Root canal treatment of three-rooted maxillary first and second premolars - a case report

Aim To report the diagnosis and successful clinical management of a patient with anatomical variation in maxillary first and second premolars.Summary Maxillary premolars have a highly variable root canal morphology, but it is rare, especially in the second premolar, to find three canals. This article describes the diagnosis and clinical management of first and second premolars with three canals and three separate roots, drawing particular attention to radiographic interpretation and access refinements.

SINUS HISTIOCYTOSIS WITH MASSIVE LYMPHADENOPATHY (ROSAI-DORFMAN DISEASE) - CYTOMORPHOLOGIC ANALYSIS ON FINE-NEEDLE ASPIRATES

Cytomorphologic characteristics of smears from fine-needle aspirates (FNA) of three cases of sinus histiocytosis with massive lymphadenopathy (SHML) (Rosai-Dorfman disease) are described. All aspirates showed mature lymphocytes, plasma cells, and large pale histiocytes with well-preserved lymphocytes within the cytoplasm (lymphocytophagocytosis). The cases were confirmed by surgical biopsy, and the immunohistochemical findings suggested a macrophage origin for this lesion. The value of FNA analysis as an aid to diagnosis of SHML is discussed.

ANATOMIC OBSERVATIONS OF THE CORONARY SINUS IN THE DOG (CANIS-FAMILIARIS)

The coronary sinus was investigated in 34 normal adult dogs, in order to verify its formation, tributaries, length and the valves, as well as the relationship of the venous walls to the epicardium and to the myocardium. The valve of the coronary sinus was observed in only 4 cases (1.7 %). In 30 cases (98.3 %) the ostium of the coronary sinus was lacking a valve. The valve of Vieussens double, was found at the level of the transition between the great cardiac vein and the coronary sinus, as well as others parietal venous valves. A comparison with the human pattern was made, particularly regarding the action of the valve of the coronary sinus and the formation of the sinus.

Bone regeneration at implants placed into extraction sockets of maxillary incisors in dogs

AimTo compare the influence of autologous or deproteinized bovine bone mineral as grafting material on healing of buccal dehiscence defects at implants installed immediately into the maxillary second incisor extraction socket in dogs.Material and methodsIn the maxillary second incisor sockets of 12 Labrador dogs, implants were installed immediately following tooth extraction. A standardized buccal defect was created and autologous bone particles or deproteinized bovine bone mineral were used to fill the defects. A collagen membrane was placed to cover the graft material, and the flaps were sutured to fully submerge the experimental areas. Six animals were sacrificed after 2 months, and six after 4 months of healing. Ground sections were obtained for histological evaluation.ResultsAfter 2 months of healing, all implants were osseointegrated. All buccal dehiscence defects were completely filled after 2 months irrespective of the augmentation material (autologous bone or Bio-Oss (R)) applied. Bone-to-implant contact (BIC) on the denuded implant surfaces was within a normal range of 30-40%. However, the newly formed tissue at 2 months was partially resorbed (> 50% of the area measurements) after 4 months.ConclusionsApplying either autologous bone or deproteinized bovine bone mineral to dehiscences at implants installed immediately into extraction sockets resulted in high degree of regeneration of the defects with satisfactory BIC on the denuded implant surface.To cite this article:De Santis E, Botticelli D, Pantani F, Pereira FP, Beolchini M, Lang NP. Bone regeneration at implants placed into extraction sockets of maxillary incisors in dogs.Clin. Oral Impl. Res. 22, 2011; 430-437.

Enamel Defects in Maxillary Central Incisors of Infants With Unilateral Cleft Lip

Objective: To evaluate the presence of enamel alterations in deciduous maxillary central incisors of infants with unilateral cleft lip and alveolar ridge, with or without cleft palate, and to compare the occurrence and location of these alterations between the central incisor adjacent to the cleft and the contralateral incisor.Design: Intraoral clinical examination was performed after tooth cleaning and drying by a single examiner with the aid of a dental mirror, dental probe, and artificial light, with the child positioned on a dental chair. The defects were recorded in a standardized manner according to the criteria of the Modified Developmental Defects of Enamel Index.Setting: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) at Bauru, São Paulo, Brazil.Patients: One hundred one infants were evaluated. All were white, of both genders, aged 12 to 36 months and had at least two thirds of the crowns of maxillary incisors erupted.Results: Demarcated opacity was the most common defect at both cleft and noncleft sides, followed by diffuse opacity. The occurrence of hypoplasia at the cleft side was 11.8%. Most defects affected less than one third of the crown.Conclusion: The occurrence of enamel defects in deciduous maxillary central incisors of patients with unilateral cleft lip was 42.6%, mainly affecting the cleft side as to both number and severity.

