Following trauma, chronic periapical process, or tooth extraction, a large loss of bone volume is noticed during the healing process. To facilitate the placement of dental implants, various surgical ...procedures are used for an optimal alveolar ridge profile, while maintaining adequate bone dimensions. The main aim of this study was to determine the healing ability (histologically and immunohistologically) of alveolar bone defects during augmentation with two different biomaterials: injectable biphasic calcium phosphate (BCP) and anorganic bovine bone (ABB). Thirty-eight subjects were randomly divided into two groups. The first group received the tested bone substitute biomaterial (BSB), i.e., BCP (maxresorb inject
), and the second group received an alternative to the gold standard, i.e., ABB (Bio-Oss
). The histopathological, histomorphometric, and immunohistochemical analyses gave comparable results for these bone substitute materials in terms of newly formed bone: (BCP: 39.91 ± 8.49%, ABB: 41.73 ± 13.99%), residual biomaterial (BCP: 28.61 ± 11.38%, ABB: 31.72 ± 15.52%), and soft tissue (BCP: 31.49 ± 11.09%, ABB: 26.54 ± 7.25%), with no significant difference found between the groups (
< 0.05,
-test), proving that BCP is equally suitable and successful for alveolar bone regeneration.
This prospective, randomized, controlled clinical trial reports clinical, radiographic, histologic and immunohistochemical results of autologous dentin graft (ADG) and its comparison with a mixture ...of bovine xenograft with autologous bone (BX+AB). After tooth extraction in the esthetic zone of maxilla, the alveolar ridge of 20 patients in the test group was augmented with ADG, while 17 patients in the control group received the combination of BX+AB. Cone beam computed tomography (CBCT) was performed before tooth extraction and after 4 months when a total of 22 bone biopsies were harvested and subjected to histological and immunohistochemical analysis. Radiological analysis showed comparable results of bone dimension loss in both groups. Quantitative histologic analysis showed comparable results with no statistically significant differences between the groups. Immunohistochemical staining with TNF-α and BMP-4 antibodies revealed immunopositivity in both groups. A statistically significant difference between the groups was found in the intensity of TNF-α in the area of newly formed bone (
= 0.0003) and around remaining biomaterial particles (
= 0.0027), and in the intensity of BMP-4 in the area around biomaterial particles (
= 0.0001). Overall, ADG showed biocompatibility and achieved successful bone regeneration in the esthetic zone of the maxilla similar to BX+AB.
A case is presented of upper lip angiomyoma in a 36-year-old man. The tumor was painless, palpable and clinically visible. The operation was performed under local anesthesia in the Outpatient ...Department. There were no complications during the postoperative course. Current literature on the subject is listed in the introduction, followed by presentation of the case and histologic characteristics of the tumor. This case is described as one of the differential diagnostic possibilities in the diagnosis of soft tissue tumors of the lip. Also, through review of the literature, different clinical appearances of angiomyoma, histologic variations and immunohistochemical characteristics are discussed that can help identify this tumor.
During the Croatian War of Independence, 1991-1995, Croatian soldiers were exposed to traumatic and stressful events. Certain number of soldiers who took part in the war, developed depression and ...posttraumatic stress disorder (PTSD). Stress is one of the etiological factors in the development of myofascial pain (MPS), although the mechanism of these processes is not entirely understood. The aims of this study were to determine the frequency of myofascial pain among Croatian war veterans with depression and PTSD, association between MPS and severity of depression, to describe the most common locations of trigger points in the region of head and neck, and to find out if there is any association in frequency between MPS and endotracheal intubation.
A total of 101 Croatian war veterans suffering from PTSD and depression participated in the current study. Diagnosis of myofascial pain was based on detailed anamnestic history and careful clinical examination.
Our findings showed a high rate of myofascial pain among Croatian war veterans, with occipital region and right temporal region as the most common places of trigger points. Higher severity of depression was accompanied by a higher percentage of subjects with MPS. Finally, there was no significant association between endotracheal intubation and development of MPS among the war veterans.
It can be concluded that the rate of myofascial pain among Croatian war veterans is high and therefore it must be considered in patients with depression and PTSD. Moreover, the severity of depressive symptomatology seems to be related to the presence of myofascial pain.
Metastases to the oral cavity are uncommon, accounting for only 1% of all oral malignant tumors. When they occur they mostly originate from primary tumors of the lungs, kidney, breast and prostate. ...Oral metastases from the primary colorectal carcinoma are much more infrequent.
We present an unusual case of a 78-year-old man with a soft tissue oral metastasis originating from the primary colorectal carcinoma.The patient was referred to the Department of Otorhinolaryngology, Head and Neck Surgery with an intraoral mass on the right side of the maxilla. The diagnosis was confirmed by histopathologic examination and immunohistochemical analysis.
