Steroid cover in dentistry: recommendations following a review of current policy in UK dental teaching hospitals.

This article reports a project that was undertaken to determine current UK dental hospital policy with regard to the management of patients taking therapeutic doses of corticosteroids receiving dental treatment under local anaesthesia. There is variation in the medical management of this patient group, and whether practice should be standardized by means of a national policy document warrants consideration.

Investigation of the effect of FK506 (tacrolimus) and cyclosporin on gingival overgrowth following paediatric liver transplantation.

Introduction: Gingival overgrowth associated with immunosuppression following liver transplantation is a commonly recognized clinical problem. The aims of this study were to determine the incidence of gingival overgrowth in a group of children post liver transplantation and to compare gingival overgrowth in children receiving FK506 with those receiving cyclosporin.

Methods: Seventy-nine children (aged 15-196 months) undergoing liver transplantation at Birmingham Children's Hospital between October 1998 and October 2000 were studied.

Crowns and other extra-coronal restorations: preparations for full veneer crowns.

Preparations for full veneer crowns is the eighth in the series on crowns and other extra-coronal restorations. Whilst handpiece skills are important, many other factors combine to ensure provision of a satisfactory full veneer crown (also termed 'full coverage crown'). Our aim in writing this article is to consider the principles which influence crown preparation, seasoned with clinical advice our undergraduate and postgraduate students have found useful.

The management of traumatically intruded permanent incisors in children.

Trauma to the permanent dentition, particularly the maxillary incisors, is common. Prompt and appropriate management can significantly improve the prognosis for many of these dentoalveolar injuries. Unfortunately, much of this trauma is left untreated.

Localized scleroderma in a 12-year-old girl presenting as gingival recession. A case report and literature review.

Scleroderma is a connective tissue disorder that displays considerable clinical heterogeneity. This case describes a 12-year-old girl who presented with a localized form of the disease. The consequences were a severe and progressive localized gingival recession affecting two maxillary incisors, a localized lip defect and scarring of the forehead.

Drug-induced gingival overgrowth: a case with auto-correction of incisor drifting.

Drug-induced gingival overgrowth is an iatrogenic clinical condition, which affects a proportion of patients medicated for conditions such as hypertension, epilepsy and the prevention of organ transplant rejection. Clinical manifestation can vary in severity from minor problems to complete coverage of the standing teeth. Drifting of teeth can also occur, producing further aesthetic and functional problems for the patient.

Dens evaginatus on the labial surface of a central incisor: a case report.

A 7-year-old girl in the mixed dentition phase presented with abnormal morphology of the upper right central incisor. The diagnosis was a dens evaginatus, an anomaly of odontogenesis of unknown aetiology. This article describes the management of this anomaly and discusses the importance of maintaining space in the developing dentition.

Dyskeratosis congenita: report of a case.

Dyskeratosis congenita is a rare multisystem condition involving mainly the ectoderm. It is characterized by a triad of reticular skin pigmentation, nail dystrophy and leukoplakia of mucous membranes. Oral and dental abnormalities may also be present.

Rhinoliths presenting during routine radiography: two cases.

Rhinoliths are calcified masses found within the nasal cavity. They are an uncommon finding and usually present to ENT surgeons. This article presents two cases where rhinoliths have been recognized in the dental setting, and discusses their management and treatment.

Allergy to a common component of resin-bonding systems: a case report.

Allergies to materials routinely used in dentistry are becoming more prevalent. The hydrophilic resin 2-hydroxyethyl methacrylate is a common constituent of systems designed to bond resin-based restorative materials to dentine. It has been considered to have a high sensitizing potential, although dental patient-related allergies to the resin appear to be rare.

The provision of dental implants in the National Health Service Hospital dental services--a national questionnaire.

Objective: To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment.

Design/setting: Anonymous postal questionnaire in the United Kingdom.

Subjects: Consultants in restorative dentistry.

Dental and oral lesions in two patients with focal dermal hypoplasia (Goltz syndrome).

This report is concerned with the manifestations associated with focal dermal hypoplasia (Goltz syndrome) in two patients. Goltz syndrome is a rare polydysplastic syndrome. Systemic findings were similar to those previously reported in the literature and are illustrated.

Provision of general dental care for children with cleft lip and palate--parental attitudes and experiences.

Objective: To evaluate the attitudes of parents of 4-8 year-old children with cleft lip and palate (CLP) towards the provision of paediatric dental care and to assess their experience of treatment within the General Dental Services.

