Palatine Tonsilloliths: A Retrospective Study on 500 Digital Panoramic Radiographs.

AIM: This study aimed to investigate palatine tonsilloliths in the Lebanese population via digital panoramic radiographs. MATERIALS AND METHODS: Digital panoramic radiographs of a sample of 500 Lebanese adult patients (281 females and 219 males) with an average age of 47.9 years were included in this study and assessed for tonsilloliths. The IBM® SPSS® (IBM, Armonk, NY, USA) version 20.0 for Windows was used to carry out statistical analysis of the data collected. RESULTS: Tonsilloliths were found in 7.2% of cases (36 out of 500; belonging to 18 females and 18 males). Among these, 13 cases were on the right side, 12 on the left side and 11 were bilateral. Affected patients' age ranged from 24 to 84 years (mean of 61 years). There was no statically significant relation between tonsilloliths presence and gender, while a low positive correlation was observed between tonsilloliths and age (r = 0.193). CONCLUSION: Palatine tonsilloliths may be discovered fortuitously on panoramic radiographs utilized regularly in dental offices; their incidence increases with age. CLINICAL SIGNIFICANCE: Panoramic radiographs may have a beneficial role in detecting palatine tonsilloliths sometimes connected to unpleasant symptoms such as non-specific chronic halitosis.

Juvenile Trabecular Ossifying Fibroma of the Maxilla: a Case Report.

INTRODUCTION: Juvenile ossifying fibromas are uncommon benign tumors. Their aggressiveness added to their high tendency to recur, provoke real diagnostic and therapeutic challenges for the dental practitioner and make a postoperative follow-up over the years indispensable. CASE REPORT: In this report, we present a case of a seven-year-old girl presented with a swelling in the face at the upper right maxillary region. After clinical, radiological, and histopathological examinations the diagnosis of trabecular juvenile ossifying fibroma was made. The lesion was surgically excised and followed up for two years with no evidence of recurrence.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study.

BACKGROUND: Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures. MATERIALS AND METHODS: Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically. RESULTS: Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group. CONCLUSION: A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Implant Failure and Marginal Bone Loss Between Axial and Tilted Implant: An Umbrella Review with Meta-analysis.

OBJECTIVES: Several anatomical and histological limitations can complicate implant placement, angulated implant positioning appeared to compensate these limitations. However several studies suggested a higher rate of marginal bone loss and implant failure regarding tilted implants in comparison with conventional implant. Therefore this umbrella review aims to summarize and analyze all the evidence available concerning marginal bone loss and implant failure between tilted and axial implants. METHODS: An electronic literature search was conducted, without any language restrictions and only systematic reviews with meta-analysis or meta-analysis studies were included. The outcomes assessed in this review were implant failure and marginal bone loss in mm. Relative risks (RRs) and the differences of the mean (MD) were calculated with 95% confidence intervals (CIs) regarding implant failure and marginal bone loss respectively. RESULTS: in total 8 studies were included, based on the short-term results, a non-significant mean difference (MD=0.00; 95% Cl; -0.01-0.02; p-value = 0.75) was recorded between tilted and axial implants supporting full-arch dentures, meanwhile a significant mean difference was recorded on a 3 years and long term follow-up reached (MD= 0.08 95% Cl = 0.05-0.11; p value<0.00001)) and (MD= 0.18; 95% Cl= 0.15-0.20; p value< 0.00001) respectively, and an insignificant difference was observed between tilted and axial implants regarding implant failure (RR=1.02; 95% Cl=0.85-1.23; p value= 0.81) Conclusion: this review based on high and moderated quality studies with low risk of bias demonstrated no significant outcome was observed between tilted implants supporting full-arch or fixed partial denture and axial implants regarding implant failure.

Combined conservative treatment of a recurrent mandibular keratocyst by enucleation, diode laser, 5-Fluorouracil and dental implants: a case report with 18 years-follow up.

In 2017, the World Health Organization classified the odontogenic keratocyst as a developmental odontogenic cyst. The posterior parts of the mandible, especially the angle and the ramus, are the most involved sites. Due to their high recurrence rate, keratocysts are managed surgically with careful complete excision. Additionally, chemical solutions such as Carnoy's solution, modified Carnoy's solution, and 5-Fluorouracil have been associated with surgical treatment. Diode lasers generate diverse wavelengths that have photothermal and photochemical special properties and could have some effects on the lining epithelium remnants of the cyst. In this paper, we discuss a case of mandibular recurrent odontogenic keratocyst treated with 5-Fluorouracil topical application after enucleation and diode laser application with 18 years follow-up and teeth replacement with dental implant. 5-Fluorouracil and diode laser have been found to be very effective in the treatment of keratocysts.

