Osteomyelitis is described as an inflammation of bone and bone marrow that may develop in the jaws following a chronic odontogenic infection or for a variety of other reasons. This situation may be acute, sub-acute or chronic, resulting in a totally different clinical picture.
A consistent zone of ipsilateral tenderness adjacent to the maxillary molar root apices often is present in patients with atypical facial pain. The author performed bilateral palpation and recorded the temperature of this area on 18 consecutive patients with facial pain. He found tenderness and increased temperature on the involved side of the face in 15 and 17 patients, respectively. In two control groups of 10 patients without pain and 10 TMD patients, he observed no significant association between maxillary tenderness and increased temperature.
Thirteen patients with symptomatic oral lichen planus had been shown by patch testing to be allergic to ammoniated mercuric chloride. Replacement of amalgam restorations in these patients effected an improvement in all but one case. In some cases the resolution of symptoms was dramatic following the replacement of one or two fillings. The authors feel that the removal of all amalgam fillings need not be necessary except in the most intractable case.
Hemophilic pseudotumor of bone is a rare condition that occurs in patients with hemophilia. To date only 10 cases have been reported in the mandible, and none has been reported in the maxilla. The clinical, radiographic, and histologic features and treatment approaches of two cases of hemophilic pseudotumor occurring in the jaws are presented. One of them is probably the first one reported in the maxilla. Both patients had a history of trauma to the area.
The corresponding systemic uptake of Hg was estimated to 12 µg/d based on external data relating air Hg°-exposures to urinary Hg-excretions. The worst case individual showed a gross mass balance of 200 µg Hg/d connected to a systemic uptake of 70 µg Hg/d. These values were compared to the average intake of to al-Hg by a Swedish diet (2 µg/d) and to the WHO’s tolerable value for intake of total-Hg by food (45 µg/d). Upscaled to the entire Swedish population (8 mill.), the data suggests a fecal/urinary emission to the environment of 100 kg Hg yearly originating from a population load of amalgam fillings containing 90,000 kg of Hg.
Bacterial endotoxic reactions can cause osteonecrosis in humans by disseminated intravascular coagulation. The authors first used a combination of the Shwartzman reaction and corticoid injections in rabbits to develop a new animal model of osteonecrosis. This model showed a significantly higher incidence and wider area of osteonecrosis in the femur and humerus than that found in rabbits with either Shwartzman reaction or steroid injection alone. Osteonecrosis was observed in several foci that were distributed from the diaphysis to the epiphysis in both bones. Histologically, the bone marrow cells underwent necrosis, whereas the bone trabeculae demonstrated either empty lacunae or pycnotic nuclei of osteocytes. Exogenous steroids appeared to potentiate the Shwartzman reaction and the magnitude of osteonecrosis, perhaps by increasing endothelial damage and hypercoagulability of those intraosseous and extraosseous vessels that subsequently thrombosed. This model may not only be useful in clarifying the etiology and early pathogenesis of human osteonecrosis after corticoid therapy, but also in designing pharmaceuticals for prevention and early treatment.
This paper investigates the hypothesis that mercury from silver dental fillings (amalgam) may be related to multiple sclerosis (MS). It compares blood findings between MS subjects who had their amalgams removed to MS subjects with amalgams. MS subjects with amalgams were found to have significantly lower levels of red blood cells, hemoglobin and hematocrit compared to MS subjects with amalgam removal. Thyroxine levels were also significantly lower in the MS amalgam group and they had significantly lower levels of total T Lymphocytes and T-8 (CD8) suppressor cells. The MS amalgam group had significantly higher blood urea nitrogen and lower serum IgG. Hair mercury was significantly higher in the MS subjects compared to the non-MS control group. A health questionnaire found that MS subjects with amalgams had significantly more (33.7%) exacerbations during the past 12 months compared to the MS volunteers with amalgam removal. The paper also examines epidemiological correlations between dental caries and MS; as well as how mercury could be causing the pathological and physiological changes found in multiple sclerosis.
A review of literature and documentation suggests that concentrations of fluoride above 0.2 mg/L have lethal (LC50) effects on and inhibit migration of “endangered” salmon species whose stocks are now in serious decline in the US Northwest and British Columbia. Fluoride added to drinking water,”to improve dental health”, enters the fresh water eco-system, in various ways, at levels above 0.2 mg/L. This factor, if considered in “critical habitat” decisions, should lead to the development of a strategy calling for a ban on fluoridation and rapid sunsetting of the practice of disposal of industrial fluoride waste into fresh water.
Literature reviews of oral lesions frequently lack an appropriate historic perspective, presuming that the mid- to late-twentieth century reports are the first valid reports available. The mid-nineteenth century dental journals, however, are replete with clinical, surgical, and microscopic descriptions of oral tumors and cysts. Most of these have never been referenced during the present century. The purpose of this article is to report the earliest dental journal references for a variety of odontogenic tumors and cysts. These references are derived from a canvass of all dental journals published from the first journal (American Journal of Dental Science) in 1839 to the appearance of Dental Cosmos and the organization of the American Dental Association in 1860.
Glass ionomer cements reportedly bond to tooth surfaces by physicochemical interaction and slowly release fluoride. 1 Two mechanisms are involved in fluoride release, a rapid surface elution and a slower bulk diffusion of fluoride ions. 2, 3 The greatest release of fluoride reportedly occurs in the first 24 hr, and then remains constant for several months before it tapers off after 2 years.4, 5 Such slow release of fluoride from silicate cements has been shown to have an anticariogenic effect.6, 7 dependent primarily on the longevity of the release.8 Recent research also has reported an antimicrobial effect of glass ionomer cements in vitro 9 and in vivo.10, 11 The objectives of our in vitro experiments were to determine the fluoride and acid release of several glass ionomer cements over time, and the relationship of the fluoride and acid to the antibacterial effects of these cements. (Pediatr Dent 16: 1994)