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Language Journal of Clinical and Experimental Dentistry. 2013. Vol. 5, no. 5
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- Squamous odontogenic tumor-like proliferation in a radicular cyst: A case report(2013) Sala PĂ©rez, Sergi; Marco Molina, Vicente; Gay Escoda, CosmeThe squamous odontogenic tumour is a rare benign neoplasm whose aetiology remains unknown. It usually appears in the jaw and its origin could be related to the ephitelial remnants of Malassez. Histologically comprises numerous islets of squamous, non-keratinized, well-differentiated and rounded epithelial cells a fibrous stroma without signs of atypical cells. There is a non-neoplastic lesion with the same histological pattern than the squamous odontogenic tumour. This entity is characterized by squamous odontogenic tumour proliferations isolated into the cyst wall of an odontogenic cyst. It is rare and has a benign behavior. It has been suggested that these epithelial proliferations could be the former expression of the neoplastic form. It is very important to carry out clinical and radiological controls periodically. So far it has not been documented any change towards a squamous odontogenic tumour nor toward malignancy in a squamous odontogenic tumour like proliferation
- In vitro comparison of flexural strength and elastic modulus of three provisional crown materials used in fixed prosthodontics(2013) Poonacha, Vachan; Poonacha, Seema; Salagundi, Basavaraj; Rupesh, P.-L.; Raghavan, RohitObjectives: To evaluate and compare the flexural strength and the elastic moduli of three provisional crown materials (methyl methacrylate based autopolymerized resin, bis acryl composite based autopolymerized resin and urethane dimethacrylate based light polymerized resin) after storing in artificial saliva and testing at intervals of 24 hours and 7 days. Study design: A metal master mould with four slots of dimensions 25x2x2 mm was fabricated to obtain samples of standard dimensions. A total of 135 specimens were thus obtained with 45 each of three provisional materials. Further 15 samples of each group were tested after storing for one hour at room temperature and again at intervals of 24 hours and 7 days after storing in artificial saliva. Three point flexural tests were carried out in the universal testing machine to calculate the flexural strength and the elastic modulus. The changes were calculated and data was analyzed with Fisher's test and ANOVA. Results: The flexural strength of the methyl methacrylate resin reduced significantly while bis-acrylic composite resin showed a significant increase in its flexural strength after storing in artificial saliva for 24 hours and the values of both remained constant thereafter. Contrary to these findings, light polymerized resin showed a significant decrease in flexural strength after storing in artificial saliva for 24 hours and then significantly increased in flexural strength after 7 days. However the changes in the values for elastic modulus of respective materials were statistically insignificant. Conclusion: Methacrylate based autopolymerizing resin showed the highest flexural strength and elastic moduli after fabrication and after storing in artificial saliva and for 24 hours and 7 days. Bis-acrylic composite resin showed the least flexural strength and elastic moduli.
- Rehabilitation with implant-supported overdentures in total edentulous patients: a review(2013) MartĂnez-Lage AzorĂn, L.; Segura AndrĂ©s, Gustavo; Faus LĂłpez, Joan; AgustĂn Panadero, RubĂ©nObjectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Results and conclusions: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patient's satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems.
- Fractographic study of the behavior of different ceramic veneers on full coverage crowns in relation to supporting core materials(2013) Farga Niñoles, Ignacio; AgustĂn Panadero, RubĂ©n; Román RodrĂguez, Juan Luis; Solá Ruiz, MarĂa Fernanda; Granell Ruiz, MarĂa; Fons Font, AntonioObjectives: To observe porcelain veneer behavior of zirconia and metal-ceramic full coverage crowns when subjected to compression testing, comparing zirconia cores to metal cores. Study Design: The porcelain fracture surfaces of 120 full coverage crowns (60 with a metal core and 60 with a zirconia core) subjected to static load (compression) testing were analyzed. Image analysis was performed using macroscopic processing with 8x and 12x enlargement. Five samples from each group were prepared and underwent scanning electron microscope (SEM) analysis in order to make a fractographic study of fracture propagation in the contact area and composition analysis in the most significant areas of the specimen. Results: Statistically significant differences in fracture type (cohesive or adhesive) were found between the metalceramic and zirconia groups: the incidence of adhesive fracture was seen to be greater in metal-ceramic groups (92%) and cohesive fracture was more frequent in zirconium oxide groups (72%). The fracture propagation pattern was on the periphery of the contact area in the full coverage crown restorations selected for fractographic study. Conclusions: The greater frequency of cohesive fracture in restorations with zirconia cores indicates that their behavior is inadequate compared to metal-ceramic restorations and that further research is needed to improve their clinical performance.
