Higher oxidative stress in human dental pulp stem cells cultured at 21% O2 compared to 5% O2

Preoperative Evaluation and Treatment Planning. Zygomatic Implant Critical Zone (ZICZ) Location

Association Between Clinical and Microbiologic Cluster Profiles and Peri-implantitis

Purpose: The correlation between associated local factors and peri-implantitis remains unknown. The aim of this study was to investigate the association between the clinical and microbiologic profiles and periimplantitis to eventually categorize different groups of this disease. Materials and Methods: Subjects with at least one implant presenting signs of peri-implantitis were selected. The clinical, radiographic, occlusal, and microbiologic profiles of these infected implants were collected. Cases were classified into five peri-implantitis groups according to potential disease-triggering factors: surgically, prosthetically, biomechanically, purely plaque-associated, and a combination of th…

Uvular paralysis after dental anesthesia

Cranial nerve motor effects resulting from intraoral anesthesia are infrequent but well documented. Facial nerve involvement caused by diffusion of the anesthetic solution towards the parotid can give rise to a transient facial motor defect that tends to disappear as the anesthetic effect wears off.1,2 Facial paralysis lasting for several days has also been related to intraoral anesthesia, possibly due to reflex spasm and ischemic neuritis.1,3 One report described a patient with isolated involvement of the chorda tympani nerve following inferior alveolar injection, associated with dysgeusia.4 Ophthalmologic complications secondary to intraoral anesthesia include transient blindness resultin…

Influence of partial O 2 pressure on the adhesion, proliferation, and osteogenic differentiation of human dental pulp stem cells on β-tricalcium phosphate scaffold

Our purpose was to analyse the influence of O2 pressure on the adhesion, proliferation, and osteogenic differentiation of human dental pulp stem cells (DPSC) on 3-tricalcium phosphate (3-TCP) scaffold. DPSC isolated from extracted third molars were seeded on 3-TCP and cultured under 3% or 21% O2 pressure. Cell adhesion, proliferation, and differentiation over the biomaterial were evaluated at 7, 13, 18, and 23 days of culture. Cell adhesion was determined by light microscopy, proliferation by DNA quantification, and osteogenic differentiation by alkaline phosphatase activity analysis. All DPSC adhered to 3-TCP with both O2 conditions. Cell proliferation values were higher at 3% O2 in each t…

Fibroma cemento-osificante mandibular: presentación de dos casos y revisión de la literatura

Presentamos dos casos clínicos de lesiones radiotransparentes mandibulares en mujeres jóvenes, que simularon patología infecciosa crónica periapical. En ambos el hallazgo fue casual puesto que no produjeron ningún tipo de sintomatología. En un caso se llegó al diagnóstico (tras la cirugía periapical y el estudio anatomo-patológico) después de realizar la endodoncia del diente implicado y comprobar la no resolución del área periapical. En el otro caso, cuya lesión abarcaba el periápice de los 4 incisivos inferiores, se realizó directamente la cirugía tras comprobar la vitalidad pulpar positiva de estos dientes. Con posterioridad a la intervención quirúrgica se realizó la endodoncia de los di…

Activation of p38, p21, and NRF-2 Mediates Decreased Proliferation of Human Dental Pulp Stem Cells Cultured under 21% O2

Summary High rates of stem cell proliferation are important in regenerative medicine and in stem cell banking for clinical use. Ambient oxygen tensions (21% O2) are normally used for in vitro culture, but physiological levels in vivo range between 3% and 6% O2. We compared proliferation of human dental pulp stem cells (hDPSCs) cultured under 21% versus 3% O2. The rate of hDPSC proliferation is significantly lower at 21% O2 compared to physiological oxygen levels due to enhanced oxidative stress. Under 21% O2, increased p38 phosphorylation led to activation of p21. Increased generation of reactive oxygen species and p21 led to activation of the NRF-2 signaling pathway. The upregulation of NR…

Benign paroxysmal positional vertigo as a complication of osteotome expansion of the maxillary alveolar ridge.