Oral metastases occur rarely and often can mimic much more common benign lesions, therefore they should be considered as a possibility in a differential diagnosis.
Actinomycosis of the cheek Vidaković, Bruno; Macan, Darko; Perić, Berislav ...
Srpski arhiv za celokupno lekarstvo,
07/2014, Letnik:
142, Številka:
7-8
Journal Article
Odprti dostop
Actinomycosis is an uncommon chronic granulomatous infection first described by Bollinger in 1 877.The infection is caused by actinomyces species and it is characterized by slow contiguous spread and ...suppurative inflammation, formation of multiple abscesses and sinus tracts with possible drainage of "sulfur granules".
We report an unusual case of actinomycosis of the cheek that occurred 6 years after buccal odontogenic abscess. A 56-year-old male was referred to the Department of Oral Surgery because of a painless swelling of the left cheek, which initiated three weeks prior to the referral. The diagnosis of actinomycosis was confirmed by histopathologic examination. In accordance with the diagnosis oral penicillin was prescribed for four months with complete resolution.
This case of actinomycosis is presented as a rarity. For proper diagnosis, careful examination and a high degree of clinical suspicion are necessary.
Abstract
Objectives: This study is aimed to investigate occurrence of myofascial pain syndrome in a group of Croatian war veterans suffering from post-traumatic stress disorder PTSD and to compare ...them with a healthy normal control HNC group, and to describe the most frequent locations of trigger points in the head and neck region.
Methods: A total of 202 male subjects participated in the examination. They were divided into a group of war veterans suffering from a PTSD and an HNC group. The first group consisted of 101 war veterans with PTSD mean age = 47.22 years, range = 33-73 years; the HNC group consisted of 101 subjects mean age = 46.72 years, range = 34-61 years who did not participate in the War of Independence.
Results: The PTSD group revealed a higher prevalence of headaches p < 0.001, cervical spine problems p < 0.001, jaw clicking and popping p = 0.032, teeth grinding or clenching during the day p < 0.001, teeth grinding or clenching while sleeping p < 0.001, jaw ache in the morning p < 0.001, jaw problems while chewing p < 0.001, parafunctions p < 0.001, muscle stiffness p < 0.001, and trigger points p < 0.001 than the HNC group.
Conclusion: The frequency of myofascial pain among war veterans with PTSD is significantly higher than in the HNC group. Myofascial pain must be considered among patients with PTSD, and if diagnosed must be treated in order to improve primary therapy of PTSD, and to improve quality of life of the patients.
Angiomyoma--angioleiomyoma of the cheek Vidaković, Bruno; Knezević, Ana Kotarac; Manojlović, Spomenka ...
Collegium antropologicum
35, Številka:
1
Journal Article
Recenzirano
The authors present the case of an angiomyoma--angioleiomyoma of the cheek in a 58-year-old man. The tumour was palpable, although clinically not visible, and the only case of a tumour of smooth ...muscle treated in the Clinical Department of Oral Surgery over the last 40 years. The operation was performed in the Outpatient Department by intraoral procedure. The postoperative course passed without complications. Current literature on leiomyomas is cited in the Introduction, followed by presentation of the case and histological characteristics of the tumour The example is presented as a rarity and one of the differential diagnostic possibilities in the diagnostics of soft tissue tumours in the oral cavity.
The aim of the study was to explore certain risk factors for trigeminal neuralgia (TN), assess the prevalence of misdiagnoses of TN made by primary care dentists, compare the treatment practice for ...TN at the Department of Oral Surgery with the guidelines, and the importance of interdisciplinary approach in TN treatment. The study included 237 patient records (70 men and 167 women, aged 5-91 years) referred to the Department under the diagnosis of TN. From their medical records, demographic data, referral diagnose, clinical diagnose, additional diagnostic procedures and treatment were analysed. Neuralgia of the trigeminal nerve affects predominantly elderly female population, while the impact of the season on the incidence of the disease has not been determined. The most common therapy used at the Department were blockades, carbamazepine or their combination. 63.3% patients were referred for further diagnostic tests following the first examination. The number of misdiagnosed cases referred by primary care dentists (33.6%) points that better training in diagnosing TN is needed for the dental practitioners. The treatment methods at the Department need to be harmonized with the latest guidelines on neuralgia treatment. Due to the complexity of etiological factors, an interdisciplinary approach is necessary.
