Biomedical subjects
Publications and source records attributed to R I Brooke.
The findings in twenty-two cases of a condition that causes pain in the teeth and gingivae are presented. Two cases are described in detail. The importance of recognizing the problem and avoiding unnecessary dental treatment is stressed. The most effective treatment appears to be reassurance and the use of antidepressant drugs.
A persistent form of trismus which sometimes follows inferior alveolar nerve block is described. Clinical data from sixteen cases indicate that in most cases the condition responds to conservative therapy.
Two unusual forms of infection after local anesthesia have been presented. The first, a case of cellulitis, was thought initially to be a hypersensitivity reaction. The second, a case of impetigo, might prove difficult to diagnose because of its relative rarity.
Since the term traumatic pseudolipoma of the buccal mucosa was originally propounded to describe a traumatic herniation of the buccal fat pad, five additional cases have been reported. The evidence from these cases, together with the occurrence of similar lesions of the buttocks and anterior abdominal wall, is presented, and the suggestion is made that there is now sufficient reason to believe that this condition is a clinical entity for which the name traumatic pseudolipoma would appear to be justified.
Chronic granulomatous disease (CGD) has been recognized as a specific entity since 1957. Although a significant number of patients with this inherited disorder of leukocyte function exhibit oral manifestations which might be seen by the dentist, the dental literature contains no descriptions of this disease. The purpose of this article is to present a case of CGD exhibiting oral lesions, to document these lesions clinically and histopathologically, and to discuss the differential diagnosis of this disorder.
The clinical findings in thirty-five cases of periodic migrainous neuralgia (PMN) are given. Typical case histories are used to illustrate the fact that the condition may mimic dental pain. The nomenclature and association of the condition with migraine are briefly discussed, and a plea is made that the condition always be considered in cases of facial pain, when other clinical features of the disease are present, in order to save needless loss of teeth and delay in treatment.
Clinical data are producted which appear to show that the response to therapy of myofascial pain dysfunction syndrome (MPDS) is much less favorable when the patient has been involved in a road traffic or similar accident which precipiated the condition. Reasons for this difference and the differences between postinjury MPDS and nonpostinjury MPDS patients may be a consequence of litigation and, in addition, may be due to the personality of the patient. Evidence to support this hypothesis is seen when the condition is compared with such disorders as low back pain. Further research is needed to explore the etiology and treatment implications of these differences.
The findings in 194 cases of myofascial pain dysfunction syndrome are summarized and the differential diagnosis of the condition is discussed. Conservative methods of treatment were used in all cases, and follow-up revealed complete or almost complete recovery in 75 per cent of the patients; this percentage was increased still further when relaxation and coping skills training were used. Those patients who had been involved in accidents with direct or indirect trauma to one or both joints showed a significantly higher proportion of nonresponse to therapy.
Spherical granular and filamentous intranuclear bodies were found in the marginal epithelial cells of recurrent aphthous ulcers with a herpetiform pattern. They ranged from 0.8 to 1.2 mu in size with one to four bodies being present in any one nucleus. Because of their size and the demonstrated lack of DNA or RNA, it was thought that they were not viral in nature, as has been previously reported. It is hypothesized that intranuclear bodies of the type found in this study represent a common manifestation of altered cellular metabolsim produced by several etiologic factors.
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The rationale for the clinical existence of a less commonly found form of recurrent oral ulceration, herpetiform ulceration (HFU), is presented, illustrated by six clinical cases. The clinical and laboratory features that separate it from recurrent herpetic ulceration (RHU) and recurrent minor aphthous ulceration (RHU) are discussed. Although a viral cause has been proposed for the condition, based on the finding of intranuclear bodies, electron microscopic and other laboratory investigations by the authors indicate that there is insufficient evidence at present to confirm this. Since HFU does have a significant number of histologic and immunologic features in common with recurrent apthous ulceration, it is thought that it should be considered to be a variant of this condition until the true cause of it is revealed.
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