Total Oral Rehabilitation with Dental Implants in an Elderly Patient with Concomitant Diseases: a Case Report

We report a case of restoration of the masticatory and phonetic functions of a senior patient with comorbidities who receives systemic medication and lacks sufficient bone volume for implant placement in the accurate position. X-ray shows severe asymmetric atrophy of the mandible, especially on the right sight, which affects the location of the mandibular canal. This greatly limits and complicates the restoration of the masticatory and phonetic functions with conventional prostheses. Adequate management of medication and long-term disease control of the patient allow safe surgery for tooth extraction and placement of intraosseous implants in the jaw bones.

Evaluation of maxillary bones using cone beam computed tomography: A systematic review

Cone beam computed tomography is widely used in dentistry, due to its easy accessibility, low cost and better accuracy compared to medical tomography. The present study aims to conduct a systematic review of the literature on the evaluation of jaw bones using cone beam computed tomography. A bibliographic search was performed in the electronic databases PubMed, Scopus, Embase and Web of Science. At the end of the analysis, 10 articles published between 1998 and 2015 were included. Cone beam computed tomography is a precise and fast method, used to evaluate digital images in high resolution, with sharpness, precision. In addition, the acquisition of these images is essential to measure bone elements, in quantity and quality. It should also be noted that the forecast of bone strength will depend on several factors, such as bone density and microarchitecture. Thus, the professional and reduces the likelihood of making mistakes, which interfere with the prognosis of dental treatment.

Modern Surgical Methods of Treatment of Odontogenic Jaw Cysts (Literature Review and Own Data)

The purpose of the study was to analyze the data of modern domestic and foreign professional literature, which are devoted to new surgical methods of treatment of odontogenic cysts, to highlight the results of own clinical studies on the effectiveness of developed methods of cystectomy in jaw bones and their anesthesia. Materials and methods. Analytical and bibliosemantic methods were used in the research. The search for scientific information on medical topics for the period from 2010 to 2021 was carried out in the databases of electronic searching systems. Results and discussion. The use of standard techniques of conduction anesthesia of the trigeminal nerve is not always effective during cystectomy in the lateral parts of the mandible, due to the variability of branching of the trigeminal nerve, the possibility of additional innervation of the jaw branch from the superficial cervical plexus. Taking into account these anatomical factors, it is painless to perform a cystectomy of odontogenic cysts on the mandible. During oronasal cystectomy of odontogenic cysts that have grown into the nasal cavity it is advisable to block the nasopalatine nerve in the middle nasal passage. Modified methods of marsupialization can be used as an independent method of treatment of odontogenic cysts of large size, or be combined with radical removal of the cyst membrane. The use of ultrasound medical techniques reduces the risk of damage to adjacent soft tissues during enucleation of bone membranes in complex topographic and anatomical areas. The use of modern laser technologies and medical radiophysical equipment can increase the effectiveness of surgical treatment of odontogenic jaw cysts. The use of endovideosurgery techniques reduces the percentage of intraoperative complications. The introduction of computer spatial imaging of anatomical objects in dental practice has made it possible to develop new surgical technologies for precision-guided osteotomy and resection of the tips of the roots of masticatory teeth adjacent to the shells of radicular jaw cysts. Conclusion. In modern clinical practice, technical developments are used, which are based on the latest advances in laser optics, radio physics, bioacoustics, computer technology, which minimizes injuries during cystectomy operations, reduces the frequency of intraoperative complications. Individual-anatomical features of innervation of the maxillofacial area should be taken into account during local anesthesia, cystectomy and cystotomy operations in the jaw bones

Diverse stem-chondrichthyan oral structures and evidence for an independently acquired acanthodid dentition

The teeth of sharks famously form a series of transversely organized files with a conveyor-belt replacement that are borne directly on the jaw cartilages, in contrast to the dermal plate-borne dentition of bony fishes that undergoes site-specific replacement. A major obstacle in understanding how this system evolved is the poorly understood relationships of the earliest chondrichthyans and the profusion of morphologically and terminologically diverse bones, cartilages, splints and whorls that they possess. Here, we use tomographic methods to investigate mandibular structures in several early branching ‘acanthodian’-grade stem-chondrichthyans. We show that the dentigerous jaw bones of disparate genera of ischnacanthids are united by a common construction, being growing bones with non-shedding dentition. Mandibular splints, which support the ventro-lateral edge of the Meckel's cartilage in some taxa, are formed from dermal bone and may be an acanthodid synapomorphy. We demonstrate that the teeth of Acanthodopsis are borne directly on the mandibular cartilage and that this taxon is deeply nested within an edentulous radiation, representing an unexpected independent origin of teeth. Many or even all of the range of unusual oral structures may be apomorphic, but they should nonetheless be considered when building hypotheses of tooth and jaw evolution, both in chondrichthyans and more broadly.

