Chief Complaint Of Pain Research Articles

A 5 Year Follow Up of Intentionally Replanted Tooth- A Case Report

Intentional replantation can be an alternative choice and to restore an original tooth to function in the mouth instead of replacing it with prosthesis. This case report describes intentional replantation of a maxillary first premolar and its 5 year follow up. A 42-year old woman with the chief complaint of pain and swelling in her gums in the upper right premolar area. Direct digital radiograph revealed the presence of a vertical fracture line with respect to the right maxillary first premolar, extending from the cementoenamel junction (CEJ) to the middle-third of the root, along with large periapical radiolucency. In view of the patient’s objection to undergo surgery, intentional replantation was suggested as an alternative. The patient returned for clinical and radiographic follow-up at 1, 5 months and 1 year and 5 years. At the last visit, after 5 years, no pain and symptoms and normal appearance of periradicular area was evident. Case Study Annual Research & Review in Biology, 4(3): 520-526, 2014 521

Expect the Exceptional

ABSTRACT A 20-year-old female reported with chief complaint of pain in the left mandibular third molar region. Intraoral examination revealed inflamed area was notice near the retromolar area. Radiological examination showed impacted left third molar with pericoronal radiolucency of about 2.5 mm. Surgically, a very small cystic cavity was noticed surrounding the crown of the impacted third molar. Histopathological examination revealed a small cystic space lined by epithelium of two to three cell layers thick. The final diagnosis of dentigerous cyst was made. Thus, odontogenic lesion may be found in radiographically normal follicular space. How to cite this article Sarode GS, Sarode SC, Patil S. Expect the Exceptional. World J Dent 2014;5(3):196-197.

Treatment of Adamantinoma in Tibial Diaphysis by Hemicortical Resection and Strut Allograft

Introduction: Adamantinoma is a primary low-grade, malignant bone tumor, of unknown histogenesis which is a rare neoplasm, comprise only 0.1–0.5% of all primary bonetumors. It is slightly more common in men than women, with a ratio of 5:4. Wide tumour resection and limb salvage is the treatment of choice. Case report: A 24 year female reffered with chief complaints of pain and limping lasting for approximately 2 years. Plain X-ray showed an expansile multicystic lesion at the diaphysis of the left tibia anterior cortex with periosteal reaction . We used an oscillating bone saw to perform a total resection of the lesion preserving the anterior cortex. Tibial defect created with this resection was replaced with a 14 cm. long strut cadaveric femoral allograft that fixed to tibia with a dynamic commpresive plate (DCP) and screws. Discussion: In surgical treatment of Adamantinoma, total resection was not performed and remain intact posterior cortex to increased the patient satisfaction, at the same time, bone fixation and early weight bearing at the postoperative. We believe that the defect will be able to union with appropriate fixation of the allograft also be long size.

Full Mouth Rehabilitation of a Child with Cerebral Palsy under General Anesthesia

ABSTRACTCerebral palsy is defined as a nonprogressive brain disorder of movement and posture. The patient is characterized by mental and motor disabilities, sensory impairments of vision and hearing, besides having seizures and contraction joints. The dentist, doctors and healthcare professionals who treat patients with disabilities play an important role in health promotion and improvement in quality of life through multidisciplinary clinical planning especially in cerebral palsy patients who need special care. The aim of this case report was to describe a clinical case in which preventive and surgical interventions were performed in a 6-year-old male child with cerebral palsy under general anesthesia who reported to the Department of Pediatric and Preventive Dentistry, DAPMRV Dental College, Bengaluru, with the chief complaint of pain and swelling in upper left and lower right back tooth region. The approach targeted to the oral health of the patient with cerebral palsy can be considered as an important strategy for promoting the overall health and quality of life.How to cite this articleJaya AR, Praveen P, Ananthraj A, Nihal NK. Full Mouth Rehabilitation of a Child with Cerebral Palsy under General Anesthesia. J Health Sci Res 2014;5(2):29-32.