- Endodontic management of open apex using MTA and platelet-rich fibrin membrane barrier: A newer matrix concept(2013) Khetarpal, Ambica; Chaudhry, Sarika; Talwar, Sangeeta; Verma, MaheshObjectives: Endodontic management of open apex using MTA and platelet-rich fibrin membrane as an apical matrix barrier. Study design: An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontist. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barriers. This article demonstrates the use of an apical matrix barrier in form of a platelet rich fibrin membrane for stabilization of MTA in root end apexification procedure. PRF is an autologous fibrin matrix containing a large quantity of platelet and leukocyte cytokines, which enhance healing by release of growth factors. These case reports present apexification and successful healing with combined use of MTA and PRF membrane as an apical barrier Results: PRF membrane can serve as an efficient apical matrix for condensation of MTA. Combination of PRF membrane and MTA is an effective method for management of difficult cases of open apex. PRF is a strong fibrin membrane enriched with platelet and growth factors that accelerate periapical healing.
- Clinical and microbiological diagnosis of oral candidiasis(2013) Coronado Castellote, Laura; Jiménez Soriano, YolandaIntroduction: Candidiasis or oral candidiasis is the most frequent mucocutaneous mycosis of the oral cavity. It is produced by the genus Candida, which is found in the oral cavity of 53% of the general population as a common commensal organism. One hundred and fifty species have been isolated in the oral cavity, and 80% of the isolates correspond to Candida albicans, which can colonize the oral cavity alone or in combination with other species. Transformation from commensal organism to pathogen depends on the intervention of different predisposing factors that modify the microenvironment of the oral cavity and favor the appearance of opportunistic infection. The present study offers a literature review on the diagnosis of oral candidiasis, with the purpose of establishing when complementary microbiological techniques for the diagnosis of oral candidiasis should be used, and which techniques are most commonly employed in routine clinical practice in order to establish a definitive diagnosis. Materials and methods: A Medline-PubMed, Scopus and Cochrane search was made covering the last 10 years. Results: The diagnosis of oral candidiasis is fundamentally clinical. Microbiological techniques are used when the clinical diagnosis needs to be confirmed, for establishing a differential diagnosis with other diseases, and in cases characterized by resistance to antifungal drugs. Biopsies in turn are indicated in patients with hyperplastic candidiasis. Staining (10% KOH) and culture (Sabouraud dextrose agar) are the methods most commonly used for diagnosing primary candidiasis. Identification of the individual species of Candida is usually carried out with CHROMagar Candida®. For the diagnosis of invasive candidiasis, and in cases requiring differentiation between C. albicans and C. dubliniensis, use is made of immunological and genetic techniques such as ELISA and PCR.
- Smear layer removal in canals shaped with reciprocating rotary systems(2013) Amaral, Paula; Forner Navarro, Leopoldo; Llena Puy, MarĂa CarmenThe aim was to assess the presence of smear layer after canal instrumentation with two reciprocating rotary systems and a continuous motion one. Thirty canals were shaped with Reciproc, WaveOne or Mtwo systems. Smear layer was assessed following a three value scale at coronal, middle and apical levels with a scanning electron microscopy. Reciproc scores: coronal third, 20% of the cases: 0, 60%: 1, 20%: 2; middle third, 10%: 0, 20%: 1, 70%:2; apical third: 2 in all cases. WaveOne scores: coronal third, 0 (40%), 1 (30%) and 2 (30%); middle third, 0 (20%), 1 (50%), 2 (30%); apical third, 0 (20%), 2 (80%) of cases. MTwo scores: coronal third 0 (50%), 1 (30%) 2 (20%); middle third 0 (20%), 1 (50%), 2 (30%); apical third, 0 (10%), 1 (10%), 2 (80%). No significant differences (p>0.05) were found between the three used systems.
- The largest bilateral gemination of permanent maxillary central incisors: report of a case(2013) Shokri, Abbas; Baharvand, Maryam; Mortazavi, HamedGemination is defined as an attempt to make two teeth from one enamel organ. Bilateral presentation of this phenomenon is very rare, with prevalence of 0.01% to 0.04% in the primary, and 0.05% in the permanent dentition. This paper describes a rare case of huge bilateral gemination of permanent maxillary central incisors in a nine-yearold Iranian boy with poor aesthetic. The patient did not have history of anomaly in his primary dentition and in his family either. This type of dental anomaly can cause clinical problems in the form of malocclusion, poor aesthetic, and impaction of adjacent teeth, caries, and periodontal destruction.
