Nasopalatine duct cyst: A jigsaw puzzle

For the success of endodontic treatment outcome, diagnosis plays a very important role. Endodontic diagnosis is similar to a jigsaw puzzle which cannot be made from a single isolated piece of information. Radiography plays a vital role in diagnosing dental diseases. Overcoming the major disadvantage of two dimensional imaging of superimposing the dento-alveolar structures, 3 dimensional images by Cone Beam Computed Tomography is of great help. It is very common that when radiographs show a superimposition of the incisive foramen over the apex of maxillary central incisors, mimicking apical periodontitis, unnecessary endodontic treatment or retreatment may be prescribed. Diseases of non endodontic origin that affect the tooth apex, such as Nasopalatine duct cyst, should be included in the differential diagnosis. In the present case report the role of CBCT in diagnosis is being discussed.

Possibility of Human Gender Recognition Using Raman Spectra of Teeth

Gender determination of the human remains can be very challenging, especially in the case of incomplete ones. Herein, we report a proof-of-concept experiment where the possibility of gender recognition using Raman spectroscopy of teeth is investigated. Raman spectra were recorded from male and female molars and premolars on two distinct sites, tooth apex and anatomical neck. Recorded spectra were sorted into suitable datasets and initially analyzed with principal component analysis, which showed a distinction between spectra of male and female teeth. Then, reduced datasets with scores of the first 20 principal components were formed and two classification algorithms, support vector machine and artificial neural networks, were applied to form classification models for gender recognition. The obtained results showed that gender recognition with Raman spectra of teeth is possible but strongly depends both on the tooth type and spectrum recording site. The difference in classification accuracy between different tooth types and recording sites are discussed in terms of the molecular structure difference caused by the influence of masticatory loading or gender-dependent life events.

A new species of a rare genus, Truxonchus quangi sp. n. (Mononchida, Anatonchidae) from bat xat nature reserve in Lao Cai Province, Vietnam

Truxonchus quangi sp. n. is described and illustrated from Vietnam. Females of the new species are characterized by large body size (L = 4.8-5.8 mm); barrel shaped buccal cavity of large size (105-113 x 66-73 µm) with one dorsal tooth and two subventral teeth posteriorly directed, of equal shape, size and apex position; dorsal tooth apex located 36-39% of buccal cavity length from its base; reproductive system didelphic-amphidelphic, vagina long, 39-45% of corresponding body width, with distinct par refringens vaginae, sclerotized pieces rounded in optical section; tail long, filiform, ventrally arcuate, with three small caudal glands in tandem and prominent subventral spinneret. The new species is close to T. dolichurus but differs by the larger buccal cavity, more anterior position of the dorsal tooth apex, more anterior vulval position and presence of advulval pores.

EFICÁCIA DA REVASCULARIZAÇÃO NA FORMAÇÃO DO ÁPICE RADICULAR EM PACIENTES COM RIZOGÊNESE INCOMPLETA: UMA REVISÃO INTEGRATIVA

Objetivos: Verificar a eficácia da revascularização para induzir a continuidade de formação do ápice radicular em pacientes com rizogênese incompleta. Metodologia: A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, Embase, Web of Science e LILACS, sendo selecionados quatro artigos publicados entre 2011 e 2021. Resultados: Um total de 27 pacientes diagnosticados com necrose pulpar foi incluído, de ambos os sexos. Os testes de percussão, térmico e elétrico no exame clínico foram realizados em 4 pacientes. Todos os pacientes fizeram radiografia periapical para análise inicial. O tratamento endodôntico foi realizado com indução do sangramento apical do canal radicular para revascularização em todos os estudos. No acompanhamento de até 4 anos, observou-se, radiograficamente, aumento do comprimento e espessura radicular, diminuição e posterior desaparecimento da radioluscência periapical, estreitamento do ápice radicular, desenvolvimento radicular e redução da lesão periapical. Conclusão: A revascularização permite que, mesmo após o estímulo para indução de sangramento, a região periapical continue a formação radicular por mais tempo quando comparada a outros materiais endodônticos. THE EFFECTIVENESS OF REVASCULARIZATION ON ROOT APEX FORMATION IN PATIENTS WITH IMMATURE PERMANENT TEETH: AN INTEGRATIVE REVIEW ABSTRACT Objectives: To verify the effectiveness of revascularization to induce further root apex formation in patients with immature permanent teeth. Method: A searching strategy was performed at PubMed, Embase, Web of Science, and LILACS electronic database, four articles issued between 2011 and 2021 were screened. Results: A total of 27 patients diagnosed with pulp necrosis were included, both genders. Percussion, electric, and thermal pulp testing were performed for clinical examination in those 4 patients. All the patients had a periapical x-ray taken for initial analysis. The endodontic treatment was performed with the apex-induced bleeding into the root canal for the revascularization in all the studies. At a 4-year follow-up it was observed, radiographically, an increase in root length and thickness, and afterward the periapical radiolucency disappearance, the root apex narrowing, root growing, and the periapical lesion reduction. Conclusion: Revascularization enables, even after the stimulus for bleeding induction, the periapical region to further continue the root formation when compared to other endodontic materials. Descriptors: Endodontics. Pulp Necrosis. Tooth Apex.

