Oral and Maxillofacial Surgery

The KEY3 is an advanced Er:YAGlaser system with an inbuilt fluorescence diagnostic system. The laser can be operated manually or with the aid of fluorescence guidance. The latter can be used for "autopilot" guidance of laser surgical procedures. The laser wavelength of 2.94µm is effective for ablating soft tissues as well as bone and tooth structure.

The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. Material and Methods: A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through March 13, 2019. Comparative and non-comparative studies evaluating horizontal ridge augmentation with allogeneic bone block were included. Cochrane risk of bias tool and Newcastle-Ottawa Scale were used to evaluate risk of bias. Results: One comparative study with high quality and 12 non-comparative studies fulfilled the inclusion criteria. Considerable heterogeneity prevented meta-analysis from being performed. The comparative retrospective short-term study demonstrated no significant difference in implant treatment outcome between the two treatment modalities. Non-comparative long-term studies revealed high implant survival, gain in alveolar ridge width and bone regeneration with allogeneic bone block. However, noncomparative studies disclosed high incidence of complications including dehiscence, exposure of allogeneic bone block and partial or total loss of the grafts. Conclusions: There seemed to be no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. However, increased risk of complications was frequently reported with allogeneic bone block.

The aim of this systematic review was to test the hypothesis of no difference in complications and donor site morbidity following harvesting of autogenous bone graft from the ascending mandibular ramus compared with the chin region. Material and Methods: MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through June 26, 2020. Randomized and controlled trials were included. Outcome measures included pain, infection, mucosal dehiscence, altered sensation or vitality of adjacent tooth/teeth, neurosensory disturbances and patient-reported outcome measures. Risk of bias was assessed by Cochrane risk of bias tool and Newcastle-Ottawa Scale. Results: Ten controlled trials of high-quality fulfilled inclusion criteria. Risk of infection and mucosal dehiscence seems to be comparable with the two treatment modalities. However, harvesting from the chin seems to be associated with increased risk of pain, altered sensation or loss of tooth vitality, and neurosensory disturbances. Willingness to undergo the same treatment again was reported with both treatment modalities, but significant higher satisfaction, lower discomfort and acceptance of the surgical procedure was reported following harvesting from the ascending mandibular ramus. The hypothesis was rejected due to higher prevalence and severity of complications and donor site morbidity following harvesting of autogenous bone graft from the chin region. Dissimilar evaluation methods and various methodological confounding factors posed serious restrictions for literature review in a quantitative systematic manner. Conclusions drawn from results of this systematic review should therefore be interpreted with caution.

Objectives: Test the hypothesis of no difference in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. Material and Methods: A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 5 th of July, 2019 were included. Randomised controlled trials and controlled trials with an observation period of minimum six months were included. Primary outcomes included survival of suprastructures and implants. Secondary outcomes included implant stability quotient, peri-implant marginal bone loss, bone regeneration, patient-reported outcome measures, biologic and mechanical complications. The electronic search and hand-searching resulted in 1068 entries. Six randomised controlled trials characterised by low to high risk of bias and one controlled trial with high risk of bias fulfilled the inclusion criteria. High implant survival rate was reported with both treatment modalities. Meta-analyses disclosed a mean difference of newly formed bone of 6.4% (confidence interval = 0 to 12.9) and non-mineralised tissue of -1.1% (confidence interval = -2.7 to 0.5), indicating more newly formed bone and diminished non-mineralised with barrier membrane coverage. Conclusions: There seem to be no statistically significant differences in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. However, barrier membrane coverage increases percentage of newly formed bone and diminishes proliferation of non-mineralised tissue. Thus, barrier membrane coverage seems to be beneficial and also preventing displacement of the grafting material.

O granuloma piogenico e uma lesao benigna constituida por tecido de granulacao que se origina no tecido conjuntivo da pele ou mucosa. E considerado uma lesao reacional e multifatorial relacionada a agressoes repetitivas, traumas, irritantes locais e pobre higiene bucal. Acomete mais frequentemente adolescentes, adultos jovens de 11 a 40 anos, e fica localizado mais na maxila. As mulheres sao mais afetadas que os homens, em razao dos efeitos vasculares provocados pelos hormonios femininos. O tratamento consiste na excisao cirurgica local. O diagnostico diferencial e feito com outras lesoes, como lesao periferica de celulas gigantes (LPCG), hemangiomas e sarcoma de Kaposi, e deve ser feito pela biopsia seguida de exame histopatologico. O objetivo com este trabalho foi relatar um caso de granuloma piogenico diagnosticado na clinica de diagnostico IV da Unoesc Joacaba. O caso apresentado e de uma paciente, sexo feminino, 50 anos, que fazia uso de placa miorelaxante para dormir e tambem ...

Os bisfosfonatos (BFs) sao farmacos utilizados na prevencao e tratamento de doencas osseas, onde ha um intensa atividade dos osteclastos na reabsorcao ossea. Como efeito adverso, tais farmacos podem interferir na angiogenese, por meio da inibicao do fator de crescimento endotelial vascular, e desenvolver metastases osseas nos ossos maxilares, sobretudo apos exodontias. O objetivo deste trabalho e descrever, a partir de uma revisao de literatura as caracteristicas clinicas da osteonecrose induzida por BFs, drogas mais suscetiveis ao aparecimento da doenca, e bem como a conduta mais indicada para cada caso. Os BFs agem bloqueando a reabsorcao ossea, promovendo inibicao dos osteoclastos e osteoblastos, apoptose dos osteoclastos, bem como interferindo na angiogenese. O pamidronato e o zoledronato sao os principais BFs responsaveis pelo processo de osteonecrose dos maxilares. Ocorre uma maior prevalencia da osteonecrose na mandibula, embora haja um envolvimento de ambos os maxilares. Os ...

