Complete impaction of primary teeth is a very rare condition and less seen at the dental office compared with permanent dentition. To report the use of cone-beam computed tomography in the management of a 7-year-old boy with completely impacted maxillary second deciduous molar due to the presence of odontoma and a cystic lesion.

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BACKGROUND: Transient tachypnea of the newborn (TTN) is a self-limited increase in the work of breathing in near-and full-term infants; it is attributed to a delay in the clearance of alveolar fluids. Prophylactic antibiotics are usually administered until blood cultures are reported negative for 48 hours. OBJECTIVES: To prospectively compare outcomes of infants presented with classic TTN who were treated with or denied from intravenous antibiotics. METHODS: A prospective cohort study was conducted on all infants admitted with classic TTN. Pre-set diagnostic criteria for classic TTN were applied in order to exclude other cases presenting with respiratory distress. Infants with classic TTN were stratified into two groups based on whether they received or did not receive antibiotics. The decision to administer antibiotics solely depended upon the style of the covering physician at the time of admission to the NICU. The following investigations were obtained from infants of both groups: blood culture, C-reactive protein, complete blood count, blood gas profile and chest X-ray. RESULTS: A total of 15146 full-term infants were delivered during the study period; of them 923 were admitted to the NICU. Classic TTN was diagnosed in 168 infants; of them 106 (63%) received and 62 (37%) did not receive antibiotics. Two infants in the treated group and an infant in the non-treated group had microbiologically confirmed bacteremia. Infants in the treatment group stayed longer in the hospital (72 ± 6 vs. 48 ± 3 hrs). No recorded cases required readmission in either group. CONCLUSIONS: With the application of strict criteria for classic TTN and the close observation in the NICU, the empiric use of antibiotics may be avoidable. Randomized controlled trials are needed to confirm the feasibility and safety of such approach.

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Midface injuries are normally the result of high forces impacted on the face, that can bypass the power of the connection buttresses, which are thick and strong, base of skull is also a rigid and tough structure which requires significant forces to break. In our case, multiple midface and cranial base fractures are presented, which reflect injury caused by high forces and normally, these result in instability in the facial skeleton, or cause CSF rhinorrhea, or sharp spicules to endanger the orbit or the anterior cranial fossa, or the presence of any other indication of surgery. It is unusual to find such an extent of facial trauma and such a multiplication of fractures on the midface and cranial base levels, yet they were stable enough and without a real indication to require surgical interference.