Management of a Peripheral Giant Cell Granuloma Related to an Implant-Supported Prosthesis: A Case Report.

Peripheral giant cell granulomas (PGCGs) are benign oral cavity tumors, reactive in nature, caused by local trauma or irritation. A 51-year-old woman presented with a soft tissue lesion related to an implant at site 36 (FDI numbering system). An excisional biopsy was completed, and the soft tissue mass was diagnosed as a PGCG. The biopsy led to a lack of keratinized tissue and vestibular depth around the implant site. After the initial healing phase, a free gingival graft was completed. Then, following soft tissue maturation, the cement-retained implant-supported prosthesis was converted into a screwretained implant-supported prosthesis that was easily accessible. With a combined periodontal and restorative approach, the KT increased, adequate vestibular depth was achieved, and there was no recurrence of the PGCG.

Newly Developed Low Dose 180-degree CBCT Protocol Reduces Radiation Dose Without Compromising Diagnostic Value.

PURPOSE: To compare the standard 360-degree CBCT acquisition protocol to the low dose 180-degree CBCT protocol for implant planning. MATERIALS AND METHODS: Two groups of patients, each consisting of 35 patients, were included in the study. The first group was imaged with the conventional 360-degree CBCT protocol, and the second group was imaged with the low dose 180-degree CBCT protocol. The primary outcome of this study was the number of scans that needed to be repeated due to poor image quality. In addition, six secondary parameters were evaluated quantitatively and qualitatively. RESULTS: The results showed that there was no need to repeat any of the CBCT scans that were obtained in either group, which showed that 360-degree and 180-degree protocols had comparable image quality. As for the secondary parameters, the results showed that the evaluators were able to evaluate the six chosen parameters in a comparable manner. CONCLUSIONS: The 180-degree low dose CBCT scan is a viable option for dental implant treatment planning in the posterior mandible as it provides comparable and adequate information regarding accuracy of measurements, identification of critical structures, evaluation of bone quality, and any pathology.

Management of a Peripheral Giant Cell Granuloma Related to an Implant Supported Prosthesis: A Case Report.

INTRODUCTION: Peripheral Giant Cell Granulomas (PGCGs) are benign oral cavity tumors, reactive in nature, caused by local trauma or irritation. CASE PRESENTATION: A 51-year-old female patient presented with a soft tissue lesion related to implant site #19. Excisional biopsy was completed, and the soft tissue mass was diagnosed as a Peripheral Giant Cell Granuloma (PGCG). The biopsy led to absence of keratinized tissue and vestibular depth around the implant site. After the initial healing phase of the biopsy, a free gingival graft was completed and following the maturation of the soft tissue the cement retained implant supported prosthesis was converted into a screw retained implant supported prosthesis. CONCLUSION: With a combined periodontal and restorative approach increased KT, adequate vestibular depth, no recurrence of the PGCG was achieved as well as an easily accessible screw retained implant supported prosthesis.

Newly Developed Low Dose 180-degree CBCT Protocol Reduces Radiation Dose Without Compromising Diagnostic Value.

PURPOSE: To compare the standard 360-degree CBCT acquisition protocol to the low dose 180-degree CBCT protocol for implant planning. MATERIALS AND METHODS: Two groups of patients, each consisting of 35 patients, were included in the study. The first group was imaged with the conventional 360-degree CBCT protocol, and the second group was imaged with the low dose 180-degree CBCT protocol. The primary outcome of this study was the number of scans that needed to be repeated due to poor image quality. In addition, six secondary parameters were evaluated quantitatively and qualitatively. RESULTS: The results showed that there was no need to repeat any of the CBCT scans that were obtained in either group, which showed that 360-degree and 180-degree protocols had comparable image quality. As for the secondary parameters, the results showed that the evaluators were able to evaluate the six chosen parameters in a comparable manner. CONCLUSION: The 180-degree low dose CBCT scan is a viable option for dental implant treatment planning in the posterior mandible as it provides comparable and adequate information regarding accuracy of measurements, identification of critical structures, evaluation of bone quality, and any pathology.

Staged Approach of Frenectomy Followed by Modified Tunnel and Subepithelial Connective Tissue Graft in Single Mandibular Anterior Recessions: A Clinical Report of Three Cases.

This case report proposes a unique approach for managing Cairo gingival recession types 1 and 2 (RT1 and RT2, respectively) in the mandibular anterior region, where anatomical features such as a high frenal attachment or a shallow vestibule preclude the use of a coronally advanced flap. Three systemically healthy patients presenting with Cairo RT1 and RT2 gingival recessions were included. The recessions were managed with a staged approach of frenectomy followed by a modified tunnel in combination with connective tissue graft. Significant root coverage was achieved in all three cases. This treatment approach allows for root coverage, relief of frenal pull, keratinized tissue gain, and increased vestibular depth in very challenging Cairo RT1 and RT2 gingival recessions in mandibular anterior teeth. A short-term follow-up of 3 to 6 months showed stable results in all presented cases.