Maxillary ulceration resulting from using a rapid maxillary expander in a diabetic patient

One of the characteristics of diabetes mellitus is the exaggerated inflammatory response. The present report shows the reaction from the use of a rapid maxillary expander in a diabetic patient. A 9-year-old child presented an uncommon reaction to the treatment with a rapid maxillary expander, and on follow-up examination, it was discovered that the patient had diabetes mellitus. After controlling the disease, the proposed treatment was used without further incidents. The case calls attention to the presence of uncommon responses to treatment and the need for the orthodontist to suspect a patient's systemic compromise. (Angle Orthod. 2011;81:546-550.)

Microscopic studies on the transition between the sigmoid sinus, the superior bulb of the jugular vein and the first portion of the internal jugular vein

The author studied the structure of the tissue components of the tunicae of the terminal segment of the sigmoid sinus, particularly at the level of the transition between the sigmoid sinus, the superior bulb of the jugular vein and the first portion of the human internal jugular vein; it was established that the transition between the sigmoid sinus and the first portion of the internal jugular vein occupies the whole extension of the superior bulb of the jugular vein up to the inferior third of the first portion of this vessel. These vascular walls exhibit a structure similar to that of the dura, i.e. the tunica adventitia is formed by fascicles of collagenic fibers which describe discontinuous spirals, more open proximal to the beginning of the first portion of the internal jugular vein. Approximately in the inferior third of the first portion of the internal jugular vein, there appear fascicles of smooth muscle fibers which are arranged similarly to those of the venous walls. The tunica intima of these vascular segments exhibits an endothelium resting on a network of elastic fibers which may play the role of an internal elastic lamina. From the bony border of the jugular foramen there originates a connective system whose fascicles of collagenic and elastic fibers incorporate to the wall of the internal jugular vein after describing a stretch in spiral around the vascular lumen.

Is coronary sinus blood oxygen tension behavior determined by myocardial oxygen tension variation during cardiac reperfusion?

The relationship between coronary sinus blood oxygen tension (CSPO 2) and myocardial oxygen tension (MPO 2) variations during cardiac ischemia and reperfusion was studied in anesthetized open-chest dogs. Oxygen tension was measured by a polarographic method. Ischemia resulted in a slightly decreased CSPO 2 and a more pronounced reduction of MPO 2. After reperfusion the CSPO 2 rose rapidly and transiently before it returned gradually to the control level. By contrast, during the recovery period, the MPO 2 increased slowly, with recovery occurring long after the peak of CSPO 2. These data suggest that during the reperfusion phase, the CSPO 2 variation is probably due to opening of the myocardial arteriovenous shunts instead of an increase of flow through the myocardial capillary bed.

New treatment for frontal sinus hypertrophy

A new treatment of frontal sinus hypertrophy is described. The anterior wall is removed, inverted, and attached again. The resulting depression is filled with bone dust. Details are discussed, and a case is presented.

Anatomic data of the human coronary sinus

The authors studied the formation, tributaries, lenght and the ostium of the coronary sinus, as well as the relationship of the venous walls to the myocardium and to the epicardium. The observations were made out of 143 hearts of subjects of different ages, and it was found that the most frequent display of the coronary sinus valve was a semilunar form (52 adults, 15 youngsters, 2 children, 3 newborn); it was also found valves in a cribiform or septal form. The absence of the valve of coronary sinus was noted in 53 cases (42 adults, 9 youngsters, 2 newborn). The valve of Vieussens was found, in some cases, at the level of the transition between the great cardiac vein and the coronary sinus, as well as others single or double parietal venous valves. The action of the valve of coronary sinus is also discussed by the authors.

Morphology of the walls of the cavernous sinus of Cebus apella (tufted capuchin monkey)

The morphology of the dura mater and its relationship with the structures of the cavernous sinus were analyzed in five tufted capuchin monkeys (Cebus apella) using histological sections, showing that the walls of the cavernous sinus of this species are similar to those of other primates, including man. Except for the medial wall of the cavernous sinus, the remaining walls consist of two distinct dura mater layers. The deep layer of the lateral wall of the cavernous sinus is contiguous to the sheath of the oculomotor, trochlear and ophthalmic nerves. Arterioles, venules, venous spaces, neuronal bodies and nervous fiber bundles are found on this lateral wall.

Immediate replantation of maxillary incisors in rats: effects of tooth immersion in sodium fluoride and subsequent removal of the periodontal ligament.

The advantages and disadvantages of maintaining the periodontal ligament (PDL) in immediate replantation as well as chemical treatment of the root surface have been a matter of discussion because the vitality of such tissue in surgery is always questioned. This study evaluated the effects of conserving the tooth in sodium fluoride and the removal of the PDL before replantation of incisors in rats. There was more cementum-dentin resorption in the group with the PDL. The group without the PDL showed more discreet resorption, repair occurred through the newly formed bone tissue in the PDL space and ankylosis was more extensive than in the group with the PDL.