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Language Journal of Clinical and Experimental Dentistry. 2011. Vol. 3, no. 3
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- Subcutaneous emphysema resulting from surgical extraction without elevation of a mucoperiosteal skin flap(2011) Peñarrocha Diago, MarĂa; Ata-Ali Mahmud, Francisco Javier; Carrillo GarcĂa, Celia; Peñarrocha Diago, MiguelSubcutaneous emphysema, is a rare occurrence in dental practice. It is usually benign and self-limiting; nevertheless, severe consequences can result from surgical treatment. Emphysema occurs when air is injected into the subcutaneous layer of the tissue, this may come from either an air turbine handpiece or air syringe. Due to the danger of developing emphysema, procedures using compressed air are not recommended in dental extractions involving the raising of a skin flap, bone sectioning or exeresis. Two determining factors are always involved with subcutaneous emphysema. On the one hand, a compressed air procedure (air turbine handpiece, air-water syringe), and on the other, a communication between the oral cavity and deeper tissue producing dissection. Early diagnosis and treatment are critical to prevent the trapped air leaking into other areas. The aim is to present a case of subcutaneous emphysema related to dental extraction, without raising a mucoperiosteal flap, possibly caused by close contact between the air turbine handpiece and the tooth during sectioning which forced air into the subcutaneous tissue.
- Rhino cerebral mucormycosis: a report of two cases and review of literature.(2011) Sujatha, Reddy S.; Rakesh, Nagaraju; Deepa, Lanjekar; Ashish, Lanjekar; Shridevi, BijjalMucormycosis is caused by fungi of the order Mucorales and is one of the fulminant and fatal mycotic infections known to human beings with a high mortality rate. Rhinocerebral mucormycosis is the most common type and its extension to the orbit and brain is quite usual. It is commonly reported in immunocompromised patients such as poorly controlled diabetes mellitus, blood dyscrasias, malnutrition, neutropenia, iron overload, organ transplant, and immunosuppressive therapy. Mucormycosis is on the rise with an increase in incidence of Diabetes mellitus and HIV infection leading to immunocompromised status of the patient. Here in, reporting two cases of rhinocerebral mucormycosis in two uncontrolled diabetic patients with deep palatal perforation in one case and this is a rare and late occurrence. Both the patients were successfully treated with a combination of surgical debridement and systemic amphotericin B administration. By presenting this case report we would like to point out that mucormycosis should be included in the differential diagnosis of hard palate ulcers and cellulitis.
- Diagnostic and clinical procedures of a patient with oral-facial-digital type II syndrome: a case report(2011) Lage, Carla de Souza; Silva, Luis Candido Pinto da; Fonseca, Luciana; Cruz, Roberval de AlmeidaThe oral-facial-digital syndromes (OFD) are part of a great number of genetic disorders. They are classified in categories based on characteristic abnormalities, including OFD type I (Papillon-Leage and Psaume syndrome) and OFD type II (Mohr syndrome). The aim of this article is to describe a clinical case of a patient with oral- facial-digital type II syndrome or Mohr syndrome, who underwent surgery for supernumerary teeth removal under endovenous sedation. Moreover, it is intended to discuss the importance of diagnostic and clinical procedures, with proper and concise indications about the limitations of patients with special needs treatment. Due to their clinical and physiological limitations, they must be treated by qualified professionals who are capable of performing various dental treatment procedures, including surgical removal of supernumerary teeth
- Pemphigus vulgaris and mucous membrane pemphigoid: update on etiopathogenesis, oral manifestations and managementy.(2011) Ata-Ali Mahmud, Fadi; Ata-Ali Mahmud, Francisco JavierIntroduction: The treatment of oral mucosal disorders must be based on an early and correct diagnosis. Pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) are among the diseases that pose the greatest diagnostic difficulties for dentists, with scores of 7.35 and 8.03, respectively , on a scale from 0-10. Objective: To conduct a literature review on PV and MMP, and to summarize the case series involving more than two patients with these diseases. Material and Methods: A PubMed – Medline search was carried out, using the key words “pemphigus vulgaris” and “oral mucous membrane pemphigoid”. The search was limited to “case reports” and “dental journals”, and yielded a total of 122 articles on PV and 68 on MMP. The review considered only those accessible publications involving series of over two patients. Results: Seven articles on PV and 5 on MMP, involving series of over two patients, were finally included. Conclusions: A review has been made of the most recent literature on PV and MMP, documenting those series reporting over two patients.
