Histological Analysis of the Mandible in Patients with Type 2 Diabetes Mellitus for Implant-Prosthetic Rehabilitation. A Pilot Case-Control Study

Diabetes mellitus has a major impact on the metabolic activity of a significant number of tissues. Its impact on the jaw bones cannot be neglected, especially if rehabilitation using prosthetic restorations supported on dental implants is intended. The aim of this study is to comparatively analyze vascularization, the degree of mineralization and the cellular component of the mandible in type 2 diabetes mellitus patients undergoing dental implant placement. For this study, eight patients assigned to two groups were selected. The study group included four patients with type 2 diabetes mellitus in whom dental implants were placed, and the control group comprised 4 patients without systemic pathology. The bone debris obtained after dental implant placement were collected and analyzed using hematoxylin-eosin and PAS–Alcian Blue staining. The results obtained indicated the presence of diabetic angiopathy in the mandible, a higher cellular density in the diabetic bone, and a lower degree of mineralization in the bone taken from patients of the study group. In conclusion, histological changes can be detected in the mandible of patients with type 2 diabetes mellitus compared to those without systemic disease, but their effect on bone healing cannot be quantified

Obilježja fraktura kostiju lica i vezane ozljede mekog tkiva: retrospektivna studija na 1007 pacijenata

Background: Knowing the severity of a pathology in a population helps to both establish a rapid diagnosis and to prepare medical staff to provide adequate and complete treatment. The aim of this study was to determine the patterns of maxillofacial fractures and their associated soft tissue injuries in order to identify the specific types of maxillofacial fractures with the highest incidence of associated soft tissue injuries. Methods: A 10-year retrospective evaluation of maxillofacial trauma was performed on 1007 patients. All 1007 patients were clinically and paraclinically confirmed to have facial skeletal injuries. Results: The highest incidence of maxillofacial fractures was found in the mandible (62.16%), the mandibular angle being the most frequently involved (28.84%). Most of the fractures were complete (97.82%), displaced (87.98%) and closed (86.30%). Hematoma was the most common associated soft tissue injury (44.79%). In mandibular trauma, the incidence of hematoma and laceration was the highest in angle and simultaneous multiple fracture lines (p=0.002). In the midface, hematoma was more frequently associated with non-comminuted zygomatic bone fractures (p=0.003), while laceration was associated with multiple underlying fracture lines (p=0.002). Conclusions: Patients presenting with hematomas will most frequently have an underlying single closed fracture line, while patients with lacerations will most frequently present underlying multiple and displaced fractures.Pozadina: Poznavanje težine dane patologije u populaciji pomaže u bržem postavljanju dijagnoze i pripremanju medicinskog osoblja na pružanje adekvatnog i kompletnog liječenja. Cilj ove studije bio je odrediti karakteristike maksilofacijalnih fraktura i vezanih ozljeda mekog tkiva kako bi se odredile vrste maksilofacijalnih fraktura s najvišom pojavnosti vezanih ozljeda mekog tkiva. Metode: Provedena je retrospektivna analiza maksilofacijalnih trauma na 1007 pacijenata u razdoblju od 10 godina. Kod svih 1007 pacijenata je klinički i paraklinički potvrđeno prisustvo ozljeda facijalnog skeleta. Rezultati: Najviša pojavnost maksilofacijalnih fraktura nađena je u mandibuli (62,16%), pri čemu je kut mandibule bio najčešće zahvaćen (28,84%). Većina je fraktura bila potpuna (97,82%), dislocirana (87,98%) i zatvorena (86,30%). Hematomi su bila najčešća vezana ozljeda mekog tkiva (44,79%). U mandibularnim traumama je pojavnost hematoma i laceracija bila najviša u kutnim prijelomima i kod simultanih višestrukih linija prijeloma (p=0,002). U srednjem licu, hematomi su bili češći u ne-kominutivnim zigomatičnim frakturama (p=0,003), dok su laceracije bile povezane s višestrukim frakturnim linijama (p=0,002). Zaključci: Pacijenti s hematomima će najčešće imati jednu zatvorenu liniju frakture, dok će pacijenti s laceracijama najčešće imati višestruke i dislocirane frakture

A Sebaceous Cyst Located in the Maxillary Sinus

Maxillary sinus cysts are quite common, being most frequently detected on the occasion of radiological investigations. On an OPG (orthopantomogram), these cysts appear as round masses, similar to a dome, in contact with one of the walls or the floor of the maxillary sinus. In this study, authors present the case of a patient with a maxillary cyst involving the maxillary sinus. Removal of the maxillary cyst was performed with the extraction of the causative tooth. Complete removal of the sebaceous cyst is mandatory in order to avoid recurrences and potential infectious complications. &nbsp

Implant-prosthetic Rehabilitation after Removal of a Maxillary Cyst with Maxillary Sinus Involvement, without using Bone Augmentation Materials

Inflammatory odontogenic cysts are among the most frequent lesions of the maxillary bones. Through their evolution, these pathological formations may affect adjacent anatomical structures such as the nasal fossae or the maxillary sinus. Patient rehabilitation is a time-consuming process that can be a challenge for medical practitioners. In this study, authors present the case of a patient with a maxillary cyst involving the maxillary sinus, rehabilitated by implant-prosthetic treatment without using bone augmentation materials. Removal of the maxillary cyst was performed with the preservation of the maxillary sinus membrane, with apicectomy of the teeth adjacent to the cyst and extraction of the causative tooth. The post-cystectomy bone defect was protected with a pericardium membrane, and after 6 months postoperatively, a dental implant was placed in the edentulous area. Three years after cystectomy, the presence of mature bone in the defect area and the stability of the implant-prosthetic restoration could be observed. The rehabilitation method proved to be effective in obtaining a predictable and stable therapeutic outcome

