Yitzhak Marmary

Juvenile recurrent parotitis: clinicoradiologic follow-up study and the beneficial effect of sialography.

In twenty-two children juvenile recurrent parotitis (JRP) was diagnosed on the basis of age at onset, duration of parotid swelling episodes, frequency of attacks, lack of pus formation, and typical sialograms. Age at onset and severity of the disease varied widely. There was a high incidence of upper respiratory tract infection, and in some cases a familial history of JRP was noted. The sialograms revealed acinar and ductal atrophy and severe sialectasis. A dominant feature was impaired glandular function. The follow-up period was notable for a striking decrease in the number of incidents of glandular swelling regardless of the patients age at the time of his or her first visit to our clinic. Since drug treatment was administered prior to our first examination and no medicaments were prescribed by us, the improvement in the clinical status of the patients is attributed to the sialographic procedures.

Scleroderma: Oral manifestations

An oral clinical and radiologic study of twenty-one patients suffering from scleroderma revealed that in one half of the patients the blood sedimentation rate and the antinuclear factor were elevated. When both these laboratory findings were present at the same time, they proved to be well correlated. The majority of the patients had limited mouth opening. Gross jawbone changes affecting the mandibular condyle, coronoid process, and posterior part of the ascending ramus occurred in four patients. There was no correlation in these four patients with regard to the bone changes and clinical and laboratory findings or to age and duration of illness. Widening of the periodontal ligament space, as measured in a meticulous manner, was a feature in all twenty-one patients and in all teeth.

Does an impacted tooth cause root resorption of the adjacent one

External root resorption caused by an adjacent impacted tooth was studied radiographically in 199 cases. Resorption of the root had occurred in fifteen instances (7.5 per cent), the cervical region being least affected. The incidence was highest in the 21 to 30-year-old group and mainly involved male patients. Resorption of the periodontium alone was found in sixteen additional patients; of these, five were followed for 1 year after extraction of the impacted tooth. During this period, the damaged periodontium was completely re-established.

The “anchored disc phenomenon”: A proposed etiology for sudden-onset, severe, and persistent closed lock of the temporomandibular joint

This article establishes a rationale for a particular type of sudden and severely restricted mouth opening caused by anchoring of the disc to the fossa termed anchored disc phenomenon, describes the possible pathogenesis of this disorder, and recommends appropriate treatment. The clinical characteristics supporting the proposed pathogenesis, and treatment of the disorder are based on data published in the literature and clinical experience with the diagnosis and treatment of this disorder.

Alveolar bone repair following extraction of impacted mandibular third molars

Bone regeneration following extraction of impacted mandibular third molars was measured on 83 preoperative and postoperative radiographs. The patient sample was divided into two age groups, 20 to 29 years and 30 to 50 years. Postoperatively, there was an average net gain of 2.15 mm in bone level. The degree of bone healing is affected primarily by age and, to a lesser extent, by the presence of generalized inflammation (periodontitis).

A radiographic survey of periapical jawbone lesions.

A radiographic survey of the jawbone adjacent to the teeth revealed a high incidence of bone pathosis in 889 randomly chosen patients. Jaw lesions, nearly all inflammatory, were present in every second person. Bone-destructive inflammatory processes (rarefying osteitis) were the most frequently encountered lesions, occurring in both the maxilla and the mandible. Bone-appositioning inflammatory processes (condensing osteitis), on the other hand, appeared mostly in the mandible, very often involving the first molar, thus indicating the differing biologic behavior of the two jawbones. Other bony manifestations in the mandible, such as enostosis and periapical cemental dysplasia, although relatively rare, also formed part of the picture. In light of the absence of related symptoms, the clinical significance of these widely prevalent periapical lesions has to be reconsidered.

A novel and non-invasive method for the removal of salivary gland stones

A non-invasive method for salivary gland stone disintegration by shock waves is proposed. An in vitro experiment, in which a large sialolith was subjected to shock waves produced by a Dornier lithotriptor, demonstrated the complete destruction of the stone. The advantages of the method and the need for modification of the existing equipment is discussed.

Spontaneous regeneration of the parotid salivary gland following juvenile recurrent parotitis

Sialograms of an 18-year-old female patient known to suffer from juvenile recurrent parotitis (JRP) disclosed the destructive glandular changes typical of the disease. During the 10 years subsequent to the sialographic examination, the patient did not experience any further attacks of JRP. Sialograms carried out when the patient was 28 years of age demonstrated a normal gland. This case illustrates that a damaged parotid gland is capable of regeneration following JRP.

Thyroid papillary carcinoma presenting as jaw and parotid gland metastases

A slowly progressing colloidal goiter of 20 years standing was excised in a 67-year old woman. Two years later, a metastatic tumor inducing facial swelling was diagnosed radiologically in the left parotid gland and left ascending mandibular ramus. The incisional biopsy confirmed papillary carcinoma of thyroid origin. The patient refused treatment. Six months later, she returned to the clinic and presented with advanced destructive changes of the involved structures. This rare case of unrestricted malignant growth may shed light upon the sequence and mode of metastatic invasion.

Osteomyelitis of the mandible in a patient with osteopetrosis

Abstract A 14-year-old boy had had recurrent abscesses and fistulae in the mandible for four years. Tooth extractions, performed by the local dentist, failed to improve his condition. The radiographs taken upon admission to hospital showed dense jaw bone. A subsequent skeletal survey revealed hypermineralized bones, and skeletal scintography demonstrated infected foci in the tibia and femur in addition to those in the mandible. Blood tests proved severe anemia. The diagnosis of osteomyelitis superimposed on osteopetrosis was established. Treatment consisted of blood transfusions and local and systemic antibiotics. Removal of the sequestra and implantation of tubes for local jaw irrigation were surgically performed.