The aim of this study was to evaluate functionality and clinical application of a novel immediate device in the treatment of temporomandibular disorders (TMDs). To address the research purpose, authors developed and implemented a randomized control clinical trial. PATIENTS AND METHODS: Eighty patients were enrolled in this study and were randomly divided into two subgroups based on the treatment applied: patient group (PG) and control group (CG). The CG was not subjected to any kind of treatment, even placebo, in order to be able to assess the spontaneous development of the pathology over time. The PG was treated applying the novel device for a maximum of three months. The following parameters were evaluated at baseline (T0) and at the end of therapy (T1): presence/absence of articular noises, painful symptomatology (articular pains, muscle pains, headache, cervicalgia), parafunctional habits and duration of symptoms. The x 2-index of association was performed, with a p-value < 0.05 considered as statistically significant. RESULTS: No patient in the PG worsened its symptomatology. Thirteen patients (33%) declared themselves cured from their symptoms and were included in a monitoring protocol. Twenty-seven patients (67%) improved their symptoms and were treated with other conservative conventional methods to complete the therapeutic cycle. Therefore, 100% of PG obtained benefits from the application of the new therapeutic approach. In contrast, among patients of CG, eighteen subjects (45%) worsened their symptoms, while eighteen (45%) were defined as stationaries compared to T0 and only four (10%) were defined as improved. CONCLUSIONS: The device presented the following advantages: immediacy of use, reduction of waiting times for its application, good tolerability and comfort and specificity in the execution of tongue rehabilitation exercises.

Background The life expectancy of patients with Human Immunodeficiency Virus (HIV) has increased, but its oral manifestations can affect the Oral Health-Related Quality of Life (OHRQoL) of these patients. This study aimed to evaluate OHRQoL in HIV-infected patients and determine its related factors. Methods In this cross-sectional study, 250 HIV-infected patients were randomly selected from Shiraz Voluntary Counseling and Testing center in 2019. OHRQoL was measured using the revised Geriatric Oral Health Assessment Index for HIV patients. The associations between patients’ OHRQoL and demographic characteristics were examined. Results The mean score of the patients&#39; OHRQoL was 24.55 ± 6.27. The lowest and highest scores belonged to the psychosocial and pain categories, respectively. In the univariate analysis, the OHRQoL was significantly associated with patients&#39; age (p = 0.012), duration of the disease (p = 0.009), job (p = 0.006), edentulous status (p = 0.003), and wearing...

Background Human immunodeficiency virus (HIV) continues to be a major global issue. HIV-infected patients commonly experience oral health problems. This study aimed to assess oral health status of the patients and its related factors in Shiraz, Iran. Methods In this cross-sectional study, by using simple random sampling, 250 HIV-infected patients were selected from Shiraz Voluntary Counseling and Testing Center in 2019. Patients&#39; decayed, missing, and filled tooth (DMFT) index, plaque index (PI), and community periodontal index (CPI) were determined. Associations between patients&#39; characteristics and the above-mentioned indices were examined by using Pearson correlation, one-way ANOVA, chi-square, and independent sample T test. The effect of possible confounding factors was controlled by using multiple linear regression and logistic models. Results Of the 222 participants, 111 (50%) had 15 or more missing teeth and 79 (35.6%) were edentulous. Their mean (SD) DMFT and PI were...

Concerning malignant submandibular gland tumors, a rare disease entity, there are few recent reports of long term treatment results and of prognostic factors modifying these results. The clinical data of 43 patients with malignant submandibular gland tumors who were treated at the Netherlands Cancer Institute between 1973 and 1994 were reviewed to evaluate treatment results and to control described prognostic factors. The median follow-up for patients alive at the end of follow-up was 143 months. Only univariate analyses were performed. The crude 5-and 10-year survival rates were 50% and 36%, respectively; the 5-and 10-year disease specific survival (DSS) rates were 61% and 51%, respectively; and the 5-and 10-year recurrence free percentages were 57% and 52%, respectively. Factors predicting crude survival were age at diagnosis (P ϭ 0.0006), International Union Against Cancer/American Joint Committee on Cancer (UICC/ AJCC) TNM classification and its regrouping into tumor stage (P ϭ 0.001), and clinical skin invasion (P ϭ 0.005). In surgically treated patients, soft tissue invasion (P ϭ 0.005), metastatic lymph nodes (P ϭ 0.006), and perineural growth (P ϭ 0.01) were prognostic for survival. Factors predicting DSS were the UICC/AJCC TNM classification and regrouping into tumor stage (P ϭ 0.002). In surgical patients, perineural growth (P ϭ 0.0008) conferred a lower DSS. Factors predicting tumor recurrence were the UICC/AJCC TNM classification and its regrouping into tumor stage (P ϭ 0.009). In surgical patients, perineural growth (P ϭ 0.003) predicts tumor recurrence. Of patients with submandibular gland carcinoma treated according to a stable treatment protocol in a European tertiary referral center, 52% were tumor free 10 years later. Patients exhibiting the described adverse prognostic factors are likely to benefit from added radiotherapy.

La displasia fibrosa es un padecimiento benigno crónico que se caracteriza por remplazar hueso por tejido fibro-óseo anormal y que provoca distorsión y debilidad ósea en las regiones afectadas, entre las que destacan las costillas, la tibia, el fémur, el maxilar, la mandíbula y el cráneo. Se detecta en la infancia y su progresión habitualmente se detiene al inicio de la pubertad, cuando el hueso ha terminado su desarrollo; sin embargo, se han detectado algunos casos en la edad adulta en los que su curso es asintomático e incidental; asimismo, se ha encontrado afección en huesos vecinos diferentes a los implicados inicialmente. La displasia fibrosa craneofacial puede manifestarse en diversas formas clínicas, según el hueso afectado, de lo cual dependerá el abordaje y el tratamiento. Es motivo de esta comunicación hacer una revisión de la bibliografía y exponer cinco casos clínicos con afección craneofacial, así como el manejo que se le dio a cada uno.

