Case Study of Eruption Cysts

Case Study of Eruption Cysts Eruption cyst not uncommon: A series of three cases Abstract Aim: Presentation of three clinical cases with an eruption cyst Background:  Eruption cysts are rarely seen benign cysts most commonly encountered on the mucosa before the tooth eruption Case description: In two patients, eruption cyst occurred in the maxillary arch and in one patient it foundin the lower arch. The three eruption cysts were found with the permanent teeth. Surgical treatment was done in all three cases and tooth erupted in normal pattern Conclusion: Eruption cyst requires surgical interventionwhen patient experiences any hurt, bleeding or when they get infected and face unesthetic appearance. Surgical excision requires to relive the child from discomfort. Clinical significance: Knowledge about occurrence of eruption cyst, a rare developmental eruption disturbance is very essential to provide the correct diagnosis and treatment Key words: Benign cyst, eruption cyst, surgical excision INTRODUCTION eruption cysts are rarely encountered benign soft tissue lesions seen on the mucosa before the tooth eruption takes place. Some authors belived them as either dentigerous cysts or follicular cysts. However, they are categorized as separate lesions as they seen only in soft tissue. The pathogenesis behind the development of this cyst is not known. One author has found trauma, infection and deficient space for eruption as main etiological factors for their occurrence based on the retrospective study of their 36 cases. It appears to be to arise from the separation of the epithelium ffrom the enamel of the crown of the tooth due to an accumulation of fluid or blood in a dilated follicular space. The exact etiology of occurrence of eruption cyst is not clear. Aguilo et al.3 in their retrospective clinical study of 36 cases, found early trauma, infection and the  deficient space for eruption as possible causative factors. It seems to be toarise from the separation of the epithelium from the enamel of the crown of the tooth due to an accumulation of fluid  or blood in a dilated follicular space literature search shows low prevalence of these cysts. The reason behind low prevalence could be attributed to the fact of being them considered as dentigerous cysts by many investigators  in addition to this only few reports show the definitive diagnosis of these cysts using biopsy since they are benign lesions This may also suggest that either the eruption cyst is an unusual lesion or it is an accepted local disturbance that is associated with the eruption of many teeth. The clinicalsignificanceof low prevalence may also be due to the factthatmost often the dentist sees only symptomatic eruption cysts and the majorityresolves unnoticed CASES DISCRIPTION We hereby report three cases of eruption cyst who reported to the Out Patient Department of  Pedodontics and preventive dentistry, College of Dental sciences, Davangere, India  Case No A12-year-old  male child along with his parents reported with the  chief complaint of bluish black swelling on the gums in the front region of the upper jaw [Figure1a]. History of the case revealed lesion started appearing weeks back as translucent swelling over normal mucosa and it increased to its present size.  The color of the  lesion also slowly changed from its normal red mucosa to the present bluish black colorone week back No fluid  discharge or any other associated symptoms were associated. The general physical examination of the child showed no abnormalitiesExamination of the oral cavity revealed that the child was in the mixed dentition stage.  Soft tissue examination did not show any abnormalities except, the presence ofswelling on the buccal gingiva with respect to unerupte d 11, not extending to palatal surface. Clinically the lesion as bluish-black, circumscribed, fluctuant swelling that measured approximately 1 x 1.5 cm in diameter and was very soft inconsistency. The mucosa was smooth and no ulcerationor bleeding was present Case No An 8-year-old female patient reported with the chief complaint of non erupting upper front tooth along  with a swelling in upper anterior region Figure  1b]. Lesion started appearing 6weeks back as translucent swelling over normal mucosa and it slowly increased to  reach present size. It associated with dull aching pain on mastication.  The general physical examination of the child showed no abnormalities.  Examination of the oral cavity  showedthat the child was in the mixed dentition stage. All the permanent 1st molars had completely erupted and allcentral incisors except were erupted. Swelling measured approximately 1x 1 cm in diameter and was very soft and fluctuant and slightly bluish in color. The was smooth with no ulceration or bleeding Case No A 7- year-old boy reported with the chief complaint of swelling inlower left back tooth region [Figure 2a]. Lesion started appearing 3 weeks back translucent swelling in the region of unerupted left permanent first molarand it slowly increased to its present size.  