Oral surgery, oral medicine, and oral pathology
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Oral Surg. Oral Med. Oral Pathol. · Jul 1993
Case ReportsEpstein's syndrome. Implications for oral surgery.
Epstein's syndrome is a rare inherited disorder that appears principally as nephritis and deafness with thrombocytopathic thrombocytopenia producing a bleeding tendency. Management of the disorder for oral surgical procedures is discussed and highlighted by a case report.
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Oral Surg. Oral Med. Oral Pathol. · May 1993
Randomized Controlled Trial Clinical TrialNarcotic receptor blockade and its effect on the analgesic response to placebo and ibuprofen after oral surgery.
The purpose of this study was to evaluate the contribution of endogenous opiates to the analgesic response after treatment with placebo, codeine, and ibuprofen after oral surgery. Eighty-one patients undergoing complicated dental extractions were pretreated with either a placebo or the narcotic antagonist naltrexone 50 mg, 30 minutes before surgery. After surgery, patients self administered one of three possible postsurgical medications, which included placebo, codeine 60 mg, and ibuprofen 400 mg, when their pain reached a moderate or severe intensity. ⋯ The administration of naltrexone before surgery reduced the analgesic response to both placebo and codeine. Pretreatment with naltrexone did not diminish the peak analgesic response to ibuprofen, but surprisingly prolonged (p < .05) the duration of its action. The results suggest that a blockade of endogenous opiates by naltrexone diminished the placebo response, but that naltrexone may prolong ibuprofen analgesia by some unknown mechanism.
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Oral Surg. Oral Med. Oral Pathol. · Mar 1993
Case ReportsQuincke's disease: nonhereditary angioneurotic edema of the uvula.
We report two cases of Quincke's disease, an isolated form of angioneurotic edema involving the uvula that is induced by several factors, including foods, drugs, and inhalants. Although Quincke's disease has prominent oral manifestations, it has only rarely been described in the dental literature. ⋯ A hereditary form of angioneurotic edema is associated with a biochemical defect; this must be differentiated from nonhereditary, localized forms such as Quincke's disease to determine appropriate treatment and predict prognosis. Clinical features and laboratory tests can distinguish hereditary angioneurotic edema from the nonhereditary form.
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The accumulation mechanisms of technetium-99m methylene diphosphonate were investigated using fetal mice calvaria, osteoblast-like cells, collagen sponges, and hydroxyapatite powder. Technetium-99m methylene diphosphonate accumulation was found consistently in the area of cells growing out from calvarial fragments cultured for 10 days. Accumulation was also seen on autoradiographs of calvarial fragments immediately fixed with 90% ethanol. ⋯ There was no relation between the osteoblast-like cell number and technetium-99m methylene diphosphonate accumulation. Technetium-99m methylene diphosphonate did not accumulate in collagen sponges. These findings suggest that the accumulation of technetium-99m methylene diphosphonate is by both chemical adsorption onto the surface of the hydroxyapatite in bone and incorporation into the crystalline structure of hydroxyapatite.