- A review of 413 salivary gland tumours in the head and neck region.(2013) Lawal, Ahmed O.; Adisa, Akinyele O.; Kolude, Bamidele; Adeyemi, Bukola Folasade; Olajide, Mofoluwaso A.Objectives: Salivary gland tumours (SGTs) are a group of heterogeneous lesions with complex clinico-pathological characteristics and distinct biological behaviours. Previous studies have reported geographic variations in site distribution, incidence and histological types of SGTs. The aim of this study was to describe the demography of SGTs seen at a tertiary health centre and compare findings with previous studies. Study design: Data on SGTs from archives of the Department of Oral Pathology and the Department of Pathology, University College Hospital Ibadan were retrieved. Information about histological types, age, sex and location were analyzed using SPSS for Window (version 20.0; SPSS Inc. Chicago, IL). Reactive and tumor-like lesions such as sialometaplasia, benign lymphoepithelial lesion, lymphoepithelial cyst, mucocele, mucous extravasation phenomenon, ranula, and sialosis were excluded from the study. Results: 413 SGTs consisting of 221 (53.5%) malignant and 192 (46.5%) benign lesions were seen. SGTs occurred more in females (50.6%) than males (49.4%) with a mean age of 43.7 (±16.9) years and peak age in the fifth decade of life. The parotid with 171 (41.4%) cases was the commonest site, followed by palate with 89 (21.5%) cases, while only 7(1.7%) cases were seen in sublingual gland. Pleomorphic adenoma with 169 (40.9%) was the most frequent SGT followed by adenoid cystic carcinoma with 93 (22.5%) cases which also was the most frequent malignant SGT while only 3 (0.7%) cases of Warthin's tumour were seen. Conclusion: This report is one of few that showed a higher occurrence of malignant SGTs compared to their benign counterparts. The findings were essentially similar to findings in Africa but showed SGTs to be more common in females. The reason(s) for high occurrence of malignant SGTs in minor salivary glands and the rarity of Warthins tumour in this study and other African series compared to those from America needs further investigation.
- Mesiodistal crown diameters and tooth size discrepancy of permanent dentition in thalassemic patients(2013) Hattab, F.N.Objectives: To provide a description of mesiodistal crown diameters (MD) and tooth-size discrepancy (TSD) of the permanent dentition in patients with thalassemia major (TM) and to compare the results with those of unaffected control group. Study design: The sample consisted of 46 thalassemic patients, 25 males and 21 females aged 7.3 to 23.7 years (mean ± SD = 11.2 ± 3.9 years) and control group matched by age and sex. Dental casts of the participants were measured for MD, using a digital sliding caliper. Descriptive statistics were computed for each individual tooth. Student t-test was used for comparison of mean values between males and females as well as between thalassemic and control groups. The differences between sets of data were evaluated by analysis of variance (ANOVA). Results: All means for MD of thalassemic males and females were smaller than their controls, with 20 of the 24 comparisons being statistically significant (ranged from P<0.05 to P<0.001). In both thalassemic and control groups, males exhibited significantly larger MD than females in most instances. Canines displayed the most sexual dimorphic teeth in the dentition. Lateral incisors showed the greatest variability indicated by the coefficient of variation, while the first molars were the least variable teeth (7.6% vs. 5.3%). There were no statistically significant differences in the anterior and overall tooth-size discrepancy ratios between sexes or between thalassemic and control groups. The mean anterior ratio (79.5%) and overall ratio (92.4%) of the control group were significantly larger than of Bolton ratios; P<0.001 and P<0.05, respectively. Conclusions: The present study demonstrated that thalassemic males and females exhibited significantly smaller MD than the control group. The TSD ratios in both thalassemic and control groups were significantly larger than those of Bolton sample. These findings should be taken into account when planning orthodontic treatment for thalassemic patients.