Examination of the oral cavity revealed that the child was in the mixed dentition stage. All the permanent 1st molars had completely erupted  except mandibular left molar Swelling measured approximately 2 x 2.5 cm in diameter and was very soft and fluctuant with bluish color. In this case too, the overlying smooth with no ulceration present Radiographic examination Case 1 showed presence of 11, case 2 showed presenceof 21, case 3 showed presence of 36 in the stage of eruption and involvement or any radiolucency surrounding this tooth.Based on clinical and radiographic examination, the lesions were diagnosed as eruption cyst associated with 11, Treatment The clinical condit ion was explained to the parents and they were advised to observe the swellings for another 2 weeks as it may rupture on its and may notrequire any surgical intervention. Patients reported after 15-20 days. In all three cases, the swelling was not resolved and complained of discomfort associated with swelling while chewing food. The surgical procedure was explained to the parents and consent was obtained for the same. A blood investigation was carried out before the procedure.In first two patients,the treatment included incising the eruption cyst with BP bladeno.15 and draining the contents of the cyst. A window was cut leading to the exposureof 11 and 21. In third patient as little big with thick mucosa overlying, the superficial part present over 36 was excised completely and it was sent for histological examination. content of the cyst was drained completely. Post operative instructions were given in all patients [Figure 1c, 1d and 2b]. The case 1 and case reviewed after one month and a normal eruption pattern was observed [Figure 1e, 1f]. In addition of surgical excision of cyst in case 3, pulp for 74, cementation of modified distal shoe with intra-mucosal extension was cemented to guide the eruption of 36 [Figure 2c] and reverse crown and loop space maintainer cementation was done to prevent the mesial migration of 46. Case reviewed after 2 and 4 weeks and a of 36 was observed [Figure 2d and 3a]. After 3 month, when complete eruption of 36 was observed, distal shoe appliance was replaced and loop space maintainer [Figure 3b Microscopic examination: Haematoxylin and Eosin stained section from case No. 3 revealed, stratified squamous parakeratinized epithelium with areas of acanthosis. Connective tissue was moderately fibrous with areas of extravasated RBCs, few blood vessels and chronic inflammatory cell infiltrate of plasma cells and lymphocytes. Few inactive odontogenic rests was also seen in the connective tissue DISCUSSION on clinical examination eruption cysts appears as aelevated dome shaped swelling more commonly encountered on the mucosa of the alveolar ridge. On palpation these lesions feel soft in consistency and the surface colour usually appears as bluish, purple to black or transparent color  on clinical examination eruption cysts appears as aelevated dome shaped swe lling more commonly encountered on the mucosa of the alveolar ridge. On palpation these lesions feel soft in consistency and the surface colour usually appears as bluish, purple to black or transparent color. It  raised Clinically, eruption cyst appears as a dome shaped raised swelling in the mucosa of the alveolar ridge, which is soft to touch and the color ranges from transparent, bluish, purple to blue-black.2 Inall three presented cases here, the  color of the cyst ranged from reddish black to bluish  Eruption cyst found to appear more in the upper arch compared to lower and commonly involving anterior teeth.to be more prevalent in the maxillary archinvolving anterior teeth. Eruption cyst associated with molars and premolars is very rare. Nagaveni et al.,5 reported development of this cyst in relation to mandibular first premolar which is a rare finding on radiographic examination it is difficult to differeciate between the cystic space of eruption cyst. The reason could be the presence of both the cyst and tooth in the soft tissue. In case of dentigerous cyst we can appreciate anunilocular radiolucent region in the shape of a half moon on the crown of a non-erupted tooth. 2on h istological examination the eruption cysts shows the similar microscopic features of the dentigerous cysts which consists of connective fibrous tissue covered by a fine layer of non-keratinized cellular epithelium.  Ã‚  area It is difficult to distinguish the cystic space of eruption cyston radiographbecause both the cyst and tooth are directly in the soft tissue  in contrast to dentigerous cyst in which a well-defined  unilocular radiolucentarea is observed in the form of a half moon on the crown of a non-erupted tooth.2Histologically,the eruptioncyst presents the same microscopic characteristics as the dentigerous cyst, with connective?brous tissue covered with a fine layer of non-keratinized cellular epithelium.2 On histologic examination of tissue excised from case no. 3 showed stratified squamous parakeratinized epithelium with focal areas of acanthosis, chronic inflammatory cells and few inactive odontogenic rests in connective tissue  most of the times, the eruption c ysts do not need any treatment and they resolve on their own. 4,7 surgical treatment is required when they show bleeding, infected, hurts the patients or esthetically unpleasing. 