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11 pages, 218 KiB

Open AccessArticle

Airway Management and General Anesthesia in Pediatric Patients with Special Needs Undergoing Dental Surgery: A Retrospective Study

by Alessandra Ciccozzi, Ettore Lupi, Stefano Necozione, Filippo Giovannetti, Antonio Oliva, Roberta Ciuffini, Chiara Angeletti, Franco Marinangeli and Alba Piroli

Reports 2024, 7(3), 79; https://doi.org/10.3390/reports7030079 - 17 Sep 2024

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Abstract

Background: The definition of patients with special needs (SNs) is used in the literature to refer to individuals with mental and physical disorders for whom the usual perioperative pathways are not applicable due to lack of cooperation, regardless of age. Studies in the [...] Read more.

Background: The definition of patients with special needs (SNs) is used in the literature to refer to individuals with mental and physical disorders for whom the usual perioperative pathways are not applicable due to lack of cooperation, regardless of age. Studies in the literature recognize the appropriateness of general anesthesia for performing day surgery dental care in this type of patient. Objectives: The main objective was to assess the possible incidence of difficult airway management, understood as difficulty ventilating and/or intubating the patient. A secondary objective was to highlight the influence of general anesthesia on patient outcomes by testing the incidence of perioperative complications. Methods: The present retrospective, single-center, observational study involved 41 uncooperative patients aged between 3 and 17 undergoing dental surgery under general anesthesia. Data relating to airway management and general anesthesia present in the medical records were analyzed. Results: Tracheal intubation was successfully completed in all of the patients considered, and in no case did the patient have to be woken up because of difficulty in airway management. No perioperative complications attributable to anesthesia were found in any patients. Conclusions: From the present experience, it can be concluded that general anesthesia is a suitable option for performing dental care in pediatric subjects with special needs, and that although the peculiar perioperative management of these patients might increase the risk of possible anesthesia-related side effects, no complications have been encountered in any case. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

12 pages, 3437 KiB

Open AccessArticle

Comparison of the Haas Expander and the Elastodontic Device for the Resolution of Transverse Discrepancies in Growing Patients: A Single-Centre Observational Study

by Eleonora Ortu, Sara Di Nicolantonio, Samuele Cova, Davide Pietropaoli, Lucia De Simone and Annalisa Monaco

Reports 2024, 7(2), 41; https://doi.org/10.3390/reports7020041 - 21 May 2024

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Abstract

Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient [...] Read more.

Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient test group, 16 females and 16 males, mean age 7.08 ± 0.44) or Haas expander (32 patient control group, 16 females and 16 males, mean age 7.32 ± 0.50). The two groups exhibited similar orthodontic features. The orthodontic criteria were: skeletal class I relationship; molar class I relationship; complete eruption of upper sixths; presence of unilateral or bilateral cross bite. All dental casts were examined and subsequently scanned with an intraoral scanner (I-Tero) pre-treatment (T0) and 12 months after the onset of therapy (T1) to assess the distance between the decidous upper canines (ICW, intercanine width) and the distance between the mesiopalatal cusps of the upper first molars (IMW, intermolar width). For statistical analysis, the t-test for continous variables and the chi-square test for categorical variables were used, respectively. Results: There were no statistically significant differences between the mean and SD of the expansions that resulted from the Haas expander and the elastodontic devices (Haas expander vs. Eptamed: ICW_T1 (Haas) = 42.34 (3.09), ICW_T1 (Eptamed) = 42.69 (2.77); p = 0.743; IMW_T1 (Haas) = 34.22 (2.29), IMW_T1 (Eptamed) = 34.00 (2.56); p = 0.800). The two devices were similarly effective. Conclusions: Elastodontic devices and the Haas expander can successfully help the orthodontist to conduct upper arch expansion treatment. However, elastodontic devices are more comfortable during the resolution of palatal discrepancies compared to palatal expander devices. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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8 pages, 8240 KiB

Open AccessCase Report

Oral Candidiasis in a Diabetic Patient Wearing Bar-Retained Provisional Overdenture: Clinical Case Report

by Christopher Diego Nicholson-Becerra, Mónica Orozco-Gallardo, Arturo Cisneros-Moya, Evangelina Gutiérrez-Cortés and Andréa Dolores Correia Miranda Valdivia

Reports 2024, 7(4), 96; https://doi.org/10.3390/reports7040096 - 11 Nov 2024

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Abstract

Background and Clinical Significance: Denture stomatitis is a clinical manifestation of oral candidiasis, often seen in individuals wearing removable dentures that lead to the formation of sub-prosthetic stomatitis. This is particularly common in maladjusted appliances that have been in use for many [...] Read more.

