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Biomedical subjects

N J Schuman

Publications and source records attributed to N J Schuman.

At least 19 recordsLinked to original sources
PubMed2001

Subcutaneous emphysema after restorative dental treatment.

Subcutaneous emphysema is an uncommon phenomenon in dentistry, usually occurring with the use of air-driven, high-speed handpieces during dental and oral surgery, operative, endodontic, or periodontal treatment. Air is forced into a surgical wound or subepithelial laceration in the oral cavity, dissecting through the different layers of tissue fasciae, and usually creating a unilateral enlargement of the facial and/or submandibular regions. This occurs with or without crepitus, pain, and airway obstruction. Treatment usually consists of antibiotic and mild analgesic therapy, close observation, and reassurance by the attending dentist. Symptoms generally subside in 3 to 10 days; however, consultation with a physician is necessary to rule out further complications.

Administration, Oral↗
PubMed1999

The clinical significance of beta hemolytic streptococci of the milleri group in oral abscesses.

Aspirated exudate from 50 patients with oral abscesses were cultured and bacterial growth was assessed qualitatively and semi-quantitatively. Bacteria were recovered from all specimens. The mean number of species isolated per specimen was 3.6 Both facultative and obligate anaerobes were isolated from 39 (78%) specimens. The most commonly isolated facultative anaerobic species was Streptococcus virdans group, while pigmented gram negative bacilli were the most commonly isolated obligate anaerobes. Beta-hemolytic Streptococci of the "milleri" groups were recovered from 11 (22%) of the abscesses. Eight of those isolates were determined to carry Lancefield group F antigen, 2 group C, and 1 isolate was not groupable for any Lancefield antigen. These abscesses may be sequelae of oral infectious disease or trauma. Patients with oral abscesses infected with beta hemolytic Streptococci are apt to be male, and less than 35 years old. They are also likely to have a more rapid onset of infection and to require hospitalization for intensive treatment of a life threatening condition.

Adolescent↗
PubMed1999

A clinical approach to dental nutrition among the elderly: a description and discussion of geriatric dental nutrition.

This paper describes the role of nutrition in dentistry, especially as it relates to elderly patients. The nutritional aspects are well understood, but seldom considered in treatment plan formulation and execution, even in an academic health setting. When dental school programs are shown to have clinical relevance to a target population and are faculty supported, they are most successful. This is the case at the University of Tennessee College of Dentistry in Memphis. The role of the Nutritionist focuses on the periodontal and dental aspects of geriatric patient exposure to disease causing agents in the diet. Nutritionist, dentist, student and patient all participate in a team effort to lower patient exposures and the development of a healthful diet. In this clinical approach to geriatric patient dental nutrition, all parties contribute to the success of the whole.

Aged↗
PubMed1998

Estimated skin exposure as an indicator for comparing radiovisiography (RVG) versus conventional Ektaspeed Plus dental radiography.

An Everest 3000 Radiovisiography (RVG) Video system (Trophy USA Inc., Fredericksburg, VA 22402) was compared with conventional radiography using Ektaspeed Plus film (Eastman Kodak Co., Rochester, NY 14650). Previous studies of the RVG system with a special computer controlled x-ray timer (Trophy USA, Inc.) claimed a significant reduction in radiation. Trophy has also claimed that the RVG system can provide diagnostic quality images utilizing existing conventional x-ray generators. This study used a conventional timer and generator. Since it would be logical to assume that many practitioners would use the equipment "in place" rather than invest in new, unfamiliar equipment. Estimated Skin Exposure (air) was used as the primary criteria for comparative purposes. Exposure has been defined as "a measure of radiation quantity, the capacity of ionize air. The roentgen (R), is the traditional unit of radiation exposure measured in air"; The results indicate that the RVG system when combined with a standard conventional timer actually generated greater radiation exposure than does standard, routine radiography.

Evaluation Studies as Topic↗
PubMed1998

Biomechanical criteria for evaluating prefabricated post-and-core systems: a guide for the restorative dentist.

Selecting the optimum prefabricated post-and-core system can be a complex and imprecise exercise for the restorative dentist. First, no single prefabricated post-and-core system fits all situations. Second, the vast number of post-and-core components currently on the market complicates the selection process. Finally, useful biomechanical criteria for evaluating prefabricated post-and-core components are difficult to quantify. The prefabricated post-and-core system consists of three components: the post, a core material, and a luting cement. Each combination of component types is a potential system alternative. This article presents useful biomechanical criteria, based on current restorative guidelines, for evaluating the basic components of any prefabricated post-and-core system.

Biomechanical Phenomena↗
PubMed1997

Cranial polyneuropathy--Ramsay Hunt's syndrome: case report and discussion.

