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Language Journal of Clinical and Experimental Dentistry. 2014. Vol. 6, no. 2
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- Proposal of a "Checklist" for endodontic treatment(2014) Díaz-Flores García, Victor; Perea Pérez, Bernardo; Labajo González, Elena; Santiago Sáez, Andrés; Cisneros Cabello, RafaelObjectives: On the basis of the 'Surgical Checklist' proposed by the WHO, we propose a new Checklist model adapted to the procedures of endodontic treatment. Study Design: The proposed document contains 21 items which are broken down into two groups: those which must be verified before beginning the treatment, and those which must be verified after completing it, but before the patient leaves the dentist's office. Results: The Checklist is an easy-to-use tool that requires little time but provides, order, logic and systematization by taking into account certain basic concepts to increase patient safety. Discussion: We believe that the result is a Checklist that is easy to complete and which ensure the fulfillment of the key points on patient safety in the field of endodontics.
- Prevalence of impacted and supernumerary teeth in the North Indian population(2014) Santosh, Patil; Maheshwari, SnehaObjective: Dental impaction is a very frequent problem. Supernumerary teeth, or hyperdontia, are the presence of additional teeth to the normal series in the either of the dentition. The presence of impacted and/or supernumerary teeth can cause various complications. The objective of the present study was to determine the prevalence of impacted and supernumerary teeth in the North Indian population. Study Design: The panoramic radiographic records of 4750 patients attending the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 to December 2012 were examined for this retrospective study. The ages of the patients ranged from 8 to 72 years, with a mean of 34.6 years. Results: A total of 798 (16.8%) patients presented with 1126 impacted teeth. Impacted canines were the most prevalent (9.7%), followed by impacted premolars (4.3%). Supernumerary teeth (1.6%) and impacted molars (1.2%) were less prevalent. Among the 842 impacted teeth, the most frequently affected teeth were the canines (56.7%), followed by premolars (27.8%), and supernumerary teeth (9.3%), while the prevalence of impacted molars was quite lower (6.2%). Conclusion: The most frequently impacted teeth were maxillary canines and the mesiodens were the most common supernumerary tooth. The early diagnosis of supernumerary and impacted teeth is essential to prevent malocclusion and malalignment of permanent teeth demonstrating the importance of panoramic radiographs in their detection.
- Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer(2014) Alonso Ezpeleta, Luis Oscar; Martín, Pablo J.; López López, José; Castellanos Cosano, Lizett; Martín González, Jenifer; Segura-Egea, Juan J.A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion.
- Replantation of a maxillary second molar after removal of a third molar with a dentigerous cyst: Case report and 12-month follow-up(2014) Peñarrocha Diago, María; Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, MiguelThe aim of this study was to describe the replantation of a maxillary second right molar, which had been removed for surgical reasons in order to remove a dentigerous cyst associated with the adjacent third molar, and the case's 12-month follow-up. A 51-year-old man presented swelling in the right maxillary area. Radiographic examination showed a large radiolucency in close proximity to the third molar, suggesting a follicular cyst. The third molar was extracted and the cyst underwent curettage. The second molar had to be extracted to enable complete removal of the cyst and to achieve primary closure of the wound, which would have been impossible without repositioning the molar. With this objective, extraoral endodontic treatment was performed, the root-end was resected and prepared with ultrasonic retrotips, and root-end filling was accomplished with MTA before the molar was replanted. At the 12-month follow-up, the tooth showed no clinical signs or symptoms, probing depth was no greater than 3 mm and radiographic examination showed no evidence of root resorption or periapical lesion.
- Clinical evaluation of bond failures and survival between mandibular canine-to-canine retainers made of flexible spiral wire and fiber-reinforced composite(2014) Sfondrini, Maria Francesca; Fraticelli, D.; Castellazzi, Linda; Scribante, Andrea; Gandini, PaolaObjectives: The purpose of this longitudinal prospective randomized study was to evaluate the clinical reliability of two different types of postorthodontic treatment retainers: a silanised-treated glass fibers-reinforced resin composite (FRC) and a directly bonded multistranded stainless steel wire. The hypothesis of the study was to assess if significant differences are present between failure rates of the two retainers. Study Design: This prospective study was based on an assessment of 87 patients (35 men and 52 women),with an average age of 24 years who required a lower arch fixed retainer after orthodontic treatment. Patients were divided in two groups. Assignment was carried out with random tables. A follow-up examination was carried out once a month. The number, cause, and date of single bond adhesive failures were recorded for both retainers over 12 months. Teeth that were rebonded after failure were not included in the success analysis. Statistical analysis was performed by means of a Fisher's exact test, Kaplan-Meier survival estimates, and log rank test. Results: Bond failure rate was significantly higher (P=0.0392) for multistranded metallic wire than for FRC. Conclusions: Glass fiber-reinforced resin composite retainers and multistranded metallic wires showed no significant difference in single bond failure rates over a one-year follow up.
