Conservative management of dentigerous cyst in children: Report of two clinical cases.

The dentigerous cyst is the second most common odontogenic. The prevalence rates ranging from 0.8% to 3.6% in the general population. It affects people especially at the second and third decade of life with a male predilection. It presents a preference for the mandibular region particularly for the second lower premolar. Surgical marsupialization or decompression are the most conservative treatment modalities as it prevents the risks of cyst removal as nerve injuries and preserves the unerupted tooth. Two clinical cases of two young patients presenting a dentigerous cyst involving impacted teeth, which were successfully treated by decompression will be reported in order to highlight the benefits and limits of cyst decompression as well as detailing its operating protocol and its instructions.

An innovative technique to treat epulis fissuratum: A case report.

The purpose of this article is to present a case demonstrating the treatment of epulis fissuratum due to a poorly adapted prosthesis using a single surgical procedure involving conventional excision and free gingival graft. We, herein, present a case involving a 58-year-old patient with epulis fissuratum. Treatment of this case was essential due to the masticatory problems. This technique can be effective to deepen the height of the residual alveolar ridge and to increase the amount of keratinized tissue.

Epidermoid cyst of the buccal mucosa-An uncommon entity: Case report and literature review.

Epidermoid cyst of the buccal mucosa is rare. Nevertheless, it must be included in the differential diagnosis of swelling in this area. The diagnosis is based on anatomopathological examination. The surgical enucleation is the gold standard of treatment.

Preprosthetic Management of "Flabby Ridge" on Edentulous Patient.

For edentulous patients, the integrity of the osteomucosal-bearing surface is a significant factor for the balance of the future removable prosthesis. The supporting tissues are influenced by several factors. Physiological bone resorption, senescence, and changes caused by systemic diseases and polypharmacy lead to modifications in these tissues. Similarly, trauma caused by an ill-fitted prosthesis influences the degree of bone resorption and the development of hyperplastic tissue. The etiology of bone resorption is multifactorial and complex, with continuous individual variations that are often unexplained. Although, no study has been able to establish the importance of the different factors in relation to each other, it is often reported that chronic excessive mechanical pressure in relation to occlusal constraints is responsible for the appearance of local resorption's areas. The aim of this work is to present, through three clinical cases, the various factors involved in the alteration of the osteomucous-bearing surface and eventually, possible therapeutic attitude to deal with.

[The role of piezosurgery in the treatment of a rare case of superinfected cemento-osseous dysplasia caused by actinomyces: a case report]. / L´intérêt de la piézochirurgie dans le traitement d'une dysplasie cémento-osseuse surinfectée par actinomycose: à propos d'un cas.

Cemento-osseous dysplasia is a benign fibro-osseous lesion affecting the alveolar bone. It is classified into three forms: periapical, focal or florid dysplasia. It is often asymptomatic and fortuitously discovered during a routine radiological examination. However, it may become symptomatic after superinfection, after patient's exposure to oral bacterial flora. We here report a case of florid cemento-osseous dysplasia associated with actinomycosis of bone in a 53-year-old Tunisian woman. This superinfection has been rarely reported in the literature; Boolean Searching on PubMed for the keywords "cemento-osseous dysplasia AND actinomyces" displays a single article (Smith et al. 2011). The treatment of actinomycosis infection often requires long-term antibiotic therapy, sometimes associated with surgical debridement, as in the case of this patient who underwent piezosurgery to treat dysplasia and necrotic bone.

Piezoelectric-Assisted Removal of a Mandibular Cementoossifying Fibroma: An Innovative Technique.

Diagnosis of cementoossifying fibroma is oriented by the clinical and radiological aspects of the lesion. Histology confirms the diagnosis. Treatment is surgical with enucleation-resection depending on the lesion size or wider resection with bone reconstruction in cases of large fibromas. The use of piezoelectric bone surgery is associated with low surgical trauma, exceptional precision, and fast healing response. It also allows easy performance of complex osteotomy and reduces the necessary dimensions of mucoperiosteal dissection. The purpose of the present article was to present the advantages of piezoelectric-assisted surgical removal of a cementoosseous fibroma of the mandible and to provide a precise description of the procedure using atraumatic surgery.

Gingival Melanin Depigmentation by 808 nm Diode Laser: Report of a Case.

