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Language Journal of Clinical and Experimental Dentistry. 2019. Vol. 11, no. 6
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- Vascular leiomyoma in the oral cavity : report of two cases(2019) Ribeiro, Jaqueline-Lemes; Costa, Fernanda-Herrera; Cavalcante, Ana Sueli Rodrigues; Kaminagakura, Estela; Carvalho, Yasmin Rodarte; Anbinder, Ana LiaVascular leiomyomas (VL) are benign lesions of perivascular origin. We report two new cases and discuss their clinical, histological and immunohistochemical characteristics, in order to facilitate the diagnosis and treatment of such lesions. The patients, both male, presented asymptomatic nodules located in the bottom of the labial sulcus and buccal mucosa. In the second case, color doppler ultrasonography was performed, which showed no change in blood flow. After excisional biopsies, a limited lesion was observed histologically, with multiple tortuous vessels of varying sizes and calibers, and among them, spindle cells bundles, positive for smooth muscle actin. Oral VLs have clinical features similar to those of other more common lesions, making preoperative diagnosis difficult. Imaging examination, such as color doppler ultrasonography, may help in diagnosis. In general, excisional biopsy is performed, due to the ease of removal of the lesion during surgery. The treatment of choice is the complete excision of the lesion, which has an excellent prognosis and a low rate of recurrence.
- Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies(2019) Zubizarreta Macho, Álvaro; Ferreiroa Navarro, Alberto; Agustín Panadero, Rubén; Rico Romano, Cristina; Lobo-Galindo, Ana Belén; Mena Álvarez, JesúsBackground: The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. Material and Methods: This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. Results: Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. Conclusions: The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations.
- Ceramic veneers on central incisors without finish line using bopt in a case with gingival asymmetry(2019) Peris, Helia; Godoy, Laura; Cogolludo, Pablo G.; Ferreiroa Navarro, Alberto
- Cysts and tumors of the jaws treated by marsupialization : a description of 4 clinical cases(2019) Briki, Sondes; Elleuch, Wael; Karray, Fathi; Abdelmoula, Mohamed; Tanoubi, IssamSince the 4th edition of the World Health Organization?s Classification of Head and Neck Tumours was published in January of 2017, the keratocystic odontogenic tumor is back into the cyst category as odontogenic keratocyst (OKC). Depending on the size of the cyst, its location and the patients? age, several treatment options are available: curettage, enucleation, radical treatment and marsupialization. The marsupialization is a conservative technique used in early tumor stages, as curative treatment for the odontogenic cyst. Despite its disadvantages and controversies, the marsupialization remains an interesting therapeutic choice in the case of large cysts, or in very young or old patients. We describe, in this article, four clinical cases of odontogenic cysts. We report the surgical management and the subsequent evolution of the patients. The discussion focuses on the indications, advantages and limitations of the odontogenic cyst?s marsupialization. We review the specific conditions of the odontogenic cysts that could make the marsupialization the optimal therapeutic option. In our cases, the marsupialization proved to be a conservative technique which allowed the respect of neighboring anatomical structures, particularly in the case of large cysts, but requires prolonged clinical and radiological monitoring. Pathological entity for our cases was different. Thus, the treatment outcome may be different too. This series is very small and the reader should be cautious about drawing broad conclusions regarding the optimal therapeutic choice.
- Aneurysmal bone cyst of the mandible with conservative surgical management : a case report(2019) Alvarez Martínez, Efraín; Posso-Zapata, Mónica-Vanessa; Florez-Arango, Vanessa-Andrea; Lopera Valle, Johan Sebastián; Ardila Medina, Carlos MartínThe aneurysmal bone cyst is a nonneoplastic, osteolytic and locally destructive lesion that mainly affects the metaphyseal area of long bones and only 2% of it is diagnosed in the maxillofacial skeleton. Although surgical treatment is the most common option, it is associated to high morbidity rates. The case of an aneurysmal bone cyst of a considerable size in a 27-year-old male patient illustrating a conservative surgical approach with preservation of the dental structures in the mandible to limit aesthetic and functional side effects is presented. Two-year clinical follow-up was performed with no evidence of recurrence.