Intraosseousschwannoma: A Case Report and Review

Bony schwannoma is a rare benign tumour derived from Schwann cells of nerve fibres in the bone. It accounts for less than 1% of bony benign tumour, and prone to occur in the sacrum and mandible, occurrence in scapula is very rare. Here we report a 50-year-old woman with the chief complaint of pain in the left scapula. Imaging examination showed a giant, irregular, swelling lesion with distinct border involving the left scapula, extending into the left shoulder glenoid and pressing the surrounding soft tissues. Needle biopsy showed that the tumour was composed of spindle cells with S-100 protein positive, mimicking a benign neurogenic tumour. Then a complete excision was performed by removing the tumour and the surrounding tissues including partial left shoulder glenoid. Histologically, Antoni type A areas were the predominant microscopic pattern with occasional alternation by Antoni type B areas. Immunohistochemistry found that the neoplastic cells were scatteredly positive for S-100 protein. All these features suggest a diagnosis of an intraosseousschwannoma of the left scapula. Follow-up of the patient for ten months found no recurrence or sign of other tumours following complete tumour resection without any adjuvant therapy. In conclusion, this case of giant intraosseousschwannoma of the scapula is a rare benign bony tumour, and its diagnosis combined with clinical, imaging and pre-operative needle biopsy is important to guide further therapy, and avoid overtreatment.

Simple Bone Cyst of Metacarpal: Rare Lesion with Unique Treatment.

Introduction:Simple bone cyst or unicameral bone cyst (UBC) are benign cystic lesions commonly found in femur and humerus. However hand is a very rare site of occurrence. Treatment described for UBC of hand commonly involves curettage and bone grafting.Case Report:A 7 year old right hand dominant girl presented to us with chief complaints of pain and swelling in right 4th metacarpal since 2 month. On imaging, plain radiographs of right hand showed expansile lytic lesion on Metaphyseal-diaphyseal region of 4th metacarpal with pathological fracture. MRI showed cystic lesions with internal loculations and fluid-fluid levels (Fig 2). There was minimal soft tissue extension. We performed aspiration which showed serosanguinous fluid with haemorrhagic tinge. With the diagnosis of unicameral bone cyst in mind we performed and closed intramedullary nail with k wire. The cyst healed up completely within 2 months. There was no recurrence at 18 month follow up.Conclusion:In conclusion simple bone cyst is very rare in metacarpal bone. However it should be considered as important differential since it warrants simple treatment and extensive procedures should be avoided.

Accidental injection of formalin: case report of severe negligence in dental office.

Accidental injection of formalin: case report of severe negligence in dental office.

Mandibular bilateral fourth molars - a rare and interesting occurrence.

A 24-year-old healthy male visited our private clinic in Bangalore with chief complaint of pain and discomfort in lower right back teeth region since 4-5 days. On intraoral examination, soft tissues which covered 3/4th of occlusal (distocclusal) surfaces of 48 appeared to be moderately inflamed and the other entire oral tissues appeared to be normal. An IOPA radiograph in relation to 47, 48 was taken and a diagnosis of a partially impacted (soft tissue impaction) third molar with pericoronitis was given. The patient was advised surgical removal of third molar, for which he gave his consent. Third molar extraction was planned and it was successfully done under local anaesthesia, based on IOPA radiograph, but intra operatively, distal to third molar, a globular mass of enamel like glossy appearance was observed, which prompted us to investigate further by orthopantomography (OPG). OPG revealed impacted, bilateral, mandibular fourth molars [Table/Fig-1]. Considering the possible complications, both the distomolars were planned to be surgically removed after obtaining the patient’s consent. The distomolars were of supplemental type, which resembled third molars. After one week, post-operative oral examination revealed uneventful healing. Anna KS called them as “ghost tooth” which had evolved from behind third molars [1]. [Table/Fig-1]: OPG revealing impacted mandibular bilateral 4th molars The prevalence of Supernumerary Teeth (ST) for deciduous teeth varies between 0.3% to 0.8%, whereas for permanent teeth, it ranges between 2 and 3.8%, depending upon the literature source/population [2]. Multiple opinions regarding their aetiology exist. Most authors point to phylogenetic factors (atavism) and state that they result from continued hyper activity of dental lamina, whereas some authors opine that they arise from dichotomy of tooth germ [3]. A careful check for a family history of ST could point to the presence of a genetically determined syndrome. Whether odontomas come under the category of ST, is still a controversy, in most of the literature sources. They are most of the times designated as evolutive odontogenic tumours. Hence, studies involving ST, exclude odontomas, though morphologically they resemble ST. If multiple ST are found, anamnesis can be done to rule out congenital abnormalities/syndromes which may have many other significant features.

Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma

Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation. Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure. FNA taken at the time of EUS was consistent with inflammatory pathology. Triple phase CT of the abdomen revealed a splenic artery pseudoaneurysm with multiple splenic infarcts. After resuscitation we planned an emergency laparotomy; splenic artery pseudoaneurysm densely adherent to adjacent structures and associated with distal pancreatic necrosis was found. We performed splenectomy with repair of the defect in the stomach wall and necrosectomy. Postoperative course was uneventful and patient was discharged on day 8. Conclusion. Pseudoaneurysm can be at times a very difficult situation to manage; options available are either catheter embolisation if patient is vitally stable, or otherwise, exploration.

明らかな外傷を認めなかった破傷風の2例

Tetanus develops following inoculation of damaged human tissue with Clostridium tetani which transforms into a vegetative rod-shaped bacterium and produces the tetanospasmin. Usually we make a diagnosis of tetanus based on typical symptoms and history of trauma. But, when patients have no noticeable history of trauma, we have to diagnose tetanus on the basis of the clinical course and symptoms. We report herein on two cases of tetanus without a clear history of trauma. The first patient visited us with the chief complaints of pain in the neck and shoulder, and difficulty in opening the mouth. Based on these symptoms, we diagnosed tetani in the first stage and we started treatment, consisting mainly of human anti-tetanus immunoglobulin on the first day. The second patient also had typical symptoms of tetanus. However, he rejected the use of human anti-tetanus immunoglobulin on the first day. Because his symptoms worsened on the 2nd day, we insisted that he used it. On the 5th hospital day he developed partial opisthotonus of neck. However he recovered without tracheotomy or intratracheal intubation.

Fitting silicone hydrogel contact lenses with special diameters in a microcornea with micro and dislocated pupil

Purpose: Sarcoidosis is a chronic, multisystem granulomatous inflammatory disorder of unknown etiology. It is characterised by infiltration of tissues with macrophages and Th1/Th17lymphocytes, which culminates in the formation of noncaseating (nonnecrotizing) epithelioid cell granuloma in the affected organ. The author presents a case report of a patient who presented with bilateral granulomatous anterior uveitis as the presenting feature of ocular sarcoidosis. Method: A 40-year-old woman presented to the office with a chief complaint of pain, photophobia, tearing, redness, and cloudy vision in both eyes of 7 days duration. Clinical evaluation revealed bilateral granulomatous anterior uveitis with inflammatory ocular hypertension. Laboratory investigation demonstrated raised levels of serum Angiotensin-Converting Enzyme (ACE) and chest radiography revealed moderate bilateral pulmonary interstitial disease. The diagnosis was re-evaluated as presumed sarcoidosis-associated granulomatous anterior uveitis in line with the diagnostic criteria of the International Workshop on Ocular Sarcoidosis (IWOS). Result: A successful resolution of the granulomatous anterior uveitis with inflammatory ocular hypertension was achieved with topical therapy with corticosteroid, cycloplegia and ocular hypotensive agent. Theocular condition resolvedwithout any complications within 6 weeks. Conclusion: Sarcoid-associated anterior uveitis is an immunemediated sight-threatening eye condition. The inflammatory response in ocular sarcoidosis is characterised by an overexpression of proinflammatory cytokines and chemokines. Because Th1and Th17derived cytokines play a role in the pathomechanism of ocular sarcoidosis, early diagnosis and intervention with immunosuppressive therapy are vital to reducing ocular morbidity.

