BRIX3000® Papain Gel for Cavity Treatment in the Adult Patient

Tooth decay is a multifactorial disease. Fermentable sugar, host factors, and cariogenic microbial flora are several agents that influence dental structure. In literature, alternative protocols for treating cavities are always of interest in terms of reducing pain and preserving tissue. In this case report, the use of a new gel-based on papain, which has a chemical effect on bacteria and allows the consistency of the altered tissue to be modified, leads to a less traumatic removal of the infected tissue. In this case report, BRIX3000, a gel with papain as its main ingredient, was used to treat an interproximal cavity on an upper premolar of a 35-year-old man frightened of the turbine. After a clinical check of all the systematic conditions and a first view of the oral cavity, the protocol was explained to the patient, and informed consent was obtained. The protocol involved applying the papain gel directly to the cavity, and after 2.5–3 minutes, it was removed. The complete removal of the infected tissue was achieved in three steps. The patient reported no discomfort, and the cavity was completely treated and ready to be restored. In conclusion, BRIX3000 seems to be a good alternative to the turbine in cavity treatment, particularly in patients who have discomfort during traditional treatments and are frightened of the turbine.

Download Full-text

Transnasal endoscopic approach with powered instrumentation for treating squamous papilloma in the nasopharyngeal surface of the soft palate

The Journal of Laryngology & Otology ◽

10.1017/s0022215112003167 ◽

2013 ◽

Vol 127 (5) ◽

pp. 516-518 ◽

Cited By ~ 2

Author(s):

J-H Lee ◽

Y-O Lee ◽

C-H Lee ◽

K-S Cho

Keyword(s):

Case Report ◽

Soft Palate ◽

Relevant Literature ◽

Complete Removal ◽

Transoral Approach ◽

Endoscopic Approach ◽

Squamous Papilloma ◽

Novel Approach ◽

Patient Reported ◽

Transnasal Endoscopic Approach

AbstractObjective:To demonstrate a safe and effective method for complete resection of squamous papilloma in the nasopharyngeal surface of the soft palate. This technique was used on a patient in whom the papilloma had twice recurred following uvulopalatopharyngoplasty.Methods:Case report and review of the relevant literature.Results:The patient reported in this paper had recurrent squamous papilloma in the nasopharyngeal surface of the soft palate following uvulopalatopharyngoplasty. He also suffered from nasal regurgitation when drinking water. This lesion, which was difficult to access, was successfully treated via a transnasal endoscopic approach using powered instrumentation.Conclusion:This case report highlights a novel approach for the complete removal of a recurrent papilloma in a relatively inaccessible location. Compared with a transoral approach such as uvulopalatopharyngoplasty, the transnasal endoscopic approach using powered instrumentation could provide a safer, faster, easier and less invasive means of treating squamous papilloma in the nasopharyngeal surface of the soft palate, especially for a lesion that recurs following a transoral approach.

Download Full-text

AB0858 SUCCESSFUL TERM PREGNANCY IN A PATIENT WITH GRANULOMATOSIS WITH POLYANGIITIS AFTER UNDERGOING RITUXIMAB THERAPY - CASE REPORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4016 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1452.2-1453

Author(s):

O. Sirenko ◽

O. Kuryata ◽

T. Lysunets ◽

A. Legkobyt ◽

H. Mostova

Keyword(s):