Single Immediate Implant Placement with Provisional Crown in the Esthetic Zone with 6 Years Follow-Up.

Background: Immediate implant placement (IIP) has become an attractive treatment for many patients. It reduces time and the number of appointments and protects soft and hard tissue, which, in many circumstances, leads to a better esthetic outcome. IIP with provisionalization (IIPP) may contribute to a more promising result due to the guidance of soft tissue and the preservation of the hard tissue. Indications for IIPP are quite strict, and cone beam computed tomography (CBCT) is a must for case selection. Objective: This case report will demonstrate how IIP with immediate provisionalization can result in a high esthetic outcome and no discomfort for the patient. Case presentation: A 50-year-old female presented for implant placement following the extraction of a superior central incisor due to a vertical fracture. IIPP has been used. Conclusion: IIPP can accomplish a stable esthetic result in the case of ideal three-dimensional implant positioning, a well-polished provisional restoration with an S-shaped buccal emergence profile, and by respecting the mesial and distal embrasure spaces for papilla maturity.

Peripheral Osteoma: A Report of a Case in the Anterior Mandibular Region.

Osteomas are benign lesions that arise from the proliferation of either cancellous or compact bone. They can be categorized as extra-skeletal, peripheral, or central. Extra-skeletal soft tissue osteomas often develop within muscles, while peripheral and central osteomas emerge from the periosteum and endosteum, respectively. Osteomas are usually asymptomatic and rarely affect the jaws. In the mandible, they typically occur in the posterior regions. In this report, we present the case of a 46-year-old female with a mandibular peripheral osteoma located in the anterior region and treated by total resection via median cervicotomy.

Idiopathic Osteosclerosis and Condensing Osteitis in a Sample of the Lebanese Population: A Digital Panoramic Based Study.

Background: Idiopathic osteosclerosis (IO) is an area of enlarged bone production in the jaw that usually appears radiopaque and round, elliptical, or irregular in shape. Condensing osteitis (CO) is a focalized osseous reaction leading to periapical sclerotic bone growth. Objective: The aim of this study was to investigate the prevalence, localization, shape, and dental relationship of IO and CO in a group of Lebanese patients and to correlate these findings to age and gender. Methods: 520 digital panoramic radiographs of patients (215 men and 305 women) ranging in age from 18 to 77 (mean age 40.89 years) who visited the Faculty of Dental Medicine, Lebanese University, for dental treatment were included in this study and assessed for IO and CO. The prevalence of the two lesions according to gender and age, as well as their localization, and dental relationship, were recorded and saved in an Excel sheet. Results: Among the 520 radiographs, 47 (9%) showed IO, and 30 (5.8%) showed CO. Both lesions are more frequent among females in their third decade and are essentially found in the mandible, mainly in relation to the root apices. Conclusion: Within the limits of this study, we concluded that in our sample of the Lebanese population, the prevalence of IO and CO is low and supports the theory that IO can be defined as developmental variations of normal bony architecture unrelated to a local stimulant, and CO could be considered reactive bone formations related to pulpitis, deep restoration, or caries.

Dental Anomalies in a Sample of Lebanese Children: a Retrospective Study.

Background: Dental anomalies (DAs) represent a significant chapter in pediatric dentistry with a lot of practical relevance. Both primary and permanent dentitions may be affected. Objective: The main objective of our study was to evaluate, using digital panoramic radiographs, the prevalence, distribution, and patterns of DAs in a sample of Lebanese children aged between 8 and 15 years old. Methods: 112 digital panoramic radiographs of patients aged between 8 and 15 years (60 males and 52 females) from the year 2017 till 2022 attending the department of Pediatric Dentistry and Dental Public Health at the Faculty of Dental Medicine at the Lebanese University were assessed for DAs of number (hypodontia, oligodontia, hyperdontia), of size (microdontia, macrodontia), of shape (fusion, gemination, dilaceration, taurodontism), of position (transposition, ectopia, impaction), and of structure (dentin dysplasia, amelogenesis imperfecta, dentinogenesis imperfecta). The data were analyzed statistically using Chi-square and Fisher's exact tests. Results: Out of 112 patient radiographs, 84 showed at least one DA, which suggests a very high prevalence (75%). Among them, 36.9% exhibited multiple types of anomalies. These 84 patients showed a total of 274 DAs, distributed equally among males and females. Conclusion: Dentists should be alerted to the presence of DAs. Their high prevalence requires careful clinical and radiological examinations for early detection. Regular monitoring is mandatory and could guide preventive approaches to minimize associated dental complications.

Comparison of Osseointegration in Novel Laser-Textured and SLA Implants.

