The Radicular Cyst in a Child: Case Report

The most commonly occurring odontogenic cysts of the jaws are radicular cysts. Causes of jaw cysts are different, numerous and depend on the type of cyst. The basic precondition for the occurrence of a cystic lesion is the previous presence of epithelial tissue at the site of future development of the cystic formation. Radicular cysts are one of the most common odontogenic cysts and arise from epithelial so-called Malassez - these residues in the periodontal tissue, as a consequence of inflammation of the pulp. They can occur at any age, and are equally prevalent in both sexes. The aim of this paper is to present the clinical symptoms and treatment of a radicular cyst in a 12-year-old child. The treatment of radicular cysts in most cases is surgical. The possibilities for such treatment and the choice of surgical method depend on the size of the cyst, its location, and the pathological formation.   The present article reported a case of a 12-year-old male with the chief complaint of  pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border between   mandibular central incisive.  The case was managed by complete enucleation under local  anesthesia without extraction of any teeth. We chose enucleation (cystectomy) as a surgical procedure as the method of choice, because postoperative complications are the rarest, and the best healing is also provided. Аfter one month of surgery treatment, complete wound healing was recorded at the clinical control at the Department for oral surgery

Forensic dentistry: The key to the truth

Introduction Human organism can be identified through testing and analysis of DNA sequences. The most common source of DNA for analysis is blood, soft tissues, hair, bones and teeth. Teeth represent a tissue of choice for analysis in those cases where there is high degree of degradation of other tissues. Hard tooth structure provides protection and preservation of DNA molecules. The aim was to investigate which group of teeth and dental tissue (pulp or hard dental tissues) has the greatest amount of DNA. Material and method Forty-five extracted teeth were analyzed. In the first examination 30 teeth were divided into the three groups (10 teeth each): first group were incisors, second premolars and third molars. The teeth were measured before and after the procedure of DNA isolation using special scale with precision of 0.02-0.000005ng. The procedure included grinding teeth in a blender and DNA isolation using commercial kits (isolation with magnetic particles). For the second test 15 teeth divided into two groups were used. In the first group isolation of DNA molecules was performed from pulp tissue, and in the second group from hard dental tissues. The quantification of samples was done with Quantifiler® Duo DNA Quantification Kit by Applied Biosystems. Results The greatest amount of DNA was obtained from molars (0.230011ng/μl/g) while the smallest amount of DNA was obtained from incisors and it was 0.06437ng/μl/g. In addition, the amount of DNA isolated from pulp tissue was significantly greater than that from hard dental tissues (pulp of molars obtained quantitatively the largest amount of DNA). Conclusion Main tissue to be used for the isolation of DNA from a tooth is pulp, but in those cases when it is not present (endodontic treatment), hard dental tissues provide sufficient quantity of DNA for identification procedures. The group of teeth that provides the greatest amount of DNA is molars

Humoral immune response before and after surgical therapy in patients with odontogenic inflammatory cysts

Odontogenic inflammatory cysts are pathological lesions that are often represented in clinical practice and they presented potential focal points with an impact on other organs and systems in the body. The aim of this research is to compare the patients’ humoral immune response by verifying the level of immunoglobulins IgA, IgG and IgM in the serum before and one month after surgical therapy in patients with odontogenic inflammatory cysts. 44 male and female patients diagnosed with odontogenic inflammatory cysts were included in the study and divided into three groups (Group 1-patients with radicular cysts-23, Group 2-patients with residual cysts-10, and, Group 3-patients with periodontal cysts-11). The values ​​of IgA, IgM and IgG in serum were examined before and one month after the surgical therapy in the device Cobas 6000 model c501 (Roche, Germany). In all three examined parameters of humoral immunity (IgA, IgG and IgM in serum), a significant difference was observed in the patients in addition to a decrease in their values ​​1 month after the surgical intervention compared to before the intervention. The level of IgA before and 1 month after intervention between the three groups of patients did not indicate a significant difference for a consequent p=0.2716 vs. p=0.2898. A significant difference between the three groups of patients, before and 1 month after the surgery, was also not found in terms of the IgG level for a consequent p=0.2692 vs. p=0.3614. The comparison of the three groups of patients regarding the level of IgM in serum indicated a significantly higher value of this parameter in patients with periodontal cyst compared to radicular and residual cyst before the intervention (p=0.0067) and 1 month after the intervention (p=0.0263). The levels of immunoglobulins in patients with odontogenic inflammatory cysts before surgical treatment were significantly elevated, depending on the type of cyst. Their surgical removal generates a decrease in their level. These findings suggest that IgA, IgG and IgM may play an important role in the occurrence, development and persistence of cystic lesions. Keywords: Odontogenic inflammatory cysts, immunological analysis, humoral immune response, immunoglobulins IgA IgG and IgM

