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The purpose of this study was to describe the extent to which mothers engage in distracting activities during infant feeding. Mothers reported engaging in other activities during 52% of feedings; television watching was the most prevalent activity reported. Further research on the impact of distraction on feeding outcomes is needed., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: To report a case of adrenocorticotropic hormone-independent Cushing syndrome (CS) diagnosed and treated surgically during the third trimester of pregnancy and resulting in delivery of a healthy baby boy., Methods: We present a detailed case report, and we review and evaluate the English-language literature on CS during pregnancy., Results: During pregnancy, the occurrence of CS is a rare event. The diagnosis of CS during pregnancy is difficult to establish because of the normal physiologic hypercortisolemia of pregnancy. In our patient, laboratory testing revealed a random serum cortisol level of 56.5 microg/dL, a suppressed plasma adrenocorticotropic hormone level (<5 pg/mL), and a substantially elevated 24-hour urinary cortisol (1,708 microg). Noncontrast magnetic resonance imaging of the abdomen disclosed a 3.5-cm left adrenal mass. Laparoscopic left adrenalectomy was successfully performed during the early third trimester, and a healthy baby was born at 36 weeks of gestation by means of a cesarean delivery., Conclusion: The occurrence of CS during pregnancy is rare; however, when it does occur, adrenal tumors are more common than pituitary tumors. Caution should be used during interpretation of laboratory tests to evaluate for CS during pregnancy because of the normal increase in hypothalamic-pituitary-adrenal axis function during pregnancy. The current case demonstrates the safety and utility of noncontrast magnetic resonance imaging for localization of a tumor during pregnancy, as well as the safe use of laparoscopic surgical treatment of CS during the early third trimester.

It is the author's belief, after analyzing forces and stresses on the periodontium for more than 30 years, that stabilization of severely mobile teeth can retain teeth, if in health, almost indefinitely. Because these teeth are retained using restorative materials, recurrent caries is a problem that needs to be treated. Tooth loss resulting from caries can occur. In the author's 26 years of using extracoronal adhesive resins for splinting, the technology of adhesive bonding and restorative resins have been improved. Earlier shortcomings of the physical properties of these materials never dissuaded the author from recommending splinting. When the cases were presented to the patient and the referring dentist, the types of the current materials used to splint teeth were immaterial. Realizing that improvements in adhesives and resins would be developed, the near-hopeless teeth were retained. Because the elderly population is the fastest-growing segment of the population, caries control is more of a concern than it was 50 or more years ago. Because teeth are being retained longer in this cohort, and because caries has a greater potential to exist, supportive periodontal therapy and recalls and caries examination become more important.

This investigation compared the site prevalence of 40 subgingival species in 30 periodontally healthy (mean age 36+/-9 years), 35 elders with a well-maintained periodontium (mean age 77+/-5) and 138 adult periodontitis subjects (mean age 46+/-11). Subgingival plaque samples were taken from the mesial aspect of each tooth (up to 28 samples) in the 203 subjects at baseline. The presence and levels of 40 subgingival taxa were determined in 5003 plaque samples using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. The % of sites colonized by each species (prevalence) was computed for each subject. Differences in prevalence and levels among groups were sought using the Kruskal-Wallis test. Commonly detected species, such as Actinomyces naeslundii genospecies 2, Streptococcus sanguis and Streptococcus oralis did not differ significantly among subject groups. After adjusting for multiple comparisons, 4 species were significantly elevated and at greater prevalence in the periodontitis group. Mean % of sites (+/-SEM) colonized by Bacteroides forsythus was 10+/-3, 12+/-2 and 40+/-2 (p<0.001) for healthy, elder and periodontitis groups respectively. The odds ratio was 14.4:1 that a subject had periodontitis when B. forsythus was detected at > or = 5% of sampled sites. Mean prevalence for Porphyromonas gingivalis in healthy, elder and periodontitis subjects was 4+/-2, 5+/-2 and 23+/-2 respectively (p<0.001); for Treponema denticola 12+/-4, 10+/-3 and 30+/-2 (p<0.001) and for Selenomonas noxia 6+/-2, 7+/-2 and 19+/-2 (p<0.01). Similar differences among subject groups were observed when only sites with PD 0-4 mm were analyzed. The data suggest an etiologic role for B. forsythus, P. gingivalis, T. denticola and S. noxia in adult periodontitis.

We report an unusual case of maxillary osteosarcoma presenting as supracrestal bone formation in a 41-year-old woman. This case is of interest from the point of view of radiographic appearance of supracrestal bone formation with widened periodontal ligaments and the buccal and palatal swelling of the tissues. Moreover, to the best of our knowledge, the histopathologic evidence of cemental resorption has not been reported earlier.

Neurofibromas have not been reported in the periodontal literature. In this case report, a 27-year-old female presented with a complaint of a lump in the maxillary left palatal tissue; periodontal evaluation revealed a mass 15 x 8 x 4 mm on the palatal mucosa. After removal, the region healed without recurrence. The patient was referred to her physician for a physical, and no evidence of neurofibromatosis was found elsewhere, suggesting that this case represented an example of an isolated oral neurofibroma lesion.

A modified technique using a submarginal free mucosal graft has been developed to aid in root coverage. The gingival collar of keratinized tissue is relaxed via a horizontal or semilunar incision and coronally placed. The periosteum is retained on the osseous structures of the recipient site. A free mucosal graft from the palate is sutured submarginally, while the dentist places tension on the gingival collar in an incisal direction. This method has been found, in 8 years of study, to be a predictable way for the periodontist to cover receded gingival tissue where esthetics or root sensitivity is a factor.

Two extensive periodontal recessive lesions in bilateral maxillary cuspid ares were treated surgically with free autogenous masticatory mucosal grafts. No attempt was made initially to achieve total root surface coverage. Evaluation of the sites during a 4-year postoperative period demonstrated unusual degrees of "creeping attachment." The maxillary left cuspid graft completely covered the root with 9 mm of gingival-equivalent tissue while the maxillary right cuspid area displayed 90% (7 mm) root surface coverage.

A modified distal wedge procedure has been developed for use adjacent to edentulous areas. The purpose of this procedure is to eliminate pockets, yet retain keratinized tissue. Ease of flap design, the creation of access to the underlying osseous structures, and ease of closure are demonstrated by illustrations and Kodachromes.