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Language Journal of Clinical and Experimental Dentistry. 2023. Vol. 15, no. 12
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- Delayed diagnosis of advanced stage Leukemia in Two Pediatric Patients with Oral Manifestation(Medicina Oral S.L, 2023) Gangwar, AnshulBACKGROUND: Leukemia is a disease in which hematopoietic stem cell mutation leads to the uncontrolled growth of immature blood cells. These abnormal cells, which displace healthy cells, are the reason for the bone marrow's failure and demise. OBJECTIVE: To report unnoticed cases of delayed Leukemia in two patients. CASE REPORT: A 9-year-old male and 14-year-old female born to a non-consanguineous marriage presented with oral manifestations after getting dental treatment in their native place. Acute Leukemia was suspected based on their total blood count. CONCLUSIONS: Understanding the unusual symptoms and signs of acute Leukemia aids in early identification and effective patient care. Key words:Hematologic Neoplasms, Classification, Incidence, Diagnosis, Child, Young Adult.
- A Rare Case of Shprintzen-Goldberg craniosynostosis syndrome with Hirschsprung disorder: Dental characteristics and its Clinical Management(Medicina Oral S.L, 2023) Khandelwal, Deepak; Kulkarni, Shruti-Vinod; Kalra, Namita; Tyagi, Rishi; Khatri, Amit; Yangdol, PadmaShprintzen-Goldberg syndrome (SGS) is an autosomal dominant syndrome caused by de novo gene mutations. It is characterized by a number of congenital defects such as craniofacial, skeletal, neurological, and connective tissue abnormalities. It is characterized by craniosynostosis and marfanoid features. To our knowledge, approximately 75 shprintzen-goldberg syndrome cases have been documented since it was first described in 1982. Rare cases of shprintzen-goldberg syndrome have been reported in which the mutated gene was inherited from an unaffected parent through their germline cells i.e., egg or sperm cells. This is a case report of a 6-year-old boy with clinically diagnosed Shprintzen-Goldberg Syndrome with Hirschsprung disease. Patient reported with multiple caries and malpositioned teeth. The treatment initiated with awareness about cariogenic foods, oral hygiene instructions and diet counselling. Subsequently, comprehensive rehabilitation was done. Key words:Dental management, Craniosynostosis, Hirschsprung disorder.
- Comparison of postoperative pain reduction following laser, ultrasonic activation and conventional needle irrigation after root canal treatment - A randomized clinical trial(Medicina Oral S.L, 2023) Mathevanan, Swarna; Sureshbabu, Nivedhitha-Malli; Solete, Pradeep; Teja, Kavalipurapu-Venkata; Jose, JerryBACKGROUND: To compare the incidence of postoperative pain and analgesic intake on the administration of passive ultrasonic irrigation (PUI) using IrriSafeTM, laser-activated irrigation (LAI) using Er:Cr: YSGG in comparison to conventional needle irrigation (CNI) in participants diagnosed with symptomatic irreversible pulpitis (SIP). MATERIAL AND METHODS: In this randomised double-blinded parallel trial, 75 participants requiring root canal treatment in mandibular first molars diagnosed with SIP were enrolled. A 10 cm visual analogue scale (VAS) was used for pain assessment and patients presented with a preoperative pain score of 5 cm and above were only selected. After biomechanical preparation, the final irrigation protocols varied based on the irrigation protocol employed. In CNI, intracanal irrigation was conducted without agitation using a 31G side vented needle. In PUI, irrigant activation was conducted using IrriSafeTM and in LAI, irrigant activation was conducted using a pulsed Er:Cr: YSGG (2940 nm) laser with radial firing tip (RFT - 2). The pain scores and analgesic intake were assessed postoperatively after obturation at 6, 24 and 48 h. RESULTS: A significant reduction in postoperative pain levels and analgesic intake was seen among all groups at assessed time intervals (pLAI>PUI (p<0.05) respectively. CONCLUSIONS: Participants diagnosed with SIP receiving PUI and LAI showed low and comparable levels of postoperative pain scores. Based on the analgesic intake, PUI showed the least analgesic intake when compared to LAI and CNI respectively. Key words:Endodontics, Root canal irrigants, Postoperative Pain, Passive ultrasonic activation, Laser ultrasonic activation.
