A Rare Case Report of Non-Familial Sporadic Reoccurrence of Cherubism: Difficulties from the Surgeon’s Point of View

Cherubism is a rare bone dysplasia in children characterized by symmetrical bone resorption limited only to the jaws and diagnosed as bone lesions filled with soft fibrous giant cell-rich tissue that can expand and cause severe facial deformity. Most patients have germline mutations in the gene encoding SH3BP2, a signaling adaptor protein involved in adaptive and innate immune responses. Treatment depends on the clinical course of the disease. The current case report presents a young patient with cysts in frontal region of maxilla without family history, that had recurrences of cysts, and is representing a less documented, rare case. Histological finding at that time was indicating a giant cell granuloma and later a grey tumor. Due to the existence of other pathological findings in the jaws with the presence of giant cells, we had difficulties to diagnose cherubism as surgeons

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Family Related Non Syndromic Supernumerary Teeth -Case Reports

Hiperdontia is the condition characterized by supernumerary teeth, the teeth that appear in addition to the regular number of teeth. They can appear in any area of the dental arch and can affect any dental organ. We will present case reports of three children of the same family aged, 10, 11, 13 years, who were multidisciplinary treated for supernumerary teeth condition. Follow up is presented with RTG and photos taken during the treatments. Patients with non-syndromic supernumerary teeth might be related to heredity factor, therefore familial history should be carefully examined. For proper treatment of this condition is necessary to establish close cooperation in between Pedodontist, Oral surgeon and Orthodontist

Cherubism

Cherubism is a rare bone dysplasia that is characterized by symmetrical bone resorption limited to the jaws. Bone lesions are filled with soft fibrous giant cell-rich tissue that can expand and cause severe facial deformity. The disorder typically begins in children beteween age 2-7 and continues until puberty; in most cases the lesions regress spontaneously. Most patients with cherubism have germline mutations in the gene encoding SH3BP2, an adapter protein involved in adaptive and innate immune response signaling. There are a small number of pathological findings in jaws with giant cells, and normaly they should be diagnosed very easy. But very often we as surgeons and pathologists have problems in that field. The basic problem is how to differentiate them, because there is a difference in their behavior and also we are treating them in different ways. The presence of multinucleated giant cellsin fibro-osseous lesions of the jaws have led to considerable confusion and the giant cells themselves are of little diagnostic importance. This work present a case, a young patient that came in our department for the first time when she was 8 years old (2003) with cysts in frontal region of maxilla. HP finding at that time was a giant cellgranuloma. With this kind of diagnosis we have justified the operation in maxilla. Than she came back again after 3years, clinically she had characteristics cherubin face. We were confused with high level of parathormon 77.0 (8-74) and we changed our direction of diagnosis-grey tumor and in the same time alkaline phosphat was 694,5 (100-700). After detailed analyses the function of paratiroid glad was normal and with dynamic scintigrafy we concluded no changes in other bones of the body. In close disscusion with the pathologist the case was deeply analised and the final diagnose of HP was Cherubism

Intra-Alveolar Application of Clindamycin- Impact in reducing the incidence of Complications following Surgical Removal of Mandibular Third Molar

The most commonly performed surgical procedures in oral surgery are extractions of third mandibular teeth. Complications following the extraction of third mandibular teeth which may occur are pain, alveolar osteitis, and edema. The purpose of this study was to determinate if the effectiveness of intra-alveolar application of Clindamycin could reduce the incidence of pain, alveolar osteitis and edema after the extraction of third mandibular tooth in nonsmoker patients. Patients who qualified for the prospective, randomized, placebo-controlled trial were nonsmokers. In a group of 30 patients, mandibular third molars in both sides were extracted on the same day. In total 60 third mandibular molars were extracted. The left side was a study group in which we applied the Clindamycin intra alveolary, and the right side was a control group. Tooth extraction was performed under local anesthesia. At 1, 2, and 5 days after surgery, postextraction evaluation was recorded by the same examiner.The results demonstrate an effectiveness of intra-alveolar application of Clindamycin in reducing the incidence of pain (with Clindamycin M 45.7 vs. without Clindamycin 18.7) but not in reducing alveolar osteitis and edema

The changes in levels of blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction

Abstract Objectives The extraction of a tooth exacerbates the stress in diabetic patients leading to diabetic complications so the aim was to evaluate the changes in blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction to pay special attention during a routine surgical procedure. Materials and Methods The research included 40 patients with type 2 diabetes with indications of tooth extraction. They were divided into two subgroups by 20 participants and split according to local anesthesia (lidocaine with additional adrenaline or lidocaine only). Cortisol, blood sugar, blood pressure, arterial pulse, and blood oxygen saturation were measured. Patients were also evaluated for their sensitivity to pain through the Visual Analog Scale (VAS). Results Cortisol and glucose levels scientifically increased throughout the procedure. Meanwhile, systolic, and diastolic blood pressure and saturation showed no difference between the measurements during and after tooth extraction (p = .280; p = .090; p = .590, respectively). Most patients (60.0%) felt no pain during/after the procedure. None of the subjects was feeling more pain than 30 points by VAS. The comparison between groups receiving lidocaine showed no statistical differences when adding adrenaline to lidocaine. Evaluation of pain by VAS showed that more patients felt pain when they were receiving lidocaine without adrenaline. Conclusions Diabetic patients require a more cautious approach when undergoing teeth extractions despite it being a routine procedure

Ten golden rules for optimal antibiotic use in hospital settings : the WARNING call to action

Abstract: Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice