Ridge preservation of compromised extraction sockets applying a soft cortical membrane: A canine proof-of-principle evaluation.

OBJECTIVES: To explore whether placement of a soft cortical membrane can restore and regenerate the original alveolar ridge contour in deficient sockets. MATERIALS AND METHODS: One Beagle dog was used in this proof-of-principle evaluation. In a first intervention, a standardized buccal dehiscence defect was artificially created at the distal roots of the 3rd and 4th mandibular premolars. Four weeks later, following endodontic treatment of the mesial roots, teeth were hemisected and the distal roots were extracted without raising a flap. A cortical membrane (Lamina®, Osteobiol) was placed outside of the bony envelope of the extraction socket to rebuild the buccal bone contour. Afterwards, sockets were filled with a collagen-modified porcine bone graft material (Gen-Os®, Osteobiol) to the level of the surrounding bone height. The socket orifice was closed with a porcine dermal matrix (Derma®). After four months, block specimens containing the socket-sites and remaining roots were retrieved, histologically processed and analyzed. RESULTS: Surgery and post-operative healing were uneventful. Histologically, bone formation under the membrane was found, i.e. bony protrusions and ossicles by osteoblasts could be identified. Concomitantly, the membrane showed clear signs of degradation. Bone substitute was well integrated in newly formed bone and resorption of particles was found. CONCLUSION: Three major observations were made in the present proof-of-principle study: (i) regeneration of a compromised socket seems possible when applying the presented approach, (ii) the soft cortical membrane was sufficiently stable to allow for the establishment of the contour and to inhibit soft tissue invasion and (iii) the applied xenogenic graft material was undergoing remodelling processes while allowing adequate bone regeneration.

Odontología deportiva y prevención de trauma dentoalveolar / Sports dentistry and prevention of dentoalveolar traumas

La odontología deportiva es la rama de la medicina deportiva que se ocupa de la prevención y el tratamiento de las lesiones bucodentales y las enfermedades orales asociadas al deporte y el ejercicio. Por lo que se hace necesario la intervención de profesionales de la salud bucodental para hacer evaluaciones del deportista y el deporte que practica para ver los riesgos que puede tener de desarrollar y sufrir lesiones bucodentales como traumas dentoalveolares y lesiones no cariosas. Y de este modo realizar las recomendaciones a cada paciente que practica deporte, de los elementos que deben usar como equipamiento bucodental para evitar o reducir el daño dentoalveolar (AU)

Sports dentistry is the branch of sports medicine that deals with the prevention and treatment of oral injuries and oral diseases associated with sports and exercise. Therefore it is necessary the intervention of oral health professionals to make evaluations of the athlete and the sport he practices to see the risks that may have to develop and suffer oral injuries such as dentoalveolar trauma and non-carious lesions. And in this way make the recommendations to each patient who practices sports, of the elements that should be used as oral equipment to avoid or reduce dentoalveolar damage (AU)

Uso de Hepar sulphur en el tratamiento de la alveolitis húmeda / Use of Hepar sulfur in the treatment of wet alveolitis

Fue realizado un estudio pre experimental de intervención con 50 pacientes que consultaron un servicio de urgencia entre noviembre de 2016 y julio de 2017 con diagnóstico de alveolitis húmeda con el objetivo de evaluar la efectividad del tratamiento homeopático en esta patología. Todos os pacientes fueron tratados con Hepar sulphur 30cH hasta completar 10 días. Los pacientes fueron citados a nueva consulta a las 24, 48, 72 horas, 5, 7 y 10 días del inicio del tratamiento para su evolución. La desaparición total del dolor a las 72 horas de comenzado el tratamiento homeopático ocurrió en casi la totalidad de los pacientes (98%) y la mayoría (98%) estuvieron satisfechos con el tratamiento recibido. Se puede considerar que el tratamiento de la alveolitis húmeda con Hepar sulphur 30cH fue efectivo. (AU)

We performed a pre experimental intervention study with 50 patients who visited an emergency department for alveolitis from November 2016 through July 2017 to assess the effectiveness of homeopathic treatment. All the participants received Hepar sulphur 30cH for 10 days and were assessed 1,2, 3, 5, 7 and 10 days. In almost all the participants (98%) pain fully disappeared after 72 hours of homeopathic treatment, and most (8%) reported to be satisfied with the treatment received. We conclude that treatment of alveolitis with Hepar sulphur 30cH was effective. (AU)

