scholarly journals Preserving the vitality of teeth adjacent to a large radicular cyst in periapical microsurgery: a case report with 4-year follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Elhakim ◽  
Sunil Kim ◽  
Euiseong Kim ◽  
Alaa H. Elshazli
Keyword(s):  
Case Report ◽  
False Negative ◽  
Bone Destruction ◽  
Blood Perfusion ◽  
Treatment Modalities ◽  
Radicular Cyst ◽  
Complete Excision ◽  
Negative Results ◽  
Periapical Cyst

Abstract Background Radicular cysts may enlarge considerably, cause extensive bone destruction, and jeopardize the integrity of the associated vital teeth. The different treatment approaches are aimed mainly at eliminating the cystic epithelial membrane while reducing the risk of injury to vital structures. Contrary to other treatment modalities, preapical surgery offers an unequivocal single occasion resolution for the patient. However, it has been associated with higher risk of collateral damages. Case presentation A patient presented with a large radicular cyst originating from a maxillary lateral incisor. The adjacent central and canine teeth initially failed to exhibit responses to sensibility tests but showed signs of vitality. Microsurgical management was aimed at enucleating the cystic membrane while maintaining adjacent teeth vitality. Upon careful and controlled cyst enucleation under the dental operating microscope, the neurovascular bundle of one of the involved teeth was visualized and its integrity was maintained throughout the procedure. Results The procedure was successful and follow up recalls revealed recovery of normal sensibility of tooth 11 and 13 with complete bone regeneration around their apices. Conclusion Within the limitation of the present case report, we demonstrated that complete excision of large periapical cyst can be performed without sacrificing the vitality of the adjacent teeth, by preserving the integrity of their neurovascular supply through controlled microsurgical enucleation, and by a potential apical vascular repair ensuing unintended injury. Diagnosing the pulp vitality of non-offending teeth whose apices protrude into the cystic lumen is a complex process and can be misleading. Pressure from the growing cyst can inhibit vital teeth responses to neural-based sensibility tests leading to false negative results. Thus, in such cases, the use of blood perfusion-based vitality testing is recommended for correct initial diagnosis.

Preserving the vitality of adjacent teeth by microsurgical enucleation of a large radicular cyst: A case report with 4-year follow-up

2021 ◽  
Author(s):  
Ahmed Elhakim ◽  
Sunil Kim ◽  
Euiseong Kim ◽  
Alaa H. Elshazli
Keyword(s):  
Bone Destruction ◽  
Vascular Supply ◽  
Treatment Modalities ◽  
Radicular Cyst ◽  
Operating Microscope ◽  
Case Presentation ◽  
Risk Of Injury ◽  
Maxillary Lateral Incisor ◽  
Microsurgical Techniques

Abstract Background: Radicular cysts may enlarge considerably, cause extensive bone destruction, and jeopardize the integrity of the associated vital teeth. The different treatment approaches are aimed mainly at eliminating the cystic epithelial membrane while reducing the risk of injury to vital structures. Contrary to other treatment modalities, preapical surgery offers an unequivocal single occasion resolution for the patient. However, it has been associated with higher risk of collateral damages.Case presentation: When a patient presented with a large radicular cyst originating from a maxillary lateral incisor, the adjacent central and canine teeth initially failed to exhibit responses to sensibility tests but showed signs of vitality. Microsurgical management was aimed at enucleating the cystic membrane while maintaining adjacent teeth vitality by preserving their apical vascular supply. Upon careful and controlled cyst enucleation under the dental operating microscope, the neurovascular bundle of one of the involved teeth was visualized and its integrity was maintained throughout the procedure.Results: The procedure was successful and follow up recalls revealed recovery of normal sensibility of tooth 11 and 13 with complete bone regeneration around their apices.Conclusions: The findings of this report demonstrate that teeth adjacent to radicular cysts albeit vital, may fail to respond to sensibility tests and that their vitality can be successfully preserved by utilizing the appropriate microsurgical techniques for direct cyst enucleation.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

scholarly journals Case Report: Dilemma To Save Or Not To Save A Tooth

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Yee Woo Yap ◽  
Azillah Mohd Ali
Keyword(s):  
Case Report ◽  
Root Formation ◽  
Dentigerous Cyst ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Odontogenic Cysts ◽  
Standard Assessment ◽  
Good Healing

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.

scholarly journals Immediate Esthetic Rehabilitation of Periodontally Compromised Anterior Tooth Using Natural Tooth as Pontic

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
K. Pavan Kumar ◽  
Surya Kumari Nujella ◽  
S. Sujatha Gopal ◽  
K. Karthik Roy
Keyword(s):  
Case Report ◽  
Anterior Tooth ◽  
Treatment Modalities ◽  
Fibre Reinforcement ◽  
Present Case Report ◽  
Composite Restorations ◽  
Anterior Teeth ◽  
Reinforced Composite ◽  
Natural Tooth

