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Language Journal of Clinical and Experimental Dentistry. 2011. Vol. 3, no. 1
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- A rare case of congenital absence of permanent canines associated with other dental anomalies(2011) GunaShekhar, M.; Srinivas Rao, K.; Dutta, B.Agenesis of permanent canines is a rare condition and that of both maxillary and mandibular permanent canines is extremely rare. Reports of such cases are very scarce in the literature. It may occur either isolated or in association with other dental anomalies. This paper reports an unusual case of agenesis of both the maxillary permanent canines and mandibular right permanent canine occurring in association with congenitally missing mandibular permanent central incisors and microdontic maxillary lateral incisors in a 10 year-old Indian male.
- Oral manifestations and dental management of patient with leukocyte alterations(2011) Mancheño Franch, Aisha; Gavaldá Esteve, Carmen; Sarrión Pérez, María GraciaLeukocytes are the main cellular elements of inflammatory and immune reactions of the organism. Leukocyte alterations are the consequence of an imbalance between the formation of leukocytes in the bone marrow and its elimination by the mononuclear phagocytic system. Factors that can modify leukopoyesis are varied and can lead to an alteration in the number of leukocytes or tumoral alterations of white cells (leukemias, lymphomas and plasma cell tumors). There is also a wide range of clinical manifestations that can derive from them: from very slight symptoms to life-threatening conditions. In some cases oral manifestations will be the first signs and it will be the dentist’s responsibility to identify the underlying disorder and guide the diagnosis of the patient. It is important to be familiar with the special management required for these patients, in which the dental treatment can affect the course of the underlying disease. The objective of this article is to review the literature concerning the oral manifestations and the considerations that must factor in the dental treatment of patients with leukocyte alterations.
- Cemento-ossifying fibroma of the mandible: presentation of a case and review of the literature(2011) Silvestre Rangil, Javier; Silvestre Donat, Francisco Javier; Requeni Bernal, JuanIntroduction: Cemento-ossifying fibroma is a benign fibro-osseous maxillary tumor belonging to the same category as fibrous dysplasia and cement-ossifying dysplasia. The aim of present study was report a case of cement-ossifying mandibular fibroma and offers a review of the literature on this disorder. Case report: A 41-year-old woman presented for conventional dental treatment. A control panoramic X-ray study revealed a rounded, mixed-type image in the mandible, located in the periapical zone from tooth 4.3 to 3.3. The patient presented no symptoms and had no medical history of interest. A sample of the lesion was obtained for histopathological study, which yielded a definitive diagnosis of cemento-ossifying fibroma. Discussion: The World Health Organization classifies cemento-ossifying fibroma as a fibro-osseous neoplasm included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential to for fibrous tissue, cement and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Although the underlying cause is not known, there have been reports of past trauma in the area of the lesion. Due to the good delimitation of the tumor, surgical removal and curettage is the treatment of choice.
- Atypical ameloblastoma - an enigma in diagnosis: review of literature and report of a case(2011) Thomas-George, Bibin; Bishen, Kundendu A.Ameloblastoma, a benign neoplasm of jaw bones is the most common of all odontogenic tumors. Its pathology is generally well understood and is easy to diagnose. This article presents a rare case of an ameloblastoma with atypical features depicting an example of the diagnostic difficulty posed by some ameloblastomas and briefly reviews the classification and literature of odontogenic malignancies. This case is unusual in the fact that although the clinical presentation was suggestive of a malignancy, the histological features were not sufficient to warrant the lesion as malignant. Albeit, the features of epithelial dedifferentiation were evident at post operative histopathological evaluation but no proof was available to authenticate frank metastasis or carcinoma. The case was diagnosed as an atypical ameloblastoma and frequent follow up was recommended. This article discusses about ameloblastic carcinoma, other odontogenic malignancies and emphasizes the need for standardization and quantification of the fundamental concepts of odontogenic malignancies for more reliable and early diagnosis for better treatment and prognosis
- Dental management in transplant patients(2011) Carlos Fabuel, Laura; Gavaldá Esteve, Carmen; Sarrión Pérez, María GraciaIntroduction: Transplant is the replacement with therapeutic purposes, of organs, tissues or cellular material for others, from a donor who is usually a human, alive or dead. In recent years, transplant organs have been developed by the advances that have occurred with immunosuppressive drugs and medical-surgical technology. Due to the frequency of transplants that are performed today, it is common to find these patients in dental clinics. Objectives: To review the literature on oral manifestations in transplant patients and general dental management and according to transplant organs (heart, lung, liver, kidney, pancreas and bone marrow). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 30 articles (eight literature reviews, three randomized clinical trials, one cohort study, three case-control studies, eight clinical case series and seven cross-sectional studies). Results and discussion: We describe the most common oral manifestations in transplant patients (viral, bacterial and fungal infections, gingival enlargement secondary to drug therapy and higher risk in the development of oral malignancy) and the special dental management that should be carried out on these patients, generally and specifically according to the type of transplant.Introduction: Transplant is the replacement with therapeutic purposes, of organs, tissues or cellular material for others, from a donor who is usually a human, alive or dead. In recent years, transplant organs have been developed by the advances that have occurred with immunosuppressive drugs and medical-surgical technology. Due to the frequency of transplants that are performed today, it is common to find these patients in dental clinics. Objectives: To review the literature on oral manifestations in transplant patients and general dental management and according to transplant organs (heart, lung, liver, kidney, pancreas and bone marrow). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 30 articles (eight literature reviews, three randomized clinical trials, one cohort study, three case-control studies, eight clinical case series and seven cross-sectional studies). Results and discussion: We describe the most common oral manifestations in transplant patients (viral, bacterial and fungal infections, gingival enlargement secondary to drug therapy and higher risk in the development of oral malignancy) and the special dental management that should be carried out on these patients, generally and specifically according to the type of transplant.
