A descriptive study of 113 unerupted supernumerary teeth in 79 pediatric patients in Barcelona

Unerupted supernumerary teeth, depending on the morphology, number and distribution can give rise to various alterations in the eruption and development of those permanent teeth to which they are related. Objectives: We aimed to make an epidemiological and descriptive study of the clinical characteristics of patients in Barcelona, their surgical treatment and how said treatment was hindered. Materials and methods: A descriptive study including 113 supernumerary teeth from 79 healthy pediatric patients between 5 and 19 years of age, which underwent surgery in our hospital during a 2 year period (May 2005 / May 2007), taking into account the variables of personal data, gender, age, location, number, morphology, positionaxis, radiological study, surgical treatment, related pathologies, and surgical complications. Results: Male patients (51) were more frequently affected than female (28) patients mainly within the central incisors-mesiodens (53.16%), in which the unique form (68.52%) predominates in conoid morphology (69.62%). Surgical treatment was done by palatal/lingual extraction (49.37%), with few surgical complications (only 1 case of post-surgical bleeding). Conclusion: Incidence in supernumerary teeth is higher among male patients (ratio M:F of 1.82:1). They are most frequently located in the maxilla (82%), specifically, in the premaxilla (77%). Most cases presented only one supernumerary tooth (68.5%) and, in multiple cases, the premolar region is predominant. The conoid shape is the commonest morphology (69.62%). Surgical extraction, was done by palatal/lingual in 49.37% of the cases, as opposed to the vestibular approach in 45.57%

Implant-supported fixed prostheses in a Patient with Osteogenesis Imperfecta : a 4-year follow-up

Osteogenesis Imperfecta (OI) is a rare autosomal dominant connective tissue disorder in wich, the bone quality and density is affected. OI includes some metabolic disorders and have a wide range of clinical presentations. In Osteogenesis Imperfecta bone has a very low density and it is a disorder currently treated with bisphosphonates. Quality and quantity of bone is important for establishment of osseointegration in dental implants. There are few reported cases in the literature. This is a case report of a 61 year-old man with grade IV OI, rehabilitated with implant-supported fixed prostheses in the posterior right and left mandible, whithout bone grafts. At the 4-year follow-up, clinical and imaging study showed no evidence of pathology in the peri-implant tissues. The final outcome is a correct occlusion and masticatory function. This case shows that dental implants may be a treatment option in this patients, however there is still quite limited scientific evidence

Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol

Background: Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients. Material and Methods: This is a descriptive study of healthy patients, without any diagnosis of syndrome, ranging between 4 and 14 years that have been surgically treated and rehabilitated post-surgery within a period of 2 years. Results: 101 frenectomies and lingual plasties have been performed and patients have been treated following the protocol of action that we hereby present. After the surgical intervention, the degree of ankyloglossia has been improved, considering correction in 29 (28%) of the patients (95% CI: 20%, 38%), reaching, with the post-surgical orofacial rehabilitation, a correction of 97 (96%) of the participants (95% CI: 90%, 98%). Conclusions: The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty. The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain

Histologic and histomorphometric evaluation of a new bioactive liquid bbl on implant surface: a preclinical study in foxhound dogs

Background: bioactive chemical surface modifications improve the wettability and osse-ointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre‐treated with a novel bone bioactive liquid (BBL) and the commercially available BLT‐SLA active. Methods: forty BLT‐SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT‐SLA pre‐treated with BBL) and control (BLT‐SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone‐to‐implant contact (BIC), inter‐thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry. Results: all animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo‐integrated. Relative to control groups, test implants demon-strated a significant 1.5‐ and 1.7‐fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82–0.92 mm vs. 33–48 mm in the control group). Conclusions: Relative to the commercially available BLT‐SLA active implants, BLT‐SLA pre‐treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.This research was funded by: Biointelligent Technology Systems SL, Barcelona, Spain

Chemically defined conditions mediate an efficient induction of dental pulp pluripotent-like stem cells into hepatocyte-like cells

Liver diseases are major causes of morbidity and mortality. Dental pulp pluripotent-like stem cells (DPPSCs) are of a considerable promise in tissue engineering and regenerative medicine as a new source of tissue-specific cells; therefore, this study is aimed at demonstrating their ability to generate functional hepatocyte-like cells in vitro. Cells were differentiated on a collagen scaffold in serum-free media supplemented with growth factors and cytokines to recapitulate liver development. At day 5, the differentiated DPPSC cells expressed the endodermal markers FOXA1 and FOXA2. Then, the cells were derived into the hepatic lineage generating hepatocyte-like cells. In addition to the associated morphological changes, the cells expressed the hepatic genes HNF6 and AFP. The terminally differentiated hepatocyte-like cells expressed the liver functional proteins albumin and CYP3A4. In this study, we report an efficient serum-free protocol to differentiate DPPSCs into functional hepatocyte-like cells. Our approach promotes the use of DPPSCs as a new source of adult stem cells for prospective use in liver regenerative medicine.This study was funded by the Universitat Internacional de Catalunya (UIC), the Agència de Gestió d’Ajuts Universitaris i de Recerca, Generalitat de Catalunya project number (SGR 1060 for MA), the Kuwait Foundation for the Advancement of Sciences (KFAS), and the Dasman Diabetes Institute under project number (RA-2013-009 for AAM). CGR, EMS, and RNT were funded by the predoctoral grant Junior Faculty award from the Obra Social, 'la Caixa' Foundation, and UIC

