Reimplantation of an avulsed mature permanent tooth after 6 days: a 1-year follow-up.

Tooth avulsion in children and adolescents demands emergency treatment to increase the chances of successful reimplantation. The treatment prognosis depends on intrinsic and extrinsic factors, such as the extra-alveolar time until reimplantation, storage medium, handling, and periodontal ligament condition of the avulsed tooth as well as the patient's general health. This case report describes the treatment of an 11-year-old boy who suffered an avulsion of the maxillary right central incisor followed by delayed reimplantation after the tooth was stored in a dry medium for 6 days. Although the tooth was kept in extremely unfavorable conditions, tooth reimplantation was attempted because the patient was young and it was desirable to avoid psychological trauma as well as esthetic and functional problems. The treatment performed followed the guidelines of the International Association of Dental Traumatology for an avulsed tooth with a closed apex and extraoral dry time exceeding 60 minutes. At a 1-year follow-up appointment, the tooth exhibited clinical function, no mobility or pain symptoms, and mild signs of ankylosis. A radiographic image showed resorption by substitution. Although the long-term prognosis is uncertain, this treatment approach was advantageous for the patient because it maintained esthetics, function, and alveolar bone height.

Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla.

Follicular lymphoid hyperplasia is a very rare though benign reactive process of an unknown pathogenesis that may resemble a follicular lymphoma, clinically and histologically. Oral reactive follicular hyperplasia (RFH) has been described on the hard or soft palate and at the base of the tongue. We describe here the first case of RFH presenting as an aggressive tumor on the right posterior side of the maxilla in a 24-year-old male patient. The lesion had a clinical evolution of 18 months and was noticed after the surgical extraction of the right third molar, although we cannot assume a cause-effect relation with that surgical event whatsoever. His medical history was unremarkable. Following an incisional biopsy, histological examination revealed lymphoid follicles comprised by germinal centers surrounded by well-defined mantle zones. The germinal centers were positive for Bcl-6, CD10, CD20, CD21, CD23, CD79a, and Ki-67, while negative for Bcl-2, CD2, CD3, CD5, and CD138. The mantle and interfollicular zones were positive for Bcl-2, CD2, CD3, CD5, CD20, and CD138. Both areas were diffusively positive for kappa and lambda, showing polyclonality. The patient underwent a vigorous curettage of the lesion with no reoccurrences at 36 months of follow-up. This case report demonstrates that morphologic and immunohistochemical analyses are crucial to differentiate RFH from follicular lymphoma, leading to proper management.

Accuracy in the diagnosis of the mental nerve loop: a comparative study between panoramic radiography and cone beam computed tomography / Precisión en el diagnóstico del bucle del nervio mental: estudio comparativo entre radiografía panorámica y tomografía computadorizada de haz cónico

Dental implant and chin osteotomy are executed on the mandible body and the mental nerve is an important anatomical limit. The aim of this research was to know the position of the mental nerve loop comparing result in panoramic radiography and cone beam computed tomography. We analyzed 94 hemimandibles and the patient sample comprised female and male subjects of ages ranging from 18 to 52 years (mean age, 35 years) selected randomly from the database of patients at the Division of Oral Radiology at Piracicaba Dental School State University of Campinas; the anterior loop (AL) of the mental nerve was evaluated regarding the presence or absence, which was classified as rectilinear or curvilinear and measurement of its length was obtained. The observations were made in the digital panoramic radiography (PR) and the cone beam computed tomography (CBCT) according to a routine technique. The frequencies of the AL identified through PR and CBCT were different: in PR the loop was identified in 42.6% of cases, and only 12.8% were bilateral. In contrast, the AL was detected in 29.8% of the samples using CBCT, with 6.4% being bilateral; Statistical comparison between PR and CBCT showed that the PR led to false-positive diagnosis of the AL in this sample. According to the results of this study, the frequency of AL is low. Thus, it can be assumed that it is not a common condition in this population.

