BACKGROUND AND OBJECTIVE:Immunologically mediated mucocutaneous diseases frequently manifest initially in the oral cavity and often exhibit overlapping clinical features. This overlap complicates early clinical diagnosis and may delay appropriate management. The present study aimed to assess the prevalence and clinicopathological characteristics of oral lichen planus, oral pemphigus and oral pemphigoid in a large retrospective cohort. MATERIAL AND METHODS:A retrospective analysis of 6300 biopsy records archived over a 21-year period was performed. Cases diagnosed histopathologically as oral lichen planus, oral pemphigus and oral pemphigoid were included. Demographic details and clinical features were retrieved from records. Hematoxylin and eosin stained sections were re-evaluated using current diagnostic criteria. Descriptive statistical analysis was carried out using SPSS version 21. RESULTS:Out of 6300 cases, 105 (1.66%) were immunologically mediated oral diseases. Oral lichen planus constituted 86 cases (1.36%), oral pemphigoid 15 cases (0.23%) and oral pemphigus 4 cases (0.06%). Characteristic clinicopathological features were observed for each entity, with oral lichen planus being the most prevalent. CONCLUSIONS:Immunologically mediated oral diseases represented a small proportion of oral biopsy specimens. Overlapping clinical features necessitate careful clinicopathological correlation to ensure accurate diagnosis. Histopathological examination remains essential for definitive diagnosis and appropriate management.
OBJECTIVE:Until now no studies were conducted to evaluate the cyclic fatigue resistance of both - rotary and reciprocating - endodontic instruments with and without cryogenic treatment. Therefore, the aim of this in vitro study was to evaluate the effect of cryogenic therapy on the cyclic fatigue resistance of various nickel-titanium rotary and reciprocating endodontic files in an artificial 90º curved canal. MATERIAL AND METHODS:This in vitro study was conducted using 20 rotary and 20 reciprocating nickel-titanium (NiTi) instruments: 10 ProTaper Next, 10 ProTaper Ultimate, 10 Reciproc and 10 Plex RC-ONE. All instruments were divided equally into control and cryogenic treatment groups. Instruments in cryogenic treatment groups were immersed in liquid nitrogen (-196ºC) for 24 hours, after which they were gradually returned to the room temperature. All instruments were tested in an artificial canal with a 90º curvature, and the entire process was recorded till the instrument fracture. Time to fracture was multiplied by the corresponding rotation speed. Statistical analysis was performed using IBM SPSS Statistics software. RESULTS:The results of this study revealed statistically significant positive effect of cryogenic treatment on the cyclic fatigue resistance of Reciproc system instruments, while no statistically significant effect of cryotherapy was observed in the other instrument groups. When comparing different instrument systems in the cryogenic treatment groups, Reciproc instruments demonstrated statistically significantly higher cyclic fatigue resistance than other instruments in this study. CONCLUSIONS:Our research demonstrated the efficacy of deep cryogenic treatment in increasing the cyclic fatigue resistance of reciprocating endodontic instrument system Reciproc. The study also showed the significantly better Reciproc resistance to cyclic fatigue than rotary ProTaper Next and ProTaper Ultimate instruments.
PURPOSE:The aim of the present study was to evaluate the difference between bone atrophy, pink esthetic score, and long-term results in socket shield technique compared to traditional immediate implantation. MATERIALS AND METHODS:The literature review was carried out according to PRISMA principles and the database search was performed using the following keywords: "Socket shield technique ", "Root membrane ", "Pink esthetic score ", and "Immediate dental implant loading ". This review involved studies with humans that were published in English. The studies were published between 2018 and 2025, and the socket shield technique was compared with traditional immediate implantation. RESULTS:Out of 517 records, 5 randomized controlled trials were selected, reporting 169 patients who received 184 implants (92 socket-shield technique, 92 immediate implant). Meta-analysis of the Pink Esthetic Score outcomes showed that implants placed using the socket-shield technique (intervention group) achieved significantly higher pink esthetic scores than those implants placed immediately (pooled mean difference = 1.29; 95% CI: 0.32-2.26; p=0.0095), demonstrating a statistically significant effect in favor of the intervention group. Our systematic review demonstrates that socket-shield technique provides superior preservation of marginal bone compared with traditional immediate implantation protocols. CONCLUSIONS:The socket shield technique allows implant rehabilitation characterized by better aesthetic outcomes and minimal bone loss compared to traditional immediate implantation.
