Digital repair for a patient with limited mouth opening: a case report and literature review / 口腔疾病防治

Objective@#To explore an accurate method to obtain an intraoral model of patients with specific limited mouth opening (microstomia) due to systemic scleroderma.@*Methods@#This study followed medical ethics, and informed consent has been obtained from patients. A case of Ken's Type I mandibular dentition defect scleroderma with limited mouth opening was addressed with digital technology as the leading method combined with the traditional impression method of segmental impression. Individual trays were made based on the patient's left and right mandibular dentition, and segmented molds were obtained. Simultaneously, intraoral scanning was performed to obtain the morphological data of both the soft and hard tissues of the upper and lower mandibles. After each part of the model was obtained, the mandibular model was scanned and digitally aligned to form the final denture model, and the final removable partial denture was designed and made by computer aided design/computer aided manufacturing (CAD/CAM) technology. At the same time, combined with the literature, the diagnosis and treatment of removable partial denture in patients with limited mouth opening were retrospectively analyzed.@*Results@#The denture was well retained and achieved a good repair effect. The patients expressed satisfaction with the mastication efficiency and other functions of the denture. The findings of the literature review show that the integration of digital technology with the traditional impression method, along with computer fitting, can accurately obtain the patient's oral model and facilitate successful follow-up repairs. However, when the anterior mandibular dentition of the patient is absent, the margin of error is increased in this procedure, which deserves further exploration.@*Conclusion@#Utilizing digital technology as the leading method, combined with the traditional impression method of segmental impression, for the repair of dental defects in patients with limited mouth opening, has proven to be effective. Thus, patients report a positive medical experience with high satisfaction, indicating that this approach is worthy of clinical promotion.

Epidermoid cysts of the orofacial region: A clinico-pathological study of 13 cases with review of literature

Background: Epidermoid cysts (ECs) are uncommon benign cystic lesions derived from the germinative epithelium. Head and neck ECs constitute only 7% of all ECs whereas only 1.6% are seen intraorally. The floor of the mouth is the commonest intraoral site whereas tongue, lips, buccal mucosa, and jaws are less commonly involved intraoral sites. To date, very few large case series of ECs of head and neck have been published. To the best of our knowledge, this is the third-largest case series of 11 intraoral ECs along with 2 extra-oral cases in the pre-auricular region. Aims: To highlight the typical and atypical features of ECs in the common as well as rare sites and draw attention to its consideration as a differential diagnosis for head and neck masses. Settings and Design: Archival data of 13 histopathological cases identified as ECs were analyzed from the Department of Oral Pathology at a tertiary dental hospital and college in New Delhi from 2007 to 2020. Materials and Methods: The demographic, clinical, radiographic, histopathological features, and treatment modalities were recorded and analyzed. Statistical Analysis Used: Appropriate statistical tests were used. Results: The study found strong male predilection in the ratio of 10:3 with an average age of presentation as 28 years. The pre-auricular region and floor of the mouth were the common sites involved followed by buccal mucosa, lips, and jaws. All patients presented with slowly growing swelling with dysphagia, dyspnea, and dysphonia seen in larger cysts on the floor of the mouth. Microscopically, all cases were lined with stratified squamous epithelium filled with laminated layers of keratin. Two cases showed the presence of melanin. One case showed recurrence even after complete surgical excision. Conclusion: ECs, though a rare entity, should be considered in differential diagnosis for head and neck masses and require close follow-up due to their potential for malignant transformation.

Factors influencing the accuracy of intraoral impression in implant restoration / 口腔疾病防治

@#Due to advances in digital technology, intraoral impressions have been increasingly used to fabricate implant restorations because of its simplicity, high efficiency, comfortableness and convenience. In clinical practice, the accuracy of intraoral impressions depends on various factors, including scanner technique, status of dentition and implants, auxiliary devices, materials and environment, which might influence its accuracy and limit its application. When applied to patients missing more teeth, its accuracy may be insufficient. It is suggested that intraoral impressions be used cautiously when there are multiple and far apart implants and that the scan body not be tightened excessively and that maintain appropriate environmental conditions. In this article, we have reviewed recent relevant literature and the factors affecting the accuracy of intraoral impressions for implant restoration.