- Accuracy of zygomatic dental implant placement using computer-aided static and dynamic navigation systems compared with a mixed reality appliance. An in vitro study(Medicina Oral S.L, 2023) González-Rueda, Juan-Ramón; Galparsoro-Catalán, Agustín; de Paz-Hermoso, Víctor-Manuel; Riad-Deglow, Elena; Zubizarreta-Macho, Álvaro; Pato-Mourelo, Jesús; Hernández-Montero, Sofía; Montero-Martín, JavierBACKGROUND: Analyze and compare the accuracy of zygomatic dental implant placement carried out using a static navigation surgery, a dynamic navigation surgery and an augmented reality appliance. MATERIAL AND METHODS: Eighty (80) zygomatic dental implants were randomly assigned to one of four study groups: A: static navigation implant surgery (n = 20) (GI); B: dynamic navigation implant surgery (n = 20) (NI); C: augmented reality appliance implant placement (n = 20) (ARI) and D: free hand technique (n = 20) (FHI). A preoperative cone-beam computed tomography (CBCT) scan of the existing situation was performed to plan the surgical approach for the computer assisted implant surgery study groups. Four zygomatic dental implants were placed in anatomical-based polyurethane models (n = 20) manufactured by stereolithography, and a postoperative CBCT scan was taken. Subsequently, the preoperative planning and postoperative CBCT scans were uploaded to dental implant software to analyze the coronal global, apical global, and angular deviations. Results were analyzed using linear regression models with repeated measures to assess the differences according to the group, according to the position, and the interaction between both variables. If statistically significant differences were detected, 2-to-2 comparisons were made between the groups/positions. RESULTS: The results did not show statistically significant differences between the coronal global deviations of GI (5.54 ± 1.72 mm), NI (5.43 ± 2.13 mm), ARI (5.64 ± 1.11 mm) and FHI (4.75 ± 1.58 mm). However, showed statistically significant differences between the apical global deviations of FHI (3.20 ± 1.45 mm) and NI (4.92 ± 1.89 mm) (p = 0.0078), FHI and GI (5.33 ± 2.14 mm) (p = 0.0005) and FHI and ARI (4.88 ± 1.54 mm) (p = 0.0132). In addition, the results showed also statistically significant differences between the angular deviations of FHI (8.47º ± 4.40º) and NI (7.36º ± 4.12º) (p = 0.0086) and between GI (5.30º ± 2.80º) and ARI (9.60º ± 4.25º) (p = 0.0005). CONCLUSIONS: Free-hand technique provides greater accuracy of zygomatic dental implant placement than computer-assisted implant surgical techniques, and zygomatic dental implants placed in the anterior region are more accurate than in the posterior region. However, it is an in vitro study and further clinical studies must be conducted to extrapolate the results to the clinical setting. Key words:Implantology, computer assisted implant surgery, image-guided surgery, augmented reality, navigation surgery, zygomatic implants.
