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Journal of Clinical Medicine May 2024Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects....
Three-Dimensional Cone Beam Computed Tomography (CBCT)-Derived Soft Tissue Changes in Patients with Unilateral Cleft Lip, Alveolus, and Palate with Midfacial Deficiency after 1.5 Years of Bone-Anchored Maxillary Protraction.
Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. The results revealed a moderate positive correlation (Pearson's correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (-1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects.
PubMed: 38792430
DOI: 10.3390/jcm13102890 -
International Journal of Molecular... May 2024Orthodontic space closure following tooth extraction is often hindered by alveolar bone deficiency. This study investigates the therapeutic use of nuclear factor-kappa B...
Orthodontic space closure following tooth extraction is often hindered by alveolar bone deficiency. This study investigates the therapeutic use of nuclear factor-kappa B (NF-κB) decoy oligodeoxynucleotides loaded with polylactic-co-glycolic acid nanospheres (PLGA-NfDs) to mitigate alveolar bone loss during orthodontic tooth movement (OTM) following the bilateral extraction of maxillary first molars in a controlled experiment involving forty rats of OTM model with ethics approved. The decreased tendency of the OTM distance and inclination angle with increased bone volume and improved trabecular bone structure indicated minimized alveolar bone destruction. Reverse transcription-quantitative polymerase chain reaction and histomorphometric analysis demonstrated the suppression of inflammation and bone resorption by downregulating the expression of tartrate-resistant acid phosphatase, tumor necrosis factor-α, interleukin-1β, cathepsin K, NF-κB p65, and receptor activator of NF-κB ligand while provoking periodontal regeneration by upregulating the expression of alkaline phosphatase, transforming growth factor-β1, osteopontin, and fibroblast growth factor-2. Importantly, relative gene expression over the maxillary second molar compression side in proximity to the alveolus highlighted the pharmacological effect of intra-socket PLGA-NfD administration, as evidenced by elevated osteocalcin expression, indicative of enhanced osteocytogenesis. These findings emphasize that locally administered PLGA-NfD serves as an effective inflammatory suppressor and yields periodontal regenerative responses following tooth extraction.
Topics: Animals; Polylactic Acid-Polyglycolic Acid Copolymer; Rats; Nanospheres; Tooth Movement Techniques; Oligodeoxyribonucleotides; Tooth Socket; Male; NF-kappa B; Wound Healing; Alveolar Bone Loss; Tooth Extraction
PubMed: 38791262
DOI: 10.3390/ijms25105223 -
Dentistry Journal Apr 2024Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket...
Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root resorption of tooth 3.7. Extraction of 3.7 and autotransplantation of 3.8 was planned, following a 6-week orthodontic phase for periodontal ligament activation and teeth mobilization. Due to the different root morphology between the compromised and donor teeth and the high mandibular bone density, the receiving socket preparation was performed using guided surgery templates. Two surgical splints were designed with a surgical planning software. Tooth 3.7 was extracted, the recipient site was guided-milled, and tooth 3.8 was transplanted into the new socket in approximately one second of extra-alveolar time. The rapidity of the extra-alveolar time facilitated complete healing without resorting to root canal treatment. Five-year radiological control does not show any periapical lesion or root resorption. The surgical procedure for tooth autotransplantation is fundamental: it must be as atraumatic as possible to preserve the periodontal ligament of the tooth and the receiving socket, and the dentist must minimize the extra-alveolar time. Guided surgery is a reliable solution to combine all these aspects.
PubMed: 38786522
DOI: 10.3390/dj12050124 -
Turkish Archives of Otorhinolaryngology Dec 2023Early surgical debridement is vital for favorable outcomes in acute invasive fungal sinusitis (AIFS). Our study aimed to propose guidelines with tailored, conservative...
OBJECTIVE
Early surgical debridement is vital for favorable outcomes in acute invasive fungal sinusitis (AIFS). Our study aimed to propose guidelines with tailored, conservative surgical procedures based on areas of involvement and evaluate their usefulness in avoiding repeated debridement.
METHODS
This retrospective observational study was conducted on 150 AIFS patients operated on with the proposed surgical guidelines from May to June 2021 at a tertiary care hospital. Data including demography, comorbidities, surgical procedures, revision surgery, and outcome were collected and analyzed.
RESULTS
All 150 patients underwent bilateral endoscopic sinonasal debridement. Among them, 108 patients (72%) had current or recent coronavirus disease (COVID) infection. Ninety-two patients (61.3%) required additional procedures based on disease extent. Twenty patients (15.4%) required revision debridement because of progressive or recurrent disease. Mean age of this group was 46.15 (standard deviation ±11.2) years with a strong male predominance (9:1). Seventeen had diabetes mellitus, 12 suffered from active COVID-19 infection and six had received corticosteroids. None of the 31 patients who had recovered from COVID-19 or had no comorbidities required revision surgery. Age, gender, and comorbidities were not significant predictors for revision surgery. Fourteen patients (70%) underwent second surgery within one month of primary surgery. Predominant disease locations were alveolus and palate (55% each), and in 80% the site was uninvolved at primary surgery. The most common revision procedure was inferior partial maxillectomy (60%). At follow-up, all were asymptomatic with no evidence of disease.