Three dimensional titanium miniplates in the management of mandibular fractures

Introduction: In 1992, Farmand developed three dimensional (3D) plate with quadrangular design, formed by joining two miniplates with interconnecting crossbars. 3D titanium plates and screws were then gradually developed. Here we report two cases in which 3D titanium miniplates were used in the management of mandibular fractures. Case presentation: A 21 year old male patient presented with the chief complaint of pain and swelling in the anterior region of the jaw due to road traffic accident. On further clinical and radiological evaluation, mandibular symphysis fracture was diagnosed and was posted for surgery under general anesthesia using 3D titanium miniplates through lower anterior vestibular incision. The fracture segment was reduced anatomically and fixed with 3D non-locking miniplates following which closure was done using 3-0 silk/vicryl suture and was followed for 6 months Another 24 year old male patient reported with the chief complaint of pain and inability to open the jaw due to a history of assault. Right mandibular parasymphysis fracture was diagnosed and was posted for surgery under general anesthesia using 3D titanium miniplates through intraoral approach. The healing was uneventful. Conclusion: 3D titanium miniplates are a superior method of fixation as they restore normal form and function early and lead to better approximation and stability.

Idiopathic pseudo-aneurysm of intrathoracic left subclavian artery – a case report

We report an interesting case of left subclavian artery pseudo-aneurysm presenting in a 35 years old male patient with the chief complaints of pain in the back of left chest radiating to left arm for 6 months duration. The chest skiagram showed well defined homogenous round opacity measuring around 3 in. in diameter, involving the left upper zone towards the midline. Computed Tomography (CT) scan thorax showed thickening of soft tissues surrounding the proximal left subclavian artery. CT angiography stamped it as large aneurysmal dilatation of proximal left subclavian artery. On exploratory thoracotomy it was found to be a pseudoaneurysm which was repaired successfully. Pathological examination of the biopsy obtained from the arterial wall did not prove any specific etiology.

Anaplastic solitary plasmacytoma of mandible, masquerading as sarcoma

Plasma cell neoplasm is characterized by a monoclonal neoplastic proliferation of plasma cells and solitary plasmocytoma of bone (SPB) is a localized form. It usually occurs in vertebrae and secondarily in long bones. Its presence in mandible is extremely rare event. A 48-year-old man consulted to our clinic with a chief complaint of pain in his mandible. Radiography revealed a destructive lesion in body and ramus. The initial pathologic evaluation revealed a high grade pleomorphic neoplasm. The diagnosis was confirmed by immunohistochemical markers. Overall, plasmacytoma with anaplastic features can be confused with high grade sarcoma clinically and histologically.

Rapid 13C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain

Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing.Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February 2011 until February 2012 at a single academic urban ED. Enrolled subjects were tested for H. pylori using a rapid point of care 13C Urea Breath Test (UBT) [Exalenz Bioscience]. We compared patient characteristics between those who tested positive versus negative for the disease.Results: A total of 205 patients with upper abdominal pain were tested over 12 months, and 24% (95% confidence interval: 19% to 30%) tested positive for H. pylori. Black subjects were more likely to test positive than white subjects (28% v. 6%, P < 0.001). Other factors, such as age and sex, were not different between the 2 groups.Conclusion: In our ED, H. pylori infection was present in 1 in 4 patients with epigastric pain, and testing with a UBT was feasible. Further study is needed to determine the risk factors associated with infection, the prevalence of H. pylori in other EDs, the effect of the test on ED length of stay and the costeffectiveness of an ED-based test-and-treat strategy.

Radicular cyst followed by incomplete pulp therapy in primary molar: A case report

Radicular cysts are one of the most common odontogenic cyst of the jaws. However, those arising from primary teeth are rare. An 8-year-old boy reported to the Department of Pedodontics and Preventive Dentistry with the chief complaint of pain and swelling on the lower left primary molar tooth region. Radiographic examination revealed a well-defined radiolucency with continuous hyperostotic border. Considering the age of the child, size of lesion, and involvement of unerupted premolars; marsupialization was preferred as a conservative treatment of choice. The success of the treatment was evident both clinically and radiographically during the follow-up period.

