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PubMedDate not supplied

Eutectic mixture of local anesthetics in adult urology patients: an observational trial.

BACKGROUND AND OBJECTIVES: The effectiveness of EMLA eutectic mixture of local anesthetics, (ASTRA Co, France) cream in minor surgery on the penis and its acceptability in unpremedicated outpatients were assessed. METHODS: EMLA cream was applied 1 hour before surgery (fremulum plasty, circumcision or dorsal section for phimosis, and condyloma accuminatum) in addition to a subcutaneous infiltration of lidocaine 1%, just before incision in cases of circumcision. Verbal Rating Scale (VSR) was assessed during the surgery and the acceptance 15 days later by a questionnaire. RESULTS: Thirty-two patients included. In all of the cases, the application of EMLA cream was sufficient, with the exception of one (fremulum plasty). General anesthesia was used for this patient unable to tolerate the proprioceptive sensations (VRS = 0). In cases of circumcision, the subcutaneous infiltration was not experienced as painful. Eighty-eight percent of patients who answered the questionnaire confirmed that if they had to be reoperated on, they would opt for this technique of anesthesia. CONCLUSION: EMLA cream is effective in minor penile surgery in adult patients, and it is associated with subcutaneous infiltration of local anesthetic in the case of circumcision.

Adult↗
PubMed2001

Palatal radicular multigrooves associated with severe periodontal defects in maxillary central incisors.

BACKGROUND: This case report describes a rare condition of palatal radicular multigrooves on teeth 11 and 21 with severe periodontal defects and the findings at 3-year follow-up. METHOD: Radiculoplasty using hand curettes and rotary burs were used to remove the multigrooves on the root surfaces and change the wrinkled root form to the relatively flat and smooth normal root morphology. Minor tooth movement and frenotomy were performed for a diastema between teeth 11 and 21. Supportive periodontal therapy started immediately after completion of the active treatment. RESULTS: Improved healthy periodontal tissues and adequate plaque control have been maintained.

Adult↗
PubMed2002

Lichen sclerosus et atrophicus manifesting with localized loss of periodontal attachment.

Lichen sclerosus et atrophicus (LSA) is a chronic mucocutaneous inflammatory disorder of uncertain aetiology that is clinically characterized by the appearance of well delimited white plaques or papules, preferentially affecting the skin and genitals, and more rarely the oral cavity. We present the case of a woman with LSA limited to the oral cavity in the form of a well delimited, flat whitish lesion affecting the vestibular gingiva of the right upper incisors and left central incisor, and extending towards the vestibular fundus and frenulum of the upper lip. Widening of the periodontal space was observed, with gingival recession and attachment loss limited to these teeth. Local corticosteroid injections caused the mucosal lesion but not the periodontal alterations to resolve. Emphasis is placed on the importance of knowledge of this condition in relation to establishing a diagnosis, and on its periodontal repercussions.

Adult↗
PubMed2004

Morphological, histochemical, and immunocytochemical study of CO2 and Er:YAG laser effect on oral soft tissues.

OBJECTIVE: The purpose of this study was to investigate the morphological, histochemical, and immunocytochemical changes of the oral mucosa after CO(2) or Er:YAG laser irradiation. BACKGROUND DATA: There have been no comparative reports on CO(2) and Er:YAG laser effects on human oral soft tissues. MATERIALS AND METHODS: Tissue preservation was studied in 40 oral biopsies of young patients obtained by CO(2) and Er:YAG laser surgery. Hematoxylin-eosin and Giemsa stains, PAS/diastase treatment, AE1 and AE2 cytokeratins, MiB1/Ki67, and bcl-2 immunoreactions were performed on the laser cut edges on formalin fixed, paraffin embedded biopsies. RESULTS: CO(2) laser biopsies show blisters, clefts and erosions of the epithelium. Intracellular edema and lengthened nuclei were also seen. The glycogen content results decreased in CO(2) laser biopsies. Good expression for cytokeratins and cell-cycle proliferation markers were found in Er:YAG biopsies, on the contrary the apoptosis marker was better expressed in CO(2) laser biopsies. CONCLUSION: The results suggest that Er:YAG laser may be routinely used in surgery, because of its minimal damage of the epithelial tissue, its low inflammatory reaction, its quicker healing process and its lower risk of scarring.

Adolescent↗
PubMed1996

Clinical assessments of the erbium:YAG laser for soft tissue surgery and scaling.

We evaluated the clinical usefulness of an erbium:YAG laser for soft tissue surgery, and scaling. Thirty-one patients with soft tissue lesions (13 males and 18 females from 24 to 71 years old), and 60 patients with calculus deposits (21 males and 39 females from 19 to 72 years old) were treated with the laser. The clinical parameters evaluated were pain, redness, swelling of the gingiva, and the subjective patient comfort parameters including uneasiness with the sound and vibration associated with laser treatment. Additionally, hemorrhage and wound healing during and after the surgery, the roughness of the root surface after scaling, and the effectiveness of scaling using the laser were examined. Laser surgery caused less hemorrhage and resulted in better wound healing when compared with conventional methods. It was easy to remove calculi from the root surface with the laser in 95% of the cases. Although the scaled site showed some irregularity, it was not clinically significant in 98% of the cases. Only a few patients complained about the unpleasant sound and vibration. There were no complications or side effects during this clinical trial. Thus, this study suggests that an Er:YAG laser is useful for soft tissue surgery and scaling.