Uso de Hepar sulphur en el tratamiento de la alveolitis húmeda / Use of Hepar sulfur in the treatment of wet alveolitis

Fue realizado un estudio pre experimental de intervención con 50 pacientes que consultaron un servicio de urgencia entre noviembre de 2016 y julio de 2017 con diagnóstico de alveolitis húmeda con el objetivo de evaluar la efectividad del tratamiento homeopático en esta patología. Todos os pacientes fueron tratados con Hepar sulphur 30cH hasta completar 10 días. Los pacientes fueron citados a nueva consulta a las 24, 48, 72 horas, 5, 7 y 10 días del inicio del tratamiento para su evolución. La desaparición total del dolor a las 72 horas de comenzado el tratamiento homeopático ocurrió en casi la totalidad de los pacientes (98%) y la mayoría (98%) estuvieron satisfechos con el tratamiento recibido. Se puede considerar que el tratamiento de la alveolitis húmeda con Hepar sulphur 30cH fue efectivo. (AU)

We performed a pre experimental intervention study with 50 patients who visited an emergency department for alveolitis from November 2016 through July 2017 to assess the effectiveness of homeopathic treatment. All the participants received Hepar sulphur 30cH for 10 days and were assessed 1,2, 3, 5, 7 and 10 days. In almost all the participants (98%) pain fully disappeared after 72 hours of homeopathic treatment, and most (8%) reported to be satisfied with the treatment received. We conclude that treatment of alveolitis with Hepar sulphur 30cH was effective. (AU)

Characterization of consultations for odontogenic abscesses in a major Chilean hospital

OBJECTIVES: To characterize consultations for odontogenic abscesses at the dental and maxillofacial unit of the public emergency hospital in Santiago, Chile. METHODOLOGY: descriptive study, involving consecutive sampling of patients with diagnosis of odontogenic abscess, conducted between august and september 2016. descriptive statistics were performed to determine the frequency of diagnosis, affected tooth, sex and need for hospitalization. RESULTS: odontogenic abscesses accounted for 6.3 percent (n=414) of a total of 6,535 consultations. males represented 59 percent; 42 percent of odontogenic abscesses presented in molars and maxillary premolars. the vestibular space was the most frequently affected anatomical space (50 percent), associated in 53 percent of the cases to submucosal abscesses. ninety-eight per cent of patients were successfully treated on an outpatient basis, 2 percent required hospitalization, mainly associated to abscesses involving the deep submandibular space. CONCLUSION: odontogenic abscesses account for a low percentage of dental emergencies at the public emergency hospital in Santiago, Chile. most cases receive outpatient treatment.

Diagnosis of alveolar and root fractures: an in vitro study comparing CBCT imaging with periapical radiographs

Abstract Objective To compare periapical radiograph (PR) and cone-beam computed tomography (CBCT) in the diagnosis of alveolar and root fractures. Material and Methods Sixty incisor teeth (20 higid and 40 with root fracture) from dogs were inserted in 60 anterior alveolar sockets (40 higid and 20 with alveolar fracture) of 15 macerated canine maxillae. Each fractured socket had a root fractured tooth inserted in it. Afterwards, each maxilla was submitted to PR in two different vertical angulation incidences, and to CBCT imaging with a small field of view (FOV) and high-definition protocol. Images were randomized and posteriorly analyzed by two oral and maxillofacial radiologists two times, with a two-week interval between observations. Results Sensitivity and specificity values were good for root fractures for PR and CBCT. For alveolar fractures, sensitivity ranged from 0.10 to 0.90 for PR and from 0.50 to 0.65 for CBCT. Specificity for alveolar fractures showed lower results than for root fractures for PR and CBCT. Areas under the ROC curve showed good results for both PR and CBCT for root fractures. However, results were fair for both PR and CBCT for alveolar fractures. When submitted to repeated measures ANOVA tests, there was a statistically significant difference between PR and CBCT for root fractures. Root fracture intraobserver agreement ranged from 0.90 to 0.93, and alveolar fracture intraobserver agreement ranged from 0.30 to 0.57. Interobserver agreement results were substantial for root fractures and poor/fair for alveolar fractures (0.11 for PR and 0.30 for CBCT). Conclusion Periapical radiograph with two different vertical angulations may be considered an accurate method to detect root fractures. However, PR showed poorer results than CBCT for the diagnosis of alveolar fractures. When no fractures are diagnosed in PR and the patient describes pain symptoms, the subsequent exam of choice is CBCT.

