Evaluation of Human Periodontal Ligament and Osteosarcoma Cell Attachment and Viability on Particulate Bone and Dentin Allografts

Purpose: Various bone grafting substitutes have been used in the periodontics for bone regeneration which include autografts, allografts, xenografts and alloplasts. Autogenous particulate dentin has been used successfully as a bone grafting substitute. The aim of present study was to evaluate the effect of demineralized and mineralized freeze-dried bone allograft and particulate dentin on osteoblasts-like cells and human periodontal fibroblasts. Materials and methods: Demineralized freeze-dried bone allograft (DFDBA) and freeze-dried bone allograft (FDBA) and ground dentin was used in the study. Particulate dentin was divided into four groups according to the size of the particles and demineralization - small dentin (particle size less than 200 µm), small dentin demineralized, large dentin (particle size 250-1200 µm), large dentin demineralized. Effect of all the specimens was checked on osteoblast-like cells (MG63) and human periodontal ligament cell lines. Percentage of surviving cells was measured using colorimetric MTT assay spectrophotometrically on 7th and 14th day of the cell culture. Scanning electron microscopy (SEM) was used to check the cellular attachment. Results: Demineralized dentin matrix has shown significantly enhanced viable cell percentage for both the cell lines. DFDBA and demineralized dentin has reported comparable percentage of surviving cells. Dentin seems to be more compatible with osteoblastslike cells than fibroblast. FDBA has shown the least favorable results. Cellular attachment for both the cell lines can be appreciated on SEM images. Conclusion: Demineralized particulate dentin has reported considerable percentage of cell viability making it a reasonable option for bone grafting substitute.

Green Tea mouthwash for reducing dental plaque

Paraguay is a country popular for the use herbal products for health care. Extensive studies have been made on the natural mouthwashes with fewer side effects as an alternative to chemical ones. In the case of reducing dental plaque, a green tea mouthwash has been studied alone or combined with other natural agents.

Evaluation of the Accuracy of an Intraoral Scanner: An Update on the Omnicam

Computerized optical impression making is one of the most exciting topics in dentistry today. Therefore, it is very important to know how accurate these devices are. Purpose: To investigate the influence of a software update of an intraoral scanner. Materials and Methods: Accuracy was tested in terms of trueness and precision. An acrylic model was scanned with an industrial scanner. The dataset was used as reference for the evaluation of the CEREC AC Omnicam datasets and statistical analyses implemented. Results: Trueness and precision values very significantly smaller with the latest software version as opposed to the previous version. Conclusion: Within the limits of the present study, the investigated intraoral scanner meets the highest standards in terms of trueness and precision. The authors strongly recommend to not use software other than the proprietary workflows to export files to the open STL file format.

Maxillary sinusitis of odontogenic origin in relation to ectopic 2.8 associated with follicular dentigerous cyst: Combined transnasal and oral endoscopic approach, a case report

Purpose of the study: To describe the management of orosinusal pathology by combined transnasal endoscopy and oral combined. Methods: The 54-year-old patient underwent a dental and otolaryngological evaluation for left odontogenic maxillary sinusitis in relation to plausible dental follicular cyst of ectopic element 2.8. The symptoms reported at the time of access to the hospital were nasal obstruction and nocturnal rhonchopathy. To the ENT evaluation in videorinoscopy with rigid optics, complex deviation of the nasal septum was relevated with not any evident formations or pathological secretions. While on inspection of the oral cavity the mucous membranes appeared unscathed. Alveolus of 1.6 previosuly extracted was evident. The radiological examination, facial CT, revealed the left maxillary sinus almost completely occupied by a cystic appearance, with thin calcified walls and homogeneous content that has a dental element, probably the 2.8, which fenestrates the vestibular cortex of the lateral wall of the maxillary sinus. This lesion erodes the medial wall of the sinus, obliterating the ostio-meatal complex and imprinting the ipsilateral ethmoidal cells. Biohumoral tests showed normal coagulation parameters, indices of renal function, liver and ionemia. The patient under general anesthesia and oral intubation with a combined intervention of the left anterior FESS, intrasulcular flap from dental elements 2.7 to 2.3 with mesial releasing incision, moderate osteotomy, ectopic 2.8 extraction and enucleation of the cystic lesion with simultaneous closure of the orosinusal communication with advancement of the Bichat adipose bolla and closure by first intention. In the same session, the ENT moment is carried out trans nasally for total left uncinectomy, medium antrostomy with the union of the natural ostium and the accessory ostium. Bilateral lower turbinoplasty with bipolar forceps. The patient was then controlled after 15 days and six months, showing good healing and no signs of recurrence at the rhinoscopic check on the physical examination of the oral cavity. Results: based on the clinical and radiological aspect, the diagnosis of a follicular dentigerous cyst (WHO 2017) covered by a multi-layered non-keratinized paving epithelium, with moderate chronic inflammation, including gigantocellular and cholesteric crystals, is reached from the microbiological and histological examination. Necrotic amorphous material coexists including rare hyphae and fungal spores, with therefore mycotic and actinomycotic super infection. Conclusions: The combined oral and nasal intervention, allowed by the collaboration between the oral surgeon and ENT, has made it possible to shorten the healing time and to resolve the pathology without any sign of recurrence.