Description of a new species Coomansus batxatensis (Mononchida, Mononchidae) from Vietnam, with an updated key to species

Coomansus batxatensis sp. nov., recorded from Vietnam, is described and illustrated and its phylogenetic relationship within the Mononchida is analysed. The molecular data (18S and 28S ribosomal DNA) are provided for the new species. The new species is characterized by small body size (body length, L = 0.7–0.9 mm); buccal cavity sub-rectangular in shape, flattened at base, 21–24 × 12–13 μm or 1.9 (1.7–2.0) times as long as wide; posterior position of dorsal tooth apex (59–63% from the base of buccal cavity); pars refringens vaginae with faint and small (2.5 × 1.7 μm) teardrop-shaped pieces, short pars distalis vaginae; and males with short spicules (50–51.5 μm) with rounded head and conical blade part. The new species is close to Coomansus parvus but differs from it by the smaller buccal cavity size, more posterior position of the dorsal tooth apex, longer tail and presence of males. An updated identification key to Coomansus species and a compendium of all the species known are presented.

Description of a new species, Actus hagiangensis (Mononchida, Mylonchulidae) from Ha Giang province, Vietnam

Actus hagiangensis sp. nov. is described and illustrated from Vietnam. Females of the new species are characterized by medium body size (L = 1.1–1.4 mm), barrel shaped buccal cavity of medium size (26–31 x 13–15 µm) with dorsal tooth apex located 75–81% of buccal cavity length from base and two longitudinal subventral rows, each with four rasp-like denticles; reproductive system didelphic-amphidelphic, vagina short with distinct par refringens vaginae, sclerotized pieces globular in optical section; tail elongate-conoid, slightly ventrally arcuate, with three caudal glands and prominent spinneret. Male with spicules 46 µm in length, and slender, slightly curved gubernaculum, 12 µm long, without accessory piece. This is the first report of a male specimen of the genus Actus. The new species is close to A. salvadoricus but differs by the larger buccal cavity, more anterior position of the dorsal tooth apex and more rounded vaginal sclerotized pieces.

Imaging of Radiolucent Jaw Lesions

Radiolucent lesions in the jaw bones comprise a whole spectrum of odontogenic and nonodontogenic lesions. Although the imaging appearance is not always specific, careful radiologic analysis may contribute to characterization of these lesions. A useful approach is to first analyze the absence or presence of a relationship of the lesion to the teeth. The relation may be either near the tooth apex or crown of the tooth. Other lesions may or may not show any specific anatomical location. After analysis of the primary location of the lesion, additional criteria that may help in further imaging characterization are lesion demarcation and morphology, involvement of the cortex and periosteum, and soft tissue changes. This article describes the most characteristic and prevalent radiolucent lesions of the jaws at each location. In routine clinical practice, cone beam computed tomography is sufficient for appropriate lesion characterization, although magnetic resonance imaging may be useful in selected cases.