- Diffuse large B-cell lymphoma, not otherwise specified of the palate: a case report(2013) Souto, Giovanna Ribeiro; Pereira, ThaĂs dos Santos Fontes; Castro, Alexandre Fonseca de; Mesquita, Ricardo AlvesDiffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin´s lymphoma found in oral and maxillofacial regions. A large number of cases may be biologically heterogeneous, which are commonly defined as DLBCL, not otherwise specified (NOS) by the World Health Organization (WHO-2008). The present case reports on an ulcer of raised and irregular edges, found on the border between the hard and soft palate, as the first and only manifestation of an extranodal non-Hodgkin lymphoma in an 85-year-old patient. Incisional biopsy was carried out, and the specimen revealed a proliferation of large lymphoid cells suggestive of diffuse large cell lymphoma. An immunohistochemical analysis was performed. EBV-RNA was assessed by in situ hybridization that also proved to be negative. Immunohistochemical and EBV analyses are important to avoid delays and inappropriate treatment strategies. Although advanced age is considered an adverse prognostic factor, early diagnosis did prove to be a key contributory factor in the cure of non-Hodgkin lymphoma.
- Alternative to oral dicoumarin anticoagulants:Considerations in dental care(2013) Mingarro de León, Ana; Chaveli López, BegonyaIntroduction: For over 50 years, vitamin K antagonists such as warfarin (Aldocumar®) and acenocoumarol (Sintrom ®) have been the gold standard for reducing the risk of cerebrovascular events. In the last 5 years alternative anticoagulants have been evaluated that act directly upon a concrete target within the coagulation cascade, thereby affording a more predictable anticoagulant effect. The present study offers an update on the new oral anticoagulants and reviews the implications referred to the dental care of patients administered these substances. Material and methods: An exhaustive PubMed-Medline and Cochrane Library search was made of the main alternatives to conventional oral anticoagulation, covering those studies published in English and Spanish over the last 10 years. Specialized textbooks and pharmaceutical catalogs were also consulted. A total of 184 articles were identified, of which 76 met the inclusion criteria. Results: The new oral anticoagulants dabigatran, rivaroxaban and apixaban are safe and effective, and offer a series of advantages, including rapid action, no need for constant monitoring, few drug and food interactions, and a broad therapeutic margin. These drugs are expensive, however, and some lack a specific antidote, while others must be administered twice a day. Regarding the dental treatment of patients receiving these drugs, suspension or modification of the background medication is not required when performing invasive dental procedures, except where indicated by the prescribing physician. Conclusions: The new oral anticoagulants do not pose significantly greater risks than conventional oral anticoagulants when providing invasive dental treatment, and their suspension is not strictly required in such situations.
- True vertical validation in facial orthognathic surgery planning(2013) Espinar Escalona, E.; Ruiz Navarro, MarĂa BelĂ©n; Barrera Mora, JosĂ© MÂŞ; Llamas Carreras, JosĂ© MarĂa; Puigdollers PĂ©rez, Andreu; Ayala Puente, JorgeObjectives: To validate the effectiveness of the original standards of True Vertical (TV) Subnasal Line in orthognatic surgery planning. The present study evaluates the changes occurring in patients with skeletal Class II alterations programmed for orthognathic surgery with a view to improving their facial profile. Study desing: We showed a series of black profiles (composed by a first control group of subjects with normal occlusion, and another two additional groups comprised patients before -Group 2- and after orthognatic surgical correction of Class II malocclusion -Group 3-) for three groups of observers (orthodontists, surgeons and laypeople). The facial images became black silhouettes in order to determine a series of parameters (including aesthetic assessment) by means of the observers. Their observation were assessed using a 5-point Likert scale. Results: The sample was composed of 52 profile's subjects who were tested for a total of 72 observers. Aesthetic assessment yielded mean scores of 2.57, 1.67 and 2.46 for groups 1, 2 and 3, respectively. There was a statistically significant difference (p<0.001) between group 1 versus group 2. There were no significant differences in terms of observer assessment of aesthetics, with the exception of a wider perception range among the orthodontists. Regarding the studied profile measures, significant differences were recorded for point B' and Pg' (p<0.02) between groups 2 and 3 (i.e., pre- versus post-surgery). Conclusions: The results of our study suggest the subnasale vertical and sagittal measures of the lower third of the face are decisive in facial aesthetics, and therefore also for the planning of orthognathic surgery. Consequently, these aesthetic parameters can be used as an objective tool for the planning of orthodontic treatment.