Background and Clinical Significance: Denture stomatitis is a clinical manifestation of oral candidiasis, often seen in individuals wearing removable dentures that lead to the formation of sub-prosthetic stomatitis. This is particularly common in maladjusted appliances that have been in use for many years. Studies have shown that patients with systemic diseases such as diabetes, or other medical complexities, have a higher likelihood of developing denture stomatitis. To address this problem, the use of implant-retained dentures with different types of attachments has been introduced, providing increased comfort and hygiene for edentulous patients. However, this solution is not without its own set of challenges, being that the prolonged contact with mucosal surfaces can lead to challenges in cleaning and managing plaque depending on the attachment. Case Presentation: In this clinical case report, we present a female patient who developed bar-retained prosthetic stomatitis induced by oral candidiasis a few months after receiving her provisional prosthesis. Conclusions: In conclusion, this case report emphasizes the need to consider both systemic and local factors when preventing and treating denture stomatitis. By understanding the risk factors involved, healthcare professionals can provide their patients with the best possible care, helping to reduce the prevalence of oral candidiasis in individuals who use implant-retained dentures. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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9 pages, 3272 KiB

Open AccessCase Report

Mural Unicystic Ameloblastoma of the Mandible: A Case Report

by Mina Al Azawi, Nikolaos Shinas, Vasileios Zisis, Dhurata Shosho, Athanasios Poulopoulos and Deeba Kashtwari

Reports 2024, 7(4), 93; https://doi.org/10.3390/reports7040093 - 7 Nov 2024

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Abstract

Background and Clinical Significance: Among the odontogenic tumors, ameloblastoma is one of the most notorious, although it remains relatively rare, accounting for approximately one percent of all oral tumors. This neoplasm, derived from odontogenic epithelium, may arise from the developing enamel organ, [...] Read more.

Background and Clinical Significance: Among the odontogenic tumors, ameloblastoma is one of the most notorious, although it remains relatively rare, accounting for approximately one percent of all oral tumors. This neoplasm, derived from odontogenic epithelium, may arise from the developing enamel organ, epithelial cell rests of dental lamina, epithelial lining of odontogenic cysts, and basal cells of oral epithelium. This is a case presentation of a mural unicystic ameloblastoma, the most aggressive subtype and the one with the highest chance of recurrence. Case Presentation: A patient was referred by his dentist for root canal treatment at the Emergency Dental Clinic of Boston University. The patient complained of mandibular numbness. A panoramic radiograph was acquired, revealing a radiolucent lesion in the right mandible. Clinical examination detected a soft swelling perforating the buccal cortex in the area of #27–#30. A Cone-Beam CT (CBCT) was acquired in the Oral and Maxillofacial Radiology Clinic revealing a well-defined, partially corticated entity in the periapical area of teeth #27 through #30, with evidence of scalloping borders. The internal structure was unilocular and uniformly low-density. The entity caused interruption of the lamina dura of the associated teeth and inferior displacement of the inferior alveolar canal. Differential diagnoses included unicystic ameloblastoma (UA) and central giant cell granuloma as a second less likely diagnosis. An incisional biopsy was performed for further evaluation. Biopsy confirmed UA with mural involvement. Conclusions: UAs typically exhibit less aggressive behavior. However, cases like this one, where mural involvement is noted and no associated impaction is detected, underline the possibility of variable radiographic presentation and the significance of a multidisciplinary approach in correct diagnosis and treatment. Histological subtyping is crucial for guiding treatment. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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7 pages, 5123 KiB

Open AccessCase Report

Concurrent Onset of Central Retinal Vein Occlusion and Inflammation of a Large Maxillary Odontogenic Cyst: Case Report and Analysis

by Vlatko Kopić, Andrijana Kopić, Mihael Mišir and Sanjin Petrović

Reports 2024, 7(3), 55; https://doi.org/10.3390/reports7030055 - 14 Jul 2024

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Abstract

Central retinal vein occlusion typically manifests in older individuals with underlying systemic pathology, leading to a spectrum of symptoms ranging from blurred vision to complete vision loss. While odontogenic infections are recognized for causing complications affecting the eye and vision, their potential role [...] Read more.

