ABSTRACT Introduction Current clinical practice in the literature tends to eliminate routine testing in patients classified as ASA I (healthy or with mild, controlled disease) for minor surgery, such as dentoalveolar procedures, as these tests are considered unnecessary. The objective of this study was to challenge this practice by evaluating the prevalence of abnormal laboratory results in a large cohort of 1.610 ASA I patients undergoing dentoalveolar surgery. Methodology A retrospective study was conducted at the Universitario Hospital of Maracaibo between 2023 and 2025, analysing the complete blood count results of 1610 ASA I patients, which challenges the prevailing global approach. Six complete blood count parameters (Haemoglobin, Haematocrit, Platelets, White Blood Count, Segmented Neutrophils and Lymphocytes) were selected and the sample proportion of abnormalities was compared to the threshold using the Z‐test for proportions. Results A high and significant prevalence of abnormalities was found in most parameters: Haemoglobin (23.91%), Haematocrit (13.35%), White Blood Cell Count (16.15%) and Lymphocytes (22.05%). Conclusion Statistical analysis strongly refutes the notion that the risk of haematological pathology in ASA I patients is insignificant. The prevalence of abnormalities in the red blood cell series (anaemia) and white blood cell series (infectious/inflammatory processes) is statistically significant. These findings justify routine blood counts in this population.
ABSTRACT Background Oral metastases from lung cancer are exceedingly rare and often mimic primary oral lesions, posing significant diagnostic challenges. Case Presentation We report a patient under oncological care for pulmonary adenocarcinoma who developed a rapidly enlarging 3‐cm mandibular gingival mass. An incisional biopsy was performed to investigate suspected malignancy. Histopathological analysis revealed a poorly differentiated, infiltrative epithelial neoplasm. Immunohistochemistry demonstrated diffuse positivity for cytokeratin (AE1/AE3) and strong nuclear expression of thyroid transcription factor‐1 (TTF‐1). Negative markers, including p63, CD45, PAX8, and S100, successfully excluded primary oral squamous cell carcinoma and other mimics, confirming metastatic pulmonary adenocarcinoma. The patient received palliative care but deteriorated rapidly. Conclusion Metastatic lung cancer must be considered in the differential diagnosis of atypical gingival lesions. Prompt biopsy combined with targeted immunohistochemistry, particularly TTF‐1, is essential for accurate diagnosis and guiding appropriate palliative management.
ABSTRACT Background Solitary bone cysts (SBCs) are non‐epithelialized intraosseous cavities that predominantly affect the posterior mandible of children and young adults. Their occurrence in the anterior mandible is uncommon, and available data remain limited. Aim This study aimed to systematically review the available literature on SBCs of the anterior mandible, synthesizing epidemiological, clinical, radiological and surgical findings. In addition, two well‐documented clinical cases are presented to illustrate the diagnostic challenges and therapeutic outcomes associated with this uncommon yet clinically relevant entity, emphasizing the importance of a cautious and structured diagnostic approach. Methods A systematic literature search was conducted in PubMed, Embase and Web of Science databases in accordance with PRISMA guidelines. Studies reporting SBCs exclusively located in the anterior mandible were included. Data extraction focused on patient demographics, clinical presentation, lesion localization, radiographic characteristics, treatment modalities and follow‐up outcomes. Results Twenty articles published between 1990 and 2026 were included and two documented clinical cases have been added, comprising 56 individual cases. The mean age at diagnosis was 16.8 years (range: 9–41 years), with a slight female predominance. Most lesions were asymptomatic and incidentally discovered. Lesion localization was specified in 24 cases, while laterality was not reported in 32 cases. Radiographically, all lesions were described as unilocular radiolucency, although detailed radiographic features were not available in 16 cases. Surgical exploration with curettage was performed in all cases, except in one study of 14 cases where the treatment is not specified. Follow‐up outcomes were reported in 21 cases, all demonstrating complete clinical and radiographic resolution. No recurrences were observed. Conclusion SBCs of the anterior mandible primarily affect young patients and show an excellent prognosis following surgical exploration with curettage.