- Bilateral buccal space lipoma : a rare case presentation(2019) Goutzanis, Lampros; Chliaoutakis, Agamemnon; Kalyvas, DemosBackground: The lipoma of the oral cavity is a relatively rare pathology, characterized by overgrowth of the mature adipocytes. Buccal fat pad lipomas usually interfere with the esthetics and the function of the face. Case Presentation: A sixteen-year-old patient reported slow-growing swelling, which started two years ago. Clinical examination revealed two bilateral masses in the soft tissue. MRI imaging revealed a characteristic image of bilateral lipomas connected to the buccal fat pad. Surgical removal was conducted and the histology report confirmed our clinical diagnosis of common lipoma. Discussion: The lipoma of the buccal fat pad is a benign neoplasm of the adipose tissue. It should be removed when functional or esthetic problems occur and emphasis should be put on the correct surgical technique. Conclusions: The bilateral buccal fat pad lipoma is an extremely rare condition of the oral cavity. Surgical removal with intraoral approach is the preferable treatment, together with intense care of the anatomical structures of the buccal space.
- Detection of Candida albicans biofilm proteins induced by glucose, lactose, soy protein, and iron(2019) Listiana-Kriswandini, Indah; Budi-Rahardjo, Markus; Soesilawati, Pratiwi; Prisca-Suciadi, AileenBackground: Oral candidiasis is one of the most common fungal infections, which attack the mucosa of the oral cavity. These lesions are mostly caused by the fungal species Candida albicans. Candida albicans is included in the normal oral microorganisms that are opportunistic pathogens, and its presence is quite large, which can reach 75% of the total oral fungal population. Research on specific proteins of Candida biofilm can be an alternative to early prevention of oral infections such as Oral Candidiasis. This biofilm protein can be used as a reference in making kits to detect the presence of microbes that cause infectious diseases. The purpose of this study was to determine molecular weight of Candida albicans biofilm protein induced by 5% glucose, 5% lactose, soy protein, and 5% iron. Material and Methods: This experimental laboratory study used SDS-PAGE electrophoresis to determine the molecular weight of Candida albicans biofilm proteins induced by glucose 5%, lactose 5%, soy protein, and iron 5%. Results: Biofilm induced by 5% glucose shows four protein bands: 71,6 kDa; 56,1 kDa; 49,7 kDa; and 41 kDa. Biofilm induced by 5% lactose shows seven protein bands: 71 kDa; 61,2 kDa; 57,7 kDa; 55,3 kDa; 48,9 kDa; 39,5 kDa; and 29,8 kDa. Biofilm induced by soy protein shows one protein band: 49,4 kDa. Biofilm induced by 5% iron shows one protein band: 51,1 kDa Conclusions: Candida albicans biofilm induced by 5% glucose has four protein band candidates, 5% lactose has seven candidates of protein band, and soy protein and 5% iron each has a candidate of protein band, which can be used as a target for the detection of oral Candidiasis.