- Frequency of surgical bone augmentation methods complementary to dental implant placement: A study evaluated with cone beam computed tomography(Medicina Oral S.L, 2023) Mateo, Gutierrez-Draxl; Mazón-Esteve, Juan-Pedro; Pineda-Villacorta, Carlos-Rafael; Blaya-Tarraga, Juan-Antonio; Diaz-Fernandez, José-MaríaBACKGROUND: The success of dental implants largely depends on the quantity and quality of available bone. Occasionally, it is necessary to perform additional surgical techniques alongside implant placement to increase the available bone volume and ensure the success and survival of treatments. The objective of this study was to evaluate, through cone beam computed tomography, the need for supplementary bone augmentation methods in implant placement. Additionally, the study aimed to assess the frequency of such techniques based on gender, anatomical sectors, and types of bone augmentation procedures. MATERIAL AND METHODS: The analysis included 106 cone beam computed tomography images obtained from 77 patients over the age of 18 who sought oral rehabilitation with implants at the University Clinic of the Master's Program in Oral Implantology at the European University of Valencia. RESULTS: A total of 201 edentulous sextants were analyzed. It was observed that 63.68% of the sextants required a bone augmentation technique, and there was a statistically significant difference (p=0.039) regarding the need for supplementary techniques in women. The need for bone augmentation by sectors was most prevalent the horizontal type (48.11%) and in the mandible (29.41%). About crestal and lateral approaches for sinus elevation, there was a higher need for the lateral technique (49.38%), and a statistically significant difference was evident (p=0.015). CONCLUSIONS: A high frequency of bone augmentation need for implant placement was demonstrated. It was shown that some form of supplementary surgical method was required in implant placement (63.68%). The highest need for bone augmentation was observed in the posterior maxillary sector, primarily in the vertical type (29.27%), accompanied by lateral window sinus elevation technique (49.38%). Key words:Bone graft, Dental implant, Guided bone regeneration, Sinus floor augmentation, Cone beam computed tomography.
- Evaluation of trabecular bone in individuals with periodontitis using fractal analysis: An observational cross-sectional study(Medicina Oral S.L, 2023) Yarkac, Fatma-Ucan; Tassoker, Melek; Atay, Ummuhan-Tekin; Azman, DuyguBACKGROUND: It is very difficult to objectively evaluate the negative changes in bone structure due to periodontitis. The present study was aimed to evaluate the trabecular bone structure between healthy individuals and periodontitis patients by fractal analysis (FA) on digital panoramic radiographs. MATERIAL AND METHODS: The study included 50 periodontally healthy individuals (control group), 50 individuals with Stage 1 periodontitis (S1-P group), 50 individuals with Stage 2 periodontitis (S2-P), and 50 individuals with Stage 3 periodontitis (S3-P), a total of 200 individuals were included. The fractal dimension (FD) value of the trabecular bone in the interdental space between mandibular first molar and second premolar tooth roots was evaluated using Image J program. The mean FD values of the two regions were calculated by box counting method. RESULTS: There was a statistically significant difference between the groups in terms of all periodontal parameter values (p<0.05). The mean FD values of individuals diagnosed with periodontitis were 1.36±0.08 in the S1-P group, 1.35±0.07 in the S2-P group, 1.28±0.15 in the S3-P group, and 1.44±0.06 in the control group. When the FD values between the groups were examined, it was seen that there was a statistically significant difference between the control and individuals with periodontitis, and the mean FD values were significantly higher in the healthy group (p<0.05). The best receiver operator curve was identified for periodontitis at the ≤1.409 cut-off FD value (area under the curve: 0.828; 95% CI: 0.758-0.899); p=0.000, p<0.001). CONCLUSIONS: FD evaluation can give an objective result about the effect of periodontitis on alveolar bone. The FD values of trabecular bone are different in healthy individuals and individuals with different stages of periodontitis. The findings suggested that a negative correlation between the periodontal data with the sites in which FD was measured and as the periodontitis stage progresses, FD decreases. Key words:Diagnosis, Periodontal Diseases, Radiographic Evaluation.
