Complication of facial cellulitis: muscle hematoma after surgical treatment of complicated pericoronitis

Observation: A 24-year-old man was referred to the dental emergency department for the management of a left submandibular cellulitis. The origin was a mandibular third molar. Drainage of the cellulitis and avulsion of the tooth were performed under general anesthesia. The follow-up was marked by a secondary infection of peri-zygomatic hematoma requiring a second drainage procedure. Discussion: The origin of the hematoma was a tear of the insertions of the mandibular elevators secondary to the trismus. The patient underwent two back-to-back general anesthesia procedures with tight trismus making induction and intubation difficult. Conclusion: A two-stage treatment with initial drainage and delayed avulsion after improvement of trismus is discussed

Duration of treatment with bisphosphonates at the time of osteonecrosis of the jaw onset in patients with rheumatoid arthritis. Review.

International audienceIntroductionRheumatoid arthritis (RA) is a frequent and co-morbid condition. One of the main complications is induced osteoporosis. Treatments related to this complication significantly modify oral and implant management. Affected patients represent a population at intermediate risk of osteonecrosis of the jaw (ONJ). The objective was to search the literature for durations of treatment with bisphosphonates at the time of ONJ occurrence in patients with RA in order to obtain an average duration.Materials And MethodsA bibliographic search in the PUBMED/MEDLINE database was carried out using the following equation “(osteonecrosis) AND jaw) AND rheumatoid arthritis” with no time limitation. The primary study endpoint was the duration of treatment with bisphosphonates (BP) at the time of ONJ onset in patients with RA.Results12 articles accounting for 50 patients were included. Patients had had a median of 46.8 months of treatment with BP before ONJ occurred. Mean, minimum and maximum treatment times were 48.68, 6 and 120 months, respectively. The standard deviation was 27.77 months.DiscussionThe median treatment duration in our cohort of patients with RA was less than that reported for osteoporosis. We therefore recommend that practitioners take additional precautions regarding oral surgery or implant procedures, particularly in patients with RA who have been treated with BP for more than 4 years

In vitro effects of two silicate-based materials, Biodentine and BioRoot RCS, on dental pulp stem cells in models of reactionary and reparative dentinogenesis.

Calcium silicate-based cements are biomaterials with calcium oxide and carbonate filler additives. Their properties are close to those of dentin, making them useful in restorative dentistry and endodontics. The aim of this study was to evaluate the in vitro biological effects of two such calcium silicate cements, Biodentine (BD) and Bioroot (BR), on dental stem cells in both direct and indirect contact models. The two models used aimed to mimic reparative dentin formation (direct contact) and reactionary dentin formation (indirect contact). An original aspect of this study is the use of an interposed thin agarose gel layer to assess the effects of diffusible components from the materials.The two biomaterials were compared and did not modify dental pulp stem cell (DPSC) proliferation. BD and BR showed no significant cytotoxicity, although some cell death occurred in direct contact. No apoptosis or inflammation induction was detected. A striking increase of mineralization induction was observed in the presence of BD and BR, and this effect was greater in direct contact. Surprisingly, biomineralization occurred even in the absence of mineralization medium. This differentiation was accompanied by expression of odontoblast-associated genes. Exposure by indirect contact did not stimulate the induction to such a level.These two biomaterials both seem to be bioactive and biocompatible, preserving DPSC proliferation, migration and adhesion. The observed strong mineralization induction through direct contact highlights the potential of these biomaterials for clinical application in dentin-pulp complex regeneration

Cytoskeleton and major extracellular matrix proteins were analyzed by immunofluorescence.

<p>Actin was observed in DPSC (A), DPSC with BD (B) and in DPSC with BR (C); vimentin and tubulin (D, E and F); and type 1 collagen and fibronectin (G, H and I). The observed decrease in type 1 collagen, when DPSC were in contact with biomaterials, was confirmed using RT-qPCR (5J), whereas protein secretion was not modified by the experimental conditions (Fig 5K). Scale Bar: 100μm.</p

Media used in the study.

<p>Media used in the study.</p