Background: Osseointegration is defined as the direct structural and functional connection between neo-formed bone and dental implants. Among the parameters suggested to predominantly influencing the establishment of a successful osseointegration is the quality of the implant surface, which may enhance the strength and speed of this biomechanical process. Objective: The purpose of this study was to evaluate the ability of a novel laser-treated surface, compared to sandblasted, large-grit, acid-etched (SLA) surfaces, to enhance and accelerate implant integration in delayed implant placement.Methods: Thirty patients with two missing posterior teeth were enrolled in this study. Each patient received, at a randomly allocated site, an implant with a conventional SLA surface, and at a second site, an implant with laser-textured surface. A total of 60 tissue-level implants were subsequently placed. Implant stability (ISQ) was measured using resonance frequency analysis (RFA). ISQ was assessed at baseline (T0), 8 weeks (T1), and 12 weeks (T2) following implant placement. Results: There was a statistical difference in implant stability between laser-textured and SLA group at 12 weeks postoperatively. Implant stabilization showed a successful osseointegration with both surface types. Conclusion: Both laser and SLA surface treatments had positive impacts on implant stabilization following delayed placement. Laser-treated surfaces presented higher values of osseointegration at 3 months postoperatively.

Bilateral ectopic third molar in the maxillary sinuses associated with dentigerous cyst: a case report.

A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molars. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla, when the cyst expands into the sinus, it usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old woman with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.

Use of Connective Tissue Graft and Coronally Advanced Flap in Areas of Buccal Contour Concavities for Nonsubmerged Implant Placement.

There is a lack of scientific evidence concerning the best timing of soft tissue management around implants, as well as a divergence of topics concerning optimal procedures. The objective of this study is to evaluate the gain in buccal contour and soft tissue stability after a surgical technique combining nonsubmerged implant placement with submarginal connective tissue graft (CTG) and coronally advanced flap (CAF). Seven patients (4 males and 3 females) underwent surgery for transmucosal implant placement in partially edentulous areas showing mild to moderate buccal contour concavities using a technique combining CTG and CAF. The following parameters were evaluated: keratinized tissue height (KTH), soft tissue thickness (STT), and vertical soft tissue level (VSTL) at T0 (before surgery), T1 (6 months after surgery), T2 (12 months after surgery) and T3 (2 years after surgery). After two years, we observed an increase of 78.5% in buccal KTH, 64% in STT, and 24% in VSTL. No implant presented any sign of mucositis or bone loss. Non-submerged implant placement using an "envelope flap design" in addition to CTG and CAF is beneficial.

Hereditary Gingival Fibromatosis: A Report of a Severe Case.

Hereditary gingival fibromatosis (HGF) is an uncommon condition characterized by a benign, local, or diffuse gingival overgrowth. It may cover the teeth partially or totally, causing essential aesthetic, phonetic, and masticatory disorders. In this report, we discuss a case of an 11-year-old boy who presented with severe gingival enlargement. The diagnosis of HGF was made based on clinical examination and family history, with two of the patient's brothers and his paternal aunt being affected with the same disease. The patient was managed with electrosurgery under general anesthesia.

Sialolith of Unusual Size and Shape in the Anterior Segment of the Submandibular Duct.

Sialolithiasis is a common condition characterized by the formation of salivary stones or calculi, also known as sialoliths, within a salivary gland or its duct. Usually, sialolithiasis presents as salivary gland swelling with intermittent pain around mealtime. All salivary glands can develop sialolithiasis, yet it occurs most commonly in the submandibular gland. In this report, we describe an unusual large sialolith measuring 1.7 cm and uncommonly resembling a canine tooth. The sialolith was removed surgically via intraoral approach, and the salivary secretion was restored.

Intraosseous Lipoma: A Report of a Case in the Mandibular Symphysis Region.

Intraosseous lipomas are benign lesions of the bone. In the jaws, they are very rare and in most cases incidentally discovered on panoramic radiographs taken in dental practice. They are usually asymptomatic and appear radiologically as a radiolucent image sometimes including some radio-opacities. Histologically, they consist of mature adipose tissue associated with variable degrees of necrotic fat and calcification. In this report, we describe a case of intraosseous lipoma in the mandibular symphysis region of a 37-year-old female as well as the treatment adopted.

Evaluation of Marginal and Internal Fit at Implant-Abutment Interface of Original and Compatible Nonoriginal Abutments.

