The purpose of this study was to evaluate the association between signs of trauma from occlusion, severity of periodontitis and radiographic record of bone support. The maxillary first molars of 300 individuals were independently evaluated by two examiners for signs of trauma from occlusion, pattern or occlusal contacts and severity of periodontitis. Each site was also evaluated radiographically by an independent third examiner. The results indicated that: teeth with either bidigital mobility, functional mobility, a widened periodontal ligament space or the presence of radiographically visible calculus had a deeper probing depth, more loss of clinical attachment and less radiographic osseous support than teeth without these findings, teeth with occlusal contacts in centric relation, working, nonworking or protrusive positions did not exhibit any greater severity of periodontitis than teeth without these contacts, teeth with both functional mobility and radiographically widened periodontal ligament space had deeper probing depth, more clinical attachment loss and less radiographic osseous support than teeth without these findings and given equal clinical attachment levels, teeth with evidence of functional mobility and a widened periodontal ligament space had less radiographic osseous support than teeth without these findings.
Of 19 patients with blunt testicular trauma diagnosed and staged correctly by physical examination and ultrasonography 10 were explored surgically and 9 were managed nonoperatively (treatment was supported by ultrasonography). Fractured testicles occurred in 5 of the 10 explored patients and were repaired surgically, and in 2 of the 9 conservatively managed patients. These 2 patients refused an operation. Ultrasonography can show disruption of the testicle as evidenced by intratesticular lucencies representing hematoma, extruded testicular parenchyma or a fragmented testicle. The tunica albuginea is too thin to be defined consistently and, thus, it could not be used as a parameter for disruption in the 10 patients who were explored surgically. Ultrasonography used in conjunction with a thorough physical examination is highly accurate, readily available, noninvasive and gives minimal discomfort. This modality can be used to follow nonoperative scrotal injury to resolution. With the availability of high resolution real-time ultrasonography more rapid and reliable screening of the scrotum is possible.
We report a rare case of uterus didelphia with left hematocolpos and ipsilateral renal agenesis, associated with contralateral vesicoureteral reflux and chronic atrophic pyelonephritis. In the literature 9 cases of uterus didelphia with left hematocolpos but without concomitant reflux and recurrent bacterial pyelonephritis are reported. The embryogenesis of müllerian duct abnormalities, associated clinical findings, including abdominal tenderness and pelvic mass, diagnostic modalities of cystoscopy, excretory urography, laparoscopy and hysterosalpinography are discussed. Early accurate diagnosis and treatment will decrease morbidity and unnecessary surgical procedures.
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