Diagnosis and management of chronic osteomyelitis and cemento-osseous dysplasia of the mandible

Dental Update ◽  
2019 ◽  
Vol 46 (11) ◽  
pp. 1062-1066
Author(s):  
Arifa Akram ◽  
Tajinder Lidhar ◽  
Katy Marie Valentine ◽  
Roger Webb
Keyword(s):  
Bone Marrow ◽  
General Practitioner ◽  
Clinical Relevance ◽  
Periodontal Ligament ◽  
Chronic Osteomyelitis ◽  
Incidental Finding ◽  
Signs And Symptoms ◽  
Management Options ◽  
Osseous Dysplasia ◽  
Clinical Considerations

Chronic osteomyelitis is a severe and persistent infection of the bone including the bone marrow. Cemento-osseous dysplasias are a group of conditions arising from the periodontal ligament tissue and are categorized into peri-apical, focal and florid. A case of a patient with buccal and submandibular swelling associated with a discharging sinus between LR45 was presented. History, examination and investigations confirmed a diagnosis of chronic osteomyelitis and an incidental finding of florid cemento-osseous dysplasia of the mandible. The patient's treatment is discussed within the context of important clinical considerations required in managing these patients. CPD/Clinical Relevance: It is pertinent for a general practitioner to be aware of signs and symptoms associated with chronic osteomyelitis and understand the management options.

scholarly journals Osteoclastic effects of mBMMSCs under compressive pressure during orthodontic tooth movement

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jing Wang ◽  
Delong Jiao ◽  
Xiaofeng Huang ◽  
Yuxing Bai
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Normal Saline ◽  
Periodontal Ligament ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Mouse Bone Marrow ◽  
Micro Ct ◽  
Tail Vein

Abstract Background During orthodontic tooth movement (OTM), alveolar bone remodelling is closely related to mechanical force. It is unclear whether stem cells can affect osteoclastogenesis to promote OTM. This study aimed to investigate the role of mouse bone marrow mesenchymal stem cells (mBMMSCs) under compression load in OTM. Methods A mouse OTM model was established, and GFP-labelled mBMMSCs and normal saline were injected into different groups of mice by tail vein injection. OTM distance was measured using tissue specimens and micro-computed tomography (micro-CT). The locations of mBMMSCs were traced using GFP immunohistochemistry. Haematoxylin-eosin staining, tartrate-resistant acid phosphate (TRAP) staining and immunohistochemistry of Runx2 and lipoprotein lipase were used to assess changes in the periodontal ligament during OTM. mBMMSCs under compression were co-cultured with mouse bone marrow-derived macrophages (mBMMs), and the gene expression levels of Rankl, Mmp-9, TRAP, Ctsk, Alp, Runx2, Ocn and Osterix were determined by RT-PCR. Results Ten days after mBMMSCs were injected into the tail vein of mice, the OTM distance increased from 176 (normal saline) to 298.4 μm, as determined by tissue specimen observation, and 174.2 to 302.6 μm, as determined by micro-CT metrological analysis. GFP-labelled mBMMSCs were mostly located on the compressed side of the periodontal ligament. Compared to the saline group, the number of osteoclasts in the alveolar bone increased significantly (P < 0.01) on the compressed side in the mBMMSC group. Three days after mBMMSC injection, the number of Runx2-GFP double-positive cells on the tension side was significantly higher than that on the compression side. After applying compressive force on the mBMMSCs in vitro for 2 days, RANKL expression was significantly higher than in the non-compression cells, but expression of Alp, Runx2, Ocn and Osterix was significantly decreased (P < 0.05). The numbers of osteoclasts differentiated in response to mBMMs co-cultured with mBMMSCs under pressure load and expression of osteoclast differentiation marker genes (Mmp-9, TRAP and Ctsk) were significantly higher than those in mBMMs stimulated by M-CSF alone (P < 0.05). Conclusions mBMMSCs are not only recruited to the compressed side of the periodontal ligament but can also promote osteoclastogenesis by expressing Rankl, improving the efficiency of OTM.

scholarly journals Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Gustavo Cancela e Penna ◽  
Henrique Gomes Mendes ◽  
Adele O. Kraft ◽  
Cynthia Koeppel Berenstein ◽  
Bernardo Fonseca ◽  
...  
Keyword(s):  
Papillary Carcinoma ◽  
Unusual Case ◽  
Incidental Finding ◽  
Thyroglossal Duct Cyst ◽  
Papillary Thyroid ◽  
Management Options ◽  
Current Management ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Sistrunk Procedure

Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.