La displasia fibrosa es un padecimiento benigno crónico que se caracteriza por remplazar hueso por tejido fibro-óseo anormal y que provoca distorsión y debilidad ósea en las regiones afectadas, entre las que destacan las costillas, la tibia, el fémur, el maxilar, la mandíbula y el cráneo. Se detecta en la infancia y su progresión habitualmente se detiene al inicio de la pubertad, cuando el hueso ha terminado su desarrollo; sin embargo, se han detectado algunos casos en la edad adulta en los que su curso es asintomático e incidental; asimismo, se ha encontrado afección en huesos vecinos diferentes a los implicados inicialmente. La displasia fibrosa craneofacial puede manifestarse en diversas formas clínicas, según el hueso afectado, de lo cual dependerá el abordaje y el tratamiento. Es motivo de esta comunicación hacer una revisión de la bibliografía y exponer cinco casos clínicos con afección craneofacial, así como el manejo que se le dio a cada uno. Abstract

Introduction The purpose of this study was to compare the outcome of open treatment of mandibular fracture (symphysis or parasymphysis) using lag screw or mini plate clinically as well as radiologically in young (age range 12-45 years) and healthy individuals of poor socioeconomic status. Method This prospective study was conducted on 30 patients diagnosed as cases of displaced mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated to either of two groups--Group A: Two 2.5 mm stainless steel lag screws were placed in 15 patients. Group B: Two 2.5 mm stainless steel mini plates were placed in 15 patients for the fixation of fractures. Subsequent follow up was done on 2nd, 4th, 6th and 8th week postoperatively. During every follow up patient was assessed clinically for infection, malocclusion, loosening of plate/screw, sensory disturbance, plate fracture, malunion/non-union, devitalisation of associated dentoalveolar segment and masticatory efficiency. Radiographs were taken if necessary and patients were further assessed for any complaint. Pain was objectively measured using a visual analogue scale, bite force was measured using a bite force transducer at biweekly interval. The data collected was subjected to unpaired t test and paired t test for statistical analysis. During follow up period a significant improvement in bite force was present in both the groups, with more improvement seen in the lag screw group (p \ 0.01). There was a significant pain reduction present in the lag screw group (p \ 0.01) and also masticatory efficiency showed a steadier improvement in lag screw group while mini plate group patients showed a tendency to masticate only food items of medium hard consistency. Conclusion The sample size is small to conclude lag screws are better than mini plates but the result of our study provides a basis for further studies done to conclude that the application of LAG SCREW is an effective, inexpensive, quick treatment modality to accelerate healing of fresh, displaced mandibular anterior fracture.

The purpose of this study was to evaluate the expression of cdk4 and p16, the proteins implicated in hyperproliferation and arrest in oral lichen planus and to compare their expression in erosive and non-erosive oral lichen planus and with normal mucosa and oral squamous cell carcinoma. Material and Methods: Analysis of cdk4 and p16 expression was done in 43 erosive oral lichen planus (EOLP) and 17 non-erosive oral lichen planus (NOLP) cases, 10 normal mucosa and 10 oral squamous cell carcinoma (OSCC) cases with immunohistochemistry. Results: This study demonstrated a significantly increased expression of cytoplasmic cdk4 (80% cases, cells stained -19.6%), and cytoplasmic p16 (68.3% cases, cells stained -16.4%) in oral lichen planus (OLP) compared to normal mucosa. cdk4 was much higher in OSCC in both cytoplasm and nuclei compared to normal mucosa. Also, while comparing OLP with positive control, significant difference was noted for cdk4 and p16, with expression being more in OSCC. While comparing EOLP with NOLP; significant differences were seen for cdk4 cytoplasmic staining only, for number of cases with positive staining as well as number of cells stained. Conclusions: Overexpression of cytoplasmic cdk4 and p16 was registered in oral lichen planus, however considerably lower than in squamous cell carcinoma. Erosive oral lichen planus demonstrated overexpression of cytoplasmic cdk4 and premalignant nature compared to non-erosive lesion. Therefore there is an obvious possibility for cytoplasmic expression of cdk4 and p16 to predict malignant potential of oral lichen planus lesions.

The purpose of this study was to evaluate the expression of cdk4 and p16, the proteins implicated in hyperproliferation and arrest in oral lichen planus and to compare their expression in erosive and non-erosive oral lichen planus and with normal mucosa and oral squamous cell carcinoma. Material and Methods: Analysis of cdk4 and p16 expression was done in 43 erosive oral lichen planus (EOLP) and 17 non-erosive oral lichen planus (NOLP) cases, 10 normal mucosa and 10 oral squamous cell carcinoma (OSCC) cases with immunohistochemistry. Results: This study demonstrated a significantly increased expression of cytoplasmic cdk4 (80% cases, cells stained -19.6%), and cytoplasmic p16 (68.3% cases, cells stained -16.4%) in oral lichen planus (OLP) compared to normal mucosa. cdk4 was much higher in OSCC in both cytoplasm and nuclei compared to normal mucosa. Also, while comparing OLP with positive control, significant difference was noted for cdk4 and p16, with expression being more in OSCC. While comparing EOLP with NOLP; significant differences were seen for cdk4 cytoplasmic staining only, for number of cases with positive staining as well as number of cells stained. Conclusions: Overexpression of cytoplasmic cdk4 and p16 was registered in oral lichen planus, however considerably lower than in squamous cell carcinoma. Erosive oral lichen planus demonstrated overexpression of cytoplasmic cdk4 and premalignant nature compared to non-erosive lesion. Therefore there is an obvious possibility for cytoplasmic expression of cdk4 and p16 to predict malignant potential of oral lichen planus lesions.

