Maxillomandibular Vascular Malformations: Report of Four Cases

Maxillomandibular or dental arcade arteriovenous malformations (AVMs) are uncommon lesions with potential for life-threatening bleeding. We report three cases of vascular malformations and a case of pyogenic granuloma and propose a contrast-enhanced computed tomography (CT)-based workup of these lesions for definitive treatment. Four cases of orodental bleeding were diagnosed based on CT angiography (CTA) and treated using endovascular means. Three of them were subsequently operated and confirmed by histopathology. Two were low-flow AVMs, the third one a case of pyogenic granuloma, and one high-flow AVM. The first three lesions were embolized with polyvinyl alcohol particles and subsequently operated and the fourth high-flow one embolized using liquid embolic agent n-butyl cyanoacrylate (Glue). CTA can be used to show separate lesions of arterial vascularity and those of delayed/ venous enhancing lesions. Arterial phase-enhancing lesions are again subdivided in digital subtraction angiography into those of low-to-moderate vascularity and those with high flow, which are treated using particle embolization and liquid glue/onyx (± coil) embolization, respectively. The delayed venous phase enhancing lesions may mimic neoplasms and after tissue biopsy may be managed by sclerotherapy.

The Use of Digital Technologies for Teaching Dentistry

The study considers the possibilities of using advanced digital technologies in dental practice and training. The Digital Smile Design methodology has been characterized; this is an innovative technological solution used to perform an aesthetic analysis, plan the virtual treatment tactics, draw up a plan of necessary dental procedures, as well as visualize the preliminary therapy result. As part of the "Aesthetic Dentistry" course, the technological capabilities of the Digital Smile Design software have been studied. The study involved 25 four-year students of the Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University. At the initial stage of the research, the students were provided with digital photos, including a 3D model of the dental arcade and surrounding soft tissue and video materials of the clinical case, on the basis of which a smile in accordance with the morpho-psychological characteristics of the patient was designed. The students tested the technological capabilities of the Digital Smile Design software, in particular SmileDesignerPro, AestheticDigitalSmileDesign, Cerec SW 4.2, PlanmecaRomexisSmileDesign, VisagiSMile, DSD AppbyCoachman, 3Shape SmileDesign, ExocadSmileCreator, DentalTreatmentSimulation ™ PRO. Based on the results obtained, the key advantages of the Digital Smile Design methodology in aesthetic and orthopedic dentistry have been identified. Having studied the process of designing a digital smile within the framework of the "Aesthetic Dentistry" course and conducted a survey of students to determine the practical convenience of the technologies, the Digital Smile Design software was ranked according to its advantages in dental practice and training.

Intramucosal esophageal dissection after esophagogastroduodenoscopy: two case reports

Introduction: Intramucosal esophageal dissection (IED) is an uncommon disorder, described as the separation of the mucosa and/or submucosa from deeper muscular layers due to abrupt increase in intraesophageal pressure. Case presentation: The first case il that of a 52 – years old female patient who underwent an esophagogastroduodenoscopy for control. After the procedure an extensive subcutaneous emphysema of the neck and a massive pneumomediastinum occurred. The patient was successfully treated with a conservative approach. The second case is that of a 43-years old male patient affected by Down’s Syndrome, who underwent an esopagogastroduodenoscopy because of persisting dysphagia. The endoscopic showed the presence of a serrated stricture at 20 centimeters from dental arcade. After the procedure he fell dysphagia. A neck-chest TC-SCAN showed superior and posterior pneumomediastinum and subcutaneous emphysema, without signs of mediastinitis. The patient was successfully treated with conservative approach. After a few days, a new chest CT-SCAN showed the presence of an anomalous right subclavian artery arising from the descending part of the aortic arch, causing dysphagia lusoria. Discussion: The causes of IED include iatrogenic instrumentation, hemostatic applications, mucosal injuries from ingestion of sharp foreign body, or spontaneous. A fluoroscopic upper gastrointestinal series or upper gastrointestinal endoscopy has been widely used to diagnose IED. CT and magnetic resonance are useful for differential diagnosis. In the absence of signs of mediastinitis management is conservative. Conclusion: CT SCAN should be the first exam to perform in the suspicion of IED. The first line treatment should be conservative. In case of the onset of complications and in patients who are refractory to conservative management, endoscopic or surgical treatment are indicated.

Experimental Researches Regarding Mechanical Behaviour of Dental Prototypes realized by Additive Technologies

The paper presents the behaviour of dental models subjected to mechanical loads. Maxillary dental arcade was obtained by additive technologies – fused deposition modelling and digital light processing. Also, it were used different materials - ABS, CarbonFil, biocompatible ABS, photopolymeric resin and the dental prototypes were tested in two areas - molar and central incisor zones with a transducer force HV 500. The experimental results highlighted the behaviour of the dental models realized by additive technologies in order to determine the maximum compressive force and maximum deformation of the maxillary in function of the material and the technology used.