Bone-targeted erythrocyte-cancer hybrid membrane-camouflaged nanoparticles for enhancing photothermal and hypoxia-activated chemotherapy of bone invasion by OSCC

Background Jaw bones are the most common organs to be invaded by oral malignancies, such as oral squamous cell carcinoma (OSCC), because of their special anatomical relationship. Various serious complications, such as pathological fractures and bone pain can significantly decrease the quality of life or even survival outcomes for a patient. Although chemotherapy is a promising strategy for bone invasion treatment, its clinical applications are limited by the lack of tumor-specific targeting and poor permeability in bone tissue. Therefore, it is necessary to develop a smart bone and cancer dual targeting drug delivery platform. Results We designed a dual targeting nano-biomimetic drug delivery vehicle Asp8[H40-TPZ/IR780@(RBC-H)] that has excellent bone and cancer targeting as well as immune escape abilities to treat malignancies in jaw bones. These nanoparticles were camouflaged with a head and neck squamous cell carcinoma WSU-HN6 cell (H) and red blood cell (RBC) hybrid membrane, which were modified by an oligopeptide of eight aspartate acid (Asp8). The spherical morphology and typical core-shell structure of biomimetic nanoparticles were observed by transmission electron microscopy. These nanoparticles exhibited the same surface proteins as those of WSU-HN6 and RBC. Flow cytometry and confocal microscopy showed a greater uptake of the biomimetic nanoparticles when compared to bare H40-PEG nanoparticles. Biodistribution of the nanoparticles in vivo revealed that they were mainly localized in the area of bone invasion by WSU-HN6 cells. Moreover, the Asp8[H40-TPZ/IR780@(RBC-H)] nanoparticles exhibited effective cancer growth inhibition properties when compared to other TPZ or IR780 formulations. Conclusions Asp8[H40-TPZ/IR780@(RBC-H)] has bone targeting, tumor-homing and immune escape abilities, therefore, it is an efficient multi-targeting drug delivery platform for achieving precise anti-cancer therapy during bone invasion. Graphical Abstract

AUTO-TRANSPLANTATION: AN INTERIM TREATMENT MODALITY (CURRENT UPDATES)

Paediatric dental patients demand special care and wider vision while treatment planning due to ongoing growth of jaw bones and existing permanent tooth buds within the bone. Tooth loss is very common even in younger age patients due to extensive tooth decay or as a result of traumatic dental injuries. Implants are in high demand to restore the lost tooth but use of implants is limited to adults or older age group. Thus auto-transplantation may be an intermediate or permanent treatment option to such cases due simple, less time consuming and cost effectiveness. Sidewise auto-transplantation maintains the bone dimensions to make it available further treatment on failure. Present review article include all the required facts about auto-transplantion.

A rare case of plasmacytoma of mandible revealing plasma cell myeloma

Multiple myeloma (MM) is a malignant proliferation of plasma cells with multiple foci. Plasmacytoma is a solitary plasma cell neoplasm involving a single bone. The most commonly involved bone is vertebra. Jaw bones are rarely involved as a first bone as they have lesser hematopoietic marrow. A solitary plasmacytoma may progress to multiple myeloma within few months to year. We present a case of a swelling of mandible that on further investigations confirmed the diagnosis of multiple myeloma. We have discussed the course of treatment given and its prognosis. Keywords: multiple myeloma; plasmacytoma of jaw; bence jones Protein; abnormal plasma cells; CD138.

1678 A Rare Example of a Simple Bone Cyst of The Ascending Ramus in A Paediatric Patient

A simple bone cyst is described as an intra-osseous pseudocyst, devoid of an epithelial lining and either empty of filled with serous or sanguineous fluid. This case presents a rare example of a simple bone cyst of the ascending ramus of the mandible in a paediatric patient. Studies have shown that less than 5% of simple bone cysts of the jaw bones are located within the mandibular ramus, with the most common site being the premolar-molar region (75%). The 14-year-old female was referred by her orthodontist to the local Oral and Maxillofacial department, for an incidental finding on her pre-orthodontic OPT of a radiolucency in the left ascending ramus. Her medical history was clear, she was asymptomatic and had no sensory deficit. A CT scan demonstrated a 22mm multilocular radiolucency centred on the left ascending ramus, extending superiorly up to the base of the coronoid process and condylar neck. Inferiorly, the radiolucency abutted but did not involve the unerupted third molar. The scan highlighted thinning of the buccal and lingual cortices putting the patient at risk of pathological fracture. The inferior alveolar nerve canal passed through the lingual aspect of the radiolucency. The patient underwent exploration of the left mandible which revealed an empty bony cavity, with no cystic lining or contents. The definitive diagnosis of a simple bone cyst was established. She experienced satisfactory healing by her review appointment 4 weeks post-surgery. Combined radiographic and clinical assessment is important in the diagnosis of simple bone cysts.