[Histomorphometric evaluation of ridge preservation after molar tooth extraction].

OBJECTIVE: To evaluate bone formation in human extraction sockets with absorbed surrounding walls augmented with Bio-Oss and Bio-Gide after a 6-month healing period by histologic and histomorphometric analyses. METHODS: Six fresh molar tooth extraction sockets in 6 patients who required periodontally compromised moral tooth extraction were included in this study. The six fresh extraction sockets were grafted with Bio-Oss particle covered with Bio-Gide. The 2.8 mm×6.0 mm cylindric bone specimens were taken from the graft sites with aid of stent 6 months after the surgery. Histologic and histomorphometric analyses were performed. RESULTS: The histological results showed Bio-Oss particles were easily distinguished from the newly formed bone, small amounts of new bone were formed among the Bio-Oss particles, large amounts of connective tissue were found. Intimate contact between the newly formed bone and the small part of Bio-Oss particles was present. All the biopsy cylinders measurement demonstrated a high inter-individual variability in the percentage of the bone, connective tissues and Bio-Oss particles. The new bone occupied 11.54% (0-28.40%) of the total area; the connective tissues were 53.42% (34.08%-74.59%) and the Bio-Oss particles were 35.04% (13.92%-50.87%). The percentage of the particles, which were in contact with bone tissues, amounted to 20.13% (0-48.50%). CONCLUSION: Sites grafted with Bio-Oss particles covered with Bio-Gide were comprised of connective tissues and small amounts of newly formed bone surrounding the graft particles.

Relação entre características peculiares em radiografia panorâmica e a incidência de alteração sensorial do nervo alveolar inferior após cirurgia de remoção de terceiros molares inferiores / The relationship between peculiar features in panoramic radiograph and the incidence of sensory disturbance of the alveolar nerve after inferior third molar extraction

Há um crescente interesse na Odontologia em determinar a probabilidade e prevenir que ocorram alterações sensoriais no feixe vásculo-nervoso alveolar inferior (FVNAI) durante a remoção cirúrgica de terceiros molares inferiores. Este estudo tem por objetivo avaliar e descrever as observações encontradas na literatura sobre os sinais radiográficos correlacionados à proximidade das raízes dos terceiros molares inferiores com o FVNAI. A pesquisa bibliográfica foi realizada utilizando o banco de dados MEDLINE, via PubMed. Somente foram incluídos artigos escritos na língua inglesa. O resumo de todos os artigos da busca eletrônica foi avaliado de acordo com a pertinência para os estudos. De acordo com a revisão realizada, os sinais radiográficos mais associados com alterações sensoriais pós-exodontia dos terceiros molares inferiores foram escurecimento da raiz, interrupção da linha branca e desvio do canal. A verdadeira relação entre os terceiros molares inferiores e o canal mandibular aumenta o risco de lesão do nervo alveolar inferior e uma avaliação precisa deste relacionamento é essencial para evitar os riscos da cirurgia. Sendo assim, os cirurgiões devem estar cientes das limitações dos marcadores radiográficos das panorâmicas e devem considerar a imagem mais detalhada em casos específicos em que mais de um marcador radiográfico esteja presente...

There is a growing interest in determining the probability and preventing alterations in sensory-vascular bundle of the inferior alveolar nerve (SVBIAN) during surgical removal of lower third molars. This study aimed to evaluate and describe the observations in the literature about the correlation between radiographic signs and the proximity of the third molar roots with SVBIAN. A literature search was performed using the MEDLINE database via PubMed. Only articles written in English were included. The summary of all articles were evaluated according to relevance of the studies. According to the performed review, the radiographic signs most related with sensory changes after extraction of lower third molars were darkening of the root, interruption of the white line and diversion channel. The true relationship between third molars and mandibular canal increases the risk of injury to the inferior alveolar nerve, and an accurate assessment of this relationship is essential to avoid the risks related to this surgery. Therefore, surgeons should be aware of the limitations of the panoramic radiographic markers, and should consider more detailed image in specific cases where more than one radiographic marker is present...