Compliance to IR(ME)R guidelines for dental pantomogram reporting

Purpose: The aim of this audit was to improve clinician compliance to IR(ME)R 2017 guidance for radiograph reporting. Method: A sample of 100 patients who had a dental pantomogram radiograph taken in the Oral & Maxillofacial Surgery department had their notes assessed for a radiograph justification, grading and report. Results: The results of audit cycle 1 indicated a need for engagement from the clinicians to improve adherence to the IR(ME)R guidelines. The results were discussed at various departmental meetings and a poster was developed and strategically placed throughout the department as a reminder of elements required to be recorded in notes. Cycle 2 showed great improvements in compliance to IR(ME)R guidance. This will continue to be audited until 100% compliance is attained. Conclusion: IR(ME)R guidelines are in place in order to protect patients and ensure there is no unnecessary radiation exposure and that all exposures are clearly documented and justified. The audit has shown improvements in clinicians compliance to radiograph justification, grading and reporting.

Periodontal Plastic Surgery

Periodontal Plastic Surgery comprises a limited number of surgical procedures which focus on the establishment of normal morphology and architecture of periodontal tissues in order to achieve aesthetical, biological and functional outcomes. The main surgical techniques concern the correction of morphology, position and amount of gingiva and in some cases the reconstruction and augmentation of alveolar ridge. Those surgical procedures include the treatment of gingival recession, surgical crown lengthening, augmentation of the width of attached gingiva and,the vertical or horizontal augmentation of alveolar ridge. Each surgical technique is followed by determined indications, contra-indications, advantages, disadvantages and, predictability.

Mandibular Bone Defect Imaging Features in Cone Beam Computed Tomography: A Case Report

Mandibular bone defect or Stafne bone defect is usually an incidental finding in imaging examinations due to its lack of symptomatology. It is often observed as a radiolucent lesion with well defined limits. In this report it is demonstrated a case of mandibular bone defect close to the mandible angle, in a 16-year old female, that performed cone beam computed tomography examination in order to verify the proximity of the third inferior molar to the mandibular canal. In this case, it was verified that the defect was continuous to the mandible border and it had a thick sclerotic margin. No treatment is necessary to mandibular bone defects, but regular follow-ups are strongly recommended.

Horseshoe Le Fort I osteotomy for gummy smile and facial asymmetry: Two cases

Introduction: In cases with gummy smile or asymmetry of the maxilla, superior repositioning of the maxilla is required. If superior repositioning by a Le Fort I osteotomy alone is difficult, a horseshoe Le Fort I osteotomy can be used. Presentation of cases: Case 1: A 24-year-old Japanese woman patient presented with a gummy smile and an open bite. After we performed a horseshoe Le Fort I osteotomy, the maxillary segment was repositioned superiorly 3.0 mm at upper tooth number 1 (U1) and 5.0 mm at upper tooth number 6 (U6). Case 2: A 21-year-old Japanese man presented with severe facial asymmetry. After we performed a unilateral modified horseshoe Le Fort I osteotomy, the maxillary segment was superiorly repositioned 6.0 mm at the right U6. Discussion: This procedure eliminated the risk of intraoperative bleeding because it was unnecessary to remove bones around the descending palatine artery, and it was possible to maintain the chamber size of the nasal cavities. Conclusion: The horseshoe Le Fort I osteotomy is a reliable technique for cases with severe gummy smile or asymmetry of the maxilla.

Pansinusitis from Dental Origin: Pre and Post-Treatment Multi-Slice Computed Tomography Imaging

Oroantral communication is a teeth post-extraction complication defined as a communication created between the maxillary sinus floor and the oral cavity. If it is not treated, oroantral communication may progress to an oroantral fistula and/or sinusitis. Maxillary sinus communication with paranasal sinuses may allow the spread of sinusal disease, leading to the development of pansinusitis. Pansinusitis can progress to life-threatening intracranial complications, such as meningismus, focal neurological disorders, loss of consciousness and seizures. In this case report, it is described a case of post-extraction OAC which progressed to an oroantral fistula and pansinusitis, detected by multislice computed tomography. After the proper treatment, which included the use of antibiotics and communication surgical closure, multislice computed tomography revealed lack of opacification of paranasal sinus with an acceptable outcome.