P Shanmuhasuntharam

Susuks: charm needles in facial soft tissues

Susuks or charm needles are a form of talisman inserted and worn subcutaneously, in the face and other parts of the body, in the belief that they will enhance or preserve the wearers beauty, youth, charisma, strength or health, or bring success in business. This mystic practice is found among some south-east Asian people, especially Malayan and Muslim females. Most susuk wearers are secretive about their hidden talismans, but these gold or silver needles are being discovered with increasing frequency now that radiographs are used more widely. An understanding of this practice and an awareness of its existence is important to avoid misdiagnosis and mismanagement of these patients. The practice of susuk wearing and its relevance to dentistry is discussed. Nine cases of facial susuk wearers are presented and previous reports are reviewed

Susuks (charm needles) in the craniofacial region

ObjectivesWe conducted a study to determine the numbers of susuks (charm needles) and their distribution in the craniofacial region of susuk wearers, and the sex, racial affiliation, and age of the wearers. In addition, we sought to determine whether the presence of susuks posed any potential hazard to patients undergoing magnetic resonance imaging (MRI).MethodsWe studied various radiographs of 33 susuk wearers (age range, 33–69 years) and investigated the most common sites of insertion in the craniofacial region. A susuk was also suspended inside a 1.5-T MRI machine to determined whether it was attracted by the machine’s magnet.ResultsThe largest number of susuks that we observed in the craniofacial region was 39 pins, and susuks were particularly numerous in Malay Muslim women. Other sites with susuks were the maxillofacial region (except the temporomandibular region) and the forehead. The susuks showed no ferromagnetic characteristics.ConclusionsAs susuks are made from gold, they are generally biocompatible with human tissue and do not cause problems to their wearers. Gold and the other minor metal constituents found in susuks have no ferromagnetic characteristics and therefore pose no hazard to patients undergoing MRI.

Extreme distal migration of a maxillary canine.

A case of extreme distal migration of the left maxillary canine is reported. The canine had erupted buccal to the contact area between the left second premolar and first molar. Past reports of similar ectopia are reviewed

A case of dengue‐related osteonecrosis of the maxillary dentoalveolar bone

Dengue is a mosquito transmitted flaviviral infection which can give rise to severe haemorrhage (dengue haemorrhagic fever) and with capillary leakage induces hypovolaemic shock (dengue shock syndrome). Although dengue symptoms and complications have been known for many decades, there has only been one documented case of osteonecrosis of the maxilla which was treated by excision of the necrotic bone. In this case of dengue infection, extensive maxillary osteonecrosis and minimal root resorption appeared to follow factitious injury with a toothpick but resolved with non-surgical management.

A simple method to enable feeding during maxillomandibular fixation of the jaws

The use of maxillomandibular fixation after surgery on the jaw bone invariably affects the dietary intake and the oral hygiene of patients. When the upper and lower jaws are kept in occlusion, the patient has to take bland food that has to sieve through the crevices between teeth to enter the oral cavity. This results in food accumulation around teeth, orthodontic appliances, and surgical wound. Feeding in this manner can also be very trying on some patients. A simple method is devised in which finely minced food can be introduced by a catheter directly into the oral cavity.