- Forensic dentistry in human identification: A review of the literature(2014) Ata-Ali Mahmud, Francisco Javier; Ata-Ali Mahmud, FadiAn update is provided of the literature on the role of odontology in human identification, based on a PubMed-Medline search of the last 5 years and using the terms: 'forensic dentistry' (n = 464 articles), 'forensic odontology' (n = 141 articles) and 'forensic dentistry identification' (n = 169 articles). Apart from these initial 774 articles, others considered to be important and which were generated by a manual search and cited as references in review articles were also included. Forensic dentistry requires interdisciplinary knowledge, since the data obtained from the oral cavity can contribute to identify an individual or provide information needed in a legal process. Furthermore, the data obtained from the oral cavity can narrow the search range of an individual and play a key role in the victim identification process following mass disasters or catastrophes. This literature search covering the last 5 years describes the novelties referred to buccodental studies in comparative identification, buccodental evaluation in reconstructive identification, human bites as a method for identifying the aggressor, and the role of DNA in dental identification. The oral cavity is a rich and noninvasive source of DNA, and can be used to solve problems of a social, economic or legal nature.
- Microleakage and shear bond strength of orthodontc brackets bonded to hypomineralized enamel following different surface preparations(2014) Shahabi, Mostafa; Ahrari, Farzaneh; Mohamadipour, Hamideh; Moosavi, HoriehObjectives: This study investigated the effects of several conditioning methods on shear bond strength (SBS) and microleakage of orthodontic brackets bonded to demineralized enamel. Study Design: One hundred premolars were selected and immersed in a cariogenic solution for 12 weeks. The teeth were randomly assigned into 5 groups. In groups 1 and 2, the teeth underwent acid etching for 30 and 120 seconds, respectively. In group 3, a combination of laser and acid etching was employed. A self-etch primer (SEP) was applied in group 4 and in group 5, the teeth were exposed to acidulated phosphate fluoride (APF) for 4 minutes before etching. After bracket bonding, the teeth were immersed in methylen blue for 12 hours and then were mounted in acrylic resin. SBS was determined with an Instron Universal Testing Machine and the amount of microleakage under the brackets was assessed under a stereomicroscope. Results: The lowest SBS was related to the SEP group and the highest one was observed in the specimens prepared by APF+acid etching. There was a significant difference in SBS (p=0.009), but not in microleakage (p=0.971) of the study groups. The SBS of the specimens treated with SEP was significantly Lower than the other groups, which were not significantly different from each other. The SEP group displayed a higher frequency of bond failure at the enamel-adhesive interface. Conclusion: Enamel preparation with SEP provided the lowest SBS among the groups. All groups showed some degree of microleakage. There was no significant correlation between SBS and microleakage.
- Etiological factors in second mandibular molar impaction(2014) Cassetta, Michele; Altieri, Federica; Calasso, SabrinaObjectives: The impaction of the second mandibular molar (MM2) has recently become more prevalent. Several etiological hypothesis have been proposed to investigate the association between skeletal features and impaction of MM2. The aims of this study were to analyze the skeletal features in patients with MM2 impaction and the association between arrested eruption of MM2 and the presence of the third mandibular molar (MM3). Study Design: In this retrospective study 48 subjects from 3,530 Caucasian orthodontic patients with MM2 impaction were included in a study group (SG) and compared to a control group (CG) of 200 subjects without MM2 impaction. Panoramic radiographs evaluated the presence or absence of the MM3 germ. Cephalometric analysis was performed to evaluate linear and angular skeletal values. For the statistical analysis, descriptive statistics, Student'fs t-test, 'Ô2 test and odds ratio (OR) were used. Results: The paired comparisons between SG and CG showed in cephalometric analysis both a reduced mandibular gonial angle (ArGoMe) and lowered Jarabak'fs polygon value with a statistically significant difference (P. 0.05). MM3 was statistically significant associated (P. 0.05) with MM2 impaction but it is not a risk factor (OR 0.817). Conclusions: Subjects with MM2 impaction show a vertical condylar growth direction. MM3 is not a risk factor for MM2 impaction.
- Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes ' a pilot study(2014) Vineetha, Ravindranath; Pai, Keerthilatha M.; Vengal, Manoj; Gopalakrishna, Kodyalamoole; Narayanakurup, DineshIntroduction: Salivary biomarkers are suggested to provide a reliable, noninvasive and objective measurement of chronic psychosocial stress and helps in assessment of pivotal role of stress in causation or precipitation of multitude of health problems Objectives: To evaluate the usefulness of salivary alpha amylase activity as an objective indicator of chronic stress and to find out any correlation between stress- related mucosal complaints and its levels. Study Design: Study was conducted among 50 subjects suffering from chronic stress related problems and 50 nonstressed individuals who were screened with a psychometric questionnaire. Brief case history and oral examination was carried out and about one ml of unstimulated saliva was collected. Salivary alpha amylase levels estimated were compared between study and control group and between subjects with and without oral mucosal changes using non parametric Mann Whitney U test Results: There was statistically significant higher salivary alpha amylase levels in study group (p = .002) and salivary alpha amylase between the oral mucosal complaints group and without oral mucosal complaints group within the total study population were found to be statistically significant (p=0.045). Conclusion: Salivary amylase activity increases in patients with chronic psychosocial stress and may be used as a biomarker of chronic stress, but it may not be an indicator to suggest the development of stress related oral mucosal changes.
- Unifocal orofacial granulomatosis in retromolar mucosa:surgical treatment with Er,Cr:YSGG laser(2014) Castelo, Pablo; Seoane Romero, Juan M.; García Caballero, Lucía; Suárez Peñaranda, J. M.; Romero Méndez, María Amparo; Varela Centelles, Pablo IgnacioOrofacial granulomatosis is defined by permanent or recurrent swelling of orofacial tissues with different multiform and multifocal clinical patterns. An 11-year old boy presented with a 2-month history of mucosa enlargement. Intraoral examination revealed an erythematous, polylobulated, exophytic lesion with a smooth surface located in retromolar mucosa, non-tender and non-infiltratated to palpation. The diagnosis was inflammatory lesion compatible with pyogenic granuloma and laser excision was decided. Haematological parameters were within normal range, as well as chest Xrays. These findings lead to a diagnosis of non-symptomatic orofacial granulomatosis, whose early diagnosis can minimize the impact of systemic-related disorders, like Chron's disease.
- Testing international dental maturation scoring system and population-specific Demirjian versions on Saudi sub-population(2014) Baghdadi, Ziad-D.Objectives: The purpose of this study was to test the applicability of the Demirjian method and revised versions for estimating chronological age (CA) from dental age (DA) in a sample of children. Study Design: A sample of 252 individuals of known age (4 to 14 yrs), sex (males: 125, females: 127), and ethnicity (Saudi) was collected. Each individual was aged using the original Demirjian method and revised versions, including Saudi, Kuwaiti, Belgian, and revised international curves. The differences between dental age and chronological age were analyzed using paired sample t-tests with Bonferroni corrections and multinomial regression tests at the 0.05 level of significance. Results: The results indicated an over-aging of the sample as a whole by about 10 months using Demirjian tables, 5.5 months using Kuwaiti tables, 24.7 months using Belgian tables, and 5 months using revised international tables. The sample was under-aged by 0.6 month using Saudi tables. The overall discrepancies between CA and DA were statistically significant (P < 0.0001) for all methods with the exception of Saudi curves. Conclusions: The findings suggest that the Saudi population method is most accurate on a Saudi population.
- Orthopantomography contribution to prevent isquemic stroke(2014) Abecasis, Pedro; Chimenos Küstner, Eduardo; López López, JoséObjectives: The ortopantomography (OPG) can be a valuable way for an early detection of calcified atheroma plaques, thus contributing for a preliminary stroke risk evaluation. The study looks for the existence of calcified atheroma plates through the use of OPG, comparing the results with the stenosis percentage found through eco-doppler. It has been analyzed the correlation of the number of years as a smoker, arterial hypertension and body mass index, against the risk of having calcified atheroma plaques. Study Design: Observational, transversal and prospective study with 84 patients from the Dental Center of Hospital Particular de Lisboa. First the patients answered to an inquiry and them they were submitted to an OPG and an eco-doppler. Results and Conclusions: It is possible to detect calcified atheroma plaques in the carotid artery through an OPG and patients who have them have got a fifteen fold greater risk of suffering from carotid stenosis. In this study, it has been confirmed the increase in carotid stenosis for long term smokers (OR = 1,033, n=18, 42,9%). The study results show that hypertension patients have a probability 5,426 greater than normal of developing atheroma plaques (with sig=0,049). Amid analyzed patients, the correlation between obesity and the existence of carotid atheroma plaques was significant, although negative (sig=0,047). OPG can help find patients with higher risk of isquemic stroke.
- Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries(2014) Heravi, Farzin; Ahrari, Farzaneh; Mahdavi, Mahdieh; Basafa, SoroushObjectives: This study investigated the effectiveness of low power red and infrared lasers and that of Er:YAG laser, in association with CPP-ACPF cream, on remineralization of white spot lesions. Study Design: Fifty intact premolars were immersed in a demineralization solution for 10 weeks to induce caries like lesions and then were divided into five groups. In group 1, the teeth were covered with a CPP-ACPF cream for 3 minutes and then irradiated with a low power red laser (660 nm, 200 mW) for 1 minute through the cream. In group 2, the treatment was the same as that in group 1, but an infrared laser (810 nm, 200 mW) was employed. The specimens in group 3 were irradiated with an Er:YAG laser (100 mJ, 10 Hz) combined with CPP-ACPF. In group 4, the CPP-ACPF cream was applied for 4 minutes and group 5 was submitted to neither laser nor CPP-ACPF. The micro Vickers hardness was compared at 20, 60 and 100 ì from the enamel surface among the groups. Results: The highest microhardness was observed in the low power red and Er:YAG laser groups and the lowest one belonged to the CPP-ACPF alone and control groups. However, no significant difference was found in microhardness of the experimental groups at any of the evaluation depths (p>0.05). Conclusion: With the laser parameters used in this study, neither the combined application of Er:YAG laser with CPP-ACPF nor the combination of low power lasers with CPP-ACPF provided a significant increase in remineralization of enamel caries.
- Lingual nerve injury after third molar removal: Unilateral atrophy of fungiform papillae(2014) Martos Fernández, Míriam; de Pablo García-Cuenca, Alba; Bescós Atín, SocorroBackground: Pain and sensory changes due to lingual nerve injury are one of the most common alterations that follow surgical removal of third molar. They are usually transient but other less common complications, such as the atrophy of fungiform papillae, have an uncertain prognosis. Case Description: We report a case of a 34-year-old woman who presented a unilateral lingual atrophy of fungiform papillae after third molar extraction accompanied by severe dysesthesia that altered her daily life significantly during the following months and how this complication evolved over time. We conducted a literature review on the different factors that can lead to a lingual nerve injury. Clinical Implications: The clinical evolution of temporary and permanent somatosensitve injuries is an important fact to take into consideration during the postoperative management because it will indicate the lesion prognosis.
- Dental management of patients receiving anticoagulant and/or antiplatelet treatment(2014) Mingarro de León, Ana; Chaveli López, Begonya; Gavaldá Esteve, CarmenIntroduction: Adequate hemostasis is crucial for the success of invasive dental treatment, since bleeding problems can give rise to complications associated with important morbidity-mortality. The dental treatment of patients who tend to an increased risk of bleeding due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in the daily practice of dental professionals. Adequate knowledge of the mechanisms underlying hemostasis, and the optimized management of such patients, are therefore very important issues. Objectives: A study is made of the anticoagulant / antiplatelet drugs currently available on the market, with evaluation of the risks and benefits of suspending such drugs prior to invasive dental treatment. In addition, a review is made of the current management protocols used in these patients. Material and Methods: A literature search was made in the PubMed, Cochrane Library and Scopus databases, covering all studies published in the last 5 years in English and Spanish. Studies conducted in humans and with scientific evidence levels 1 and 2 (metaanalyses, systematic reviews, randomized phase 1 and 2 trials, cohort studies and case-control studies) were considered. The keywords used for the search were: tooth extraction, oral surgery, hemostasis, platelet aggregation inhibitors, antiplatelet drugs, anticoagulants, warfarin, acenocoumarol. Results and Conclusions: Many management protocols have been developed, though in all cases a full clinical history is required, together with complementary hemostatic tests to minimize any risks derived from dental treatment. Many authors consider that patient medication indicated for the treatment of background disease should not be altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown to suffice for controlling possible bleeding problems resulting from dental treatment.