Invasive Fungal Sinusitis following Liver or Bone Marrow Transplantation

1994 ◽  
Vol 8 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Perry J. Johnson ◽  
William M. Lydiatt ◽  
James V. Huerter ◽  
Frederic P. Ogren ◽  
Julie M. Vose ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Effective Means ◽  
Management Strategies ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Fungal Sinusitis ◽  
Hematopoietic Growth Factors ◽  
Invasive Fungal Sinusitis

Invasive fungal infection of the nose and paranasal sinuses occurs almost exclusively in immunocompromised patients and is increasingly recognized as a complication of organ transplantation. We performed a retrospective chart review of 955 bone marrow and 749 liver transplant patients to identify risk factors, presenting signs and symptoms, methods of diagnosis, and successful management strategies. We report on five cases following bone marrow transplantation and one case following liver transplantation. Neutropenia is the single most important risk factor in the development of and recovery from invasive fungal sinusitis. Early diagnosis, combined with antifungal agents, hematopoietic growth factors, and aggressive surgical debridement is the most effective means of management.

scholarly journals Osteomielitis supuratif kronis pada mandibula edentulus Chronic suppurative osteomyelitis on edentulous mandible

2013 ◽  
Vol 12 (1) ◽  
pp. 33
Author(s):  
Leliya Syamsoelily ◽  
Surijana Mappangara ◽  
M. Hendra Chandha ◽  
Muhammad Ruslin
Keyword(s):  
Elderly Patient ◽  
Bone Marrow ◽  
General Anesthesia ◽  
Chronic Osteomyelitis ◽  
Healing Process ◽  
Spongy Bone ◽  
Focal Infection ◽  
Edentulous Mandible ◽  
Vitamin Therapy ◽  
Systemic Condition

Osteomyelitis is an infection of the jaw that extends to the jaw bone, which is the spongy, bone marrow, cortex, andperiosteum. Infection occurs in the calcified bone when fluid in the medullary cavity or under the periosteum interferewith the blood supply. In this case, it was reported an elderly patient with a diagnosis of chronic osteomyelitis ofmandible edentulous dextra. The treatment were sequesterectomy and extraction the radix of tooth 43 by generalanesthesia, and combinating with antibiotics. It was concluded that patient of chronic suppurative osteomyelitis of themandible edentulus could be diagnosed through clinical and radiological examination, and successfully treated withsequesterectomy and extracting the radix under general anesthesia. So the improvement of systemic condition, foodnutrition, vitamin therapy, accelerate the healing process. Treatment of focal infection as soon as possible to avoidmore severe complications.

Tonic Pupil

2019 ◽  
pp. 199-204
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Viral Infections ◽  
Incidental Finding ◽  
Eye Drops ◽  
Sphincter Muscle ◽  
Management Options ◽  
Orbital Surgery ◽  
Fisher Syndrome ◽  
Tonic Pupil ◽  
Pupil Reaction ◽  
Characteristic Features

A tonic pupil is caused by a lesion affecting the postganglionic parasympathetic innervation of the pupil. It can be an incidental finding on examination or associated with visual symptoms, such as photophobia. In this chapter, we begin by briefly reviewing the differential diagnosis of photophobia. We next review the characteristic features of tonic pupil, which include poor pupil reaction to light, segmental palsy of the iris sphincter muscle, accommodation palsy, and tonic pupil reaction to near. We then review the causes of tonic pupil, which include viral infections, trauma, orbital surgery, or neurologic diseases, such as Miller Fisher syndrome. We then go on to discuss the clinical features, diagnostic evaluation, and prognosis of idiopathic tonic pupil, which is also known as an Adie pupil. Lastly, we briefly discuss the management options for tonic pupil, which include use of sunglasses and dilute pilocarpine eye drops.

The orthodontic-surgical management of a patient with gorlin syndrome: a case report

Dental Update ◽  
2019 ◽  
Vol 46 (11) ◽  
pp. 1056-1061
Author(s):  
Madeleine Storey ◽  
Susi Caldwell ◽  
Simon Watkinson ◽  
Manu Patel
Keyword(s):  
Case Report ◽  
Incidental Finding ◽  
Young Patients ◽  
Permanent Teeth ◽  
Gorlin Syndrome ◽  
Close Collaboration ◽  
Management Options ◽  
Jaw Cysts ◽  
Odontogenic Keratocysts ◽  
General Dental Practitioner

This case report describes the management of a patient following the incidental finding of multiple odontogenic keratocysts on an orthopantomogram by the patient's general dental practitioner (GDP). The cysts were extensive and had caused considerable displacement of the unerupted permanent teeth. Following marsupialisation, the teeth were aligned orthodontically. This article describes the features of odontogenic keratocysts, the associated Gorlin syndrome, and the management options available. The importance of close collaboration between the Oral and Maxillofacial Surgical and Orthodontic teams is highlighted. CPD/Clinical Relevance: Odontogenic keratocysts are benign but locally aggressive jaw cysts. They occur most commonly as solitary lesions in the jaws of healthy individuals, but may also be a feature of Gorlin syndrome. In young patients there is potential for severely displaced teeth to improve their position spontaneously and erupt.

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