Morphofunctional Features in Angle Second Class Malocclusion on Dental Gypsum Models

The large diversity of clinical forms in Angle second class malocclusion explains the interest of researchers and clinicians in identifying changes in the dental arch in subdivisions II/1 and II/2. The purpose of the study is to identify the characteristics of the dental alveolar arch in order to determine the differences between class II/l and II/2 malocclusions. The study was conducted on dental gypsum models of 62 orthodontic untreated patients diagnosed with class II/1 Angle malocclusion, respectively class II/2. The results obtained by us reveals a statistically significant differentiation in the dental arcade, a narrowed maxillary arch at the molar level and elongated at premolar and molar level, in subdivision II/l. Our data are consistent with the results of literature. The knowledge of dental arch features serves to develop a correct and complete diagnosis and also to reach the therapeutic goals and to evaluate post-treatment response in short, medium and long term.

Interrelations Between Odonto-Parodontal Affects of the First Permanent Molar and their Odontogenetic and Morfostructural Peculiarities

The permanent first molar is the first tooth in the permanent series that erupts into the archway and thus transforms the temporary dental arcade into mixed arcade, being the only stable element throughout the mixed dentition. The plurivalent importance of the permanent molar must be considered permanently in the harmonious development of the dento apparatus. This tooth has a determining role in dental arcade functionality, being the oldest witness of the permanent occlusion. The permanent first molar is a guardian of the occlusal memory and contributes to the agreement of the predetermined with the posterior one (the temporo-mandibular joint). The first permanent molar improves the relationships in the vertical plane, the early loss of it generates morphological and functional disorders which takes place cascaded across the arcade, and its extraction must be considered a personal failure of the dentist. The study consists of 80 patients divided into two groups; the group I consists of 45 children with chronological ages ranged between 5-6.6 years; the second group selected from dental care, a total of 35 children aged between 8.6-10 years. Dental caries morbidity has increased significantly over time and surprised by age the younger becoming a true social scourge. The current pediatric dentistry emphasizes new aspects of the normal and pathological growth of the dento-maxillary apparatus and underlines the special significance of the morpho-structural and functional integrity of the odontous units in close correlation with the subsequent development of the dento-maxillary apparatus in general.

Development of cyclic shedding teeth from semi-shedding teeth: the inner dental arcade of the stem osteichthyan Lophosteus

The numerous cushion-shaped tooth-bearing plates attributed to the stem group osteichthyan Lophosteus superbus , which are argued here to represent an early form of the osteichthyan inner dental arcade, display a previously unknown and presumably primitive mode of tooth shedding by basal hard tissue resorption. They carry regularly spaced, recumbent, gently recurved teeth arranged in transverse tooth files that diverge towards the lingual margin of the cushion. Three-dimensional reconstruction from propagation phase-contrast synchrotron microtomography (PPC-SRµCT) reveals remnants of the first-generation teeth embedded in the basal plate, a feature never previously observed in any taxon. These teeth were shed by semi-basal resorption with the periphery of their bases retained as dentine rings. The rings are highly overlapped, which evidences tooth shedding prior to adding the next first-generation tooth at the growing edge of the plate. The first generation of teeth is thus diachronous. Successor teeth at the same sites underwent cyclical replacing and shedding through basal resorption, producing stacks of buried resorption surfaces separated by bone of attachment. The number and spatial arrangement of resorption surfaces elucidates that basal resorption of replacement teeth had taken place at the older tooth sites before the addition of the youngest first-generation teeth at the lingual margin. Thus, the replacement tooth buds cannot have been generated by a single permanent dental lamina at the lingual edge of the tooth cushion, but must have arisen either from successional dental laminae associated with the individual predecessor teeth, or directly from the dental epithelium of these teeth. The virtual histological dissection of these Late Silurian microfossils broadens our understanding of the development of the gnathostome dental systems and the acquisition of the osteichthyan-type of tooth replacement.

The state of oral health in patients with chronic renal failure – partially study stage

Aim. Obtaining stage results, pre-test questionnaire oral health’s assessment in patients with chronic kidney disease (CKD) – chronic renal failure (CRF), with or without nephritic syndrome, with or without initiated dialysis treatment. Material and method: the study was conducted by applying the questionnaire (pre-test) on a group of 30 patients – 15 patients in the target and 15 patients in the control group. Recorded data have been used for statistical analysis. Group distribution – gender: equal, 50% each group; age: average (years): 60.6 years old on target group and 62.6 years old on control group. IRC average time period (years) has been: 8.55 years on target group (women – 8.12 years and man – 9.04 years). On both groups the number of non-smoking patient has been higher then smoking patients. 9 patients on target group (5 women and 4 men) were framed on nephritic syndrome (average period of 16.5 years). Dialysis patients: 7 (4 women and 3 men), with an average period of 3 years. 67% of patients (target group) were in the range of 15-60 ml/min glomerular filtration rate. On the control group 30% of patients were between the values of 90-120 ml/min (or higher) and 50% in the range of 60-90 ml/min. Results and conclusions. In terms of oral health status of patients with CKD it was found that 50% of them are partially edentulous on more than a half-dental arcade, and 60% have no dentures.