Background and Clinical Significance: Tooth impaction is a developmental anomaly characterized by the inability of a tooth to emerge into its predetermined anatomical position within the oral cavity during the normal eruption period. Impaction of the mandibular second premolar is an uncommon condition and poses a heightened risk of neurosensory injury when the tooth is adjacent to the mental foramen. Early diagnosis and precise planning are therefore essential. Case Presentation: This case report presents a rare instance of an asymptomatic impacted mandibular second premolar located in close proximity to the mental foramen in a 44-year-old female patient. The impaction was discovered incidentally on an orthopantomogram, and Cone-Beam Computed Tomography (CBCT) confirmed intimate contact between the root of the impacted second premolar and the mental nerve. Surgical removal was performed under local anesthesia via a conservative triangular flap and a corticotomy window. Platelet-Rich Fibrin (PRF) generated from autologous blood was placed in the socket to foster healing. The proximity of the mental foramen dictated minimal bone removal and atraumatic luxation to avoid nerve stretch or compression. PRF was selected as an effective biomaterial shown to accelerate soft tissue healing and moderate postoperative discomfort, potentially reducing the likelihood of neurosensory disturbance. The socket presented satisfactory healing, and neurosensory function was normal at the first week follow-up and remained normal at 7 months postoperatively (longest follow-up), and no complications were reported by the patient. Conclusions: CBCT-guided planning, meticulous surgical techniques, and adjunctive PRF allowed for safe extraction without post-operative paraesthesia. Timely identification of such rare impactions broadens treatment options and minimizes complications.

Background In recent years, minimally invasive and non-invasive rejuvenation methods have been welcomed. PRP has been used widely for skin rejuvenation, but there are few studies on PRP for lip rejuvenation. Objective The objective of this study was to investigate the preliminary effects of PRP for lip rejuvenation. Methods Between October 2018 and April 2023, 15 participants with lip aging (1 male, 14 females; range 27–58 years) were treated with PRP. The follow-up time was 3 to 24months. After 3 to 6 times treatments, beauty seekers and experienced physicians jointly evaluated effectiveness of treatment. The assessment included improvements in the colour, wrinkles, and skin texture of the lips before and after treatment. Results According to the beauty seekers and Surgeons ’evaluation, the aging characteristics of the lips of the 15 beauty seekers have been improved to varying degrees. The most obvious improvement was that the color of the lips which became more vivid. There was n...

<Objective> Platelet-rich plasma (PRP) has been used as a therapeutic tool to promote wound healing, in orthopedics, dermatology, oral surgery, etc. However, the mechanisms underlying the wound healing effects of PRP remain unclear. The purpose of this study was to evaluate the effectiveness of applying PRP, particularly in the management of tooth extraction sockets. <Materials and Methods> Three upper molars of Fischer rats were extracted, and blood was drawn from the hearts of other rats to prepare PRP. The PRP was activated and applied to the bone defects of the experimental group, and nothing was applied to the bone defects of the control group. <Results> On day 3, fibrin network and granulation tissue, which are abundant in blood capillaries, were seen under the PRP layer in the experimental group. On the other hand, only inflammatory cells and a fibrin network were observed in the bone defects of the control group. On day 7, granulation tissue was seen in the bone defects in both the control group and experimental group, although excavation of granulation tissue was noted in the control group. <Conclusions> The results demonstrated the presence of a rich fibrin network and early inflammatory reactions in the experimental group, which may lead to rise of thick, vessel-rich granulation tissue. The application of PRP may stimulate wound healing in tooth extraction bone defects, and PRP may confer some beneficial effects on the outcomes.

This study evaluated Method 300, a complementary teaching methodology in Dentistry. Thirty participants were divided into 6 groups according to the scores obtained in a placement test ranging from 0 to 10. Students with scores lower than 6 were classified as having poor academic performance; students with scores equal to or greater than 6 were considered as having good academic performance. Each group included at least one student with good performance. Our methodology consisted of two application cycles, each including one different test; however, only students with low performance could undergo the second testing. Students held meetings twice a week for one hour and thirty minutes. Of the 54 students initially enrolled in the subject, 24 dropped out, leaving 30 students who completed all the proposed activities. In cycle 1, 24 (80%) students showed poor academic performance and 6 (20%) good. Students with poor performance in P1 significantly improved after P1 300 test application (P < 0.001). After cycle 1 activities, all 30 participants showed significant improvement. In cycle 2, the number of students with good performance tripled when compared to cycle 1, resulting in a decrease in the number of students with poor performance (P = 0.205). Results show that the Method 300 is an important teaching-learning resource in Dentistry, to be used as a complementary methodology to lectures.

This study evaluated Method 300, a complementary teaching methodology in Dentistry. Thirty participants were divided into 6 groups according to the scores obtained in a placement test ranging from 0 to 10. Students with scores lower than 6 were classified as having poor academic performance; students with scores equal to or greater than 6 were considered as having good academic performance. Each group included at least one student with good performance. Our methodology consisted of two application cycles, each including one different test; however, only students with low performance could undergo the second testing. Students held meetings twice a week for one hour and thirty minutes. Of the 54 students initially enrolled in the subject, 24 dropped out, leaving 30 students who completed all the proposed activities. In cycle 1, 24 (80%) students showed poor academic performance and 6 (20%) good. Students with poor performance in P1 significantly improved after P1 300 test application (P < 0.001). After cycle 1 activities, all 30 participants showed significant improvement. In cycle 2, the number of students with good performance tripled when compared to cycle 1, resulting in a decrease in the number of students with poor performance (P = 0.205). Results show that the Method 300 is an important teaching-learning resource in Dentistry, to be used as a complementary methodology to lectures.