A comparative study of the clinical application of anatomical healing abutments versus finished healing abutments for mandibular first molar implants / 口腔疾病防治

Objective @#To evaluate the effect of anatomical healing abutments for mandibular first molars on the morphological changes of gingival soft tissue after implant restoration, as well as on peri-implant gingival molding, food ingrowth and patient satisfaction, to provide a basis for clinical selection. @*Methods @# Twenty-six patients who received implant restoration for a single missing mandibular first molar between September 2020 and September 2021 at the Oral Implant Center of Changsha Stomatological Hospital were randomly divided into a control group (13 cases with 14 implants) and a trial group (13 cases with 14 implants), of which 12 were male and 14 were female; the trial group had anatomical healing abutments applied for 4 weeks and then underwent crown restoration, while the control group finished five time points (before the second stage surgery, 4 weeks after the second stage surgery, immediately after the crown restoration, 4 weeks after the crown restoration, and 12 weeks after the crown restoration). A 3Shape intraoral scanner was used to scan the jaw before and 4 weeks after the second stage surgery to quantify the soft tissue changes and compare the effect of the healing abutment on gingival molding between the two groups. The incidence of food impaction was recorded and compared between the two groups at 4 weeks and 12 weeks after crown restoration. Patient satisfaction was recorded and compared between the two groups immediately after crown restoration, 4 weeks after crown restoration and 12 weeks after crown restoration@*Results @# Four weeks after implant surgery, it was observed that the gingival proximal and distal gingival papillae increased on the coronal side in the test group compared to the control group, 0.50 (0.26, 0.72) mm in the near-medium test group and 0.27 (0.24, 0.38) mm in the control group, with a statistically significant difference (P = 0.029), and 0.48 (0.26, 0.62) mm in the far-medium test group and 0.23 (0.13, 0.39) mm in the control group, with a statistically significant difference (P = 0.004). There was no statistically significant difference (P>0.05) in the buccolingual to gingival margin apex to coronal molding or in the buccolingual to lingual soft tissue at 0, 1, or 2 mm of the root of the middle 1/3 apex of the buccal and lingual gingival margins between the two groups. Compared to the control group, there was no statistically significant difference in the incidence of food impaction observed 4 weeks and 12 weeks after crown restoration in the test group (P>0.05). The satisfaction scores were higher in the trial group than in the control group immediately, 4 weeks, and 12 weeks after crown restoration, and the difference between the groups was statistically significant (P < 0.05). @*Conclusion @# The anatomical healing abutment for the implant mandibular first molar was superior to the finished healing abutment in terms of soft tissue contouring with an increase in the coronal aspect of the proximal and distal gingival papillae, resulting in high patient satisfaction.

Study of tooth drifts after orthodontic extractions in cases of interruption / 口腔疾病防治

Objective @# To compare the tooth drift differences between different types of patients after orthodontic extraction for 1.5 months (45 days) without return to the clinic on time for some reasons.@*Methods@#This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A total of 84 patients had bilateral premolars extracted but were not bonded the bracket for some reasons. The upper and lower jaw dental models were cast, scanned, and reconstructed in 3D. Patients were divided into 12 groups based on extraction positions (first premolar or second premolar), jaw types (maxilla or mandible) and vertical facial types (average angle, high angle, or low angle). Multivariate analysis of variance was used to analyze the changes in the following five indicators in different types of patients who were interrupted for 1.5 months after extraction: anterior tooth crowding, width between canines, width between first molars, tooth extraction space, and overbite of anterior teeth. @*Results @#The tooth extraction position, jaw type and vertical facial type had an effect on the reduction in tooth extraction space and anterior tooth crowding before and after the sudden emergent state (1.5 months after tooth extraction) (P<0.001), and the tooth extraction position and vertical facial type had an effect on the increase in anterior tooth overbite (P<0.001). The drift of bilateral adjacent teeth was greater in patients with first premolars extracted than in those with second premolars extracted (P<0.001), and the drift of bilateral adjacent teeth in the maxilla was larger than that of the mandible (P<0.001). The drift of bilateral adjacent teeth in patients with high angles was more obvious than that of patients with average angles and low angles (P<0.001). @* Conclusion@# For orthodontic patients who have maxillary tooth extraction, first premolar extraction, and even high angles in the vertical facial type, the bilateral adjacent teeth are easier to drift, orthodontic treatment should be carried out soon after extraction, and attention should be given to anchorage control.

A study on the application of intraoral camera in the identification of oral anatomical landmarks / 北京大学学报(医学版)