CONCLUSION
The proposed surgical guidelines for AIFS allow for adequate surgical debridement with preservation of optimum functional status. Low revision surgery rates and good outcomes with minimal morbidity validate its usefulness.
PubMed: 38784956
DOI: 10.4274/tao.2024.2023-10-4 -
Brazilian Oral Research 2024The aim of this systematic review was to answer the following question: "Does alendronate, a nitrogen-containing bisphosphonate, improve or impair alveolar socket...
The aim of this systematic review was to answer the following question: "Does alendronate, a nitrogen-containing bisphosphonate, improve or impair alveolar socket healing after tooth extraction in animal models"? To this end, a systematic review of the literature was carried out in PubMed, Scopus, LILACS, Web of Science, as well as in the gray literature up to May 2023. Preclinical studies that evaluated alveolar healing after tooth extraction and the intake of sodium alendronate compared with placebo were included. Two investigators were responsible for screening the articles independently, extracting the data, and assessing their quality through the SYRCLE's RoB tool for randomized trials in animal studies. The study selection process, study characteristics, risk of bias in studies, impact of alendronate on bone healing, and certainty of evidence were described in text and table formats. Methodological differences among the studies were restricted to the synthesis methods. The synthesis of qualitative results followed the Synthesis Without Meta-analysis (SWiM) reporting guideline. From the 19 included studies, five were considered to have low risk, three were of unclear risk, and eleven presented a high risk of bias. The studies were considered heterogeneous regarding alendronate posology, including its dosage and route of administration. Furthermore, a variety of animal species, different age ranges, diverse teeth extracted, and exposure or not to ovariectomy contributed to the lack of parity of the selected studies. Our results indicated that alendronate monotherapy negatively affects the early phase of wound healing after tooth extraction in preclinical studies, suggesting that the bone resorption process after tooth extraction in animals treated with alendronate might impair the bone healing process of the extraction socket. In conclusion, alendronate administration restrains bone resorption, thereby delaying alveolar socket healing . Future studies should be conducted to validate these findings and to better understand the effects of alendronate therapy on oral tissues.
Topics: Alendronate; Tooth Extraction; Animals; Wound Healing; Tooth Socket; Bone Density Conservation Agents
PubMed: 38747825
DOI: 10.1590/1807-3107bor-2024.vol38.0038 -
Journal of Applied Oral Science :... 2024Studies have highlighted numerous benefits of ozone therapy in the field of medicine and dentistry, including its antimicrobial efficacy against various pathogenic...
OBJECTIVE
Studies have highlighted numerous benefits of ozone therapy in the field of medicine and dentistry, including its antimicrobial efficacy against various pathogenic microorganisms, its ability to modulate the immune system effectively, reduce inflammation, prevent hypoxia, and support tissue regeneration. However, its effects on dental extraction healing remain to be elucidated. .Therefore, this study aimed to evaluate the effects of systemically administered ozone (O3) at different doses in the healing of dental extraction sockets in rats.
METHODOLOGY
To this end, 72 Wistar rats were randomly divided into four groups after extraction of the right upper central incisor: Group C - control, no systemic treatment; Group OZ0.3 - animals received a single dose of 0.3 mg/kg O3; Group OZ0.7 - a single dose of 0.7 mg/kg O3; and Group OZ1.0 - a single dose of 1.0 mg/kg O3, intraperitoneally. In total, six animals from each group were euthanized at 7, 14, and 21 days after the commencement of treatment. Bone samples were harvested and further analyzed by descriptive histology, histomorphometry, and immunohistochemistry for osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) protein expression.
RESULTS
All applied doses of O3 were shown to increase the percentage of bone tissue (PBT) after 21 days compared to group C. After 14 days, the OZ0.7 and OZ1.0 groups showed significantly higher PBT when compared to group C. The OZ1.0 group presented the most beneficial results regarding PBT among groups, which denotes a dose-dependent response. OCN immunostaining was higher in all groups at 21 days. However, after seven and 14 days, the OZ1.0 group showed a significant increase in OCN immunostaining compared to C group. No differences in TRAP+ osteoclasts were found between groups and time points.
CONCLUSION
Therefore, O3 therapy at higher doses might be beneficial for bone repair of the alveolar socket following tooth extraction.
Topics: Animals; Ozone; Rats, Wistar; Tooth Extraction; Tooth Socket; Wound Healing; Tartrate-Resistant Acid Phosphatase; Immunohistochemistry; Osteocalcin; Time Factors; Male; Random Allocation; Reproducibility of Results; Treatment Outcome; Reference Values
PubMed: 38747807
DOI: 10.1590/1678-7757-2023-0412 -
Cureus Apr 2024Solitary median maxillary central incisor (SMMCI) syndrome is complex and usually develops 35-38 days postconception during the intrauterine period. A noteworthy...