Evaluación clínica comparativa de la efectividad de dos anestésicos, aplicados tópicamente en la mucosa oral

Introducción: La anestesia local, es el método más habitual y seguro para prevenir el dolor en los tratamientos odonto-estomatológicos. La parte más temida del procedimiento odontológico es la inyección del anestésico. La anestesia tópica de epitelio y mucosas es útil principalmente para impedir el dolor de la inyección. Objetivo general: Evaluar la efectividad de la anestesia tópica, en diferentes presentaciones, en la mucosa oral.Objetivos específicos: Analizar la efectividad de un anestésico tópico tipo gel comparándolo con dos placebos tipo gel. Analizar la efectividad de un anestésico tópico tipo solución líquida y compararlo con dos placebos tipo solución líquida. Analizar y comparar la efectividad de la anestesia tópica en estudiantes de segundo curso de odontología y estudiantes de cuarto curso de odontología. Por último evaluar y comparar la efectividad de un anestésico tópico tipo gel con un anestésico tópico tipo solución líquida.Material y métodos: Este trabajo ha sido diseñado como un ensayo clínico, experimental, controlado, a doble ciego. Se ha realizado un estudio clínico, en estudiantes de segundo y cuarto curso de la licenciatura de Odontología de la Universitat Internacional de Catalunya. Se ha analizado la efectividad del spray de lidocaína al 15% y del gel de benzocaína al 20% en un total de 341 estudiantes de odontología. Se han realizado dos pruebas A y B, en las cuales se han utilizado los mismos anestésicos tópicos, pero diferentes placebos. En la prueba A (186 voluntarios) se ha utilizado como placebo vaselina pura y suero fisiológico y en la prueba B (155 voluntarios) se ha utilizado como placebo gel de fluor y fluor solución. En cada prueba A y B, los participantes forman parejas y entre ellos se aplican los 4 preparados, durante 2 minutos. La zona de aplicación de los preparados y la zona de punción con la aguja de 27G, de longitud de 35 mm, ha sido siempre la misma, en el fondo de vestíbulo a nivel de caninos y premolares en cada cuadrante. Inmediatamente después de cada punción se realiza una valoración del dolor con la escala visual de rostros del dolor.Se ha realizado un análisis estadístico con Statgraphics plus (versión 5.1). Resultados: En el análisis de la varianza para el dolor, se han obteniendo resultados para la prueba A, resultados para la prueba B y una comparación de los resultados de la prueba A y B.El p-Valor para Preparado y el p-Valor para Curso son estadísticamente significativos, en cambio el p-valor para Sexo no es estadísticamente significativo. En el gráfico de interacción entre Preparado y Curso, obtienen menos dolor los voluntarios de segundo curso de odontología que los de cuarto curso

Gingival Bleeding of a High-Flow Mandibular Arteriovenous Malformation in a Child with 8-Year Follow-Up

Intraosseous arteriovenous malformations (AVMs) in the head and neck region are uncommon. There are several types and they can have a wide range of clinical presentations. Depending on the blood flow through the AVM, the treatment may be challenging for the attending team and may lead to life-threatening hemorrhages. A clinical case report is presented. A 9-year-old girl, seen for gingival bleeding during oral hygiene, was found to have a high-flow AVM located within and around the mandible. Two-stage treatment consisted of intra-arterial embolization followed by intraoral injection of a sclerosing agent 8 weeks later. At the 8-year follow-up, imaging study showed no evidence of recurrent lesion inside or outside the bone. The final outcome is a correct occlusion with a symmetric facial result. This case shows that conservative treatment may be the first treatment option mostly in children. Arteriography and transcortical injection were enough to control the AVM

Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy

The problems of suction in newborns give rise to multiple consequences for both the mother and the newborn. The objective of this paper is to present a case of ankyloglossia (“tongue-tie”) and the suction problems that were treated by a multidisciplinary team. The subject is a 17-day-old male patient, with ankyloglossia and suction problems during breastfeeding (pain in the breastfeeding mother, poor weight gain, and long breastfeeds). The patient followed the circuit established in our centre between the services of Oral and Maxillofacial Surgery and Breastfeeding and Speech Therapy and Orofacial Rehabilitation (CELERE). The evolution following the breastfeeding sessions, the myofunctional stimulation, and the lingual frenotomy was very favourable, thereby solving the suction problems that the newborn presented. All our patients receive breastfeeding sessions and myofunctional therapy as treatment. We know that a frenotomy is not always necessary and we believe that the stimulation of sucking before and after the surgical intervention is important in order to improve the final result