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Language Journal of Clinical and Experimental Dentistry. 2011. Vol. 3, no. 2
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- Dental considerations in patients with heart disease(2011) Cruz Pamplona, Marta; Jiménez Soriano, Yolanda; Sarrión Pérez, María GraciaSummary: Cardiovascular diseases are one of the main causes of death in the developed world, and represent the first cause of mortality in Spain. In addition to their associated morbidity, such disorders are important due to the number of affected individuals and the many patients subjected to treatment because of them. Objective: An update is provided on the oral manifestations seen in patients with arterial hypertension, ischemic heart disease, arrhythmias and heart failure, and on the dental management of such patients. Material and methods: A Medline-PubMed search was conducted of the literature over the last 10 years using the keywords: “cardiopathy”, “dental management”, “endocarditis”, “hypertension” and “arrhythmia”. A total of 31 articles were reviewed, of which 22 were literature reviews, three were expert committee guides, four clinical trials and two case series. Results: The drug treatments used by these patients can give rise to oral manifestations in the form of xerostomia, lichenoid reactions, burning mouth sensation, loss of taste sensation, gingival hyperplasia and bleeding, as well as extraoral manifestations such as sialadenosis. An inadequately controlled cardiological patient constitutes a risk case in dental practice; dental surgeons therefore must take a series of aspects into account before treating such patients, in order to avoid complications.
- Effect of different cryosurgical protocols using liquid nitrogen on bone tissue: a histomorphological analyze(2011) Gurgel Costa, Fábio Wildson; Brito, Gerly Anne de Castro; Pessoa, Rosana Maria Andrade; Studart Soares, Eduardo CostaThe aim of the present experimental study was to evaluate the morphological effects of different liquid nitrogen cryosurgery protocols on bone tissue. The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphologically. Histologically, an increase in bone necrosis was observed for the two protocols in the second week after cryotherapy. A significant osteogenic phase was observed after 4 weeks. Moreover, complete remodeling process was encountered at the end of the morphological observation period (12 weeks), especially on oneminute protocol. Thus, this study indicated that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. In addition, the second experimental week was critical for bone necrosis with either cryotherapy protocol. Further studies are important for the understanding of the long-term behavior of bone tissue after cryoapplication of liquid nitrogen
- Comparison of Partial Recording Protocols in Disease Assessment among Periodontitis Patients in a Central Indian Population(2011) Anand, Pradeep S.; Kamath, Kavitha P.; D' Souza, Neevan D RObjectives: Partial recording protocols may be used for the purpose of assessing periodontal disease extent and severity in epidemiological studies. As there is very little data at present regarding the reliability of any partial examination methods among Indian populations, as an initial study, an attempt was made to determine the reliability of 9 different protocols in estimating the extent and severity of periodontal disease among periodontitis patients in a central Indian population. Study Design: Probing depths (PD) and clinical attachment levels (CAL) were recorded in 85 periodontitis patients on 6 sites on all the teeth excluding the third molars. Nine partial recording protocols (PRP) were compared with the full-mouth examination. Intra-class correlation coefficients (ICC) were calculated for mean PD, mean CAL, and percentage of sites with various thresholds of PD and CAL to determine the agreement between the PRP and the full-mouth examination. The sensitivity of different PRP for defining prevalence of sites with PD ≥6 and ≥7 mm and CAL ≥7 and ≥8 mm was also determined. Results: For all the tested PRP, the ICCs were consistently >0.9. The methods involving examination of 4 sites/ tooth slightly over-estimated the disease extent and severity in comparison with the full-mouth examination as well as PRP involving examination of 6 sites/tooth. Conclusions: The findings of the present study suggest that the tested PRP are in good agreement with the fullmouth examination. However, further studies need to be conducted with an improved methodology in a larger sample of subjects from the general population.