- Biomechanics of anterior endocrowns with different designs and depths: Study of finite elements(Medicina Oral S.L, 2023) Cruzado-Oliva, Fredy-Hugo; Alarco-La Rosa, Luis-Felipe; Vega-Anticona, Alexander; Arbildo-Vega, Heber-IsacBACKGROUND: To date, there is no clear consensus in the literature on which endocrown design and depth is the most effective treatment option for restoring endodontically treated maxillary central incisors. Aim: To determine the stress distribution of the anterior endocrowns by means of finite element analysis. MATERIAL AND METHODS: Nine 3D finite element models (groups A - I) were made, each one representing a restoration system of endodontically treated upper central incisors. The models were endocrowns with and without ferrules at 0, 1, 3, and 5 mm depth and a post-core stump control group. A static load of 100N of force was applied to the palatal face at 45º from the long axis of the tooth. The Von Mise values and the maximum stress in the crown, dentin and resin cementum were evaluated separately. RESULTS: The maximum stress distribution was C < B < A < D < H < F < E < G < I and the Von Mises stresses were in the upper 1/3 of the retainer of endocrowns A, B, C and D. ; in the vestibular neck in endocrowns E and F; in the final 1/3 of the retainer in the endocrown G; in the middle 1/3 of the retainer in the H endocrown; and at the level of the vestibular neck of the crown in model I. CONCLUSIONS: The smallest distribution of maximum and Von Mises stresses was observed in model C. Key words:Finite element analysis, Biomechanics, upper central incisor, endodontically treated teeth, dental restoration.
- 3-D assessment of skeletal and dentoalveolar bilateral dimensions in unilateral impacted palatal canine cases - A CBCT study(Medicina Oral S.L, 2023) Sharma, Swati; Sharma, Payal; Rathore, Akshay; Raza, MonisBACKGROUND: The aim of this study was to compare skeletal and dentoalveolar dimensions in subjects with maxillary unilateral impacted palatal canines versus the unaffected contralateral side using CBCT. MATERIAL AND METHODS: Skeletal and dentoalveolar variables (Anterior alveolar ridge height, Anterior dentoalveolar height , nasal cavity width, basal nasal width, Lateral angulation of long axis of the incisors and canines with respect to the nasal horizontal plane, premolar to median raphe width, dimensions of lateral incisor and canine, root resorption of lateral incisors, crown-root angulation of lateral incisor, and sector classification of canine) were compared between the impacted and the contralateral sides. As the data had normal distribution, means were compared using students t test. The significance was set at p<0.05. The root resorption in lateral incisor was compared using Chi square test. RESULTS: Lateral angulation of long axis of canines, nasal cavity width, basal lateral width, and premolar to median raphe width were found to be significantly different. Maximum number fell in sector 4 (n = 23, 38.3%) in sector classification. Root resorption of lateral incisor on impacted side was insignificant. CONCLUSIONS: Skeletal and dento-alveolar dimensions vary between the impacted and non-impacted sides in unilateral palatal canine impaction cases. Canines on the impacted side were more mesially angulated compared to the non-impacted side. The nasal cavity width, basal lateral width and premolar to median raphe width were significantly less on the impacted side compared to the non- impacted side. Key words:Impacted canine, CBCT, skeletal dimensions, diagnosis, orthodontic treatment.
- Craniofacial morphology in Obstructive Sleep Apnea patients(Medicina Oral S.L, 2023) Ciavarella, Domenico; Lorusso, Mauro; Campobasso, Alessandra; Cazzolla, Angela-Pia; Montaruli, Graziano; Burlon, Giuseppe; Lo Muzio, Eleonora; Laurenziello, Michele; Tepedino, MicheleBACKGROUND: To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs. MATERIAL AND METHODS: One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p< 0.05. RESULTS: A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p<0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p<0,01) and ODI (rho= -0,2443; p<0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p<0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p<0,05) and ODI (rho=0,1970; p<0,05). CONCLUSIONS: The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words:OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway.
