47 research outputs found
Epidermolysis bullosa and Kindler syndrome - where is the border in oral manifestaions
Get PDFEpidermolysis bullosa (EB) represents a rare chronic autoimmune subepidermal vesiculobullous disorder that affects the skin and mucosa and is characterized by blistering and mechanical fragility of the skin. The most recent classification recognizes four major EB groups: intraepidermal EB (Simplex), junctional EB, dermolytic EB (Dystrophic), and mixed EB (Kindler syndrome). Kindler syndrome is a rare genodermatosis with clinical features of trauma-induced blistering, poikiloderma, skin atrophy, mucosal inflammation and varying degrees of photosensitivity. Although Kindler syndrome is classified as a subtype of epidermolysis bullosa, it has distinct clinicopathological and molecular abnormalities.The clinical features of the syndrome have been annotated by different authors but definite criteria to confirm the diagnosis have not yet been generally accepted
ORAL MUCOSA DAMAGE BECAUSE OF HYPOCHLORITE ACCIDENT – A CASE REPORT AND LITERATURE REVIEW
No full textBackground Hypochlorite solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue especially due to its cytotoxic features.
Objective The aim of our paper is to present a case of damage of oral mucosa because of leakage of 3% hypochlorite through rubber dam during endodontic treatment.
Material and methods We present a 31 years old female with necrosis of buccal mucosa during the endodontic treatment of 46.
Results Three days after the procedure the patient was referred to our department for consultation and treatment. Antiseptic lavage was performed and oral antibiotic was administrated. After 5 days intraoral examination showed signs of almost full recovery.
Conclusion The need for proper tooth isolation during restorative procedures is obvious. Anything that obscures the operative field negatively impacts operator efficiency and effectiveness. Visibility, patient/operator safety, infection control and the physical properties of dental materials are all compromised when proper isolation is lacking
MECHANISM OF INJURY - A SIGNIFICANT COMPONENT IN EVALUATION OF MAXILLOFACIAL TRAUMATIC PATIENTS STATUS
Get PDFKnowing the injury mechanisms is of extreme importance for correct diagnostic evaluation. Specific injury models can be related to exactly determine trauma mechanisms. Understanding the way of injury may be a key to solving the occult injuries. Thus, some life threatening injuries may be diagnosed without present clinical symptoms at the moment of examination.
Purpose: The aim of our study is to analyse the risk factors for arising of associated maxillofacial trauma injuries (AMFI)
Material and methods: A total of 352 traumatic patients were retrospectively and prospectively examined for the period 05. 2005 - 12. 2011, treated at the Department of Oral and maxillofacial surgery at the St. Anna University Hospital, Sofia, whereas AMFI were determined in 129 patients
Results: Our study results indicate that most often, RTA are a reason for a combined trauma at the age group of 20-29, followed by the age group of 30-39, and less in the age group of 40-49. The most often reasons for combined traumas are RTA(road traffic accident) and IPV(interpersonal violence), each of which has a relative share, significantly higher than the other reasons (x2, р<0.001). Our study results indicate that following a RTA, the most common combined trauma is CrT - 31 patients, followed by muscular skeletal system trauma - 11, equal number of eye injuries and polytrauma – 4 patients, spinal cord trauma - 1, and more than one concomitant injury - 1. When analyzing the mutual relation between aetiology and combined trauma, the most common reasons are included (RTA and thrash) as well as combined traumas (neurosurgical, MSS trauma and eye trauma). Conclusion: Data analysis in our study indicates that trauma mechanism is the most important factor that imposes the need of CT examination, especially in intoxicated and disorientated patients, as well as in unconscious patients
Treatment of gingival recession with hypersensitivity using free soft-tissue graft procedures
No full textIntroduction: The main goal of root coverage procedure is complete coverage of the recession defect with good esthetic results related to the adjacent soft tissues and minimal probing depth after the healing process. Aim: The aim of this study was to compare the efficiency of surgical and nonsurgical treatment options in patients with gingival recession and dentin hypersensitivity. Materials and methods: Sixty patients with gingival recession Miller Class I and II with hypersensitivity and esthetic concerns were included. Of these, 30 patients were treated with free soft-tissue graft procedures and 30 people as controls were treated with anti-hypersensitivity gel. The surgically treated patients were allocated into two groups: 20 of them with coronally advanced flap with subepithelial connective tissue graft and 10 with free gingival graft. Results: We achieved full coverage on the exposed root surfaces in 19 patients treated with coronally advanced flap and de-epithelized graft and partial root coverage in one of them. Patients treated with free gingival graft procedure achieved full root coverage in 7 of them and partial in 3 of them (gingival recession = 1 mm after surgery). The surgical treatment allowed resolution of the esthetic issues of patients and elimination or reduction of the dentin hypersensitivity. In the control group, there was partial elimination of root sensitivity. Conclusions: In the surgically treated group with both techniques, we achieved resolution of dentin hypersensitivity and coverage of the root surface with healthy keratinized tissues. These techniques can be considered as treatment options for dentin hypersensitivity depending on the indications
MYOSITIS OSSIFICANS TRAUMATICA OF THE MASSETER MUSCLE- review of the literature and case report.
