and cultural bases of West European societies. And finally, postwar immigration exacerbated the social tensions that helped to undermine the consensual foundations of the postwar political order."

Endodermal sinus tumor: report of a case associated with pregnancy.

The case of a 15-year-old black primigravida with an 18-week intrauterine gestation and concurrent endodermal sinus tumor is presented. Rationale for therapy is discussed.

Pelvic neurofibromatosis.

A case of asymptomatic and previously undiagnosed neurofibromatosis which presented with clitoral enlargement, "cafe-au-lait" spots, and pelvic masses is described. The literature on neurofibromatosis as it involves the female genital tract is reviewed.