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Biomedical subjects

J P R van Merkesteyn

Publications and source records attributed to J P R van Merkesteyn.

3 recordsLinked to original sources

[Burning-mouth syndrome: consideration of maintenance factors].

Burning-mouth syndrome is characterised by a number of complaints of which the burning sensation in the mouth is the most important but cannot be explained by known medical causes. Although psychological factors can predispose for or trigger physical symptoms without a medical explanation, treatment directed at the proposed psychological causes has not proven to be very effective and is not acceptable for most patients. Treatment directed at reducing the consequences of the complaint that could play a role in maintaining the problem is, however, effective and is accepted by almost all patients. Consequences that could maintain the burning-mouth syndrome are anxiety, depression, selective attention, and measures taken to find relief but which can irritate the oral mucosa. The treating physician should inform the patient and help him to change his behaviour. If patients have become depressed or very anxious as a consequence of the complaints they should be referred to a cognitive-behaviour therapist specialised in the treatment of patients with physical symptoms without a medical explanation.

Antidepressive Agents↗

[Using corticosteroids to prevent postoperative oedema].

Corticosteroids are produced in the adrenal gland cortex and are subdivided in mineralocorticosteroids and glucocorticosteroids. Usually, corticosteroids are prescribed as drugs to replace natural corticosteroids in case of insufficient functioning adrenal glands and in numerous diseases because of their anti-inflammatory and immunosuppressive effects. Based on literature data, it was concluded in this article that corticosteroids are never indicated as a preventive measure in regular dentistry and oral and maxillofacial surgery. Only in cases of major elective oral and maxillofacial surgery, prescription of corticosteroids may be considered.

Adrenal Cortex Hormones↗

Value of panoramic radiographs in paediatric pre-bone marrow transplantation oral evaluation.

Panoramic radiographs (orthopantomogram [OPT]) are, beside clinical examination, helpful in detecting possible dental foci of infections before bone marrow transplantation (BMT). The value of an OPT in paediatric BMT-recipients was assessed by the results of dental evaluation, consisting of an OPT and a consultation by an oral surgeon, in 161 children between 1987 and 1999. Eleven out of 161 children had at least one oral focus of infection that required treatment before myeloablative therapy. In seven children the foci were detectable both clinically and radiographically and in two children the foci were visible only clinically. Only two children had a focus that was only detectable by means of radiographs. In both patients it concerned erupting third molars. In conclusion, we recommend an OPT only when the child has clinically obvious abnormalities. In addition, in older children an OPT will be indicated to evaluate the third molars.

Adolescent↗