Gingival hyperpigmentation frequently poses an aesthetic problem, especially in patients with gingival smile. This paper presents the use of a 808 nm pulsed diode laser for gingival depigmentation in a 22-year-old male patient, with a frequency of 20,000 Hz, a peak power of 5 W, and a pulse width of 26 microseconds, using a 400 nm flexible optic fiber. The hyperpigmented gingival tissue was removed without bleeding or postoperative pain. Three weeks later, the gum resumed its normal, firm, and pink appearance. No significant recurrence was noted after a follow-up of 4 months. However, perfect control of this device is necessary to avoid certain consequences such as bone exposure or gingival fenestrations.

Mucosal coronally positioned flap technique for management of excessive gingival display.

Improvement of smile esthetics is a major goal of modern dentistry. Various treatment modalities have been proposed to correct excessive gingival display, depending on intraoral or extraoral etiologies. This report aimed to document the use of mucosal coronally positioned flap called surgical lip repositioning technique for the management of a gummy smile associated with vertical maxillary excess. The procedure restricts the muscle pull of the elevator lip muscles by shortening the vestibule, thus reducing the gingival display when smiling. Rapid surgical healing with minimal postoperative sequelae was observed. The follow up examinations showed esthetic satisfaction up to 6 months postoperatively, at the end of one year a partial relapse was observed. Although the short-term stable results of lip repositioning surgery appear satisfying postoperatively, its utility as a long-term treatment option remains questionable. More studies with larger sample size and long-term follow-up are necessary to establish the level of scientific evidence of this procedure.

Biochemical parameters and oxidative stress markers in Tunisian patients with periodontal disease.

BACKGROUND: Oxidative stress is involved in many diseases including diabetes and cancer. Numbers of studies have suggested its involvement in the pathogenesis of periodontal diseases. The aim of this study was to evaluate the levels of biochemical parameters and oxidative stress markers in plasma of healthy and chronic periodontitis patients. METHODS: One hundred thirty subjects were divided into two groups; patients (mean age = 42 ± 13.6 y.o) and control (mean age = 44.8 ± 12.6 y.o). Patients and healthy subjects were free from any infection, coronary or heart disease, diabetes or liver failure. Total cholesterol, LDLc, HDLc, Triglycerides (TG), creatinine, uric acid (UA), glucose and urea levels as well as the activities of enzymatic antioxidants such as catalase, glutathione reductase (GR) and total antioxidant capacity (TAOC), were measured in plasma samples using colorimetric assays. Statistical differences between groups were determined by Student's t-test and p ≤ 0.05 was considered as significant. RESULTS: Periodontitis patients exhibited significant decrease in the activities of catalase, TAOC, GR and TG, cholesterol, LDLc, glucose, HDLc, uric acid levels in plasma samples in comparison with healthy subjects. However, no statistically significant differences in the levels of creatinine and urea were observed between the two groups. CONCLUSION: The reduction of plasma antioxidant activities (Catalase, TAOC, GR) may have a role in the pathogenesis of periodontal diseases. Our findings suggest a decrease in the host capacity to control the damage caused by oxidative stress. Therefore, therapeutic strategies, aiming at modulating the oxidative stress could be considered as potential tools for the prevention or treatment of periodontal diseases and their potential systemic effects on the general health.

Outcome of Initial Endodontic Treatment Performed, by One Specialist, in 122 Tunisian Patients: A Retrospective Study.

OBJECTIVE: To assess the 6- to 24-month outcome of endodontic treatments performed, by one specialist, and to identify prognostic factors that may influence initial endodontic treatment outcome (IETO). METHODS: One hundred and forty-six patients out of 163 were included. A number of 201 teeth were endodontically treated, and an overall number of 408 canals were obturated. Of these, 165 teeth received initial endodontic treatment (IET). The criteria of the European Society of Endodontology were used to assess the IETO. The level of significance was set at p < 0.05%. RESULTS: Apical periodontitis (AP) was present in 42.5% of all cases, with a PAI >3 in 28.5%. The success rate (SR) was 91.5%. It was significantly higher in vital teeth (97%) than in devital teeth (87.7%) (p=0.04); however, a lower SR was recorded in teeth with AP (p=0.02). The lesion healed in 60 teeth (85.7%), decreased in size in 4 teeth (5.7%), and increased in size in 6 teeth (8.5%). A higher SR was obtained when a permanent restoration was present (94%) than absent (68.7%) (p=0.005). CONCLUSION: Within the limitations of the study, pulp and periapical status and permanent restoration are found to be strong outcome predictors.