2,8 Treatment is done to give relief from the discomfort resulting from the eruption cysts. The treatment involves simple excision or excision of the overlying tissue to expose the crown and draining the fluid is carried out in cases where the underlying tooth is not erupting or when the cyst is increasing in size. Mostly, the eruption cysts do not require treatment and majority of them disappear on their own.4,7 Surgical intervention is required when they hurt bleed, are infected, or esthetic problems arise.2,8 Treatment has to be performed in order for the childto be relived from discomfort arising lesion.Simple incision or partial excision of the overlying tissue to expose the crown anddraining the fluidis indicated when the underlying tooth is not erupting or the cyst is enlarging advanced imaging techniques like the diode laser system is an excellent equipment for the management of eruption cyst. The advantages include elimination for the need of local anesthesia in majority cases.9 As a result the occurrence of possible complications, toxicity and allergic reactions are avoided. This diode laser has bactericidalcoagulative effects. In addition to this one can appreciate mild bleeding and better visualization of the working area as compared to conventional scalpel method of treating erupti on cysts. 10 In thepresented 3 cases, we used scalpel for incising or excising the lesion as we did not have access to the laser therapy in our department. The diode laser system is an excellent toolfor management of eruption cyst,since it eliminates the need for local anesthesia in most cases Painless character of laser has been attributed to its transitory anesthetic effect due to the blocking of the  nerve conduction in Na/K pump.9 The patient is comfortable, not noticing the sensation of vibration or observing the contact of the laser handpiece with the mucosa.4As of local anesthesia is not used, the possibility of complications, toxicityand allergic reactions are eliminated. The diode laser has bactericidal coagulative effectsalso.Compared with conventional scalpel there is mild bleeding and better visibility of working areawith use of laser.10 In the presented 3 cases, we used scalpel for incising or excising the lesion as we did not have access to the laser therapy in our institution. Conclusion: Eruption cyst requires surgical intervention when they hurt, bleed, are infected, or esthetic problems arise. Treatment has to be performed in order to relive the child from discomfort. Clinical significance: Knowledge about occurrence of eruption cyst among clinicians is very essential to provide the correct diagnosis and treatment.

Project Controls Essay

I have developed a proposal that would create a secure system within our organization. Below is the outline that should help prevent disaster recovery or in the case, backup our disaster recovery procedures. Duration Critical Task Sequencing The project will detail an array of critical task sequences including: * Pre-project Envisioning – Evaluation of HR database and corporate objectives, formulation of cost/benefit analysis, establishment of project scope and major milestones, securing of executive sponsorship and buy-in * Planning Structure – Project assembly, computing and testing environments, preliminary design, system array, and maintenance orientation * System deployment – Deployment of hardware and software systems, pilot test evaluations * Post-Implementation Review – Backup/restore maintenance, performance monitoring, system re-forecasting, establishment of ongoing infrastructure team Variance Baseline Achieving the desired outcome for the HR Resource Deployment will require a stringent and concentrated focus on maintaining adherence to the project timeline. Throughout this timeline, variance data will be closely observed and documented. Capturing variance data is an adamant goal for the project managers. Variance data will help to expose possible weaknesses of the planning process, and serve as priceless information for future endeavors. The means of collecting variance data will be comprised of the following: Delegation of variance targets. Prior to the project start, prime areas of variance will be decided upon for tracking. These areas will be closely monitored and documented. Targeted variances will form the baseline of the project, and will consist of measurements of quality, project milestones achieved, performance metrics,  and budget adherence. The success versus failure Planned versus actual. Variance data will be looked at according to what is planned as opposed to what the actual outcome will be. This will largely be focused on the proposed scheduling timeline and project cost expectancies. As the project advances, variance data will be tracked according to what deviates from the planned objectives. This data will be captured in real time in order to provide insight for future milestone proceedings. Estimates versus planned. This variance metric will focus on what was estimated for project details, such as schedule and cost, prior to the approved project plan. Such data will assist in greater accuracy of project planning, and will help to eliminate the guessing game. These variance metrics will be acquired through the collaboration between all stakeholders and resources. Maintaining high quality controls is a process that includes a lot of planning but when well maintains it builds the trust in the customers and eventually helps both organization businesses. As an organization maintains a high quality control one must know that there is also other aspects which is where being innovative and keeping a reasonable price adds to the equation. As many new customers are acquired a lot