- Prevalence of biopsied oral lesions in a Department of Oral Surgery (2007 - 2009)(2011) Fierro, Claudia; Almendros Marqués, Nieves; Berini Aytés, Leonardo; Gay Escoda, CosmeObjectives: To determine the prevalence of the hard and soft tissue lesions biopsied in the Department of Oral Surgery of the Barcelona University Dental Clinic (Barcelona, Spain). Study design: A retrospective descriptive study was made of the biopsies performed between January 2007 and April 2009 in our Department of Oral Surgery. The following variables were recorded: age, the sex, location of the lesion, the biopsy technique, the reason for consultation, and the histological result obtained. Results: A total of 460 lesions amenable to histological analysis and corresponding to 450 patients were analyzed. The most frequently biopsied lesions were maxillary cysts, including particularly root cysts (20%). Other very common disorders in our series were epithelial hyperplasias (10.6%) and fibromas (10%). There was a broad range of histopathological results, with un total of 36 different diagnoses. Three of the 460 biopsies yielded two squamous cell carcinomas and one ameloblastoma. Conclusions: The most prevalent hard tissue lesions were chronic maxillary periapical lesions, while epithelial hyperplasias and fibromas were the most frequent soft tissue lesions. Emphasis is placed on the need for biopsy particularly for studying premalignant and malignant lesions, in view of the importance of securing an early diagnosis.
- Odontogenic tumors in Western India (Gujarat): analysis of 209 cases(2011) Gill, Sharanjeet; Chawda, Jyoti; Jani, DhavalObjective: Odontogenic tumors show a distinct geographic variation. In 2005 a new WHO classification was published which included odontogenic keratocyst as one of the odontogenic tumors, renaming it as a keratocystic odontogenic tumor. To our knowledge there are only few studies based on 2005 classification in Asian subcontinent. This study was done to determine the relative frequency of odontogenic tumors in Gujarat and compare it with reports from other parts of the world. Study Design: A retrospective study was designed. Necessary information was obtained from the records of the Oral Pathology Department, GDCH Ahmedabad. The histopathological diagnosis were re-evaluated according to the criteria of WHO histological classification 2005. Results: A total of 209 cases were reported in just a short span of 5-years. The most frequent histologic type was ameloblastoma 47.4%, followed by Keratocystic odontogenic tumor (KCOT) 23.4%. Odontomas which are the most frequent odontogenic tumor in European and American subcontinent, accounted only 5.3% in this study. Conclusion: In India ameloblastoma and KCOT are the most frequent odontogenic tumors, thus supporting the distinct geographic variation of these rare tumors.
- Management of tooth discoloration in non-vital endodontically treated tooth: a report of 6 year follow-up(2011) Nagaveni, N.B.; Umashankara, K.V.; Radhika, N.B.; Satisha, T.S.Discoloration of teeth, especially the anteriors, can result in considerably cosmetic impairment in young children. It is the pediatric dentist’s responsibility to supervise those children who seek to undergo a whitening treatment to ensure the maximum cosmetic benefit within the boundaries of oral and systematic health. Among bleaching techniques, the walking bleach technique with sodium perborate and distilled water stands out because of its superior esthetic results with no side effects. This paper presents a case of tooth discoloration in non-vital tooth which was successfully bleached using walking bleach method. After 6 year follow up the prognosis was good with no reversal of tooth discoloration and absence of external cervical resorption.
- Chronic Sclerosing Sialadenitis (Kuttner Tumor) in the sublingual gland: unusual manifestation related to partial edentulism and chronic masticatory trauma.(2011) Pinheiro, Tiago NovaesChronic sclerosing sialadenitis or Küttner tumor is an unusual chronic inflammatory disease of the salivary gland that mimics a malignant neoplasm clinically because of presentation as a hard mass. The diagnosis can only be made histologically and is an underrecognized entity. Recent studies have shown important features that characterizes the disease mainly as an autoimmune reaction. The aim of this work is to report a case of a 40-year-old man, presenting with a three-year history of a painless, moderate sublingual mass related to a partial edentulism of the teeth 36 and 37. Functional evaluation revealed an awkward misplacement of the mass into the edentulous site. Clinical and radiographic procedures revealed a decreased salivary flow and no signs of remarkable pain or sialolithiasis. Sublingualectomy was performed and histopathological examination confirmed the presence of nonobstructive chronic sclerosing sialadenitis of the sublingual gland. The possible autoimmune reaction triggered by hidden (sequestered) antigens exposed by chronic masticatory trauma is discussed.
