Part I. Hospital dental services in Colorado.
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Biomedical subjects
Publications and source records attributed to R G Sanger.
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Sickle-cell disease is characterized by chronic hemolytic anemia, rapid destruction of defective erythrocytes, with consequent circulatory disturbances. Thromboses and infarctions with resultant osseous manifestations tend to be localized in the ends of the long bones or in the medullary area, the latter often becoming apparent in the jaws. Three case reports are presented to illustrate osseous changes observed in the jaws of these sickle-cell patients. The radiographic findings demonstrate the adaptive mechanisms of bone metabolism in response to vascular infarction, infection, or both in some sickle-cell anemia patients. A differential diagnosis is suggested for osseous lesions observed in the jaws of these patients.
A case of sarcoidosis manifesting primarily in the oral cavity has been documented and clinicopathological findings are discussed. The diagnosis of sarcoidosis can nearly always be established by an assessment of the clinical picture in combination with the histologic features of an adequate biopsy specimen. The Kveim test is a useful tool in clinical diagnosis, but is not always positive in patients with sarcoidosis. The clinician should also be aware that false positives can occur. Scalene node biopsy can also be a useful diagnostic adjunct. The current case emphasizes that biopsy of an intraoral lesion, scalene node biopsy, and Kveim testing are useful in establishing a diagnosis of sarcoidosis.
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A survey of American dental schools was conducted to determine the extent to which genetics is currently taught. Results indicate that there is a stronger emphasis at the postdoctoral level than at the predoctoral level and that the approach to teaching genetics tends to multidisciplinary. Some dental schools have already given organizational status to genetics and have instituted clinical activities in orofacial or craniofacial genetics. Considerable interest was shown in audiovisual materials and autotutorial programs in genetics. A greater emphasis on the teaching of genetics at the predoctoral, postdoctoral, and continuing education level is recommended. More trained orofacial geneticists are needed to support didactic and clinical activities within the dental schools.
Over the past decade, genetics has played an increasingly important role in both predoctoral and postdoctoral dental programs. In an effort to define the scope of genetics education at the postdoctoral level, this paper outlines desired learning objectives and presents a curriculum model which has proven effective in meeting these objectives.
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The first case in the dental literature of congenital contractural arachnodactyly (C.C.A. syndrome) is presented. This newly delineated syndrome is an autosomal dominant heritable disorder of connective tissue. Its similarities to Marfan's syndrome and homocystinuria, as well as other syndromes, are discussed. The lack of cardiovascular disease, specific ocular anomalies, and mental retardation are presented in the differential diagnosis of the C.C.A syndrome with Marfan's syndrome and homocystinuria.
Early recognition of ectrodactyly, ectodermal dysplasia, and clefting of the lip and palate as a syndrome could result in more beneficial treatment for the patient. Patients with the EEC syndrome often have ocular and auricular deficiencies that progressively become more severe. These patients are often seen first by cleft palate teams who make the diagnosis. The patient's dental status requires frequent evaluation after corrective procedures for cleft lip and cleft palate.
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