Denture - induced fibrous hyperplasia (epulis fissuratum)

Denture-induced fibrous hyperplasia (epulis fissuratum) occurs in complete denture patients, because of constant irritative action that induces the mucosa to grow under poorly fitting dentures. The epulis fissuratm usually occurs in the vestibular mucosa, where the denture flange contacts the tissue. It consists of painless folds of fibrous connective tissue that are firm to palpation. These lesions must be removed, and to avoid a relapse, new complete dentures should be made to maintain healthy surgical tissues. Aim: The purpose of this study was to present a case report of the surgical treatment of epulis fissuratum, as a support to clinical diagnosis with histopathological finding, and to provide satisfactory results of rehabilitation in oral function and tissue health with new denture. An epulis fissuratum is a benign condition but, if ulcerated, it can mimic more serious conditions like oral cancer. Thus, microscopic histopathological examination of the removed tissue is an imperative to be accomplished in order to confirm the doctor's clinical diagnosis

Evaluation quality of life after apicoectomy using two defferent flap design

INTRODUCTION. Apicectomy has become an integral part of a comprehensive dental treatment. The primary objective of apicectomy is to eradicate the etiological agents of periapical pathoses and to restore the periodontium to a state of biologic and functional health. The aim of this study was to evaluate patient experience of quality of life following apicoectomy using two different flap design gingival (envelope) and semilunar. MATERIAL AND METHOD. The study consisted of 60 patients referred for oral surgical treatment - apicoectomy with periapical osteotomy on frontal teeth. One operator were carried out the treatments. All patients were given a questionnaire with 15 questions to evaluate their quality of life for 7 days after the oral surgery interventions. The patient’s answers were referred as: not at all -1; very little -2; some- 3; quite a bit – 4; very much-5). An equal number of patients were assigned to each group. Group 1 was treated by apicoectomy with gingival flap design and Group 2 was treated by apicoectomy with semilunar flap design. The statistical evaluation included descriptive and analytical methods. RESULTS. The average time needed for completion the surgical procedure was approximately 45 minutes. The results showed that patients in Group 1 reported significantly more pain and took significantly more analgesics on day 3. On days 1 and 2, patients of the Group 2 reported significantly more difficulty in mouth opening, mastication, and the ability to speak. CONCLUSION. High incidence of symptoms were reported by the patients in both groups. There were no significant differences found in the distribution of patients according to age, gender, periradicular diagnosis, and site of operation between the two groups. The apicoectomy procedure using semilunar flap design provided significantly less postoperative pain, but more difficulties in mouth opening, mastication, and the ability to speak immediately postoperatively. Key words: oral surgery, apicoectomy, quality of life, flap design, pai

Management of bone defects with Bio-oss

Introduction: The defects in the alveolar bone might appear as a result of congenital malformations, traumatic injuries, periodontal disease, surgical traumas, chronic periapical changes and tumors from benign or malignant origin. The aim of this study was to provide solid and healthy area with application of Bio-Oss in the defect. Materials and methods: Based on the clinical diagnosisestablished by previously taken history, clinical examination and radiographic images oral-surgery interventions was made. To realize the aim of this work, augmentative material was implicated in the bone defects made in the patients after removal of follicular cyst, chronic periapical lesion, and parodontopathia. During the first and seventh day of the interventions, the patients have been followed through from aspect of possible development of local and general complications after the oral-surgery intervention. After period of one, three and six mount control x-ray was made. Results: Obtained results confirmed that: volume of the socket and defect of the bone was kept, fast revascularization was achieved, bone formation and slow resorption of the augmentative material was achieved, and period of normal healing without infection was also achieved. Conclusions: The augmentative materials used for treatment of bone defects besides their basic chemical and physical characteristics referring to their solubility in the body fluids, the transformation, modulation and resorption must be completely safe or secure, i.e. not to bring any risk of infection, immunological risk, physiological intolerance or inhibition of the process of restitutio ad integrum. In our study Bio-Oss was confirmed as augmentative material who had this characteristics. Keywords: bone defect, resorption of the bone, augmentative material, Bio-Os

The Effect of the Use of Different Types of Cement and Zirconium Post Systems on Endondontically Treated Teeth