of the times this might be a direct result of on customer recommending another new customer. When this statement is true the new customer expects the same treatment and if not better. Therefore, one must stay innovative and open to new ideas and changes in order to fulfill the new customers’ needs. On-Going Evaluation and Status of Project There will be a definitive checklist for who will be responsible for the development and submission of projects reports. Evaluations will be performed on an as-we-go basis as to attempt to not miss anything important along the way. If there is anything that will be confidential or require a security clearance, these things will be handled by either the Project Manager or a member of management. Any projects that require the participation of stakeholders will be documented for future use and testing. All ongoing reports will also be given to all principal stakeholders along  the way. As each goal or milestone is met, it will be tested and retested for consistency to make sure what was done will stand the test of time (until the next project or upgrade). Method Used The Method that is used for determining whether the project has met its objectives is a survey. The survey can be done to figure if everything has been a success. Riordan employees will fill a survey out to give feedback on, if they are satisfied with the projects performance or not. Surveys can only provide estimates for the population, but cannot be a true measurements. You can measure surveys by the consistency of responses to questions about the project over a long amount of time period. REFERENCE Microsoft Office. Retrieved from http://office.microsoft.com/en-us/project-help/leading-practices-for-applying-variance-data-to-future-projects-HA010174487.aspx

Compare the techniques that Heckerling and Austen use to alert us to how we should view Cher and Emma

Using the opening scenes of Clueless and the opening chapters of Emma, compare the techniques that Heckerling and Austen use to alert us to how we should view Cher and Emma. Both texts use various techniques to present the two heroines, Emma and Cher. Emma is presented to the responder as an omniscient text, presenting the responder with all the character's opinions as well as Austin's opinion, particularly concerning the social hierarchy of the era. We are first presented with Austin's perspective in the opening chapter of the book, when Emma is described as â€Å"handsome, clever, and rich with a comfortable home and happy disposition†. As well as this submissive description the responder is also shown Emma's faults as â€Å"having rather too much her own way, and a disposition to think a little too well of herself†. As a result of the text being presented majoritivly through third person creating an objective status, the responder is shown that Emma has selfish tendencies despite all her good intentions. This is demonstrated to the responder as the wedding of a friend, with whom Emma shared â€Å"the intimacy of sisters†, is described in the text as â€Å"a gentle sorrow†. Despite the happiness of Emma's dearest friend, Miss. Taylor (now Mrs. Weston), Emma thinks only of herself and the unhappiness and emptiness that will be felt as a result of Miss Taylor's absence in the Woodhouse's home. The first paragraph sets the tone for the novel as the responder is forewarned of Emma having a crisis during the text, this is effectively projected by the inclusion of the word â€Å"seemed†. This shows the responder that Emma's ‘perfect' existence will be challenged throughout the novel, as her match making schemes fail with ominous (doomed) consequences. The description of Highbury shows the social status of Emma and her Father, â€Å"The Woodhouse's were first in consequence there. All looked up to them. † The description of Emma is juxtaposed by the description of Mr. Knightley, â€Å"a sensible man about seven or eight-and-thirty†¦ a very old and intimate friend of the family†. This shows the composer's intent to portray Emma as naive, young and self-orientated, as the two descriptions vary greatly as Mr. Knightley is portrayed as wise and â€Å"sensible†. The responder is further shown the father like figure of Mr. Knightley's character when Austen tells that â€Å"Mr. Knightley, in fact, was one of the few people who could see faults in Emma Woodhouse, and the only one who ever told her of them†. The presence of Mr. Knightley in the first chapter and the inclusion of his disagreement with Emma over her involvement in the match of Miss Taylor and Mr. Weston, depicts to the responder Emma's egocentric tendencies. The fact that Mr. Knightley, the wise and older character, implies that Emma merely â€Å"made a lucky guess†¦ likely to have done harm to yourself, than good to them, by interference†, influences the reader to view Emma as meddlesome and narcissistic (self-absorbed). Clueless is presented to the responder through a different medium, thus the composer, Amy Heckerling uses different techniques to portray the heroine, Cher. The main contrast between the opening chapters of Emma and the opening scenes of Clueless is the way in which the text is presented. Cher informs the responder as the main protagonist and narrator of the text. This allows the responder to empathise and affiliate a personal attachment with her, as they see only her perspective throughout the entire text.