- Comparative evaluation of sealing ability, penetration and adaptation of a self etching pit and fissure sealant- stereomicroscopic and scanning electron microscopic analyses(2019) Garg, Dhruv; Mahabala, Karuna; Lewis, Amita; Natarajan, Srikant; Nayak, Anupama; Rao, AshwinBackground: The efficacy of pit and fissure sealants in preventing occlusal caries is a well-established fact. Considering the difficulty in achieving strict isolation for a longer duration while treating the pediatric patients, a simplified procedure of sealant application is desirable. While, a self-etching sealant, Prevent Seal offers a quick procedure, the physical properties of this material haven?t been studied yet. Thus, this study was aimed to comparatively evaluate sealing ability, penetration and adaptation of a self-etching pit and fissure sealant and a conventional resin sealant. Material and Methods: This was an in vitro intergroup comparative study, which consisted of 2 groups- Group I (Conventional acid etch sealant, Clinpro) and Group II (Self etching sealant, Prevent Seal). Out of 32 selected teeth 16 were used to study microleakage, with the help of dye penetration test using Övrebö and Raadal criteria. Remaining 16 were used to evaluate sealant penetration and adaptation viz bubbles in the bottom of fissure, debris in the fissure, tags in the bottom of the fissure and tags at cuspal slopes and fissure entrance was done using stereomicroscope. Post stereomicroscopic evaluation 4 samples each were randomly chosen from both the groups and checked for etching pattern using Scanning electronic microscope. Results: The comparison of tested properties between the groups was done using Chi square test. There was no statistically significant difference observed when microleakage and sealant penetration / adaptation properties were compared between two groups (p=0.63 and p= 0.131, 0.131, 0.302, 0.106 respectively). No conclusive results could be withdrawn while etching patterns were compared between the groups (p=0.717). Conclusions: The self-etching sealant Prevent seal was found to have similar microleakage, sealant penetration and adaptation properties as conventional acid etch sealant.
- A comparative evaluation between cheiloscopic patterns and the permanent molar relationships to predict the future malocclusions(2019) Ravindra, Vignesh; Rekha, Vishnu; Annamalai, Sankar; Sharmin, Ditto; Norouzi Baghkomeh, ParisaBackground: To assess the correlation between different cheiloscopic patterns with the permanent molar relationships. Material and Methods: 300 children who are 14-16 years old with completely erupted 2nd permanent molars upto occlusal table were recruited and the pattern of molar terminal plane was recorded in the proforma. Lip prints of these subjects were recorded with lipstick-cellophane method and middle 10mm of lower lip was analysed for the lip print pattern as suggested by Sivapathasundharam et al. The pattern were classified based on Tsuchihashi and Suzuki classification. Results: Type II (branched) pattern was the most predominant cheiloscopic pattern. The predominant patterns which related to the Angle?s classification were; type I (complete vertical) pattern for class I, type IV (reticular) pattern for class II and presence of type IV (reticular) pattern and absence of type I? (incomplete vertical) pattern for class III. In class III molar relationship, males showed an increased type II (branched) pattern and females showed an increased type IV (reticluar) pattern. Conclusions: Lip prints can provide an alternative to dermatoglyphics to predict malocclusions in permanent dentition. Further studies with larger sample size are required to provide an insight into its significant correlations.
- Symmetry of root and root canal morphology of mandibular incisors : a cone-beam computed tomography study in vivo(2019) Valenti-Obino, Federico; Di Nardo, Dario; Quero, Linda; Miccoli, Gabriele; Gambarini, Gianluca; Testarelli, Luca; Galli, MassimoBackground: Aim of this study was to analyze the root canal configuration in mandibular central and lateral incisors in vivo using cone-beam computed tomography (CBCT) imaging. Material and Methods: A total of 487 mandibular central incisors and 491 mandibular lateral incisors from 250 patients were examined using CBCT imaging, previously taken for diagnosis and treatment. The number of roots, root canal system configuration, presence of apical confluences, distance between confluences and radiographic root end, symmetry between left and right elements were recorded and statistically analyzed. Results: All the examined teeth presented only one root. No significant differences were found between the prevalence of two root canals in mandibular central incisors (219 teeth, 45%) compared to lateral incisors (211 teeth, 43%). Conclusions: The percentage of Vertucci type II configuration was higher than expected, being more frequent than type III. Type I was the prevalent, while other configurations were present but rare.