Central retinal vein occlusion typically manifests in older individuals with underlying systemic pathology, leading to a spectrum of symptoms ranging from blurred vision to complete vision loss. While odontogenic infections are recognized for causing complications affecting the eye and vision, their potential role as an etiological factor in cases of sudden vision impairment merits consideration. This article presents a case involving central retinal vein thrombosis, wherein resolution was achieved through a combination of ophthalmic therapy and the surgical removal of a concurrently existing large inflamed odontogenic cyst located in the ipsilateral hemimaxilla. This case underscores the importance of recognizing odontogenic factors in the assessment of sudden vision impairment and the efficacy of a multidisciplinary therapeutic approach. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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6 pages, 3804 KiB

Open AccessInteresting Images

Gingival Cyst of the Adult: A Case Description with a Relevant Literature Analysis

by Marta Forte, Antonio d’Amati, Alfonso Manfuso, Massimiliano Vittoli, Giorgia Girone, Eliano Cascardi and Saverio Capodiferro

Reports 2024, 7(3), 51; https://doi.org/10.3390/reports7030051 - 24 Jun 2024

Viewed by 1353

Abstract

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic [...] Read more.

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic tumors. The aim of this paper is to report a new case occurring in an adult, analyzing the clinical, radiographic, and histopathological features as guidelines for a differential diagnosis. We report a 49-year-old patient complaining of a small, pigmented lesion localized on the attached gingiva with no history of trauma, which was surgically excised and histologically diagnosed as a gingival cyst. A differential diagnosis may be challenging for clinicians it includes a wide spectrum of inflammatory and non-inflammatory lesions, so a correct diagnostical–therapeutical approach is needed to avoid possible overtreatment and minimize the recurrence rate. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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6 pages, 2673 KiB

Open AccessCase Report

Endoscopic Surgical Approach for a Mesiodens in the Nasal Cavity: A Rare Phenomenon

by Enzo Iacomino, Chiara Fratini, Federica Zoccali, Francesca Cambria, Matteo Laudani, Alberto Eibenstein, Christian Barbato, Marco de Vincentiis and Antonio Minni

Reports 2024, 7(2), 46; https://doi.org/10.3390/reports7020046 - 13 Jun 2024

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Abstract

The nasal cavity is a sporadic site for mesiodens, and if it is impacted in the lower nasal floor or localized in the nasal septum, it may cause various nasal symptoms such as nasal obstruction, recurrent rhinitis, and epistaxis. Early diagnosis is made [...] Read more.

The nasal cavity is a sporadic site for mesiodens, and if it is impacted in the lower nasal floor or localized in the nasal septum, it may cause various nasal symptoms such as nasal obstruction, recurrent rhinitis, and epistaxis. Early diagnosis is made through clinical findings and a cone-beam computed tomography (CBCT) scan, but a definite treatment plan has not yet been developed. This study aims to present a case of a mesiodens in a 27-year-old male, located in the nasal septum, an unusual and rare site, and its surgical removal using an endoscopic nasal approach with subperiosteal intranasal dissection. The result of the study appears significant because this technique led to fewer postoperative complications, and it appears to be safer and more effective than the traditional palatal or transoral approach. Moreover, the nasal endoscopic approach is more natural to the ear, nose, and throat (ENT) surgeons than the transoral approach. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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12 pages, 5608 KiB

Open AccessCase Report

Leukocyte-Platelet-Rich Fibrin in Bone Regeneration after Periapical Surgery: A 30-Month Follow-Up Clinical Report

by Hatim A. Qurban, Hatem Hazzaa Hamadallah, Mohammad A. Madkhaly, Muhannad M. Hakeem and Ahmed Yaseen Alqutaibi

Reports 2024, 7(2), 32; https://doi.org/10.3390/reports7020032 - 26 Apr 2024

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Abstract

Aim and background: Periapical lesions, which occur due to the infection and necrosis of dental pulp, are a significant dental pathology that poses risks to oral and systemic health. These lesions often require interventions such as root canal treatment or periapical surgery. Recent [...] Read more.