Free Gingival Graft versus Mucograft: Histological Evaluation

INTRODUCTION: The correction of the gingival recession is of esthetical and functional significance, but the tissue regeneration can only be confirmed by a histological examination.AIM: This study aims to make a comparison between the free gingival graft and the autograft.MATERIAL AND METHODS: This study included 24 patients with single and multiple gingival recessions. Twelve patients were treated with a free gingival graft and the other twelve with a micrograft. Six months after the surgical procedure, a micro-punch biopsy of the transplantation area was performed. The tissue was histologically evaluated, graded in 4 categories: immature, mature, fragmented and edematous collagen tissue. The elastic fibres were also examined and graded in three categories: with a normal structure, fragmented rare and fragmented multiplied.RESULTS: Regarding the type of collagen tissue that was present, there was a significant difference between the two groups of patients, with a larger number of patients treated with a micrograft showing a presence of mature tissue, compared to the patients treated with a free gingival graft. A larger number of patients in both of the groups displayed elastic fibres with a rare fragmented structure; 33.3% of the patients showed a normal structure; 50% demonstrated a normal structure.CONCLUSION: The patients treated with a free gingival graft showed a larger presence of fragmented collagen tissue and fragmented elastic fibres, whereas a mature tissue was predominantly present in the surgical area where a Geistlich Mucograft was placed

Odontoma as an etiological factor for impaction of teeth

Odontoma is considered to be the most common odontogenic tumor of the oral cavity. Most odontoma are discovered during routine radiographic investigations and can cause disturbances in the teeth eruption. Here we report two cases, where the odontoma are the main etiological factor for tooth impaction. The aim of this study is to determine the necessity of the removal of the odontoma as a main etiological factor for tooth impaction in order to induce successful tooth eruption. In the first case, a radiography examination using orthopantomogram showed radio-opaque lesions mesial to the impacted right mandibular canine. The lesion was surgically removed under local anesthesia. After mucoperiosteal flap was raised, superficial bone was removed followed by the removal of the calcified structures. The flap was approximated and sutured. In the second case, a radiography examination using CBCT revealed presence of radio-opaque lesions next to the unerupted left maxillary canine. Surgery was performed under local anesthesia. After the primary canine was removed, the odontomas were removed in order to establish eruption path for the canine. The results of this study show that using the appropriate surgical protocols that eliminate odontogenic lesions can establish adequate environment for teeth to erupt. Diagnosis of odontoma at an early age and its surgical excision may prevent eruption disturbances. A careful follow-up of the case, implementing preventive and interceptive orthodontics, if necessary, prevents future malocclusion. Keywords: CBCT, Odontoma, Surgery, Tooth impactio

The link between the presence of an odontogenic radicular cyst and the body 's immune response (case report)

Odontogenic radicular cysts are the most common odontogenic inflammatory cysts. Immunopathological reactions play a dominant role in their etiopathogenesis. This study aimed to determine the presence of T and B lymphocytes, cells in the inflammatory infiltrate and, the impact of the cystic lesion on the systemic immune response by verifying the changes in the immune system by applying the immunohistochemical method in a patient with a residual cyst in the lower jaw. and one month after surgery. Case Report: A 60-year-old woman with a residual cyst in her lower jaw was admitted to the Oral Surgery Clinic. Immunoassay of blood was performed to determine the values of immunoglobulins IgA, IgG and Ig M before surgery, cyst enucleation in toto, pathohistological and immunohistochemical analysis of CD3, CD4, CD8, CD20, and CD68 markers. Immunological blood tests were performed one month after surgery. Pathohistological and immunohistochemical analysis confirmed the diagnosis of radicular (residual) cyst in the mandible with the presence of multilayered squamous epithelium beneath which is an inflammatory infiltrate with granulation tissue and deposited cholesterol crystals with predominant lymphadenopathy of predominant lymphadenopathy. %), are dominated by macrophages and histiocytes. Serum immunoglobulin IgA, Ig G, and IgM levels were reduced after surgery. The use of pathohistological and immunohistochemical analyzes proves the presence of cellular and humoral immune responses and their role in the etiopathogenesis and development of cysts, while immunoassays confirm the presence of human immunoglobulin this suggests the importance of early detection and therapeutic approach to radicular cysts. Keywords: residual cyst, pathohistological, immunohistochemical and immunological analysis, human immune response