INTRODUCTION:Sialolithiasis is a relatively uncommon alteration of the salivary gland characterized by the presence of calcified structures within the glandular parenchyma or its ductal system, causing swelling and pain. AIM:Present a series of six cases of sialolithiasis in the submandibular and parotid glands, the diagnostic process, and the adopted treatment approach. CASE SERIES:Five reported cases occurred in the submandibular gland, and only one in the parotid gland. Three patients presented with painful symptoms, increased volume, and purulent secretions, while the other three cases were asymptomatic. All sialoliths were diagnosed through radiographic exams. The treatment consisted of sialolith removal via surgical approach and/or salivary flow stimulation via local massage. CONCLUSION:Sialolithiasis is diagnosed through clinical and imaging evaluation, and conservative treatment approaches preserve the integrity and function of the gland.
OBJECTIVE:To study the peculiarities of the anatomical structure and architecture of the mandibular in children at different age to CT data. METHODS:161 CT scans of the bones of the facial skull of children aged 1 to 18 years were selected. Orientation of the tomographic slices was based on the standardized protocol of CT studies. Differences were considered significant when p values were lower than 0.05. RESULTS:The width of the lower jaw was greatest in the area of the angle and chin symphysis. The general dynamics of the thickening of the cortical layer of the lower jaw from the vestibular side differed from the dynamics of the formation of the lingual cortex. The density of the cortical layer increased with age: the difference between its average value in the age groups of 1-3 years and 14-17 years was 16-46%. CONCLUSIONS:The width of the lower jaw in the process of its growth and development increases in different areas by an average of 6-58%. The thickening of the cortical layer with age is more intensive than the general increase in its thickness and amounts to 41-51% for various areas of the jaw, except for the head of the condylar process. The radiological density of the cortical layer increases with age by 6-67%, and reaches 2064.2±180.54 in the older age group.
A 35-year-old patient reported with sharp pain on biting and sensitivity to cold concerning the first right premolar. On recording the history, clinical examination and tests such as vitality, bite test, transillumination, periodontal probing and radiographs a diagnosis of cracked tooth syndrome (CTS) was made. The root canal treatment was completed, but the patient did not turn up for the coronal restoration, resulting in a vertical root fracture and extraction. VRF's (Vertical Root Fracture) are more commonly encountered following endodontic treatment. Also, in teeth without endodontic treatment, with habits like bruxism and eating coarse, hard food. Early diagnosis of cracked teeth and fractures is critical for a clinician since it permits a conservative and preventive approach. Delay in diagnosis and treatment will result in involvement of the underlying periodontium, causing periodontal pockets, abscess formation and bone loss thereby further complicating the outcome.
Hutchinson - Gilford Progeria syndrome (HGPS) is a very rare syndrome characterized by early onset senescence. It is manifested as premature aging with involvement of hair, skin, nail, cardiovascular and bone manifestations. This syndrome has also been reported to be associated with craniofacial anomalies. With regard to these craniofacial phenotypes of Hutchinson - Gilford Progeria syndrome several studies are being undertaken all around the world. Here we present one such rare case of HGPS associated with craniofacial anomaly along with cleft lip and cleft palate in an eleven year old boy.
PURPOSE:The purpose of this study was to evaluate the success of pterygoid implants in clinical patient examination and to prove that pterygoid implants are a suitable alternative for restoring chewing function with implants in the atrophied maxilla. MATERIAL AND METHODS:The instantaneous study was conducted in October 2023 - April 2024 at the KDK Karpavičius D. CLINIC:Patients who had pterygoid implants inserted 6-96 months ago were invited for a follow-up examination and clinical-radiological oral examination. All subjects gave their written consent and were guaranteed anonymity. The 37 respondents of the research consisted of patients from 40 years old to patients 78 years old. During the study, a clinical and radiographic oral examination was performed to assess the support of 47 implants, restorations, probing depth, bleeding, plaque, recession, keratinized gingival volume, marginal bone loss, signs of periodontitis at other teeth/implants, as well as the time since implantation, age, gender, and smoking habits were also recorded. RESULTS:No rejected pterygoid implants were identified. Thus, no implants were characterized by marginal bone loss or recession. It was found that smokers had poorer oral hygiene habits. Poorer hygiene led to bleeding gums at pterygoid implants, and it was also observed that older patients clean their teeth and implants less frequently and have more signs of periodontitis. Although there was no evidence of marginal bone loss, pockets were felt around the implants, which affected the thickness of the keratinized gingiva. CONCLUSIONS:The success rate of pterygoid implants is very high, so these implants may be a good alternative for restoring the function of the atrophied maxilla. Poor oral hygiene habits, smoking, and age can affect the success of pterygoid implants.
