Maxillary Cemento-Ossifying Fibroma in a Male Patient with End-Stage Chronic Renal Disease

Aims & Objectives: The cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion with controversial features that occurs most frequently in the mandible of female individuals. The presence of chronic renal disease (CRD) is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. The aim of this report was to describe clinical, radiological and histopathological characteristics of an unusual case of COF who was also presented with CRD. Case Description: A 41 year-old male patient undergoing chronic hemodialysis was referred because of the painless, slow growing, firm mass in the maxilla. Cone Beam Computed Tomography disclosed a well-circumscribed lesion containing numerous ring-shaped and curvilinear ossified nodules in the left premolar-molar region. Patient was operated under local anesthesia. The histopathological examination revealed irregularly shaped bone and cementum-like hard tissue calcifications contained within hypercellular fibrous tissue stroma, leading to a final diagnosis of cemento-ossifying fibroma. Conclusion: The clinical characteristics and radiological appearance of maxillary COF is unspecific and its relapse potential is unpredictable. A reliable classification at the cellular level is required to support evidence based clinical decisions, particularly in the presence of systemic conditions such as CRD

The effects of supplemental melatonin administration on the healing of bone defects in streptozotocin-induced diabetic rats

Diabetes mellitus (DM) causes an increased production of free radicals that can impair bone healing. Melatonin is a hormone secreted mainly by the pineal gland, which participates in the neutralization process of free radicals. Objective The aim of this study was to investigate histologic and biochemical effects of supplemental melatonin administration on bone healing and antioxidant defense mechanism in diabetic rats. Material and Methods Eighty-six Sprague-Dawley male rats were used in this study. Diabetes mellitus was induced by intraperitoneal (i.p.) administration of 65 mg/kg streptozotocin (STZ). Surgical bone defects were prepared in the tibia of each animal. Diabetic animals and those in control groups were treated either with daily melatonin (250 μg/animal/day/i.p.) diluted in ethanol, only ethanol, or sterile saline solution. Rats were humanely killed at the 10th and 30th postoperative days. Plasma levels of Advanced Oxidation Protein Products (AOPP), Malondialdehyde (MDA), and Superoxide Dismutase (SOD) were measured. The number of osteoblasts, blood vessels and the area of new mineralized tissue formation were calculated in histologic sections. Results At the 10th day, DM+MEL (rats receiving both STZ and melatonin) group had significantly higher number of osteoblasts and blood vessels as well as larger new mineralized tissue surfaces (

The Influence of Hyperbaric Oxygen Treatment on the Healing of Experimental Defects Filled with Different Bone Graft Substitutes

To assess potential effects of hyperbaric oxygen (HBOT) on artificial bone grafts, β - Tricalcium phosphate (β-TCP) and calcium phosphate coated bovine bone (CPCBB) substitutes were applied to standard bone defects in rat tibiae. The control defects were left empty. Half of the animals received 60 minutes of 2.4 atmosphere absolute (ATA) of HBOT. Rats were sacrificed at one, two and four weeks. Bone healing was assessed histologically and histomorphometrically using light microscopy. The periosteum over the bone defects was examined ultrastructurally. Cardiac blood was collected to determine the serum osteocalcin levels. The HBOT increased new bone formation in the unfilled controls and β-TCP groups and significantly decreased cartilage matrix and fibrous tissue formations in all groups. Active osteoblasts and highly organized collagen fibrils were prominent in the periosteum of β-TCP and control groups. Serum osteocalcin levels also increased with HBOT. The healing of defects filled with CPCBB was similar to the controls and it did not respond to HBOT. These findings suggested that the HBOT had beneficial effects on the healing of unfilled bone defects and those filled with β-TCP bone substitute but not with CPCBB, indicating a material-specific influence pattern of HBOT

The effect of the mandibular plane angle on fracture line stability: An ex vivo experimental study

Background/Aims Mandibular angle fractures fixated with plate osteosynthesis techniques have to withstand the effects of muscle attachments. Individual variations in the craniofacial morphology may alter the biomechanical resistance of the bone-plate construct. The aim of the present study was to determine the influence of variations in the mandibular plane angle (MPa) on the biomechanical stability of sheep mandibular angle fractures (MAFs). Materials and Methods Sixty sheep hemi-mandibles were used. The mandibles were positioned on a test jig that simulated low (15 degrees, group L), normal (25 degrees, group N), and high (35 degrees, group H) MPa. Unfavorable MAFs were created with thin diamond cutting disks. One four-hole, 9.0-mm-spacing, standard titanium miniplate of 2.0 mm thickness and 5.0-mm-long screws were inserted at the superior border of the alveolar bone in monoplanar orientation. Specimens were then subjected to vertical loads between 10 N and 150 N in a universal testing machine. The displacement values at each 10 N force increment and the load magnitude at which 3.0 mm displacement limit was reached were recorded. Results Starting from 40 N, the displacement values at each 10 N increment in the H group were significantly higher than those of the L and N groups until 150 N (P < 0.05). The force magnitude required to reach 3.0 mm of displacement in the H group was significantly lower than that for the L and N groups (P < 0.05 for each). Conclusions The one-miniplate monoplanar fixation technique used in sheep MAF with high MPa is more likely to offer lower biomechanical resistance to the vertical forces applied over the molar region than do the normal and low MPa