Aim and background: Periapical lesions, which occur due to the infection and necrosis of dental pulp, are a significant dental pathology that poses risks to oral and systemic health. These lesions often require interventions such as root canal treatment or periapical surgery. Recent research has focused on the effectiveness of biocompatible materials, including mineral trioxide aggregate, bioceramics, and leukocyte-platelet-rich fibrin (L’PRF), in improving healing outcomes. This report presents the application of leukocyte-platelet-rich fibrin (L’PRF) derived from the patient’s autologous blood to enhance bone healing. Case description: A 61-year-old woman with well-controlled hypertension and good oral hygiene visited the dental clinic due to a painless swelling near her upper left central incisor. After examination, it was determined that she had a periapical granuloma. The patient underwent successful root canal retreatment and apical surgery, during which leukocyte-platelet-rich fibrin was applied. After 30 months, she experienced significant improvement with no symptoms and substantial bone regeneration. Conclusion: Clinical evidence and this case study indicate that leukocyte-platelet-rich fibrin (L’PRF) may enhance healing post periapical surgery. Further research, including more extensive and longer-term randomized trials, must confirm L’PRF’s effectiveness and refine treatment protocols. Clinical significance: L’PRF enhances bone healing post periapical surgery. Clinicians should consider integrating L’PRF in periapical surgeries, ensure diligent follow-up, and inform patients of its long-term advantages. Further randomized trials are needed to refine L’PRF clinical guidelines. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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12 pages, 1966 KiB

Open AccessEditor’s ChoiceCase Report

Surgical Treatment of Multiple Bone Cysts Using a Platelet-Rich Fibrin and BoneAlbumin Composite Graft: A Case Report

by Martin Major, Márton Kivovics, Bence Tamás Szabó, Tamás Déri, Melinda Polyák, Noémi Piroska Jákob, Dániel Csete, Attila Mócsai, Zsolt Németh and György Szabó

Reports 2024, 7(1), 7; https://doi.org/10.3390/reports7010007 - 22 Jan 2024

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Abstract

Promising research results have been obtained on the tissue-regeneration properties of PRF (platelet-rich fibrin) in dentistry and maxillofacial surgery. PRF presumably promotes healing and accelerates ossification. In this case report, the patient had a history of Gorlin–Goltz syndrome, also called nevoid basal cell [...] Read more.

Promising research results have been obtained on the tissue-regeneration properties of PRF (platelet-rich fibrin) in dentistry and maxillofacial surgery. PRF presumably promotes healing and accelerates ossification. In this case report, the patient had a history of Gorlin–Goltz syndrome, also called nevoid basal cell carcinoma syndrome, an autosomal dominant neurocutaneous disease that was known for many years. As a consequence, cysts were detected in both the mandible and maxilla. We performed decompression on this 37-year-old patient, followed by a cystectomy on an extensive lesion in the right angle of the mandible. One cyst from each side of the body mandible and one from the maxilla were completely enucleated, as determined using an intraoral exploration. The resulting bone defect was filled with a composite graft composed of a mixture of A-PRF and a serum albumin-coated bone allograft (BoneAlbumin). The wound was then covered with a PRF membrane. The surgical sites were closed per primam. The postoperative period was uneventful. Biopsies were performed after three and six months of healing for histological micromorphometry analyses. Dental implants were placed at the sampling site. Three months after the implantation, the ossified implants were fitted with superstructures. To date, no complications have appeared with the bone augmentation. The authors interpret from the findings that the combination of A-PRF and BoneAlbumin can be validated as a prosperous bone substitute. It can be safely implanted after a 3-month ossification period. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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8 pages, 6872 KiB

Open AccessCase Report

Hyoid Bone Metastases: An Unusual Case

by Gian Piero Di Marco, Cinzia Tucci, Enzo Iacomino, Vincenzo Corridore, Maria Lauriello, Alessandra Fioretti and Alberto Eibenstein

Reports 2023, 6(4), 59; https://doi.org/10.3390/reports6040059 - 8 Dec 2023

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Abstract

(1) Background: Secondary tumors of the hyoid bone are extremely rare in clinics. In the literature, there is only one study about hyoid bone metastases from sigmoid adenocarcinoma. (2) Methods: We report a case of hyoid bone metastases in a 78-year-old patient treated [...] Read more.

