Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation

OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known side effect of certain drugs that are used to influence bone metabolism to treat osteometabolic disease or cancers. The purpose of our study was to investigate how high-concentration and low-concentration bisphosphonate (BP) intake affects the disease severity. MATERIALS AND METHODS: Data collected from the medical records of 52 patients treated with BPs, antiresorptive, antiangiogenic drugs and diagnosed with MRONJ were included in this study. Age, sex, type of systemic disease, type of drug, duration of drug treatment, jaw area with MRONJ, drug administration protocol, and MRONJ clinical and radiological findings were obtained. Patients were divided into two groups: anti-neoplastic (Group I, n=23) and anti-osteoporotic (Group II, n=29). Statistical evaluations were performed using the IBM SPSS ver. 21.0 program. RESULTS: In both groups, more females had MRONJ. MRONJ was found in the mandibles of 30 patients (Group I, n=14; Group II, n=16). When we classified patients according to the American Association of Oral and Maxillofacial Surgeons staging system, significant differences were seen between groups (χ2=12.23, P<0.01). More patients with advanced stage (stage 2–3) MRONJ were found in Group I (60.9%). CONCLUSION: According to our results, high-concentration BP intake, age and duration of drug intake increased disease severity.

An unusual complication during arthrocentesis: N. facialis paralysis, with N. lingualis and N. alveolaris inferior anesthesia

This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

Conservative management of a dentigerous cyst associated with eruption of teeth in a 7-year-old girl: a case report

Dentigerous cysts are benign odontogenic cysts that are related to the crowns of permanent teeth. The lesion in this study was detected in a routine panoramic radiograph that revealed a well-defined osteolytic lesion that measured 2.5 cm in diameter, with the crown of the mandibular permanent second premolar displaced to the lower border of the mandible. The apex of the tooth was still open. The aim of this article was to report the case of a 7-year-old girl with a dentigerous cyst associated with the tooth buds of premolars. The therapeutic approach consisted of extraction of the primary molar and marsupialization of the lesion. After 40 months of follow-up, spontaneous eruption of the impacted premolar was observed. In conclusion, marsupialization can be the first treatment choice for conservative management of dentigerous cysts in pre-adolescents.

Investigation of flexural strength and cytotoxicity of acrylic resin copolymers by using different polymerization methods

PURPOSE: The aim of this study was to appraise the some mechanical properties of polymethyl methacrylate based denture base resin polymerized by copolymerization mechanism, and to investigate the cytotoxic effect of these copolymer resins. MATERIALS AND METHODS: 2-hydroxyethyl methacrylate (HEMA) and isobutyl methacrylate (IBMA) were added to monomers of conventional heat polymerized and injection-molded poly methyl methacrylate (PMMA) resin contents of 2%, 3%, and 5% by volume and polymerization was carried out. Three-point bending test was performed to detect flexural strength and the elasticity modulus of the resins. To determine the statistical differences between the study groups, the Kruskall-Wallis test was performed. Then pairwise comparisons were performed between significant groups by Mann-Whitney U test. Agar-overlay test was performed to determine cytotoxic effect of copolymer resins. Chemical analysis was determined by FTIR spectrum. RESULTS: Synthesis of the copolymer was approved by FTIR spectroscopy. Within the conventional heat-polymerized group maximum transverse strength had been seen in the HEMA 2% concentration; however, when the concentration ratio increased, the strength decreased. In the injection-molded group, maximum transverse strength had been seen in the IBMA 2% concentration; also as the concentration ratio increased, the strength decreased. Only IBMA showed no cytotoxic effect at low concentrations when both two polymerization methods applied while HEMA showed cytotoxic effect in the injection-molded resins. CONCLUSION: Within the limitations of this study, it may be concluded that IBMA and HEMA may be used in low concentration and at high temperature to obtain non-cytotoxic and durable copolymer structure.