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Language Journal of Clinical and Experimental Dentistry. 2014. Vol. 6, no. 5
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- Ghost cell odontogenic carcinoma: a rare case report and review of literature(2014) Martos Fernández, MÃriam; Alberola Ferranti, Margarita; Hueto Madrid, Juan Antonio; Bescós AtÃn, SocorroObjectives: Ghost cell odontogenic carcinoma is a rare condition characterized by ameloblastic-like islands of epithelial cells with aberrant keratinitation in the form of Ghost cell with varying amounts of dysplastic dentina. Material and Methods: We report a case of a 70 year-old woman with a rapid onset of painful swelling right maxillary tumor. Magnetic resonance showed a huge tumor dependent on the right half of the right hard palate with invasion of the pterygoid process and focally to the second branch of the trigeminal. Radiological stage was T4N0. The patient underwent a right subtotal maxillectomy with clear margins. Adjuvant radiotherapy was given. The patient was free of residual or recurrent disease 12 months after surgery. Results: The tumor was 3,9cm in diameter. It was spongy and whitish gray. Microscopically the tumor was arranged in nets and trabeculae, occasionally forming palisade. Tumoral cells had clear cytoplasm with vesicular nuclei. There was atipia and mitosi with vascular and perineural invasion. The excised tumor was diagnosed as a GCOC. Conclusions: Ghost cell carcinoma is a rare odontogenic carcinoma. Its course is unpredictable, ranging from locally invasive tumors of slow growth to highly aggressive and infiltrative ones. Wide surgical excision with clean margins is the treatment of choice although its combination with postoperative radiation therapy, with or without chemotherapy, remains controversial.
- An unusual case report of basal cell adenoma: a diagnostic enchanter(2014) Gupta, Swati; Rehani, Shweta; Mehendiratta, Monica; Kumra, Madhumani; Gupta, Ramakant; Jain, KanuOral lesions show a wide range of biologic behaviours. There are various lesions which may mimic others and present in such an unusual manner thus making them very difficult to diagnose clinico-pathologically. An accurate diagnosis is not only important for correct treatment planning but also for determination of prognosis. Thus, it is very important for a surgical pathologist to be aware of the various atypical presentations of the lesions. The present unusual case report of basal cell adenoma occurring on upper lip with frank areas of calcifications and abundant inspissated mucoid secretions is an example of one such case. BCA is an uncommon benign epithelial salivary gland neoplasm. It is one of the nine subcategories of salivary gland epithelial tumours according to WHO 2005 classification of salivary gland tumors. It is composed of basaloid cells organized with a prominent basal cell layer and distinct basement membrane-like structure and no myxochondroid stromal component as seen in pleomorphic adenomas. To our best knowledge, no case in English literature has been reported BCA with exuberant inspissated mucoid secretions and frank areas of calcifications to such a large extent and this is the first case to report the same.
- Ossifying odontogenic fibroma: a rare case report(2014) Amaral, Márcio Bruno Figueiredo; Souto, Giovanna Ribeiro; Horta, Martinho Campolina Rebello; Gomez, Ricardo Santiago; Mesquita, Ricardo AlvesOdontogenic fibroma (OF) is a rare benign odontogenic neoplasm that is most commonly found in the mandibular/ premolar region of female patients in the second to fourth decades of life. Well-defined radiolucent lesions that may induce root resorption are normally observed. Rare variants of OF have been described in the prior literature, including references to: 1) giant cell lesions, 2) amyloid-like protein deposition, and 3) ossifying variants. Immuno - histochemistry can contribute to understanding the biological behavior and the pathogenesis of OF. Therefore, this case report aimed to describe a new case of ossifying OF and discuss the histopathology and immunohistochemical features.
- Cavernous hemangioma of the parotid gland in adults(2014) Lara Sánchez, Hugo; Peral Cagigal, B.; Madrigal Rubiales, Beatriz; Verrier Hernández, AlbertoHemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, never - theless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults.
- Restore the natural: a review and case series report on reattachment(2014) Jagannath Torvi, Sourabh; Kala, M.Reattachment of the original tooth fragment to the fractured tooth helps in maintaining the tooth's color, wear resistance, morphology and translucency in the restoration. This article describes the reattachment of fractured fragment using a fiber post and dual cure resin cement with a self-etching adhesive. Two young male patients reported with a complicated crown fracture of the right maxillary central incisor due a road traffic accident. The fractured fragments were loosely attached to the palatal gingival tissue, which was then surgically removed and preserved for the reattachment procedure. The fractured tooth segments were successfully reattached following fiber post cementation. Tooth fragment reattachment procedure offers ultraconservative, safe, fast and esthetically pleasing results when the fractured fragment is available due to the improvement of adhesive techniques and restorative materials. Fiber reinforced resins not only allows creation of esthetic restoration but also the preservation and reinforcement of tooth structure. At the 18months follow-up, the resultant appearance was acceptable to the patient.
