Search

A comparison between thirty-nine patients with primary osteoarthrosis and forty-four normal control subjects has, with the exception of one clinical feature, shown no significant clinical or radiologic differences between the tempormandibular joints of the two groups. A palpable click was significantly more common in the osteoarthrosis group, but this sign probably has no relationship to degenerative joint disease. Involvement of the temporomandibular joint does not appear to be a feature of primary osteoarthrosis.

1. A case of multiple bone lesions in a patient infected by Avian-Battey bacillus is reported. 2. It is suggested that the prognosis in future Heaf-negative cases may be improved by studies of the cellular response to the infection.

Five cases of MNBCCS caused by a dominant gene in three generations of one family are described. The history suggests that one other member of the family is affected. Another a 6 months old child, has some suggestive features—Skin lesions and/or dental cysts were major clinical signs which caused the three older patients to present for treatment. The disease was unsuspected in two younger patients 7 and 5 years old.— Intracranial calcifications and rib malformations were present in all the patients in whom the disease was proved, and all showed generalised bone changes.

The findings in a clinicopathologic study of sixty-six previously unreported cases of traumatic bone cysts are presented and compared with the findings in more than 150 previously reported cases. Most of the patients were between 11 and 20 years of age, and there was no difference in the incidence of the lesion between the sexes. Most patients were asymptomatic, although a significant number of them had symptoms and/or bony expansion. Vitality of teeth was not related to etiology or pathogenesis. In some cases the radiographic findings suggested a traumatic bone cyst, but surgical exploration was essential for definitive diagnosis. The lesion occurs in the maxilla more often than previously reported, although the mandible is still the most common location. The etiology and pathogenesis of the traumatic bone cyst remain unknown. Although the possibility that trauma plays a role in some cases cannot be excluded, present evidence is far from convincing.

Five cases of chronically infected extraction wounds containing sequestra have been investigated histopathologically. In each case actinomyces-like colonies were reported closely related to necrotic bone surfaces. In one case, bacteriologie investigation of the curettings proved the microorganism to be Actinomyces naeslundi. It would be presumptuous to conclude that each of the above cases would have yielded similar results bacteriologically, but there must be a strong possibility that the microorganisms were all actinomyces of one type or other.

Summary Twenty-six patients who developed radio-osteomyelitis after radiation therapy of various tumours of the oral cavity were studied. Special attention was paid to the dentition in the line of irradiation during treatment. In 22 cases, the highest dosage which caused radio-osteomyelitis was 11,415 rHD, and the lowest 4,064 rHD. In four patients who were treated in other hospitals, we could not find the irradiation dosage applied to them. — The occurrence of radio-osteomyelitis did not necessarily indicate that cancer had been completely eliminated. Of the 26 patients under review, 19 of them were free of cancer, and in 7 cases (26.9%), there was a recurrence of tumour or new cancer or metastasis. The period of latence before cancer recurrence was evidenced varied from 3 months to 4 years.

Osteodystrophia fibrosa generalisata has been described from the standpoint of its localization within the jaws. A general clinical symptomatology has been presented, and the clinical and radiologic findings have been discussed in detail—especially as they apply to the maxillary region. A case has been presented that illustrates the problems in differential diagnosis between the resorptive giant-cell granulomas and primary giant-cell tumors and the generalized form of the disease. The importance of an exact diagnosis has been stressed. All patients with giant-cell lesions should have tests of blood chemistry, serum calcium, phosphorus, and alkaline phosphatase, as well as a thorough x-ray examination of the skeleton.

A family with the naevoid basal cell carcinoma syndrome is described. Three affected members in one sibship suffered from anosmia. One member has shown a most severe constellation of defects including cataracts, hypertelorism, and anosmia, together with hypogonadism secondary to partial pituitary dysfunction. It is suggested that this latter also represents a previously unreported manifestation of the syndrome.

Immunoglobulin levels in cyst-fluids from 19 odontogenic cysts were significantly higher than in the sera of the same patients. Mean cyst/serum ratios for IgA, IgG, and IgM were 3.0, 2.1, and 1.8 respectively. Immunofluorescent staining of sections of cyst walls showed that the characteristic cellular mural aggregates contained many cells forming immunoglobulins; IgA plasma cells were preponderant, but IgG and IgM cells were also seen. In some cases plasma cells were seen penetrating the epithelial lining of the cyst and entering the cavity. It seems that immunoglobulins reaching the cyst cavity are transported by the cells that make them.

Histories of two dentists with self-inflicted radiologic damage are given. Guidelines are suggested for prophylactic extractions in patients undergoing oral irradiation.