OBJECTIVE:To present a case where bilateral mandibular tori complicated prosthetic rehabilitation and to discuss the etiology, clinical features and management of this anatomical variant based on a review of current literature. CASE REPORT:A 45-year-old female presented with gingival bleeding and lower anterior tooth mobility. Clinical and radiographic examination revealed chronic periodontitis, missing teeth (#35, #36, #37, #46) and bilateral, lobulated mandibular tori. The left torus was surgically removed under local anesthesia using a chisel and mallet to facilitate the fabrication of a removable partial denture. Postoperative healing was uneventful, with complete mucosal healing observed at one month. The prosthesis was subsequently delivered successfully. CONCLUSIONS:While often asymptomatic, mandibular tori can impede prosthetic treatment. Surgical removal is a predictable procedure when indicated, leading to favorable functional and prosthetic outcomes. This case underscores the importance of interdisciplinary management in oral healthcare.
OBJECTIVE:The study aimed to evaluate the influence of two different rotary systems on GuttaCore obturation material overextension in curved root canals. METHODS:Sixty-two canals of the extracted human molars with root canals of moderate and severe curvature were included. The teeth were randomly divided into 2 groups according to the rotary instruments used for the root canal shaping: PU group (n=31) - ProTaper Ultimate, and XP group (n=31) - XP-endo Shaper. After shaping root canals were obturated with GuttaCore and AH Plus sealer according to the manufacturer's instructions that differed between the groups. The length of the obturation material was evaluated radiographically and microscopically. The categorical variables homogeneous distribution was evaluated by the Chi-square (χ2) test. The odds ratio was evaluated to assess the tendency of obturation material overextension in one group compared to another. RESULTS:After applying inclusion criteria for the root canal obturation quality assessment, 16 specimens were excluded from the further study due to the low-quality obturation. Significantly more specimens with no obturation material overextension in the PU group than in the XP group (p=0.014) were observed. In the XP group, a significantly higher incidence of sealer, sealer and gutta-percha overextension was detected compared to the PU group. The chance of obturation material overextension in the XP group was higher than in the PU group. CONCLUSION:The root canals prepared with XP-endo Shaper and obturated with GuttaCore according to the manufacturer's instructions had a higher obturation material overextension incidence in curved root canals compared to ProTaper Ultimate.
BACKGROUND:Changes in the sinus membrane in the form of thickening or opacification often pose challenges in the differential diagnosis between rhinological and odontogenic causes. Due to their clinical similarities, the development of a radiological diagnosis, with Cone Beam Computed Tomography (CBCT) being the technique of choice, will be crucial for achieving an accurate diagnosis. MATERIAL AND METHODS:A descriptive retrospective study was designed, comprising a pilot sample of 20 patients from the Faculty of Dentistry, Complutense University of Madrid, who had previously undergone a maxillary cone beam computed tomography (CBCT). The research applies Di Girolamo's classification to categorize radiological findings and assesses the relationship between sinus pathology and factors such as age, gender, and odontogenic causes. RESULTS:A total of 20 CBCT scans and health surveys from patients (14 males and 6 females), with mean age of 60 ± 8.14years were studied. Some type of sinus pathology was observed in 30 sinuses (75%) and no pathology in 10 sinuses (25%). Regarding potential etiology, dental pathology was the most prevalent (63.6%), followed by implants (18%) and oroantral communications (9%). CONCLUSION:There is a high incidence of sinus pathology. Sinus pathology is diagnosed more frequently in men and smokers. The most common types of sinus pathology are thickening of the sinus membrane, followed by opacification of the maxillary sinus.
Osteoma is a leisurely growing benign tumour involving bone consisting of well differentiated compact or cancellous bone that increases in size by continuous growth. It can be of a central, peripheral or extraskeletal type. The peripheral type emerges from periosteum. Solitary osteoma can be classified as peripheral (parosteal, periosteal or exophytic) when arising from the periosteum, central (endosteal) when arising from the endosteum or extraskeltal (so- called osseous choristoma) when arising in soft tissue. This article describes a case of 27 years old female who presented with painless swelling in the left body mandible and which was slowly growing and resulted in facial disfigurement. Ostectomy of the lesion was done under general anaesthesia. Postoperatively there was no complication and there was no facial asymmetry. After one year of follow up no recurrence was noted and patient has been kept on regular follow up.
