Oral Health Case Reports

Numb chin syndrome (NCS), or mental nerve neuropathy, is a sensory neuropathy of the mental nerve and is characterized by hypoesthesia, paresthesia, or a numbness sensation of the chin and lower lip. NCS is caused by multiple etiologies including cancer invasion. We present a case series of three multiple myeloma patients with NCS where the jaw symptoms are a manifestation of disease relapse with extra-medullary myeloma infiltration, including soft tissue plasmacytoma involving the mental nerve noted along the jaw bone. The soft tissue plasmacytoma was detected using magnetic resonance imaging (MRI), which is the preferable diagnostic imaging technique to evaluate this type of problem. Furthermore, we found that in all cases, the involved immunoglobulin was IgA. This is interesting because IgA is the main immunoglobulin secreted by salivary glands. In addition, it seems that NCS could serve as one of the ominous prognostic factors in these patients.

Papillon-Lefevre syndrome is a rare autosomal recessive disorder in which the frequently observed manifestations are palm plantar keratinization and premature loss of both deciduous and permanent teeth. Here I present a rare case report of Papillon-Lefevre syndrome in 9 year old Peadatric patient along with a comprehensive review of the etiology, pathology, clinical features, differential diagnosis and management of the condition.

Adenomatoid odontogenic tumor [AOT] is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst. AOT accounts for about 1% until 9% of all odontogenic tumors. It is predominantly found in young female patients, located more often in maxilla and most often associated with an unerupted permanent tooth. However, AOT frequently resemble other odontogenic lesions such as dentigerous cysts or ameloblastoma. For illustration a rare case of an AOT in the mandible in a 12-year-old female patient is presented

Abstract Objectives: To examine the effect of energy application on microhardness of glass-ionomer cement (GIC), and the effect of the temperature applied on pulp temperature, in vitro and in vivo.

Methods: Discs of EQUIA (GC Co. Japan) were examined for microhardness using Vickers indentations after heat application of 50 or 60oC for 30 or 60 seconds using light curing devices or a specific heating device, and compared to self setting GIC. The measurements were performed after 30, 60 minutes and after 5 days. Heat was applied to GIC occlusal restorations in deciduous and permanent teeth both in vitro and in vivo and the effect on pulp temperature was measured using a thermo-coupling device.

Results: The best microhardness results were observed using a specific heating device at 50oC for 30 or 60 seconds, and the differences to self setting material after 60 minutes were statistically significant. After 5 days the differences in microhardness were non-significant. Temperature of 60oC caused the pulp temperature to rise with more than the accepted 5.5oC and may cause irreversible damage to the pulp. Similar pulpal temperature changes were observed in vitro and in vivo in deciduous and permanent teeth.

Significance: The application of heat energy to GIC using a heating device improved the surface microhardness significantly during the first 60 minutes. The temperature to be used is around 50oC for 30 or 60 seconds in order not to cause irreversible damage to the pulp.

A technique for clinical shade analysisis presented. The technique involves first eliminating shade tabs with dissimilar shades, and then taking digital images of the target tooth with a shade tab aligned edge-to-edge. The imageof the shade tab is then digitally duplicated, cropped, and flipped. The cropped and flipped shade tab is aligned adjacentto the target tooth to visualize the color gradient

Background: Caffeine is a methylxanthine which may decrease salivation through adrenergic mechanisms. Few studies have formally tested whether caffeine actually decreases saliva production.

Methods:Eleven volunteers collected unstimulated 1-minute saliva production (1-MSP) after an overnight fast, followed shortly by a stimulated 1-MSP while chewing a stick of chewing gum. We then asked them to drink a beverage randomly selected to contain either regular or decaffeinated instant coffee. Caffeine content was doubleblinded. 1-MSP, both unstimulated and stimulated were then collected 30, 60, 90, and 120 minutes later. The following morning the subject followed the same protocol but drank the other kind of beverage. We used a mixedeffects linear model to analyze our data.

Results: The adjusted mean difference between decaffeinated and caffeinated 1-MSP was -0.14 ml (p<0.05). Stimulation with chewing gum caused an unadjusted increase of 2.02 ml (p<0.001) and an adjusted increase of 2.01 ml (p<0.05). Variation for the unstimulated 1-MSP was much lower (SD 0.4 ml) than the stimulated 1-MSP (SD 1.01 ml), whereas variation for caffeinated 1-MSP (SD 1.29 ml) was similar to decaffeinated 1-MSP (SD 1.25 ml).

Conclusion: Caffeine modestly but significantly decreased both Unstimulated and stimulated saliva production. The effect of caffeine was approximately 6.5% that of stimulation. The effect from caffeine was consistent across both stimulated and unstimulated samples. Additionally, caffeine did not increase the variability of saliva production either within or between individuals, in contrast to the effect from stimulation

Langerhan’s Cell Histiocytosis formerly known as histiocytosis X traditionally denotes a group of diseases that stem from proliferative reticuloendothelial disturbances. The etiology and pathogenesis of the disease remain debatable.The present paper reports a case occuring in a three and a half year old ( 3½ year pediatric) child reported to the department of oral pathology with gingival enlargement of the jaws, also disscussed are the radiological features along with histopathological features of the case.

Pindborg tumor is a rare benign epithelial odontogenic tumor occurring most frequently in the posterior part of the lower jaw. I herein report a case of a 12 year old pediatric male patient with a painless swelling of the left maxilla of 5 months duration. Radio graphically, a well circumscribed unilocular radiolucency containing radiopaque foci associated with impacted tooth was seen, along with cortical bone expansion. Histopathology showed sheets of polyhedral epithelial cells in a fibrous stroma. Cells showed distinct cellular outlines with prominent intercellular bridges. Large areas of amorphous, eosinophilic, hyalinized material seen and calcifications within the amyloid-like material (Liesegang ring calcifications) were evident, confirming a diagnosis of Pindborg tumour (Calcifying Epithelial Odontogenic Tumor). The patient was treated by surgical excision of the tumor.

We present the case of a newborn with a rare combination of trifid tongue, macroglossia, ankyloglossia, median cleft of the lower lip, bony Tumour on the mandible and cleft of the palate. Our surgical procedure consisted in the release and repair of the trifid tongue; removal of the Tumour on the mandible and repair of the cleft of the lower lip. Finally, we carried out a novel technique to reduce the enlarged tongue. This new technique of achieving uniform tongue reduction has its essential character in a rocket-like incision in the tongue, which is different in construction and quality from the over plus of techniques described so far. Among its variety of skills is the reduction of the square-like form and preclusion of the midline trough of the keyhole technique. It gives a functionally satisfactory and aesthetically pleasing result. The surgeons who apply this surgical procedure call it the Oji technique