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Medically Compromised Patients

What’s your diagnosis of this case?

This case is presented by:  Dr. Eric T. Stoopler, D.M.D., FDS RCSEd, FDS RCSEng Dr. Juan M. Bugueno, D.D.S. Dr. Kevin Sweeney, D.D.S. Dr. David C. Stanton, D.M.D., M.D., F.A.C.S  Click here to view the BRONJ Case Diagnosis and Treatment Case Presentation A 64-year-old Caucasian female presented for evaluation of symptomatic exposed bone of a two-year duration post extraction of maxillary teeth with immediate placement of four dental implants. Medical history: Is at stage IV breast adenocarcinoma treated with surgery and trastuzumab. Received intravenous zoledronic acid (ZA) 4 mg monthly for approximately two years for metastatic bone disease. Underwent dental surgery ...

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“Failure to Erupt Syndrome”: Myth or Reality?

This question was submitted by a general dentist: Three siblings have been diagnosed with “failure to erupt syndrome.” The oldest had removal surgery and implants. How rare is this syndrome and how common for all three to have it?  Dr. Ian McConnachie, pediatric dentist at Woodroffe Pediatric Dentistry, provided the following initial and quick response. I am unaware of any condition called “Failure to Erupt Syndrome.” There is a small list of conditions where one finds a failure of at least several teeth to erupt. The one we all remember from our dental student days is cleidocranial dysplasia and the slide of ...

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How would you treat this case?

This case was submitted by a team of dental faculty members in the Oral Medicine and Pathology departments of the University of Pennsylvania School of Dental Medicine.  Alicia M. Houston, D.D.S. (Resident – Department of Oral Medicine) Faizan Alawi, D.D.S. (Associate Professor of Pathology – Department of Pathology) Eric T. Stoopler, D.M.D., FDS, RCSEd, FDS RCSEng  (Associate Professor of Oral Medicine) Case was edited by Dr. Suham Alexander, Oasis Clinical Editor  Case Presentation Findings Extraoral – NSF Intraoral – 2x2cm ulceration at R posterior lateral border of the tongue with indurated borders No herpes simplex virus found in direct fluorescent ...

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What are the effects of radiotherapy on dental hard tissue?

This summary is based on the article published in the journal of Clinical Oral Investigation: The effect of radiotherapy on dental hard tissue. A systematic review (January 2014) H. F. J. Lieshout & C. P. Bots Context Decay of teeth, erosion and disintegration of hard dental tissue are clinically often seen side effects after radiotherapy for tumours in the head and neck region. Purpose of the Review To investigate if these side effects are due to structural changes in dental hard tissues, the current literature was searched. It can influence the quality of life gravely. Results Tooth destruction occurs often and soon after irradiation. There ...

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What is the epidemiology of oral health conditions in older people?

This summary is based on the article published in Gerodontology: Epidemiology of oral health conditions in older people (February 2014) William Murray Thomson Context The main conditions of interest when considering the epidemiology of oral diseases among older people are tooth loss, dental caries, periodontitis, dry mouth and oral pre-cancer/cancer, along with oralhealth-related quality of life (OHRQoL). Purpose of the Article This article presents an overview of what is known about the epidemiology of each of the main conditions of interest among older populations. Key Points Although complete tooth loss is declining, incremental tooth loss continues and is an important determinant of poor OHRQoL. Dental ...

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Does wearing dentures change sensory nerve responses under the denture base?

This summary is based on the article published in Gerodontology: Does wearing dentures change sensory nerve responses under the denture base? (March 2014) Nana Ito, Suguru Kimoto and Yasuhiko Kawai Context The standard textbook on complete dentures suggests the necessity of relief for the incisive and posterior palatine foramina of denture wearers to prevent the impingement of the nerves and vessels passing through these foramina. However, concrete evidence of the effect of dentures on the sensory function of the nerves underlying dentures is lacking. Purpose of the Study The study aim was to investigate the influence of denture-induced compression on sensory nerve responses to stimulations. ...

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Does periodontal treatment matter for periodontitis patients with cardiovascular disease?

This summary is based on the article publishedin the Journal of Clinical Periodontology: Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis (January 2014) Wijnand J. Teeuw, Dagmar E. Slot, Hendri Susanto, Victor E. A. Gerdes, Frank Abbas, Francesco D’Aiuto, John J. P. Kastelein and Bruno G. Loos Context Periodontitis is a common chronic multifactorial infectious disease of the supporting structures of the teeth (root cementum, periodontal ligament and alveolar bone) and a major cause of tooth loss. Several causal mechanisms have been proposed whereby bacterial pathogens, antigens, endotoxins, and/or inflammatory cytokines from periodontal lesions in the oral cavity contribute to the process of atherogenesis as well as to thromboembolic events and thereby increase the risk for cardiovascular ...

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Do we need further proof on the dangers of smoking?

This summary is based on the 2014 US Surgeon General’s report: The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014. Read the Executive Summary (PDF) Read the full report (PDF) For the United States, the epidemic of smokingcaused disease in the twentieth century ranks among the greatest public health catastrophes of the century, while the decline of smoking consequent to tobacco control is surely one of public health’s greatest successes. However, the current rate of progress in tobacco control is not fast enough, and much more needs to be done to end the tobacco epidemic. Unacceptably high levels of smokingattributable disease and death, and the ...

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