BACKGROUND The management of malocclusion has developed greatly in terms of treatment simulation and biomechanics, but treatment duration has been a great concern to the clinician as well as the patient. Vitamin D stimulates both osteoclasts and osteoblasts and was found to be the most significant in Orthodontic Tooth Movement acceleration. Inflammatory cytokines like IL-17A also play an important role in osteoclastogenesis and enhances the rate of Orthodontic Tooth Movement. AIM To perform a simultaneous evaluation of pro inflammatory salivary cytokine IL-17A and salivary vitamin D3 and to correlate their role on orthodontic tooth movement. MATERIALS AND METHODS A prospective cohort study was conducted among n = 97 patients . Saliva samples were collected from the patients at three phases of the orthodontic treatment, centrifuged and stored at 4℃ for evaluation of salivary Vitamin D3 levels and Pro-inflammatory cytokine IL-17A using ELISA. RESULTS The mean salivary VitaminD3 levels...

The purpose of this study was to compare dentalanxiety levels among first-, second-, third-, fourth-and fifth-year dental students. To evaluate the level of dental anxiety against dental interventions, online questionnaires were applied to first year (n=96), second year (n=96), third year (n=109), fourth year (n=107) and fifth year (n=92) dental students. The students' demographic information (age, gender) was also recorded. These questionnaires included the Modified Dental Anxiety Scale (MDAS). The students whose MDAS score was ≥19 were considered as highly anxious. The statistical analysis was performed using IBM SPSS Statistics 24 (IBM SPSS, USA).This study was conducted with a total of 500 students including 220 male and 280 female students. The students with an MDAS score of 19 (having dental anxiety) were 23 people (4.6%) in total. No statistically significant difference was found between the class years of the students in terms of their mean MDAS scores (p: 0.387). When the responses given to the 5 items in MDAS were evaluated, only the responses given to the 1st and 5th questions had statistically significant differences (p<0.01).An inversely proportional situation, such as a decrease in dental anxiety as the class year of students gets more advanced, was not valid for our study. Many previous studies have shown that both education level and dental education may be effective in reducing the level of dental anxiety. However, the results of our study did not support this situation.

dontojenik miksoma (OM) nadir görülen, genellikle semptomsuz, yavaş büyüyen, iyi huylu bir tümördür. Tüm odontojenik tümörlerin %1-17,7'sini oluşturur. 4-6 OM'ların diş germinin mezenkimal yapılarından köken aldığı düşünülmektedir. 7 Genellikle ikinci ve üçüncü dekadlarda ortaya çıksa da, her yaşta görülebilir. Daha sıklıkla mandibula posteriorunda ortaya çıkar. Mandibula maksilladan daha fazla etkilenir. Radyografide uniloküler veya multiloküler radyolüsent görüntü verir. Tümör sahasında diş rezorpsiyonuna yol açabilir. Bu nedenle radyografik ayırıcı tanısı ameloblastoma, santral dev hücreli granüloma, fibroma ve fibröz displazi ile yapılır. Lezyonun yumuşak dokuda görülen formu periferal miksoma olarak sınıflandırılabilir. Ağız içi ve çevresi yu-

The aim of this study is to investigate the proliferative potential of rests of odontogenic epithelium found in follicles of unerupted teeth, epithelium of oral mucosa and epithelial linings of various odontogenic cysts. MIB-1 expression was studied in the rests of odontogenic epithelium (n = 10), healthy oral mucosa (n = 10), odontogenic keratocysts (n = 10) and other odontogenic cysts (n = 10) using an avidin-biotin peroxidase technique on paraffin sections. The number of positively stained cells was counted on 10 representative areas of epithelium using a Â40 objective. The average number of MIB-1 positive cells in each group was calculated. No MIB-1 positive cells were seen in the rests of odontogenic epithelium. The mean numbers of MIB-1 positive cells detected within the epithelium of oral mucosa, and of radicular and dentigerous cysts were similar. The number of MIB-1 positive cells was found to be increased in the presence of marked inflammatory cell infiltration. The highest number of MIB-1 positive cells was seen in the keratocysts. These findings suggest that removal of an unerupted tooth to prevent the possibility of neoplastic transformation of rests of odontogenic epithelium is not a justifiable rationale.

Oncocytoma is a rare benign salivary gland tumor, which mostly occurs in the parotid gland. In this article, we describe an early onset of oncocytoma of minor salivary gland in a 36-year, white male. On clinical examination, we encounter with a painless, granular, sessile mass. After Excisional biopsy, the histopathological features revealed sheets of cells with abundant granular eosinophilic cytoplasm, and large, round nuclei that are known as "Oncocyte".

Background Few studies have investigated oral health-related quality of life (OHRQoL) in young individuals with juvenile idiopathic arthritis (JIA). Aims were to investigate whether OHRQoL differs between children and adolescents with JIA compared to controls without JIA, while adjusting for socio-demographic-, behavioral- and oral health-related covariates. Furthermore, to explore whether socio-behavioral and oral health-related covariates of OHRQoL vary according to group affiliation and finally, specifically for individuals with JIA, to investigate whether disease-specific features associate with OHRQoL. We hypothesized that participants with JIA have poorer OHRQoL compared to participants without JIA. Methods In this comparative cross-sectional study participants with JIA (n = 224) were matched to controls without JIA (n = 224). OHRQoL was assessed according to Early Childhood Oral Health Impact Scale (ECOHIS) (4–11-years-olds) and the child version of Oral Impacts on Daily Perf...

With socioeconomic development and changing aesthetic paradigms, people are increasingly attentive to facial beauty. The proportions, harmony, and balance of facial features have become aesthetic focal points. Among the facial features, the nose and chin (mentum) are particularly critical: the nose largely determines the three-dimensional impression of the face, while the chin influences the lower-face contour and overall proportions. Modifying or enhancing these regions can visually elevate facial aesthetics and significantly impact individual psychological confidence.