Orthodontics and Endodontics: clinical decision-making

ABSTRACT Endodontically treated teeth may be moved, as endodontic treatment is not a contraindication for orthodontic treatment. Apical periodontal repair begins when the periapical or pulp lesion has completely resolved. This may happen immediately after treatment if the filling material causes little or no irritation of periapical tissues, and particularly if the material is fully contained within the canal. When it leaks, a foreign body granuloma forms and persists for some months or indefinitely, depending on the composition of the filling material. Materials containing calcium hydroxide with no resin components undergo phagocytosis and disappear in some months, as macrophages gradually remove them. Materials containing resins, silicone, ionomers, zinc oxide-eugenol, bioceramics or gutta-percha remain in the site and induce the formation of foreign body granulomas. Although this does not preclude tooth movement, patients should be followed up every three months using periapical images to control the position of the material in relation to the tooth apex. “Pseudo” overfilling may be avoided if permanent filling is delayed until the time when orthodontic treatment is completed.

The Difference Upper Incisor and Upper Molar Alveolar Bone Loss between Smoker and Non-Smoker Patient with Chronic Periodontitis

Periodontitis is one of most common oral disease. Chronic periodontitis is characterised by gingival inflamation, periodontal pocket, lost of attachment, and alveolar bone loss. Smoking is a risk factor of periodontal disease that has direct effect to periodontal tissue. Smoking prevalence in Indonesia during 2013 was about 56,7% among men and about 1,9% among women. Smoking modifies the periodontal microbial challenge and host cytokine levels. Some studies showed that smoker has greater alveolar bone loss than non-smoker, and teeth that have the greatest alveolar bone loss are incisor and followed by molar. The aim of this study is to know the upper incisor and upper molar alveolar bone loss differences between smoker and non-smoker patient with chronic periodontitis. The study’s samples are 92 chronic periodontitis statuses and 200 periapical radiographs that selected by purposive sampling techinque. This study will measure the distance between cementoenamel junction to alveolar bone crest, cementoenamel junction to tooth apex, and alveolar bone loss percentage at upper incisor and upper molar. To compare the differences upper incisor and upper molar alveolar bone loss at patient with chronic periodontitis between smoker and non-smoker will be analyzed by independent t test and Mann-Whitney U test. The result showed that smoker has greater alveolar bone loss than non-smoker. There is no significant differences at upper incisor alveolar bone loss and there is significant differences at upper molar alveolar bone loss between smoker and non-smoker patient with chronic periodontitis.

СOMPLICATIONS OF ENDODONTIC TREATMENT: PECULIARITIES OF CLINICAL SIGNS, DIAGNOSIS

Endodontic lesions take leading positions in the structure of modern dentistry. General areas of the displacement of filling material or instruments because of the poor quality of endodontic treatment have been established, and the features of clinicoroentgenological and neurological manifestations of the complications of endodontic dentistry have also been determined. Due to the poor quality of endodontic treatment, general areas of the displacement of filling material or instruments have been identified, they are the mandibular canal, the maxillary sinus and periapical bone tissue. We have performed the examination of 32 patients with various complications after endodontic treatment during 2017 to 2018. The majority of patients were adults – 28(87,5%), over the age of 60 – 4(12,5%), there were 84,4% females and 15,6% males within the group. The patients were divided into 3 groups according to localization of foreign bodies: the first group contained patients with foreign bodies present in the area of mandibular canal – 5(15,6%); the patients represented by the material in the maxillary sinus cavity made up the second group – 9(28,1%); the group of patients whose material was localized behind the tooth apex in the bone tissue included 18(56,2%)persons. The greatest number of complications after endodontic therapy was observed during the treatment of molars– 67,9%. Duration of disease (from the end of endodontic treatment to the hour of addressing the clinic) varied from 1 to 6 months. For the purpose of identification, the foreign material localization along with traditional clinic examination, which includes complaints analysis, anamnesis data, estimation of general health status and local manifestations of the disease, the dental intraoral X-ray, plain roentgenography and computed tomography of the bones of the jaws were performed. Assessment of the tissues sensitivity was conducted by the method of comparative palpation of the skin and mucosa at the areas of innervation of the trigeminal nerve branches. As a result of the investigation we have determined that regardless of exact localization of the foreign material, surgical complications after endodontic treatment were always accompanied with pain syndrome of different intensity, reduction of sensitivity during the placement of the filling material in the area of mandibular canal (extra- or intracanal), signs of inflammation development (bounded or generalized adjacently to mucosa of maxillary sinus) or persistent pain syndrome during displacement of filling material into the bone tissue behind the tooth apex. To specify areas and borders of the localization of the foreign body, the findings of the roentgenological investigations, in particular computed tomography, were critical.