Classification and Epidemiology of Traumatic Dentoalveolar Injuries in Dogs and Cats: 959 Injuries in 660 Patient Visits (2004-2012).

The objective of this study was to determine the epidemiology of traumatic dentoalveolar injuries (TDI) in dogs and cats and to evaluate the applicability of a human classification system for TDI in dogs and cats. All patients diagnosed with a TDI were identified from the University of Wisconsin-Madison School of Veterinary Medicine Dentistry and Oral Surgery Service case log and the hospital patient processing software. The study population consisted of 621 dogs and cats, in a total of 660 patient visits from 2004 to 2012, admitted for oral treatment and subsequently diagnosed with at least one TDI Medical records including diagnostic imaging studies were reviewed to group the injury according to a classification system used in humans for TDI. Patient signalment, tooth injured, and number of injuries per patient were recorded and tabulated. The overall prevalence of TDI was 26.2%. The mean +/- SD number of TDI per patient was 1.45 +/- 0.85. All 14 classes of TDI recognized by the classification system utilized in humans were identified, and all (100%) TDI identified in this study were classifiable using this system. Enamel-dentin-pulp fracture was the most common TDI (49.6%). The most commonly injured teeth were the mandibular or maxillary canine teeth (35.5%). The most common age for dogs and cats with TDI were 3-6 years (33.0%) and 7-10 years (31.3%). With a frequency of 1 in 4 animals, TDI are common and represent a significant pet health concern. Most TDI are considered severe and require timely, and sometimes immediate, treatment. The adoption and utilization of a complete classification system, such as the one used in this study, is recommended in order to improve future epidemiological study of TDI in animals.

Comportamiento de traumatismos dentoalveolares en niños deportistas del área "Ciro Frías", del municipio de Arroyo Naranjo / Behavior of dentoalveolar traumas among children from Ciro Frías sports area in the municipality of Arroyo Naranjo

Los traumatismos dentoalveolares constituyen una de las principales urgencias estomatológicas. Objetivo: caracterizar el comportamiento de los traumatismos dentarios en niños deportistas del área Ciro Frías. Métodos: se realizó un estudio observacional descriptivo, de corte transversal, en deportistas menores de 19 años del área Ciro Frías, del municipio Arroyo Naranjo, La Habana, desde febrero de 2011 hasta febrero de 2012. El universo estuvo constituido por 57 niños. Se utilizó un formulario de datos creado por los autores y validado por un comité de expertos; se realizó examen bucal y facial; se vaciaron los datos y se procesaron utilizando estadística descriptiva. Las variables estudiadas fueron: edad, sexo, deporte, momento del traumatismo, dientes lesionados, localización en la arcada, tipo de trauma dentario, etiología, asistencia al estomatólogo y tratamiento. Resultados: los niños que más traumatismos dentarios presentaron fueron los de 12 a 14 años (45,6 por ciento) y el sexo más afectado fue el masculino (77,2 por ciento). Los traumas ocurrieron principalmente fuera del entrenamiento (61,4 por ciento) y el deporte con más niños afectados fue el Karate (19,3 por ciento). Los dientes más dañados fueron los incisivos centrales superiores (62,9 por ciento). La fractura no complicada de la corona (32,3 por ciento) fue la lesión más acentuada. La etiología principal de los traumas fue la práctica de deportes (36,8 por ciento). El 68,4 por ciento de los niños no recibieron tratamiento. Conclusiones: predominaron los traumas en el sexo masculino, entre 12 a 14 años, fuera del entrenamiento. El deporte con más niños afectados fue el Karate. Los dientes más lesionados fueron los incisivos centrales superiores. Los traumatismos más frecuentes fueron las fracturas no complicadas de la corona y la infractura del esmalte. Las causas de traumatismos dentarios más frecuentes fueron la práctica de deportes y las caídas. Prevalecieron los niños que no asistieron a consulta estomatológica y que no recibieron tratamiento(AU)