Design: Postal questionnaire distributed to all parents of 4-8 year-old children on the Birmingham CLP database.

Results: The response rate was 77%.

Molecular pathogenesis of oral squamous carcinoma.

Oral squamous carcinogenesis is a multistep process in which multiple genetic events occur that alter the normal functions of oncogenes and tumour suppressor genes. This can result in increased production of growth factors or numbers of cell surface receptors, enhanced intracellular messenger messenger signalling, and/or increased production of transcription factors. In combination with the loss of tumour suppressor activity, this leads to a cell phenotype capable of increased cell proliferation, with loss of cell cohesion, and the ability to infiltrate local tissue and spread to distant sites.

Oral management of patients following oncology treatment: literature review.

Many tumours of the head and neck are treated by clinical oncologists using radiotherapy. This treatment modality is particularly effective in destroying rapidly dividing cells, hence its value in cancer treatment. The tissues of the oral mucosa, the salivary glands and blood vessels can be damaged as the result of radiotherapy treatment.

Chronic sclerosing sialadenitis of the submandibular and parotid glands: a report of a case and review of the literature.

Chronic sclerosing sialadenitis (also known as Küttner tumor) is a chronic inflammatory condition of the salivary glands, first described by Küttner in 1896. Clinically, the disease cannot be distinguished from a true neoplasm. The submandibular gland is affected more commonly than any other salivary gland.

Cleidocranial dysplasia: modern concepts of treatment and a report of an orthodontic resistant case requiring a restorative solution.

A case is presented of a young boy with cleidocranial dysplasia, whose multiple supernumerary teeth prevented the eruption of most of his permanent teeth. His maxillary incisor teeth failed to erupt following removal of anterior supernumerary elements and orthodontic traction. Lack of abutment teeth and a difficult maxillary base made prosthetic treatment almost impossible.

Juvenile ossifying fibroma. An analysis of eight cases and a comparison with other fibro-osseous lesions.

Juvenile ossifying fibroma (JOF) is a well-defined clinical and histological entity that has recently been separated from other fibro-osseous lesions, including cemento-ossifying fibromas. Its biological behaviour is well defined, but unexplained. Its behaviour, clinical and histological appearance, however, bears resemblance to osteofibrous dysplasia of long bones, a lesion that in some cases has been reported to be part of a spectrum of diseases associated with adamantinoma, thus accounting for its variable biological behaviour.

Behçet's syndrome: a multidisciplinary approach to clinical care.

Behçet's syndrome is a multisystem disorder characterized by recurrent orogenital ulceration and an occlusive vasculitis. Histologically, there is a combination of a perivascular lymphocytic infiltration with endothelial cell damage coupled with a pro-thrombotic tendency. We present a multidisciplinary approach to the management of Behçet's syndrome, and compare our findings with other published studies.

A severe reaction to carbamazepine: consequences for patient monitoring.

Carbamazepine is a drug commonly prescribed by medical and dental practitioners for the treatment of trigeminal neuralgia. Although included in the Dental Practitioners' Formulary, general dental practitioners (GDPs) rarely prescribe this medication. Those GDPs who do prescribe carbamazepine may need to liaise with the patient's medical practitioner for haematological monitoring.

The importance of oral hygiene in nutritional support.

Disorders of the mouth can significantly impair the quality of life of the ill patient. For patients requiring nutritional support, especially those who are unable to take food via the oral route, good oral hygiene is of prime importance. This article, the third in a series on nutrition, suggests aims and objectives for mouthcare plus an assessment tool for recording the oral state of patients on admission.

An ossifying fibroma presenting as Stafne's idiopathic bone cavity.

The purpose of this paper is to present a case of a fibro-osseous lesion which was diagnosed as an ossifying fibroma rather than a cemento-ossifying fibroma because of its location away from the tooth bearing parts of the jaw and the absence of cemental tissue in the excised specimen. Its location and features on a panoramic radiographic made Stafne's idiopathic bone cavity a possible diagnosis.

Parotid gland metastases of two uncommon neoplasms with low metastatic potential.

Oligodendrogliomas are uncommon intracranial glial tumours in which extracranial spread is only rarely reported. Similarly, both intracranial and ocular medulloepitheliomas are also rare, with metastatic spread from the ocular neoplasm being less common than its intracranial counterpart. We report cases of an intracranial oligodendroglioma and an ocular medulloepithelioma both of which metastasised to the parotid gland.