For patients who require removal of anterior teeth and their replacement various treatment modalities are available. With advancement in technology and availability of glass/polyethylene fibres, use of natural tooth as pontic with fibre reinforced composite restorations offers the promising results. The present case report describes management of periodontally compromised mandibular anterior tooth using natural tooth pontic with fibre reinforcement. A 1-year follow-up showed that the bridge was intact with good esthetics and no problem was reported.

scholarly journals False Covid-19 Test Results – Could We Do Things Better? A Personal Opinion

2020 ◽  
Vol 8 (5) ◽  
Author(s):  
Suzanne Lisbeth Ekelund
Keyword(s):  
False Positive ◽  
False Negative ◽  
Test Results ◽  
Negative Results ◽  
False Negative Results ◽  
Personal Opinion ◽  
Potential Problems

This paper describes the problems with false covid-19 test results, both false positive and false negative results. The problems are related to the quality of tests, test sampling and the currently limited follow-up procedures. A test and follow-up strategy that could decrease the potential problems is suggested.

scholarly journals Cerebral arteriovenous malformation radiosurgery after intracranial hemorrhage: A case report and literature review

2017 ◽  
Vol 70 (7-8) ◽  
pp. 241-244
Author(s):  
Bojan Jelaca ◽  
Tomislav Cigic ◽  
Vladimir Papic ◽  
Mladen Karan ◽  
Jagos Golubovic ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Intracranial Hemorrhage ◽  
Good Condition ◽  
Gamma Knife Radiosurgery ◽  
Treatment Modalities ◽  
Temporal Region ◽  
Surgical Morbidity

Introduction. Treatment of cerebral arteriovenous malformations is very challenging and controversial in spite of current recommendations. Surgery is recommended in patients with hemorrhagic stroke, but in patients with good neurological status, when symptoms improve rapidly, the risk of surgical morbidity may be much higher than the risk of rebleeding. Case report. We report a case of a patient with an intracranial hemorrhage due to a ruptured arteriovenous malformation located in the right temporal region of the brain. Because of angiographic and anatomical features of the arteriovenous malformation (deep location and deep venous drainage, but also small arteriovenous malformation nidus size), radiosurgery was the preferred treatment modality. The patient was treated conservatively in the acute stage, and the arteriovenous malformation was subsequently completely eradicated with gamma knife radiosurgery. During the 3-year imaging follow-up, no sings of rebleeding were found. Also, angiography demonstrated that the arteriovenous malformation was completely excluded from the cerebral circulation. The patient was in a good condition and presented without neurological deficits or seizures during the follow-up period. Conclusion. All treatment modalities carry a risk of neurological compromise, but gamma knife radiosurgery may be a good option, even in cases with hemorrhagic presentation. It needs to be mentioned that complete obliteration takes approximately 1 to 3 years after the treatment, and in some cases it cannot be obtained.

scholarly journals Periapical Cyst Following Replantation of Avulsed Teeth: A Case Report

2020 ◽  
pp. 1-6
Author(s):  
T. A. Oyedele ◽  
B. Sodipo ◽  
O. A. Adetayo ◽  
A. O. Ajimoko ◽  
E. Olawale
Keyword(s):  
Case Report ◽  
Cystic Lesion ◽  
Benign Lesion ◽  
Radiographic Examination ◽  
Dental Clinic ◽  
Case Presentation ◽  
Traumatic Injuries ◽  
Periapical Cyst ◽  
Histology Report

Introduction: Avulsion has been described as the traumatic displacement of the tooth out of the socket, and it accounts for 0.5% to 16% of traumatic injuries in the permanent dentition. Many complications have been associated with avulsed tooth following replantation. This paper aimed at presenting a case of the large cystic lesion following replantation of avulsed teeth. Case Presentation: A case of a 17-year-old undergraduate student who presented in the dental clinic for medical screening as a mandatory exercise upon gaining admission. During the examination, a purulent pus discharge was noticed on the labial sulcus about tooth 11. History revealed that she had avulsion of teeth 11 and 12 about 4-years earlier that was replanted and splinted for 2-3 weeks and subsequently she was discharged from the clinic without any further treatment. Radiographic examination revealed periapical radiolucency without well define margin about teeth 11 and 12. Periapical surgery was carried out and two large cystic cavities were seen at about teeth 11 and 12 during surgery. The histology report of the specimen revealed a benign lesion suggesting periapical cyst. Conclusion: There is the need for adequate follow-up and monitoring of replanted teeth the following avulsion to arrest any complication that might arise from the procedure. Also, the importance of endodontic treatment following replantation of the avulsed tooth cannot be overemphasized.