Follicular Ameloblastoma with Granular Changes Affecting Mandible &amp; Maxilla - A Case Report

Ameloblastoma is defined as a benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium lying in a fibrous stroma. Ameloblastomas are believed to have an epithelial origin, i.e. remnants of the dental lamina, remnants of Hertwig's root sheath (the epithelial remains of Malassez), epithelium of odontogenic cysts (particularly dentigerous cysts) and odontomas, the developing enamel organ and the basal cells of the surface epithelium of the jaws. Here we report a case of follicular cell ameloblastoma in a 45 years old female patient with a chief complaint of pain & swelling over the left side of face since 5 years. H & E stained sections showed stratified squamous hyperkeratotic epithelium with break in the continuity of the basement membrane. The underlying connective tissue contains numerous nests, strands, sheets & islands of dysplastic to atypical epithelial cells suggestive of malignancy in a fibro cellular stroma with little or no inflammatory cell infiltration. Hemimandibulectomy was done including condyle and coronoid process and the tumor mass. A 2.5 mm stainless steel reconstruction plate was fixed for the mandibular reconstruction. There was a marked resorption of the maxillary bone due to tumor expansion but maxilla was not involved directly into the tumor extension.

Occult infection in an elderly woman with a chief complaint of pain

Occult infection in an elderly woman with a chief complaint of pain

Oral desmoplastic melanoma mimicking inflammatory hyperplasia

Desmoplastic melanoma (DM) arising in the oral cavity is a rare neoplasm that may be confused with a variety of non-melanocytic benign or malignant lesions. To present a case of DM in the oral mucosa mimicking fibrous inflammatory hyperplasia, discusses the difficulties involved in the diagnosis and offers a literature review on the clinicopathologic and immunohistochemincal aspects of this neoplasm. A 62-year-old white male, smoker, was referred with a chief complaint of pain and swelling in the palate. The oral examination revealed multiple brown-to-black patches and a non-pigmented sessile nodule located on the mucosa of the hard palate. The clinical diagnosis of the pigmented lesions was either oral melanosis or melanoma. The nodular lesion was clinically diagnosed as fibrous inflammatory hyperplasia. Incisional biopsy was performed on the pigmented lesion and the microscopic sections revealed a melanotic macule. The nodular lesions histologically revealed an amelanotic desmoplastic melanoma. Reactive lesions close to a pigmented area should be investigated with great care.

A Clinical and Histological Report of a Tooth with an Open Apex Treated with Regenerative Endodontics Using Platelet-rich Plasma

IntroductionIn patients, the outcomes of teeth with necrotic pulps and open apexes that have been treated with regenerative endodontics have always been evaluated clinically and radiographically. The purpose of this case report is to present the clinical, radiographic, and histological findings of a regenerative procedure using platelet-rich plasma (PRP) 14 months after the procedure. MethodsA 12-year-old boy whose maxillary second premolar tooth had been treated with regenerative endodontics was seen with a chief complaint of pain and sensitivity to cold. After clinical and radiographic examinations, a pulpal diagnosis of reversible pulpitis and normal periapical tissues was made for this tooth. Because of the patient’s complaint and his guardian’s insistence on either a root canal treatment or an extraction, a root canal treatment was performed in this tooth. After entry into the root canal, the soft tissue present in the canal was removed with the aid of a large barbed broach and examined histologically. ResultsExamination of the tissue removed from the root canal of this tooth revealed the presence of a vital pulp-like vital connective tissue. There was no evidence of bone in the specimen. Very few inflammatory cells were noted in the periphery of the specimen. ConclusionsBased on these findings, it appears that pulp-like tissue can be generated in a human tooth with the use of PRP as a scaffold in regenerative endodontic procedures.