Contemporary Clinical Dentistry最新文献

Introduction: Knowledge of the anatomical structures related to the anterior maxilla is essential to anticipate complications in oral and maxillofacial surgery procedures. The aim of this study was to determine the anatomical characteristics of the nasopalatine canal (NPC) in adults using cone-beam computed tomography (CBCT).

Materials and methods: This retrospective study included a sample of 195 CBCTs of Peruvian adults (56.4% women) aged 19-60 years (mean age: 43.73 ± 11.16). Sagittal NPC slices were selected for measurement by a calibrated evaluator (intraclass correlation coefficient ≥0.817) based on length (mm), inclination in degrees (°) and type (vertical <10° and inclined ≥10°), inferior diameter and shape (cylindrical, funnel, hourglass, and spindle). ANOVA, Kruskal-Wallis, Student's t-test, Mann-Whitney U, Spearman's correlation, and Chi-square tests were used at a significance level of P < 0.05.

Results: The NPC was characterized by a length of 10.91 ± 2.38 mm, a diameter of 3.46 ± 0.93 mm, an inclination angle of 19.17° ± 8.26° with a predominant inclination ≥10° (85.6%), and a cylindrical shape (55.4%). A larger diameter was associated with men, whereas a greater inclination was associated with women (P = 0.008 and P = 0.002, respectively). No significant differences were found when NPC parameters were compared according to age or with each other (P > 0.05).

Conclusions: The study describes the anatomical characteristics of the NPC in a sample of Peruvian adults with anterosuperior dentition and their dimorphism by sex and age in relation to diameter and inclination.

Introduction: Electrical impedance spectroscopy (EIS) has recently developed as a novel diagnostic device for screening and evaluating cervical dysplasia, prostate cancer, breast cancer, and basal cell carcinoma. The current study aimed to validate and evaluate bioimpedance as a diagnostic tool for tobacco-induced oral lesions.

Methodology: The study comprised 50 oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) tissue specimens for in vitro study and 320 subjects for in vivo study. Bioimpedance device prepared and calibrated. EIS measurements were done for the habit and control groups and were compared.

Results: The impedance value in the control group was significantly higher compared to the OPMD and OSCC groups. Diagnosis based on bioimpedance spectroscopy measurements has a sensitivity of 95.9% and a specificity of 86.7%.

Conclusion: Bioimpedance device can help in decision-making for differentiating OPMD and OSCC cases and their management, especially in primary healthcare settings.

Background: Angiogenesis is recognized as a predominant factor for tumor growth and metastasis. Use of biomarkers to target tumor holds a promising treatment strategy and to assess prognosis.

Objectives: To assess angiogenic activity by analyzing CD34 microvascular density (MVD) count in different histologic grades of oral squamous cell carcinoma (OSCC).

Materials and methods: Sixty archival samples are categorized in four groups. Immunohistochemical method with anti-CD34 was used for analyzing MVD.

Results: The mean count of MVD is higher in OSCC than in normal mucosa and also significant among different histologic grades. Highly significant correlation is observed among different groups of OSCC samples.

Conclusion: CD34 shows a promising result in OSCC.

This case report emphasizes the diagnostic role of cone-beam computed tomography (CBCT) in identifying a rare pediatric case of ameloblastic fibroma (AF), comprising approximately 2% of odontogenic tumors. The 10-year-old patient initially presented with painless left mandibular posterior gingival swelling, resembling radicular or dentigerous cysts in clinical and conventional radiographic assessments. However, CBCT revealed a distinct periapical radiolucency linked to deciduous molar roots and an unerupted premolar, exposing mandibular lingual plate thinning and buccal plate disruption. The lesion extended beyond the unerupted premolar's enamel-cementum junction, suggesting an odontogenic tumor. Subsequent biopsy and histopathological examination confirmed AF. CBCT played a pivotal role in evaluating the lesion's interaction with surrounding bone structures, guiding treatment decisions, and contributing to an accurate diagnosis. Successful lesion excision, deciduous tooth extraction, and a disease-free year-long follow-up underscore the significance of enhancing diagnostic precision and managing uncommon odontogenic pathologies like AF.

Taurodontism is an anomaly affecting the morphology and anatomy of the tooth, leading to apical displacement of the furcation in multirooted teeth. This leads to an enlarged body of the tooth and reduced size of the root. Taurodontism is a rare dental finding. The endodontic management of such teeth is challenging because of their altered morphology, presence of extra canals, and enlarged pulp chamber. A cone-beam computed tomography is recommended to analyze the root canal morphology. Endocrowns can be used for prosthetic rehabilitation as they utilize retention from the elongated pulp chamber. This case presents a rare occurrence of bilateral maxillary and mandibular teeth with taurodontism. Five out of eight teeth were hypertaurodont, which is a very rare phenomenon. Two teeth were root canal treated followed by rehabilitation with endocrown.

