• The non-healing extraction socket: a diagnostic dilemma – case report and discussion

      Henry, Cian (Irish Dental Assocation (IDA), 2016-08)
      Although the healing of extraction sockets is generally a rapid and uncomplicated process, delayed healing, overt infection, or failure of recent exodontia sites to heal can occur. Delayed healing is reported to occur in less than 11% of all extractions.1 A variety of factors may be implicated and the dental clinician must be aware pre-operatively of both local and systemic influences. The vast majority of cases are the result of innocuous, local factors such as dry socket or infection.1 However, the potentially life-threatening, malignant lesions complicating this phenomenon can be underestimated.2-8 Therefore, it is incumbent on dental professionals to familiarise themselves with the normal inflammatory and reparative processes involved in the restitution of mucosal continuity which follow extraction, and the potential pathological lesions that interfere with healing. Failure of an extraction socket to exhibit satisfactory signs of healing in a timely manner (within three to four weeks) warrants urgent referral to an oral and maxillofacial surgeon for investigation.
    • Obturation of the root canal system

      Duncan, HF; Kanagasingam, S (Oxford, Wiley-Blackwell, 2011)
    • Obturation of the root canal system.

      Duncan, H.F; Kanagasingam, S.; Dublin Dental University Hospital (Wiley-Blackwell, 2011-07)
    • Occupation and risk of upper aerodigestive tract cancer: the ARCAGE study.

      Richiardi, Lorenzo; Corbin, Marine; Marron, Manuela; Ahrens, Wolfgang; Pohlabeln, Hermann; Lagiou, Pagona; Minaki, Ploumitsa; Agudo, Antonio; Castellsague, Xavier; Slamova, Alena; et al. (2012-05-15)
      We investigated the association between occupational history and upper aerodigestive tract (UADT) cancer risk in the ARCAGE European case-control study. The study included 1,851 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1,949 controls. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ever employment in 283 occupations and 172 industries, adjusting for smoking and alcohol. Men (1,457 cases) and women (394 cases) were analyzed separately and we incorporated a semi-Bayes adjustment approach for multiple comparisons. Among men, we found increased risks for occupational categories previously reported to be associated with at least one type of UADT cancer, including painters (OR = 1.74, 95% CI: 1.01-3.00), bricklayers (1.58, 1.05-2.37), workers employed in the erection of roofs and frames (2.62, 1.08-6.36), reinforced concreters (3.46, 1.11-10.8), dockers (2.91, 1.05-8.05) and workers employed in the construction of roads (3.03, 1.23-7.46), general construction of buildings (1.44, 1.12-1.85) and cargo handling (2.60, 1.17-5.75). With the exception of the first three categories, risks both increased when restricting to long duration of employment and remained elevated after semi-Bayes adjustment. Increased risks were also found for loggers (3.56, 1.20-10.5) and cattle and dairy farming (3.60, 1.15-11.2). Among women, there was no clear evidence of increased risks of UADT cancer in association with occupations or industrial activities. This study provides evidence of an association between some occupational categories and UADT cancer risk among men. The most consistent findings, also supported by previous studies, were obtained for specific workers employed in the construction industry.
    • The occurrence of paraesthesia of the maxillary division of the trigeminal nerve after dental local anaesthetic use: a case report

      Moorthy, Advan; Stassen, Leo FA (Journal of the Irish Dental Association, 2015-02)
      Local anaesthetics are usually safe, effective and indispensable drugs used routinely in dentistry. Local anaesthetics allow dentistry to be practised in a painfree environment. However, their use may involve complications. Paraesthesia can be defined as persistent anaesthesia (anaesthesia well beyond the expected duration) or as an altered sensation (tingling or itching).1-3 It is the result of damage to a nerve and the occurrence of paraesthesia following the use of local anaesthesia in dentistry represents a rare but important side effect, which is often under-reported4-8 and is important in medico-legal practice. To date, there have been very few recorded incidences or published cases of maxillary nerve paraesthesia following the use of dental local anaesthetic for a routine extraction
    • Oral and neck examination for early detection of oral cancer a practical guide

      MacCarthy, Dr Denise (Irish Dental Association, 2011-08)
    • Oral and neck examination for early detection of oral cancer--a practical guide.

      MacCarthy, Denise; Flint, Stephen R; Healy, Claire; Stassen, Leo F A; Dublin Dental University Hospital, Trinity College Dublin. dmaccarthy@dental.tcd.ie (2011-08)
      Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of 'field cancerisation'/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.
    • Oral and neck examination for early detection of oral cancer--a practical guide.

      MacCarthy, Denise; Flint, Stephen R; Healy, Claire; Stassen, Leo F A; Dublin Dental University Hospital, Trinity College Dublin. dmaccarthy@dental.tcd.ie (2011-08)
      Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of 'field cancerisation'/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.
    • Oral features and dental health in Hurler Syndrome following hematopoietic stem cell transplantation.

