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Biomedical subjects

Helen Witherow

Publications and source records attributed to Helen Witherow.

5 recordsLinked to original sources

The oral implications of caustic soda ingestion in children.

The morbidity related to caustic soda (sodium hydroxide) ingestion is well described in the literature. The majority of publications have concentrated on the effects to the trachea and gastrointestinal tract, with little reference to the oral and peri-oral areas. Accidental ingestion of sodium hydroxide-containing substances is fortunately rare; however the consequences can be devastating. Three cases of children who drank caustic substances are described. Treatment included fitting splints, injecting steroids, local surgical procedures, and the use of dynamic appliances to maintain mouth opening. Despite these interventions, all patients developed severe scarring, resulting in stenosis of the oral musculature and extra-articular ankylosis. There is perhaps a role for further investigation of early use of antiproliferative agents to prevent scarring, more aggressive surgery, and long-term physiotherapy appliance use. These patients require lifelong follow-up.

Burns, Chemical↗

Transmigration of a maxillary canine. A case report.

In the oral cavity, transmigration is defined as a tooth that crosses the mid-line by more than half its length. Following extensive literature review, it was found that, although well documented with respect to mandibular canines, there were only two publications detailing maxillary cuspid transmigration. This report presents a case of transmigration where the left maxillary canine gradually crossed the mid-line and migrated to the right side in a patient with hemifacial microsomia and cleft palate. The Mupparapu classification of the migratory pattern of the mandibular canines is discussed. Various clinical considerations, as well as guidelines for general practitioners to diagnose and manage such a condition, are also discussed.

Child↗

Oral manifestations of systemic diseases.

In the clinical examination for systemic diseases, inspection of the oral cavity is often overlooked. This area provides a wide array of clinical signs that may help the clinician establish a diagnosis. This article provides a summary of the more common oral manifestations of systemic disease.

Bone Diseases↗

Midline odontogenic infections: a continuing diagnostic problem.

Cutaneous sinus tracts and facial swellings of odontogenic origin have been well documented in the literature. These lesions however continue to be incorrectly diagnosed resulting in inadequate and unnecessary treatment. This paper reports two cases of midline odontogenic infections presenting as skin lesions. Neither patient complained of dental problems, and intraoral examination failed to reveal pathology. Both had been treated over an 18-month period, undergoing multiple surgical procedures before the correct diagnosis was made. Lesions on the face can be the result of occult chronic odontogenic infection. Awareness of a possible dental cause, especially with facial lesions that recur after excision is essential. The use of vitality testing of the teeth and appropriate radiographs ensures the correct diagnosis should not be missed.

Adult↗

Comparative reproducibility of three methods of radiographic assessment of alveolar bone grafting.

The aims of this study were to compare the reproducibility of three radiographic methods of assessing the quality of alveolar bone grafts, namely the Bergland, Kindelan and Chelsea Scales, and evaluate their application in the mixed and permanent dentitions. Additionally the use of occlusal versus periapical radiographs was assessed. Three examiners applied each scale on two occasions to the radiographs of 48 cleft lip and palate patients who had received alveolar bone grafts in 59 sites (11 had bilateral clefts). The agreement between repeated assessments by the same observer at different time points was measured by the kappa statistic, for each of the three assessors and each of the types of radiographic scale in turn. None of the three scales was found to be more reproducible than the others (kappa statistics for intraobserver variation ranged from 0.61 to 0.70). The agreement between observers was also similar across the three radiographic scales (multiple kappa statistics for inter-observer variation ranged from 0.45 to 0.51). Likewise, neither occlusal nor periapical radiographs were found to enable greater reproducibility of assessment. Surprisingly there was a tendency to greater reproducibility in the mixed than in the permanent dentition, which suggests the outcome of alveolar bone grafting may be assessed at an earlier stage than currently adopted. The outcome of alveolar bone grafting in this group of patients was generally successful.

Alveolar Process↗