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Volume 2, Problème 2 (2016)

Rapport de cas

A Guided Surgical Technique for the Use of Small Diameter Implants in the Anterior Mandible: Report of a Case

Kory Grahl, Brittany Rich and Andrew P Ingel

Introduction: Over the last five years 3,276 implants have been placed at the University of Nevada Las Vegas School Of Dental Medicine. Of those, 55 have been small diameter implants (SDI), accounting for less than 2% of all dental implants. Nine SDI’s were placed for fixed restorations. This case report demonstrates the use of SDI’s for a fixed, splinted restoration, utilizing a surgical guide for both the osteotomies and implant placement.

Methods: Two 2.0 mm × 15 mm SDI’s (Shatkin F.I.R.S.T.) were placed in the location of teeth #23 and #24. A surgical guide (Shatkin F.I.R.S.T Laboratory) was used for initial osteotomies to ensure proper angulation and for final placement of the SDI’s. A laboratory fabricated splinted acrylic temporary (Shatkin F.I.R.S.T.) was placed during the healing phase.

Results: Both SDI’s displayed successful integration, based on the Health Scale for Dental Implants. The SDI’s displayed no mobility, no pain or tenderness upon function, <2 mm of radiographic bone loss from initial surgery, and no exudates. The final splinted Porcelain-Fused-to-Metal (PFM) restoration was fabricated using conventional crown and bridge techniques and was cemented using FujiCEM.

Conclusion: SDI’s are indicated in cases where bucco-lingual bone width is limited and bone and soft tissue grafting are not possible. A surgical guide can be used to ensure proper placement and angulation of SDI’s. Placement of a single traditional implant with cantilever prosthesis has an increased chance of prosthesis failure in five years. SDI’s, in this application, have a success rate comparable to traditional implants. This case demonstrated a guided surgical technique for SDI’s without extensive bone or soft tissue grafting procedures.

article de recherche

Effect of Low-Level Laser Therapy on Wounds in Intra-Oral Surgery

Thiago M Cavalcanti, Jair C Leao, Ruthineia D Lins, Maria Helena Catao, Marcela L Pontes and Luiz G Carvalho Neto

During the last two decades, much has been written in both the scientific literature and the popular press about lasers and their use in dentistry. Both soft- and hard-tissue applications have been discussed, including frenectomy, gingival contouring, caries removal and bleaching. The aim of this study is evaluate and compare the effects of laser therapy on the surgical wound repair process and painful symptoms in patients undergoing bilateral teeth extractions at the Department of Dentistry, State University of Paraiba. Three sessions of laser therapy (GaAlAs) were performed for each patient. The first session was immediately after the surgical procedure, the second occurred 48-72 h after the first session, and the third and final at 7 days after surgery, coinciding with the removal of the sutures. Of the patients examined, 65.5% at the first assessment (after the second laser therapy session) and 75% at the second assessment (after the third session) exhibited a better degree of repair on the side treated with laser (STL) compared to the side not treated with laser (SNTL). There was no difference in edema between the STL and SNTL. Regarding pink tissue colour, there was an increase in its frequency, from 25%-62.5% of cases, on the STL between the first and second assessments. Bleeding also showed an increased frequency on the STL and decreased on the SNTL in the second assessment. Regarding painful symptoms, the results revealed that, on the STL, they decreased, from 62.5%-0% between the first and second assessments, and on the SNTL, from 87.5%-12.5%. Hence, low-power laser use appeared to be effective for the repair of intraoral surgical wounds, accelerating the degree of repair, improving tissue colour and reducing pain symptoms.

Rapport de cas

Oral Inflammatory Myofibroblastic Tumor: Two Additional Cases and Literature Review

Nagamani Narayana, Hardeep Chehal

OIMT poses a diagnostic challenge as it is part of the vast spectrum of spindle cell neoplasms. It is a controversial tumor composed of a proliferation of myofibroblasts intermingled with an inflammatory cell infiltrate composed of lymphocytes, plasma cells, and eosinophils in focal areas of collagenous stroma. Before this nomenclature was proposed by World Health Organization (WHO) in 1994, this entity was defined by a variety of names such as: inflammatory pseudotumor, histiocytoma, plasma cell histiocytoma complex, plasma cell granuloma, fibrohistiocytoma, xanthomatous granuloma, myxoid hamartoma, xanthomatous pseudotumor, spindle cell pseudotumor, inflammatory fibrosarcoma, benign myofibroblastoma, and inflammatory myofibroblastic proliferation. WHO has classified OIMT as an intermediate soft-tissue myofibroblastic neoplasm according to its well reproducible histological morphology. The first case was reported in the lungs and though it may be found anywhere in the body, the lung, liver and gastrointestinal tract are the most common sites of involvement. In the head and neck region, it has been reported in the orbit, larynx, parapharyngeal spaces, maxillary sinus, submandibular region and the oral cavity. Oral lesions may be intraosseous or in the soft tissue. The etiology is controversial