Epilepsy patients can show a wide range of oral and maxillofacial injuries after seizures. However, the occurrence of oral soft tissue necrosis (OSTN) has been rarely reported. In the current report, a 55-year-old man with refractory epilepsy was referred for evaluation of an extensive injury in the oral mucosa after a severe seizure. Intraoral examination revealed a painless grayish-white necrotic area in the posterior region of the buccal mucosa on the left side measuring about 2×3 cm. Clinical findings led to the diagnosis of post-traumatic OSTN and the patient underwent surgical debridement on an outpatient basis. Two-month follow-up showed complete healing associated with the formation of fibrous tissue. A review of the literature demonstrated that post-traumatic OSTN was not reported among oral and/or maxillofacial injuries found in epilepsy patients. However, the current report reinforces that soft tissue necrosis may occur in the oral cavity of these patients after seizures. Post-traumatic OSTN should be considered an oral injury found in patients with refractory epilepsy.
BACKGROUND:There is a lack of evidence of possible implant fracture after implantoplasty due to decreased implant diameter. PURPOSE:To compare narrow diameter titanium dental implants fracture resistance after implantoplasty performed by computer numerical control (CNC) lathe machine which helped to standardize study setting. MATERIALS AND METHODS:Twelve (n=12) narrow diameter (3.6×11.0 mm) endosteal screw-shaped bone-level dental implants with an internal connection which are made from grade IV titanium were randomly divided into 2 groups containing six (n=6) implants each. The test group was exposed to implantoplasty using a computer numerical control (CNC) lathe-turning machine. Implantoplasty was performed removing 5.5 mm of implant threads from the implant coronal part downwards towards the apical part, which resulted in a 0.2 mm coronal diameter reduction. Implants from both groups were positioned on metal pipes using three-dimensional (3D) printed guides. The space inside the pipe was filled with epoxy resin. Every sample had an individually 3D-printed chrome-cobalt (Cr-Co) alloy crown, which distributed forces during the test. Implants were compressed in a universal testing machine. Statistical analysis was performed using IBM SPSS 29.0 software. RESULTS:Performing implantoplasty with CNC lathe-turning machine was a success, which helped to standardize study settings. The control group showed average resistance to a maximum compressive force of 443.76 N, while the test group showed average resistance to a maximum compressive force of 409.42 N. No statistical significance was found between groups on the compressive force aspect. CONCLUSION:This in vitro study shows that implantoplasty does not have a significant effect on decreasing fracture resistance of narrow diameter titanium dental implants.
INTRODUCTION:Cleft lip and palate (CLP) is a common congenital defect where dental anomalies are seen at a higher rate compared to the general population. The study aimed to identify, compare and correlate dental anomalies in non-syndromic cleft lip and palate subjects. MATERIAL AND METHODS:A total of 100 patients with cleft lip and palate were evaluated for the presence of dental anomalies. After informed consent, clinical and radiological examination of the patients was performed. Cone beam computed tomography sections were analysed and dental anomalies present were recorded. The observations were tabulated and the data was subjected to statistical analysis. RESULTS:Ninety six percent of the cleft population had at least one dental anomaly. Patients with unilateral cleft lip and palate showed the highest prevalence of dental anomalies. Missing teeth (87%) were the most common dental anomaly followed by ectopic eruption, microdontia, enamel hypoplasia and impacted teeth. Other dental anomalies like odontomes and pulp stones were found at a lower prevalence rate. CONCLUSION:Patients with CLP are highly susceptible to the occurrence of dental anomalies. Thorough clinical and radiographic examination, careful planning and implementation of specialized services are needed in an effort to provide early diagnosis and comprehensive treatment.
Anomalous anatomical relationship of spinal accessory nerve and internal jugular vein can make neck dissection very challenging while removing nodal metastasis in oral cancer. We report here one such situation which was a surprise finding on table. We feel all clinicians encountering internal jugular vein should be aware of this to avoid neurovascular complication.