Dentoalveolar traumas are one of the main causes of dental emergencies. Objective: characterize the behavior of dental traumas among children from "Ciro Frías" sports area. Methods: an cross-sectional observational descriptive study was conducted with children under 19 years of age from Ciro Frías sports area in the municipality of Arroyo Naranjo, Havana, from February 2011 to February 2012. The study universe was composed of 57 children. Data collection was based on a form developed by the authors and validated by an experts committee. Oral and facial examination was performed, and the information was recorded and processed using descriptive statistics. The variables studied were age, sex, sport, time of trauma, injured teeth, location in the arcade, type of dental trauma, etiology, visit to the dentist and treatment. Results: dental traumas predominated in the 12-14 age group (45,6 percent) and the male sex (77,2 percent). Most (61,4 percent) occurred outside training sessions, and karate was the sport with most injured children (19,3 percent). Upper central incisors were the most commonly affected teeth (62,9 percent). Uncomplicated crown fracture was the most common injury (32,3 percent). Sports practice was the main etiology of traumas (36,8 percent). 68,4 percent of the children injured did not receive any treatment. Conclusions: there was a predominance of the male sex, the 12-14 age group and occurrence outside training sessions. Karate was the sport with most children injured. Upper central incisors were the most commonly affected teeth. The most common traumas were uncomplicated fractures of the crown and the enamel infrastructure. The most common causes of dental traumas were sports practice and falls. There was a predominance of children not visiting the dentist and not receiving treatment(AU)

Técnica de preservación del volumen alveolar post-extracción utilizando hueso liofilizado y lámina ósea cortical / Preservation techniques of alveolar post-extraction volume using liophilisate bone and cortical bone sheets

Se evaluó la eficacia del hueso liofilizado humano (Matriz Ósea UNC en Polvo) injertado en cavidades alveolares post-extracción, recubierto por una lámina ósea cortical (Matriz Ósea UNC en membrana), en el tratamiento de preservación del perfil volumétrico del reborde alveolar.La metodología de trabajo se fundamentó en: 1) El estudio de una casuística de 27 casos clínicos en pacientes de ambos sexos que poseían elementos dentarios unirradiculares con indicación de extracción. Se injertó en las cavidades óseas resultantes hueso liofilizado, contenido in situ mediante una lámina ósea cortical parcialmente desmineralizada. Los pacientes fueron evaluados clínica y radiográficamente, mediante modelos de estudio, Rx convencional y radiovisiografía que permitieron mensurar las modificaciones producidas por resorción durante un año. Se realizaron controles pre y post-operatorios, a los 7, 15, 30, 60, 90, 120, 180 y 360 días. A los modelos de yeso preliminares y a los obtenidos a los 120 y 360 días se les efectuaron cortes transversales en las zonas de estudio y se los escaneó. Las imágenes obtenidas se procesaron mediante un analizador de imágenes (Image Pro-Plus). Los datos se analizaron estadísticamente con software específico (SPSS). El estudio demostró que las mayores modificaciones dimensionales del reborde se observaron sobre el área superficial del alvéolo y en los primeros 4 meses post-extracción. La lámina cortical presentó características físicas, estructurales y biológicas que le permitieron actuar como barrera física oclusiva, minimizando los fenómenos de inhibición celular heterotípica y favoreciendo los procesos osteogénicos por el mecanismo de osteopromoción...

Human efficacy lyophilized bone (UNC Bone Matrix Powder) grafted post-extraction alveolar sacs, covered by a cortical bone plate (UNC Bone Matrix membrane), in the treatment volume preservation ridge profile was evaluated. The working methodology was based on: 1) The study of a case series of 27 clinical cases in patients of both sexes who had single-rooted tooth elements indicating extraction. It was grafted bone cavities in the resulting lyophilized bone content in situ by a partially demineralized cortical bone plate. Patients were evaluated clinically and radiographically, using study models, and conventional Rx radiovisiography that allowed mensurar resorption induced changes for a year. Pre and post-operative controls at 7, 15, 30, 60, 90, 120, 180 and 360 days were performed. A preliminary plaster models and those obtained at 120 and 360 days transects were conducted in the study areas and were scanned. The images obtained were processed by an image analyzer (Image Pro-Plus). The data were statistically analyzed with software (SPSS) .The study showed that older flange dimensional changes were observed on the surface area of the alveoli and in the first 4 months post-extraction. The cortical sheet submitted physical, structural, and biological characteristics that allowed him to act as occlusive physical barrier, minimizing heterotypic cellular inhibition phenomena and processes favoring osteogenic mechanism osteopromoción...