Ramsay Hunt's syndrome is an infectious cranial polyneuropathy caused by varicella zoster, the herpetic virus that also causes chickenpox and shingles. Its symptoms include facial paralysis, ear pain, and an auricular rash. Oral lesions are also present in most cases. This syndrome can affect any cranial nerve and usually affects multiple nerves, causing central, cervical, and peripheral effects. This article reports the case of a 35-year-old white female who was treated by the oral surgery service of a large urban hospital, after first reporting to the emergency clinic. Her reported symptoms of unilateral left-side facial paralysis, auricular pain, and trigeminal hyperesthesia were confirmed by clinical examination. An initial short low-dose steroid regimen was unsuccessful. A second daily dosage of 50 mg of prednisone was successful in 21 days. No permanent sequelae were evident or reported after treatment.

Adult↗
PubMed1997

Dental transplants: discussion and case report.

A 21-year-old Chinese male patient presented to an urban dental clinic with a transplanted molar, which had been removed from a human cadaver. The tooth was in occlusal function for three years, stable, and without mobility. Radiographs of the tooth showed root resorption and apparent ankylosis. Individual transplantation of human teeth has been considered surgical dental treatment of an empirical nature for centuries. Two types of human tooth transplantation are usually considered in the dental literature. An allotransplantation or allograft is a transplantation of tissue (tooth) between different individuals of identical species. An autotransplantation or autograft is a transplantation of tissue within the same individual (obviously within the same species). Replacement of an avulsed tooth, while technically an autograft is considered a replantation, rather than a transplant. Tooth transplantations in the late 20th century are usually performed in developing third world countries, where patient dental education is minimal, and the cost of more technology based forms of tooth replacement (prosthodontics, synthetic implants) are economically prohibitive. Transplantation of permanent teeth is rarely seen in the United States in the 1990's due to the use of titanium implants, although pediatric, adolescent, and disabled patients, especially those with limited incomes, could benefit from the re-introduction of dental transplants.

Adult↗
PubMed1997

Ethical decisions in dental treatment planning using the Ozar model: a descriptive study of fifty-two consecutive patients.

Chairside dental ethics necessitates special consideration by the faculty member-dentist, the dental student, and the patient. The patient must always be aware of treatment options, in addition to learning the health status of the oral hard and soft tissues, costs, and time to be involved to accomplish proposed treatment. What may seem like a burden to an individual practitioner is actually only the necessities incurred by any self governing profession. Fifty-two consecutive dental patients had their cases reviewed for the ethical behavior of the dentist-practitioner, student, and patient. Categories reviewed were informed consent (100%), agreement, compromise, economic issues, conflict, and institutional issues. The results were: 1. Agreement: 17 cases, 2. Compromise: 21 cases, 3. Economic Issues: 4 cases, 4. Conflict: 6 cases, and 5. Institutional Issues: 4 cases. Fourteen percent of all patients were minors. Ninety percent of the patients were treated. Of those 10% not treated, five percent were for medical reasons, and five percent of the patients refused treatment. These results were placed in the Ozar Model 9 and were categorized as follows: 1. Appropriate pain free oral function: 22 cases, 2. Patient Autonomy: 14 cases, 3. Life and health: 9 cases, 4. Preferred practice values: 6 cases, and 5. Other external considerations: 1 case. This template demonstrated appropriate ethical behavior on the part of dentists, students, and patients, especially with a 90% treatment group, and only 5% refusing treatment. The 52 consecutive patients were characteristic of the University of Tennessee's overall patient pool. No identifiable differences were found between patients regardless of gender, age, or race.

Adolescent↗
PubMed1997

Dental odontomas: a retrospective study of 104 cases.

An odontoma refers to any tumor of odontogenic origin. Three distinct types of odontomas have been distinguished in the dental literature: complex, compound, and ameloblastic fibro-odontoma. Odontomas are usually associated with overly retained primary and unerupted permanent teeth. The exact etiology of odontomas is unknown, but local trauma, infection, inheritance, and genetic mutation have been postulated as possible causes of odontomas. Studies have found that males are more likely than females to have odontomas, with most frequent occurrence in the second decade of life. One hundred four biopsy reports with a diagnosis of odontoma were analyzed for age, race, gender, location, pre-operative diagnosis, and postoperative laboratory findings. Most odontomas occurred in the 11-20 age group, with Caucasians predominating. The majority were located in the maxilla, and 85 percent were correctly diagnosed clinically by the attending dentist prior to confirmation by histologic pathology reports of the biopsy specimens. The vast majority were compound odontomas (64.4%) with complex odontomas comprising 31.0% of the total lesions. No ameloblastic fibro-odontomas were diagnosed.

Adolescent↗
PubMed1997

Perimylolysis of the permanent dentition in an adolescent.