- Expression of endocan and vascular endothelial growth factor in recurrent minor aphthous ulcers(2019) Mahmoud, Enji A.; Moneim, Wesam-Abdel; Shaker, Olfat G.; Ghalwash, Dalia M.Background: Recurrent aphthous ulcers (RAU) are common painful inflammatory lesions of the mucous lining of the mouth. Endocan, previously identified as endothelial cell specific molecule-1, is implicated as a vital player in the regulation of several inflammatory processes. A number of inflammatory cytokines and pro-angiogenic growth factors including VEGF upregulate endothelial cells synthesis and expression of endocan. Material and Methods: Clinical scores of pain and ulcer size as well as level of endocan and VEGF were determined in swaps from aphthous ulcer and contra lateral normal mucosa in 30 patients (nine males and twenty one females) with age ranging from 18 to 45 years and mean age is 31.5 years. Results: In the early days of ulcer development, ulcer showed statistically significantly higher mean endocan (8.2 ±5.3) and VEGF levels (1220.7 ±294.6) than control healthy mucosal site (1.1 ±0.5) and (518.6 ± 61.7) respectively. An increase in endocan is associated with an increase in pain score and vice versa. A statistically significant positive correlation were also found between endocan and VEGF levels. Conclusions: Endocan and VEGF are strongly associated with the destructive phase of minor aphthous ulcers especially Endocan which was positively correlated with pain severity
- Shear bond strength of debonded ceramic restorations re-cemented by means of a cleaning and retreatment protocol(2019) Pineda Vásquez, Luisa; Fons Font, Antonio; Bustos Salvador, José Luis; Alonso Pérez Barquero, Jorge; Román Rodríguez, Juan LuisBackground: As there is no standard method for re-cementing debonded partial ceramic restorations, the aim of this study was to evaluate the use of a non-invasive thermal protocol for cleaning and retreatment, and to study its influence on shear bond strength. Material and Methods: Twenty ceramic samples (IPS e.max CAD®) were bonded to composite cement cylinders and underwent a shear bond strength test (G1, n=20). A second group was created (G2, n=20), representing debonded restorations. To simulate debonding, the samples were artificially contaminated with composite cement. After debonding, these underwent a thermal protocol to remove remaining adhesive. After rebonding to the composite cement cylinders, samples underwent the shear bond strength test. Results: Median bond strengths for G1 and G2 were 7.28±3.23; 7.06±3.41 MPa, respectively, without significant difference between the groups (p=0.983). Conclusions: Debonded lithium disilicate glass-ceramic restorations should undergo a laboratory cleaning and retreatment protocol before being returned to the clinic for rebonding.
- XRMA analysis and X-ray diffraction analysis of dental enamel from human permanent teeth exposed to hydrogen peroxide of varying pH(2019) Sabel, Nina; Karlsson, Andreas; Sjolin, LennartBackground: This in vitro investigation shows how 3.3% H2 O2 , at different pH-values affects the enamel. Material and Methods: A number of fifteen human premolars were used. The enamel of the coronal half in six of the teeth, were exposed by H2 O2 . Nine teeth were prepared to enamel powder. The enamel was exposed to 3.3% H2 O2 , at six different pH-values (pH range 4.5 - 7.0). Analyses of the topography of enamel performed by scanning electron microscope (SEM) and the chemical composition of enamel by X-ray microanalysis (XRMA). X-ray powder diffraction (XRD) analysed the crystallinity in enamel powder . Results: The exposure to H2 O2 at pH<5.5 resulted in a rougher topography of the enamel, according to the SEM studies. The XRMA analysis revealed a increase in the ratio of Ca:C. Exposure to H2 O2 at pH>5.5 resulted in a decrease of O in the exposed enamel, and changes in C:P, Ca:C, Ca:P and Ca:O were observed. The H2 O2 2 did not affect the unit cell parameters, but the signal-to-noise level was increased for slightly acidic or neutral solutions. The unit cell parameters decreased in the acidic solutions. Conclusions: The exposure to H2 O2 at varying pH values affect the enamel with two different mechanisms. One effect is the oxidation of the organic or bioorganic matter in the hydroxyapatite matrix, due to the use of 3.3% H2 O2 . The other effect is due to the current pH of the H2 O2 , since the structure of the hydroxyapatite starts to erode when the pH<5.5.