OBJECTIVE@#To preliminarily explore the applicable scenarios of an intraoral camera to assist oral anatomical landmarks recognition, so as to improve the clinical diagnosis and treatment mode, cultivate the concept of caring for patients, strengthen doctor-patient communication, assist experts to teach, and improve the clinical diagnosis and efficacy rate.@*METHODS@#A new type of an intraoral camera was applied in the recognition of oral anatomy landmarks and four application scenarios were developed, namely: (1) clinical diagnosis and treatment scenarios, in which doctors used intraoral camera to conduct a comprehensive examination of patients in the mouth and take videos and photos; (2) doctor-patient communication scenarios, when the doctor told the patient about the treatment plan, the video or photo taken by the intraoral camera was displayed to the patient; (3) expert teaching scenarios, when the expert used an intraoral camera to teach in the patient's mouth, and the young doctor learned oral anatomical signs on the projection screen, with the study of theoretical lessons; (4) difficult case recording scenarios, in the process of clinical diagnosis and treatment, when encountering difficult cases, you could use intraoral camera to record and take photos for young doctors to discuss, and experts to comment and guide.@*RESULTS@#The application of intraoral camera could: (1) improve the clinical diagnosis and treatment mode and raise the clinical diagnosis and efficacy rate; (2) stimulate young doctors' interest in learning, use intraoral camera in assessments, and skillfully combine theoretical knowledge of anatomical landmarks with clinical practice, so as to improve the teaching effect; (3) cultivate, through self or mutual use, the concept of caring for patients and reinforce the importance of gentle operation; (4) strengthen doctor-patient communication. Doctors could communicate with patients more visually, so that the patients could better understand their own situation, and strengthen the patients' trust in the doctors.@*CONCLUSION@#Intraoral camera can assist oral clinical diagnosis and treatment, such as the recognition of oral anatomical landmarks. It plays a certain role in promoting the improvement of clinical diagnosis and treatment mode, stimulating learning interest, cultivating the concept of caring for patients, and enhancing doctor-patient communication.

Intraoral device for sociodigital inclusion of patient with quadriplegia / Dispositivo intraoral para inclusão sócio-digital de paciente com tetraplegia

Introduction: The use of computers, tablets, and cell phones with the Internet by people with quadriplegia from spinal cord injuries is much lower when compared to the general population. The quality of life of these people can be substantially improved through access to these technologies, which would allow a quadriplegic to take advantage of the rapid evolution of information and communication. Many of these individuals have the function of preserved neck and mouth muscles, and it is possible to manipulate intraoral devices as an adaptation tool. Case Report: We report an intraoral device installation in a patient with quadriplegia, a victim of a firearm accident, who had a great desire to reuse the tablet for internet access. A device made of acrylic resin, similar to a myorelaxant plate, was designed to allow the use of a computer that was comfortable and at the same time, the patient could talk and not harm the dental structures. The person responsible agreed to participate in the research and signed the consent form. In addition, the work was submitted to an ethics committee. Considerations: The ideal intra-oral device for patient rehabilitation should be inexpensive, easy to adapt and promote muscle relaxation besides allowing the patient to expand their abilities and digitally increase their autonomy for society.

Introdução: O uso de computadores, tablets e celulares com internet por pessoas com tetraplegia por lesão medular é muito menor quando comparado à população geral. A qualidade de vida dessas pessoas pode ser, substancialmente, melhorada por meio do acesso a essas tecnologias, o que permitiria aos tetraplégicos aproveitar a rápida evolução da informação e da comunicação. Muitos desses indivíduos têm a função de músculos cervicais e bucais preservados, sendo possível a manipulação de dispositivos intraorais como ferramenta de adaptação. Relato de Caso: Relatamos a instalação de um dispositivo intraoral em um paciente com tetraplegia, vítima de acidente com arma de fogo, que tinha grande desejo de reutilizar o tablet para acesso à internet. Um dispositivo feito de resina acrílica, semelhante a uma placa miorrelaxante, foi projetado para permitir o uso de um computador que fosse confortável e, ao mesmo tempo, o paciente pudesse falar e não prejudicar as estruturas dentárias. O responsável concordou em participar da pesquisa e assinou o termo de consentimento. Além disso, o trabalho foi submetido a um comitê de ética. Considerações: O dispositivo intraoral ideal para a reabilitação do paciente deve ser barato, de fácil adaptação e promover o relaxamento muscular, além de permitir que o paciente amplie suas habilidades e aumente sua autonomia pessoal, digitalmente para a sociedade.

Aparelhos de registro tipo "George Gauge" para posição mandibular terapêutica em aparelhos intra-orais para ronco primeiro e síndrome obstrutiva da apneia e hiponeia / Obstrutiva do sono (SHAOS) type recording devices "George Gauge" recording devices for therapeutic mandibular position in intraoralappliances for snoring first and obstructive sleepapnea hyponea syndrome (SHAOS)

