Comparative study of the premature extraction of primary teeth of children treated under local and under general anesthesia

The premature extraction of primary teeth of children could be done both under local or under general anesthesia. Тhe method of choice depends on different factors. Dental treatment under GA is an effective way to provide necessary dental care to children with special needs, medically-compromised, cognitively immature, highly anxious. The aim of this study is to compare the average age and the average DMFT index of the children with premature extraction of primary teeth treated under local and under general anesthesia. Subject of monitoring of the research were 60 children. The clinical group consists of 30 children with teeth for premature extraction under general anesthesia and the control group consists of 30 children for premature extraction under local anesthesia. The dental status was examined and registered by the DMFT index. The age of the children was filled out in special registration cards. There was a statistically significant difference in the age and the DMFT index between the first group (4.67±0.26 average age) and second group (4.67±0.26 average age ). The DMFT index for the first (clinical) group is 7.18±0.66 and – 5.17±0.33 for the second (control) group. The results show the connection between the carious activity and the need of prevention in younger children

Glandular odontogenic cyst—a review of characteristic features, treatment, and recurrence

INTRODUCTION: The glandular odontogenic cyst is classified as a developmental epithelial odontogenic cyst and defined as “arising in the tooth-bearing areas of the jaws and characterized by an epithelial lining with cuboidal or columnar cells both at the surface and lining crypts or cyst-like spaces within the thickness of the epithelium”. AIM: This review outlines the epidemiology, clinical and radiological presentation, histological characteristics, additional markers aiding in the correct diagnosis, treatment modalities, and recurrence rates of glandular odontogenic cysts. MATERIALS AND METHODS: For the purpose of this review, literature reviews and case reports with included literature reviews from the Scopus, PubMed, and ScienceDirect databases were used. The bibliography of the selected articles was additionally analyzed. RESULTS: The glandular odontogenic cyst is a relatively rare entity, clinically and radiographically non-specific. It is often misdiagnosed because of its overlapping histopathological features with other odontogenic cysts such as lateral periodontal or botryoid cyst, dentigerous and radicular cysts with mucous metaplasia, and central mucoepidermoid carcinoma. Regarding the treatment, both conservative and radical methods may be applied. These cysts have a high propensity for recurrence and display an aggressive behavior. CONCLUSION: Clinically and radiographically glandular odontogenic cysts can resemble several other lesions of the jaws, which denotes the importance of a precise histopathological diagnosis. The choice of treatment should be based on the degree of aggressive behavior of the cyst. Meticulous examination, appropriate treatment planning, and sufficient follow-up periods are key to a successful outcome

COMBINING A LATERALLY MOVED FLAP IN CLOSING LOCAL GINGIVAL RECESSION WITH THE USE OF STRAUMANN EMDOGAIN GEL

So far there is no universal solution regarding treatment of gingival recession. The author proposes his own version of updating one of the methods of treating gingival recession, namely a laterally moved flap with the addition of enamel matrix proteins. In the author’s opinion, this method is the least invasive and there are the least contraindications to it

Epidemiological study of premature extraction of 5-6-year-old children from Northeastern Bulgaria

Primary teeth lost one or more years before the time of their physiological exfoliation are prematurely lost. The aim of this study is to show the percentage of prematurely extracted teeth of urban and rural children, the types of the prematurely lost teeth and the reasons for their early lost. Subject of monitoring of the epidemiological research were 1200 children (half of them are from urban regions and the other half are from rural areas) examined by strictly calibrated teams of dental specialists. The DMF (T+t) index is used to measure the dental health. We calculate the missing teeth associated with the age of the children. The teeth we considered as a prematurely lost, were extracted one and more years before the time of their physiological exfoliation. The percentage of the prematurely extracted teeth is 4,6. There was a statistically significant difference in the relative shares of the prematurely extracted teeth of the urban (3,67 %) and the rural children (5%). The second molars are the most often extracted primary teeth both of the rural children (61,67%) and the urban children (57,7%), followed by the first molars - 35,29% for the rural and 34,41% for the urban children. The canines are the most rarely prematurely extracted teeth - 2,49% (rural children), 7,7% (urban children).The main reason for the early teeth loss is the carious lesions - in 94,12% and only 5,89% - other reasons. This results demonstrates the connection between premature extraction of the primary teeth, carious activity and the need of prophylaxis