Case Report ◽

Granulomatosis With Polyangiitis ◽

Disease Onset ◽

Biological Agents ◽

Term Pregnancy ◽

Aseptic Necrosis ◽

Azathioprine Therapy ◽

Disease Remission ◽

Obstetric Medicine ◽

Patient Reported

Background:Granulomatosis with polyangiitis (GWP) is a relatively rare disease with the lack of experience in the management of pregnancy currently. Potentially negative factors of pregnancy prognosis are both disease-related and teratogenic effects of specific vasculitis therapy [1].Objectives:To describe a clinical case of Successful term pregnancy in a patient with Granulomatosis with polyangiitis after undergoing rituximab therapy.Methods:19 years-old woman was admitted to the rheumatology department of Clinical Regional Hospital After Mechnicov in 2013 with the debut of Granulomatosis with polyangiitis. Her disease course included recurrent rhinitis and sinusitis, Granulomatosis of the eye orbits. Positive ANCA titers were present in the disease onset. In the preceding 7 years she had been treated with corticosteroids, cyclophospan (discontinuated in 2017 because of lack of efficiency), than azathioprine. Aseptic necrosis of the both femoral head was estimated on fifth disease year. In 2018 azathioprine therapy had been discontinued owing to the disease progression and biological agents were prescribed – rituximab with positive effect. The disease remission was achived by rituximab therapy, the patient was warned about the need for contraception. The last dose of rituximab was introduced in February 2020. However, in March 2020, the patient reported pregnancy and therapy was discontinued. At the onset of pregnancy she was treated with 6 mg oral methylprednisolone. Daily and this dose was stable till all pregnancy period. Fetal growth assessment, congenital abnormalities screening test, and laboratory tests for gestational diabetes and preeclampsia were unremarkable during all gestational trimesters. The ANCA titers remained negative and renal function was normal and there was no flare during all pregnancy period.Results:At 38 weeks’ gestation a spontataneous labor started without induction. A 3270-g healthy boy delivered with APGAR score of 9 at 1 minute and 5 minutes. Postpartum the disease remained in remission, and the patient was maintained on corticosteroids. The infant was healthy, with normal development.Conclusion:Thus, the use of biological agents therapy in patients with GWP shows possible ways to safe reproductive potential with disease remission achievement.References:[1]Daher A, Sauvetre G, Girszyn N, Verspyck E, Levesque H, Le Besnerais M. Granulomatosis with polyangiitis and pregnancy: A case report and review of the literature. Obstetric Medicine. 2020;13(2):76-82. doi:10.1177/1753495X18822581Disclosure of Interests:None declared

Download Full-text

Concurrent Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm (HeLPS): A Case Report and a Review of the Literature

Neurosurgery ◽

10.1093/neuros/nyz546 ◽

2019 ◽

Vol 87 (5) ◽

pp. E573-E577

Author(s):

C Michael Honey ◽

Marie T Krüger ◽

Alan R Rheaume ◽

Josue M Avecillas-Chasin ◽

Murray D Morrison ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Microvascular Decompression ◽

Medical Condition ◽

Posterior Inferior Cerebellar Artery ◽

Cranial Nerves ◽

Conversion Disorder ◽

Glossopharyngeal Neuralgia ◽

Neurovascular Compression ◽

Patient Reported

Abstract BACKGROUND AND IMPORTANCE Hemi-laryngopharyngeal spasm (HeLPS) has been recently described but is not yet widely recognized. Patients describe intermittent coughing and choking and can be cured following microvascular decompression of their Xth cranial nerve. This case report and literature review highlight that HeLPS can co-occur with glossopharyngeal neuralgia (GN) and has been previously described (but not recognized) in the neurosurgical literature. CLINICAL PRESENTATION A patient with GN and additional symptoms compatible with HeLPS is presented. The patient reported left-sided, intermittent, swallow-induced, severe electrical pain radiating from her ear to her throat (GN). She also reported intermittent severe coughing, throat contractions causing a sense of suffocation, and dysphonia (HeLPS). All her symptoms resolved following a left microvascular decompression of a loop of the posterior inferior cerebellar artery that was pulsating against both the IXth and Xth cranial nerves. A review of the senior author's database revealed another patient with this combination of symptoms. An international literature review found 27 patients have been previously described with symptoms of GN and the additional (but not recognized at the time) symptoms of HeLPS. CONCLUSION This review highlights that patients with symptoms compatible with HeLPS have been reported since 1926 in at least 4 languages. This additional evidence supports the growing recognition that HeLPS is another neurovascular compression syndrome. Patients with HeLPS continue to be misdiagnosed as conversion disorder. The increased recognition of this new medical condition will require neurosurgical treatment and should alleviate the suffering of these patients.