- Ameloblastic fibroma: a rare case appearing as a mixed radiographic image(2014) Castro, Jurema Freire Lisboa de; Correia, Andreza Veruska Lira; Santos, Lucas Alexandre Moraes; Guerra, Luiz Antônio Portela; Ramos Perez, Flávia Maria de Moraes; Perez, Danyel Elias da CruzAmeloblastic fibroma (AF) is a benign tumor of mixed odontogenic origin, which affects predominantly young individuals. AF appearing as a mixed radiographic image is very rare. This report describes a case of AF in a 12- year-old male identified during a routine radiographic exam for orthodontic treatment planning. The panoramic radiography revealed a well-defined multilocular mixed image located in the mandible between the roots of the left mandibular second premolar and first molar. The lesion was excised under local anesthesia. Histopathological analysis revealed islands of epithelial cells and columnar peripheral cells showing a nucleus in inverted polarization, interspersed with spindle-shaped cells and abundant extracellular matrix deposition. No atypia was observed. The diagnosis of AF was established. No tumor recurred up to 30 months after treatment. Although rare, AF should be also considered in the differential diagnosis of mixed radiographic images of the jaws in young patients.
- Current treatment of oral candidiasis: a literature review(2014) Garcia Cuesta, Carla; Sarrión Pérez, MarÃa Gracia; Bagán Sebastián, José VicenteCandidiasis or oral candidosis is one of the most common human opportunistic fungal infections of the oral cavity. This pathology has a wide variety of treatment which has been studied until these days. The present study offers a literature review on the treatment of oral candidiasis, with the purpose of establish which treatment is the most suitable in each case. Searching the 24 latest articles about treatment of candidiasis it concluded that the incidence depends on the type of the candidiasis and the virulence of the infection. Although nystatin and amphotericin b were the most drugs used locally, fluconazole oral suspension is proving to be a very effective drug in the treatment of oral candidiasis. Fluconazole was found to be the drug of choice as a systemic treatment of oral candidiasis. Due to its good antifungal properties, its high acceptance of the patient and its efficacy compared with other antifungal drugs. But this drug is not always effective, so we need to evaluate and distinguish others like itraconazole or ketoconazole, in that cases when Candida strains resist to fluconazole.
- A retrospective study of 171 patients with oral lichen planus in the East Bohemia - Czech Republic - single center experience(2014) Radochová, VladimÃra; DrÃzhal, Ivo; Slezák, RadovanObjectives: Oral lichen planus is chronic inflammatory disease with a high prevalence in the population. This study describes the epidemiological and clinical characteristics of group of patients with oral lichen planus in the Czech Republic. Material and Methods: Data was taken from the medical records of 171 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové with histologically confirmed clinical diagnosis of oral lichen planus in the period 2003 - 2013. The data were retrospectively reviewed. Results: Of the 171 patients, 116 (67.8%) were women and 55 (32.2%) were men. The mean age was 55.2 ± 12.4 years (range of 85.0 - 20.9). The reticular form was the most frequent 93.6% (160 pts.), desquamative gingivitis was 12.9% (22). The buccal mucosa was the site most affected 89.5% (153 pts.). The lesions were asymptomatic in 52 patients (30.4%). Extraoral lesions were observed in 20.5% (35 pts.) of the patients, skin involvement was in 16.4% (28 pts.). Smokers were 29 patients. Local treatment used 116 (67.8%), only 6 patients used systemic short tome corticoid therapy. No evidence between OLP and malignant transformation was observed. Conclusions: This retrospective study show very similar profile and clinical features of the patients with OLP as in other studies.
- Areca nut and its role in oral submucous fibrosis(2014) Prabhu, Rachana V; Prabhu, Vishnudas; Chatra, Laxmikanth; Shenai, Prashant; Suvarna, Nithin; Dandekeri, SavitaAreca nut, commonly called as betel nut or supari, is a fruit of areca catechu palm tree, which is native of South Asia and Pacific Islands. The seed or endosperm is consumed fresh, boiled or after sun drying or curing. Chewing areca nut is thought to have central nervous system stimulating effect and along with this it is known to have salivary stimulating and digestive properties. According to the traditional Ayurvedic medicine, chewing areca nut and betel leaf is a good remedy against halitosis. It is also used for its deworming property. Along with these beneficial effects of areca nut one of its most harmful effects on the human body in general and oral cavity in particular is the development of potentially malignant disorder called Oral Submucous Fibrosis. The present paper discusses in detail the effects of the components of areca nut on pathogenesis of Oral Submucous Fibrosis.
