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

Supuraţiile lojilor superficiale şi profunde de masiv facial studiu statistic retrospectiv pe o perioadă de 5 ani (2000 - 2004)

Catedra de Chirurgie Orală şi Maxilo-Faxială I Universitatea de Medicină şi Farmacie "Iuliu Haţieganu" , Cluj-Napoca, RomâniaIn the study named: “The suppurations of the superficial and deep regions of the head statistical study on a 5 years period(2000-2004)”, we have made an analysis concerning the way of appearance and evolution of the suppurations ,establishing the right medical attitude necessary to treat them. . In the retrospective study, 270 patients treated in the Maxillo - Facial I Clinique in Cluj-Napoca were included. Most frequently the provenance of the heads superficial and deep suppurations are dental and parodonthal affections. The surgical treatament it’s proven to be the most efficient. Prin lucrarea intitulată „Supuraţiile lojilor superficiale şi profunde de masiv facial studiu statistic retrospectiv pe o perioadă de 5 ani (2000 - 2004)” am făcut o analiză cu privire la modul de apariţie şi evoluţie al supuraţiilor şi stabilirea unei conduite medicale adecvate pentru tratamentul acestora. Am luat în calcul un număr de 270 de pacienţi internaţi şi trataţi în Clinica de Chirurgie Orală şi Maxilo-Facială I din Cluj Napoca. Punctul cel mai frecvent de plecare al supuraţiilor este reprezentat de afecţiunile dento – pardontale. Tratamentul chirurgical s-a dovedit a fi cea mai eficientă modalitate de tratament a acestora

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

Periodontal Disease in Patient with Type 2 Diabetes Mellitus

Type 2 diabetes is one of the most important growing health problems worldwide causing several complications in different parts of the organism, including the oral cavity. Aim: The purpose of this study is to assess the periodontal disease of type 2 diabetes patients which came randomly and voluntarily for evaluation of their oral health. Materials and methods: 112 patients with marginal inflammatory pathology were selected and evaluated. The followed parameters were: age, gender, environment, status of diabetes, oral non-odontogenic lesions, local aspects of marginal tissue inflammation. Data were centralized in electronic format using Microsoft Excel software. Results: The average age of patients was 57.3, 56.25% of all patients had uncompensated diabetes with HbA1c levels over 7.5%. Most of them were males (52%) and lived in an urban community (83.93%). 52.27% had severe forms of periodontitis, requiring radical treatment, while the most common oral non-odontogenic pathology was candidosis (40.98%). Conclusion: By modifying local metabolism, diabetes increases the risk of inflammatory lesions, especially periodontitis

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

Treatment Options of Periodontal Disease and its Complications in Patient with Type 2 Diabetes Mellitus

Diabetes mellitus type 2 is the most commonly diagnosed metabolic disorder, and its prevalence is expected to increase so much, that by 2030 approximately 10% of the population will have diabetes (especially type 2). The aim of this study: is to assess the treatment methods used for oral odontogenic infections in patients with type 2 diabetes, as well as postoperative complications depending on the applied treatment method. Materials and methods: a group of 112 patients with marginal inflammatory pathology was selected and evaluated. The followed parameters were: age, gender, inflammatory lesions, treatment type, one week, three and six months postoperative evolution. Data were centralized in electronic format using Microsoft Excel software. Results: The average age of patients was 57.3, and gender distribution was almost equal (51.78% males vs. 48.21% females). The majority of patients (47.32%) underwent a conservative treatment, while almost 68% had a very good postoperative healing at the 7 day postoperative recall. There was also a significant improvement of the values of glycated hemoglobin at both the three and the six months recall, with almost 2/3 of the patients presenting a normal gingival status. Conclusion : Periodontal disease has a negatively impact on diabetes control, and can worsen its complications, but periodical periodontal treatment improves glycemic status, the latter contributing further to better oral status and lower the incidence of complications