Download Full-text

“Visual Hook” for the removal of nasal foreign body – Case report

Romanian Journal of Rhinology ◽

10.1515/rjr-2016-0029 ◽

2016 ◽

Vol 6 (24) ◽

pp. 233-234 ◽

Cited By ~ 1

Author(s):

Sabari Nath

Keyword(s):

Case Report ◽

Foreign Body ◽

Complete Removal ◽

Foreign Body Removal ◽

Body Case

Abstract We present a case of paediatric nasal foreign body removal using a flexible nasopharyngolaryngoscope, which is used both as an endoscope for visualization and as a hook for the rapid and complete removal of the nasal foreign body (“Visual Hook“).

Download Full-text

SUNCT syndrome associated with pituitary tumor: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000300029 ◽

2006 ◽

Vol 64 (2b) ◽

pp. 507-510 ◽

Cited By ~ 12

Author(s):

Pedro A.S. Rocha Filho ◽

Antonio Cezar R. Galvão ◽

Manoel J. Teixeira ◽

Getulio D. Rabello ◽

Ida Fortini ◽

...

Keyword(s):

Case Report ◽

Clinical Condition ◽

Pituitary Tumor ◽

Complete Removal ◽

Pathological Diagnosis ◽

Conjunctival Injection ◽

Intense Pain ◽

Sunct Syndrome ◽

The Subject ◽

Daily Pain

For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a frequency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subject’s serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysectomy, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.

Download Full-text

Oral and Dental Changes of Dyskeratosis Congenita: A Case Report with Literature Review

Journal of Advanced Oral Research ◽

10.1177/2320206818789761 ◽

2018 ◽

Vol 9 (1-2) ◽

pp. 20-23 ◽

Cited By ~ 1

Author(s):

Gozde Serindere

Keyword(s):

Case Report ◽

Early Diagnosis ◽

Literature Review ◽

Aggressive Periodontitis ◽

Dyskeratosis Congenita ◽

Tooth Decay ◽

Nail Dystrophy ◽

Uncommon Disease ◽

Missing Tooth ◽

Enamel Layer

Dyskeratosis congenita (DC) is an uncommon disease characterized by nail dystrophy, cutaneous hyperpigmentation, leukoplakia, pancytopenia, and malignant transformation. There can be some oral and dental changes such as oral leukoplakia, increase in tooth decay, hypodontia, thinning of enamel layer, aggressive periodontitis, intraoral brown pigmentation, missing tooth, taurodontism, and blunted roots. Most of cases belong to dermatology or pediatrics department. There are few reports about dentistry. The aim of this report is to lay emphasis on this fatal syndrome among dentists about the multisystem findings and oro-dental changes. Thus, this information may aid dentists in early diagnosis. A case of 21-year-old male diagnosed with DC is reported.

Download Full-text

Apexification Using Mineral Trioxide Aggregate and Modified Internal Matrix: A Case Report

Journal of the Bahrain Medical Society ◽

10.26715/jbms.33_2021_2_10 ◽

2021 ◽

Vol 33 (2) ◽

Keyword(s):

Case Report ◽

Mineral Trioxide Aggregate ◽

Tissue Formation ◽

Enamel Hypoplasia ◽

Hard Tissue ◽

Radiographic Evidence ◽

Radiographic Findings ◽

Immature Teeth ◽

Patient Reported ◽

Treatment Alternatives

When pulpal necrosis occurs in immature teeth, one of the treatment alternatives is the creation of an artificial apical barrier through the placement of an apical plug. However, controlling the mineral trioxide aggregate (MTA) during placement has proven difficult. Several studies evaluated the use of resorbable barriers to act as an internal matrix to prevent accidental extrusion of MTA. The aim of this case report was to document the effectiveness of Surgicel as a modified internal matrix for proper placement of MTA during management of immature teeth with necrotic pulp using the apical plug technique. A 12-year-old female patient reported with the chief complaint of a badly mutilated lower right second premolar. The tooth suffered enamel hypoplasia and had a defective coronal structure. It was asymptomatic except for slight tenderness to percussion. Based on the clinical and radiographic findings, a diagnosis of pulpal necrosis with symptomatic apical periodontitis was made. The 3- and 6-month followup showed radiographic evidence of continued root and hard tissue formation. Based on these findings, we infer that Surgicel can be used as a modified internal matrix to prevent extrusion of the MTA into the periapical area and allow for proper MTA placement. Keywords: Apexification; Apical plug; Mineral trioxide aggregate; Calcium hydroxide; Surgicel; Modified internal matrix

Download Full-text

Sphenochoanal Polyp - "The Forgotten Element?"