BACKGROUND: Prefabricated zirconium upgrading systems were examined to satisfy aesthetic needs in endodontically treated teeth. Endodontically treated teeth, together with non-metallic posts and superstructure, are substructures that enable the production of prosthetic structures that will allow aesthetics, resulting from normal light transmission. To investigate and analyse the retention of zirconium post systems cemented with RelyX Unicem 2 Automix (RLX) cement with Pull-out test. AIM: To examine the retention of zirconium post systems, cemented with Multi-Link Automix (MLA) cement and RelyX Unicem 2 Automix (RLX) cement with Pull-out test. MATERIAL AND METHODS: In this study were used, 120 post systems of the company ZIRIX NORDIN - Switzerland, with different diameters d1 = 1.2, were used: d2 = 1.35, d3 = 1.5, and two types of resin cements: Multilink Automix-Ivoclar (MLA), and RelyX Unicem 2 Automix (RLX) - 3 M ESPE. RESULTS: The analysis of the extraction force in newtons (N) zirconium post systems of Multilink Automix cement according to subgroups of three diameters is consequently 481.3 ± 1.9 vs 462.9 ± 4.5 vs 454.2 ± 2.2. The analysis of the extraction strength in the newtons (N) zirconium post systems of RelyX Unicem 2 Automix cement in the entire sample is 577.9 ± 6.1 N. CONCLUSION: The largest diameter of the posts significantly increases the resistance of fractures compared to the smaller two diameters used in the experimental study

Clinical evaluation of two different materials for retrograde root filling

BACKGROUND:Retrograde root filling is indicated when periapical inflammation cannot be resolved by conventional endodontic therapy. A retrograde filling should prevent flow of microorganisms and bacterial endotoxins from the root canal into periapical tissues. The aim was to evaluate the clinical and radiographic treatment outcome of two different materials for retrograde root filling (dentin-bonded resin nano composite and glass ionomer cement) using special preparation performance of resection surface. METHODS AND MATERIALS: Apicectomies of incisors and canines of 20 patients with indication of retrograde root filling were made. The entire resection surface was slightly concavely prepared. A total of 20 slightly concave root sections were divided into two groups of 10 individuals and filled with either root filling materials. This preparation technique prevents marginal contraction gaps during polymerization and makes a sealing of the entire resection surface possible. Controls were made after one, three, six and 12 months. RESULTS: The last control made after 12 months shows that the proportion of successful cases was significantly higher in the first group with dentin-bonded resin nano composite group (64%)than in the second glass ionomer group (42%, p<0.001). The reason for failure in the second group was loosening of the retrograde filling. CONCLUSIONS: Due to insufficient bonding strength to the concave resection surface, retrograde root filling with glass ionomer results in an unacceptably high failure rate. Dentin-bonded resin nano composite applied onto the entire, slightly concave resection surface is a feature apical filling material characterized by a high success rate

Clinical evaluation of two different materials for retrograde root filling

BACKGROUND:Retrograde root filling is indicated when periapical inflammation cannot be resolved by conventional endodontic therapy. A retrograde filling should prevent flow of microorganisms and bacterial endotoxins from the root canal into periapical tissues. The aim was to evaluate the clinical and radiographic treatment outcome of two different materials for retrograde root filling (dentin-bonded resin nano composite and glass ionomer cement) using special preparation performance of resection surface. METHODS AND MATERIALS: Apicectomies of incisors and canines of 20 patients with indication of retrograde root filling were made. The entire resection surface was slightly concavely prepared. A total of 20 slightly concave root sections were divided into two groups of 10 individuals and filled with either root filling materials. This preparation technique prevents marginal contraction gaps during polymerization and makes a sealing of the entire resection surface possible. Controls were made after one, three, six and 12 months. RESULTS: The last control made after 12 months shows that the proportion of successful cases was significantly higher in the first group with dentin-bonded resin nano composite group (64%)than in the second glass ionomer group (42%, p<0.001). The reason for failure in the second group was loosening of the retrograde filling. CONCLUSIONS: Due to insufficient bonding strength to the concave resection surface, retrograde root filling with glass ionomer results in an unacceptably high failure rate. Dentin-bonded resin nano composite applied onto the entire, slightly concave resection surface is a feature apical filling material characterized by a high success rate

Orthodontic Treatment of a Periodontally - Affected Adult Patient (Case Report)

BACKGROUND: The advanced periodontal disease is characterised by a strongly pronounced loss of attachment and reduction of the alveolar bone support, which leads to luxation, migration of the teeth, functional discomfort and poor facial aesthetics. CASE PRESENTATION: The aim of this paper is to present the case of a 26-year-old female patient, registered at the Clinic of Periodontology with highly expressed gingivitis, unsatisfactory periodontal status, presence of diastemas between the frontal teeth and attachment loss of 5-6 millimetres in different areas. We conducted a thorough classic periodontal treatment, as well as training for proper maintenance of oral hygiene, with frequent professional oral-prophylactic sessions, complemented with orthodontic treatment. Fixed orthodontic appliances were installed, and mild forces were applied for gradual levelling of the teeth, with constant control of the periodontal status. After 20 months of treatment, the patient was in retention. CONCLUSION: Orthodontic therapy of periodontally-affected teeth can begin only after exhaustive administration of a periodontal treatment. Orthodontic treatment as an addition to the periodontal restoration must be gradual with mild forces for an optimal dental response, thus helping to improve function, facial aesthetics and psychological confidence of adult patients