- Sialolith and adenoid cystic carcinoma in the submandibular gland: a rare case(2011) Deep-Singh-Nanda, Kanwar; Mehta, AnuragSalivary calculi occur most frequently in the submandibular gland of the human beings. It is because of the specific anatomy of both the glands and its duct. Presentation typically consists of a painful swelling of the gland at meal times, when the effect of obstruction is most acute. The clinical signs, in most of times, can lead us to the diagnosis easily. The coexistence of sialolith and malignant tumors are very rare. This case report is about a male patient of 45 year with a swelling in the submandibular region for the last eighteen months with an intermittent episode of moderate to severe pain which increased during a mealtime and diagnosed as sialolith on radiograph, but on biopsy proved to be adenoid cystic carcinoma along with sialolith. This case report describes the coexistence of sialolithiasis and adenoid cystic carcinoma in the submandibular gland with advantages and limitations of various imaging studies to be used by health care professionals prior to reaching definitive conclusion
- Extraction and immediate placement of root analogue zirconia implants: an overview(2011) Prithviraj, D.R.; Regish, K.M.; Deeksha, Sharma; Shruthi, D.Dental implants constitute a well-established approach for replacement of lost teeth with titanium being the most favored material for implantation. However, titanium has its limitations in esthetically demanding cases and neither the form nor material of such implants has changed much over the past 40 years. Immediate implantation has been introduced to overcome the disadvantages of conventional implantation which in turn has many disadvantages owing to the incongruence of the implant to the extraction socket. Today, there is scientific evidence that zirconia dental implants osseointegrate well and offer many advantages over titanium implants. The successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics, biocompatibility, and bright tooth-like color, zirconia (zirconium dioxide, ZrO2) has the potential to become a substitute for titanium as dental implant material. In addition, there are previous reports on the successful use of Zirconia as root-analogue implants by reproducing the contours of the extracted tooth. This article presents an overview of the technique of using root analogue zirconia dental implants as an immediate implantation material which are replicas of the extracted tooth and therefore truly anatomical and socket friendly.
- Effect of the methacrylate-based endodontic sealer Epiphany on rat peritoneal macrophages viability(2011) MartĂn González, Jenifer; Castellanos Cosano, Lizett; LĂłpez FrĂas, Francisco Javier; Sánchez DomĂnguez, Benito; Calvo Monroy, Cristina; Alonso Ezpeleta, Luis Oscar; Segura-Egea, Juan J.Objective: To evaluate the effect of the endodontic sealer Epiphany on rat peritoneal macrophages viability. Materials and methods: Peritoneal macrophages were obtained from Wistar rats and resuspended in RPMI- 1640 medium. Undiluted (crude extract) and diluted extracts to 10%, 1%, 0.1%, 0.01%, 0.001% and 0.0001% of Epiphany, AH 26 and AH Plus sealers on RPMI-1640 medium were tested for cytotoxicity to rat peritoneal macrophages using the trypan blue dye exclusion assay. Data were analyzed statistically by the Kruskal-Wallis and Mann-Whitney tests at 5% significance level. Results: Crude extract of Epiphany killed 51% of cells, but was less cytotoxic that crude extracts of AH Plus and AH 26, which killed 81% and 86% of cells, respectively. Ten-fold dilutions of Epiphany, AH Plus and AH 26 killed 44%, 56%, 62% of macrophages, respectively. A hundred dilution of Epiphany only killed 7% of macrophages, but the same dilution of AH Plus and AH 26 killed 10% and 31% of macrophages, respectively. Lower dilutions of sealer extracts caused minimal cell death as compared to the control groups (p>0.05). Conclusions: The methacrylate-based endodontic sealer Epiphany showed lower cytotoxicity on macrophages than resin-based sealers AH Plus and AH 26. Dilution of elutes of the three materials by tenfold markedly reduced their effects
- Sonoporation, a redefined ultrasound modality as therapeutic aid: a review.(2011) Sheikh, Soheyl; Pallagatti, Shambulingappa; Singh, Balwinder; Puri, Nidhi; Singh, Ravinder; Kalucha, AmanTraditionally a diagnostic modality, ultrasound is emerging as a promising tool for non-invasive therapy, drug delivery, and gene therapy. The ultrasound is a mechanical wave energy generated in a medium as oscillating pressure in space and time at frequencies above 20 kHz, beyond the audible range. The ultrasound exposure generates bioeffects resulting in tissue heating, shear stress, and cavitation, which have been exploited for therapeutic applications. Ultrasound cavitation, enhanced by injected micro bubbles, perturbs cell membrane structures to cause sonoporation and increases the permeability to bioactive materials. Ultrasound-mediated gene delivery has been applied to heart, blood vessel, lung, kidney, muscle, head and neck tumour with enhanced gene transfection efficiency. The genes can be incorporated into microbubbles which in turn can target a specific disease site. Local drug delivery ensures sufficient drug concentration at the diseased region while limiting toxicity for healthy tissues. Nevertheless, it has only recently become popular as a technique to enhance drug release from drug delivery systems. This review presents the main findings in the field of sonoporation, namely drug delivery, gene delivery and DNA transfer.