scholarly journals Chondroblastoma of thoracic vertebra in young adult causing paraparesis

2017 ◽  
Vol 31 (3) ◽  
pp. 335-338
Author(s):  
Pramod J. Giri ◽  
Vaibhav S. Chavan
Keyword(s):  
Case Report ◽  
World Literature ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Thoracic Vertebra ◽  
Complete Excision ◽  
The World ◽  
Posterior Element ◽  
Almost All

Abstract Chondroblastoma of spine is very rare condition. To best of our knowledge, fewer than 30 cases have been reported in the world literature. Almost all of them involved both anterior & posterior component of vertebra. There are only few reports with isolated posterior element involvement. Clinical presentation of paraparesis because of vertebral chondroblastoma is very rare. This case report presents 17 yr old male with chondroblastoma involving posterior thoracic vertebra presenting with quadriparesis which improved after successful treatment. Early diagnosis and complete excision with periodic follow up is necessary for treatment of this disease.

scholarly journals Case Report: Three's a crowd: a case report examining the diagnostic and pharmacokinetic challenges in HIV-tuberculous meningitis-malaria co-infection

2018 ◽  
Vol 3 ◽  
pp. 111
Author(s):  
Jayne Ellis ◽  
Prosperity C. Eneh ◽  
Kenneth Ssebambulidde ◽  
Morris K. Rutakingirwa ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Guidelines ◽  
Plasma Concentrations ◽  
False Negative ◽  
Peripheral Blood Smear ◽  
Pharmacokinetic Studies ◽  
Global Public Health ◽  
Cytochrome P450 Enzymes ◽  
Negative Results ◽  
False Negative Results

In 2016, 10.4 million cases of tuberculosis (TB) were reported globally. Malaria also continues to be a global public health threat. Due to marked epidemiological overlap in the global burden of TB and malaria, co-infection does occur. An HIV-infected, 32-year-old male presented with a two-week history of headache with fevers to Mulago National Referral Hospital, Uganda. Five months prior, he was diagnosed with pulmonary TB. He endorsed poor adherence to anti-tuberculous medications. Mycobacterium tuberculosis in CSF was confirmed on Xpert MTB/RIF Ultra. On day 2, he was initiated on dexamethasone at 0.4mg/kg/day and induction TB-medications were re-commenced (rifampicin, isoniazid, ethambutol, pyrazinamide) for TBM. He continued to spike high-grade fevers, a peripheral blood smear showed P. falciparum parasites despite a negative malaria rapid diagnostic test (RDT). He received three doses of IV artesunate and then completed 3 days of oral artemether/lumefantrine. To our knowledge this is the first published case of HIV-TBM-malaria co-infection. TBM/malaria co-infection poses a number of management challenges. Due to potential overlap in symptoms between TBM and malaria, it is important to remain vigilant for co-infection. Access to accurate parasitological diagnostics is essential, as RDT use continues to expand, it is essential that clinicians are aware of the potential for false negative results. Anti-malarial therapeutic options are limited due to important drug-drug interactions (DDIs). Rifampicin is a potent enzyme inducer of several hepatic cytochrome P450 enzymes, this induction results in reduced plasma concentrations of several anti-malarial medications. Despite recognition of potential DDIs between rifampicin and artemisinin compounds, and rifampicin and quinine, no treatment guidelines currently exist for managing patients with co-infection. There is both an urgent need for the development of new anti-malarial drugs which do not interact with rifampicin and for pharmacokinetic studies to guide dose modification of existing anti-malarial drugs to inform clinical practice guidelines.

False Negative Carrier Screening in Spinal Muscular Atrophy

2019 ◽  
Vol 35 (4) ◽  
pp. 274-277
Author(s):  
Sophie Butcher ◽  
Melanie Smith ◽  
Ian R. Woodcock ◽  
Martin Delatycki ◽  
Monique M. Ryan ◽  
...  
Keyword(s):  
Case Report ◽  
Spinal Muscular Atrophy ◽  
Muscular Atrophy ◽  
Diagnostic Testing ◽  
False Negative ◽  
Carrier Screening ◽  
Carrier Testing ◽  
Clinical Suspicion ◽  
Negative Results ◽  
False Negative Results

We describe a case of spinal muscular atrophy diagnosed in an infant despite previous parental carrier testing suggesting low risk of the disease. This case report explains how this situation arose and illustrates that clinicians need to perform diagnostic testing in children where clinical suspicion for spinal muscular atrophy is high, regardless of the result of previous parental carrier testing, because of the risk of false negative results.

Sign in / Sign up

Export Citation Format

Share Document