ABSTRACT Background The fracture of implant abutment screws is a rare but clinically meaningful intraoral mechanical complication that threatens implant‐supported prostheses; their recovery can be very difficult. Traditional retrieval has its disadvantages, including the need for specific instruments and the risk of damaging internal threads of the implant. This report presents a straightforward, conservative, and low‐cost chairside method of recovering a broken abutment screw with the use of a modified hand instrument. Case Presentation A 46‐year‐old female diagnosed following movement of an implant‐supported crown in the maxillary right central incisor region since a road traffic incident. During clinical and radiographic evaluation, a fractured abutment screw was detected in a well‐osseointegrated internal hex implant. The exposed screw fragment was prepared with a straight fissure carbide bur to create a shallow horizontal groove. A chisel‐shaped hand instrument, improvised from a commonly available dental tool, was inserted into the slot and occupied in the screw groove with controlled anticlockwise motion to retrieve the fractured screw. The integrity of the internal implant threads was confirmed clinically and by an impression of the implant connection. Management and Outcome After retrieval, minor peri‐implant dehiscence was clinically managed with guided bone regeneration, and a dental implant was reinserted at the adjacent edentulous site. Both implants were returned to function at the end of a normal healing period, with screw‐retained prostheses resulting in satisfactory functional and aesthetic outcomes without morbidity. Clinical Significance The technique described offers a simple, cheap, reproducible, and minimally invasive approach to retrieve fractured implant abutment screws without the use of special ultrasonic devices or retrieval kits. Implant–abutment interface preservation reduces the risk of implant damage, enables prosthetic rehabilitation, and serves as an alternative practice in routine clinical procedures.
ABSTRACT Background Tooth extraction remains one of the most common dental procedures globally, often serving as a last resort when preventive and restorative treatments fail. Despite advancements in dentistry, extractions are still highly prevalent in low‐ and middle‐income countries, including Ghana. Aim This study assessed the prevalence and indications for tooth extraction among adult patients at the Komfo Anokye Teaching Hospital (KATH). Methods An analytical hospital‐based cross‐sectional study was conducted at the oral diagnostic clinic of KATH. Using a structured, interviewer administered questionnaire, data were collected from 361 adult patients who had been clerked, selected by convenience sampling. Tooth extraction was ascertained by self‐report. Descriptive statistics were used to summarize the prevalence of tooth extraction and the reported indications for extraction, while chi‐square tests assessed associations between lifetime tooth extraction and socio‐demographic variables. Results The lifetime prevalence of tooth extraction, defined as the proportion of participants who reported ever having had at least one permanent tooth extracted, was 35.2% (127 of 361); a total of 295 teeth had been extracted among these participants. In addition, 33.0% (119 of 361) of participants reported that tooth extraction was the reason for their most recent dental visit. Among the 122 participants who provided details of their most recent extraction, tooth decay was the leading indication (36.1%), followed by retained roots (23.8%) and fractured teeth (16.4%). Periodontal disease accounted for 6.6% of cases, while orthodontic and trauma‐related reasons were the least frequent (0.8% each). Notably, 58.2% of extractions were patient self‐requests rather than professional recommendations, and 45.9% of patients delayed seeking care for more than 1 month, with lack of perceived severity being the main reason for delay (61.2%). Lifetime extraction was most prevalent among respondents aged 60 years and above (56.1%), married individuals (46.8%), those with primary education (53.8%) and retirees (58.0%). Statistically significant associations were found between lifetime extraction and age ( p < 0.001), marital status ( p = 0.001), educational level ( p = 0.031) and occupation ( p = 0.006), but not gender or residence. Conclusion The study highlights a substantial burden of tooth loss among the respondents, primarily driven by caries and preventable complications such as retained roots and fractures. The findings underscore the need for strengthened preventive care, improved oral health education and enhanced accessibility of restorative services to reduce avoidable extractions and improve oral health outcomes in Ghana.
