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Language Journal of Clinical and Experimental Dentistry. 2010. Vol. 2, no. 1
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- Latex allergy in dentistry: clinical cases report(2010) Raggio, Daniela-Prócida; Camargo, Lucila Basto; Naspitz, Giselle Maria C C; Bonifácio, Clarissa Calil; Politano, Gabriel Tilli; Mendes, Fausto Medeiros; Kiertsman, FlaviaGenerally natural rubber latex (NRL) allergy is detected after some exposition to the material. As NRL is com- monly found in different materials used daily in dental clinic, the allergy can be manifested in the pediatric dentistry clinic. The first clinical manifestation can be smooth but also severe, therefore it is important to know different manifestations and how to prevent them. Objective: Report two clinical cases of natural rubber latex allergy in children and to present the safety measures that must be taken during clinical assistance, as using metallic saliva ejector, vinyl gloves for the treatment procedures and as an option to rubber dam. Cases Report: Case 1- Patient presented body swellings after contact with latex. Case 2- Patient presented skin eruptions and urticaria after contact with balloons suggesting possible NRL allergy. Conclusions: The precautions must always be taken during the dental treatment of natural rubber latex allergic patients in order to achieve satisfactory results by avoiding dermatitis or even anaphylactic shock.
- Magnetic resonance imaging in human teeth internal space visualization for requirements of dental prosthetics(2010) Tanasiewicz, MartaObjectives: The aim of this work has been a verification possibility to use 3D spin echo magnetic resonance imaging techniques in the dentistry within the scope of a dimensional imaging of the inner spaces of teeth during an prosthetic procedure. Methods: 6 extracted molar teeth were used after preparation for the inner root canals fixations. Magnetic resonance (MR) measurements were carried out on a 4.7 T MRI system with Maran DRX console and home built actively shielded gradient coils and rf probe head. Results: Research proceedings made it possible to compare the quality of internal tooth space after preparation for inner root canals fixations constructed using both classical methods (polymer mass impression) and non-imressional methods (MRI representation) Conclusions: A numerical model of prepared root canals obtained with the method of the magnetic resonance visualization may constitute in the future a basis for a non-impressional technique of imaging, usefull for dental prosthetics. A numerical model of the prepared root canals obtained with the method of the magnetic resonance visualization imaging combined with the method of images analysis, may in the future constitute a basis for an automatic 3D modelling of the inner root canals fixations, supported with computer applications dedicated for the designing purposes (CAD-computer aided design).
- Gingival and submandibular lymph node metastasis of sigmoid colon adenocarcinoma(2010) Landeyro, Julieta; Raventos Estelle, A.; Mommsen, J.; Elguezabal, A.; Gené Hijós, M.; Boutayeb, L.; Martinez, M.S.Introduction: Metastatic tumors of oral and maxillofacial region compromise 1% of all malignant oral neoplasms. Most commonly affect the jaw bone and less commonly intraoral soft tissues. They originate mainly from primary tumors of lung, breast, colon-rectum, prostate and kidney. Case report: a 77 years old man with history of sigmoid colon adenocarcinoma and liver metastasis. Two years later of being free of disease, he presented with submandi- bular lymphadenopathy and a gingival mass in right upper jaw. Fine needle aspiration of the node and biopsy of the gingival mass were performed. The cytological smears showed cohesive cell groups on a necrotic background. Biopsy examination showed subepithelial infiltration by neoplasm of glandular pattern with immunoreactivity for keratin 20 and carcinoembryonic antigen. A definitive diagnosis of node and oral metastases of colon adenocarcinoma was made. Discussion: Metastases in the oral and maxillofacial region are very uncommon and usually represent an advanced stage and disseminated disease. They present non specific radiologic and clinical features so it is imperative to reach a definitive diagnosis the cytological/histological examination. Because of its rarity, the diagnosis of metastases in the oral region are a challenging, both to the clinician and to the pathologist, in recogni- sing that a lesion is metastasic and in determining the site of origin
- Self-inflicted oral soft-tissue burn due to local behavior and treatment(2010) Dilsiz, AlparslanInjuries to oral soft-tissues can occur due to accidental, iatrogenic, and factitious traumas. They may present as burns, ulcerations, and gingival recession. Chemical, thermal, and physical agents are the main causative agents for oral soft-tissues burns. The purpose of this case report was to illustrate the destructive nature of the local behavior and to describe the successful treatment of this case. A 20-year-old girl with severe pain and burning sensation in the left maxillary region, which was interfering with normal eating and speaking, was admitted to periodontology clinic. Upon questioning, the patient readily admitted traumatizing her gingival and cheek mucosa with alcohol. Treatment consisted of oral hygiene instruction, mechanical debridement, local antimicrobial agents, systemic anal- gesic and guidance for patient. The burn lesions in the oral cavity can occur at dental offices and homes. The early detection by the patient and the immediate institution of therapeutic measures ensured a rapid cure and possibly prevented further mucosal damage. In addition, we believe that guidance and education are important prophylactic tools for prevent from these local behavior.