Influence of the height of the alveolar bone in the distal parts of the upper jaw on the odontogenic inflammatory processes in the maxillary sinus

Aim: To determine whether the height of the alveolar bone affects the transmission of inflammation from the periapex of the tooth to the maxillary sinus.Background: The maxillary sinus is the largest of all paranasal cavities and is located in the body of the upper jaw. The inflammatory process in the teeth can often ascend to the maxillary sinuses and thus can cause odontogenic maxillary sinusitis. Untreated periapical inflammatory processes of the teeth in the distal parts of the upper jaw are the most common cause of odontogenic sinusitis. Data in the literature show that there is a correlation between the thickness of the mucosa of the maxillary sinus and the proximity of some anatomical structures, such as the height of the alveolar bone between the distal teeth of the upper jaw and the floor of the maxillary sinus.Methods: To accomplish the task, we analyzed 109 CBCT images of patients with odontogenic cysts of the upper jaw, located in the area below the floor of the maxillary sinus. In 61 of them the residual alveolar bone was less than 3 mm. For the other 48 it was over 5 mm. The group of teeth, included in the study, consisted of premolars and molars. Above each tooth with an odontogenic cyst, the thickness of the mucosa of the maxillary cavity was measured. For normal mucosa we considered thickness of 0 – 2 mm, and for pathological – thickness of over 2 mm. Group I – In this group we included odontogenic cysts in which the measured distance between the cystic cavity and the floor of the maxillary sinus was less than 3 mm.Group II – In this group we included odontogenic cysts in which the measured distance between the cystic cavity and the floor of the maxillary sinus was over 5 mm.Results: The following results were obtained in group I. Of the 61 cases with an odontogenic cyst present and alveolar bone height below 3 mm, the mean measured value in mm of sinus membrane thickness was 5.7 mm. The maximum value was 13 mm and the minimum was 2 mm. In group II we obtained the following results: we had 47 cases of radicular cysts of the distal teeth of the upper jaw, and the height of the bone to the floor of the maxillary sinus was 5 mm and more. The average thickness of the maxillary sinus mucosa was 2.21 mm. For comparison, up to 2 mm in the scientific literature is considered a healthy clinical mucosa. The minimum measured value was 1 mm and the maximum value was 8 mm.Conclusions: Based on the results obtained, we can conclude that there is a clear relationship between the thickening of the maxillary sinus membrane and the present periapical pathology of the maxillary distal teeth when they are close to or in contact with the floor of the maxillary sinus. This dependence increases with decreasing the volume of the residual alveolar bone

Prevention of the malocclusions of children with prematurely extracted teeth. Spacemaintainers- types and indications

Запазването на място се налага във временно и смесено съзъбие, за да се предотврати скъсяването на зъбната дъга. Използването на местопазители при преждевременна загуба на временни зъби във временно и смесено съзъбие в подходящото време може да профилактира последиците от скъсяването на зъбната дъга и нуждата от комплексно ортодонтско лечение в по-късен етап. Целта на настоящия обзор е подробно да се разгледат видовете местопазители, техните предимства и недостатъци. Профилактичните мероприятия при преждевременната загуба на временните зъби са преди всичко детските протезни конструкции - местопазителите.Preserving a place in the denture is necessary in order to prevent shortening of the dental arch in the temporary and mixed dentition. Using space maintainers, in the cases of an early tooth lost in temporary and mixed dentition at the right time, could prevent the effects of the shortening of the dental arch and the need for comprehensive orthodontic treatment in the future. The aim of this review is to examine the types of space maintainers, their advantages and disadvantages. Preventive measures in premature loss of temporary teeth are mainly children's prosthetic constructions - the space maintainers