- Bone height measurement of maxillary and mandibular bones in panoramic radiographs of edentulous patients(2011) Ural, Çağrı; Bereket, Cihan; Sener, Ýsmail; Aktan, Ali Murat; Akpinar, Yusuf ZiyaObjectives. The purpose of this in vitro study were to determine variation in maxillary and mandibular vertical measurements and to assess vertical bone loss made from panoramic radiographs in edentulous measurements. Study Design. In this descriptive study, a total of 600 panoramic radiograph’s of edentulous patient were examined. The mean ages of edentulous patients were 31 and 87 years respectively. Measurements were made from reference lines drawn from anatomic landmarks on standardized panoramic rediographs. All radiographs were made using a standardized manner by the same technician. Twelve sites were measured on every panoramic radiograph whenever possible, five sites in the maxilla and seven sites in the mandible. Results. In the maxilla all vertical measurements distance were significantly greater in the edentulous men than in the edentulous women (p<0,05). In the mandible all vertical measurements distance were significantly greater in the edentulous men than in the edentulous women (p<0,05). Conclusion. The results of this study may guide clinicians to make primer decision of implant insertion area for implant supported prosthesis in edentulous patients
- Dental considerations for the patient with diabetes(2011) Martí Álamo, Silvia; Jiménez Soriano, Yolanda; Sarrión Pérez, María GraciaDiabetes mellitus (DM) is one of the most frequent pathologies that dentists encounter, due to its high prevalence worldwide. It is diagnosed by the repeated obtaining of fasting plasma glucose levels of 126 mg/ dl or higher, or glycosylated hemoglobin of 6’5% or higher. Diabetes (especially if it is not well controlled) brings with it a greater risk of periodontal disease, which is the most frequent complication. On the other hand, the possible influence of periodontal disease on glycemic control is still not well established. Other reported manifestations are xerostomia, sialadenosis and burning mouth syndrome. With regard to dental caries, oral lichen planus and candidosis, recent studies have not revealed a significantly higher incidence in these patients. For dental treatment, the type of diabetes suffered, the treatment given for the disease, and the glycemic control status (using the glycosylated hemoglobin test) should be known. Patients should receive short morning appointments to reduce stress. The dentist has to be aware of the possible occurrence of an acute complication (hypoglycemia or hyperglycemia). Furthermore, these patients suffer from delayed wound healing and major susceptibility to infections.