- Effect of addition of bioactive glass to resin modified glass ionomer cement on enamel demineralization under orthodontic brackets(2019) Shirazi, Maryam; Tamadon, Mohamadali; Izadi, MozhganBackground: Enamel demineralization and white spot lesions around orthodontic brackets is a common problem associated with fixed orthodontic treatment. Glass ionomer cements (GICs) are commonly used for bracket bonding and recently, bioactive glass (BAG) was added to GICs to enhance deposition of calcium phosphate in adjacent dental structure. This study sought to assess the effect of addition of BAG particles to resin modified GIC (RMGIC) on enamel demineralization under orthodontic brackets. Material and Methods: In this in vitro, experimental study, 60 sound human premolars were immersed in distilled water at 6°C. The teeth were randomly divided into three groups. Using a sticker, a window measuring 7x7 mm was created on the buccal surface. The remaining surfaces were coated with nail varnish twice with a 3-hour interval. After 24 hours, the stickers were removed. Brackets were bonded to tooth surfaces using Transbond XT (control), Fuji II LC RMGIC and Fuji II LC containing 30% BAG particles. To induce acid attacks, the teeth were immersed in demineralizing solution for 6 hours. For pH cycling, the teeth were then immersed in remineralizing solution for 18 hours. This process was repeated for 21 days. Next, the teeth were longitudinally sectioned into two halves and the depth of demineralization was measured from the deepest point to the surface under a polarized light microscope. Data were analyzed using one-way ANOVA, and pairwise comparisons were carried out using Tukey?s test. Results: The mean depth of demineralization was 73.8±22.29, 118.08±29.42 and 182.98±20.69 µm in the BAG, RMGIC and Transbond XT groups, respectively. One-way ANOVA showed significant differences in terms of depth of demineralization among the three groups (P=0.0001). Tukey?s test revealed significant differences in depth of demineralization. Conclusions: Addition of BAG to RMGIC can significantly decrease the depth of enamel demineralization under orthodontic brackets in vitro.
- Role of 0.5 M mannitol as an adjuvant with lidocaine with or without epinephrine for inferior alveolar nerve block : a randomized control trial(2019) Pathak, Pranshu-Kumar; Singh, Awadhesh-Kumar; Agrawal, Sudhanshu; Singh, Dipti; Mali, Dhananjay-Kumar; Kumar, UdayBackground: The most commonly used local anesthetic in dentistry is lidocaine. For decades, mannitol is the most widely used agent in the management of raised intracranial pressure and as prophylaxis against acute renal failure surgeries. Material and Methods: 120 patients were randomly divided into four groups, 30 patients in each group. Group A was administered 2% lidocaine with 1:80000 epinephrine; group B, 2% lidocaine with 1:80000 epinephrine and 0.5 M mannitol; group C, 2% lidocaine and 0.5 M mannitol; and group D (control group), 2% lidocaine for achieving local anesthesia. Extraction of lower erupted tooth was done under inferior alveolar nerve block. Parameters taken were onset of anesthesia, duration of anesthesia and pain. Heft-Parker visual analogue scale was taken to evaluate the pain response during procedure after every 10 minutes until complete return of sensation by probing. The Chi-square test was used to compare the pain among the groups. The continuous variables were compared among the groups by one way analysis of variance (ANOVA) followed by Tukey?s post-hoc comparison tests. The p-value <0.05 was considered significant. Results: The onset of tingling sensation was higher among the patients of group C (1.53±0.57) than group B (1.50±0.58), group D (1.48±0.51) and group A (1.45±0.62) but difference among the groups was statistically insignificant (p>0.05). The total time in return of sensation was higher among the patients of group C (70.30±4.34) than group A (65.94±3.45), group B (62.23±7.47) and group D (47.70±8.04) but difference among the groups was found to be statistically significant (p=0.0001). There was no significant (p>0.05) difference in the pain at baseline and at start. No pain was found among all the patients from 10 minutes to subsequent time intervals. Conclusions: Mannitol was effective in increasing the efficacy of lidocaine as an adjuvant to local anesthetic solution in inferior alveolar nerve block.