An Effect Of Money On People - Free Essay Example

Sample details Pages: 4 Words: 1061 Downloads: 8 Date added: 2019/03/26 Category Literature Essay Level High school Tags: The Great Gatsby Essay Did you like this example? Money being unable to buy happiness The Great Gatsby is a tragic story about love and how money affects the lives of the characters in the novel. Fitzgerald emphasizes what exactly the American Dream is through the use of symbolism and the egotistic nature of the characters. The idea of the American Dream isnt necessarily material items. Don’t waste time! Our writers will create an original "An Effect Of Money On People" essay for you Create order In actuality working hard and accomplishing goals in life to become successful in society is really what the American Dream is. The author also uses good diction and language to show the character development of Gatsby and Daisy, by showing the complicated romance between them. Although money may provide short term satisfaction, whether it be through material items or in vain, there is no amount of money that can provide long term happiness. In the novel, Gatsbys ultimate goal wasnt necessarily to become wealthy because of greed, but more for the sake of winning Daisy back. Gatsby grew up poor however, he was very determined to become successful. Money being able to buy happiness doesnt apply to Gatsby. Daisy is the only thing that will bring happiness to Gatsby, nothing else. Gatsby loves Daisy, but he cannot be with her because she is with Tom and it is difficult for him to express his love to her at first. Gatsby is a very secretive and closed off man, so he shows his love for her in the only way he knows how which is buying her love with excessive parties, flowers, and clothes . Materials are no match to real authentic love. You can satisfy or please a person with materials but money cannot buy someones love or trust. There is more to life than wealth and the book emphasizes that claim greatly because throughout the story the characters have their own set of problems that climax towards the end of the plot. Everything about Gatsbys new wealth was all for a certain motive. He hosted parties and everyone was invited. Daisy herself is explicitly connected with money here, which allows the reader to see Gatsbys desire for her as desire for wealth, money, and status more generally. So while Daisy is materialistic and is drawn to Gatsby again due to his newly-acquired wealth, we see Gatsby is drawn to her as well due to the money and status she represents. In the text it states, I couldnt forgive him or like him but I saw that what he had done was, to him, entirely justified. It was all very careless and confused. They were careless people, Tom and Daisy they smas hed up things and creatures and then retreated back into their money or their vast carelessness or whatever it was that kept them together, and let other people clean up the mess they had made ( Fitzgerald page,146). Money here is more than just status, its a shield against responsibility, which allows Tom and Daisy to behave recklessly while other characters suffer and die in pursuit of their dreams. In the end Tom and Daisy simply go back to their boring and careless lives, but all the money Gatsby tried so hard to make didnt end up doing much for him because Daisy still had love for her husband. Money does have value but it may not necessary make people happy in the book. Gatsby spends a huge amount of money to host parties that he doesnt really enjoy. He has a desire to grab Daisys attention and make her fall in love again because of Gatsbys new life with more money. Gatsby could not use money to buy Daisys love. Also, Gatsby knows of many important people that surrounded his life, who come to his party before, after he dies only a few people come to his funeral. Wealth and power are gone away with Gatsby. Gatsbys dream could not be achieved by only using his money. This shows that money does not actually give true happiness. The characters in the book who are higher class people may be able to buy all the things they want with money to make them happy, but actually it is only temporary. I believe that love and trust from family is what really makes people truly happy as it is eternal, and these are the things that they lack as most people tend to have problems with their partner. For example, Tom and Daisy. However, for Gatsby he was even willing to participate in illegal activities to become rich but ultimately to win daisy back. Materialism and wealth is a huge factor that has always been apart of Daisys life. She married Tom Buchanan for his wealth. Daisy being used to having everything makes her character seem very careless. Chapter 1 introduces us to daisy with, ive been everywhere and done everything. Although the audience is aware of the abundance of money Daisy has, she has also been through alot. Daisy married Tom knowing how much money he possess. Tom has been unfaithful and Daisy is very aware of his affairs but she continues to stays with him because, of the money. As the reader learns more about Daisy it is very easy to establish a claim that Daisy is ann unhappy women. I know this because, when Daisy had went to visit Gatsby for the first time after five years she begins to let out all of her emotion to Gatsby. In the text it says, it makes me sad because ive never seen such beautiful shirts before(chapter 5). This tells me Daisy became very emotionally because she finally saw what her life could have been with a man she truly loved. Daisy didnt marry the man she truly loved and it is easy to tell she is hiding from her reality and allowing her life to fall around her. I believe that in some ways money can negatively consume your life. Money was the fatal flaw of the entirety of the cast in this novel. The majority of the characters were incredibly wealthy yet their lives were empty. They continuously tried to fill the voids in their lives with expensive and meaningless materials that failed in giving their lives any substance. Gatsby himself had all the money one could ask for, but he did not have the one thing he wanted, Daisy. This is the perfect example of how money truly cannot buy love, or happiness.