Predictors for Dental Intervention in Children After Dental Injury: A Retrospective Analysis and Literature Review.

OBJECTIVE: This study aimed to explore risk factors for dental intervention in patients presenting to the pediatric emergency department (PED) after dental injury. METHODS: We retrospectively explored patients aged 0 to 18 years who presented to our PED between 2017 and 2021 after dental injury. RESULTS: Of the total of 830 patients (mean age 7.1 ± 3.9 years, 589 [71.0%] male patients), 237 (28.5%) required dental intervention. All patients with alveolar fractures and those with involvement of permanent teeth with extrusive luxation mandated urgent dental consultation. Additional independent predictors for dental intervention for primary tooth injury were: root fracture (adjusted odds ratio [aOR] 38.4; 95% confidence interval [CI], 3.95-373.22; P = 0.002), facial bone involvement (aOR 12.40; 95% CI, 2.33-65.93; P = 0.003), lateral luxation (aOR 6.9; 95% CI, 4.27-11.27; P < 0.001), extrusive luxation (aOR 6.44; 95% CI, 2.74-15.14; P < 0.001), and avulsion (aOR 2.06; 95% CI, 1.23-3.45; P = 0.006). Additional independent predictors for permanent tooth injury were lateral luxation (aOR 27.8; 95% CI, 6.1-126.6; P < 0.001) and avulsion (aOR 6.8; 95% CI, 2.9-15.9; P < 0.001). CONCLUSIONS: Alveolar fracture is a severe dental injury, requiring intervention, for primary and permanent teeth injuries. Tooth luxation with significant mobility or malocclusion, incomplete avulsion, a suspected root involvement, or facial bone injury in the primary teeth and tooth luxation (extrusive/lateral) and avulsion in the permanent teeth dictate urgent dental consultation and intervention. Clinical algorithms for dental injury management are suggested.

Surgical management of odontogenic cysts involving the maxillary sinus- a retrospective study.

OBJECTIVE: To describe our strategy for the management of odontogenic cysts involving the maxillary sinus, and to define the role of transnasal endoscopic sinus surgery in the treatment algorithm. METHODS: A retrospective study was conducted. Included were all consecutive patients with odontogenic cysts involving the maxillary sinus who were treated in a single medical center between 2011 and 2019. Their medical records were reviewed for demographic data, preoperative presentation, surgical approach, final pathology, and postoperative course. Odontogenic cysts were classified as small or large according to maxillary sinus extension within or beyond the alveolar recess, respectively. RESULTS: A total of 30 patients with odontogenic cysts involving the maxillary sinus were treated by a team of maxillofacial and endoscopic sinus surgeons during the study period. There were 11 cases of dentigerous cysts, 11 radicular cysts, seven odontogenic keratocysts (OKCs), and one glandular cyst. Sixteen cases were managed by transnasal endoscopic sinus surgery alone and 14 were managed by a combined intraoral and endoscopic sinus surgery approach. A total of 22 patients had large cysts and total resection was achieved in 20 of them. There was one case of OKC recurrence during an average follow-up of 31 months. No major complications were recorded. CONCLUSIONS: The endoscopic approach can serve as an alternative to the transalveolar or lateral window approach. The endoscopic approach is associated with low morbidity and low recurrence rates.

Accelerated Bone Regeneration by Nitrogen-Doped Carbon Dots Functionalized with Hydroxyapatite Nanoparticles.

We investigated the osteogenic potential of nitrogen-doped carbon dots (NCDs) conjugated with hydroxyapatite (HA) nanoparticles on the MC3T3-E1 osteoblast cell functions and in a zebrafish (ZF) jawbone regeneration (JBR) model. The NCDs-HA nanoparticles were fabricated by a hydrothermal cum co-precipitation technique. The surface structures of NCDs-HA nanoparticles were characterized by X-ray diffraction; Fourier transform infrared (FTIR), UV-vis, and laser fluorescence spectroscopies; and scanning electron microscopy, transmission electron microscopy (TEM), energy-dispersive spectrometry (EDS), and NMR analyses. The TEM data confirmed that the NCDs are well conjugated on the HA nanoparticle surfaces. The fluorescent spectroscopy results indicated that the NCDs-HA exhibited promising luminescent emission in vitro. Finally, we validated the chemical structure of NCDs-HA nanoparticles on the basis of FTIR, EDS, and 31P NMR analysis and observed that NCDs are bound with HA by electrostatic interaction and H-bonding. Cell proliferation assay, alkaline phosphatase, and Alizarin red staining were used to confirm the effect of NCDs-HA nanoparticles on MC3T3-E1 osteoblast proliferation, differentiation, and mineralization, respectively. Reverse transcriptase polymerase chain reaction was used to measure the expression of the osteogenic genes like runt-related transcription factor 2, alkaline phosphatase, and osteocalcin. ZF-JBR model was used to confirm the effect of NCDs-HA nanoparticles on bone regeneration. NCDs-HA nanoparticles demonstrated cell imaging ability, enhanced alkaline phosphatase activity, mineralization, and expression of the osteogenic genes in osteoblast cells, indicating possible theranostic function. Further, NCDs-HA nanoparticles significantly enhanced ZF bone regeneration and mineral density compared to HA nanoparticles, indicating a therapeutic potential of NCDs-HA nanoparticles in bone regeneration and fracture healing.