Periodontal Disease in the COVID-19 Era: Potential Reservoir and Increased Risk for SARS-CoV-2

Abstract Since December 2019, an outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and is now becoming a global Pandemic, with over 10.5 million cases worldwide. Angiotensin-converting enzyme-2 (ACE-2) has been considered the main receptor for the SARS-CoV-2 entry into human cells, and they are known to be present not only in lungs (therefore the common viral pneumonia) but also in nasopharyngeal mucosa, salivary cells and oral epithelial cells. Moreover, there seems to be recent evidence showing that the crevicular fluid on the periodontal pockets of patients presenting periodontitis could harbor SARS-CoV-2 and act as a potential reservoir for increased viral load in the oral cavity of COVID-positive patients. Additionally, sites with active periodontal disease might contribute for virus binding and tissue infection due to elevated expression of furin and cathepsin L proteases, which play a major role in enabling the SARS-CoV-2 to bind ACE-2 receptors and facilitating endosomal fusion in the host cells. Taken together this news and views article highlight possible virus reservoirs in COVID-positive patients, as well as increased risk for infection in patients with active periodontal disease, further proposing potential targets for antiviral intervention on SARS-CoV-2 infection.

Factors Affecting the Outcome of Non-Surgical Endodontic Treatments Performed by Undergraduate Students in a Greek Dental School.

OBJECTIVE: To evaluate the outcome of initial endodontic treatments performed by undergraduate students in a Greek dental school and to determine the factors that may impact the treatment outcome. METHODS: From a randomly selected sample of 677 non-surgical endodontic treatments performed between 2012 and 2015, follow-up appointments were scheduled with patients whose dental records matched the inclusion criteria. After clinical and radiographic examination, the treatment outcome was classified as 'success' (healed/healing) or 'failure' (uncertain/unsatisfactory healing). The statistical analysis of the data was performed using generalized estimating equations. Intra-examiner and inter-examiner agreements were checked with the intraclass correlation coefficient and with Cohen's kappa. The statistical significance level was set at P<0.05. RESULTS: A total of 244 teeth (349 roots) were included for further analysis, and the mean follow-up period was 2.8 years. Overall, the success rate for the treated roots was 72.8%. Μultivariate analysis revealed four decisive factors as having a positive impact on the outcome, namely, the absence of voids within the root fillings (P<0.001), the absence of pre-operative periapical lesions (P=0.001), the extension of the root filling material by 0-2 mm from the radiographic apex (P<0.001) and the root type (anterior roots: P=0.015 and premolar roots: P=0.011). The association of gender, arch, pulp status and type of coronal restoration with the outcome was not statistically significant (P>0.05). Moreover, when the outcome according to pre-operative periapical status and the technical variables of root fillings (apical extension and density) was investigated, roots without periapical lesion, with a root filling material extended 0-2 mm within the apex and without voids revealed the highest success rate (94.5%). CONCLUSION: The success rate of non-surgical endodontic treatments performed in a Greek dental school was in the range of those reported in other studies. The pre-operative periapical status, technical variables of root fillings (apical extension and density) and root type were regarded as significant prognostic factors of the outcome.

Quality of Root Canal Fillings Performed by Undergraduate Students and the Related Factors on the Treatment Outcome: A 2- to 5-Year Follow-Up.

OBJECTIVE: To evaluate radiographically the quality of root canal fillings performed by undergraduate students between 2012 and 2015, and to investigate the impact of their quality in correlation with root type, preoperative periapical status, and type of restorative treatment on the treatment outcome. METHODS: Six hundred seventy-seven non-surgical root canal treatments were performed by undergraduate students from the Aristotle University of Thessaloniki at the endodontic department clinics between 2012 and 2015. Two hundred forty-four teeth (349 roots) fulfilled the criteria and were clinically and radiographically re-examined between 2016 and 2017, and the outcome was classified as "success" or "failure." Root canal fillings were radiographically evaluated in terms of apical extension and density. The root filling was classified as acceptable when both parameters were rated as acceptable. Statistical analysis was performed using generalized estimating equations. Pairwise comparisons were performed by the sequential Bonferroni method. Intra-examiner and inter-examiner agreements were checked by the intraclass correlation coefficient and Cohen's kappa. The statistical significance level was set at P<0.05. RESULTS: The percentage of the roots with acceptable root canal fillings was 40.4%. The molar roots demonstrated the lowest rate (30.7%) compared with the anterior (53%, P<0.05) and premolar teeth (43%, P>0.05). The results of the correlation of the quality of the root canal fillings with the root type, preoperative periapical status, type of coronal restoration, and the treatment outcome showed that the unacceptable quality of root canal filling in relation to root or presence of periapical lesion or crown revealed the lowest success rates (47.2%, 40.3%, and 52.3%, respectively). In contrast, results showed that roots with canal fillings of acceptable quality demonstrated success rates close to 90%, regardless of the other variables. CONCLUSION: Within the limitations of the present study, the percentage of radiographically acceptable root canal fillings performed in the undergraduate clinic of the Department of Endodontology at Aristotle University of Thessaloniki was low (40.4%). Results showed that there was a strong association of higher success rates with root fillings of acceptable quality.