Implantes dentales y la osteotomía de mentón son realizadas en el cuerpo mandibular y el nervio mental es un importante limite anatómico. El objetivo de esta investigación es conocer la posición del bucle del nervio mental comparando resultados entre radiografia panorámica y tomografía computadorizada de haz cónico (TCHC). Fueron analizadas 94 hemimandíbulas; la muestra de pacientes de sexo feminino y masculino con edades fluctuando entre 18 y 52 años (edad media, 35 años) seleccionados de la base de datos de pacientes de la División de Radiología de la Facultad de Odontología de Piracicaba, Universidad Estadual de Campinas; el bucle anterior (BA) del nervio mental fue evaluado según su presencia o ausencia, el cual fue clasificado como rectilíneo o curvilíneo obteniéndose el largo total del bucle; las observaciones fueron realizadas en radiografías panorámicas digitales (RP) y en TCHC de acuerdo a técnicas de rutina. La frecuencia de identificación del BA en RP y TCHC fue diferente: en la PR, el BA se identificó en un 42,6% de los casos y solo el 12,8% fue bilateral. En contraste, el BA fue detectado en el 29,8% de la muestra utilizando TCHC, con un 6,4% bilateral; la comparación estadística entre RP y TCHC muestra que la RP lleva a diagnósticos falsos positivos de la muestra de BA. De acuerdo con los resultados de este estudio, la frecuencia de BA es baja. Por este motivo se puede asumir que esta es una condición anatómica poco frecuente en la población estudiada.

Accuracy in the Diagnosis of the Mental Nerve Loop. A Comparative Study Between Panoramic Radiography and Cone Beam Computed Tomography.

Dental implant and chin osteotomy are executed on the mandible body and the mental nerve is an important anatomical limit. The aim of this research was to know the position of the mental nerve loop comparing result in panoramic radiography and cone beam computed tomography. We analyzed 94 hemimandibles and the patient sample comprised female and male subjects of ages ranging from 18 to 52 years (mean age, 35 years) selected randomly from the database of patients at the Division of Oral Radiology at Piracicaba Dental School State University of Campinas; the anterior loop (AL) of the mental nerve was evaluated regarding the presence or absence, which was classified as rectilinear or curvilinear and measurement of its length was obtained. The observations were made in the digital panoramic radiography (PR) and the cone beam computed tomography (CBCT) according to a routine technique. The frequencies of the AL identified through PR and CBCT were different: in PR the loop was identified in 42.6% of cases, and only 12.8% were bilateral. In contrast, the AL was detected in 29.8% of the samples using CBCT, with 6.4% being bilateral; Statistical comparison between PR and CBCT showed that the PR led to false-positive diagnosis of the AL in this sample. According to the results of this study, the frequency of AL is low. Thus, it can be assumed that it is not a common condition in this population.

Surgical techniques for the treatment of ankyloglossia in children: a case series.

This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

Surgical techniques for the treatment of ankyloglossia in children: a case series

This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

Masseter e Exodontia de Terceiros Molares: Avaliação Eletromiográfica / Masseter and Extraction of Third Molars: Electromyographic Evaluation

Proposição: Avaliar eletromiograficamente o músculo masseter quatro horas antes da cirurgia e 48 horas após, durante repouso, oclusão cêntrica forçada e abertura máxima da boca em pacientes submetidos à exodontia de terceiros molares. Metodologia: Foram selecionados 10 voluntários com terceiros molares inferiores direitos mesioangulados, classe II posição B, do gênero feminino, com idade entre 18 e 25 anos. Os dois terceiros molares do lado direito foram extraídos. Resultados: Eletromiograficamente, os resultados mostraram diferenças significativas (p<0,05) no músculo masseter direito em repouso, havendo um aumento de 44,07% da atividade elétrica entre o pré e pós-operatório, enquanto, na oclusão cêntrica forçada, uma queda da atividade de 68,68%. No masseter esquerdo, tanto no repouso quanto na oclusão cêntrica forçada, não foram observadas diferenças estatisticamente significativas (p>0,05). Na abertura máxima da boca, houve um aumento da atividade elétrica nos masseteres direito e esquerdo, entre os períodos pré e pós-operatório, de 119,96% e 93,97%, respectivamente (p<0,05). Conclusão: A exodontia de terceiros molares inferiores alterou significativamente a atividade do músculo masseter, contribuindo para o aparecimento do trismo.

Proposition: to evaluate for electromyography the masseter muscle, four hours before and forty eight hours after surgery, during rest, forced centric occlusion and maximum mouth opening, in patients undergoing extraction of third molars.Methodology: were selected 10 subjects with lower third molars mesioangulados rights, class II B position, female, aged between 18 and 25. The third molars were extracted from the right side. Results: electromyographically, the results showed significant differences (p <0.05) in right masseter muscle at rest, with an increase electrical activity of 44,07% between pre and post operatively while in centric occlusion forced a decline in activity of 68,68%. In left masseter, both at rest and forced centric occlusion, there were no statistically significant differences (p> 0.05). At maximum mouth opening was an increase of electrical activity in right and left masseter, between the preoperative and postoperative period of 119.96% and 93.97%, respectively (p <0.05). Conclusions: the extraction of lower third molars change activity of masseter muscle, contributing to the onset of trismus.