Solitary median maxillary central incisor (SMMCI) syndrome is complex and usually develops 35-38 days postconception during the intrauterine period. A noteworthy discovery is that just one central incisor in the maxillary alveolus, found exactly on the centerline, is present in both deciduous and permanent dentitions with other congenital anomalies. Around one in every 50,000 live babies exhibits this abnormality. This report describes the case of a 13-year-old female patient with SMMCI syndrome with a complaint about an unsightly appearance due to a single large upper front tooth. We underline the importance of increasing clinician awareness of SMMCI syndrome and the need for a multidisciplinary approach to its care.
PubMed: 38741811
DOI: 10.7759/cureus.58101 -
Cureus Apr 2024Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as...
Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as socket preservation, atraumatic extraction, and immediate implant placement are employed to reduce the dimensional changes associated with extraction. The socket shield technique (SST) is effective in preserving the alveolar ridge's contour, enhancing the aesthetic results of rehabilitation by maintaining the integrity of the bundle bone complex even when the buccal bone is less than 1mm. This case report presents a 23-year-old female patient with a fractured upper central incisor. The socket shield technique was chosen based on the clinical findings from the cone beam computed tomography (CBCT) scan. Immediate temporization was provided to preserve soft tissue integration. A comparison of the initial and subsequent cone beam computed tomography (CBCT) scans, along with clinical observations, suggests that the socket shield technique is a viable method for preserving both hard and soft tissue structures in the anterior dental region, thereby improving aesthetic outcomes.
PubMed: 38738015
DOI: 10.7759/cureus.57940 -
Contemporary Clinical Dentistry 2024This case report describes a case of intention replantation in a 15-year-old patient with a mandibular permanent right second molar that had undergone root canal...
This case report describes a case of intention replantation in a 15-year-old patient with a mandibular permanent right second molar that had undergone root canal treatment previously. The tooth was tender on percussion. Radiographic evaluation showed the presence of a separated instrument and periapical radiolucency. The surgical procedure was performed under local anesthesia, and the tooth was extracted. After cleaning and disinfecting the root canal system, the tooth was reimplanted, and the socket was filled with a mixture of bone graft material and a growth factor. A stainless steel crown was then placed to protect the tooth. A follow-up examination was performed after 12 months. The clinical and radiographic examinations revealed a well-healing periapical lesion with no signs of infection. The patient was asymptomatic, and the tooth was functional. The results of this case indicate that intentional replantation can lead to a favorable outcome.
PubMed: 38707664
DOI: 10.4103/ccd.ccd_134_23 -
Journal of Medical Case Reports May 2024Peripheral ossifying fibroma is a nonneoplastic inflammatory hyperplasia that originates in the periodontal ligament or periosteum in response to chronic mechanical... (Review)
Review
BACKGROUND
Peripheral ossifying fibroma is a nonneoplastic inflammatory hyperplasia that originates in the periodontal ligament or periosteum in response to chronic mechanical irritation. Peripheral ossifying fibroma develops more commonly in young females as a solitary, slow-growing, exophytic nodular mass of the gingiva, no more than 2 cm in diameter. While various synonyms have been used to refer to peripheral ossifying fibroma, very similar names have also been applied to neoplastic diseases that are pathologically distinct from peripheral ossifying fibroma, causing considerable nomenclatural confusion. Herein, we report our experience with an unusual giant peripheral ossifying fibroma with a differential diagnostic challenge in distinguishing it from a malignancy.
CASE PRESENTATION
A 68-year-old Japanese male was referred to our department with a suspected gingival malignancy presenting with an elastic hard, pedunculated, exophytic mass 60 mm in diameter in the right maxillary gingiva. In addition to computed tomography showing extensive bone destruction in the right maxillary alveolus, positron emission tomography with computed tomography revealed fluorodeoxyglucose hyperaccumulation in the gingival lesion. Although these clinical findings were highly suggestive of malignancy, repeated preoperative biopsies showed no evidence of malignancy. Since even intraoperative frozen histological examination revealed no malignancy, surgical resection was performed in the form of partial maxillectomy for benign disease, followed by thorough curettage of the surrounding granulation tissue and alveolar bone. Histologically, the excised mass consisted primarily of a fibrous component with sparse proliferation of atypical fibroblast-like cells, partly comprising ossification, leading to a final diagnosis of peripheral ossifying fibroma. No relapse was observed at the 10-month follow-up.
CONCLUSIONS
The clinical presentation of giant peripheral ossifying fibromas can make the differential diagnosis from malignancy difficult. Proper diagnosis relies on recognition of the characteristic histopathology and identification of the underlying chronic mechanical stimuli, while successful treatment mandates complete excision of the lesion and optimization of oral hygiene. Complicated terminological issues associated with peripheral ossifying fibroma require appropriate interpretation and sufficient awareness of the disease names to avoid diagnostic confusion and provide optimal management.
Topics: Humans; Fibroma, Ossifying; Male; Aged; Diagnosis, Differential; Gingival Neoplasms; Maxillary Neoplasms; Tomography, X-Ray Computed; Maxilla
PubMed: 38702820
DOI: 10.1186/s13256-024-04529-9