Istraživanje je analiziralo učestalost miofascijalene boli u populaciji branitelja liječenih od PTSP-a. Svrha istraživanja bila je utvrditi utjecaj ratom uvjetovanog stresa na pojavnost miofascijalne ...boli u području glave i vrata u populaciji hrvatskih branitelja liječenih od PTSP-a. Hipoteza je bila da postoji asocijacija izmeñu PTSP-a i miofascijalne boli u smislu učestalije pojavnosti miofascijalne boli kod ispitanika s PTSP-om u odnosu na ispitanike kontrolne grupe. U istraživanju su sudjelovala 202 ispitanika, podijeljena u dvije grupe. Prvu grupu je činio 101 hrvatski branitelj s dijagnozom PTSP-a. Kontrolnu grupu od 101 ispitanika činili su dobrovoljci iz skupine osoba koje dolaze na sistematske preglede. Analizirani su bilateralno slijedeći mišići: maseter, temporalni mišić, tetiva temporalnog mišića, medijalni pterigoidni mišić, lateralni pterigoidni mišić, sternokleidomastoidni mišić, splenius capitis i trapezius. Utvrñena je značajno veća učestalost miofascijalne boli glave i vrata kod branitelja liječenih od PTSP-a (58,4%) u odnosu na ispitanike kontrolne grupe (8,9%). Triger točke su najčešće bile lokalizirane u splenius capitisu (12,9%), desnom temporalnom mišiću (11,9%), lijevom temporalnom mišiću (7,9%) i desnom maseteru (5,9%). Kod ispitanika kontrolne skupine, s obzirom na manju pojavnost miofascijalne boli (8,9%), triger točke zabilježene su samo u lijevom temporalnom mišiću, i to kod 4% ispitanika i u spleniusu capitisu kod 5% ispitanika. Istraživanjem je utvrñeno da postoji potreba za uključivanjem doktora dentalne medicine educiranog za liječenje poremećaja žvačnog sustava i bolnih poremećaja glave i vrata u multidisciplinarni tim koju sudjeluje u liječenju hrvatskih branitelja oboljelih od PTSP-a.
Istraživanje je analiziralo učestalost miofascijalene boli u populaciji branitelja liječenih od PTSP-a. Svrha istraživanja bila je utvrditi utjecaj ratom uvjetovanog stresa na pojavnost miofascijalne boli u području glave i vrata u populaciji hrvatskih branitelja liječenih od PTSP-a. Hipoteza je bila da postoji asocijacija izmeñu PTSP-a i miofascijalne boli u smislu učestalije pojavnosti miofascijalne boli kod ispitanika s PTSP-om u odnosu na ispitanike kontrolne grupe. U istraživanju su sudjelovala 202 ispitanika, podijeljena u dvije grupe. Prvu grupu je činio 101 hrvatski branitelj s dijagnozom PTSP-a. Kontrolnu grupu od 101 ispitanika činili su dobrovoljci iz skupine osoba koje dolaze na sistematske preglede. Analizirani su bilateralno slijedeći mišići: maseter, temporalni mišić, tetiva temporalnog mišića, medijalni pterigoidni mišić, lateralni pterigoidni mišić, sternokleidomastoidni mišić, splenius capitis i trapezius. Utvrñena je značajno veća učestalost miofascijalne boli glave i vrata kod branitelja liječenih od PTSP-a (58,4%) u odnosu na ispitanike kontrolne grupe (8,9%). Triger točke su najčešće bile lokalizirane u splenius capitisu (12,9%), desnom temporalnom mišiću (11,9%), lijevom temporalnom mišiću (7,9%) i desnom maseteru (5,9%). Kod ispitanika kontrolne skupine, s obzirom na manju pojavnost miofascijalne boli (8,9%), triger točke zabilježene su samo u lijevom temporalnom mišiću, i to kod 4% ispitanika i u spleniusu capitisu kod 5% ispitanika. Istraživanjem je utvrñeno da postoji potreba za uključivanjem doktora dentalne medicine educiranog za liječenje poremećaja žvačnog sustava i bolnih poremećaja glave i vrata u multidisciplinarni tim koju sudjeluje u liječenju hrvatskih branitelja oboljelih od PTSP-a.