Prevalencia de las lesiones traumáticas que afectan a los tejidos de sostén en piezas dentarias permanentes de pacientes escolares / Prevalence of tooth-supporting structure traumatic injuries in permanent teeth of schoolchildren

Los traumatismos osteoperiodontales son lesiones que involucran tanto los tejidos dentarios como los tejidos de sostén. Constituyen una de las causas más frecuentes en la consulta de urgencia de niños y adolescentes. Las lesiones de los tejidos de sostén se dan en gran porcentaje y son: la concusión, subluxación, luxación lateral, extgrusión, intrusión y avulsión dentaria. El objetivo de este trabajo fue analizar la prevalencia de las lesiones traumáticas de los tejidos de sostén en piezas dentarias permanentes. Materiales y métodos: se estudiaron 200 pacientes de 7 a 15 años de edad con 242 traumatismos. Los casos clínicos fueron tratados bajo protocolos estandarizados y luego registrados estadísticamente. Resultados y discusión: de un total de 200 pacientes, el 69 por ciento eran masculinos y el 31 por ciento femeninos. Respecto a la edad el 64 por ciento de los traumatismos se presentaron en pacientes de 7 a 10 años y el 36 por ciento de 11 a 15 años de edad. De las 242 lesiones traumáticas estudiadas, el 51 por ciento se produjeron por accidentes en la escuela, 43 por ciento como consecuencia de la práctica de diversos deportes y un 6 por ciento correspondió a otras causas. De los 242 casos clínicos, se reconoció que el 28 por ciento corresponden a concusiones y subluxaciones. El 17 por ciento del total fueron luxaciones laterales de las cuales el 11 por ciento presentaron abombamiento de tabla y el 6 por ciento fractura de tabla. El 20 por ciento concernieron a luxaciones extrusivas y el 9 por ciento fueron luxaciones intrusivas. Por último, las avusiones dentales se prsentaron en un 30 por ciento, de éstas el 9 por ciento con ligamento periodontal vital y el 21 por ciento con ligamento periodontal no vital. Conclusiones. Los traumatismos osteoperiodontales son lesiones cada vez más frecuentes en pacientes escolares. Representan la segunda causa de pérdida de estas piezas luego de la caries dental. Es fundamental hacer hincapie en la prevención.

Secuelas en la dentición permanente por traumatismo dentoalveolar en dentición decidua / Conequeces of primary teeth trauma in the permanent dentition

El reporte del presente caso, describe el traumatismo alveólo dental sufrido por un niño de 4 años y 9 meses de edad que produjo una secuela de lesión coronaria en un incisivo central inferior permanente derecho que se encuentra en el interior del hueso madibular y en proceso de erupción, compatible con una fractura de la corona o una hipoplasia circular; tanto así, como la avulsión del incisivo central permanente izquierdo y en cuyo alveólo se aprecia una estructura radicular anormal, ocasionada por restos de tejido pulpar y la vaina epitelial de Hertwig.

This report, describes a case of dental trauma in a 4 year 9 months old boy, that produced a lesion in the crown of a non-erupted right permanent central lower incisor. The lesion is compatible with a crown fracture or a circular hypoplasia. Also we found the avulsion of the left permanent central lower incisor and an abnormal radicular structure was formed in the socket, originated by traces of pulp tissue and the Hertwig's epithelial root shealth.

Luxación extrusiva en un diente primario: manejo y seguimiento clínico radiográfico / Extrusive luxation in a primary tooth: radiographic and clinical follow-management

La terapéutica traumatológica es una de las partes de la odontología que está en continua revisión y actualización, pues los traumatismos alveolo-dentales en la dentición primaria son muy comunes en la clínica odontológica, lo que los transforma en un problema de difícil prevención debido a la etiología y edad en que ocurren los accidentes. En la luxación extrusiva, el diente es dislocado parcial y axialmente hacia fuera del alveolo, presentando movilidad y sangrado del surco gingival. El tratamiento en dientes primarios va a depender del grado de severidad de la luxación extrusiva, del desarrollo radicular del diente y del tiempo transcurrido entre el traumatismo y la atención odontológica. En el caso de extrusiones leves a moderadas, la mayoría de los autores señalan que el tratamiento consiste en la reposición del diente afectado seguido de ferulización. Basados en la literatura, el objetivo de este trabajo es reportar el caso clínico de una luxación extrusiva en un diente primario, así como el manejo y seguimiento clínico - radiográfico durante tres años