- Transmigrated canines: review and update(2011) Maceiras Perez, Alba MÂŞ; Leco Berrocal, MarĂa Isabel; Barona Dorado, Cristina; Fernández Cáliz, Fernando; MartĂnez González, JosĂ© MarĂaTransmigrated canines are impacted canines that have crossed the midline. Objective: To evaluate the epidemiological and clinical aspects that have to do with transmigrated canines. Study design: Bibliographic review of 209 transmigrated canines obtained from a review of articles from 1971 to the present. Results: Transmigrated canines are most frequent among females and are usually diagnosed within the first two decades of life. They are usually located in the mandible, with transmigration being most frequent in the left mandibular canine. In a large number of cases, the deciduous canine remains in the arcade. Transmigrated canines are most often found impacted, the primary position being mesially inclined, having crossed the midline. There is no pathology that is clearly associated with these canines, although radiolucence compatible with a cyst was found in a great percentage. Conclusions: Given that it is not possible to predict when dental transmigration is going to occur, we must monitor those mandibular canines which present a delay in their eruption, in order to try to carry out an interceptive treatment and avoid possible pathologies.
- Dental considerations in patients with respiratory problems.(2011) Claramunt Lozano, Ariadna; SarriĂłn PĂ©rez, MarĂa Gracia; Gavaldá Esteve, CarmenMany respiratory disorders can compromise routine dental care and require special treatment for the affected patients. Patients often visit the dental clinic with respiratory problems already diagnosed by other specialists. The dental professional therefore must provide correct dental care in the context of such a diagnosis. The present study offers a literature review of those respiratory disorders which can have implications for dental care. Chronic obstructive pulmonary disease (COPD) and asthma require special measures, such as working with the patient in the vertical position, since some of these subjects do not tolerate decubitus. On the other hand, patients with COPD can suffer infectious lung diseases secondary to the aspiration of microorganisms in the presence of deficient periodontal conditions. The treatments received by patients with respiratory diseases can also influence their oral health. In this sense, it has been shown that inhalatory medication used for asthma can cause oral disorders such as xerostomia, oropharyngeal candidiasis and an increased presence of caries (due to the action of β-agonists), as well as gingivitis. In contrast, oral manifestations of tuberculosis are infrequent. The clinical appearance of the lesions is very similar to that of squamous cell carcinoma; it is therefore important to establish a correct differential diagnosis in such cases. Mention also will be made of patients with obstructive sleep apnea syndrome (OSAS), characterized by critical narrowing and occlusion of the upper airways during sleep. In this context, the dental professional is often directly implicated in the management of such patients by preparing and fitting oral devices designed to advance the mandible. Lastly, mention will be made of dental management in the event of foreign body aspiration, where rapid intervention by the dental professional is critical. The basic approach in such cases is adequate prevention.
- Comparative study of oral micronucleated cell frequency in oral submucous fibrosis patients and healthy individuals(2011) Anila, Koneru; Kaveri, Hallikeri; Naikmasur, Venkatesh GObjectives: To determine the frequency of micronucleated cells and micronuclei in oral submucous fibrosis patients and to compare with healthy individuals. Study design: Twenty patients with oral submucous fibrosis and twenty age-sex-matched healthy individuals as control group participated in this study. Exfoliated cells were obtained by scraping from right and left buccal mucosa and were screened for micronucleated cells and micronuclei. Frequencies were compared between oral submucous fibrosis and control group. Also comparison was made between chewing site and non-chewing site of buccal mucosa. Results: Frequency of micronucleated cells and micronuclei in oral submucous fibrosis patients ranged from 0.6% to 5.3% and 0.50% to 5.74%, where as in control group ranged from 0.5% to 0.9% and 0.22% to 0.88% respectively. Micronucleated cells and micronuclei in oral submucous fibrosis patients were statistically significantly elevated (p < 0.05) as compared to control group. The mean percentage frequencies were higher on chewing site; however there was no statistically significant difference. Conclusion: The present study revealed an increase in micronuclei in oral submucous fibrosis patients compared to healthy individuals. With gutkha chewing habit in younger age, chances of malignant transformation are high relatively. Thus micronuclei test can be used as an early indicator of genotoxicity in oral submucous fibrosis