Is to measure the peripheral and internal gap at the implant-abutment interface of an implant system connected to its original or compatible non-original abutments. Twenty implants were assembled with four different types of abutments having the same conical internal interface. All abutments were considered compatible with Tx Astra Tech Implant SystemTM. Four groups were created and each group of five implants was connected to a different abutment; Ti DesignTM abutments (group A), DualTM abutments (group B), Natea plusTM abutments (group C) and ImplanetTM abutments (group D). The peripheral gaps between implant and abutment were observed in three points facing the flat surface of the abutment. The implant-abutment assemblies were then embedded in resin and grinded in the mesio-distal direction of the scalloped abutment margin using a diamond disk at very low speed and under water-cooling. The inner aspect of the implant abutment interface was observed in three different points, on the coronal border of the connection, in the middle area and on the apical border of the implant-abutment interface. The mean gap width was 0.543 ± 0.09 µm for group A and, respectively, 0.708 ± 0.1232 µm, 0.726 ± 0.0891 µm and 0.818 ± 0.0851 µm for groups B, C and D. When comparing group, A to B and C, a highly significant difference in numbers was obvious while an even higher variation was observed with group D. External and internal fit of components is better when using original components.

Survival Rate of Implants Placed in Residual Bone Height Less than 4.5 Millimeters with or without Bone Grafting Using Summers Method.

The aim of this retrospective study is to analyze the survival rate of implants placed in residual bone height (RBH) less than 4.5 mm during an overall follow-up of 5 years, by using Straumann and Astra implant designs with or without sinus bone grafting. A total of 77 patients were examined and treated in two private practices in the regions of Hamra and Jounieh, Lebanon, by two periodontists from 2009 to 2019. These patients received 104 implants (83 Straumann implants and 21Astra implants) where 94 implants underwent osteotomy sinus floor elevation with bone graft and 10 implants without bone graft. The radiographic images were analyzed by three examiners: two periodontists and one oral radiologist. Written informed consents were obtained from all patients prior to treatment. All patients had to fulfill the inclusion criteria elaborated hereinafter. A total of 75.96% of implants were placed at the molars sites and 24.04% at the premolars sites. All 104 implants were clinically stable except 2 Straumann implants which suffered early failure (before the implant loading) and 1 Straumann implant late failure (3 months after the implant loading). All the failed implants were placed in a RBH > 4 mm. The cumulative success rate was 97.12% during an overall follow-up of 5 years. The crestal approach for maxillary sinus floor elevation is a viable technique that can be used in patients with minimal RBH < 4.6 mm.

Bone Apposition in the Mandibular Angle in Adult Patients Diagnosed with Bruxism: a Digital Panoramic Based Study.

Background: Bruxism is defined as a movement disorder of the masticatory system leading to serious problem in the integrity of the oral dentition; it is characterized by teeth grinding and clenching and has been typically classified into three types: a) bruxism occurring during sleep, b) awake-related bruxism, and c) mixed sleep/awake-related bruxism. Objective: The aim of this study was to assess any bone apposition in the mandibular angle in a group of adult patients diagnosed with bruxism using digital panoramic radiographs. Methods: In the sample of 150 digital panoramic radiographs of 66 women and 84 men with an age range of 24-78 years and diagnosed with bruxism were evaluated. Results: Among the 300 mandibular angles evaluated, 156 (52%) showed bone apposition against 144 (48%) who did not. Conclusion: The changes in the mandibular angle, especially bone apposition, can help diagnosing long term bruxism on panoramic radiographs.

Melkersson-Rosenthal Syndrome in a 38-Year-Old Female Patient: A Rare Case With Complete Triad.

Melkersson-Rosenthal syndrome (MRS) is an uncommon neuro-mucocutaneous disease, clinically characterized by a triad of recurrent facial palsy, orofacial swelling, and fissured tongue. This report presents the case of a 38-year-old female diagnosed with MRS based on its three clinical features. A corticosteroid (1 mg/kg/day of oral prednisolone) was prescribed for a week, and then tapered off over two weeks by gradually lowering the dose. Regular annual long-term follow-ups were requested to monitor the disease activity.

Advanced Case of Squamous Cell Carcinoma of the Posterior-Lateral Border of the Tongue Invading the Floor of the Mouth.

Background: Squamous cell carcinoma (SCC) is a common cancer of the oral cavity. It mainly affects patients aged over 50 with male-to-female ratio 2:1. Most of the cases of oral SCC are linked to tobacco and alcohol use. Objective: In this report, we present a case of a 67-year-old male with a mass on the posterior-lateral border of the tongue. Case report: In this report, we present a case of a 67-yearold male with a mass on the posterior-lateral border of the tongue. Being heavy smoker and alcoholic since a young age, he was at high-risk of developing oral cancer. After thorough clinical, histopathological, and imaging assessments a poorly differentiated stage III (T3, N1, M0) SCC was confirmed. He underwent left hemiglossectomy with marginal mandibulectomy and radical neck dissection followed by radiation therapy. Conclusion: SCCs of the tongue can be often asymptomatic and identified at advanced phase leading to a poor prognosis. Therefore, their early diagnosis/management, and regular postoperative follow-ups are mandatory for better treatment outcome and recurrence prevention.