Infected Dentigerous Cyst of Maxillary Sinus Mimicking Intraoral Abscess in a Pediatric Patient: Management of Misdiagnosis and Inaccurate Treatment.

The article presents the case of a 12-year-old male patient who was suffering from exacerbated (infected) dentigerous cyst of maxillary sinus, associated with impacted canine whose symptoms were deceptively similar to intraoral abscess. The first-aid treatment performed by general dental practitioner consisted of intraoral incision and resulted in oroantral fistula formation. Eventually, the patient's ailments were not resolved, and we had to deal with serious local complications and difficulties. The treatment was performed under general anesthesia in one-day surgery system and included enucleation of the lesion, excision, and closure of oroantral fistula. Dislocated canine was not removed, and its subsequent eruption was observed.

Comparative Efficacy of Different Oral Doses of Clindamycin in Preventing Post-Operative Sequelae of Lower Third Molar Surgery-A Randomized, Triple-Blind Study.

Background and Objectives. Antibiotic regimen optimization is a major concern in post extraction sequelae management following third molar surgery, mostly owing to the absence of universal guidelines. Hence, this study aimed to determine the effect of antibiotic prophylaxis using three different doses of clindamycin on the prevention of infection and other complications following mandibular third molar disimpaction. The secondary outcome was testing whether clindamycin exhibits activity in acute or chronic models of pain using the visual analog scale of pain and the necessity for post-operative rescue analgesia. The tertiary outcome was to assess clindamycin penetration into the saliva by measuring its concentration using liquid chromatography/electrospray ionization tandem mass spectrometry. Materials and Methods. A randomized, two-center, triple-blind, controlled clinical trial was conducted, in which the patients were randomly allocated to three groups: I, receiving 150 mg clindamycin every 8 h; II, receiving 300 mg clindamycin every 8 h; and III, receiving 600 mg clindamycin every 12 h. Each group continued the therapy for five days. Results. An overall decrease in the risk of infection and other post-operative complications, such as trismus, edema, dysphagia, and lymphadenopathy, was achieved, with the best results in group I. Conclusion. As no statistical association was observed between clindamycin concentration in saliva and degree of post-operative inflammation, clindamycin concentration, or pain intensity, smaller doses of clindamycin administered over shorter time periods is recommended.

Dental implant displacement complicated by epulis fissuratum and extraoral fistula in a patient with senile dementia of Alzheimer's type.

Dental treatment of patients suffering from mental illnesses should not be neglected as good condition of oral cavity is one of the factors that determine satisfactory quality of life, not only by aesthetic but also by functional considerations.

Computer-Controlled Local Anesthesia Complication: Surgical Retrieval of a Broken Dental Needle in Noncooperative Autistic Paediatric Patient.

The article describes an unusual case of retrieval of 8 mm fragment of a broken 30-gauge 21 mm dental needle in a 6 y.o. noncooperative autistic male patient. The needle of a computer-controlled local anesthesia device was broken during an attempt to administer local anesthetic, in order to perform conservative treatment of teeth 55 and 54 by a pedodontist. Despite the fact that the patient was under nitrous oxide sedation, an unexpected movement of the patient occurred and resulted in needle breakage. Due to the lack of patient cooperation, the surgical retrieval of a broken needle was performed under general anesthesia as part of one-day surgery procedures. The purpose of the article is to emphasize careful decision-making in proper choice of dental instruments during treatment of noncooperative paediatric patients even under sedation and to suggest dentists to carry out treatment of such patients under general anesthesia.