The aims of this study were to assess the personality traits of orthognathic patients and to investigate and compare the changes related to psychosocial well-being, self-esteem, anxiety, and quality of life between presurgical and postsurgical phases in patients undergoing traditional and surgery-first orthognathic treatments. Patients and Methods: This prospective study recruited patients referred for traditional 3-stage orthognathic treatment and surgery-first orthognathic treatment. Patients were administered psychological and quality-of-life tests 3 times: during the last visit before surgery, about 4 weeks after surgery, and 6 months after surgery. Results: Of the 33 patients included, 14 presented parameters that were suggestive of personality (borderline, compulsive, antisocial, passive-aggressive) disorders. The results of the 36-item Short Form Health Survey showed significant differences with better scores for the ''surgery-first'' group for bodily pain, vitality, social functioning, and mental health (P < .05). As for the Beck Depression Inventory second edition results, at final check, surgery-first patients reported fewer depressive symptoms too. Conclusions: A surgery-first orthognathic approach allows a precocious re-establishment of harmonic esthetics of the face, thus positively influencing the compliance and psychological status of the patients.

Background/AimsManagement of maxillofacial trauma in the geriatric population poses a great challenge due to anatomical variations and medical comorbidities. The aim of this study was to analyze the management variables, timing, and outcomes of facial fractures in elderly patients (aged 70 years or more) at several European departments of oral and maxillofacial surgery.Materials and MethodsThis study was based on a systematic computer‐assisted database that allowed the recording of data from all geriatric patients with facial fractures from the involved maxillofacial surgical units across Europe between 2013 and 2017.ResultsA total of 1334 patients were included in the study: 665 patients underwent closed or open surgical treatment. A significant association (P &lt; .005) was found between the presence of concomitant injuries and a prolonged time between hospital admission and treatment. The absence of indications to treatment was associated with comorbidities and an older age (P &l...

tissue regeneration. Further, stem cells (mesenchymal or fibroblast stem cells) are being used to regenerate organs such as tooth organs. These and other scientific advances serve as fuel for the engine of biotechnology and applications to patient care. Highlights of this progress will be presented. Slavkin HC: The Human Genome: Implications for oral health and diseases, and dental education.

Background Dental fluorosis (DF) has been one of the most prevalent pediatric dental conditions associated with aesthetic concern and treatment needs. This study aimed to identify the longitudinal clinical change in the severity of DF in 8–12-year-old children and its association with gender, age, severity, and tooth type. Methods This observational study assessed the dental aspects of the 92 Colombian children in 2015 (mean age at beginning 9.71 years ± 1.23) and 2018 (mean age 13.69 years ± 1.41), from an area with high DF prevalence. DF was recorded in all permanent teeth by two calibrated examiners using the Thylstrup and Fejerskov Index (TFI). DF severity change (maximum-TFI-score) was analyzed with descriptive analysis at the tooth level. Associated factors were evaluated with the generalized linear model, binomial family, and logarithmic link function. Results TFI scores ranged between 1 (very mild) to 6 (severe), being score 2 (41.7%) the most prevalent. After three years, 2...

Atraumatic extraction is an issue of interest for both dentists and patients, as it preserves the alveolar ridge in a sound state where immediate dental implants are indicated or when rapid healingis needed, or even for successful prosthetic rehabilitation. In this study we are using the new technique of extraction where the extraction is performed atraumatically using the physics forceps , by using a single first class lever, creep,stressdistribution,rather than squeezing and pulling the alveolus. Two patients indicated for extraction of their badly decayed teeth, using atraumatic extraction technique were included in this study as case studies, the time taken for extraction was recorded for each case.Postoperative clinical evaluation was performed on the 3 rd and 7 th day to check the healing, pain intensity, and presence of any complication . In conclusion:physics forceps may be of a help in certain cases to improve the quality of dental extraction. ------------------------------...

4 Abstract: This study was conducted to evaluate the actual outcome of marsupialization when it is applied as the sole treatment of large jaw cysts. Twenty patients were included, where cyst marsupialization was performed, spiral CT scan was utilized in diagnosing, treatment planning and follow-up of the patients at 3 months, 6 months and 12months intervals. Results showed, that marsupialization is a reliable procedure for treatment of large jaw cysts, with complete elimination of the cystic cavity both clinically and radio-graphically in thirteen cases, while significant reduction in the size of the cavity was shown in the remaining seven cases. However it is expected that there will be complete elimination of the cavities within those patients at a longer follow-up period.

There are six main components of the TMJ. Retrodiscal tissue -Unlike the disc itself, the retrodiscal tissue is vascular and highly innervated. As a result, the retrodiscal tissue is often a major contributor to the pain of Temporomandibular Disorder (TMD), particularly when there is inflammation or compression within the joint.

The ultimate goal of periodontal treatment is not only the stabilization of periodontal disease but also regeneration of the periodontal tissues destroyed by severe periodontitis. The tissue engineering triad of stem cells, biological signals, and cell-seeded scaffold provides a biological template for tissue regeneration. Neural crest stem cells (NCSC) comprise a transient multipotent stem cell population that initially emerges from the junction of the epidermal and neural ectoderm through reciprocal interactions between these tissues and signals from the mesoderm during embryonic development of vertebrates. The cells then migrate to their destination in the embryo and differentiate into various dental mesenchymal stem cells which give rise to most components of the dental tissues, including periodontal ligament (PDL), alveolar bone, cementum, dental pulp, and dentin. The crucial role that NCSC play in embryonic development makes them a highly promising stem cell population for use in the regeneration of periodontal tissues. Here, we review the current understanding of the features and functions of NCSC-derived cells in dental tissues. We additionally discuss the possibility that NCSC contribute to the regeneration of periodontal tissues.