- In vitro effect of two resin based materials for treating initial caries lesion around braces, under cariogenic challenge(Medicina Oral S.L, 2023) Provenzano, Maria-Gisette-Arias; Santin, Gabriela-Cristina; Rios, Daniela; Moura, Sandra-Kiss; Palma-Dibb, Regina-Guenka; Lucietto, Tuane-Mertz; Bowman, Jay; Ramos, Adilson-LuizBACKGROUND: Orthodontic treatment makes the patient susceptible to the development of white spot lesions (WSL) due to the greater accumulation of bacterial plaque. The purpose of this in-vitro study was to evaluate the preventive effect of two resin materials on the incidence of these lesions in the region adjacent to the fixed bracket bonded under a WSL-treated area by two resin materials. MATERIAL AND METHODS: 36 extracted human molars presenting natural WSL were included. They were randomly divided into 2 groups for intervention: IC (Infiltration resin Icon®) and PS (resin sealant Pro Seal ®). Braces were bonded just above the WSL. The enamel surface around the brace was treated by one of the tested materials, leaving another part to be control. The samples were submitted again to a cariogenic challenge. The exposed enamel non-treated area from booth groups comprised the control group (E). For morphological analysis, confocal images were taken at baseline, after treatment, and after pH cycling of each sample. Lesion depth were measured (µm) and compared to the enamel thickness to calculate a demineralization index. All groups were compared using the Kruskal Wallis test and Dunn's post-test. RESULTS: PS group showed the lowest demineralization index (0.27 µm) when compared to the control area (0.39 µm) (p<0.05). IC presented a slightly higher percentage of lesions when compared to PS, however, did not differ significantly from the control exposed area. CONCLUSIONS: The resin sealant Pro Seal® had a positive protective effect under white spot environmental area and Icon® infiltrant, although showed some protection, did not statistically differ from controls. Key words:Dental Caries, Orthodontics, Dental Enamel, Sealants.
- Comparison of the Cytotoxic Effect of 3D-Printed Resins, Resin-based CAD/CAM blocks and Composite Resin(Medicina Oral S.L, 2023) Aydın, Numan; Karaoğlanoğlu, Serpil; Kılıç-Süloğlu, Aysun; Öztürk, SelenBACKGROUND: This study investigated the cytotoxic effects of 3D-printed permanent resins, resin-based CAD/CAM blocks and composite resin on human gingival fibroblast (HGF-1) and mouse fibroblast (L929) cell line. MATERIAL AND METHODS: 3D-printed permanent resins (Crowntec and Permanent Crown), resin-based CAD/CAM blocks (Vita Enamic and Brilliant Crios) and composite resin (Clearfill Majesty Posterior) were used in the study. Samples were prepared from the planned materials and kept in DMEM according to ISO 10993-12:2021 standard (3 cm2/ml). The cytotoxic effect of the materials on HGF-1 and L929 cells was examined by MTT test at the end of 24 and 72 h. Two-way analysis of variance test (ANOVA) was used to analyze cell viability data. RESULTS: 3D-printed permanent resins, resin-based CAD/CAM blocks and composite resin extracts showed similar cell viability on HGF-1 and L929 cells at the end of 24 h (p>0.05). Resin-based CAD/CAM block (Vita Enamic) produced the highest cell viability on HGF-1 and L929 cells at the end of 72 h (p0.05). CONCLUSIONS: 3D-printed permanent restoration resins showed similar cell viability on HGF-1 and L929 cells to resin-based CAD/CAM blocks and composite resin. Key words:3D-printed resin, CAD/CAM block, Composite resin, Cytotoxicity, Human Gingival Fibroblast.
- Buccal cheek mucosa solitary fibrous tumor. Case report(Medicina Oral S.L, 2023) García-López-Chicharro, Alba; Pampín-Martínez, Marta-María; López-Martínez, Clara; Aragón-Niño, Íñigo; Cebrián-Carretero, José-LuisSolitary fibrous tumor (STF) is a mesenchymal tumor that mainly appears in the pleura. Its presence in the oral cavity is very uncommon, being the buccal mucosa the most frequent location. Imaging cannot distinguish this entity between other types of tumors, being histological and immunohistochemical studies essential for its diagnosis. Immunohistochemical stains typically show positive results for CD34, Bcl2, and CD99. Surgical removal with wide margins is the gold standard treatment, requiring a close follow up due to recurrence risk. We present a case report of a solitary fibrous tumor located in the buccal cheek mucosa and the surgical approach. Key words:Solitary fibrous tumor, Buccal mucosa, Intraoral, Immunohistochemical markers.