As multifatoriedades do aumento da SHAOS têm diversas causas, desdês de obesidades até sedendarismo de grande proporção. No entanto a ciência tem feito grandes esforços para isso se altere. Mesmo assim muito tem que se pesquisar para um tratamento efetivo que seja capaz de ajudar o paciente a ter um sono reparador e uma qualidade de vida mais satisfatória. A sofisticação dos CPAP, melhores alternativas para o tratamento se sofisticaram de tal em volume, barulho e tamanho que estão aumentanto em muito sua utilização. Os mini-cpaps são uma prova disso. No entanto ainda nos confrontamos com a baixa adesão do tratamento frente ao desconforto causado. Ao aparelhos intra-orais são uma alternativa viáveis para os casos de IAH (índice de apneia e hipopneia) leve, moderada e ronco primário. Importante frisar que sem um exame de polissografia e teleradiografias laterais o Cirurgião Dentista não pode fazer nada(AU)

The multifactorial causes of the increase in SHAOS have several causes, from obesity to a large sedentary lifestyle. However science has made great efforts to change this. Even so, much remains to be researched for an effective treatment that is capable of helping the patient to have a restful sleep and a more satisfactory quality of life. The sophistication of CPAP, the best alternatives for treatment, has become so sophisticated in volume, noise and size that its use is greatly increasing. The mini-cpaps are proof of that. However, we are still faced with the low adherence to the treatment due to the discomfort caused. Intraoral appliances are a viable alternative for cases of mild, moderate AHI (apnea and hypopnea index) and primary snoring. It is important to emphasize that without a polysomnography exam and lateral teleradiographies, the Dental Surgeon cannot do anything(AU)

SCHWANNOMA TONGUE: TWO CASE REPORTS

Schwannoma of the tongue is a relatively rare tumor of the head and neck. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base of tongue. In this article we report two cases of schwannoma in young adult presented with painless swelling of the tongue. Lesion was completely excised via an intraoral approach and confirmed as schwannoma tongue in histopathology.

A comparative study of conventional and Hall techniques of crown placement using finite element stress analysis

Background: Hall technique of crown placement causes the changes in vertical occlusal dimension; the mode of settlement of which needs to be explored. Aim: To assess and compare the changing patterns of stress distribution following placement of stainless steel crowns on primary teeth by Hall and conventional techniques using a finite element model analysis. Materials and Methods: The clinical crown heights of primary molars restored with Hall and conventional techniques and opposing teeth in contact, vertical dimension changes in the primary canine area were measured using intraoral digital scan. T-scan was used to measure the changes in bite force while the finite element analysis was used to assess deformative changes on the 2nd, 5th, 10th, and 15th days. Results: The Hall technique of crown placement caused more stress distribution in the tooth supporting tissues that settled in 2 weeks as compared with conventional technique of crown placement in which settlement occurred in 2 days. Conclusion: The settling of vertical occlusal dimension as well as stress distribution in Hall technique probably takes place by intrusion of crowned tooth and opposing teeth in contact.

Avaliação da acurácia dos modelos dentários digitais obtidos para cirurgia ortognática / Assessment of the accuracy of digital dental models obtained for orthognathic surgery

O objetivo deste estudo laboratorial foi avaliar a acurácia dos modelos digitais obtidos por duas técnicas de escaneamento (escâner intraoral - Itero 5d Element® - e escâner de bancada -Straumann ®) de um modelo experimental (Nacional Ossos ®) da arcada superior confeccionada em poliuretano e do modelo de gesso obtido desta arcada. Os pontos A ­ 3mm acima do elemento 17; B ­ 3mm acima do elemento 14; C ­ 3mm acima do elemento 24; D ­ 3mm acima do elemento 27; E ­ cúspide mesiovestibular do elemento 16; F - ponto de contato mais incisal entre os elementos 11 e 21; G - Cúspide mesiovestibular do elemento 26 foram utilizados como referência para as medidas realizadas. As medidas foram realizadas em um software (Geomagic®) de simulação cirúrgica e analisadas quanto a validade e precisão das técnicas de escaneamento utilizadas em todos os grupos (1 a 5). O grupo 1 corresponde ao grupo padrão-ouro; o 2 ao grupo do escaneamento com escâner intraoral do modelo de poliuretano; o 3 ao escaneamento de bancada do modelo; o 4 ao escaneamento com escâner intraoral do modelo de gesso; e 5 ao escaneamento de bancada do modelo de gesso. Na análise da validação, todas as técnicas apresentaram-se válidas quando comparadas ao grupo controle com exceção da medida FG que apresentou diferenças estatisticamente significativas (p<0,05) entre os grupos 1 e 2. A precisão foi avaliada através do índice de correlação intraclasse (CCI) e todas as técnicas apresentaram-se altamente precisas com (CCI) próximo de 1. Desta forma, conclui-se que o escâner intraoral e o escâner de bancada utilizados neste estudo foram confiáveis quando comparados ao grupo controle e que os dois modelos de escâner utilizados se apresentaram com alta precisão (AU).