- Fungal infections involving maxillary sinus: a difficult diagnostic task(2011) Taneja, Tarun; Saxena, Susmita; Aggarwal, Pooja; Reddy, VandanaFungal infections of the paranasal sinus are increasingly recognized entity both in normal and immunocompromised individuals. Aspergillosis and Mucormycoses being the commonest of all the fungal infections involving maxillary sinus manifests as two distinct entities, a non-invasive and invasive infection. It is important to distinguish the invasive disease from the non-invasive as the treatment and prognosis are different in each. These infections present a diagnostic and therapeutic challenge to the physicians. Early diagnosis is essential in order to avoid high morbidity and mortality associated with the destructive disease and to instigate treatment before irreversible condition arise. The purpose of this paper is to add a few more cases of fungal infections involving maxillary sinus to the literature in both immunocompetent and immunocompromised patients with an emphasis on the fact that early diagnosis is vital in these infections, because delay in initiation of treatment can be life threatening due to propensity of fungi to invade adjacent blood vessels and embolize to distant organs.
- Papillary cystic acinic cell carcinoma: report of a rare lesion with unusual presentation(2011) Augustine, Jeyaseelan; Kumar, Sreeja P.; Saran, Ravindra K.; Mohanty, SujataIntroduction: Acinic cell carcinoma is an uncommon low grade tumour of the salivary glands that constitutes 2.5 to 4% of parotid gland tumours. Acinic cell carcinoma -Papillary cystic variant (ACC-PCV) is histologically composed of tumor with papillary and cystic growth patterns, with varying proportions of one or more cell types. It has been conferred significance because it has a poorer prognosis and is reported to be universally fatal in ten years. Case Report: We present a case of ACC-PCV in a sixteen year old male with unusual unicystic gross appearance, benign cytological picture and characteristic histopathological features .Cystic areas with papillary projection of surrounding cells showing characteristic tombstone or hobnail arrangements were seen. Discussion: The histogenesis and myriad architectural and cellular variations of ACC-PCV have been discussed along with its variegated cytomorphology which may lead to pitfalls in cytodiagnosis. The tumor may pose difficulty in histodiagnosis due to its resemblance to papillary carcinoma of the thyroid
- Oral Squamous Cell Carcinoma Associated with a Dental Implant: a case report and literature review(2011) Moshref, Mohammad; Jamilian, Abdolreza; Lotfi, Ali; Showkatbakhsh, RahmanObjectives: Prosthodontic rehabilitation using dental implants has become a common practice in dentistry at the present time. Although severe complications related to dental osseointegrated implants are uncommon, in recent years several cases of oral squamous cell carcinoma adjacent to dental implants have been published. Study Design: A 67-year-old edentulous woman developed an oral squamous cell carcinoma around right mandibular implant about 12 months after receiving dental implants. The treatments involve chemotherapy, explantation of the implants and radiotherapy. Result and Conclusions: The use of endosseous implants has been associated with a low risk for the development of cancer. However, this case report serves as evidence to the importance of careful screening at routine dental examinations especially if the patient suffers from peri-implantitis, any mucosal erosion or discoloration, leukoplakia around implant, pain, implant loosening, bone loss around implant, mucosal erythema, and soft tissue inflammation.
- Oral myiasis in mentally challenged patient: a case report(2011) Dandriyal, Ramakant; Pant, SwatiMyiasis is the infestation of live human and vertebrate animal with Dipterous larvae which feed on host’s dead or living tissue. This condition is a result of neglected approach towards oral hygiene along with mental and physical challenges of patient. A case of oral myiasis in the maxillary anterior region in an 18 years old female with neurologic defi-cit caused by the larvae (maggots) is reported. The management consists of manual removal of larvae by topical application of turpentine oil, oral therapy with Ivermectin and surgical debridement of oral wound.
- Esthetic and functional oral makeover of a 3 year old cleft palate patient suffering from early childhood caries using unconventional techniques(2011) Saini, Sheeba; Sharma, DeepakCleft lip and palate (CL/P) are the most common congenital craniofacial anomalies. It has been observed that these children have a higher caries experience compared their non cleft counterparts. Early childhood caries results in early pulp involvement and gross destruction of the anterior and posterior teeth. This leads to decreased masticatory efficiency, difficulty in speech, compromised esthetics, development of abnormal tongue habits and subsequent malocclusion and psychological problems. The restoration of severely decayed deciduous teeth especially anteriors presents a special challenge to dentists, particularly in uncooperative children. The following case report documents the restoration of severely mutilated deciduous teeth in an emotionally immature cleft palate patient resulting in an improvement in not only oral and general health but also helping the patient gain more self confidence.