A 35-year-old patient was a healthy, intelligent, handsome salesman. He had had immediate dentures made about six years previously. He remembers returning only once for a sore spot adjustment. When he called the dentist a second time about a sore spot, he was instructed to remove his dentures and suck on ice to cure the trouble. He said this treatment worked all right. When his dentures became loose several months later, he tried using denture powder to help retain them, but he soon found this to be messy and had to use more powder with each application to do the same job of keeping the teeth in place. When the powder material failed, he tried Poly Grip.? He said this was squeezed out of a tube and had a pasty composition, The Poly Grip had a noticeable taste and leaked from under the denture creating what he described as a “constant discomfort within the mouth.” This man then tried using Cushion Grip$ home reliner and thought that the pressures he felt constantly from this material inside his denture were good to stimulate his tissues and keep them healthy. The plastic was firm and, when trimmed, stayed where it had been placed. The newly applied plastic caused a burning sensation and anxiety to the patient. This burning sensation was so severe that it caused his eyes to water. To relieve this, he lay on his back with ice or ice water in his mouth. After the material had set and hardened, he said there were short periods of general nervousness and “hot spots.” At times, a genuine “toothache” was experienced. The patient said that once the burning sensation from a fresh application of Cushion Grip had subsided fairly well (after several hours), if he drank a cup of hot coffee the unpleasantness would begin all over again and last for several minutes. He noticed, after a few applications of the home reliner (each application lasting for from 6 to 10 weeks), that a greater thickness or quan

Nine brief articles describe current research involving astronauts. Topics covered include: physiologic changes; bone demineralization; food in space; oral hygiene technics; lunar organisms; bite boards; dental kits; dental problems in space; and filling material for astronauts’ teeth.

1.Reduction of residual ridges (RRR) needs to be recognized for what it is: a major unsolved oral disease which causes physical, psychologic, and economic problems for millions of people all over the world. 2.RRR is a chronic, progressive, irreversible, and disabling disease, probably of multifactorial origin. At the present time, the relative importance of various cofactors is not known. 3.Much is known about the pathology and the pathophysiology of this oral disease, but we need to know much more about its pathogenesis, epidemiology, and etiology. 4.The ultimate goal of research of RRR is to find better methods of prevention or control of the disease. 5.Over 25 million Americans are estimated to be totally edentulous. The need for the delivery of more prosthodontic care in this country alone is staggering. 6.More research in RRR with new methods and new thinking are badly needed in order to provide the best possible oral health care for millions of edentulous patients.

1.A clinical, cephalometric, and densitometric study of the reduction of residual ridges (RRR) was carried out on 76 edentulous clinic patients (44 women and 32 men) with a mean age 65.2 years (range of 38 to 87 years). 2.In this group of patients with varying periods of time since extraction, a high proportion of maxillary ridges were high and well rounded (Order III), including 50 per cent of those 20 years or more after extraction. In contrast, only 24 per cent of the mandibular ridges were classified as high and well rounded, and of these, 80 per cent were 2 years or less postextraction with 54 per cent classified as knife-edge (Order IV). 3.The rate of total anterior RRR varied between individuals, being immeasurable in 23 per cent and 1 mm. or more per year in 20 per cent. The highest rate in one subject studied over 3 years was 2.2 mm. per year. The average rate was 0.5 mm. per year. 4.The rate of RRR varied between the upper and lower jaws averaging 0.1 mm. per year for the maxillae and 0.4 mm. per year for the mandible. Thus, the average rate for the lower jaw was four times that of the upper. Yet, 9 per cent of the subjects had a higher rate on the maxillae than on the mandible, while the rate was the same in 26 per cent. 5.There was a low correlation between the rate of RRR and several possible cofactors, including sex, age, and bone density. 6.An average rate of anterior vertical RRR of 0.5 mm. per year could represent an average loss of 5 mm. in anterior ridge height (considerably more in some patients) in 10 years, resulting in significant loss of vertical dimension, esthetics, and comfort. Such remarkable changes in millions of edentulous people represent a staggering need for prosthodontic care. 7.New methods of prevention and treatment of this disabling disease must be found.