During a routine dental appointment at a dental school clinic, a fifteen-year-old black male patient was diagnosed with severe erosion of the dentition together with several carious lesions and a crowded dentition. During treatment of the carious lesions, severe erosion (perimylolysis) of the maxillary and mandibular teeth were observed, which at first alerted the attending clinician to a preliminary diagnosis of anorexia and/or bulimia. Because of the age, gender and social and medical history of the patient, these preliminary diagnoses were discounted, with a hypothesis of gastrointestinal disorder presented to the patient and his parents after consultation with oral medicine and oral pathology faculty. Saliva pH analysis, along with further research concluded that gastrointestinal reflux disease (GERD), surreptitious rumination, or a combination of both were possible diagnoses. Referral to a gastroenterologist for further examination was recommended, while a night-guard was fabricated for the patient to wear at night with fluoride gel. Root canal therapy together with prosthodontic care are often treatment options for patients suffering from gastrointestinal problems. This paper demonstrates how important routine dental examinations are, especially since dentists can often recognize systemic disorders whose symptoms first appear in the oral cavity.

Adolescent↗
PubMed1997

Compound odontoma associated with an impacted permanent central incisor.

In this case report, an eleven-year-old female presented to a rural dental clinic for routine dental examination. Upon evaluation of the dentition, the attending dentist discovered an over-retained primary tooth. Radiographically, a compound odontoma was present, gingival to an unerupted permanent maxillary left central incisor (number nine) and apical to the erupted primary central incisor (F). The odontoma and its overlying primary tooth were removed by an oral surgeon. The extraction site has healed uneventfully and an Orthodontic treatment plan was formulated. The etiology of odontomas is unknown but thought to be caused by trauma, infection, inheritance and/or genetic mutation. These lesions are usually found in the second decade of life and are more common in male patients. Treatment consists of complete enucleation and curettage of the odontoma site.

Child↗
PubMed1996

Survey of hepatitis B exposure and sharps injuries in dental health-care professionals.

Injuries associated with the category of dental surgical instruments known as "sharps" (i.e., syringe needles, glass, scalpel blades, dental burs, and hand instruments) are a serious concern for dental professionals because of the possible transmission of communicable diseases such as tuberculosis, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV). Hepatitis B virus has been recognized as an occupational hazard for dentists and other health-care professionals for several decades. The transmission of HIV from dentist to patient in the dental office has been known to occur in only one practice, and the vector of transmission remains unknown. No dentist has ever been reported to have contracted HIV from a patient. Adherence to infection-control procedures, especially barrier protection, has been linked closely to keeping the incidence of these infections low. This article discusses the results of an anonymous survey about "sharps" injuries and communicable diseases that was given to dentists/faculty, students, and support staff at an urban dental-school clinic.

Dental Instruments↗
PubMed1995

Compound composite odontoma associated with an impacted cuspid.

This case report involved the removal of a compound composite odontoma from a fourteen year-old male patient at an urban dental school. The pathology report did indeed reveal the tissue mass was that of a compound composite odontoma. These lesions usually occur in the second decade of life, in the anterior maxilla or mandible, with no gender or race predilection. Three types of odontomas are identified, including are: compound composite odontoma, complex composite odontoma, and ameloblastic fibro-odontoma. The etiology of these lesions is unknown, although environmental (trauma, infection) and hereditary influences play a role. Treatment consists of complete enucleation and curettage followed by histological verification by an oral pathologist.

Adolescent↗
PubMed1994

Brain abscess and dentistry: a review of the literature.

Brain abscess is a rare, extremely aggressive, life-threatening infection. A mortality rate of between 36% and 90% has been reported as recently as 1990. It is resistant to antibiotics and is one of the few bacterial infections whose morbidity and mortality statistics remain unaffected by the development of antimicrobial medications. Successful treatment appears to be dependent on early diagnosis, surgical intervention, and direct antibiotic irrigation of the surgical wound site, as well as intravenous administration of high doses of antibiotics throughout the crisis. It has been suggested that there is a relationship between dental infection or treatment and brain abscess. Dental infection and treatment have been found culpable in numerous cases reported in the literature. However, careful review of the articles reveals that dental infection or treatment has often been named as a causative factor (1) solely because an infection or treatment occurred within several months of brain abscess; (2) when nondental bacteria were cultured from the brain abscess; and (3) without culturing both the dental infection and the brain abscess to ascertain flora match.

Brain Abscess↗
PubMed1994

Antibiotics and dentistry: a brief review.

The history of dental disease has involved a variety of treatment modalities. This paper is a historical perspective of the evolution of modern antimicrobial compounds and their applications for dentistry. Many individuals have made tremendous contributions in this field, beginning more than a century ago. The two primary categories of antimicrobial agents are the naturally occurring antibacterial substances (antibiotics) and the compounds of synthetic origin. Agents of fungal origin (penicillins and cephalosporins), bacterial origin, and actinomycetes origin (aminoglycosides) comprise the former group while sulfanilamides, quinolones, and fluoroquinolones are included in the latter. The antibiotic groups of significance for dentistry are the penicillins, cephalosporins, and the aminoglycosides, including erythromycin. Due to its efficacy, low cost, and ease of administration penicillin has been the antibiotic of choice for many, if not most odontogenic infections. The agents of synthetic origin have some therapeutic value for dentistry. They are compromised by high cost, lack of effectiveness, or host toxicity.

Anti-Bacterial Agents↗