- Evaluation of horizontal ridge augmentation using beta tricalcium phosphate and demineralized bone matrix: A comparative study(2013) Shalash, Mahmoud-A.; Rahman, Hatem-A.; Azim, Amr-A.; Neemat, Amani-H.; Hawary, Hesham-E.; Nasry, Sherine-A.Objectives: To evaluate the effectiveness of beta tricalcium phosphate (Beta-TCP) alone compared to Beta-TCP and Demineralized Bone Matrix (DBM) in regenerating localized horizontal maxillary alveolar ridge deficiencies prior to implant placement. Study Design: The study included 20 patients with horizontal maxillary ridge deficiencies limited to one or more neighbouring teeth and initial ridge width of . 5mmm. Patients were divided equally into two equal groups. Ridge augmentation was performed using Guided Bone Regeneration (GBR) principals. In group I GBR was performed using Beta-TCP only, while in group II both Beta-TCP and DBM were used. Following a 6 months healing period, bone cores from both groups were retrieved and implants were inserted. Specimens were examined histologically to calculate percentage of mineralized bone. Apical and crestal changes in ridge dimensions were calculated by digital subtraction using Cone Beam Computed Tomography (CBCT) immediately after graft placement and six months later. Results: There was a statistically significant difference between the mean area percentage of mineralized bone between both groups where it was 40.1 % (range: 27.76-% 66.29 %) for group I and 68.96 % (range: 60.07 % - 87.33 %) for group II. Radiograpically, the mean ridge width in group I increased crestally to 4.66 mm (range:3.5-5mm) and apically to 6.12 mm (range: 4.1-6.7 mm). In group II the mean ridge width increased crestally to 5.2 mm (range 4.9-5.4mm) and apically to 6.9 mm (range 6.0-7.8 mm). Group II showed more bone gain with a mean of 1.37 mm crestally and 2.44 mm apically. This difference however was not statistically significant Conclusion: Within the limitations of this study the combination of DBM and Beta-TCP can be used effectively in cases exhibiting minimal alveolar ridge defects.
- Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement(2013) Cassetta, Michele; Sofan, Aisha Ali Abdullah; Altieri, Federica; Barbato, ErsiliaObjective: Mini-implant stability is primarily related to bone quality and quantity. This study evaluated alveolar cortical bone thickness and density differences between interradicular sites at different levels from the alveolar crest, and assessed the differences between adolescents (12-18 years of age) and adults (19-50 years of age), males and females, upper and lower arch, anterior and posterior region of jaws and buccal and oral side. Study Design: In this retrospective study, 48 Computed Tomography scans, performed for oral surgery purposes were selected from dental records of 3,223 Caucasian orthodontic patients. The SimPlant software (Materialise, Leuven, Belgium) was used to measure cortical bone thickness and density at 13 interradicular sites and four bone levels ( 2,4,6 and 8 mm ). For the statistical analysis descriptive statistics, Student's t-test and Pearson correlation coefficient were used. Results: Statistically significant differences in alveolar cortical bone thickness and density between age, gender, sites and sides were found (P<0.05). The Pearson correlation coefficient demonstrated a significant linear increasing of thickness and density from crest to base of alveolar crest (P.0.05). Conclusion. Adults show a thicker alveolar cortical bone than adolescents. Alveolar cortical bone thickness and density were greater in males than in females, in mandible than in maxilla, in the posterior region than the anterior, in oral than buccal side. There is an increase of thickness and density from crest to base of alveolar crest.
- Frequency of mesiodens in the pediatric population in North India: A radiographic study.(2013) Santosh, Patil; Pachori, Yaspal; Sumita, Kaswan; Khandelwal, Suneet; Likhyani, Lalit; Maheshwari, SnehaObjectives: Mesiodens are the most common supernumerary teeth, occurring in 0.15% to 2.2% of the population. The aim of the present study was to analyze the frequency and radiological features of mesiodens in the pediatric population. Material and methods: The study was based on the radiographic evaluation of 4133 pediatric patients of the age range of 4-15 years, attending the Department of Oral Medicine and Radiology during the time period between September 2008 to December 2012. In addition to the presence of a supernumerary tooth between the 2 central incisors, data regarding the number, position, shape and associated complications were also recorded. Results: The prevalence of mesiodens in the present study was 1.4%. The prevalence was estimated using a 95% confidence interval. The ratio of boys to girls was 1.8:1 and majority of cases (89.7%) had 1 mesiodens. Most of the mesiodens (59.6%) were aligned in a vertical position. 39 mesiodens (62.9%) were impacted, while 14 (22.6%) were partially erupted and only 9 (14.5%) were completely erupted into occlusion. The main complication associated with the mesiodens was midline diastema (28.6%) and 16 patients were asymptomatic. Conclusion: Mesiodens can result in spacing in the arch, delayed or ectopic eruption of the permanent incisors, further altering the occlusion and esthetics of the patient or may remain asymptomatic. It is therefore important for the practitioners to diagnose a mesiodens early in development to allow for optimal treatment plan.