- Retention of a resin-based sealant and a glass ionomer used as a fissure sealant in children with special needs(2014) Morales Chávez, Mariana Carolina; Nualart Grollmus, Zacy CarolaObjectives: The aim of this research is to evaluate the retention of sealants of resin and resin-modified ionomeric glass pits and fissures, on first permanent molars of special patients. Material and Methods: The sample was comprised by 32 children. The ages were between 7 and 18 years. The sealing procedure was made with the relative isolation of the molars to be sealed, through the use of cotton rolls. Two molars were sealed with Clinpro Sealant 3M Dental and the others with Vitremer. Checking of the sealants was made after 3 and 6 months of their placement, evaluating with 3 values: TR: Totally Restrained; PR: Partially Restrained; and CL: Completely Lost. Results: 67.18% of the resinous sealants, and 70.31% of the glass ionomer sealants were successful after three months. After six months, 57.81% of the resin-based sealants and 51.56% of the glass ionomer sealants were successful. When performing the Chi-square statistical analysis ( P <0.05) no statistical significance was observed after 6 months. Conclusions: The retention of the resin sealant was similar to that of the glass ionomer cement at the end of six months and the retention of sealants on maxillary teeth was higher than on mandibular teeth.
- Transcutaneous electric nerve stimulation (TENS) in dentistry: a review(2014) Kasat, Vikrant O.; Gupta, Aditi; Ladda, Ruchi; Kathariya, Mitesh; Saluja, Harish; Farooqui, Anjum AraTranscutaneous electric nerve stimulation (TENS) is a non-pharmacological method which is widely used by medical and paramedical professionals for the management of acute and chronic pain in a variety of conditions. Similarly, it can be utilized for the management of pain during various dental procedures as well as pain due to various conditions affecting maxillofacial region. This review aims to provide an insight into clinical research evidence available for the analgesic and non analgesic uses of TENS in pediatric as well as adult patients related to the field of dentistry. Also, an attempt is made to briefly discuss history of therapeutic electricity, mechanism of action of TENS, components of TENs equipment, types, techniques of administration, advantages and contradictions of TENS. With this we hope to raise awareness among dental fraternity regarding its dental applications thereby increasing its use in dentistry.
- Age estimation using the radiographic visibility of the periodontal ligament in lower third molars in a Portuguese population(2014) Sequeira, Catarina Dourado; Teixeira, Alexandra; Caldas, Inês Morais; Afonso, Américo; Mongiovi, Daniel PérezObjectives: The mineralization of third molars has been used repeatedly as a method of forensic age estimation. However, this procedure is of little use beyond age 18, especially to determinate if an individual is older than 21 years of age; thus, the development of new approaches is essential. The visibility of the periodontal ligament has been suggested for this purpose. The aim of this work was to determine the usefulness of this methodology in a Portuguese population. Study Design: Periodontal ligament visibility was assessed in the lower third molars, using a sample of 487 orthopantomograms, 228 of which belonging to females and 259 to males, from a Portuguese population aged 17 to 31 years. A classification of four stages based on the visual phenomenon of disappearance of the periodontal ligament of fully mineralized third molars was used. For each stage, median, variance, minimal and maximal age were assessed. Results: The relationship between age and stage of periodontal ligament had a statistical significance for both sexes. In this population, stage 3 can be used to state that a male person is over 21 years-old; for females, another marker should be used. Conclusions: This technique can be useful for determining age over 21, particularly in males. Differences between studies are evident, suggesting that specific population standards should be used when applying this technique.