Dental fear and premature tooth extraction

Dental avoidance is a high risk factor for development of odontophobia and poor oral health including premature tooth extraction in children.The aim of this study is to evaluate the connection between the dental fear and premature tooth loss. Subject of monitoring of the clinical research were 140 school children with mixed dentition. The clinical group consists of 90 children with prematurely extracted teeth. The patients from the clinical group were divided into three groups of 30 patients. The control group consists of 50 children with intact denture. А special questionnaire was filled from the parents of the examined children about the dental fear of their children, whether there is such a fear or not. The results show that while in the control group the majority of children are not afraid of dental treatment - 79,2%, then in groups surveyed more than half of the children said they are afraid of dental treatment, especially the third group - 57,7%. Conclusion: The children with prematurely extracted teeth have a higher level of dental anxiety due to which they are with poor dental health and early tooth loss. The use of behavioural techniques are recommended in order to improve their oral health

Tooth extraction with socket preservation graft prior to implant placement with mandibular (retromolar area) alveolar ridge autograft

Introduction: Prior to implant placement, adequate bone must be present. Understanding the basics of bone grafting and reconstruction techniques is critical for successful implant treatment. Different bone augmentation materials have been described with autogenous bone grafts being considered the gold standard due to their osteogenic, osteoinductive and osteoconductive potential.Aim: The purpose of this paper is to present a clinical case of using a bone block taken from the mandibular retromolar region for socket augmentation after tooth extraction for the subsequent installation of an intraosseous dental implant.Materials and Methods: In order to demonstrate using a bone block of the mandibular retromolar region for socket augmentation after tooth extraction and the subsequent installation of an intraosseous dental implant, the following case is presented: patient M., 40 years old, who planned to undergo dental implantation after extraction of tooth 47 with simultaneous socket augmentation with Bio-Oss Collagen xenograft and Bio-Gide bioresorbable membrane. Results: The application of xenograft and a barrier membrane immediately after tooth extraction failed to preserve ridge dimensions. The use of a bone autoblock taken from a place adjacent to the alveolar bone defect, which remained after an unsuccessful attempt to eliminate it immediately after the extraction of tooth 47 (Bio-Oss Collagen + Bio-Gide), provided the possibility of restoring the volume and quality of bone tissue sufficient for positioning of the NobelReplace dental implant and subsequent dental prosthetics.Conclusion: The proposed bone block technique restored bone volume and quality and allowed for the placement of an intraosseous dental implant

Comparative bacteriological examination of materials, taken from the pathologically altered mucosa of the maxillary sinus and chronic inflammatory processes, developing around the maxillary teeth

Aim: To perform a comparative bacteriological examination of a material, taken from the alveolus of an extracted tooth with chronic inflammatory disease and a material from the maxillary sinus at the closure of oroantral communication, performed immediately after extraction.Background: Odontogenic maxillary sinusitis is a common problem and a well-known condition in the dental practice. This type of maxillary sinusitis differs in its pathophysiology, pathomorphology, microbiology, diagnosis and treatment from the other types of maxillary sinusitis. Chronic inflammatory processes affecting the periodontium and periodontium of the teeth can often reach the maxillary sinuses and thus cause odontogenic maxillary sinusitis.Methods: To perform the task assigned, microbiological samples were prepared, taken intraoperatively from the inflammatory focus around the causative tooth and from the altered mucosa of the maxillary sinus. After taking into account the results of the microbiological examination, a comparative analysis of the microflora isolated from the two sites was performed. This was done in order to prove its identity and to look for the relationship between the two pathological processes. To accomplish the task, we selected 27 patients who had molar teeth extracted, not subjected to conservative treatment, whose roots protrude into the maxillary sinus or stand no more than 3 mm away. In patients where a direct contact with the maxillary sinus was made, we used two sterile swabs to take the microbiological sample – first from the alveolar walls of the extracted tooth and then through the communication made. In other patients, we created such a communication with a fissure burr ourselves, after we had already taken a sample from the alveoli of the extracted tooth. The hole size was no more than 5 mm.Results: When comparing the samples of each patient, taken from the alveoli of the extracted tooth and the pathologically altered mucosa of the maxillary sinus, we obtained the following results – compared to the frequency distribution, we can see in the following table – a match of 88.9% of all cases and in a little over 11% of the cases where not match is found between the samples.Conclusions: When the height of the available bone in the distal parts of the upper jaw between the apexes of the teeth and the floor of the maxillary sinus is below 3 mm, the risk of ascending of the inflammatory process from the periodontal tissues to the maxillary sinus is quite high – 88.89%