Benign paroxysmal positional vertigo (BPPV) is a common vestibular end organ disorder characterized by short, often recurrent episodes of vertigo that are triggered by certain head movements in the plane of the posterior semicircular canals. BPPV may be idiopathic or secondary to a number of underlying conditions such as head injury, viral labyrinthitis, stapes surgery, and chronic suppurative otitis media. 1,2 The most commonly accepted theory postulates the development of BPPV as a result of canalolithiasis, 3 heavy, inorganic particles detached from the otoconial layer by degeneration or head trauma gravitate into the posterior semicircular canal and act as a plunger on the endolymph and…

Extraction of Impacted Maxillary Canines With Simultaneous Implant Placement

When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only option available, followed by implant placement. If apical and ridge crest bone remains after the extraction of the maxillary canines, an immediate implant can be placed. The implant is anchored bicortically with good primary fixation. This article presents a new surgical technique that allows an immediate implant placement after the extraction of the maxillary canines. The full circumference of the implant is left without bone coverage, except for the apical and coronal area. The implant screw threads and the bone defect are covered with the bone shavings collected by the filt…

Acyclovir treatment in 2 patients with benign trigeminal sensory neuropathy

Bifid mandibular canal.

Abstract Purpose: To determine the incidence and characteristics of bifid mandibular canals. Methods: A retrospective study was performed using panoramic radiographs of 2012 patients subjected to dental treatment in the Dental Clinic of the Valencia University Dental School (Valencia, Spain) between 1996 and 1999. The goal was to investigate the presence of double mandibular canals. Results: The extraoral panoramic radiographs revealed a total of 7 images suggestive of bifid canals. Mandibular computed tomography revealed the existence of this anatomic variant in 2 of 3 patients. An analysis was performed on the incidence of this type of image in extraoral panoramic radiography, its possibl…

Pain and swelling after periapical surgery related to oral hygiene and smoking.

Objectives To evaluate pain and swelling during the first week after periapical surgery and its relation to patient age, gender, oral hygiene, and smoking. Study design One hundred two patients (31 men and 71 women) with a mean age of 40.2 years underwent periapical surgery. Age, gender, and oral hygiene and cigarette smoking before and during the postoperative course were noted. Pain and swelling scores were recorded on a descriptive 4-point scale at 2, 6, and 12 hours after surgery, and each day thereafter for 1 week. The data were statistically evaluated for significant differences. Results The highest intensity of pain occurred during the first 48 hours, and swelling peaked on the secon…

Surgical treatment of localized gingival recessions using coronally advanced flaps with or without subepithelial connective tissue graft.

Background A coronally advanced flap with subepithelial connective tissue graft is the gold standard surgical treatment of gingival recessions, since it offers a higher probability of achieving complete root coverage compared with other techniques. However, optimum short- and middle-term clinical results have also been obtained with coronally advanced flaps alone. The aim of the present study was to evaluate the results obtained by the surgical treatment of localized gingival recessions using coronally advanced flaps with or without subepithelial connective tissue graft. Material and Methods The reduction of recession height was assessed, together with the gain in gingival attachment apical…

Immunohistochemical study of Langerhans cells in periapical lesions: correlation with inflammatory cell infiltration and epithelial cell proliferation.

Aim: The aim of this study is to determine the presence and distribution of Langerhans cells in periapical lesions, and correlate this with inflammatory cell infiltration and epithelial cell proliferation. Material and Methods: Seventy chronic dental periradicular lesions, obtained during periapical surgery from 70 patients, were included in this study, including: 46 granulomas, 18 scar tissue and 6 periradicular cysts. Immunohistochemical staining was performed using the following markers: CD3 to analyze the inflammatory infiltrate, CD1a to determine the presence of Langerhans cells and Ki67 to analyze the epithelial cell proliferation. The CD1a immunostaining density was established follo…

Analysis of the peri-implant microbiota in 90 dental implants and its relationship to crevicular fluid volume

Objective: To evaluate the presence within the peri-implant sulcus of Tannerela forsythia (Tf), Porphyromonas gingivales (Pg), Treponema denticola (Td) and Aggregatibacter actinomycetemcomitans (Aa), and relate these bacteria to the peri-implant crevicular fluid volume (PICFV). Material and Method: A prospective and cross-sectional clinical case series study was made. For the measurement of crevicular fluid, use was made of the Periotron ® 8000 (Proflow Incorporated. New York, USA), measuring the volume in Periotron units (PU). For the detection of periodontopathogenic bacteria we used the IAI-PadoTest 4.5 (IAI Inc., IAI Institute, Zuchwil, Switzerland) - a system for the detection of Tf, P…

Intentional replantation for the management of maxillary sinusitis.