- Cephalometric evaluation of soft tissue changes after extraction of upper first premolars in class II div 1 patients(2014) Amirabadi, Gholamreza-Eslami; Mirzaie, Marzieh; Kushki, Somayyeh-Mehrabi; Olyaee, PooyaIntroduction: Tooth extraction to provide sufficient space, or camouflage of underlying skeletal problems is quite common in orthodontics. The present study evaluated soft tissue changes after upper first premolars extraction in class II div 1 patients. Material and Methods: 20 cases (15 females, 5 males), with a mean age of 17.8±2.9 years with class II div1 malocclusion and normal vertical height, who needed upper first premolars extraction were selected. Pre- and post- treatment lateral cephalometric radiographs were digitized. Image analysis was conducted by View Box 3.1.1 software. Paired t-test was used for comparison of pre- and post-treatment results. Results: The relationship of upper and lower lip to E-line and B-line had significant reduction. Dental variables of U1-NA(mm), U1-NA(°), overjet and overbite showed statistically significant reduction. Interincisal angle had significant increase. There were no significant difference in lower incisor variables and skeletal variables like SN- GoGn and FMA. Conclusions: Extraction of upper first premolars in patients with class II div 1 malocclusion resulted in normal position of lips as presented by Holdaway, Legan and Ricketts which play a role in aesthetic profile. However, the amount of lip retraction was different from patient to patient.
- The therapeutic effects of chamomilla tincture mouthwash on oral aphthae: a randomized clinical trial(2014) Seyyedi, Seyyed Amir; Sanatkhani, Majid; Pakfetrat, Atessa; Olyaee, PooyaIntroduction: Recurrent aphthous stomatitis (RAS) is a common clinical condition producing painful ulcerations in the oral cavity. However, there has been no optimal therapeutic approach. Topical and systemic steroids commonly prescribed for the condition have local and systemic side-effects. Recently, there is growing tendency toward herbal medication in the modern society. The objective of this study was to assess the efficacy of a chamomilla mouth rinse on reducing the signs and symptoms of aphthous lesions in comparison with a placebo mouth rinse. Material and Methods: A randomized, triple-blind, placebo-controlled trial was performed on 36 patients, from cases diagnosed with RAS, attending the Department of Oral Medicine, Mashhad University of Medical Sciences. They were randomly divided into two groups: the intervention group(A), receiving chamomilla mouth rinse, and the control group (B) receiving a placebo rinse. The ability of the solution to control the pain and burning sensation and the number and size of the ulcers were evaluated. Results: The number of ulcers in the 3 rd visit (four days after treatment) showed a significant difference between the groups ( P <0.001). The pain and burning sensation (VAS) was reduced significantly in the test group in the 2 nd ( p =0.001),3 rd and 4 th visit ( P <0.001). Conclusions: Chamomilla mouth rinse was effective in the treatment of RAS, controlling the pain and burning sensation without producing any adverse side effects and can be advised as an alternative RAS treatment.
- A parent motivational interviewing program for dental care in children of a rural population(2014) González Del Castillo McGrath, Mauricio; Guizar Mendoza, Juan Manuel; Madrigal Orozco, Catalina; Anguiano Flores, Laura; Amador Licona, NormaObjectives: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. Study Design: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. Results: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p <0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p <0.0001). Bacterial plaque determined by the O'Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p = 0.002) respectively. Conclusions: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque.
- Comparison of anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis(2014) Sood, Ravi; Hans, Manoj-Kumar; Shetty, ShashitObjectives: This study was done to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine with that of 2% lidocaine with 1:80,000 epinephrine during pulpectomy in patients with irreversible pulpitis for inferior alveolar nerve block in mandibular posterior teeth. Material and Methods: Patients with irreversible pulpitis referred to the Department of Conservative Dentistry and Endodontics, K.D. Dental College, randomly received a conventional inferior alveolar nerve block containing 1.8 mL of either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine. After the patient's subjective assessment of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation was recorded and the absence/presence of pain was recorded through visual analogue scale. Results: The pulpal anesthesia success for articaine (76%) was slightly more than with lidocaine (58%) as measured with pulp tester as well as for the pain reported during the procedure the success rate of articaine (88%) was slightly more than that of lidocaine (82%) although the difference between the two solutions was not statistically significant. Conclusions: Both the local anesthetic solutions had similar effects on patients with irreversible pulpitis when used for inferior alveolar nerve block.
- Condylar distances in hypermobile temporomandibular joints of patients with excessive mouth openings by using computed tomography(2014) Haghigaht, Abbas; Davoudi, Amin; Rybalov, Oleg; Hatami, AminObjectives: hypermobility in Temporomandibular joint (TMJ) can manifest higher range of motions in mandible. The aim of this study was to compare the position and distances of the head of condyle to glenoid fossa in TMJs of healthy individuals and patients with mild, moderate and severe TMJ hypermobility. Material and Methods: In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of joint hypermobility were included and Computed tomography were administered for both TMJs. The patients were divided into three groups based on their maximum mouth opening (MMO): (A) with MMO of 50-55 mm; (B) with MMO between 55 to 65 mm; and (C) with MMO >65 mm. Also, 15 healthy people with profiled tomography in the last 6 months were assumed as control group (N) with normal MMO (<50 mm). The position of condyle from articular eminence while MMO; and the distances from anterior, superior and posterior border of condyle and facing wall of glenoid fossa were measured in closed mouth from the tomography of all contributors. The collected data were analyzed by one-way ANOVA, Post Hoc and Chi-Square tests using SPSS software version 15 at significant level of 0.05. Results: The superior and posterior distances were significantly higher in groups A, B and C than healthy individuals (all P values<0.01). The anterior distance was significant between groups B and N only in right TMJ ( P =0.013). Conclusions: TMJ hypermobility showed the characteristic of increased condylar distance in posterior and superior specially in higher excessive mouth opening.
- Bulk filling of Class II cavities with a dual-cure composite: effect of curing mode and enamel etching on marginal adaptation(2014) Bahillo Varela, José; Bortolotto, Tissiana; Roig Cayón, Miguel; Krejci, IvoObjectives: This study attempted to find a simple adhesive restorative technique for class I and II cavities on posterior teeth. Study Design: The tested materials were a self-etching adhesive (Parabond, Coltène/Whaledent) and a dual-cure composite (Paracore, Coltène/Whaledent) used in bulk to restore the cavities. Class II MO cavities were performed and assigned to 4 groups depending on the orthophosphoric acid (H 3 PO 4 ) conditioning of enamel and polymerization method used (chemical or dual). Specimens were subjected to quantitative marginal analysis before and after thermo-mechanical loading. Results: Higher percentages of marginal adaptation at the total margin length, both before and after thermo-mechanical loading, were found in groups in which enamel was etched with phosphoric acid, without significant differences between the chemically and dual-cured modes. The restorations performance was similar on enamel and dentin, obtaining low results of adaptation on occlusal enamel in the groups without enamel etching, the lowest scores were on cervical dentin in the group with no ortophosphoric acid and self-cured. Conclusions: A dual-cure composite applied in bulk on acid etched enamel obtained acceptable marginal adaptation results, and may be an alternative technique for the restoration of class II cavities.
- A comparative study of fluoride release from two different sealants(2014) Ananda, SR.; Mythri, H.Objectives: The introduction of fluoride releasing sealants and glass ionomer cements as fissure sealants adds another dimension to prevention of pit and fissure caries. The ability of resin sealants and glass ionomer cements to release fluoride on a long term basis to the sealed enamel and the adjacent unsealed pit and fissure and cuspal in - cline enamel may allow for further reduction in pit and fissure caries experience for children. Hence, the study was conducted to compare the amount of fluoride release in the plaque after placing fluoride releasing pit and fissure sealants and glass ionomer fissure sealants used in Atraumatic Restorative Treatment (ART) approach. To compare the fluoride release of both the materials at the different time intervals. Material and Methods: A total of 60 school going children were included in this study. Before application of the sealants, baseline plaque fluoride levels were estimated from all the study subjects. After application of sealants again the same was estimated at an interval of 24 hour, 9 days, 2 weeks and 4 weeks. Results: The peak plaque fluoride levels were achieved at 24 hours after application of fissure sealants in all the groups. Conclusions: Within the limitation of the study, the present study indicated that fluoride releasing fissure sealants may act as a source of fluoride in plaque which will help in preventing pit and fissure and smooth surface caries in the tooth sealed with fissure sealants.
- Incidence and factors associated with flare-ups in a post graduate programme in the indian population(2014) Pamboo, Jaya; Hans, Manoj-Kumar; Kumaraswamy, B.N.; Chander, Subhash; Bhaskaran, SajeevObjectives: The study had twin objectives: to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment in the Department of Conservative Dentistry and Endodontics in Vyas Dental college and hospital, Jodhpur during a period of one year, and also to examine the correlation with pre-operative and operative variables. Material and Methods: Data was collected from 1023 teeth from 916 patients who had received endodontic treatment over a 12- month period. Information was obtained for each patient treated, including pulp and peri-radicular diagnosis for the tooth, presence of pre-operatory pain, type of medication being used, type of instrumentation technique used and number of appointments needed to complete the root canal treatment. Results: The results showed an incidence of 2.35% for flare-ups from 1023 endodontically treated teeth. Statistical analysis was done using the chi-square test. Conclusions: Flare-ups were found to be affected significantly by gender of patient, presence of radiolucent lesions, patients taking pre-operative analgesic or anti-inflammatory drugs and on type of instrumentation technique. In contrast, there was no correlation between flare-ups and age, different arch/tooth groups and single or multiple visit endodontics.