The objective of this experimental study was to evaluate the accuracy of digital models generated by two scanning techniques (intraoral scanner - Itero 5d Element® - and desktop scanner -Straumann ®) of an experimental model of the upper arch (Nacional Ossos ®) made of polyurethane and the plaster model obtained from this arch. Points A ­ 3mm above element 17; B ­ 3mm above element 14; C ­ 3mm above element 24; D ­ 3mm above element 27; E ­ mesiobuccal cusp of element 16; F - most incisal point of contact between elements 11 and 21; G - Mesiobuccal cusp of element 26 were used as a reference for the measurements performed. The measurements were performed in a surgical simulation software (Geomagic ®) and analyzed for the validity and precision of the scanning techniques used in all groups (1 to 5). Group 1 corresponds to the gold standard group; 2 to the scanning group with intraoral scanner of the polyurethane model; 3 to the desktop scan of the model; 4 to intraoral scanner scanning of the plaster model; and 5 to the desktop scan of the plaster model. In the validation analysis, all techniques showed to be valid compared to the control group, except the FG measure, which showed statistically significant differences (p<0.05) between groups 1 and 2. Precision was assessed using the intraclass correlation(ICC) index, and all techniques were highly accurate with an ICC close to 1. Thus, it is concluded that the intraoral scanner and the bench scanner used in this study were reliable compared to the control group and that the two scanner models used presented themselves with high precision (AU).

3D Printing in Dental Science / Impresión 3D en la Ciencia Odontológica

3D printing is a technology that describes a manufacturing process previously planned and designed in a computer to create an object 1,2. This technology was introduced in dentistry by Chuck Hull since 1986 and allowed the automation and thus improved dental workflow 2. Technologies used in 3D printing involves: Stereolithography (SLA), bioprinting, fused deposition modeling (FDM), selective laser sintering (SLS), and PolyJet printing. We can choose one of them depending on the clinical use and material, need of accuracy among others. To 3D printing you need to use a scanner with an integrated software in order to capture the 3D images of the object being scanned. Those 3D images are stored in Standard Tessellation Language (STL) file 3. But what "Tessellation" means? Tessellation is the covering process of a surface, using one or more geometric shapes, with no overlaps and no gaps. It meansthat the object scanned is copied in detail with high reliability and then can be printed.

La impresión 3D es una tecnología que describe un proceso de fabricación previamente planificado y diseñado en un computador para crear un objeto. Esta tecnología fue introducida en odontología por Chuck Hull desde 1986 y permitió la automatización y, por lo tanto, mejoró el flujo de trabajo del consultorio. Las tecnologías utilizadas en la impresión 3D incluyen: estereolitografía (SLA), bioimpresión, modelado por deposición fundida (FDM), sinterización selectiva por láser (SLS) e impresión PolyJet. Podemoselegir uno de ellos dependiendo del uso clínico y material, necesidad de precisión entre otros.Para la impresión 3D, debe usar un escáner con un software integrado para capturar las imágenes 3D del objeto que se escanea. Esas imágenes 3D se almacenan en el archivo de Lenguaje estándar de teselado (STL). Pero, ¿qué significa "Teselado"? El teselado es el proceso de recubrimiento de una superficie, utilizando una o más formas geométricas, sin superposiciones ni espacios. Significa que el objeto escaneado secopia en detalle con alta confiabilidad y luego se puede imprimir.

Anterior aesthetic restoration with ultrathin porcelain veneers on asymmetric faces assisted by a four-dimensional smile design: a case report and literature review / 口腔疾病防治

Objective@#To explore the application effect of a four-dimensional smile design as the leading and facial streamline as the reference system in the aesthetic restoration of anterior teeth.@*Methods@# A case of scattered space in anterior teeth was treated with a four-dimensional smile design and digital aesthetic restoration with ultrathin porcelain veneer. The digital information of the patients was obtained through oral and facial scanning, and a four-dimensional smile design and prediction were carried out. After the treatment plan was jointly determined by doctors and patients, minimally invasive abutment preparation was carried out, and ultrathin porcelain veneer was made and bonded in place. After the operation, the esthetic degree and marginal fit were observed and reexamined one year after the repair.@* Results @#The edges of the ultrathin ceramic veneers were naturally tight, and the color was coordinated, with satisfying pink and white esthetics. The face was more harmonious and natural when smiling. One year after the restoration, the facial aesthetics were wonderful, the abutment teeth and periodontal tissues were healthy, and the patients were satisfied. The results of the literature review showed that the fitting of temporal facial scanning and intraoral scanning data can accurately predict four-dimensional smile aesthetics, simulate the real state of the dynamic smile and pronunciation process, and combine it with facial streamlines to design a natural and coordinated personalized smile for patients with asymmetric faces. However, for patients with occlusal changes, unstable occlusion or temporomandibular joint disorder, it is necessary to add data fitting, such as electronic facial arch and cone beam CT, to more accurately simulate postoperative mandibular movement.@*Conclusion@# With a four-dimensional smile design as the leading and facial streamline as the reference system, the whole process digital design assisted the restoration of asymmetric anterior teeth with ultrathin porcelain veneer and had a good effect. The postoperative smiling of patients is harmonious and beautiful, which is in line with the expected effect. Patient participation and satisfaction are high; thus, this method is worthy of clinical promotion.