- Probiotics. Going on the natural way.(2011) Sheikh, Soheyl; Pallagatti, Shambulingappa; Kalucha, Aman; Kaur, HarkamalScience is providing us the tools to diagnose and treat the infection before it causes damage. For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health. It comprises knowledge of the relationship between diet and health and the effects of food ingredients on physiological functions and health. Probiotics are commonly consumed as part of fermented foods with specially added active live cultures; such as in yogurt or as dietary supplements. The potential application of probiotics for oral health has recently been the focus of attention for various health researchers. The number of products containing probiotics entering the market is increasing. These products usually contain streptococci, lactobacilli or bifidobacteria. The application of probiotic strategies may, in near future provide an end to many infections occurring in oral cavity. This article summarizes the currently available data on the potential benefits of probiotics for oral health and potential risks associated with them.
- Lingual abscess: a rarity(2011) Byahatti, Sujata M.; Ingafou, Mohammed S. H.Abscess of the tongue seems to be a rare clinical entity and is a potentially life threatening infection. This acute enlargement of the tongue can present as an emergency, due to an air-way compromise and disseminated infection to other regions. Thus, a tongue abscess should be considered in all cases of acute tongue swellings, especially when host defenses are severely impaired. In acute cases the diagnosis of tongue abscess can be reached clinically. In later cases, culture and smear analysis are useful diagnostic tools, whereas antibiotics provide considerable amelioration of symptoms. Although none of our cases were life threatening, but we could able to diagnose these cases, based on their classic clinical symptoms and all three cases were confirmed by using standard diagnostic tool. They were put on antibiotics and anti-inflammatory drugs for the relief of symptoms followed by the local drainage. The following article explains pathophysiology, differential diagnosis and management of these tongue abscess cases in detail.
- Dental management in patients with hemostasis alteration(2011) Claramunt Lozano, Ariadna; Sarrión Pérez, María Gracia; Gavaldá Esteve, CarmenHaemostasis is a mechanism that, through different interdependent biologic processes, has the purpose of ensuring the integrity and permeability of the circulatory system. Hemostasis term means prevention the loss of blood. Interventions or treatments in the oral cavity, in particular those with a possibility of bleeding, represent a risk for patients with disorders of hemostasis. Prevention is the key to avoid bleeding complications after oral surgical procedures and therefore it is essential a detailed medical history of the patient. The appropriate diagnosis and treatment in patients with disorders of hemostasis, depends directly in the understanding of hemostasis standard mechanisms. Emphasising not only the importance of a thoughtful insight into these mechanisms, but also of the existing analysis that study them. This paper makes a synthesis of the general aspects of inherited coagulation disorders (Von Willebrand disease and Hemophilia A and B) as well as of the alterations on platelets consequence of the use of certain medication (antiplatelet and anticoagulant drugs), and their dental management.
- Multiple window access antrostomy in maxillary sinus grafting. Presentation of a clinical serie of 10 cases and literature review(2011) Martínez-Conde Llamosas, Rafael; Eguía Del Valle, Asier; Uribarri Etxebarria, Agurne; López Vicente, José; Aguirre Urízar, José ManuelObjectives: A variation on the usual maxillary sinus grafting technique and its results are presented, using a more conservative approach that provides better conditions for applying the graft in complicated situations. Material and Methods: Ten case reports are presented in which the multiple access technique was used due to the existence of large maxillary sinuses, where a wide surgical approach was needed because several implants were to be installed or cases in which sinus bone graft was part of a more extensive reconstructive prodedure. Results: All the implants that were placed after using this technique were correctly integrated and it was possible to proceed to the prosthesis stage without any problems. Conclusions: This modified technique of sinus floor bone grafting can have a beneficial effect with a lower risk of perforations, better preservation of vascularisation in the area and improved integration and stability of the implants and bone graft, specially where wider surgical access is required