Displacement of a Broken Dental Injection Needle Into the Perivertebral Space

Dental injection needle breakage is an uncommon problem in dental practice. Displacement of the broken fragment into anatomical spaces is, on the other hand, a serious complication that occurs most commonly during inferior alveolar nerve blocks as a result of material wear, incorrect application of the anesthesia technique, or sudden movement of the patient during injection. Further complications such as infection, trismus, and nerve paralysis may exacerbate the condition and, if not treated adequately, life-threatening conditions may develop over time as the fragment dislodges deeper in soft tissues. Clinical symptoms of the patient, as well as the findings gathered from detailed physical examination and radiographic evaluation, are important factors to consider before performing an exploratory surgery. Removal of a broken needle may be troublesome due to its proximity to vital anatomic structures. Multislice computed tomography is a reliable imaging modality that provides accurate information to pinpoint the exact location of the needle fragment.This report describes a case of needle breakage occurred during inferior alveolar nerve block which was performed to extract a third molar tooth and the migration of the broken fragment from the right mandibular ramus area into the perivertebral space, with special emphasis on the surgical retrieval technique with multiplanar computed tomography imaging guidance

Assessment of Dental Fear and Anxiety Levels in Eating Disorder Patients Undergoing Minor Oral Surgery

Purpose: The aim of the present study was to evaluate the levels of dental fear and anxiety in women with eating disorders (EDs) scheduled for oral surgery

An analysis of oral radiographic findings and their interpretations in women with eating disorders

Background/Purpose: Eating disorders (EDs) are life-threatening conditions that mainly affect women and can be diagnosed early by dental professionals. The aims of this study were to examine the oral radiographic status of ED patients and compare the performances of dental professionals from different backgrounds in interpreting these findings

An analysis of oral radiographic findings and their interpretations in women with eating disorders

AbstractBackground/PurposeEating disorders (EDs) are life-threatening conditions that mainly affect women and can be diagnosed early by dental professionals. The aims of this study were to examine the oral radiographic status of ED patients and compare the performances of dental professionals from different backgrounds in interpreting these findings.Materials and methodsIn total, 72 women with EDs and healthy controls matched by age, sex, educational status, and smoking status were included in the project. Standardized full-mouth intraoral periapical radiography with a bisecting-angle technique and digital panoramic imaging were performed in all participants. Five observers independently interpreted the tooth status, the condition of the periapical tissues, and the third molars.ResultsScores for intra- and interobserver consistency were acceptable and were 0.76 and 0.92, respectively. The ED group consumed a larger daily amount of acidic beverages (P < 0.05) than the controls, and a significant positive correlation was observed between the daily acidic-beverage intake and the frequency of vomiting (P < 0.05). In the ED group, the mean number of teeth with untreated carious lesions (P < 0. 01), particularly in the posterior mandibular region (P < 0.05) and periapical pathologies requiring treatment (P < 0.05), were significantly higher compared with healthy individuals. However, the radiographic depth-progression pattern of the carious lesions was similar in the two groups.ConclusionThe presence of radiographically detectable caries and periapical lesions makes ED patients more susceptible to the risk of losing their functional teeth over time, especially when considered together with their inadequate oral hygiene practices and acidic-beverage consumption. Nonetheless, dental professionals with different backgrounds can interpret such radiographic findings with similar efficiency

What happens if dental malpractice and radiological misdiagnosis get together?

The aim of this report is to describe a case presented with complaints of orbital pain and swelling in the right maxillary region. Patient&rsquo;s history revealed that she had previously visited a dental professional, a neurologist and a general radiologist who failed to diagnose her correctly. Panoramic radiography, cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) disclosed an iatrogenic displacement of a third molar and a large cystic lesion in the maxillary sinus. Patient was operated under local anesthesia. Microscopic examination of the removed specimen revealed an odontogenic cyst. The clinical characteristics of the iatrogenic displacements and the reliability of different imaging modalities were evaluated with special emphasis to the position of the dental professional

A comparison of panoramic radiography and cone beam computed tomography in the detection of osteosynthesis complications in sheep mandibular angle fractures.

Objective. The aim of this study was to compare the diagnostic efficacy of panoramic radiography (PANO) and cone beam computed tomography (CBCT) in detecting simulated complications of plate osteosynthesis applied to mandibular angle fractures (MAFs)