Pediatric cervicofacial lymphadenitis caused by Bartonella henselae

Background Chronic cervicofacial lymphadenitis in children is often caused by nontuberculous mycobacterium or Bartonella henselae species (known as cat scratch disease). Methods Bartonella henselae infection was diagnosed in 53 of 427 children with cervicofacial lymphadenopathy by polymerase chain reaction. Results The age of patients ranged from 16 to 148 months (median, 59 months), 28 (53%) were male, and 25 were female (47%). The submandibular lymph nodes were most commonly affected (92%). Patients were not treated with antibiotics. In 11 (21%) patients, aspiration of pus was performed to facilitate drainage, which led to a mean resolution of 5 ± 3.1 months compared with a mean resolution time of 8.2 ± 3.8 months for 40 patients treated with a wait-and-see policy (P = .01). Conclusions Bartonella henselae is a common pathogen in children with chronic cervicofacial lymphadenitis. Treatment usually involves a wait-and-see approach, but in selected cases, aspiration may be needed for symptomatic relief

A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement

Background: Flapless implant surgery is considered to offer advantages over the traditional flap access approach. There may be minimized bleeding, decreased surgical times and minimal patient discomfort. Controlled studies comparing patient outcome variables to support these assumptions, however, are lacking. Aim: The objective of this clinical study was to compare patient outcome variables using flapless and flapped implant surgical techniques. Patients and methods: From January 2008 to October 2008, 16 consecutive patients with edentulous maxillas were included in the study. Patients were randomly allocated to either implant placement with a flapless procedure (eight patients, mean age 54.6±2.9 years) or surgery with a conventional flap procedure (eight patients, mean age 58.7±7.2 years). All implants were placed using a Nobel guide® CT-guided surgical template. Outcome measures were the Dutch version of the Impact of Event Scale-Revised (IES-R), dental anxiety using the s-DAI and oral health-related quality of life (OHIP-14). Results: Ninety-six implants were successfully placed. All implants were placed as two-phase implants and the after-implant placement dentures were adapted. No differences could be shown between conditions on dental anxiety (s-DAI), emotional impact (IES-R), anxiety, procedure duration or technical difficulty, although the flapless group did score consistently higher. The flap procedure group reported less impact on quality of life and included more patients who reported feeling no pain at all during placement. Conclusions: Differences found in the patient outcome variables do suggest that patients in the flapless implant group had to endure more than patients in the flap group

One versus two titanium screw fixation of autologous onlay bone grafts in the anterior maxilla: a randomised histological pilot study

The aim of this study was to compare the histological presentation of local mandibular bone grafts fixed with one screw or two screws in buccal anterior maxillary augmentation procedures. Local buccal defects of the anterior maxilla were reconstructed in 12 patients (mean age 47 ± 17 years, range 18 to 67 years) using autogenous cortical bone grafts from the mandibular retromolar area. Patients were randomised using envelopes containing study identification numbers. After randomisation, two screws were used to fix the bone graft in six patients, and one screw was used in the other six patients. Four months later during implant placement, a bone biopsy was taken with a trephine. The biopsies were processed for light microscope evaluation. The mean total bone volume varied from 35.8% to 72.4% (mean 51.1% ± 13.4%) in the one-screw group and from 28.7% to 56.6% (mean 40.8% ± 11.5%) in the two-screw group. The mean non-vital bone volume ranged from 0% to 2% (mean 0.9% ± 0.9%) in the one-screw group and from 0% to 8.9% (mean 2.2% ± 3.7%) in the two-screw group. The mean osteoid volume ranged from 2.2% to 7.3% (mean 5.4% ± 1.7%) in the one-screw group and from 2.0% to 16.4% (mean 7.3% ± 5%) in the two-screw group. No significant histological differences were found between the use of one or two screws to fix an autologous bone graft in buccal bone grafting procedures prior to implant placemen