- Dental treatment considerations in the chemotherapy patient(2011) Chaveli López, Begonya; Gavaldá Esteve, Carmen; Sarrión Pérez, María GraciaCancer patients can suffer oral toxic effects secondary to antineoplastic therapy in the form of radiotherapy and/ or chemotherapy. This risk is conditioned by a range of factors, including the high cell turnover rate of the oral mucosa, the diversity and complexity of the oral microflora, and soft tissue trauma during normal oral function. The present study offers a literature review of the main oral complications secondary to chemotherapy, and describes the different options for dental treatment before, during and after oncological treatment, published in the scientific literature. To this effect a PubMed-Medline® search was made using the following keywords: chemotherapy, cancer therapy, dental management, oral mucositis, neurotoxicity, intravenous bisphosphonates and jaw osteonecrosis. The search was limited to human studies published in the last 10 years in English or Spanish. A total of 50 articles were identified: 17 research papers, 25 reviews, 6 letters to the Editor, and two clinical guides developed by expert committees. The data obtained showed the main oral complications of chemotherapy to be mucositis, neurotoxicity, susceptibility to infections, dental, salivary and taste alterations, and the development of osteonecrosis. Based on the reviewed literature, elective dental treatment can be provided before chemotherapy, with emphasis on the elimination of infectious foci. During chemotherapy, dental treatment should be limited to emergency procedures, while dental treatment of any kind can be prescribed after chemotherapy – with special considerations in the case of patients who have received treatment with intravenous bisphosphonates
- Establishing a diagnostic tool for assessing optimal treatment timing in Indian children with developing malocclusions(2011) Gupta, Kanu Priya; Garg, Shalini; Grewal, Partapjot SinghObjective: To interrelate chronological age, cervical vertebrae maturational stage and dental calcification stages and to establish latter as first level diagnostic tool to estimate timing of pubertal growth spurt. Materials and Methods: Sample derived from pretreatment panaromic and lateral cephalometric radiographs of patients 8-14 years old. Study sample divided into three groups depending upon Angle’s molar relation: Group I, Group II, Group III. According to chronological age, into: Group A: 8-11 years Group B:11-14 years, further separating males and female subjects in each group. Demirjian et al method was used to assess dental maturity and for skeletal maturity the New Improved Version of Cervical Vertebrae Maturation Method by Baccetti, Franchi and Mc Namara. Statistical analysis was performed using SPSS software package. Chi Square test and Spearman rank-order correlation coefficients measured the association between skeletal maturity indicators and dental calcification stages and statistical significance tested. Results&Conclusions: In females, permanent mandibular second molar Stage E signified circumpubertal phase corresponding with skeletal age CVMS II and for males, it was permanent mandibular first premolar stage E. Early orthodontic interventions for Angle’s Class I and Class II malocclusions should be performed at the circumpubertal period represented by CVMS II in Indian children and for Angle’s Class III malocclusion, facemask therapy beneficial in the prepubertal phase. Females showed higher significant correlation among skeletal and dental calcification stages compared to males.
- The prevalence of oral mucosal lesions in the patients visiting a dental school in Northern India in relation to sex, site and distribution: A retrospective study.(2011) Gambhir, Ramandeep Singh; Veeresha, Koratagere Lingappa; Sohi, Raman; Kakkar, Heena; Aggarwal, Amit; Gupta, DeepakObjective: To determine the distribution of oro-mucosal lesions in patients of Maharishi Markendeshwer College of Dental Sciences and Research, (MMCDSR), Mullana. Further to identify sex predilection and different sites which are more susceptible to different oro-mucosal lesions. Materials and methods: A hospital based retrospective study was carried out from 1st January 2007 till 31st December 2009 at (MMCDSR), Mullana. A total of 451 biopsy reports were studied. Distribution and prevalence of oro-mucosal lesions among the data were analyzed using SPSS software package version 13. Results: There was no mention of habits in the biopsy reports of 85.4 % (385 patients) of the subjects. Out of the 66 subjects whose habits were mentioned, 71.2 % (47 patients) used to smoke tobacco in one form or the other. 21.2 % (14 patients) used to chew tobacco, 4.5 % (3 patients) of the subjects were in the habit of both smoking and chewing tobacco. More percentage of females 53.1 % were present in the age-group of 11-20 years as compared to males 46.9 % whereas in all other age-groups males were more in number. Regarding the distribution of oral lesions in the oral cavity, buccal mucosa was the common site for the presence of potentially malignant disorders in 16.8 % of the subjects and it was also the most common site for all the lesions. Conclusion: Lesion prevalence differed significantly by age, sex, and tobacco use. Individual demographic details such as age, gender, occupation, food habits, other deleterious oral habits, religion and oral hygiene measures should have a provision in biopsy request sheet and should be duly filled which will help in identifying risk-groups. Community programmes should be taken for public health to get them screened for any oral-mucosal lesions by availing pathological lab facilities.
- Comparative analysis of mast cell count in normal oral mucosa and oral pyogenic granuloma(2011) Kamal, Reet; Dahiya, Parveen; Palaskar, Sangeeta; Shetty, V.P.Introduction: Mast cells are large granular cells that arise from a multipotent CD 34+ precursor in the bone marrow normally distributed throughout connective tissues. The most common method to study role of mast cells in any altered condition involves their identification and quantification in that condition and compare the values with that of the normal average count or number of mast cells. The present study was thus, undertaken to identify as well as quantify mast cells in oral pyogenic granuloma and compare it with the average count of mast cells in normal oral mucosa, thus aiming to assess the changes in count of mast cells in oral pyogenic granuloma. Materials and Methods: Ten cases of normal oral mucosa and thirty cases of oral pyogenic granuloma were studied for mast cell number using 1% toluidine blue. Results: An increase in mast cell number was observed in oral pyogenic granuloma. The mast cell count/high power field in pyogenic granuloma and normal oral mucosa was 10.27 and 4.58 respectively. There is a statistically significant increase in the mean of average mast cell count per high power field in oral pyogenic granuloma in comparison to normal oral mucosa. These facts may morphologically indicate a possibility of a role of mast cells in angiogenesis and recruitment of inflammatory cells which are characteristic features of oral pyogenic granuloma