Localized gingival enlargement associated with alveolar process expansion: peripheral ossifying fibroma coincident with central odontogenic fibroma.

BACKGROUND: Despite the common occurrence of localized gingival enlargements, which often represent reactive lesions, the temporal and spatial association of such a lesion with a central jaw lesion has not been reported. The purpose of this case report is to present the exceptional combination of a peripheral ossifying fibroma and a central odontogenic fibroma. The differential diagnosis and management of each lesion is reviewed. METHODS: A 45-year-old black female presented with a chief complaint of a painless protuberance in the left mandible of 1-year duration. Clinical and radiographic examination revealed a gingival enlargement localized between teeth #21 and #23 and a multilocular radiolucent lesion with radiopaque foci in the same area. Excisional biopsy of the gingival lesion and incisional biopsy of the central lesion were performed, and specimens were submitted for histopathological analysis. RESULTS: Biopsy of the gingival lesion revealed stratified squamous epithelium and highly cellular fibroblastic component presenting central areas of calcification, features consistent with a diagnosis of peripheral ossifying fibroma. The central lesion was characterized by cellular fibrous tissue admixed with rests of odontogenic epithelium and few calcification areas, features consistent with a diagnosis of central odontogenic fibroma/World Health Organization type. Subsequently, the central lesion was enucleated. After 1-year follow-up, no recurrence has been observed. CONCLUSIONS: The combination of a rare central lesion with a common gingival lesion may present unique diagnostic and therapeutic challenges. Clinician awareness regarding the possibility of such a combined presentation and its implications will help to ensure optimal treatment outcomes.

Supranumerários: revisäo de literatura. Relato de casos clínicos / Supernumerary: literature review. Cases report

A näo-erupçäo de um elemento dental pode causar preocupaçöes, principalmente quando se trata de um dente permanente anterior, visto que a funçäo e a estética ficam comprometidas, o que pode ser prejudicial à saúde psicológica do paciente. Os dentes supranumerários apresentam especial interesse, devido ao potencial que possuem de desencadear alteraçöes no desenvolvimento normal da oclusäo, interferindo de forma significativa na cronologia dentária. Neste artigo, os autores descrevem dois casos de supranumerários, destacando etiologia, prevalência, incidência, localizaçäo e tratamento, além de mostrar possíveis complicaçöes causadas pela presença dos mesmos

Comunicaçäo bucossinusal: revisäo de literatura e relato de casos / Oroantral communication: literature review and case reports

Os seios maxilares säo cavidades que, devido à sua estreita relaçäo anatômica com os dentes superiores, podem oferecer uma série de contratempos cirúrgicos, dos quais a abertura do seio maxilar ou a presença de corpos estranhos no interior do mesmo, podendo gerar uma fístula bucossinusal após a extirpaçäo de uma lesäo patológica ou exodontia. A comunicaçäo bucossinusal pode ser resolvida imediatamente ao ato cirúrgico ou posteriormente à instalaçäo de uma fístula, utilizando os mais variados recursos para a resoluçäo deste problema. Neste artigo os autores realizaram uma revisäo da literatura pertinente ao assunto e descreveram três casos de comunicaçäo bucossinusal, buscando elucidar etiologia, forma de diagnóstico e tratando as possíveis complicaçöes

Queratoacantoma: relato de caso clínico / Keratoacanthoma: a clinical case report

O caso a ser relatado é de um paciente que apresentou uma lesäo no lábio inferior após um trauma. Essa lesäo nodular e indolor teve um crescimento rápido, aproximadamente 7 semanas. Primeiramente, houve uma biópsia incisional com laudo näo-conclusivo devido à material insuficiente. Após avaliaçäo na Clínica de Cirurgia da EFOA, tendo como base as informaçöes obtidas através da anamnese, exame clínico, exame visual e palpaçäo, optou-se pela realizaçäo da biópsia excisional. O diagnóstico inicial de queratoacantoma foi confirmado pelo exame anatomopatológico