Radiological evaluation of secondar y bone grafting results in patients with cleft lip and palate

Introduction. Bone grafts are a necessary component of the care protocol for patients with cleft lip and palate (CLP). Radiological evaluation is an essential tool in evaluating the integration of the bone graft at the cleft area. Aim: Evaluation of the interdental height of the alveolar ridge in patients with CLP at the pre- and postoperative stages in order to assess the integration of bone graft in the cleft area. Material and methods: Cross-sectional clinical study, which included 34 patients with CLP; with equal distribution by gender, with an average age of 17.6±0.43 years. The study group underwent surgical treatment with bone grafting in the cleft region. The radiological evaluation was performed pre- and postoperatively (over 6 months), according to the scale of assessment proposed by Abyholm et al. Statistical evaluation of the data was performed by the Pearson correlation coefficient. Results: Overall, favorable postoperative results were observed. Initially, according to the radiological evaluation, the patients presented at the preoperative stage type III 29.4% (n = 10) and type IV - 70.6% (n = 24) of the interdental height of the alveolar ridge. Following bone grafting, it was recorded at 52.9% (n = 18) - type I, mainly in female patients (n = 11) and 47.1% (n = 16) - type II of the interdental height of the alveolar ridge , being predominantly registered in male patients (n = 10). Statistically significant differences between the sexes were not recorded (p = 0.132). The successful results obtained by secondary bone grafting in the cleft region allowed to continue the rehabilitation treatment of patients with CLP. Conclusion: Radiological evaluation of secondary bone grafting in the cleft area in terms of assessing the height of the alveolar ridge according to the scale of Abyholm et al. is a valuable diagnostic tool, readily available for assessing the condition of the grafted bone.

Lipoma versus benign symmetric lipomatosis with localization in oral and maxillofacia region

Benign tumors of fat tissue with localization in oral and maxillofacial region are an ongoing problem, with a high frequency and various manifestation causing morphofunctional and aesthetic discomfort for the patient. The article is based on comparative analysis of 2 patients that have benign tumors of the adipose tissue in the OMF region, one patient diagnosed with solitary lipoma and over patient with benign symmetric lipomatosis with anterior cervical localization. The specialized literature offers 2 methods of lipomatous tumor removal Liposuction and Lipectomy, in the article we describe the effectivity of the 2 methods. This study proved that benign tumors of fat tissue can have common morphological origin but different progression and clinical features. Early addressing of the patients and early detection diminishes the duration of the surgery, morbidity and rehabilitation of the patient.

Coronectomy of the wisdom teeth: the dental extraction alternative

Background. Coronectomy of the wisdom teeth is an alternative surgical procedure to tooth extraction, which aims to preserve the roots of the wisdom teeth in the dental socket after surgical separation of the crown, in order to avoid the injury of the inferior alveolar vascular-nervous bundle. Purpose. Minimizing the damage to the inferior alveolar nerve when extracting lower third molars caused by the intimate relationship between the nerve and the roots of the teeth, by using the technique of coronectomy, or intentional root retention. Material and Methods. Patients who reported to University Dental clinic during the period 2020–2021 for surgical removal of impacted L3M were screened for nerve–root relationship with OPG or CBCT. 15 patients underwent coronectomy as a procedure to remove the crown and upper third of the roots of a lower third molar to reduce the risk of damage to the inferior alveolar nerve. Results. 15 patients were enrolled in this study, with a total of 17 lower third molars. Sixteen sites healed primarily, but in 1 case the sockets on both sides opened and failed to close secondarily. In this case, the root fragments were later removed and found to be mobile. Conclusion. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. The technique appears to be associated with a low incidence of complications and the removal of remaining roots is required in around 6-7% of cases due to the mesial migration of the fragment and not any symptoms or reinfection.

Branchial cleft cyst. Particularities of diagnosis and treatment. Clinical case

Branchial cysts are rare congenital malformations which arise due to the partial or complete involution of branchial apparatus in the development of the human embryo, causing huge discomfort to the patient. The objective of the study is to investigate the clinical picture, the evolution, the diagnostic methods of the branchial cysts to optimize the treatment tactics. A clinical case will be presented of a 40–years–old patient which was admitted to IMU IMSP in the Oral and Maxillofacial Surgery Department with the diagnosis of a left lateral branchial cyst. The patient accuses aesthetic disorders and the presence of a voluminous swelling which was located in the upper left lateral cervical region that began 2 years ago with episodes of frequent superinfection, gradually increasing in size. Therefore, a clinical and paraclinical examination was performed (laboratory tests, ultrasonography) to specify the diagnosis and to provide additional information on adjacent anatomical structures that may influence the tactics of the surgical treatment. A surgical intervention such as „removal of the swelling” was advised. Following the excision of the cyst under general anesthesia, the postoperative period passed without any particularities. Early diagnosis will reduce the increase in size of the branchial cysts preventing inflammatory complications with their superinfection.