Oral–surgical treatment of periodontal pocket with guided bone and soft tissue regeneration

Periodontal disease is defined as a complex, multifactorial disease characterized by the loss of connective tissue attachment with destruction of periodontal tissues. The aim of periodontal therapy is to eliminate inflammatory process, prevent the progression of periodontal disease and also to regenerate the lost of periodontal tissues. Loss of the bone support by creating a periodontal pocket is one of the most common cause of tooth extraction. Their treatment can be conservative and surgical. The purpose of this paper is to demonstrate the treatment of infrabony periodontal defects with bone and soft tissue regeneration. On periodontal examination and radiographic evaluation, the female 56-year-old patient presented with an infrabony defect extending up to apical third of the mesial side of the right maxillary second molar with a probing depth of 8 mm. After conservative periodontal treatment, oral surgical intervention was performed including open flap debridement and filling the defect with xenograft and plasma rich fibrin. The application of xenograft and Plasma rich fibrin resulted in bone regeneration of the defect and successful fixed prosthodontic solution. Guided bone and soft tissue regeneration using xenograft and fibrin-rich plasma gives successful radiological and clinical signs of bone augmentation and consolidation of defects caused by loss of tooth attachment. Keywords: periodontal pocket, xenograft, PRF

Diagnostic and Prognostic Implications of the Oral Exfoliative Cytology in Oral precancer And Cancer Detection

Oral cancer is a preventable disease. In 2021, the International Agency for Research on Cancer by World Health Organization, presents the number of 377713 new cases of oral cancer in 2020, making it the 16th most common malignant disease in the world, unfortunately with poor prognosis after treatment because of the late stage of the disease [1]. Aim: to explore the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the oral exfoliative cytology (brush biopsy) as a closest, but less invasive method to the tissue biopsy, respected as a gold standard in the diagnostic procedures. Material and Methods: 60 patients divided into two study groups (30 of them with potentially malignant oral lesions and a second consisted of another 30 patients with previous oral malignant disease) were examined with brush biopsy and underwent to histopathological confirmation - tissue biopsy, selected under certain inclusion and exclusion criteria. Results: Sensitivity of brush biopsy in the group of examinees with oral potentially malignant lesions is 100%, its specificity is 66.67%, the positive predictive value is 92.31% and the negative predictive value is 100%. The accuracy of the Brush biopsy method is 93.33%. The sensitivity, in the group of patients with previous oral malignant disease, is 100%, specificity is 0%, the positive predictive value is 100% and the negative predictive value is 0%. The accuracy of this method is 100%. Conclusion: The accuracy reaches a total value of 100% for the group with previous malignant lesions (relapse) and sets the thesis that brush biopsy as screening method for oral cancer or premalignant tissue changes is enough valuable for the patients with oral epithelial changes but may be combined with some other type of screening procedures, easy to perform and less invasive ones, in order to gain relevant results applicable in the everyday clinical practice. Keywords: Oral Examination; Potentially Malignant Lesions; Oral Cancer; Diagnostic

Orthodontic and Oral Surgery Approach in Cases of Supernumerary Teeth

Introduction: Hyperdontia is an anomaly in the number of individual teeth and is manifested by a greater number of teeth in the jawbones than the normal number. Supernumerary teeth can occur in both generations of teeth, with more frequent representation in the permanent. Two forms of supernumerary teeth can be observed, typical and atypical. Typical supernumerary teeth are very similar in shape to normal teeth (dentes supernumeraria), while atypical supernumerary teeth are usually pointed in shape (dentes accessorya). Aim:The purpose of this lecture is to present the etiopathogenesis, clinical examination, diagnosis, and differential diagnosis, as well as the prognosis, therapeutic treatment, and clinical outcome of supernumerary teeth. Material and Method: The paper will present several clinical cases from its own casuistry, emphasizing the indications and contraindications for operative oral-surgical therapeutic treatment, emphasizing the criteria, conditions and factors that are of great importance in the definitive solution of supernumerary teeth. Results:There are different data on the representation of supernumerary teeth in both the deciduous and permanent teeth. Only those statistical analyzes that are based on clinical and radiological examinations during the primary and permanent dentition of each subject should be considered reliable. Conclusion: In addition to interdisciplinary cooperation, for the realization of oral-surgical interventions, the correct assessment of the expediency and determination of the most suitable time for treatment is of great importance