INTRODUCTION: The aim of this research was to analyze the incidence of myofascial pain among war veterans treated for posttraumatic stress disorder (PTSD). Myofascial pain affects muscles and fasciae. The head and neck region with its muscels is a high frequency area for developing of myofascial pain. Myofascial pain is characterized by the presence of trigger points, which can be defined as descrete hyperirritable spots in muscle fibres. Trigger points can be either active or latent. In addition to the occurence of trigger points, limited function and pain are also characteristic in affected muscles. AIMS OF THE RESEARCH: The aim of this research was to determine the influence of war-induced stress on the occurence of myofascial pain in the head and neck region among Croatian war veterans treated for PTSD. Hypothesis was that there is a correlation between PTSD and myofascial pain. According to this hypothesis, myofascial pains occurs more often among examinees that suffer from PTSD than among members of the control group. It was assumed furthermore that myofascial pain influences the symptomatology of patients with PTSD, as well as that there is a need to engage a doctor of dental medicine educated for treating disorders of the temporomandibular joint and other painful disorders of the head and neck region in the treatment of those patients. The aim of this research was to: determine the degree of attention that war veterans with PTSD devote to their own health and their attitudes towards it, and compare their results with the control group; compare, determine and test the influence of PTSD and eventual traumatization of the stomatognathic system during intubation as two possible etiologic factors for the emergence of myofascial pain in war veterans treated for PTSD; analyze the incidence of oral parafunctions and inappropriate habits among war veterans treated for PTSD and the control group; compare the incidence of pain and temporomandibular joints sounds among war veterans treated for PTSD and the control group; analyze and compare the incidence of muscle pain in the head and neck region among war veterans treated for PTSD and the control group; determine the incidence of myofascial pain among war veterans treated for PTSD; determine the localization of trigger points; present conclusions about the incidence of myofascial pain among war veterans treated for PTSD and define the exact role of doctors of dental medicine in the treatment of those patients. PATIENTS AND METHODS: 202 examinees, divided into two groups, took part in the research. The first group consisted of 101 Croatian war veterans with PTSD. All the examinees were being hospitalized in the Psychiatric Hospital Vrapče. The diagnosis of PTSD was issued in accordance to the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The control group consisted of 101 examinees volunteers that visit the hospital in order to perform a systematic health examination. Individuals with psychiatric or neurological disorders, rheumatic diseases (rheumathoid arthritis), collagenosis, orofacial pain, hormonal disorders, odontogenic abscesses, developmental anomalies and maxillofacial traumas were not included in the control group. Individuals that therapeutically use analgesics and opiates were eliminated from the control group. An analysis of the following muscels was performed bilaterally: masseter muscle, temporal muscle, temporal muscle tendon, medial pterygoid muscle, lateral pterygoid muscle, sternocleidomastoid muscle, splenius capitis and trapezius muscle. RESULTS: The research showed that war veterans treated for PTSD asses their health condition as generally poor (72,3%) or extremely poor (18,8%), the condition of the mouth as poor (47,5%) or extremely poor (17,8%), the attention devoted to their health as deficient (26,7%) and extremely deficient (6,9%). This results are to a considerable extent worse than the results of examiness in the control group. In comparison with the control group, a significantly higher comorbidity with the following diseases among war veterans with PTSD was determined: rheumatoid arthritis, collagenosis and psoriasis (35,6%), depression (99%), hearing impediments and problems with ears (51,5%), vertigo (58,4%), frequent headaches (64,4%), high blood pressure (41,6%), hormonal disorders (18,8%), problems with concentration (93,1%), sleeping disorders (100%), problems with sinuses (51,5%) and problems with cervical spine (80,2%). There was no difference between the two groups as far as the use of heart drugs is concerned, whereas other drugs, like tranquilizers, analgesics, sleeping medications and medicaments againts hypertension were considerably more frequently used by examinees with PTSD. The analyzed sample showed that there is no statistically significant difference between the incidence of myofascial pain in veterans who had been intubated and those who had not undergone intubation. The following symptoms were determined to be significantly more frequent in war veterans than in the control group: limited ability to open the mouth in the morning (29,7%) and in the evening (22,9%), a sideways shift when opening the mouth (20,8%), clenching of the teeth during the day (73,3%), teeth grinding while sleeping (47,5%), pain and tension in the jaws in the morning (37,6%) discomfort and instability when closing the mouth (54,5%). Inappropriate habits parafunctions (41,6%), and the sensation of tension and stiffness in jaw muscles (64,3%) are also significantly more frequent in the population of war veterans. Furthermore, the sound of the temporomandibular joints and pain in those joints were determined to be more frequent among war veterans with PTSD (left joint 31.7%, right joint 34,7%) than in the examinees from the control group. At the same time, war veterans display a greater incidence of muscle pain than examinees from the control group. Trigger points are mostly located in the following muscles: splenius capitis (12,9%), right temporal muscle (11,9%), left temporal muscle (7,9%) right masseter muscle (5,9%). In the control group the overall incidence of myofascial pain was much lower (8,9), and trigger points were detected only in the left temporal muscle (4%) and in the splenius capitis (5% ). A significantly higher incidence of myofascial pain in the he
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