Evaluation of the Epidemiology and Traumatic Etiology of Mandibular Fractures a 10-year Retrospective Statistical Study

The mandible or lower jaw is the most frequently fractured bone because of the mandible's prominence and relative lack of support. Literature data differ considerably with respect to the epidemiology and etiopathogeny of mandibular fractures. The aim of this study is to evidence the incidence of mandibular fractures depending on sex, age and etiology in a significant group of patients. Materials and methods: For the current study, a 10-year retrospective evaluation of cases diagnosed with mandibular fractures in the period 1 January 2002 – 31 December 2011 at the Clinic of Oral and Maxillofacial Surgery I Cluj-Napoca was performed. Data were collected from clinical observation charts, processed and compared to literature results. Results: The study included 709 patients. The highest incidence of mandibular fractures was found in the 20-29 year age group (37.24%). Most of the patients were male (92.81%) and came from an urban environment (54.58%).The most frequent cause of mandibular fractures was interpersonal violence (67.28%), followed by falls from the same level. Conclusions: Taking measures to reduce interpersonal violence would significantly decrease the incidence of mandibular fractures in our geographic area

The Pattern and Characteristics of Mandibular Fractures – A 3-Year Prospective Clinical Study

In the absence of early diagnosis and correct treatment, mandibular fractures may lead to major functional and aesthetic complications affecting the subsequent integration of the traumatized patient in society. Mandibular fractures are most frequently masked by associated injuries of adjacent soft tissues, which can mislead less experienced clinicians.Materials and methods: The aim of this study was to identify the incidence and type of injuries associated with mandibular fractures and to correlate them with the clinical characteristics of fracture lines. For this, patients diagnosed with mandibular fractures in the Clinic of Oral and Maxillofacial Surgery I in Cluj-Napoca in the period 1 January 2014 – 31 December 2016 were prospectively analyzed. Results: The study included 60 patients with 101 mandibular fracture foci. The most frequent location was subcondylar (24.75%). All fracture lines were complete (100%), the majority of which were displaced (70.30%) and intraorally open (50.70%). Displaced fractures were most frequently intraorally or extraorally open, while non-displaced fractures were closed (p=0.017). Bone fragment displacement was most frequently found in the case of lateral mandibular fractures (p=0.576). The most frequent associated injuries were laceration and soft tissue contusion, in equal proportions. Displaced fractures were most frequently accompanied by associated soft tissue injuries (p=0.035). Conclusions: Bone fragment displacement favors the opening of the fracture focus. The development and severity of concomitant soft tissue injuries are directly proportional to the degree of bone fragment displacement in the fracture focus

The influence of the prosthetic abutments colour in the aesthetics of the frontal teeth. A case report.

Introduction: Prosthetic restorations in the frontal teeth, in addition to functional and prophylactic requirements, must respond in a special way to aesthetic needs. This desideratum is a challenge, especially when the support for the future prosthetic parts is not characterized by a uniformity of color. This paper wants to highlight the importance of the color of prosthetic abutments, in the case of single restorations, for the frontal teeth. Case presentation: This manuscript presents the clinical case of a patient, with different prosthetic abutments, namely: a hybrid implant abutment - titanium and zirconium (lateral incisor - 1.2), nonvital natural teeth (central incisors – 1.1 and 2.1) and a vital natural tooth (lateral incisor – 2.2). Three single ceramic crowns on zirconium were confectioned, one with implant support and the other two on dental support, and a veneer for the vital lateral incisor. Conclusions: The prosthodontist must develop the best prosthetic solution for each individual case, together with the technician, so that the aesthetic results are not negatively influenced by the different colors of the existing prosthetic abutments

The Etiology and Epidemiology of Pediatric Facial Fractures in North-Western Romania: A 10-Year Retrospective Study

Pediatric facial fractures are not as common as facial fractures occurring in the adult population. Their therapeutic approach is different because they affect patients with active growth, and have an etiology and epidemiology that vary depending on different cultural, religious and demographic factors. This research aimed to identify the main factors involved in the etiology of pediatric facial fractures, as well as the epidemiology of pediatric facial fractures in a sample of children and adolescents from North-Western Romania. This 10-year retrospective study was performed in a tertiary center for oral and maxillofacial surgery in North-Western Romania. Medical files of patients that were admitted between 1 January 2002 and 31 December 2022 were analyzed. Pediatric patients aged 0 to 18 years were included in this study. The final sample consisted of 142 children and adolescents diagnosed with facial fractures, with this number representing 14.1% of all patients affected by facial fractures. Most frequently, fractures were identified in the 13–18 age group (78.9%, n = 112), which were more often associated with fractures caused by interpersonal violence than caused by road traffic accidents, falls or animal attacks. Boys were more affected (88%, n = 125), and were more frequently associated with fractures caused by interpersonal violence. The most frequently identified etiological factors included interpersonal violence (50%, n = 71), falls (18.3%, n = 26) and road traffic accidents (11.3%, n = 16). In terms of location, the mandible was the most affected facial bone structure (66.2%, n = 94), and patients with mandibular fractures were more frequently associated with fractures caused by interpersonal violence. The incidence of pediatric facial fractures should be lowered because they may interfere with the proper development of the facial skeleton. Establishing measures aimed at preventing interpersonal violence, as well as other causes involved in the etiology of facial fractures is imperative