The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability

Aim The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations. Methods Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration. Results The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants. Conclusion Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.

Odontome- Revisted

Odontomas are benign odontogenic tumors subdivided morphologically into complex or compound odontomas. This paper describes the case of a complex odontoma in a 31-year-old male who complained of a painless swelling in right mandibular region which was diagnosed radiographically as complex odontome. Surgical enucleation of the lesion was done and sent for histopathological examination.

The deceptive histomorphology of DGCT – A case report

Dentinogenic ghost cell tumors (DGCTs) are uncommon neoplasms classified as a solid variant of the calcifying odontogenic cyst and defined as a locally invasive neoplasm, characterized histologically by an ameloblastomatous epithelium with an area of ghost cell formation and a varying amount of dentinoid. Herein, we present the case of a 22-year old man who was referred to us due to recurrent swelling of right posterior mandibular region. The diagnosis of a DGCT was made by the use of advanced radiographic imaging and detailed histopathological examination.

The deceptive histomorphology of DGCT – A case report

Dentinogenic ghost cell tumors (DGCTs) are uncommon neoplasms classified as a solid variant of the calcifying odontogenic cyst and defined as a locally invasive neoplasm, characterized histologically by an ameloblastomatous epithelium with an area of ghost cell formation and a varying amount of dentinoid. Herein, we present the case of a 22-year old man who was referred to us due to recurrent swelling of right posterior mandibular region. The diagnosis of a DGCT was made by the use of advanced radiographic imaging and detailed histopathological examination.

Jaw region endometriosis: case report

Introduction: Endometriosis is a chronic gynecological disease, which refers to the presence of endometrial glands and stroma outside the uterine endometrium. This entity has a frequency of 10 to 15% in women of reproductive age, and its most common site of presentation is the ovary. At the extrapelvic level, the most common location is the gastrointestinal and genitourinary location. However, it can occur in any location. Presentation: The case of a 40-year-old female patient with a face tumor in the mandibular region is described, presenting with a disease time of 2 years. Among the important antecedents, two months before the appearance of the tumor region, the patient underwent endodontic surgery of a lower molar tooth, contiguous to the mandibular. Likewise, one month before the appearance of the tumor, the patient underwent an exploratory laparoscopy for electrofulguration of endometriotic foci in the uterine myometrium. The patient underwent a surgical resection of the tumor in the mandibular region described; and after reviewing the histological and immunohistochemical slides at the institution, the diagnosis of endometriosis was established. Conclusion: Extrapelvic endometriosis is rare in our country, and its diagnosis requires experience and visual training in the recognition of normal endometrial tissue. The presentation of this case was considered important because it would be the first case reported in Peru and in the world, of an endometriosis located in the mandibular region.

Clinico-Radiological Study of Odontogenic Cysts in Mandibular Region from Agartala, Tripura

BACKGROUND Most common osseous destructive lesions effecting the jawbone are odontogenic cystic lesions, which are lined by epithelium, has been involved in the formation of teeth as the epithelial cell rest are present in jawbone after teeth formation. The three most common odontogenic cysts (OCs) are radicular cyst (RC), dentigerous cyst (DC) and the odontogenic keratocyst (OKC). Less common variety is the residual cyst. Odontogenic cysts are mainly developmental and inflammatory in origin. The objective of the present study was to find clinico-radiographic characteristics of odontogenic cysts in the mandible. METHODS This was a case series (descriptive) study on OCs of mandible conducted at Tripura Medical College and Dr BRAM Teaching Hospital, Hapania, Agartala, Tripura (W), India, over a period of 6 months from August 2019 to January 2020. Subjects showing clinico-radiographic features of OCs in mandible were included, subsequently confirmed by histopathological examinations. Usually orthopantomograms (OPGs) and intra oral peri apical radiograph (IOPAs) were done for radiological findings, computed tomography (CT) scan was required for examination of the size of lesion. Data were analysed using windows excel. RESULTS Diagnosis of OCs was confirmed in 20 patients, among them, males were (60 %) and female were (40 %). The age range of the patients was 17 - 65 years. Most common type of cyst diagnosed in the study was radicular cyst in 50 % cases followed by dentigerous cysts which were in 30 % cases, odontogenic keratocysts were in 15 % patients and others were 5 %. RCs were represented in higher percentage (50 %). Right side of mandible was the most effected side (60 %) than left side (40 %). Main finding of the study was, in every type of cystic lesions, males were recorded as predominant, and it occurred in early age group. CONCLUSIONS Main finding of the study was radicular cyst which was in higher percentage (50 %) and was being most common with association of carious tooth. KEYWORDS Odontogenic Cysts, Mandible, Finding

Adenomatoid Odontogenic Tumor- A Rare Case Report of “Two Third Tumor”

Adenomatoid odontogenic tumor (AOT) is a rare odontogenic origin tumor that manifests as a slow-growing cystic neoplasm in the anterior maxilla, often in conjunction with an impacted tooth. AOTs are divided into three kinds based on their histology: follicular, extrafollicular, and peripheral. Because the source of the AOT is unknown, it's impossible to say whether the lining of an associated cyst reflects the cause i.e. a real dentigerous cyst, a cystic alteration within an AOT, or a separate entity. The diagnosis and treatment should be determined following a thorough clinical, radiographic, and histological investigation. The presented case is a rare occurrence of its sort due to the favorable patient's age and the AOT's site in the lower jaw. The current study reports on a case with follicular AOT in the anterior mandibular region (a rare location), with unusual histomorphology (snow flake and calcified areas) associated with impacted 43 and retained 83.

Implant Placement in a Cemento-Osseous Dysplasia: A case report

We present a 45-year-old black woman diagnosed with a florid cemento-osseous dysplasia (FCOD) affecting the right lower quadrant and the anterior mandibular region. The patient requested dental implants to rehabilitate the edentulous central lower incisors area (teeth # 31 and # 41) corresponding to a periapical cemento-osseous dysplasia (PCOD). Successful osseointegration of the two implants was obtained using a two-step procedure in order to limit the risk of complications associated with implant placement. Follow-up at one year showed no recurrence and good implant stability. Due to the abnormal quality of the bone in cemento-osseous dysplasia (COD), implant placement is generally avoided, and no other case reports have been reported in the literature in patients affected by PCOD. The present case suggests that in an appropriate clinical setting, implant placement may be a successful procedure.

Risk assessment of labial bone perforation in the anterior mandibular region: a virtual immediate implant placement study

Background This study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure. Methods Series qualified CBCT images of 149 participants (894 teeth) were selected to analyze the assigned anatomical parameters, including concavity depth, concavity angle, torque, and deep bone thickness. Four classes of crestal and radicular dentoalveolar bone phenotypes (CRDAPs) of mandibular anterior teeth were categorized according to the thickness of dentoalveolar bone at both crestal and radicular zones. Data were adjusted for categorical (gender and CRDAP) and continuous (age, cavity angle, cavity depth, and deep bone thickness) variables using a multivariable logistic regression analysis with generalized estimating equation method. Results The overall probability of LBP after virtual implant placement was 21.6%. There is statistically significant higher prevalence of LBP at canine (28.5%) and CRDAP class II (29.2%) regions (p < 0.001). After adjusting confounding variables, CRDAP class II and class IV regions are more likely to have LBP when compared with CRDAP class I (control) regions (p < 0.01). The risk of LBP at canine site is 6.31 times more likely than at the central incisor (control) (p < 0.01). Conclusions Using a virtual immediate implant placement technique, the prevalence of LBP is significantly higher at the mandibular canine site and thin radicular dentoalveolar phenotype in the anterior mandibular region.