Trauma therapy is a part of dentistry that is continuously reviewed and updated. As the alveolus-dental trauma in primary teeth are very common in the dental clinic, which turns into a difficult prevention problem due to the etiology and age in which accidents happen. In extrusive luxation, the tooth is partially dislocated axially outward from the socket, with mobility and bleeding of the gingival sulcus. Treatment in primary teeth will depend on the degree of severity of extruded luxation, on the tooth root development and on the time elapsed between trauma and dental care. In cases of mild to moderate extrusions, most authors suggest that treatment is the replacement of the affected tooth, followed by splinting. Based on the literature, the objective of this work is to report a clinical case of extrusive luxation in a primary tooth, describing the clinical management and radiographic follow-up of three years

Teeth in the line of mandibular fractures.

Many mandibular fractures occur through tooth sockets. The treatment plan for teeth in the line of fracture has evolved through the years because of the development of new antibiotics and fixation techniques. In this article we review the history and current studies and discuss treatment protocols for teeth in the line of mandibular fractures.

Influence of trans-operative complications on socket healing following dental extractions.

AIM: Extraction healing complications have been attributed to several factors. The influence of trans-operative complications on an extraction site wound healing was the focus of this investigation. METHODS AND MATERIALS: This prospective study was conducted at the Oral Surgery Clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (LUTH) in Nigeria . Subjects selected were those referred for one or two adjacent extractions and who satisfied the inclusion criteria for the study. The relevant pre-operative information recorded for each patient were age and sex of patient, indications for extraction, time taken to extract the tooth, tooth/teeth removed, and any trans-operative complications. Extractions were performed with dental forceps, elevators, or both under local anaesthesia. Patients were blindly evaluated on the third and seventh post-operative day for socket healing assessment without reference to pre-operative information on the patients. RESULTS: Seventy-three (24.25%) of 301 teeth considered for socket healing assessment had various trans-operative complications due to accidental crown, root, or alveolar bone fractures. Of the 73 extractions with trans-operative complications during extraction, 18 developed a socket healing complication, while 17 of the 228 extractions without trans-operative complications developed socket healing complications (p = .000). The mean (SD) time taken to extract teeth developing healing complications was also found to be significantly longer than those without healing complications (p < .01). CONCLUSIONS: The study demonstrated the combination of tooth/bone fragments in the socket and increased time of extraction due to trans-operative complications and accidents predispose to the development of extraction site wound healing disturbance.

[Repair alveolar cleft bone defects with bone marrow stromal cells].

OBJECTIVE: To explore the feasibility of repairing alveolar cleft bone defects with bone marrow stromal cells. METHODS: Total 7 patients of alveolar cleft were included in this study. The hBMSCs were isolated by percoll gradient centrifugation from patient's bone marrow aspirated from iliac crest. The hBMSCs were cultured in vitro and induced to become osteogenic cells in the DMEM medium containing 10% self-serum, beta-glycerophosphate (10 nmol/L) dexamethasone (10(-8) mol/L) , L-2-ascorbic acid(50 micromol/L), and 1, 25 (OH)2 VD3 (10 nmol/L). Induced hBMSCs of passage 3 were harvested and seeded onto partly demineralized allogenic bone matrix (pDBM) to form a cell-scaffold construct and in vitro co-culture for 1 week. The defects were repaired with the cell-scaffold construct. All cases were followed up for 3, 6 months post-operation as short-term evaluation and 1 to 3 years post-operation as long-term evaluation by three-dimensional computerized tomography (3D-CT) and clinical examination. RESULTS: 3D-CT demonstrated that engineered bone was formed in 3 months post-operation. Additionally, formed bone maintained stable up to 1 - 3 years without absorption. CONCLUSIONS: Engineered bone can be used to repair clinical alveolar cleft bone defects.

Avaliando os traumatismos dento-alveolares: revisão de literatura / Evaluating traumatic dental injury: a review of the literature

Foi realizada uma revisão da literatura sobre a freqüência das fraturas dento-alveolares, de acordo com suas classificações através de um estudo retrospectivo dos últimos dez anos sobre a fratura facial que compromete, de imediato, a funcionalidade, a estética, e, conseqüentemente, a auto-estima do paciente. As fraturas coronárias são os traumatismos mais freqüentes, seguidas pelas luxações, e a área mais afetada são as coroas desses elementos apenas em nível de esmalte.