Article de révision

Dysphagia: A Symptom Not a Disease

Vidya K Lohe* and Ravindra P Kadu

Dysphagia is difficulty in swallowing food semi-solid or solid, liquid, or both. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Patients with dysphagia may walk into dental clinic and because dysphagia is a symptom not a disease, it is a practicing dentist’s duty to recognize the underlying cause and then take treatment decisions. Among the most frequent complications of dysphagia are increased mortality and aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the pathophysiology, classification, evaluation, investigations and treatment modalities of dysphagia

Rapport de cas

A Case Report: An Unusual Case of Central Ossifying Fibroma

Samiksha Acharya*, Vidya K Lohe and Rahul R Bhowate

Central ossifying fibroma is a benign slow-growing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar and molar areas. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Occasionally treated by curettage enucleation, this conservative surgical excision is showing a recurrence rate extremely low. The following article reports a case of a 13-year-old male patient, who presented with a very large ossifying fibroma in the maxilla, which was successfully treated by surgical intervention. A brief literature review of this lesion, focusing on the histology, clinical behavior, and management of these uncommon lesions is also conducted

Rapport de cas

Developing Infrastructure for Tobacco Cessation in India through Dental Task Force

Kunal Oswal and Ashok Dhoble

Background: Tobacco use remains the world’s leading preventable cause of premature morbidity and mortality. In every nook and corner of a street of India today you have many tobacco selling vendors both smoke and smokeless forms which makes it easily accessible to tobacco consumers to have it. Tobacco industries have been marketing their product strategically targeting specifically to women’s, youth, adults and special vulnerable groups. In comparison to the tobacco selling outlets there was lack of tobacco cessation centers in India. Methodology: The tobacco intervention initiative was launched in 2009 by Indian dental association (IDA). Post its launch those dentists interested in cessation from all over the country were trained. A special two day programme was planned. A website was also developed serving as a resource for the patients, dentist and dental students. Brief interventions, self-help materials, and nicotine replacement therapy for established nicotine dependence form the mainstay of therapy which is made available through a specially designed tool-kit. A web based resource is also provided to the Dentists are trained to document all the information obtained during one on one counselling and subsequent follow-up. Results: Till date about 1036 dentists across the country has already being trained and they are actively practicing tobacco cessation in their clinics. Also these dentists are master’s trainers, as they provide further training to newer graduates and dentists. Conclusions: In the last 5 years the number of dentists enrolling for such programs was on the rise. Such initiative by IDA has definitely assisted a lot of patients to relinquish this routine. The task ahead is to maximize this potential of dentist and make such centre more easily available to the patients.

Rapport de cas

Exposing the top 10 Myths (takes) in Diagnosing and Treating Tethered Oral Tissues (Tongue-Ties and Lip-Ties) in Breastfeeding Infants

Lawrence Kotlow

Every day I can treat anywhere from 4-10 infants in need of surgical revisions of the lip and tongue (TOTS) or tethered oral tissues for difficulties latching on to their mother’s breast? The symptoms they mother and infant present with can include for the mother; nipple damage, thrush, spasm, severe pain, engorgement and in some instances the emotional impact can lead to postpartum depression when the mother-infant bond fails to properly develop [1-6]. Among the infant’s symptoms; reflux, sleep apnea, pain from gas, sleepless nights, falling to sleep when latching and non-nutritional feeds. When these parents seek care, the stories they hear from their healthcare providers, which have no credible scientific or medical basis are many. From the many comments that have been repeated to me by mothers and fathers, I have chosen the top ten what I call MYTHS (takes) to write about in this article.

Rapport de cas

Understanding the Importance of Gene and Environment in the Etiology and Prevention of Type 2 Diabetes Mellitus in High-Risk Populations

Marsha Samson*, Tushar Trivedi, Olubunmi Orekoya and Shraddha Vyas

Current literature focuses on the complications and treatment of Type 2 Diabetes Mellitus (T2DM) while clustering environmental and genetic factors to explain the disease. Interventions proposed to reduce diabetes prevalence should focus predominantly on initiating active rapports of family members and promoting a more communicationoriented preventative approach between diabetics and non-diabetics. Due to varying risks in T2DM by race and ethnicity, these populations should follow race-appropriate guidelines to prevent further T2DM occurrence and complications. The review consists of information related to the genetic component of T2DM to help identify high-risk groups and focuses on the environmental aspect of the disease to help consider appropriate techniques to reduce disease burden. Genetic factors play important roles in the pathogenesis of diabetes and thus are an essential element of understanding the cause of the disease and possible methods of prevention. Focusing on high-risk groups with T2DM could have profound effects on the current health care situation. In this review, we discuss the epidemiology of diabetes in the United States and propose methods of preventing and delaying the development of T2DM in high-risk individuals.

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