The significant growth in scientific and technological advancements within the field of dentistry has resulted in a wide range of novel treatment modalities for dentists to use. Photodynamic therapy (PDT) is an emerging, non-invasive treatment method, involving photosensitizers, light of a specific wavelength and the generation of singlet oxygen and reactive oxygen species (ROS) to eliminate unwanted eukaryotic cells (e.g., malignancies in the oral cavity) or pathogenic microorganisms. The aim of this review article is to summarize the history, general concepts, advantages and disadvantages of PDT and to provide examples for current indications of PDT in various subspecialties of dentistry (oral and maxillofacial surgery, oral medicine, endodontics, preventive dentistry, periodontology and implantology), in addition to presenting some images from our own experiences about the clinical success with PDT.

La célebre frase "Hoy dueles, mañana serás solo un recuerdo…" parecía no estar relacionada con la neuralgia del trigémino (NT) hasta la aparición de nuevas técnicas invasivas. El Papiro de Ebers (1550 a. C.) describe, con gran detalle, el empleo del opio para las cefaleas del dios Ra (1), pero es el médico griego Areteo de Capadocia (50-150 a. C.) el que realiza la primera descripción inequívoca de una migraña (2,3), "dolor en el que el espasmo distorsiona el semblante...". En 1667, John Locke describe y trata una afección facial dolorosa trigeminal con ácido sulfúrico sobre la cara de la Duquesa de Northumberland. Nicolás André (1756) describe la entidad clínica como "tic doloroso" y considera el abordaje y la destrucción directa del nervio como tratamiento. No obstante es John Fothergill, el primero en describir completamente el cuadro en 1773, ante la Sociedad Médica de Londres. En 1911, Hartel y Tapias realizan la primera alcoholización del ganglio de Gasser por vía percutánea (4), y en 1931, Kirschener sugiere la destrucción del ganglio por procedimientos no quirúrgicos, usando radiofrecuencia, aunque relamente el padre de la RF Gasser fue Sweet, mejorando resultados y reduciendo complicaciones.

Objective: To measure the treatment outcomes of the restorative procedures for children undergoing dental rehabilitation performed by dental
intern and residents (MSc, PhD and Saudi Board) at King Abdulaziz University Faculty of Dentistry (KAUFD), Jeddah, Saudi Arabia.
Materials and methods: Sixty-one dental digital records of healthy patients undergoing comprehensive dental treatment were viewed by a
single examiner. These patients were treated by dental interns, and residents (MSc, PhD and Saudi Board) at KAUFD, Jeddah, Saudi Arabia
between 2015 and 2016. Only records of patients who returned for follow-up at least 6 months after their rehabilitations were evaluated.
Results: Compared to stainless steel crowns (SSCs) failure rates, preventive resin restorations (PRRs) failure rates were higher, but not
statistically significant (P=0.559). Compared to the failure rates of SSC restorations, failure rates in composite restorations were significantly
higher (p<0.0001).
Conclusions: SSCs are the most reliable restorations for carious teeth after six months recalls.

Aim: To report the decision making in management of badly decayed First Permanent Molars (FPMs) in children and adolescents among clinical consultants (specialists) and pediatric dentists at King Abdulaziz University (KAU), Faculty of Dentistry, Jeddah, Saudi Arabia. Materials and Methods: An online survey was distributed to 150 clinical consultants (specialists) and pediatric dentists with 3 different clinical scenarios of badly decayed FPMs, in which the first age group of patients were from 6 to 9 years old, the second were 10 to 13 years old, and the third were 14 to 20 years old, the respondents were asked to choose only one proper treatment option from a list of 7 treatment choices for each clinical scenario. Results: Overall response rate was 80%. Regarding the first clinical scenario (deep caries is present in FPM with vital pulp), 47.5% of the respondent recommended indirect pulp capping for the first age group. While 52.5% of the respondents of the second age group and 55% of the respondents of the third age group recommended the use of a protective liner. Regarding the second clinical scenario (deep caries is present in the FPM exposing the pulp, however the tooth is still vital), 45.8% of the respondents recommended pulpotomy for the first age group, while 61.7% of the respondents of the second age group and 60.8% of the respondents of the third age group recommended direct pulp capping. Regarding the third clinical scenario (deep caries is present in the FPM exposing the pulp, however the tooth is non-vital), 70% of the respondents recommended apexification for the first age group. While 94.2% of the respondents of the second age group and 94.2% of the respondents of the last age group agreed to root canal treatment (RCT). Conclusion: There are noticeable controversies among dentists when it comes to decision-making in management of badly decayed FPMs for 6 to 9 years old patients and an increased tendency towards agreement as the age of patients increases.

Objective: To assess and compare the clinical and radiographic success rates of biodentine and formocresol for pulpotomy in human primary teeth. Method and Materials: A randomized, split-mouth, double-blind, controlled clinical trial was carried out in 37 healthy 4-to 8-year-old children with 56 pairs (112 teeth) of contralateral primary molars indicated for pulpotomy. Matched teeth in each pair were randomized to undergo either biodentine (n = 56 teeth) or formocresol (n = 56 teeth) pulpotomy. In both groups, the teeth were restored with stainless steel crowns. The teeth were evaluated clinically and radiographically at 3 and 6 months by two blinded, standardized, and calibrated examiners. The data were analyzed using chi-square and McNemar tests with a P value of < .05 considered significant. Results: At both the 3-and 6-month follow-ups, all the 37 children with 112 treated teeth were evaluated. Clinical and radiographic success was similar for biodentine (100%) and formocresol (100%), without any statistically significant difference (P = 1). Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the biodentine and formocresol groups, respectively. Conclusion: Both pulpotomy techniques showed favorable clinical and radiographic outcomes at 3 and 6 months posttreatment without any significant difference. Hence, biodentine has the potential to become a substitute for formocresol in primary molar pulpotomies.