- Quantification of colloid bodies in Oral Lichen Planus and Oral Lichenoid Reaction - A Histochemical Study(2011) Vij, Hitesh; Vij, Ruchieka; Rao, Nirmala; Radhakrishnan, Raghu A.; Gupta, VineetaAim: Oral lichen planus and oral lichenoid reaction are familiar keratotic lesions found on the oral mucosa. Colloid bodies can be microscopically appreciated in both these lesions. The aim of this study was to identify as well as examine the frequency of colloid bodies in oral lichen planus and oral lichenoid reaction by histochemical means. Method: The material for the study included 12 formalin-fixed paraffin-embedded tissue blocks (7 oral lichen planus and 5 oral lichenoid reaction), retrieved from the Department of Oral Pathology and Microbiology, MCODS, Manipal. Sections stained with hematoxylin-eosin (H&E) and periodic acid-Schiff (PAS) with diastase to identify, locate and examine the frequency of colloid bodies in oral lichen planus and oral lichenoid reaction. Results: It was observed that the colloid bodies in case of oral lichen planus were present in either epithelium or connective tissue but usually close to the epithelium-connective tissue junction. While in oral lichenoid reaction colloid bodies were mostly seen in lower spinous layer of epithelium. Conclusion: Colloid bodies can be used as one of the criteria to differentiate oral lichen planus from oral lichenoid reaction. However, further studies are required to permit more objective distinction between oral lichen planus and oral lichenoid reaction
- Distribution of factor XIIIa containing cells and collage nous components in radicular cysts: histochemical and immunohistochemical study(2011) Sharma, Shubhra; Patankar, SangeetaObjective: 1) To differentiate various connective tissue layers in radicular cysts 2) To find the correlation between FXIIIa containing cells and fibrosis. Factor XIII, fibrin stabilizing factor, stabilizes the clot for blood coagulation and is also responsible for connective tissue organization in healing and tissue repair. FXIIIa has an important role during the process of fibrosis in various lesions, so we conducted a study to find its role in radicular cyst. Study Design: 10 cases of radicular cyst, reported in our hospital were selected. Clinical and follow up data of those cases were collected from the archives. Material and Methods: Histochemical analysis with Masson’s trichrome was done to differentiate the three layers of radicular cyst. Immunocytochemical staining for distribution of factor XIIIa was carried out. Stained slides were examined under high power. After counting cell, data was analysed statistically. Results: Positive reaction for Factor XIIIa was observed in certain connective tissue cells in all the layers of radicular cysts. FXIIIa containing cells were numerous in intermediate layer as compared to outer fibrous layer. FXIIIa containing cells and fibrosis was increased in case of radiographically well circumscribed lesion than the diffuse lesion. It can be concluded that factor XIIIa containing cells and collagenous components in radicular cyst play an important role in fibrosis and is also correlated with healing of the lesion.
- A preliminary analysis in the preparation and obturation of oval canals(2011) Malur, Manjunath Hampanna; Goud, MallikarjunObjective: 1) to observe the appearance of uninstrumented recesses in oval canals after instrumentation using circumferential filing. 2) To determine the quality of obturation both with cold lateral compaction and thermo plasticized gutta-percha technique in these recesses Study design: Twenty non-carious, freshly extracted human mandibular incisors with single canals were divided into group I (n=10) and group II (n=10) according to the two different obturation methods. The sectioned roots were prepared with flexofiles (Dentsply, Maillefer) ranging from #15 to #40 by using circumferential filing. The obturated specimens were horizontally sectioned at 5 mm from the apex. Each section was observed under the stereomicroscope at x40 magnification. The quality of obturation in the recesses was evaluated by using 3-point scoring system; the results were subjected to statistical analysis. Results and Conclusion: The results showed that, uninstrumented recesses might be left in many oval canals, even after circumferential filing with smaller size files. In addition, the thermoplasticized obturation technique was better in filling the recesses as compared to lateral compaction but the results were statistically insignificant
- Non-invasive diagnostic tools in early detection of oral epithelial dysplasia(2011) Sharma, Navneet; Khan, MubeenObjective: The incidence of oral cancer worldwide varies 2-18% and in India 0.1 to 13.5%. Early evaluation of oral precancerous lesions can have dramatic effect on oral cancer mortality rate. Among the premalignant stage, leukoplakia is the most commonly encountered clinical lesion and epithelial dysplasia is most important predictive factor. The objective of this paper is to compare the efficacy of exfoliative cytology, toluidine blue and chemiluminescent illumination (VIZILITE) to detect early dysplastic changes in leukoplakia. Study design: Study involved 50 patients of leukoplakia (homogeneous, speckled) in the age group of 20-72 years including males and females in the ratio of 7:3. All the diagnostic procedures were carried out on each patient followed by biopsy and data was subjected to statistical analysis. Results: Comparing the results of exfoliative cytology with toluidine blue in diagnosing dysplasia in leukoplakia, it showed 50% sensitivity and 83.3 % specificity. In comparison to chemiluminescent light examination, cytology showed 42.9% sensitivity and 79.3% specificity. Chemiluminescent light examination showed 60% sensitivity and 70% specificity compared to toluidine blue. Conclusions: Overall accuracy of exfoliative cytology was less than toluidine blue, whereas latter showed superior but comparable results to chemiluminescent illumination in detecting dysplasia. However role of chemiluminescent illumination should be further investigated in demarcating dysplatic lesions