顎関節疾患の多くは, その原因の多くが関節軟部組織にあるとされていながら, この部位の検査法すなわち造影X線撮影法の顎関節部への導入は, 造影手技および造影X線像の読影が困難なこと等の理由から, 容易にはなされなかった。著者は, 顎関節造影撮影法に関する基礎的検討を行なうと共に, 新鮮屍体, 健常顎関節造影X線像所見および病的顎関節造影X線像所見を対比させ, 顎関節疾患診断に不可欠な造影X線撮影法の一般化, および読影の普遍化を試みた。色素を混入した造影剤を用いて新鮮屍体顎関節造影撮影を行ない造影所見を得た後, 肉眼解剖学的観察を行なってその関連性を追求し, 関節軟部組織の伸展性の有無が造影像にかなり影響を及ぼしていることを知った。健常顎関節21関節に対する造影からは, いわゆる正常像を得, この所見は新鮮屍体顎関節から得られた造影所見とほとんど大差なく, これを模式図として示した。正常像においても造影像の形態の多少の変化を認めたが, これは解剖学的なものによると考えられた。顎関節異常を訴えて来院した67名91関節に顎関節造影を行ない, また非罹患側に対しても31関節に関節造影を行ない得た。この造影所見と臨床症状, および単純X線所見とを対比させ関連性をもとめた。この結果臨床症状では運動痛・開口障害を合併する症型が異常造影所見を最も多く示し, 軟部組織の変化を強く疑わしめた。単純X線所見上で関節骨部組織に異常を認めた症型が造影像上でも当然異常を多く認めたが, 単純X線所見上何ら異常を示さなかった関節20関節中55%に造影像上異常を認めた。また患側に対する何んら臨床症状を示さなかった非罹患側でも関節造影により過半数を上回わる51.6%に異常所見を認めた。顎関節腔冲に注入された造影剤の消長について, ファントーム実験から得られた結果を用い, 造影剤の関節腔内での濃度が注入直後の1/2になるのに要する時間を求めて検討した。この値は, 健常顎関節, 異常顎関節共に激しい個人差が認められ造影剤の時間的消長を, 造影剤の濃度が1/2に減少するに要する時間を指標として把握し, 顎関節異常の有無を推定することには危険があると考えられた。

A review was undertaken of 374 panoramic dental radiographs of 214 children admitted to a hospital for the diagnosis or treatment, or both, of acute leukemia. The radiographs were studied for loss or thinning of the crypts of developing teeth and of the lamina dura of erupted teeth, and for the displacement of teeth. On dental radiographs, the earliest signs of acute leukemia occurred in the molar regions and the apical portion of the alveolar bone. Alternations of the jaws were shown for 62.9% of the children with active leukemia.

The findings in a family with the basal-cell nevus syndrome are presented. A new approach to the extirpation of jaw cysts (based upon the relationship between the nevoid skin lesions and the jaw cysts) is given special attention. A meningioma was noted in one patient. Finally, hyporesponsiveness to parathormone is discussed.

In a study of benign multinucleated-cell-containing lesions of the jaws, sixty-four examples of giant-cell reparative granuloma and only two of genuine giant-cell tumor of bone were encountered at the Mayo Clinic in a fifty-two-year period. Other benign giant-cell-containing lesions, such as aneurysmal bone cysts, cherubism, fibrous dysplasia, and malignant tumors, must be distinguished from giant-cell reparative granuloma. The central and peripheral tumors of this giant-cell reparative process are so similar histopathologically that differentiation must be made on roentgenographic or surgical findings, and an arbitrary designation is sometimes necessary. Giant-cell reparative granulomas respond favorably to conservative surgical removal, which is the treatment of choice.

Three cases of clinically and roentgenologically discernible gingival cysts have been described. Such lesions should be considered not only in the classification of cysts, but also in the differential diagnosis of radiolucent lesions of the jaws.

A study was made of 3,569 edentulous subjects and subjects wearing complete dentures to determine their oral status. These subjects were physically and mentally cooperative outpatients or short-term inpatients in a large general hospital. Among the aspects studied were types, age, and characteristics of dentures; intervals since last visits to a dentist; the presence of lesions, and their size, type, and location. It was found that satisfaction of the subjects with their dentures was deceptive in view of the high incidence of lesions found. The majority of the subjects had not had professional dental attention for long periods. A method of reeducating them is proposed.

Severe osteoporosis and some myelofibrosis of the alveolar bone developed in rats fed a citrate diet. The administration of coenzyme Q7 alleviated these histopathologic effects. It was also demonstrated that hypercitricemia with hypercalcemia found in the citrated rats were significantly restored to normal levels by coenzyme Q, administration.