Dental stem cells in intraoral regenerative therapy: a systematic review / Células-tronco dentárias na terapia regenerativa intraoral: uma revisão sistemática

Objective: 1) To critically review the published literature on applications of dental stem cells in the regeneration of intraoral tissues. 2) To provide an evidence-based level on research regarding application of dental stem cells in intraoral tissues regeneration. Methodology: This systematic review is conducted as per the JBI guidelines and reported as per the PRISMA. An initial literature search of papers published between 2004 and 2018 yielded 421 manuscripts. Nineteen studies satisfied the inclusion / exclusion criteria and were included for qualitative synthesis. Studies were categorized as animal (11) and human (8) trials. Five independent reviewers critically assessed the included studies. Risk of bias was assessed using SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) bias risk tool, robins-I tool for non-randomised clinical trial and Cochrane Collaboration's Tool for randomised clinical trial. Evidence levels were assessed based on JBI Criteria. Results: Animal trials mainly focused on periodontal regeneration. A high or unclear Risk of bias was more commonly found amongst animal studies. Laboratory, clinical and radiographic evaluation were used to assess the outcome. A total of Eight Human studies were conducted on a total samples size of 153 upon a wide age ranging from seven years to 60 years. Nearly 70% of the human studies used DPSC for regenerating alveolar bone defects. Conclusion: Appropriate well designed double-blind randomized clinical trials of longer duration are yet to be performed. Evidence for the included studies were 1C and 1D as per the JBI Criteria. Stem cell therapy demonstrated promising results in Periodontal tissue and alveolar bone regeneration. However, the number of studies to claim such a benefit are very limited (AU)

Objetivo: 1) Revisar criticamente a literatura publicada sobre aplicações de células-tronco dentárias na regeneração de tecidos intraorais. 2) Fornecer um nível baseado em evidências sobre pesquisas relacionadas à aplicação de células-tronco dentárias na regeneração de tecidos intraorais. Metodologia: Esta revisão sistemática é conduzida de acordo com as diretrizes do JBI e relatada de acordo com o PRISMA. Uma pesquisa bibliográfica inicial de artigos publicados entre 2004 e 2018 resultou em 421 manuscritos. Dezenove estudos satisfizeram os critérios de inclusão / exclusão e foram incluídos para síntese qualitativa. Os estudos foram categorizados como ensaios em animais (11) e humanos (8). Cinco revisores independentes avaliaram criticamente os estudos incluídos. O risco de viés foi avaliado usando a ferramenta de risco de viés do Centro de Revisão Sistemática para Experimentação com Animais de Laboratório (SYRCLE), a ferramenta robins-I para ensaios clínicos não randomizados e a Ferramenta da Colaboração Cochrane para ensaios clínicos randomizados. Os níveis de evidência foram avaliados com base nos critérios JBI. Resultados: Os ensaios em animais focaram principalmente na regeneração periodontal. Um risco alto ou pouco claro de viés foi mais comumente encontrado entre os estudos com animais. Avaliações laboratorial, clínica e radiográfica foram utilizadas para avaliar o resultado. Um total de oito estudos em humanos foram conduzidos em um tamanho total de amostras de 153 com ampla faixa etária, variando de sete a 60 anos. Quase 70% dos estudos em humanos usaram DPSC para regeneração de defeitos ósseos alveolares. Conclusão: Ensaios clínicos randomizados duplo-cegos apropriados e bem elaborados de maior duração ainda precisam ser realizados. As evidências para os estudos incluídos foram 1C e 1D de acordo com os critérios JBI. A terapia com células-tronco demonstrou resultados promissores na regeneração do tecido periodontal e do osso alveolar. No entanto, o número de estudos para reivindicar tal benefício é muito limitado (AU)

Persistent Idiopathic Dentoalveolar pain. Literature review and clinical case treated with intraoral application of Botulinum toxin / Dolor Idiopático Dentoalveolar Persistente (DIDAP). Revisión de literatura y caso clínico tratado con aplicación intraoral de toxina Botulínica

ABSTRACT: Persistent Idiopathic Dentoalveolar Pain (PIDAP) is an orofacial neuropathic pain, which can be difficult to diagnose and is usually accompanied by increasing anxiety from both the patient and the treating dentist. A case of a 38-year-old female patient is presented, and it is shown the diagnostic process and therapeutic approach. The interdisciplinary management accompanied by several pharmacological lines is highlighted: Botulinum toxin was used as an adjunctive treatment allowing it to decrease systemically administered medications dosing and therefore its possible side effects. This condition usually affects psychosocial aspects of the patient and has a major impact on his quality of life. It is very important before initiating an invasive clinical treatment, obtaining a clear differential diagnosis and assessing in some cases the presence of non-odontogenic pain, such as PIDAP.