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2021.v29i2.371 ◽

2021 ◽

Vol 29 (2) ◽

pp. 209-212

Author(s):

Misbahul Haque ◽

Subhrajit Das ◽

Subrata Mukhopadhyay

Keyword(s):

Case Report ◽

Nasal Obstruction ◽

Surgical Approach ◽

Surgical Intervention ◽

Complete Removal ◽

Endoscopic Polypectomy ◽

Complete Excision ◽

Sphenochoanal Polyp

Introduction The occurrence of isolated spheno-choanal polyps are not very common and can be very well confused with antro-choanal polyps or adenoids in adolescents and children. Appropriate diagnosis and prompt surgical intervention are essential for its removal. Case Report We report one such case of a 16 year old female who presented with complaints nasal obstruction and reduced hearing. Endoscopic polypectomy was done with complete removal of the polyp. Discussion Sphenochoanal Polyp is often misdiagnosed and proper investigations are thus essential for its diagnosis. Surgical Approach is the mainstay form of treatment with complete excision of the polyp.

Download Full-text

Inferior alveolar nerve paraesthesia after overfilling into the mandibular canal, confirmed by cone-beam computed tomography: a case report

Brazilian Dental Science ◽

10.14295/bds.2021.v24i2.2421 ◽

2021 ◽

Vol 24 (2) ◽

Author(s):

Claudemir de Souza Júnior ◽

Ricardo Machado ◽

Renee Ashley Batts ◽

Lucas da Fonseca Roberti Garcia

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Inferior Alveolar Nerve ◽

Mandibular Canal ◽

Cone Beam ◽

Filling Material ◽

Mandibular Molar ◽

Patient Reported

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling. Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.

Download Full-text

“This Is Not the Original Timeline”: A Case Report of an Extended Dissociative Episode in a Healthy Young Male Accompanied with Severe Decline in Mental State

Case Reports in Psychiatry ◽

10.1155/2021/6619579 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Godwin Tong ◽

Kieran Groom ◽

Louisa Ward ◽

Muhammad Naeem

Keyword(s):

Case Report ◽

Mental State ◽

Young Male ◽

Obsessive Compulsive ◽

Psychiatric Admission ◽

Compulsive Disorder ◽

Psychiatric Setting ◽

Patient Reported ◽

History Of ◽

Core Symptoms

Dissociation is a disconnection between a person’s thoughts, memories, feelings, actions, or sense of who he or she is. Dissociative disorders can be described and understood using the combination of five core symptoms: amnesia, depersonalisation, derealisation, identity confusion, or identity alteration. They are frequently associated with previous experience of trauma. The challenge in diagnosis and the lifetime prevalence of approximately 10% in the general population and clinical psychiatric setting ensures the relevance of this case. We write about a 21-year-old gentleman with history of autism and obsessive compulsive disorder, but no significant medical history was presented to the emergency department with increased anxiety, subsequently progressing to agitation, pacing, and becoming nonverbal. No significant findings were uncovered on laboratory blood testing (other than prolactin 737 mu/L and phosphate 0.35 mmol/L), lumbar puncture, or brain imaging. Consequently, he was admitted to a psychiatric unit for assessment. The patient continued to present with severe disorientation, limited speech, and altered state of consciousness with occasional spastic-like movements. Antipsychotic and benzodiazepine medication was initiated, with no significant change in presentation. The patient continued to be witnessed wandering and having incoherent speech. First signs of improvement came 21 days postadmission with brief conversation and lucidity. This continued to improve over the next 7 days where he was reported to be at his baseline mental state. Environmental stressors including university examinations, the COVID-19 pandemic, and recent contact with his estranged father were possible precipitants to the episode. The patient reported almost complete unawareness of the psychiatric admission. A diagnosis of dissociative disorder, unspecified, was given. This case shows the management and diagnostic challenges of patients presenting with the aforementioned symptoms. There are no formal guidelines for the management of treating dissociative episodes, and this case report suggests the possible benefits of a drug-free period of watchful waiting upon admission.

Download Full-text