This article highlights a unique case of Plummer-Vinson syndrome (PVS), also known as Paterson Brown-Kelly Syndrome. PVS is associated with a triad of symptoms, including microcytic hypochromic anemia, esophageal strictures, and dysphagia. It is commonly found in middle-aged women, particularly in the fourth and fifth decades of life, and is rarely reported in males. We present the case of a 49-year-old female patient who exhibited the classic symptoms of PVS. Given that PVS is a precancerous condition with a high potential for malignancy, early diagnosis is crucial for a better prognosis. Surveillance endoscopy and barium swallow test are recommended for monitoring. Iron repletion often improves dysphagia, and in some cases, esophageal dilatation is used to provide symptomatic relief. The mutual interaction of systemic and oral health is often underestimated, especially by patients in developing countries. Therefore, this report emphasizes the importance of thorough medical history taking and its relevance to dental health and treatment.

Actinomycotic osteomyelitis in the maxilla is a rare complication, particularly in diabetic patients following dengue infection. Actinomycosis, caused by Actinomyces israelii, typically arises in immunocompromised hosts, with dengue-induced immune dysregulation and diabetes contributing to its pathogenesis. This case report describes a 42-year-old diabetic male presenting with oroantral communication, loose posterior maxillary teeth, and persistent pus discharge 20 days postdengue. Imaging revealed bone erosion, and histopathology confirmed actinomycosis. The patient underwent partial maxillectomy with antibiotic therapy, leading to full recovery within 6 months. This case emphasizes the importance of early diagnosis and tailored treatment in managing rare bacterial infections in vulnerable populations.

Children with Down syndrome (DS) have oral manifestations, such as hypotonia of the perioral muscles, inadequate lip seal, and tongue posture changes, which affect the development of the stomatognathic system. The palatal memory plate (PMP) is an early proprioceptive stimulation therapy that aims to improve tongue posture, promote proper lip sealing, and contribute to oral balance. This study reports the treatment of PMP in a 2-month-old baby with DS. Early intervention with PMP exhibited satisfactory results, improving hypotonia, tongue posture, and lip seal even after 2 years of treatment. This improvement was enhanced by a multidisciplinary speech therapy approach to orofacial stimulation with the active participation of caregivers. Thus, the training of qualified professionals with knowledge of the specific characteristics of patients with DS is essential for a comprehensive and systematic approach to promoting their health.

The presence of both a pathologic external cervical resorption (ECR) and an iatrogenic over-enlarged root canal with a widened apex can significantly compromise the structural integrity of a tooth. Furthermore, regular restorative-endodontic management of the involved tooth poses many procedural challenges and difficulties. However, a multi-modal approach involving nonsurgical and surgical procedures with the application of advances in endodontics can help to manage and salvage such a tooth. This article aims to report on a case of multi-modal management with the application of cone-beam computed tomography, micro-endodontics, bioactive and biomimetic materials, and monobloc effect to manage and structurally rehabilitate and reinforce a tooth affected by both ECR and over enlarged canal with a widened apex. This multi-modal approach was applied with nonsurgical and surgical treatments to restoratively and endodontically manage the affected tooth. Clinical and radiographic follow-up of the tooth was uneventful and showed satisfactory and favorable outcomes.

Aim: The aim of this study was to compare the canal transportation and centering ability of four rotary endodontic file systems using cone-beam computed tomography (CBCT).

Methodology: This was an in vitro study where 40 extracted single-rooted single canal human premolar teeth were used. CBCT scans of all the teeth were taken before instrumentation and were randomly divided into four groups, with 10 samples in each; Group I-Protaper Next (PN), Group II-Protaper Gold (PG), Group III-Neo Endo Flex (NE), and Group IV-Gen Endo (GE). After cleaning and shaping, the canals with respective file systems postinstrumentation scans were performed, and the two scans were compared to determine canal transportation and centering ability at 3, 6, and 9 mm, from the apex.

Results: Statistical analysis was performed using the Kruskal-Wallis test where the results showed no statistically significant difference among the tested groups in canal transportation and centering ability at the coronal, middle, and cervical third (P > 0.05).

Conclusion: Under the conditions of the in vitro study PN, PG, NE, and GE file systems exhibited comparable behavior in terms of canal transportation and centering ability, observational data suggested that Group 1 (PN) and Group 4 (GE) demonstrated superior centering ability and reduced canal transportation.