- Papillon Lefevre syndrome: bridge between Dermatologist and Dentist(2010) Singla, Anshu; Sheikh, Soheyl; Jindal, Sanjeev Kumar; Brar, RajdeepPapillon-Lefevre syndrome is a rare autosomal recessively inherited condition which shows features common to both dentistry and dermatology. This disease is characterized by palmoplantar hyperkeratosis and severe periodon- titis. Therefore both the dentist and the dermatologist should be aware of the same because an early diagnosis of the syndrome can help to preserve the teeth by early institution of treatment, using a multidisciplinary approach. Here we present a case report of Papillon-Lefevre syndrome, along with a comprehensive review of the etiology, pathology, clinical features, differential diagnosis and management of the condition.
- Reimplantation: clinical Implications and outcome of dry storage of avulsed teeth(2010) Singla, Anshu; Garg, Shalini; Dhindsa, Abhishek; Jindal, Sanjeev KumarReimplantation refers to the insertion and temporary fixation of completely or partially avulsed teeth that have resulted from traumatic injury. Reimplantation of an avulsed tooth depends on certain clinical conditions like phy- siological status of periodontal ligament (PDL), the stage of root development and the length of extra oral time. Depending on the patient’s age, retention of the permanent incisor can maintain the aesthetic appearance, occlusal function and alveolar ridge height. Though the risk of progressive replacement resorption and subsequent tooth loss is high after a long dry storage, reimplantation makes a provision for an aesthetically acceptable permanent prosthesis at a later age. This article presents management of two cases with avulsed permanent incisors that were stored in dry conditions for seven hours and three days respectively
- Solitary keratoacanthoma involving upper lip: a diagnostic dilemma - case report and a brief review(2010) Patil, Prashant Bhimrao; Rathor, Vanita; Venkatraman, Sreenivasan; Saxena, Susmita; Kamarthi, NagarajuKeratoacanthoma (KA) is a benign epithelial proliferative lesion which frequently occurs on the sun exposed areas of the skin. KA originates within the pilosebaceous apparatus of the skin and may be solitary or multiple. Solitary KA can be difficult to differentiate from squamous cell carcinoma (SCC) both clinically and microscopically. However, the clinical course of the lesion and its ability to self involute makes it a distinct clinical entity. Solitary KA appears on the vermilion border of the lower lips with some frequency. A case of keratoacanthoma involving the upper lip is reported presenting as an exophytic growth that resolved after excisional biopsy. Photo- graphic documentation of the case along with relevant management protocol is discussed. The article emphasizes the significance of recognizing such lesion and discriminating it from SCC thus carrying diagnostic and therapeutic implications. However, in case of dilemma it is prudent to assume that the lesion is SCC unless proved otherwise clinically or histologically.
- Gingival recession associated with Orthodontic treatment and root coverage(2010) Dilsiz, Alparslan; Aydin, TugbaMany patients seek to pursue orthodontic treatment for esthetic improvement. These patients present with mal- alignment of the anterior teeth. There was strong correlation between the severity and extent of gingival recessions and past orthodontic treatment, it was suggested that orthodontic tooth movement may lead to gingival recession. The principal objective in the treatment of gingival recession is to cover the exposed root surfaces to improve es- thetics and to reduce hypersensitivity. Different soft tissue grafting procedures have been proposed in the treatment of gingival recessions. Free gingival grafts (FGG) are a reliable method for treatment of gingival recessions: An autograft is taken from the palate as replacement for the lost keratinized gingiva. The purpose of this case report was to illustrate the relationship between orthodontic therapy and gingival recession, and to describe the successful treatment of this case. A 24-year-old girl with gingival recession and hypersensitivity in the anterior mandibulary region was admitted to periodontology clinic. Treatment consisted of oral hygiene instruction, mechanical debride- ment and surgical periodontal treatment. Root coverage is performed with a FGG in a one step method. The patient and clinicians were satisfied with the result. FGG can a viable alternative in the treatment of gingival recession. Surgical periodontal treatments result in esthetic improvement, elimination of sensitivity, and less risk of develo- ping root caries
- Unusual epithelial-myoepithelial carcinoma in palate: case report and immunohistochemical study(2010) Alves, Pollianna-Muniz; Silva, Luiz Augusto Costa da; Godoy, Gustavo-Pina; Queiroga de Castro Gomes, Daliana; Guedes Queiroz, Lélia Maria; Galvão Cavalcanti, HébelEphitelial-myoepithelial carcinoma (EMC) is a neoplasm of salivary gland extremely rare and low-grade malig- nant, exhibiting predilection for major salivary gland, especially parotid gland. This paper described a case of EMC localized in soft palate. The initial clinical diagnosis were mucoepidermoid and adenoid cystic carcinoma. A incisional biopsy was performed, and the histological diagnosis was adenocarcinoma not otherwise specified. The patient underwent excisional biopsy, where was realized immunohistochemical analysis, staining the duct-like structures, where the inner layer of epithelial cells positively for CK 14, whereas outer layer of myoepithelial cells stained positively for smooth muscle actin (SMA) and vimentin antibodies. Based on these findings, the final histological diagnosis was EMC. The patient was submitted 30 sessions of radiotherapy, and she is being follow-up about 2 years without evidence recurrences.