Adult↗
PubMed2006

A comparison of postoperative pain scales in neonates.

BACKGROUND: Practical, valid and reliable pain measuring tools in neonates are required in clinical practice for effective pain management and prevention of the evaluator bias. METHODS: This prospective study was designed to cross-validate three pain scales: CRIES (cry, requires O(2), increased vital signs, expression, sleeplessness), CHIPPS (children's and infants' postoperative pain scale) and NIPS (neonatal infant pain scale) in terms of validity, reliability and practicality. The pain scales were translated. Concurrent validity, predictive validity and interrater reliability in postoperative pain were studied in 22 neonates after major surgery. Construct validity and concurrent validity in procedural pain were determined in 24 neonates before and during frenulectomy under topical anaesthesia. RESULTS: All scales had excellent interrater reliability (intraclass correlation >0.9). Construct validity was determined for all pain scales by the ability to differentiate the group with low pain scores before surgery and high scores during surgery (P<0.001). The positive correlations among all scales, ranging between r=0.30 and r=0.91, supported concurrent validity. CRIES showed the lowest correlation with other scales with correlation coefficients of r=0.30 and r=0.35. All scales yielded very good agreement (K>0.9) with routine decisions to treat postoperative pain. High sensitivity and specificity (>90%) for postoperative pain from all scales were achieved with the same cut-off point of 4. In terms of practicality, NIPS was the most acceptable (65%). CONCLUSIONS: Based on our findings, we recommended NIPS as a valid, reliable and practical tool.

Critical Care↗
PubMed2001

Face, palate, and craniofacial morphology in patients with a solitary median maxillary central incisor.

The occurrence of a solitary median maxillary central incisor (SMMCI) is a very rare condition and might be a sign of a mild degree of holoprosencephaly. In this investigation, material from 10 patients, nine girls and one boy with a SMMCI (8-17 years of age) registered in orthodontic clinics was examined. The purpose was to evaluate the clinical characteristics and craniofacial morphology in this group of patients. Oral photographs, study casts, profile radiographs, and orthopantomograms were analysed. The study showed that this group of SMMCI patients were characterized by an indistinct philtrum, an arch-shaped upper lip, absence of the fraenulum of the upper lip, a complete or incomplete mid-palatal ridge, a SMMCI, and nasal obstruction or septum deviation. The craniofacial morphology of the nine girls, compared with normal standards for girls showed a short anterior cranial base, a short, retrognathic and posteriorly inclined maxilla, and a retrognathic and posteriorly inclined mandible. Furthermore, the sella turcica had a deviant morphology in five of the 10 subjects. The results indicate that the presence of a SMMCI should not be considered as a simple dental anomaly, since it may be associated with other clinical characteristics and more complex craniofacial malformations. It is therefore suggested that the SMMCI condition in future studies is classified according to clinical symptoms and craniofacial morphology.

Adolescent↗
PubMed2001

Unilateral complete cleft lip and palate repair using lip adhesion and passive alveolar molding appliance.

To manage a unilateral complete cleft lip and palate, lip adhesion along with the positioning of a passive alveolar molding appliance was performed in infants at 3 to 6 weeks of age. The lip adhesion creates a force acting on the cleft alveolus. There-after, the greater segment of the alveolus is guided by the appliance, while the lesser segment of the alveolus is prevented from collapsing. Definite cheiloplasty was then performed at 5 to 6 months of age and palatoplasty at 12 to 14 months of age. Fifteen patients with a unilateral complete cleft lip and palate were treated using this protocol from April 1995 to October 1998. Nine were female and six were male. The mean follow-up period was 13 months. The lip adhesion failed in one patient and was performed again 1 month later. Thirteen patients developed good or fair symmetrically aligned alveolar segments plus a symmetric platform for the nose. However, two patients developed poor maxillary orthopedics because of the displacement of the appliance by the patient. The resulting lip scar was aesthetically acceptable in most patients.

Alveolar Process↗
PubMed1975

Prognostic parameters and clinical staging criteria in the epidermoid carcinoma of the vulva.

An evaluation and a critique of prognostic parameters and criteria involved in the classification and clinical staging of epidermoid carcinoma of the vulva are presented, comparing the FIGO system and a proposed more definitive system. Biostatistical as well as clinical evidence for an improved system is presented. The proposed system is based on statistically valid data, has good patient distribution, and an orderly progression for therapy and prognosis. In addition, it is well suited for computer programming and for the comparison of patients and therapy, as well as for delineating the natural history of vulvar cancer.

Carcinoma, Squamous Cell↗