Protocol for immediate implant replacement of infected teeth.

Extraction and immediate implant placement has become routine procedure due to reduced treatment time and the preservation of anatomical structures. However, in many cases, this technique involves teeth with different degrees of tissue compromise due to underlying infections. Until now, the degree of implant compromise has not been described, nor has a clinical management protocol been established for these cases. The aim of this article is to report the clinical results of a protocol used for immediate implant placement and provisionalization in infected extraction sockets. A classification of the implant surface compromise (in contact with previously infected tissue) is also described to facilitate the comparative analysis. It is possible to maintain the benefits of immediate implant placement and provisionalization in infected sites by applying a clinical protocol that considers antibiotic therapy, a thorough curettage of the infected tissue, antisepsis, and sufficient primary implant stability.

Cutaneous draining sinus tract of odontogenic origin: unusual presentation of a challenging diagnosis.

A 44-year-old woman presented with a chronically draining lesion on her cheek just lateral to the nasofacial sulcus. The lesion was refractory to treatment with oral antibiotics. Physical examination revealed poor dentition, and a panoramic radiograph demonstrated periapical abscesses in the maxillary right lateral incisor and canine. A diagnosis of cutaneous fistula of odontogenic origin was made, and the patient was treated with tooth extraction. The cutaneous fistula subsequently resolved. Intraoral examinations and radiographs are critical for making the diagnosis of cutaneous draining sinus tract of odontogenic origin. Many patients undergo unnecessary surgical therapies before having the correct diagnosis made, but root canal therapy or surgical extraction is the treatment of choice. A dental origin must be considered for any chronically draining sinus of the face or neck.

Paradental cyst: case report and review of the literature.

The origin of paradental cysts is related to inflammatory processes, especially pericoronaritis involving impacted or semi-impacted teeth. The authors present a case of paradental cyst related to lower second molar that did not show clinical evidence of inflammatory process. The main aspects related to its classification, diagnosis and clinical characteristics are also discussed.

Paradental cyst mimicking a radicular cyst on the adjacent tooth: case report and review of terminology.

A distinctive form of paradental cyst can occur on the buccal and apical aspects of erupted mandibular molars. This cyst has peculiar clinical and radiographic features, although the microscopic findings are the same as those of odontogenic inflammatory cysts. Diagnostic and therapeutic problems can occur when this lesion is misinterpreted as a radicular cyst. The purpose of this paper is to present an additional case of a paradental cyst in the buccal and mesial aspects of a mandibular second molar involving the apical area of a mandibular first molar. The difficulty of diagnosis, treatment, and controversies regarding terminology are also discussed.

Surgical exposure and orthodontic extrusion of an impacted canine tooth in a cat: a case report.

A 7 month-old, male domestic shorthaired cat was referred because of facial swelling, an operculated cystic oral mass, and impaction of the associated maxillary left canine tooth. Surgical exposure and realignment failed to result in eruption. Surgical reexposure and orthodontic extrusion resulted in a functional alignment of the tooth within the dental arch. Follow up evaluations over the 5 ensuing years indicated persistence of the facial deformation, no evidence of ameloblastic biotransformation, and a healthy tooth.

Osseous repair of a lateral periodontal cyst.

THE LATERAL PERIODONTAL CYSTS is a slow-growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through-and-through perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze-dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months.

The buccal bifurcation cyst: a prospective study of treatment outcomes in 44 sites.

OBJECTIVE: The clinical, radiographic, and histologic features of the mandibular buccal bifurcation cyst were studied to further define this lesion. The treatment and outcomes were also analyzed. STUDY DESIGN: This prospective study, which spanned 3 years, included 32 patients. Their ages ranged from 5.5 to 11 years (mean of 7.5). A total of 44 buccal bifurcation cysts were treated solely with enucleation, and patients were followed up for 2.5 to 3 years. RESULTS: All lesions were located at the buccal bifurcation of the mandibular first molar. Tilting of the buccal cusps, causing prominence of the lingual cusps, occurred in 75% of the cases. The lesion extended from the buccal bifurcation to the tooth apex in 81.2%, and a periosteal reaction on the lateral surface of the mandible adjacent to the cyst was noted in 68.8% of the cases. All of the 44 histologic reports were nonspecific, but showed a cyst lining of stratified squamous epithelium with chronic inflammation. Microbiology consisted of mixed oral flora. Complete radiographic healing in all sites without recurrence was noted in 2.5-year follow-up. The periodontal pocket depth around all the involved teeth was normalized. No loss of the mandibular first molars occurred. CONCLUSIONS: The mandibular buccal bifurcation cyst is a distinct site-specific and age-specific clinical entity treatable by enucleation without tooth extraction.

Report of a lateral periodontal cyst and gingival cyst occurring in the same patient.

The lateral periodontal cyst and gingival cyst of the adult are both developmental odontogenic cysts located predominantly in the mandibular premolar-canine region. In this paper, a case report is described of a lateral periodontal cyst and gingival cyst occurring in the same patient along with a discussion of clinical, radiographic, and histological features of these lesions.

The mandibular infected buccal cyst--a reappraisal.

The mandibular infected buccal cyst was first described over ten years ago as a discrete pathological entity found only in children. The features of this lesion have been consistently described as a buccal location adjacent to erupting first molar teeth, a thick, hyperplastic non-keratinized epithelial lining, expansion of buccal cortex and associated infection. The paradental cyst had been described some years previously. This lesion was noted to have a similar non-specific hyperplastic non-keratinized epithelial lining but was described as being associated predominantly with third molar teeth in young adults. Recently investigators have called for the mandibular infected buccal cyst to be reclassified as a variant of the paradental cyst. In this paper, ten previously unreported cases of mandibular infected buccal cysts are presented and the evidence for their reclassification as paradental cysts is advanced.

A lateral periodontal cyst in association with a follicular cyst.

A case is described in which two separate developmental odontogenic cysts were associated with an unerupted lower third molar tooth. Radiological and histological examination showed that these were a lateral periodontal cyst and a follicular (dentigerous) cyst. This unusual occurrence provides substantial evidence that the periodontal cyst may have an origin from the cell rests of Malassez.

The lateral periodontal cyst and isolated periodontal defects.

Over a period of 4 years, 41 isolated, advanced periodontal defects were selected for histologic examination. The objective of this study was to establish the presence of cystic epithelium. Twenty of the biopsies fulfilled the criteria for lateral periodontal cyst (LPC). These results indicate that there is a distinct possibility that proliferation of epithelial elements other than crevicular could be implicated in isolated periodontal defects.