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Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a conebeam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

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INTRODUCTION: Prescription opioid abuse may have adverse dental effects that are irreversible, leaving younger populations with substantially decayed dentitions. This article explores the damaging effects of three years of prescription opioid abuse to a twenty-six-year-old's dentition and oral health. CASE PRESENTATION: A twenty-six-year-old Caucasian male presented to the University of Pennsylvania School of Dental Medicine with a past medical history of Percocet® abuse. He was consuming approximately twenty tablets per day for three years, and he had neglected to visit a dentist for over five years before arriving to the School of Dental Medicine. Management and Outcome: Intraoral examination revealed gross generalized decay along with generalized plaque accumulation. He was diagnosed with severe plaque induced gingivitis with localized chronic periodontitis and xerostomia. The dental treatment for this patient included periodontal maintenance and control, caries excavation, root canal therapy, extractions of non-restorable teeth, and continuous dental education. DISCUSSION: Prescription opioids are addictive, have high abuse potential, and dentists contribute to this problem by overprescribing these drugs.

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Humans and other higher primates are unique among mammals in using complement receptor 1 (CR1, CD35) on red blood cells (RBC) to ligate complement-tagged inflammatory particles (immune complexes, apoptotic/necrotic debris, and microbes) in the circulation for quiet transport to the sinusoids of spleen and liver where resident macrophages remove the particles, but allow the RBC to return unharmed to the circulation. This process is called immune-adherence clearance. In this study we found using luminometric- and fluorescence-based methods that ligation of CR1 on human RBC promotes ATP release. Our data show that CR1-mediated ATP release does not depend on Ca(2+) or enzymes previously shown to mediate an increase in membrane deformability promoted by CR1 ligation. Furthermore, ATP release following CR1 ligation increases the mobility of the lipid fraction of RBC membranes, which in turn facilitates CR1 clustering, and thereby enhances the binding avidity of complement-opsonized particles to the RBC CR1. Finally, we have found that RBC-derived ATP has a stimulatory effect on phagocytosis of immune-adherent immune complexes.

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