Get PDFIntroduction: Myositis ossificans traumatica (MOT) is known mostly in the orthopedic literature as non-neoplastic, heterotopic bone formation within muscle or fascia, presumably due to acute trauma or repeated injury. Myositis ossificans traumatica of the masseter muscle is uncommon disease producing limitation of opening of the jaws. Purpose: To present a case of MOT of the masseter muscle in patient with history of facial trauma. Material and methods: The medical history of a 53 years patient with complaint of decreasing ability to open his mouth over the past 10 years after a blow to face. CT revealed enlarged calcification in the left masseter muscle.Conclusion: Treatment of MOT of the masseter muscle is surgical- total extirpation of the ossified muscle but also surgical techniques including osteotomy that involve the muscle attachment region should be considered and after that appropriate physical therapy
A RETROSPECTIVE ANALYSIS OF FACIAL FRACTURE ETIOLOGIES.
Get PDFPurpose: Assessment of mechanism of injury and type and location of the facial injury. Material and Methods: The medical records of 276 patients with 216 facial fractures were retrospectively analyzed. Fracture patterns were classified based on the presence or absence of fractures of the orbit, zygoma, maxilla, mandible and nose. Results: The most common etiology of trauma was assault (42.6%) followed by car accident (23.1%), fall (16.2%), sports (5%), occupational (2%), and gunshot wound (0.9%) (fig. 1). The most common fracture type was mandible fractures (31.1%), followed by nasal bone fracture (29.3%) (fig. 2). Car accident was found to be a significant predictor of panfacial fractures or associated injury, as was GSW. Sports injuries were a significant predictor of isolated upper midface fractures, and assault was a significant predictor for isolated mandible and nasal bones fractures. Car accident and GSW each were found to lead to significantly higher severity of injury than assault, fall, and sports. Conclusion: The results confirm intuitive aspects of the etiology of facial fractures that have been anecdotally supported in the past
MANAGEMENT OF MANDIBULAR THIRD MOLAR SURGERY TO PRESERVE PERIODONTAL HEALTH OF SECOND MOLAR
Get PDFBackground: Extraction of impacted third molar violates surrounding soft and bony tissues. Various surgical approaches and surgical technics have an important impact on the periodontal health of the adjacent second molar.
Purpose: The aim of this review is to analyse the causes that can affect postoperative periodontal outcomes for the mandibular second molars (LM2) adjacent to the impacted/ semi impacted mandibular third molars (LM3).
Material and Methods: Electronic searches were conducted through the MEDLINE (PubMed), Scopus, etc. databases to screen all relevant articles published from inception to April 2017.
Results: Different flap techniques had no significant impact on the probing depth reduction or on the clinical attachment level of LM2. Szmyd and paramarginal flap designs may be the most effective in reducing the probing depth after third molar surgery, and the envelope flap may be the least effective. Use of bone substitutes and guided tissue regeneration therapy has been proposed, to eliminate or prevent these periodontal defects, but there is still no consensus on their predictability or clinical benefit. Higher costs and the risk of postoperative inflammatory complications should also be taken into proper account, as with any surgical procedure. “Orthodontic extraction” is indicated for that impacted M3 that present a high risk of postoperative periodontal defects at the distal aspect of adjacent M2.