RELEVANCE OF THE PROBLEM AND AIM OF THE WORK. Chronic fungal maxillary sinusitis is an increasingly diagnosed condition in clinical practice. The diagnostic and therapeutic processes remain complex due to the nonspecific nature of clinical manifestations and the absence of standardized management protocols. The objective of this study is to assess the reliability and efficacy of current diagnostic and therapeutic methods based on recent scientific evidence. MATERIALS AND METHODS:A systematic literature review was conducted following PRISMA guidelines. PubMed, ScienceDirect, and Cochrane Library were searched for English-language articles (2016-2024) on diagnostic and therapeutic approaches for chronic fungal maxillary sinusitis. RESULTS:The analysis revealed that diagnostic and treatment strategies for chronic fungal sinusitis depend on the clinical form. MRI and histopathology proved most accurate for diagnosing invasive sinusitis, while CT was more suitable for non-invasive types. Clinical symptoms were common but not specific enough for definitive diagnosis. Surgical treatment alone was effective for non-invasive cases, whereas invasive forms required both surgery and antifungal therapy. Allergic fungal sinusitis was primarily managed with systemic corticosteroids. CONCLUSIONS:Effective management of chronic fungal maxillary sinusitis relies on accurate classification of the disease form. Radiological imaging and histological analysis are the most reliable diagnostic methods. Treatment should be form-specific: surgery for non-invasive cases, combined surgical and antifungal therapy for invasive forms, and corticosteroids for allergic fungal sinusitis.
Autism is a complex developmental disorder with multiple etiologies and varying degrees of severity. The essential characteristics of Autistic Disorder are the presence of a compromised development in social interaction, communication. Regarding oral health, autistics have a high prevalence of caries and periodontal disease, factors related to their cariogenic diet and difficulties in oral hygiene, which are common in special patients. The objective of this research is to describe and analyze the oral health of these patients, as well as to identify the main oral diseases of patients with autism accompanied by the Association of mothers and friends of autistic people in Parnaíba City, Piauí, Brazil. This is a descriptive cross-sectional research, developed through a questionnaire applied to parents or guardians about behaviors, diet, medications, oral health routine and clinical examination of the assisted children. For data storage and extraction, SQLYOG software was used, then the data were exported to the Microsoft Excel program, proceeding with the descriptive analysis. There was a higher proportion of males, poor oral hygiene and presence of parafunctional habits. For a more humanized and comprehensive approach, patients needed multidisciplinary and specialized treatment. The data obtained by the research provided crucial information for development of improvements about the autistics oral health in Parnaíba city, contributing to the life quality of these patients.
OBJECTIVE:To analyse the transition from fibrous to bony ankylosis of the temporomandibular joint (TMJ) by considering both etiological factors and underlying molecular mechanisms. MATERIAL AND METHODS:The search was conducted using the keywords "Temporomandibular Joint", "Ankylosis", "Fibrous", "Bony" or "Osseous", and "Pathogenesis" in the PubMed (MEDLINE) and Wiley Online Library databases. Relevant full-text articles in English published between 2000 and 2025 were included in this review. RESULTS:The literature review revealed that the progression of fibrous TMJ ankylosis into the osseous form is mainly determined by prolonged inflammation, mechanical damage, inappropriate treatment, and ineffective postoperative rehabilitation. According to various studies, molecular mediators such as hypoxia-inducible factor 1-alpha (HIF-1α), bone morphogenetic proteins (BMP-2, BMP-7), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β) act synergistically by promoting angiogenesis and endochondral ossification, thereby stimulating new bone formation within the joint. Moreover, the SMAD signaling pathway plays a central role in fibroblast-to-osteoblast differentiation, contributing to ossification in the ankylosed area. CONCLUSIONS:The transition of fibrous TMJ ankylosis into its osseous form is complex and multifactorial process determined by inflammation, growth factors, mechanical stress, and hypoxia. To better understand the essence of this transformation, further studies are required to elucidate the molecular mechanisms underlying this process.
A new entity called "peri-implant cyst" has recently been described. This lesion is an inflammatory odontogenic cyst on an osseointegrated implant. It arises from inflammatory stimulation and proliferation of the rests of Malassez. Although a relatively rare condition but potentially the cause of implant failure. Peri- implant cystic lesion exhibits the same radiographic and histopathological features as the radicular cyst. The diagnosis rests on the histology, radiology, and on their correlation with clinical features, in particular the location of the lesion. Herein, we report a case of a 58-year-old female diagnosed as peri-implant cyst in the periapical area of the right maxillary first premolar implant. The microscopic examination revealed a cystic lining composed of non-keratinized stratified squamous epithelium covered with multilayered epithelium. The lesion was surgically enucleated along with preservation of the implant and wit guided bone regeneration (GBR) method, without any postoperative complications and satisfactory healing, was achieved. One year later, a newly formed bone at the apical region of the right maxillary first premolar implant was radiologically observed.