口腔外科領域炎症性疾患に対し抗炎症作用を目的としてphenylbutazoneの誘導体であるKetophenylbutazone (Ketazon) を投与し, 以下の結果を得た。1) 19名 (男7名, 女12名) の対象症例を炎症群 (11例) と手術後投与群 (8例) の2群に大別した。炎症群では顎関節症が7例で最も多い。手術後投与群はすべて口腔外科外来小手術後に投与したものである。2) 効果は, 顎関節症では著明な効果を得ることが出来なかったが, 急性化膿性炎症々例, 手術後投与群では著明な効果を誌めた。3) 副作用: 胃部不快感1例, 眩暈1例計2例。以上の結果より, 本剤は急性炎に対する抗炎症効果, 手術後の抗腫脹, 鎮痛の効果は充分に認められたが顎関節症に対する対症療法としての効果は, 今後さらに症例を追加して検討することが必要と思われた。

A clinical-radiologic-histologic review of twenty-two cases of fibrous dysplasia involving the jaws is presented. The lesions showed a 13:9 predilection for the maxilla and frequently involved the maxillary sinus, orbital floor, and zygoma. The discase tends to appear early in life. Ten of the twenty-two cases were diagnosed in the first or second decades. In three additional patients the probable onset of the lesions was in the first or second decade. None of the patients in this study had apparent extracranial lesions of fibrous dysplasia. Clinically, a painless asymmetry was the only significant finding. Histologically, about one half of the cases showed the “classic” features of metaplastic woven bone in a fibrous stroma. The remaining cases showed variable amounts of lamellar bone. The presence of lamellar bone is not considered incompatible with a diagnosis of fibrous dysplasia of the jaws. The relation of fibrous dysplasia to fibrous osteoma of the jaws is discussed. Most of the so-called “fibrous osteomas” of the jaws should be considered as examples of fibrous dysplasia.

Intraoral roentgenography provides a third hand for the oral surgeon. It is the procedure most frequently employed for the preoperative and postoperative study of the tissues of the jaws and deserves credit for doing more to alter the nature and character of the work done by oral surgeons than any other aid. Oral roent­ genology has reached the status of a specialty within the practice of dentistry. It is not likely that the oral surgeon who has prepared for his specialty in the shortest time possible will have had an opportunity to gain sufficient experience in oral medicine and oral roentgenology to make him an expert, unless in his training he had an opportunity to handle thousands of patients, for each of whom complete physical and medical histories were obtained, tests and examinations were made, consultation, treatment or surgical intervention, or all t^ree, were carried out as indicated, with a follow-up study to demonstrate not only the efficacy of the prescribed treatment but, more important, the correctness of the diag­ nosis. It may follow, then, that the oral surgeon has as much need of help from the oral roentgenologist as the oral roent­ genologist has need of help from the oral surgeon. It is axiomatic that the patient will be served better by the combined efforts of the oral roentgenologist and oral surgeon than by either alone. The responsibility of obtaining roent­ genograms by the generous use o f film at different angles, and the use of contrast medium suitable for study, along with other roentgenologic aids to provide a result which is sharp in detail, falls to the roentgenologist. After studying the fin­ ished roentgenograms and drawing on his experience, he is able to offer an in­ terpretation of his observations. He must

Fibrous dysplasia should be considered in the differential diagnosis of tumors in the face and skull. The lesion is often present already in childhood and usually is most active during the general body and bone growth period. Microscopically the lesion consists of irregularly calcified and fibrous bone trabeculae. The rate of malignant degeneration is reported to be 0.4%. The main symptom is a unilateral swelling, and the disconfiguration may be remarkable without pain or other obvious symptoms. On roentgenograms the bone at the site of the lesion appears spongy with a homogeneous, fibrous-looking pattern and a thin egg-shell type of boundary. Sometimes, instead, a dissolution of the fibrous connective tissue occurs resulting in cystformations. The treatment is surgical removal of the diseased tissue; radical, mutilating operations are, however, not indicated. Twelve cases are reported. The lesion occurred in 7 males and 5 females, the maxilla was involved in 8 cases, the mandible in 2 cases, the frontal bone in 1 and the temporal bone in 1. The average duration of the illness was 8 years and the average age at onset around 17 years. Pronounced disconfiguration was seen in most cases, and extensive surgery was necessary in 8 of the patients. Malignant degeneration was not seen.

(1966). The Reduction in Face Height of Edentulous and Partially Edentulous Subjects During Long-Term Denture Wear a Longitudinal Roentgenographic Cephalometric STUDY. Acta Odontologica Scandinavica: Vol. 24, No. 2, pp. 195-239.

Cystinosis is a genetically determined metabolic disorder. It is characterized by the deposition of cystine crystals in several tissues, photophobia, and retardation of growth in addition to the characteristic signs of vitamin D-resistant rickets. Oral findings are variable and may include stomatitis, retarded dental calcification age, delayed eruption of deciduous and permanent teeth, interdental bone loss, bell-shaped roots, enlarged pulp chambers, periapical radiolucencies, and absence of the lamina dura.