      McGovern, Eleanor; Owens, Laura; Nunn, June; Bolas, Andrew; Meara, Anne O'; Fleming, Padraig; Dental Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. eleanor.mcgovern@olchc.ie (2010-09-01)
      Hurler Syndrome is associated with a deficiency of a specific lysosomal enzyme involved in the degradation of glycosaminoglycans. Hematopoietic stem cell transplantation (HSCT) in early infancy is undertaken to help prevent the accumulation of glycosaminoglycans and improve organ function.
    • Oral Hairy Leukoplakia in Healthy, Immunocompetent Individuals

      Galvin, S; Healy, CM (Irish Medical Journal, 2014-06)
      OHL, first described in 1981 and caused by the Epstein Barr Virus (EBV), presents as white, shaggy, non-removable plaques, typically on the lateral borders of the tongue 5 . It was initially considered pathognomic of HIV infection and latterly of immunosuppression. However more recently it is increasingly being reported as a complication of localised immunosuppression with topical or inhaled steroids 7-9 . Rare cases have also been documented in HIV negative individuals with no underlying history of topical or systemic immunosuppression 3,4,8,9 . It has been postulated that age may be a factor in some of these cases and chronic reactivation of EBV has been found to be related to aging 10 .
    • Oral health at risk from cutbacks

      Stassen, LF (Journal of the Irish Dental Association, 2009-08)
    • Oral health of children born small for gestational age.

      O'Connell, A C; O'Connell, S M; O'Mullane, E; Hoey, H M C V; Division of Public and Child Dental Health, Dental School, and Department of Paediatrics Trinity College, Dublin 2. anne.oconnell@dental.tcd.ie (2010-10)
      We sought to evaluate the oral health status of children born small for gestational age (SGA). Children now aged 4-8 years who were born SGA (birth weight < -2 SDS) were examined using standardised criteria. The parents completed a structured oral health questionnaire. Twenty females and 25 males, mean age 72.1 months, and mean birth weight 2.1 kg, participated in the study. Poor appetite was a concern; 32 (71%) children snacked between meals and 14 (30%) used carbonated beverages more than 3 times daily. Erosion was present in 9 (20%) children. Dental decay occurred in 22 (47%) children with 92% being untreated. Eight children had more than 5 decayed teeth. It is essential that clinicians working with children born SGA include oral health within the general health surveillance and refer these children for a dental assessment within the first 2 years to support parents in establishing safe feeding patterns for their children.
    • Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers.

      Naidu, Rahul; Nunn, June; Forde, Maarit; Community Dentistry, Faculty of Medical Sciences, The University of the West Indies, Port of Spain, Trinidad and Tobago. rsnaidu937@gmail.com (2012)
      Little is known about oral health in early childhood in the West Indies or the views and experiences of caregivers about preventive oral care and dental attendance The aims of this study were to explore and understand parents and caregivers' experience of oral healthcare for their preschool aged children and how, within their own social context, this may have shaped their oral health attitudes and behaviours. These data can be used to inform oral health promotion strategies for this age group.
    • Orthodontic extrusion in the transitional dentition: a simple technique.

      Darby, Laura J; Garvey, Therese M; O'Connell, Anne C; School of Dental Science, Trinity College, University of Dublin, Dublin, Ireland. (2009-11)
      Extrusion of teeth may be necessary in cases of delayed eruption, primary retention, traumatically intruded teeth, or subgingivally fractured teeth. Removable appliances are advantageous, as anchorage is not as tooth-dependant as in the case of fixed appliances. They are cost-effective, operator friendly, and a valuable treatment option to consider in cases where extrusion of anterior teeth in the transitional dentition is necessary. The purpose of this paper was to describe a simple, cost-effective technique using a removable appliance for extrusion of incisors in the transitional dentition.
    • Osteogenic potential of bone marrow stromal cells on smooth, roughened, and tricalcium phosphate-modified titanium alloy surfaces.

      Colombo, John S; Carley, Albert; Fleming, Garry J P; Crean, St John; Sloan, Alastair J; Waddington, Rachel J; Mineralised Tissue Group, Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, Heath Park, Cardiff, United Kingdom. (The International journal of oral & maxillofacial implants, 2012-09)
      This study investigated the influence of smooth, roughened, and tricalcium phosphate (TCP)-coated roughened titanium-aluminum-vanadium (Ti-6Al-4V) surfaces on the osteogenic potential of rat bone marrow stromal cells (BMSCs).
    • Osteonecrosis of the jaw: a rare and devastating side effect of bisphosphonates.

      Ryan, P; Saleh, I; Stassen, L F A; Oral & Maxillofacial Surgery Department, St James's Hospital, Dublin 8, Ireland. ryan.patrick.1@gmail.com (2009-12)
      Evidence has emerged that bisphosphonate use in cancer patients is associated with osteonecrosis of the jaw. This form of osteonecrosis has been termed bisphosphonate induced osteonecrosis of the jaw (BIONJ). BIONJ is commonly precipitated by a tooth extraction in patients treated with long term, potent, high dose intravenous bisphosphonates for the management of myeloma, breast or prostate cancer. The overall prevalence of BIONJ is about 5% in patients with these malignancies. Current evidence shows that the risk of BIONJ in non-cancerous patients, such as those with osteoporosis, is very low and appears to be comparable with that of the general population. Prescribing physicians need to encourage cancer patients to see their dentists before the initiation of bisphosphonate treatment, and regularly thereafter.
    • Our role is education

      Stassen, JF (Journal of the Irish Dental Association, 2009-06)