Alveolar osteitis commonly called as dry socket, alveolalgia osteomyelitis, fibrinolytic osteitis and localized osteitis alveolalgia. It is commonly seen after tooth extraction mainly in third molar extraction. It is a severely painful condition characterized by dislodgement of the blood clot that forms in the socket, leading to exposure of bone. The aproximity in incidence for all routine extraction is 3% and for impacted Mandibular third molar it reaches upto 30%. This review aims to provide an in-depth understanding of dry socket (alveolar osteitis) including it's pathophysiology, risk factors, prevention strategies and clinical management.

It is known to all, that Covid-19 has spread around the world in the last 1.5 years and has become a medical, economic and social problem 1. The occurrence of complications is increasing as the incidence of the infection increases. In Uzbekistan, many patients with this disease have severe complications such as maxillofacial defects and osteomyelitis within 6-8 months of the end of the acute infectious period, forcing patients to undergo longterm treatment. In the clinical case described in the article, osteomyelitis of the maxillofacial bone was observed in a patient with Covid-19 disease. The process was protracted, there were low signs of acute inflammation, the earliest period of sequestration was 6-8 months, the process continued after sequestration at the margins of the healthy bone. In many cases, the ineffectiveness of treatment due to co-morbidities (diabetes, arterial hypertension), microcirculatory, metabolic, immune and other disorders in the patient, the long course of the process is observed.

COVID-19 is currently causing a pandemic around the world. With the increase in the number of patients, there was a slight increase in the incidence of various complications. In particular, infectious and inflammatory diseases of the face and jaw are observed in patients with COVID-19 in the early infectious stages of the disease, as well as in the late stages. In the previous literature, as a sign or complication of COVID-19 were mentioned cases of changes in the oral cavity -ulcers, rashes, and inflammation of salivary glands. The conditions presented in this article are a serious complication of COVID-19, radically different from the usual course of osteomyelitis, in which the patient has a course with a predominance of long-term, chronic-progressive, atrophic processes. Treatment was somewhat ineffective due to local chronic inflammation (pansinusitis), metabolic, microcirculatory, immune, and coagulation disorders in patients. 2020, the World Health Organization (WHO) announced a pandemic of the new coronavirus, which indicates its global spread throughout the world. Since then, as of February 2021, there have been more than 107.8 million cases of infection worldwide and 2.37 million deaths [2]. The most common symptoms of the disease caused by the COVID-19 coronavirus are fever, weakness, cough, and diarrhea. In severe cases, acute respiratory distress syndrome (ARDS) develops, which can be fatal. . There was a slight increase in the number of complications with the increase in the number of patients, in particular, infectious-inflammatory diseases of the face and jaw are more common in patients with COVID-19 in the early infectious stages of the disease, as well as in the late stages . Such patients also have serious complications such as deformities of the facial bones, osteomyelitis, thrombosis of the cavernous sinuses. Let us overview some of such cases Case 1. Patient M.R. 65 years old. He was admitted to the Adults' ENT Department of the Multidisciplinary Clinic of the Tashkent Medical Academy with a diagnosis of upper jaw osteomyelitis, phlegmon of the infraorbital regions. According to the patient's words, 2 months before, he was treated at the Infectious Diseases Hospital with the diagnosis of COVID-19. Concomitant diseases: diabetes, pneumonia, arterial hypertension, IHD. 10 days after the Covid-19 infectious period, the patient complained of swelling around and under the left eye, redness of the skin, pain on palpation, long and diffuse pain in the left half of the head, loss of vision in the left eyeball. On clinical examination observed disorders of the left side function of the II, III, V, VII pairs of nerves (paresis, paralysis, paresthesia). Volumetric edema covered almost half of the face, the opening of the mouth was normal, the left corner of the mouth was lagging in movement due to paresis n. facialis. Ptosis was observed in the left upper eyelid. In the oral cavity -in the region of the alveolar process of the left upper jaw was observed loss of sensitivity in the teeth, the beginning of atrophy of the mucous membrane of the jaw, with redness and necrosis on the edges. Despite intensive antibacterial, antiinflammatory, anticoagulant, angioprotective vitamin therapy, insulin therapy, hormone therapy, and symptomatic treatment was observed deepening and continuation of the process. The wound in local regions and the oral cavity was treated continuously and systematically with antiseptic solutionsiodine-containing betadine, chlorhexidine solution, potassium permanganate, 3% hydrogen peroxide solution, also, with dental adhesive paste, solcoseryl, parodium gel, metrogil dental

The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient&#39;s records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries,...

Background There is little is known about the factors associated with caries experience and gingivitis among 6–11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6–11-year-old children in Nigeria. Methods A cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A seri...

Background: The association between recurrent aphthous stomatitis (RAS) and the menstrual cycle is not clearly reported in the scientific literature. Aim: The aim of this study was to find the association between the onset of RAS and various phases of the menstrual cycle. Materials and Methods: Data regarding the onset of RAS were collected from 140 female participants during various phases of the menstrual cycle. Results: Out of
140 participants, 30 reported with the incidence of RAS during the 3 months of evaluation. Out of those 30 participants, 10 had incidence of ulcers during the third week after menstruation.
Conclusions: Hormonal factors may play a role in the clinical manifestation of RAS.

Background/purpose: Even after surgical orthodontic treatment, the level of masticatory function in patients with jaw deformities is still lower than that of healthy subjects. The purpose of this study was to evaluate the effects of functional training program using gum chewing exercise after orthognathic surgery on masticatory function in patients with mandibular prognathism. Materials and methods: The study subjects were 16 patients with mandibular prognathism who underwent orthognathic surgery and 8 individuals with normal occlusion. Patients were divided into two groups (training group and non-training group; n = 8 per group). Functional training included gum chewing exercise and patient-education about masticatory function. The training; gum chewing exercise of 5 min twice a day for 90 days, started at 3 months after surgery. For each subject, electromyographic activities of masseter and temporalis muscles during maximum voluntary clenching (MVC) and jaw movement during gum che...