AIM: To present a case that emphasizes the importance of the use of intentional replantation as a technique to successfully treat a periapical lesion and an odontogenic maxillary sinusitis through the alveolus at the same time. SUMMARY: This case report presents a patient with odontogenic maxillary sinusitis secondary to periapical disease of a maxillary molar that had previously received root canal treatment. The molar was extracted, with drainage and rinsing of the maxillary sinus. The apices were resected extra-orally, the retrograde cavities prepared with ultrasound and retrograde fillings of silver amalgam placed. The tooth was then replanted. After 2 years, the patient was asymptomati…

Idiopathic Trigeminal Neuropathies: A Presentation of 15 Cases

Purpose The aim of this study is to present a clinical series of patients with trigeminal neuropathy and their treatment. Patients and Methods We present a retrospective study of 15 cases of idiopathic trigeminal neuropathies, with unilateral involvement of 1 or more divisions of the trigeminal nerve. The clinical, radiologic, and laboratory data of the patients, in addition to the treatment and clinical evolution, were reviewed. The patients were followed up for a mean of 34.4 months (range, 12-120 months). Results The study consisted of 11 women and 4 men. The numbness was predominantly located in the innervated mental area and extended in some cases to the first and second trigeminal div…

Side effects and complications of intraosseous anesthesia and conventional oral anesthesia

Objective: To analyze the side effects and complications following intraosseous anesthesia (IA), comparing them with those of the conventional oral anesthesia techniques. Material and method: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for respective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Heart rate was recorded in all cases before injection of the anesthetic solution and again 30 seconds after injection. The …

Clinical and microbiological findings in patients with peri-implantitis: a cross-sectional study

Objective The aim of this study was to analyze clinical and microbiological characters in subjects and implants affected and not affected by peri-implantitis. Additionally, same features were analyzed also intra-individually, comparing healthy and diseased implants within the same subject. Materials and methods A total of 534 patients who received at least 1 implant and coming to routine check-up or spontaneous visits at the University of Valencia were recruited. Clinical parameters including Bleeding on probing (BoP), Probing pocket depth (PPD), and Pi were screened. Samples for microbiological analysis were obtained from three locations: peri-implant sulci (PIS), inner parts of the implan…

Comparative study between manual injection intraosseous anesthesia and conventional oral anesthesia.

Objective: To compare intraosseous anesthesia (IA) with the conventional oral anesthesia techniques. Materials and methods: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for res-pective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Results: A total of 200 oral anesthetic procedures were carried out in 100 patients. The mean patient age was 28.6±9.92 years. Fifty-five vestibular infiltrations and 45 mandibular blocks we…

Treatment of orofacial pain in patients with stylomandibular ligament syndrome (Ernest Syndrome).

Introduction: Ernest syndrome involves the stylomandibular ligament. It is characterised by pain in the preauricular area and mandibular angle, radiating to the neck, shoulder, and eye on the same side, and associated with pain during palpation of that ligament. The purpose of this study is to describe the clinical characteristics, treatment, and course of the disease in a series of patients with Ernest syndrome. Methods: Retrospective observational study covering the period from 1998 to 2008. We recorded patients’ age, sex, duration of the disorder, and pain characteristics. All patients were injected with 40 mg triamcinolone acetonide at the mandibular insertion of the stylomandibular lig…

Influence of different types of pulp treatment during isolation in the obtention of human dental pulp stem cells