Surgical treatm ent of dento maxillary anomalies class III angle. Clinical case

Dento-maxillary anomalies are relatively widespread among the population, eventually leading to serious psychological and lifestyle deterioration. The purpose of this paper is to evaluate the complex orthodontic-surgical treatment in the dento-maxillary anomaly class III Angle. We aim to present the clinical case of a female patient suffering from skeletal third-class, gnathic form, who came to „Omni Dent” clinic in order to complete the second stage of associate orthodontic and surgical treatment. Medical investigations: OPG, CBCT, TRG, digital scanning, dental photography, digital programs, used at collecting data for virtual planning, establishing a complex diagnosis and choosing the best surgical technique for this case, subsequently, with the transfer of the virtual plan in the operating room through surgical guides and occlusal splints. Postoperatively, there was an obvious improvement of the facial appearance, supported by the comparison of pre- and postoperative cephalometric indices: SNA (from 76,6° to 84°), SNB (from 80,6° to 78,8°), ANB (from -4° to 5,2°), Wits (from -9,6° to 0°). Early diagnosis and detailed planning by using modern methods of examination may ensure an efficient rehabilitation of patients suffering from dento-maxillary anomalies.

The impact of socioeconomic statu on patients with oral and maxillofacial injuries

Oral pathologies are among the most common diseases in the world. However, they do not affect all members of the population to the same extent, with differences based on various geographical, social, and economic factors. This article has the aim of investigating this matter by analyzing the social status of 50 patients with OMF injuries, who were treated in the Department of Dental Surgery at the Dental Municipal Center in Chișinău, throughout the year of 2020.

Peri-implantitis: explantation versus peri-implant regeneration

Peri-implantitis is a complication in implantprosthetic rehabilitation that causes morpho-functional, masticatory and aesthetic disorders. Depending on the severity it can be approached by conservative surgical or radical treatment. The aim of the paper is the comparative analysis of conservative surgical methods (implant preservation) versus radical (explantation). We studied 2 patients who came to the SRL “Omni Dent” clinic with peri-implantitis. Manifestation, treatment and evolution in both patients were compared. Analysis criteria: bone defect extension, soft tissue appearance, tissue regeneration, implant-prosthetic rehabilitation time. In RI patient there were changes in color and appearance of the peri-implant soft tissues (hyperemia, edema, purulent discharge), peri-implant radiolucency on the entire implant surface; in the TM patient there were the same clinical signs but limited to ½ implant length. RI patient underwent explantation with re-implantation in the neighboring region 2.4 after 4 months with prosthesis fixing after another 4 months. Tissue regeneration evolved without complications. In TM patient was decided to keep the implant through curettage, implantoplasty and bone addition. Prosthetic rehabilitation followed later without complications. Timely addressing would prevent the development of complications with implant loss. The insignificant loss of peri-implant tissues can be recovered with the preservation of the implant, in the extended defects the optimal solution is the explantation with the subsequent implantprosthetic rehabilitation.

Peri-implant soft tissue au gmentation with connective tissue graft using „Two stage“ technique

Soft tissue augmentation using autogenous gingival grafts is a procedure often used in implantology and periodontal surgery. The technique of connective tissue grafting refers to the placement of connective tissue under a flap of partial thickness, which aims to induce the formation of keratinized tissue. It is indicated for partially or totally edentulous patients to increase the areas with the absence or reduction of the height of the keratinized tissue, as well as to increase the volume of soft tissue. The structural differences between the implant / bone tissue interface and the natural tooth / bone tissue make dental implants more susceptible to the development of inflammatory processes and bone loss. For these reasons, the intangibility of the seal around the implants is one of the primary objectives in its success over a long period of time. The function of the peri–implant seal is to “maintain internal homeostasis in response to external environmental challenges.”

Outcome of using plat eletrich plasma in postextractional wound treatment

Background. Platelet-enriched plasma (PRP) is a revolutionary autologous biomaterial that stimulates bone regeneration, enhances regenerative processes and postoperative wound healing, thus simplifying future implant-prosthetic rehabilitation. Objective of the study. Evaluation of PRP regeneration properties in postextractional wound regeneration. Material and Methods. The clinical examination was used as research methods: inspection, palpation, paraclinical examination: panoramic radiography / CBCT and VAS test were performed. The diagnosis and treatment plan were established, as follows: extraction associated with PRP injection. Results. At the postoperative evaluation of the patient after 7 days of treatment, the intensity of pain according to the modified VAS method showed decreased values- from 4 to 1, the postextractional wound was completely healed, the level of regeneration was attested by the absence of dehiscence, presence of the pale pink epithelium, absence of the postoperative facial edema according to the craniometric points, the Celsius signs also were absent. Conclusion. The use of PRP biomaterial in wisdom tooth extraction is a minimally invasive method of tissue regeneration that reduces the rehabilitation period and prevents the occurrence of post-extraction complications.