Eliyahu Mass

Focal epithelial hyperplasia in an Israeli family

Abstract The occurrence of focal epithelial hyperplasia in an Israeli family is reported. Four of the eleven children of the family were affected by the condition. The familial occurrence, the clinical behavior, and the possible etiologic factors are discussed.

Craniofacial Morphology of Children with Williams Syndrome

Facial dysmorphology is considered to be a major diagnostic feature in patients with Williams syndrome (WS). The dysmorphology is composed of soft tissue and skeletal components. In this study the skeletal component of the facial dysmorphology was examined by analyzing the lateral cephalometric radiographs of 8 children with WS. Seven anatomic areas were judged by means of the analysis of 48 cephalometric variables. Four skeletal features contributed to the facial appearance of children with WS: (1) the anterior cranial base was short, although the cranial base angle (N-S-Ba) was normal; (2) the angle of the mandibular plane was steep, although total facial height was normal; (3) despite the normal facial height, there was an unusual proportion of upper to lower anterior facial height and posterior to anterior facial height; and (4) the chin button (pogonion to N-B line) was deficient, although the mandible could not be classified as retrognathic. The common skeletal components were not dominant enough to characterize the facial dysmorphology completely.

A cephalometric evaluation of craniofacial morphology in familial dysautonomia.

OBJECTIVE The purpose of this study was to delineate the craniofacial and dentoalveolar morphology of patients with familial dysautonomia (FD) in order to contribute to the understanding of the association between progressive sensory and autonomic neuropathy and the characteristic appearance of the dysautonomic face. PATIENTS The study group comprised 32 patients with FD (15 females and 17 males; mean age 10.8 years, SD 3.5 years, range 5.8-19.8 years). DESIGN Lateral cephalograms from each patient were traced twice. The means of the two measurements were compared with homologous cephalometric normal values of ethnic-specific and classical norms from the literature. RESULTS In some parameters, the craniofacial morphology of the FD group was significantly different from the classical norms. There was a pronounced retrognathism in the mandible and a steep mandibular plane angle. The skeletal features of FD patients more closely resembled those of their ethnic group, although they were more retrognathic, and the mandibular growth axis was more horizontal. The incisors of these patients were more retropositioned and retroclined than were those of their healthy counterparts. CONCLUSIONS The results suggest an insufficiency of the expected dentoalveolar compensatory mechanism that usually helps to bridge skeletal discrepancies. It is postulated that the neuropathy is probably the important factor in the lack of this compensatory mechanism.

Abnormal Enamel and Pulp Dimensions in Familial Dysautonomia

In familial dysautonomia (FD), a hereditary autonomic and sensory neuropathy, somatic growth is impaired. This study was conducted to explore the possibility that tooth dimensions are altered as a consequence of neural crest dysfunction known to be present in FD. Enamel, dentin, pulp, and tooth size measurements of mandibular primary and permanent molars from FD patients were compared with those of healthy controls. It was found that although tooth size in the FD patients was smaller than normal, the enamel was thicker on the occlusal table, while the pulp chamber was smaller and disproportional to tooth size. Our results suggest distorted tooth dimensions rather than a generalized growth arrest as observed in other hereditary syndromes, such as Downs or Crouzon.

Absorption of Nickel, Chromium, and Iron by the Root Surface of Primary Molars Covered with Stainless Steel Crowns

Objective. The purpose of this study was to analyze the absorption of metal ions released from stainless steel crowns by root surface of primary molars. Study Design. Laboratory research: The study included 34 primary molars, exfoliated or extracted during routine dental treatment. 17 molars were covered with stainless-steel crowns for more than two years and compared to 17 intact primary molars. Chemical content of the mesial or distal root surface, 1 mm apically to the crown or the cemento-enamel junction (CEJ), was analyzed. An energy dispersive X-ray spectrometer (EDS) was used for chemical analysis. Results. Higher amounts of nickel, chromium, and iron (5-6 times) were found in the cementum of molars covered with stainless-steel crowns compared to intact molars. The differences between groups were highly significant (P < .001). Significance. Stainless-steel crowns release nickel, chromium, and iron in oral environment, and the ions are absorbed by the primary molars roots. The additional burden of allergenic metals should be reduced if possible.

Enamel, dentine and pulp in talon primary maxillary central incisors: a histomorphometric study.

Aim: To examine whether a talon incisor has an abnormal shape due to excess of either dental hard tissues or pulp. Methods: Two bilateral primary maxillary central incisors with talon cusp and a supernumerary mesiodens were removed from a 6-year-old boy. Histologically, 7 undecalci-fied cross sections (70 µm) were harvested from each talon tooth and from two regular primary central incisors of another child. Microradiographs of the sections were prepared and examined for enamel width, dentine width, pulp tissue area, and crown size (mesio-distal, labio-palatal) using Image Analysis. Results: No association to other developmental disorders was observed. The mean width of the enamel and dentine was similar in the talon and the regular incisors (difference 7.5% and 2.4%, respectively). The pulp area was greater in the talon teeth (37.4%). The latter had an effect on the increase in the mesio-distal and labio-palatal dimensions of the talon teeth (17.6% and 23.9%, respectively). Conclusions: The fact that the talon cusp has normal enamel and dentine layers with a substantial enlarged pulp tissue suggests that talon tooth may be a developmental anomaly originating in the stage of morphodifferentiation.

Local Anesthesia in Pediatric Dentistry-How Much is Enough?

Aim: To evaluate the doses of local anesthesia (LA) during routine dental treatment of children, used by specialists in pediatric dentistry (SPDs), residents in pediatric dentistry (RPDs) and general practitioners (GPs) and suggest recommendations for using minimal doses. Study design: A prospective research. 120 LA cartridges were collected after provided dental treatment of children by 4 specialists (SPD-55 cartridges), 5 residents in pediatric dentistry (RPD-43 cartridges) and 3 general practitioners (GPs-22 cartridges).The doses of the used solution were measured by deducting the remains in the cartridge from the original 1.8ml. Results: A significantly lower dose of LA solution was used by specialists and residents compared to GPs, (0.786/0.746 ml ± 0.4 Vs.1.65 ml ± 0.3, P<0.001). Discussion: LA guidelines intend to achieve optimal effect, increase safety and reduce side effects. Various dentists have different training and experience, as well as personality and habits, which may affect their use of LA. This prospective study evaluated these factors. Conclusions: The dentist training is a valuable predictor for the LA dose being injected to a child during dental treatment. The mean dose used in the study by specialists and residents was less than half compared to GPs, but effective enough for successful dental treatment, regardless of the number of treated teeth, the site, the type of the treatment and the patients age. We suggest increasing the awareness of using minimal effective dose of LA in pediatric dentistry.

The Lingual Taste Papillae: A Delicate and Complicated Nature’s Design for Taste Modalities Perception

The sense of taste is essential for survival. In animals, the ability to distinguish between nutrient and toxic substances is the fi nal defense mechanism after these materials have been scrutinized by their smell and appearance. In humans, there are additional features of taste, such as hedonism, which gave this sense a leading role in determining our life quality. At present, in the eyes of the western society, famous chefs enjoy a higher social position than the most talented performers, surgeons, scientists, top politicians, and even distinguished writers and poets. In our modern era, getting a seat in a prestigious French restaurant seems to be the ful fi llment of one’s whole life.