Background: Different methods have been used in order to isolate dental pulp stem cells. The aim of this study was to study the effect of different types of pulp treatment during isolation, under 3% O 2 conditions, in the time needed and the efficacy for obtaining dental pulp stem cells. Material and Methods: One hundred and twenty dental pulps were used to isolate dental pulp stem cells treating the pulp tissue during isolation using 9 different methods, using digestive, disgregation, or mechanical agents, or combining them. The cells were positive for CD133, Oct4, Nestin, Stro-1, CD34 markers, and negative for the hematopoietic cell marker CD-45, thus confirming the presence of mesenchyma…

Correcting loss of a papilla following orthodontic space opening (Atherton's patch) through implant supported rehabilitation. A case report

The objective of this case report is to describe a surgical and prosthetic technique to create a lost papilla following orthodontic space opening (Atherton´s patch) through implant supported rehabilitation. A switching platform implant was used to replace a left maxillary canine in a unitary interdental edentulous ridge with Atherton´s patch in the distal area of the upper lateral left incisor. The radiographic study revealed correct level of the interproximal bone of the adjacent teeth. A mucoperiosteal flap with crest incision and sulcular extension to the adjacent teeth was made. Special attention was paid to correct position of the implant and the distance (≥ 1.5 mm) between the platfor…

Manifestaciones orales en la histiocitosis crónica diseminada: presentación de 10 casos

La histiocitosis crónica diseminada es una enfermedad sistémica por proliferación tumoral de células histiocitarias tipo Langerhans. Su etiología y patogenia no esta del todo aclarada y las manifestaciones clínicas se producen por acúmulos e infiltrados de este tipo celular en los tejidos y órganos. Presentamos 10 pacientes, seis niños y cuatro niñas, con histiocitosis crónica diseminada. La edad de aparición de la enfermedad varió desde los 4 meses hasta los 3'2 años, con una edad media de 1'7 años. Todos los pacientes presentaron lesiones orales y en 5 de ellos éstas fueron la manifestación inicial de la enfermedad. Las alteraciones más frecuentes fueron: sangrado gingival (7 casos), afta…

On the search of the ideal barrier membrane for guided bone regeneration

Background GBRs are essential procedures in implant dentistry and periodontology where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes function the same way, as they differ from their origin and structure, it is important to understand how membranes behave and differ one from others in order to achieve a predictable treatment. Material and methods A systematic search on Medline by two independent reviewers was performed for articles published until July 2017 reporting the characteristics or properties of barrier membranes. The question that preceded the search was designed according to PICO rules. Results A total of 124 articles…

Post-traumatic trigeminal neuropathy. A study of 63 cases.

Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not a…

Tratamiento del dolor orofacial en pacientes con síndrome del ligamento estilomandibular (síndrome de Ernest)

Resumen: Introducción: El síndrome de Ernest se define como una alteración del ligamento estilomandibular, caracterizado por la presencia de dolor en la región preauricular y en el ángulo mandibular, irradiado al cuello, el hombro y el ojo del mismo lado, asociado a dolor durante la palpación del ligamento estilomandibular. El objetivo es presentar las características clínicas, el tratamiento y la evolución de una serie de pacientes con el síndrome de Ernest. Métodos: Se realizó un estudio clínico, observacional, retrospectivo, entre los años 1998 y 2008. Se recogieron todos los datos con respecto a la edad, el sexo, el tiempo de evolución y las características del dolor. A todos los pacien…

Lower-half facial migraine: a report of 11 cases.

Purpose Vascular pain of the face constitutes a variant of pain of the head, and includes migraine, cluster headache, paroxysmal hemicrania, and a facial variant of the so-called lower-half migraine. Lower-half facial migraine is a condition difficult to classify; according to the international classifications it could not be found as an individual entity. The objective of the present study is to determine the difficulties we encountered in diagnosis, the ineffective treatments provided, and the pharmacologic treatment effect. Patients and methods A study is made of 11 cases of lower-half facial migraine, corresponding to 10 women and 1 man (mean age, 35 years), commenting on the clinical c…

Oral metamizol (1 g and 2 g) versus ibuprofen and placebo in the treatment of lower third molar surgery pain: randomised double-blind multi-centre study

Objective: To assess the efficacy of metamizol 1 g and 2 g in the relief of pain after surgical extraction of the lower third molar, and to compare the therapeutic effect with that of ibuprofen 600 mg or placebo.