(1) Background: Secondary tumors of the hyoid bone are extremely rare in clinics. In the literature, there is only one study about hyoid bone metastases from sigmoid adenocarcinoma. (2) Methods: We report a case of hyoid bone metastases in a 78-year-old patient treated for rectum and sigmoid colon adenocarcinoma. (3) Results: A mass excision surgery of a rounded osteolytic mass of 4.5 × 3.6 cm in size in the central part of the hyoid bone was performed under general anesthesia, according to the multidisciplinary tumor board recommendation. (4) Conclusions: Hyoid bone metastases can occur in the rectum and sigmoid colon adenocarcinoma. A total body bone scintigraphy and CT examination are suggested to detect silent bone metastases in patients with a history of cancer and neck masses. The prognosis is good, but a regular follow-up is recommended. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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18 pages, 9092 KiB

Open AccessEditor’s ChoiceCase Report

Digital Workflow in Full Mouth Rehabilitation with Immediate Loading, Intraoral Welding and 3D-Printed Reconstructions in a Periodontal Patient: A Case Report

by Adam Nowicki and Karolina Osypko

Reports 2023, 6(4), 52; https://doi.org/10.3390/reports6040052 - 1 Nov 2023

Cited by 1 | Viewed by 2745

Abstract

Background: Complex implant reconstructions in patients with residual dentition due to periodontitis is a challenging task in many aspects. Methods: This study shows a full digital workflow combining 3D printing, guided implant placement, intraoral scanning and welding with immediate loading and digital smile [...] Read more.

Background: Complex implant reconstructions in patients with residual dentition due to periodontitis is a challenging task in many aspects. Methods: This study shows a full digital workflow combining 3D printing, guided implant placement, intraoral scanning and welding with immediate loading and digital smile design. An analog impression was taken to validate the passive fit of final restorations. The whole treatment plan was divided into three stages. The first stage included an intraoral scan of baseline dentition, and then the extraction of all teeth was performed, implanting four temporary implants and providing the patient with removable temporary prosthesis. The second stage was to scan the removable temporaries, implanting 10 implants and multi-unit abutments (MUA), and create a rigid construction via the intraoral welding of titanium bar and by fixing it to the 3D-printed temporary reconstructions (designed with DSD) as a form of immediate loading. The third stage included the scanning of screw-retained temporary reconstructions, then scanning from the MUA level and creating final reconstruction. Results: The presented workflow enabled the delivery of some sort of restoration to the patient at every moment of the treatment and to sustain the required esthetic effect with decent comfort of use even in the early stages. Conclusions: A full digital workflow is a reliable treatment method even in complex cases. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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7 pages, 943 KiB

Open AccessCase Report

Facial Nerve Palsy after Inferior Alveolar Nerve Block: A Rare Presentation of Ocular Complication and Literature Review

by Glauco Chisci, Dafne Chisci, Enea Chisci, Viola Chisci and Elettra Chisci

Reports 2023, 6(4), 47; https://doi.org/10.3390/reports6040047 - 4 Oct 2023

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Abstract

Many ocular complications are described in the literature after dental injections. Facial nerve palsy is a rare complication. We report a case of a 60-year-old woman in the American Society of Anesthesiologists (ASA) I classification under orthodontic treatment with aligners that required an [...] Read more.

Many ocular complications are described in the literature after dental injections. Facial nerve palsy is a rare complication. We report a case of a 60-year-old woman in the American Society of Anesthesiologists (ASA) I classification under orthodontic treatment with aligners that required an inferior alveolar block for endodontic treatment. Optocaine with epinephrine 1:200,000 and a disposable needle 25 G × 36 mm mounted on a dental syringe were used, and the effect of the anesthesia arose after 10 min. Facial nerve palsy on the side of the injection arose after 1 h and 40 min from the injection, and the patient was immediately visited by an ophthalmologist who reported the examination reported in the present case report. The authors report this unusual case with a subsequent onset and short duration of facial nerve palsy and discuss possible anesthetic solution pathways. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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