Conclusion: Risk factors associated with bone loss following lower third molar extraction includes age, the direction of the eruption, preoperative bone defects, and resorbtion of the LM2 root surface. Prevention of such periodontal defects continues to challenge clinicians
Prognostic value of matrix metalloproteinases in oral squamous cell carcinoma
Get PDFThe aim of this study was to investigate whether there is a correlation between the expressions of four matrix metalloproteinases (MMPs): MMP-2, MMP-7, MMP-9 and MMP-13, and the TNM (tumour-node-metastasis) stages of oral squamous cell carcinoma (OSCC); and to explore the implication of these MMPs in OSCC dissemination. Samples from 61 patients diagnosed with oropharyngeal tumour were studied by immunohistochemistry against MMP-2, MMP-7, MMP-9 and MMP-13. The assessment of immunoreactivity was semi-quantitative. The results showed that MMP-2 and MMP-9 had similar expression patterns in the tumour cells with no changes in the immunoreactivity during tumour progression. MMP-9 always had the highest expression, whereas that of MMP-2 was moderate. MMP-7 showed a significant decrease in expression levels during tumour evolution. MMP-13 had constant expression levels within stage T2 and T3, but showed a remarkable decline in immunoreactivity in stage T4. No significant differences in the MMPs immunoreactivity between tumour cells and stroma were observed. Although strong evidence for the application of MMPs as reliable predictive markers for node metastasis was not acquired, we believe that combining patients' MMPs expression intensity and clinical features may improve the diagnosis and prognosis. Strong evidence for the application of MMPs as reliable predictive markers for node metastasis was not acquired. Application of MMPs as prognostic indicators for the malignancy potential of OSCC might be considered in every case of tumour examination. We believe that combining patients' MMPs expression intensity and clinical features may improve the process of making diagnosis and prognosis
PREOPERATIVE CBCT ASSESSMENT OF DONOR SITE- SYMPHYSIS AND RAMUS BUCCAL SHELF FOR ALVEOLAR RIDGE AUGMENTATION
No full textIntroduction: Mandibular block autografts have been used extensively for alveolar ridge augmentation with great success and include the symphysis and ramus buccal shelf as donor sites.
Objectives: Purpose of our study is to analyze preoperative CBCT assessment of donor sites- (symphysis and ramus buccal shelf) for ranges of autogenous block graft.
Material and Methods: In our study, we have analyzed with CBCT these donor sites in 15 patients and were determined the osteotomy lines of the graft depends on the limiting anatomical critical structures. Also according to CBCT with 3D printing could be done stereolithographic models and 3D cutting models for optimizing surgery.
Results: Symphysis can provide a range of dense cortical cancellous bone ranging from 17,7/7,65/6,68 mm, in contrast to a typical ramus buccal shelf block graft that is 9/9,2/8,1 mm. In symphisis area, there were observed a significant difference in width of the block at the level of the second incisor and canine. Also, the thickness of the graft differs in cranial and in caudal position. About bone graft from the buccal shell of mandibular ramus, thickness decreases from cranial to caudal direction as the measurement is at about 8mm. The width of the block is bigger in a cranial direction and smaller at the half level of its height. Conclusion: Preoperative assessment of donor site is essential for the success of the procedure. These grafts can be used for predictable horizontal augmentation of 5 to 7 mm and vertical augmentation of up to and including 6 mm
A PARALLEL STUDY OF RHINOGENIC AND ODONTOGENIC MAXILLARY SINUS DISEASE.
No full textBecause of its close anatomic relations with nosal and oral cavitis, the maxillary sinus is the place of most frequent inflammatory diseases of all paranasal sinuses. Introduction: The aim of this study was to establish differences in etiology and treatment of rhinogenic and odontogenic maxillary sinusitis. Materials and methods: In this study, we analyzed the etiology, clinical characteristics of the disease, x-ray findings, clinical course and treatment of 188 cases, which were diagnosed and treated as odontogenic or rhinogenic maxillary sinusitis in the Departments of Maxillofacial surgery and Otorhinolaringology – “St. Anna” Hospital, Sofia from 2005 to 2010. Patients were divided according to age and sex. Data was systematized and analyzed. Results: This study clearly showed that rhinogenic diseases of maxillary sinus are three times more frequent than odontogenic diseases. Also the etiology of odontogenic sinusitis most often is due to mistakes in the treatment of the upper teeth (alien corpuses, perforation after extraction), which is completely different from rhinogenic sinusitis. In the surgical treatment of rhinogenic maxillary sinusitis usually endonasal polypectomy was followed by operation according to Caldwell-Luc or functional sinus endoscopy. During the surgical treatment of odontogenic sinusitis the most frequent intervention was surgical plastic of oral-antral communication with mucogingival vestibular flap followed by operation according to Caldwell-Luck what is different from the treatment of rhinogenic sinusitis.Conclusion: Maxillary sinus often suffers from inflammatory diseases and should always be examined carefully by means of anamnesis, clinic exam and x-rays to identify its origin. Upper teeth should be treated carefully in everyday’s dental practice to avoid being cause of sinusitis