RESUMEN: El Dolor Idiopático Dentoalveolar Persistente (DIDAP), es un dolor neuropático orofacial, que puede resultar difícil de diagnosticar y generalmente se acompaña de creciente angustia tanto de parte del paciente como también del odontólogo tratante. Se presenta un caso de una paciente femenina de 38 años en donde se demuestra el proceso diagnóstico y abordaje terapéutico. Se resalta el manejo interdisciplinario acompañado de varias lineas farmacológica: la toxina Botulínica se utilizó como tratamiento coadyuvante para disminuir la dosis de medicamentos administrados por vía sistémica y por ende sus posibles efectos secundarios. Esta condición habitualmente abarca aspectos psicosociales del paciente y tiende a verse sumamente afectada su calidad de vida. Es de suma relevancia antes de iniciar un tratamiento clínico invasivo, obtener un diagnóstico diferencial claro y valorar en algunos casos la presencia de dolor no ontogénico, como el DIDAP.

Schwannoma lingual: presentación de un caso y breve revisión de la literatura / Lingual schwannoma: case report and brief review of the literature

Objetivo: Reportar un caso de schwannoma lingual, así como revisar las características diagnósticas (clínicas, por imágenes e histopatológicas) y terapéuticas de esta patología mediante las publicaciones disponibles. Caso clínico: Se presenta un caso de schwannoma in- traoral en un hombre de 26 años de edad con un tumor ubica- do en el tercio anterior de la lengua. Se resolvió mediante un único procedimiento quirúrgico bajo anestesia local sin obser- varse recidivas ni secuelas al menos a 12 meses de seguimien- to a distancia. El schwannoma de la lengua es poco frecuente pero sus características clínico-imagenológicas presentan ras- gos benignos que favorecen la resolución mediante una única biopsia quirúrgica total cuando el tamaño y la ubicación sean propicios para ello (AU)

To describe a case of lingual schwannoma, and through a literature review, to provide data on clinical, imaging and pathological features, as well as treatment methods. Clinical case: A 26-year-old male patient with a swelling in the tip of the tongue was diagnosed as having oral schwannoma. A single surgery was performed, without recurrence or postoperative complications at least during a 12-month follow-up. Lingual schwannoma is a rare entity with benign clinical and imaging characteristics that ena- ble surgical removal without prior biopsy when size and oral location are favorable (AU))

Accuracy of Intraoral Scanners and Conventional pressions in Full-Arches: A Systematic Review

ABSTRACT: The aim of this study was to evaluate intraoral scanners accuracy in full-arches, comparing them with conventional impressions. A scientific research performed in MEDLINE, EBSCOhost, and SciELO databases was conducted to analyze articles published between 2015 and 2020. Clinical and in vitro studies that evaluated accuracy (precision and trueness) from intraoral scanners and conventional impressions in full-arches were included. Two tests were applied to evaluate the methodological bias from the studies. Out of the 191 articles found, seven of them were selected for a qualitative analysis. In clinical studies,intraoral scanners CEREC Omnicam and 3Shape TRIOS Colorhad the highest precision compared to conventional irreversible hydrocolloid impressions. In in vitro studies, conventional polyvinyl siloxane impressions showed the highest accuracy, followed by intraoral scanners Cadent iTero and CEREC Omnicam, while irreversible hydrocolloid impressions showed the lowest accuracy. Digital intraoral impression systems do not show superior accuracycompared to highly accurate conventional impression techniques. However, they provide excellent clinical results and both methods are clinically accepted.