Human immune response of odontogenic residual cyst (case report)

Introduction: Odontogenic residual cysts are the most common odontogenic inflammatory cysts. Immunopathological reactions play a dominant role in their etiopathogenesis. This study aimed to determine the presence of T and B lymphocyte cells in the inflammatory infiltrate by applying an immunohistochemical method in a patient with a residual cyst in the lower jaw. Case report: A 62-year-old woman with a residual cyst in the lower jaw was admitted to the Oral Surgery Clinic. Enucleation in toto of the cyst was performed and pathophysiological and immunohistochemical analyses were made. The analysis confirmed the diagnosis of residual cyst in the mandible with the presence of multilayered squamous epithelium beneath which is an inflammatory infiltrate with granulation tissue with a predominance of T lymphocytes versus B lymphocytes and rare resident macrophages. Conclusion: The use of pathophysiological and immunohistochemical analyses proves the presence of cellular and humoral immune responses and their role in the etiopathogenesis and development of cysts. Keywords: residual cyst, pathophysiological, immunohistochemical, human immune response

Retention of Approximal Guiding Plane Surfaces in Removable Partial Skeletal Prosthesis

BACKGROUND: The morphology of the retention tooth often does not correspond with the required design; hence there is often an indication for enamel recontouring or other restorative procedures.AIM: The study aimed to determine the impact of changing the path of insertion of the prosthesis by reshaping the anatomical and morphological structures of the natural teeth predetermined for the retention of the prosthesis.MATERIAL AND METHODS: The group of 40 patients with Class II, Subclass 1 according to Kennedy was formed, and 120 approximal surfaces of retention teeth were obtained. Two different types of prostheses were made on the models: one group in the zero point position of the model, and another group in the zero position of the model, with changing of the direction of input at an angle of 2Ëš.RESULTS: The difference between the established and theoretical normal distribution of frequencies was tested with the Kolmogorov-Smirnov and Lilliefors tests (r < 0.10; r < 0.01). The first group showed a retention force of 0.08 N. In the second group the retention force was 0.94 N.CONCLUSION: It could be concluded that the change in the path of insertion of the dental prosthesis with conservative restorations as composite inlays, as well as the accurate extension of the prosthesis onto guiding plane surfaces, will undoubtedly increase the retention force of the prosthesis

The Levels of Serum Immunoglobulin A, G and M in Oral Inflammatory Cysts before and after Surgical Therapy

Background/Aim: Cysts which appear in the orofacial region are represented as common pathological changes which underlying mechanism of development is still not fully clear. In recent years, a dominant role in the pathogenesis of cysts belongs to the immunopathological reactions. It is assumed that the loss of bone in cysts is due to the presence of complementary cascades, prostaglandins synthesis and numerous neutrophil granulocytes. The main objective was to determine the levels of Ig G, A and M in serum and saliva of patients with radicular, residual and periodontal cysts before and after the surgical treatment

Guided implant therapy- tips and tricks

With the introduction of computed tomography (CBCT) into daily dental practice, along with the development of software solutions in dentistry, it revolutionized the planning and protocol of dental implant placement. The development of the surgical guides and their use in the implantation procedure eliminated the possible complications that each implantologist may encounter during his work, such as injury to adjacent teeth, injury to vital anatomical structures, incorrect angulation and incorrect implant position of placed implants. This “guided implant therapy” ensures correct and proper positioning of the implants, shortens the time required for operative intervention, reduces post-operative morbidity, and eliminates the need for flap and bone grafting procedures. This paper will explain the complete procedure of planning and creating of surgical guide, present all the pros and cons of working with the guide and present a few clinical cases from daily practice