- Dental considerations in patients with liver disease(2011) Cruz Pamplona, Marta; Margaix Muñoz, María; Sarrión Pérez, María GraciaIntroduction: Liver diseases are very common, and the main underlying causes are viral infections, alcohol abuse and lipid and carbohydrate metabolic disorders. The liver has a broad range of functions in maintaining homeostasis and health, and moreover metabolizes many drug substances. Objective: An update is provided on the oral manifestations seen in patients with viral hepatitis, alcoholic and non-alcoholic liver disease, cirrhosis and hepatocellular carcinoma, and on the dental management of such patients. Material and methods: A Medline-PubMed search was conducted of the literature over the last 15 years using the keywords: “hepatitis”, “alcoholic hepatitis”, “fatty liver”, “cirrhosis” and “hepatocellular carcinoma”. A total of 28 articles were reviewed, comprising 20 literature reviews, a clinical guide, three clinical trials and four case series. Results: Oral clinical manifestations can be observed reflecting liver dysfunction, such as bleeding disorders, jaundice, foetor hepaticus, cheilitis, smooth tongue, xerostomia, bruxism and crusted perioral rash. In the case of infection caused by hepatitis C virus (HCV), the most frequent extrahepatic manifestations mostly affect the oral region in the form of lichen planus, xerostomia, Sjögren’s syndrome and sialadenitis. The main complications of the patient with liver disease are risk of contagion (for healthcare personnel and other patients), the risk of bleeding and the risk of toxicity due to alteration of the metabolism of certain drugs
- Dental considerations in pregnancy and menopause(2011) Chaveli López, Begonya; Sarrión Pérez, María Gracia; Jiménez Soriano, YolandaThe present study offers a literature review of the main oral complications observed in women during pregnancy and menopause, and describes the different dental management protocols used during these periods and during lactation, according to the scientific literature. To this effect, a PubMed-Medline search was made, using the following key word combinations: “pregnant and dentistry”, “lactation and dentistry”, “postmenopausal and dentistry”, “menopausal and dentistry” and “oral bisphosphonates and dentistry”. The search was limited to reviews, metaanalyses and clinical guides in dental journals published over the last 10 years in English and Spanish. A total of 38 publications were evaluated. Pregnancy can be characterized by an increased prevalence of caries and dental erosions, worsening of pre-existing gingivitis, or the appearance of pyogenic granulomas, among other problems. Although routine dental treatment is generally safe in pregnant patients and posteriorly during the lactation period, certain dental procedures can have potentially damaging effects, such as the use of ionizing radiations, the administration of drugs, or the generation of pain and stress. In postmenopausal women, alterations of the oral cavity are related to the hormone alterations that characterize these patients and to physiological aging of the oral tissues, potentially giving rise to periodontitis, burning mouth syndrome and xerostomia. As a result of the development of osteoporosis, these patients may be receiving treatment with oral bisphosphonates, which in turn may require changes in the dental management plan.
- Accuracy of the implant impression obtained from different impression materials and techniques: review(2011) Prithviraj, D.R.; Pujari, Malesh; Garg, Pooja; Shruthi, D.With the predictable integration of implants, the emphasis is shifted towards precise prosthesis. Reproducing the intraoral relationship of implants through impression procedures is the first step in achieving an accurate, passively fitting prosthesis. The critical aspect is to record the three dimensional orientation of the implant as it is present intraorally, other than reproducing fine surface detail for successful implant prosthodontic treatment. The development of impression techniques to accurately record implant position has become more complicated and challenging. During the prosthetic phase of implant therapy there are numerous options available to the implantologist in relation to different impression techniques and materials available for impression making. It is critical to ensure that implant – prosthesis interface have passive fit and original position of the implant maintained in the master cast. There is no evidence supporting that one impression technique or material is better than the other. In the present article the various parameters affecting the accuracy of implant impression along with impression material and technique pertaining to different clinical situations is reviewed.
- Dental considerations for the patient with renal disease(2011) Martí Álamo, Silvia; Gavaldá Esteve, Carmen; Sarrión Pérez, María GraciaChronic renal disease (CRD) is the renal disease that manifests oral consequences most frequently, and it is defined as a progressive and irreversible decline in renal function associated with a reduced glomerular filtration rate (GFR). The most frequent causes of CRD are diabetes mellitus, arterial hypertension and glomerulonephritis. CRD is classified in 5 stages – from kidney damage with normal or increased GFR to renal failure. In order to quantify the CRD, renal function is measured using the GFR, which is estimated using creatinine clearance (CC). This CC is used for dose adjustment of drugs. In dental practice, the function of the kidneys can be measured indirectly through plasmatic creatinine (Cr), that can be related to the CC using several formulas. The treatment of CRD includes dietary changes, correction of systemic complications, and dialysis or the receipt of a renal graft in severe cases. The importance of CRD for the dental practitioner lies in the fact that an increasing number of patients with this disease will probably demand dental treatment, and that up to 90% of them will show oral signs and symptoms related to this systemic disease. Dental management must be adapted to these patients’ special conditions, as a greater bleeding tendency, hypertension, anemia, drug intolerance, increased susceptibility to infections and the presence of several oral manifestations associated with either the disease or its treatment.