RESUMEN: El objetivo de este estudio fue evaluar la exactitud de escáneres intraorales en impresiones digitales de arco completo en comparación con las impresiones convencionales. Se realizó una revisión sistemática en las bases de datos MEDLINE, EBSCOhost y SciELO para analizar artículos publicados entre los años 2015 y 2020. Se incluyeron estudios clínicos e in vitro que evaluaran exactitud (precisión y/o veracidad) de escáneres intraorales impresiones convencionales en arcos completos. Dos pautas se aplicaron para evaluar el riesgo de sesgo de los estudios. De 191 artículos encontrados, 7 fueron seleccionados para un análisis cualitativo. En los estudios clínicos, los escáneres intraorales CEREC Omnicam y 3Shape TRIOS Color presentaron la mayor precisiónen comparación con las impresiones convencionales de hidrocoloide irreversible. En los estudios in vitro, las impresiones de polivinil siloxano presentaron la mayor exactitud seguido por los escáneres intraorales CadentiTero y CEREC Omnicam, mientras quelas impresiones de hidrocoloide irreversible presentaron la menor exactitud. Los sistemas de impresión digital intraoral no mostraron tener una exactitud superior comparados con las técnicas de impresión convencional de gran exactitud. Sin embargo, proveen excelentes resultados clínicos y ambos métodos son clínicamente aceptables.

Precisión de los sistemas de impresión digital intraoral en odontología restauradora: Una revisión de la literatura / Accuracy of Intraoral Digital Impression Systems in Restorative Dentistry: A Review of the Literature

Abstract: La impresión intraoral permite al odontólogo obtener directamente los datos de las piezas dentales que se requiera rehabilitar, otorgándole mayor precisión y eliminando así de la fase clínica la toma de impresión y la fabricación del modelo, aspectos sensibles a errores. El objetivo de la presente revisión es identificar el sistema de impresión digital intraoral más preciso y además identificar los factores que afectan a la precisión de esta en odontología restauradora. Mediante una revisión bibliográfica con búsqueda en las bases de datos de PubMed y Embase se obtuvieron 153 artículos, luego de la evaluación cualitativa se incluyeron en la revisión 14 que cumplieron con los criterios de inclusión y exclusión. Se determinó que la experiencia del dentista, la convergencia en la preparación dental y la terminación cervical son determinantes al momento de la toma de impresión digital, sin embargo, el uso o no de polvo no es relevante. El sistema de impresión digital Lava C.O.S., iTero y True definition son los más precisos dependiendo siempre del tipo de rehabilitación a realizar.

Abstract: Digital impresión allows the dentist to directly obtain the data of the dental pieces that neet to be rehabilitated, giving it greater precisión and thus eliminating the impression and manufacturing of the dental model, error-sensitive aspects of the clinical phase. The aim of this review is to identify the most accurate intraoral digital impression system and identifiy the factors that affect the accuracy in the restorative dentistry. Through a bibliographic review with search in PubMed and Embase databases, 153 articles were obtained, after qualitative evaluation they were included in the revisión 14 that met the inclusion and exclusion criteria. It was determined that the experience of the dentist, the convergence in the dental preparation and the cervical termination are decisive at the accuracy of the digital impression, however, the use or not of dust is not relevant. The Lava C.O.S., iTero and True definition are the most accurate always depending on the type of rehabilitation to be performed.

Clinical performance of intraoral digital impression for fixed prosthodontics: a Meta-analysis / 华西口腔医学杂志

OBJECTIVES@#To analyze the clinical performance of the intraoral digital impression (IDI) in the fixed prosthodontics.@*METHODS@#Databases of Medline (Ovid), EMBASE, Cochrane Central Register of Controlled Trials, and CNKI were searched for randomized controlled trial (RCT) on the use of IDI in fixed prosthodontics until May 2020. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. A Meta-analysis was conducted when available.@*RESULTS@#Eleven RCTs involving 618 patients were included in this study. A total of 2 and 3 studies had low and high risks of bias, respectively, and other included studies had a medium risk of bias. Results illustrated that the IDI group could shorten the impression-taken time [SMD=-5.63, 95%CI (-11.25, -0.01), @*CONCLUSIONS@#Evidence indicated a good clinical performance of IDI for fixed prosthodontics. Notably, high-quality studies are expected to further support the conclusion.

Closure of Oronasal Fistulae Post Palatoraphy with Tongue Flap in Bilateral Complete Cleft Lip Palate Patient: A Case Report

ABSTRACT@#Oronasal fistulae are common complication following palatoraphy. There are several surgical procedures to repair oronasal fistulae. However, conventional oronasal fistulae closure technique is not always possible, especially when the surrounding tissue is replaced by fibrotic tissue due to previous palatoraphy. Tissue defects in oronasal fistulae should be replaced with tissues providing good vascularisation such as pedicle tongue flap. A case of pedicle tongue flap used to close oronasal fistulae was reported. Eleven-year-old girl, presented with oronasal fistulae and bilateral alveolar cleft after previous palatoraphy. The oronasal fistulae were closed with pedicled tongue flap. The healing was uneventful, and the division of the pedicle tongue flap was done three weeks later and closed primarily. There was no dehiscence of the wound and masticatory functions were recorded. Vascularised flap such as pedicle tongue flap is a preferred technique to close oronasal fistulae after palatoraphy.