- Treatment of recurrent aphthous stomatitis. A literature review(2014) Belenguer Guallar, Irene; Jiménez Soriano, Yolanda; Claramunt Lozano, AriadnaRecurrent aphthous stomatitis (RAS) is the most common chronic disease of the oral cavity, affecting 5-25% of the population. The underlying etiology remains unclear, and no curative treatment is available. The present review examines the existing treatments for RAS with the purpose of answering a number of questions: How should these patients be treated in the dental clinic? What topical drugs are available and when should they be used? What systemic drugs are available and when should they be used? A literature search was made of the PubMed, Cochrane and Scopus databases, limited to articles published between 2008-2012, with scientific levels of evidence 1 and 2 (metaanalyses, systematic reviews, phase I and II randomized clinical trials, cohort studies and case-control studies), and conducted in humans. The results obtained indicate that the management of RAS should be based on identification and control of the possible predisposing factors, with the exclusion of possible underlying systemic causes, and the use of a detailed clinical history along with complementary procedures such as laboratory tests, where required. Only in the case of continuous outbreaks and symptoms should drug treatment be prescribed, with the initial application of local treatments in all cases. A broad range of topical medications are available, including antiseptics (chlorhexidine), antiinflammatory drugs (amlexanox), antibiotics (tetracyclines) and corticosteroids (triamcinolone acetonide). In patients with constant and aggressive outbreaks (major aphthae), pain is intense and topical treatment is unable to afford symptoms relief. Systemic therapy is indicated in such situations, in the form of corticosteroids (prednisone) or thalidomide, among other drugs.
- Peripheral ameloblastoma of the upper gingiva: Report of a case and literature review(2014) Bertossi, Dario; Favero, Vittorio; Albanese, Massimo; De Santis, Daniele; Martano, Manuela; Padovano di Leva, Antongiulio; De Florio, Iride; Nocini, Pier Francesco; Lo Muzio, L.According to the 2005 histological classification of odontogenic neoplasms by the World Health Organization, ameloblastoma is a benign, locally invasive epithelial odontogenic tumor of putative enamel organ origin. There are four distinct subgroups in which this neoplasm can be gathered: the solid/multicystic type, the unicystic type, the desmoplastic and the peripheral type. Peripheral ameloblastoma is believed to be the rarest subgroup, making up for 2 to 10% of all ameloblastomas. From its first description by Kuru in 1911 to date, less than 200 cases of PA have been described in literature. PAs commonly affect the mandible, in the maxilla the most common location is the soft palatal tissue of the tuberosity area. The present report discusses a rare case of PA aroused in the gingiva of upper jaw in a 64-year-old woman. The treatment of the lesion and its immunohistochemical phenotype are described. A review of the literature is also performed, focusing on the epidemiological and pathological aspects of the lesions and their implications on the therapy.
- Salivary and crevicular fluid interleukins in gingivitis(2014) Boronat Catalá, Montserrat; Catalá Pizarro, Montserrat; Bagán Sebastián, José VicenteIntroduction: Gingivitis is a frequent inflammatory process of the gum tissue that is mainly caused by the accumulation of plaque. The immune response against inflammatory processes is regulated in part by cytokines. Aims: Given that a continuous inflammation exists in gingivitis, it would be logical to assume that the interleukins will be altered locally in those patients. Therefore, the aim of this review was to check whether there is evidence that the interleukins can be used as diagnostic markers of inflammation levels in patients with gingivitis. Materials and Methods: A bibliographical search was undertaken using the key words interleukin and gingivitis in Pubmed, Cochrane, Scopus and Embase. Only those articles published over the last 10 years that were systematic reviews, case-controls or cohort studies in which interleukins in saliva and/or crevicular fluid was investigated in patients with gingivitis were selected. Results: Finally 15 articles were selected, all of them being case-control studies. The interleukins analyzed in the reviewed articles were: IL-1â, IL-8, IL-18, IL-11, IL-12, TNFá, IL-4, IL-17, IL-1á and IL-6. The most commonly studied interleukin is IL-1â and most authors agree that it is higher in the saliva and/or crevicular fluid of patients with gingivitis. Therefore, it could be used as a diagnostic marker of the degree of inflammation in gingivitis. Moreover, as far as the other interleukins studied are concerned, there is no clear consensus among the authors. Conclusion: There is sufficient evidence to suggest that IL-1â in saliva and/or crevicular fluid can be used as a marker of the degree of inflammation in gingivitis.