- Successful closure of the root apex in non-vital permanent incisors with wide open apices using single calcium hydroxide (caoh) dressing: report of 2 cases(2010) Nagaveni, N.B.; Umashankara, K.V.; Radhika, N.B.; Manjunath, S.Endodontic management of immature non vital permanent teeth in young pediatric patients is a great challenge to dentists. The walls of the root canals are frequently divergent and open apexes make debridement and obturation difficult. Thus closure of root apex is very essential for success of the endodontic treatment. Although different materials are used for the apexification procedure, calcium hydroxide is the material of choice for apical barrier formation and healing. There are different opinions regarding frequency of CaOH dressing change to induce complete closure of the apex. Literature suggests that dressing should be changed frequently. Therefore the aim of the present article is to report the successful closure of root apex in pulpless permanent incisors with wide open apices in two pediatric patients using single CaOH dressing.
- Some morphological features related to mandibular third molar impaction(2010) Kaya, Göksel Şimşek; Aslan, Muzaffer; Omezli, M. Melih; Dayi, ErtunçObjective: The aim of this study was to evaluate the effect of some morphological features of the mandible and mandibular permanent molars on impaction of mandibular third molars with panoramic measurements in a Turkish patient group. Study design: Standardized panoramic radiography variables compiled from 140 patients retrospectively were eva- luated. Predictive variables included mesio-distal crown width and inclination of the mandibular molars, vertical and horizontal surface dimension between distal surface of the lower second molar tooth and anterior surface of its ramus, length and width of the mandible ramus and corpus, angle of the mandible gonion, the number of the lower third molar roots, and angulations of roots of the lower third molars. Results and Conclusions: According to the data obtained in this study, the vertical height of the anterior border of the ramus, length of the posterior basal corpus, mesio-distal diameters of the first, second and the third molars, 1/3 root angle of the third molar, number of third molar roots, inclination of the first molar to increase, vertical height of the posterior border of the ramus, vertical height of alveolar crest, and height and the width of the retro-molar space to decrease are all in direct proportion to the possibility of impaction of the third molar.
- Oral mucocele: review of the literature(2010) Ata-Ali Mahmud, Francisco Javier; Carrillo García, Celia; Bonet Coloma, Cristina; Balaguer Martínez, José; Peñarrocha Diago, María; Peñarrocha Diago, MiguelMucocele is a common lesion of the oral mucosa that results from an alteration of minor salivary glands due to a mucous accumulation. Mucocele involves mucin accumulation causing limited swelling. Two histological types exist - extravasation and retention. Mucoceles can appear at any site of the oral mucosa where minor salivary glands are present. Diagnosis is principally clinical; therefore, the anamnesis should be carried out correctly, looking for previous trauma. The most common location of the extravasation mucocele is the lower lip, while retention mu- coceles can be found at any other site. Mucoceles can affect the general population, but most commonly young patients (20-30 years old). Clinically they consist of a soft, bluish and transparent cystic swelling which normally resolves spontaneously. Treatment frequently involves surgical removal. Never-theless micro marsupialization, cryosurgery, steroid injections and CO2 laser are also described. Mucocele is a common lesion and affects the general population. For this reason we felt it would be interesting review the clinical characteristics of mucoceles, and their treatment and evolution in order to aid decision-making in daily clinical practice.
- Dabigatran and rivaroxaban, new oral anticoagulants. New approaches in Dentistry(2010) Gómez Moreno, Gerardo; Aguilar Salvatierra, Antonio; Martin-Piedra, M.A.; Guardia Muñoz, Javier; Calvo Guirado, José Luis; Cabrera Ayala, Maribel; López Gallardo, Cristina; Castillo Naveros, TaniaTreatment in patients with atrial fibrillation or venous thromboembolism in recent decades has been based almost exclusively on the use of vitamin K antagonists. These drugs have a narrow therapeutic index, so it is precise to repeated adjustments of doses that require analytical monitoring. For many years it has advocated the need to have more convenient new antithrombotic drugs. So is developing a new generation of antithrombotic not related to coumarin. In 2008 and 2009, two of these new anticoagulants have been registered and approved in Europe and Ca- nada-these are dabigatran etexilate (Pradaxa ®) and rivaroxaban (Xarelto ®). Anticoagulant dabigatran is the first direct thrombin inhibitor, orally available. Specifically and reversibly inhibits thrombin, so the duration of action is predictable. The anticoagulant effect correlates well with plasma drug concentrations, which implies an effective anticoagulation with low bleeding risk without major problems of interactions with other drugs. Rivaroxaban is first oral anticoagulant inhibitor of factor Xa (FXa). It produces a predictable and reversible inhibition of FXa activity with ability to inhibit clot-bound FXa. The predictable pharmacokinetics and pharmacodynamics characteristics of dabigatran and rivaroxaban may facilitate dental management of patients who until now have been in treatment with traditional anticoagulants, given that it doesn’t require routine laboratory monitoring in the vast majority of patients treated. They also present a profile of drug interactions very favourable.
